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 The
following services are available to children and youth with
developmental
disabilities. To request them call the Regional Administrative Unit
(RAU) in
your area. To
sign up for
"waiver programs" that offer Medicaid and additional services to
eligible persons (including those whose income may be too high for
other
Medicaid), ask to be added to the Mentally Retarded / Developmentally
Disabled, "Request for Services Registry." The New Opportunities Waiver (NOW)
and
the Children's Choice Waiver both provide services
in
the home, instead of in an institution, to persons who have mental
retardation
and/or other developmental disabilities. Both cover Family Support,
Center-Based Respite, Environmental Accessibility Modifications and
Specialized
Medical Equipment and Supplies. In
addition, NOW covers services to help individuals live alone in the
community
or to assist with employment, and professional and nursing services
beyond
those Medicaid usually covers. The Children's Choice Waiver also includes Family
Training. Children remain
eligible for the Children's Choice Waiver until their nineteenth
birthday, at which time they will be transferred to an appropriate
Mentally
Retarded and Developmentally Disabled Waiver. CASE
MANAGEMENT A
case manager
works with you to develop a comprehensive list of all needed services
(such as
medical care, therapies, personal care services, equipment, social
services and
educational services) then assists you in obtaining them. If you are a
Medicaid
recipient and under the age of 21 and it is medically necessary, you
may be
eligible to receive case management services immediately. The
following benefits are available to all Medicaid-eligible children and
youth
under the age of 21 who have a medical need. To access these services,
call
the Specialty Care Resource Line toll-free at 1-877-455-9955 (TTY
1-877-544-9544). MENTAL HEALTH REHABILITATION SERVICES Children
and
youth with mental illness may receive Mental Health Rehabilitation
Services. These
services include:
clinical and medication management; individual and parent/family
intervention;
supportive and group counseling; individual and group psychosocial
skills
training; behavior intervention plan development and service
integration. All
mental health rehabilitation services
must be approved by mental health prior authorization unit. Children
and
youth who require psychological and/or behavioral services may receive
these
services from a licensed psychologist. These services include necessary
assessments and evaluations, individual therapy and family therapy. Medicaid
recipients under the age of 21 are eligible for checkups ("EPSDT
screens"). These
checkups include a
health history; physical exam; immunizations; laboratory tests,
including lead
blood level assessment; vision and hearing checks; and dental services. They are available both on
a regular basis,
and whenever additional health treatment or services are needed. EPSDT
screens
may help to find problems that need other health treatment or
additional
services. Children under 21 are entitled to receive all medically
necessary
health care, diagnostic services and treatment and other measures
covered by
Medicaid to correct or improve physical or mental conditions. This includes a wide range
of services not
covered by Medicaid for recipients over the age of 21. Personal
Care
Services are provided by attendants when physical limitations due to
illness or
injury require assistance with eating, bathing, dressing and personal
hygiene.
PCS services do not include medical tasks such as medication
administration,
tracheostomy care, feeding tubes or catheters. The Medicaid Home Health
program
or Extended Home Health program covers those medical services. PCS
services
must be ordered by a physician. The PCS service provider must request
approval
for the service from Medicaid. Children
and
youth may be eligible to receive Skilled Nursing Services in the home.
These
services are provided by a Home Health Agency.
A physician must order this service.
Once ordered by a physician, the home health agency
must request
approval for the service from Medicaid. If
a child or
youth wants rehabilitation services such as Physical, Occupational, or
Speech
Therapy, Audiology Services or Psychological Evaluation and Treatment;
these
services can be provided at school, in an early intervention center, in
an
outpatient facility, in a rehabilitation center, at home or in a
combination of
settings, depending on the child's needs.
For Medicaid to cover these services at school (ages
3 to 21), or early
intervention centers and EarlySteps (ages 0 to 3), they must be part of
the IEP
or IFSP. For
Medicaid to cover the
services through an outpatient facility, rehabilitation center or home
health
agency, they must be ordered by a physician and be prior-authorized by
Medicaid. For information on receiving these
therapies, contact your school or Children
and
youth can obtain any medically necessary medical supplies, equipment
and
appliances needed to correct or improve physical or mental conditions.
Medical
Equipment and Supplies must be ordered by a physician.
Once ordered by a physician, the supplier of
the equipment or supplies must request approval for them from Medicaid. Transportation
to and from medical appointments, if needed, is provided by Medicaid.
These
medical appointments do not have to be with Medicaid providers for the
transportation to be covered. Arrangements
for non-emergency transportation must
be made at least 48
hours in advance. Privacy Policy I Site Map I Text Site I Back to Top © ACS, Inc, 2008. All rights reserved. |