We provide home health services for medically fragile children on a long term or short term basis, including skilled nursing and attendant care as ordered by a physician. Our goal is to provide superior care and support to children and their families, thereby maintaining children’s health and preventing further hospitalizations. Working with families, we strive to help each child attain his or her maximum potential.
The Pediatric Care Program provides care to children who:
(Texas Department of State Health Services)
Children with Special Health Care Needs (CSHCN)
Services Program Health Benefits
Since 1933, Texas has worked to improve the lives of children with special health care needs. Through state and federal funds, the Children with Special Health Care Needs (CSHCN) program provides health benefits to qualified children with special health care needs and their families, and individuals of all ages with cystic fibrosis. Under Title V of the Social Security Act, the state receives a block grant to provide direct services (e.g., health benefits), as well as enabling services (e.g., case management) and population-based services (e.g., newborn screening). Title V programs, including CSHCN Health Benefits, provide and promote family-centered, community based, culturally competent, and coordinated health care and family support services. CSHCN recognizes the importance of the family as the focus of planning and service delivery, and promotes family choice and collaboration between parents and professionals. CSHCN strives to deliver services that honor and respect cultural beliefs, traditions, values, interpersonal styles, attitudes and behaviors.
The CSHCN Program Health Benefits cover the following:
| Ambulance | Inpatient Rehabilitation | Physical & Occupational Therapy |
| Ambulatory Surgery | Diagnosis & Evaluation | Meals, Lodging, and Transportation when needed to obtain medical care |
| Primary & Preventative Care | Care by Medical Specialists | Medicines |
| Speech and Hearing Services | Equipment & Medical Supplies | Orthotics & Prosthetics |
| Vision Care | Home Health Nursing | Special Nutritional Products and Services |
| Dental Care | Hospice Care | Outpatient Renal Dialysis |
| Mental Health Services | Hospital Care | Family Supports |
| Case Management |
A person younger than 21 years of age who has a chronic physical or developmental condition
OR
All CSHCN Program Health Benefits must be medically necessary for the care and treatment of a person with a chronic physical or developmental condition who is eligible. Medicaid, CHIP, and commercial health insurance benefits, if any, must be used before using CSHCN health benefits. For specific questions regarding types of benefits and eligibility, contact CSHCN through the CSHCN Inquiry Line at 1-800-252-8023.
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.
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:
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.
This service is available statewide on a first-come, first-served basis.
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.)
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.