Transcript Texas Health Steps Presentation

Texas Health Steps
Courtney Bindel, LMSW
Texas Health Steps Provider Relations
Texas Department of State Health Services
817-264-4902 or [email protected]
What is the
THSteps Program?
 Preventative portion of Medicaid
 Federal Name is EPSDT
 3 Components of THSteps
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Medical
Dental
Case Management
THSteps Medical Checkup
 Periodicity Schedule:
 Newborn, 3-5 Days, 2 weeks
 2,4,6,9,12,15,18,24,30 Months
 Yearly from 3-21 Yrs of Age
 Comprehensive and periodic evaluation of:
 Medical history
 Current health status
 Developmental and mental health assessment
 Nutritional status
 Vision and Hearing
 Immunizations and Lab work
 Anticipatory guidance
THSteps Dental Services
 Dental services begin at 6 Months
 Checkups every 6 months
 Dental coverage includes:
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Preventive Services
Treatment Services
Emergency Services
Orthodontic Services
To Find a THSteps
Medical or Dental Provider….
Contact Child’s Health Plan
or
Texas Health Steps Hotline:
1-877-THSteps (1-877-847-8377)
* Some Medicaid Doctors may not provide
Texas Health Steps
Children and Pregnant Women Case
Management (CPW)
 Service provided by licensed social worker
or registered nurse
 To assist Medicaid eligible children and highrisk pregnant women with medically needed
services in their community
 Goals
-Maximize possibility of healthy births
-Reduce or slow the deterioration of
health conditions
CPW Eligibility
 Medicaid eligible
 High-risk pregnant woman of any age
 Child 0-21 with health condition or health risk
 Case Management is required to maintain
health status or prevent deterioration
Requirements for Children
 Health condition or health risk
 Limitation of function, activities or social roles when
compared to healthy same age peers
 Areas of physical, cognitive, emotional or social growth
and development
 Examples Prematurity
 Low Birth Weight
 Birth Defects
 Developmental Delay
 Mental Retardation
 Autism
 Neurological Disorders (seizures, cerebral palsy)
 Severe Respiratory Problems (asthma)
Examples of
High-Risk Pregnancies
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History of premature delivery
Multiple births (twins, triplets)
Gestational hypertension
Gestational diabetes
History of substance abuse
History of domestic violence
Teenage pregnancy
Benefits of Case Management
Helps families Identify and address family problems
and access services in their community by
Conducting face to face comprehensive family
needs assessments
Developing an individualized family service plan
Periodic Follow-up
Referrals
Referrals may come from anywhere:
 Physicians
 Schools
 Hospitals
 Agencies
 Self-referrals
How to Make a Referral
Texas Health Steps Hotline
877-THSteps (877-847-8377)
CPW website for a list of
providers in your area:
www.dshs.state.tx.us/caseman
How Do You Become a Case
Manager?
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Program information available online:
www.dshs.state.tx.us/caseman/default.shtm
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Attend an informational seminar at DSHS to receive
application
Contact Courtney Bindel at
817-264-4902
for further information
Medical Transportation Program
 Provides free transportation to any
Medicaid appointment
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Bus tokens
Cab rides
Mileage Reimbursement
Airlines
Medical Transportation
 Must be Medicaid recipient
 Must have no other transportation available to
get to appointment
 Call at least two workdays in advance
1-877-633-8747
1-877-MED-TRIP
Additional Web Information
 www.yourtexasbenefits.com
(HHSC offices and Program Eligibility)
 www.thstepsproducts.com
(Free Brochures)
 http://txhealthsteps.com
(THSteps Training Modules with Free CEUs)
 www.chipmedicaid.org
(Medicaid/Chip
Info and Applications
Your Assistance is Needed
 Encourage Texas Health Steps
Medical Checkups every year
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Verify that Medicaid Doctor is also a
Health Steps Provider
Texas
 Encourage Dental Checkups Every 6 Months
 Referrals to the CPW program for Medical
Case Management