
CSHCN
Children with Special Health Care Needs
The CSHCN Program Health Benefits cover the following:
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Ambulance |
Inpatient Rehabilitation |
Physical & Occupational Therapy |
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Ambulatory Surgery |
Diagnosis & Evaluation |
Meals, Lodging, and Transportation when needed to obtain medical care |
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Primary & Preventative Care |
Care by Medical Specialists |
Medicines |
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Speech and Hearing Services |
Equipment & Medical Supplies |
Orthotics & Prosthetics |
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Vision Care |
Home Health Nursing |
Special Nutritional Products and Services |
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Dental Care |
Hospice Care |
Outpatient Renal Dialysis |
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Mental Health Services |
Hospital Care |
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To qualify for CSHCN health benefits, an applicant must be:
A person younger than 21 years of age who has a chronic physical or developmental condition
OR
MDCP Program
Medically Dependent Children Program (MDCP) Fact Sheet
The program provides services to support families caring for children and young adults who are medically dependent and to encourage de-institutionalization of children in nursing facilities. DADS employees provide case management services.
services
· Respite: Direct care to an individual to provide a caregiver temporary relief from care giving activities when the caregiver would usually perform such activities.
· Adjunct support services: Specific direct care needed by an individual to participate in child care, post-secondary education or independent living during the time the caregiver is at work, attending job training or attending school.
· Adaptive aids: A device that is needed to treat, rehabilitate, prevent or compensate for a condition that results in a disability or a loss of function and helps an individual perform the activities of daily living or control the environment. Adaptive aids are limited to $4,000 per eligibility period.
· Minor home modifications: A physical change to an individual’s residence that is needed to prevent institutionalization or to support the most integrated setting for an individual to remain in the community. Minor home modifications are limited to $7,500 during the individual’s lifetime and include:
o Bathroom modifications
o Doorway widening
o Ramps
· Transition Assistance Services: Services that pay for non-recurring, set-up expenses for essential items and services that allow individual to transition from a nursing facility to the community.
· Financial Management Services: Services that assist an individual or family with managing funds associated with self-directing respite and adjunct support services through the Consumer Directed Services option.
Financial Eligibility requirements
Other Eligibility Requirements
· Be under age 21.
· Meet the medical necessity criteria for nursing facility care.
· Meet disability criteria for Social Security or Medicaid benefits.
Availability
CCP
(THSteps–Comprehensive Care Program)
Texas Health Steps-Comprehensive Care Program (THSteps-CCP) is an extension of the THSteps Program. THSteps-CCP clients may receive medically necessary services that are not usually covered by Medicaid or that exceed Medicaid limits. Requests for services must be supported by documentation of medical necessity. Some services that THSteps-CCP may pay for are:
(These services must be prior authorized by the CCP Unit.)
THSteps-CCP also pays for:
Therapy services must be prior authorized, except for therapy evaluations/re-evaluations. Therapy goals include improving, maintaining, or slowing the deterioration of function. There
are no preset limits on the number of sessions that may be provided per week; however, documentation must show that the number of sessions requested is medically necessary.