Special Health Care Needs
The Kansas Special Health Care Needs (SHCN) Program promotes the functional skills of persons, who have or are at risk for a disability or chronic disease. The program is responsible for the planning, development, and promotion of the parameters and quality of specialty health care in Kansas in accordance with state and federal funding and direction.
SHCN provides specialized medical services to infants, children and youth up to age 21 who have eligible medical conditions. Additionally, the program provides services to persons of all ages with metabolic or genetic conditions screened through the Newborn Screening.
Services may include diagnostic evaluations, treatment services or care coordination and must be prior authorized. Click here for more information about services.
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 21 years. Prior authorization is required and may be obtained by phone or letter from program staff. Consultations must be scheduled with SHCN 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 settng. 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 includes developing an individual health care plan for each person eligible for SHCN services. Phone conferences with professionals and/or family members to match "needs" to resources is provided.
What part of the cost does SHCN pay?
Services must be prior approved before any cost-sharing can be determined. Services must be provided by a contracted provider with SHCN. A SHCN is the payer after insurance and Medicaid.
The Special Bequest Fund allows for specific request for financial support of medical equipment, specialized care, education or other needed items that can improve health status, function, or quality of life for those with special health care needs. All request are subject to Special Bequest Commissioner approval. Special Bequest request form can be submitted online.