Texas Health Steps

1. Texas Health Steps Courtney Bindel, LMSW Texas Health Steps Provider Relations Texas Department of State Health Services 817-264-4902 or courtney.bindel@dshs.state.tx.us

2. What is the THSteps Program? • Preventative portion of Medicaid • Federal Name is EPSDT • 3 Components of THSteps • Medical • Dental • Case Management

3. 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

4. THSteps Dental Services • Dental services begin at 6 Months • Checkups every 6 months • Dental coverage includes: • Preventive Services • Treatment Services • Emergency Services • Orthodontic Services

5. 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

6. Children and Pregnant Women Case Management (CPW) • Service provided by licensed social worker or registered nurse • To assist Medicaid eligible children and high-risk pregnant women with medically needed services in their community • Goals -Maximize possibility of healthy births -Reduce or slow the deterioration of health conditions

7. CPW Eligibility • Medicaid eligible • High-riskpregnant woman of any age • Child 0-21 with health condition or health risk • Case Management is required to maintain health status or prevent deterioration

8. 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)

9. Examples of High-Risk Pregnancies • History of premature delivery • Multiple births (twins, triplets) • Gestational hypertension • Gestational diabetes • History of substance abuse • History of domestic violence • Teenage pregnancy

10. 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 Benefits of Case Management

11. Referrals Referrals may come from anywhere: • Physicians • Schools • Hospitals • Agencies • Self-referrals

12. 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

13. How Do You Become a Case Manager? • Program information available online: www.dshs.state.tx.us/caseman/default.shtm • Attend an informational seminar at DSHS to receive application Contact Courtney Bindel at 817-264-4902 for further information

14. Medical Transportation Program • Provides free transportation to any Medicaid appointment • Bus tokens • Cab rides • Mileage Reimbursement • Airlines

15. 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

16. 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

17. Your Assistance is Needed • Encourage Texas Health Steps Medical Checkups every year • Verify that Medicaid Doctor is also a Texas Health Steps Provider • Encourage Dental Checkups Every 6 Months • Referrals to the CPW program for Medical Case Management