Public Health Region 1 Children with Special Health Care Needs (CSHCN)
Purpose
We have a goal to provide the highest quality of social work services to maximize the physical, psychological, and emotional health of the children of Region 1 who have special health care needs.
In working toward that goal, direct and indirect services will be provided in a family-centered, culturally sensitive, community-based manner to this population and other targeted populations identified by the Texas Department of State Health Services.
Department of State Health Services, PHR 1
CSHCN Program
6302 Iola Ave
Lubbock, TX 79424
Phone: 806-783-6452
Fax: 806-783-6455
Department of State Health Services, PHR 1
CSHCN Program
3407 Pony Express Way
Amarillo, TX 79118
Phone: 806-655-7151
Fax: 806-373-4757
For CSHCN Program-related questions, please contact Laura Mojica in the Lubbock area.
Services include:
Case management services are available through DSHS for children in the CSHCN Services Program. Other qualities include those who receive SSI or Medicaid or any child with special health care needs.
- Outreach
- Individual Assessment
- Education
- Advocacy
- Information and Referrals
- Case Management
- Technical Assistance
- Community Organization
DSHS Case Management
DSHS Case Managers ensure access to case management services for clients who are eligible for the following programs:
- Children with Special Health Care Needs (CSHCN-SP)
- Case Management to Children receiving SSI
- Case Management for Children and Pregnant Women
- Assessments for Personal Care Services (PCS)
When no other case management system is available, the social workers provide the case managers directly. After assessing the medical, rehabilitative, developmental, educational and social strengths and challenges of the child and family, a service plan is developed in partnership with the family to obtain needed services in the community. Our goal is to empower the family to meet their identified needs.
Case managers can assist with:
- Access to needed medical services
- Educational concerns
- Financial concerns
- Equipment and supplies
- Family problems
- Finding help in the local community
Other Case Management Services Activities
- Community education
- Community presentations
- Interagency activities
- Community resource coordination groups
Case Management for Children and Pregnant Women
Case Management for Children and Pregnant Women provides services to children with a health condition/health risk, birth until 21 years of age, and to high-risk pregnant women of all ages, in order to encourage the use of cost-effective health and health-related care. Together, the case manager and family will assess the medical, social, educational, and other medically necessary service needs of the Medicaid-eligible recipient. The regional Coordinator recruits certifies, and trains qualified Case Management contractors who provide services for their approved area. They review prospective applicants and provide training, as well as ongoing technical assistance and quality assurance for providers who are approved by the department.
A Case Manager must be a current licensed registered nurse or a currently licensed social worker in the State of Texas. They must possess 2 years of cumulative full-time work experience in the past 10 years which includes work with children up to 21 years of age, or pregnant women. This experience must include making psychosocial and health assessments and referring clients to community resources.
Children with Special Health Care Needs Services Program
The CSHCN Services Program (CSHCN-SP) is a health benefits program offered through the DSHS. This program provides special services or equipment for eligible children with certain health problems. A child can become eligible for CSHCN-SP if:
- The child lives in Texas
- The child is under age 21 or has cystic fibrosis
- The child has a coverable condition
- The family is within the income and asset limits
CSHCN-SP applicants must apply for Medicaid / Medically Needy Program, Medicaid Buy-In for Children (MBIC), and Children's Health Insurance Program (CHIP) and send copies of determinations to the regional DSHS office. If the child is NOT a U.S. citizen, a CHIP determination is not required.
CSHCN-SP will pay for such things as:
- Doctor visits
- Up to 60 days in the hospital
- Braces and artificial limbs
- Prescription drugs
- Special equipment
- Medical supplies
- Home health care
- Travel costs to medical appointments
CSHCN-SP Eligibility Staff enters applications submitted to obtain medical assistance through CSHCN Services Program. In the application process, the staff is required to verify documents, enter various proofs of residency and income, and work with families to assure that the process is completed.
Personal Care Services (PCS) Benefit
Personal Care Services is a medical benefit that provides assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs) to help clients with physical, cognitive, or behavioral functional limitations related to a disability, physical or mental illness, or chronic condition.
Examples of Activities of Daily Living (ADLs)
- Bathing
- Dressing
- Feeding
- Grooming
- Mobility
- Toileting/Toileting hygiene
- Transfers/Non-ambulatory movements
Examples of Instrumental Activities of Daily Living (IADLs)
- Housekeeping
- Laundry
- Meal preparation
- Money Management
PCS Does Not Include:
- Services when the client has the physical, cognitive, and behavioral abilities to perform the ADL or IADL
- Duplication of Medicaid services
- Nursing Care
- Respite care or childcare
Who Can Receive the Personal Care Services Benefit?
The PCS benefit is available to Texas Medicaid clients who
- Are 0-20 years of age
- Are enrolled with Texas Medicaid as THSteps clients
- Have physical cognitive or behavioral limitations related to a disability or chronic health condition that inhibits the client's ability to accomplish ADLs or IADLs.
If you have comments or suggestions, please contact us.