Children and Youth with Special Health
Care Needs
Children and Youth with Special Health Care Needs (CYSHCN) promotes the functional skills of young persons in Kansas who have or are at risk for a disability or chronic disease by providing or supporting a system of specialty health care. The program is responsible for the planning, development, and promotion of the parameters and quality of specialty health care for children and youth with disabilities in Kansas in accordance with state and federal funding and direction.
Funding: Children and Youth with Special Health Care Needs is funded by state and federal Title V funds.
Mission: To promote the functional skills of young persons in Kansas who have a disability or chronic health condition.
Goal: By providing or supporting a system of specialty health care.
Effective July 23, 2012 the CYSHCN will have four regional offices to access the CYSHCN program in addition to the Topeka Administrative Office and the Kansas City Field Office.
Kansas Resource Guide is a toll free help line answered from 8 AM to 5 PM, Monday
through Friday on regularly scheduled work days. An expanded listing and range of services available in Kansas is
available at this site. The Web site provides links to preventive, diagnostic, ongoing life time care and community
resources for Kansans with and without a disability. If busy, your call will go to voice mail. Please speak clearly
leaving a short message with your name, who/what you are calling about and a phone number with area code.
Toll Free: 1-800-332-6262
An email address to post questions is available at: ksresourceguide@kdheks.gov.
Diagnostic Services are limited to a one time evaluation to determine if medically eligible, without regard to family income, for Kansas youth under the age of 22 years. Prior authorization is required and may be obtained by phone or letter from program staff. Consultations must be scheduled with CYSHCN contracted specialty providers. Second opinions are not covered. The application process must be completed if medically eligible before additional services will be authorized.
Treatment Services include medical specialty care in an outpatient setting. Services may include hospitalizations, surgery, durable medical equipment and medications related to the eligible condition. A limited amount of physical therapy, occupational therapy is provided for eligible conditions?
Case Management Services include s developing an individual health care plan for each person eligible for CYSHCN services. Phone conferences with professionals and/or family members to match “needs” to resources is provided.
CYSHCN contracting Kansas City based pediatric specialty clinics. Click to locate clinics, maps and scheduling contacts.
CYSHCN contracting Wichita based pediatric specialty clinics. Click to locate clinics, maps and scheduling contacts.
CYSHCN contracting Outreach Specialty Clinics bring specialty consultations, and follow-along care as close to the child’s home as possible. Clinics are conducted for hearing loss, orthopedic, cardiac, juvenile rheumatoid arthritis conditions and some genetic conditions. Click to locate clinics, maps and scheduling contacts.
Who is eligible?
Each application is individually reviewed, and a decision is made according to guidelines established for medical
and financial eligibility.
- Kansas residents under the age of 22 years with a medical condition covered by the program and who meet the financial guidelines (see related table A below)
- Kansas residents of any age who have a metabolic condition covered as of 7/1/08 who meet the financial guideline (see related Table B below)
Eligible Conditions: Eligible conditions are outlined by legislative statutes.
- Spina bifida
- Cleft palate/cleft lip
- Acquired or congenital heart disease
- Burns requiring surgical intervention
- Major orthopedic problems requiring surgical intervention
- Limited gastrointestinal or genitourinary conditions requiring surgery
- Hearing Loss
- Vision disorders (limited)
- Craniofacial anomalies (selected)
- Seizures – outpatient care and drugs only
- Juvenile Rheumatoid Arthritis
- Genetic and Metabolic conditions
Effective July 1, 2008, 29 conditions recommended by the National American College of Medical Genetics are covered.
Table A: Financial guidelines for non-metabolic related conditions. (updated 05/01/2013)
Eligibility is determined using all income sources (taxable and nontaxable) of all persons (related or not) living in the same household. Please include this information to expedite application process.
Persons in Family/Household |
100% Poverty Guideline |
185% Poverty Guidline |
15% assets |
| 1 | $11,490.00 | $21,256.50 | $3,188.48 |
| 2 | $15,510.00 | $28,693.50 | $4,304.03 |
| 3 | $19,530.00 | $36,130.50 | $5,419.58 |
| 4 | $23,550.00 | $43,567.50 | $6,535.13 |
| 5 | $27,570.00 | $51,004.50 | $7,650.68 |
| 6 | $31,590.00 | $58,441.50 | $8,766.23 |
| 7 | $35,610.00 | $65,878.50 | $9,881.78 |
| 8 | $39,630.00 | $73,315.50 | $10,997.33 |
| + | $4,020.00 | $7,437.00 | $1,115.55 |
Table B: Financial guidelines for metabolic treatment products (updated 1/1/2011)
Based on the same Federal Poverty Guidelines for 2010 listed in table A. Eligibility is determined using all income sources (taxable and nontaxable) of all persons (related or not) living in the same household. Please include this information to expedite application process.
Percent of Federal Poverty Guidelines |
CYSHCN payment rate |
| 0-185% | 100% of eligible charges |
| 186-285% | 50% of eligible charges |
| 286-385% | 25% of eligible charges |
Table C: Financial guidelines for genetic/metabolic conditions. (updated 1/1/2011)
Eligibility is determined using all income sources (taxable and nontaxable) of all persons (related or not) living in the same household. Please include this information to expedite application process.
Persons in Family/Household |
100% Poverty Guideline |
100% coverage |
50% coverage |
25% coverage |
|||
185% Poverty Guidline |
15% assets |
285% Poverty Guidline |
15% assets |
385% Poverty Guideline |
15% assets |
||
| 1 | $11,490.00 | $21,256.50 | $3,188.48 | $32,746.50 | $4,911.98 | $44,236.50 | $6,635.48 |
| 2 | $15,510.00 | $28,693.50 | $4,304.03 | $44,203.50 | $6,630.53 | $59,713.50 | $8,957.03 |
| 3 | $19,530.00 | $36,130.50 | $5,419.58 | $55,660.50 | $8,349.08 | $75,190.50 | $11,278.58 |
| 4 | $23,550.00 | $43,567.50 | $6,535.13 | $67,117.50 | $10,067.63 | $90,667.50 | $13,600.13 |
| 5 | $27,570.00 | $51,004.50 | $7,650.68 | $78,574.50 | $11,786.18 | $106,144.50 | $15,921.68 |
| 6 | $31,590.00 | $58,441.50 | $8,766.23 | $90,031.50 | $13,504.73 | $121,621.50 | $18,243.23 |
| 7 | $35,610.00 | $65,878.50 | $9,881.78 | $101,488.50 | $15,223.28 | $137,098.50 | $20,564.78 |
| 8 | $39,630.00 | $73,315.50 | $10,997.33 | $112,945.50 | $16,941.83 | $152,575.50 | $22,886.33 |
| + | $4,020.00 | $7,437.00 | $1,115.55 | $11,457.00 | $1,718.55 | $15,477.00 | $2,321.55 |
What part of the cost does CYSHCN pay?
Services must be prior approved before any cost-sharing can be determined. Services must be provided by a
contracted provider with CYSHCN. CYSHCN is payor after insurance and Medicaid.
How do you apply?
Contact one of the CYSHCN offices listed or complete the on-line application form. Referral may be initiated by
any concerned person. The local public health departments and major hospital social service departments can assist
with this process as well. Required information to accompany the application can be found on the application’s
front page.
If you are a Health Care Professional or Facility and would like to become a provider for the CYSHCN program, please complete the following application and return it to the address at the top of the application or by submitting it electronically to the email address listed.
Appeal
The family may appeal the decision of denial or termination of services. The appeal should be addressed to the
director of CYSHCN. Further appeal may be directed to the Secretary of the Department of Health and Environment.