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 22 years. The following requirements apply to diagnostic services.
- Prior authorization is required and may be obtained by phone or letter from program staff.
- Consultations must be scheduled with SHCN contracted specialty providers.
- Consultants may not be used to gain a second opinion about a previous diagnosis.
- 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. The following requirements apply to treatment services.
- Applicant must be medically and financially eligible.
- Authorization must be obtained before services are received.
**NOTE: Low-protein formula or food items may be provided at a reduced cost to the family through this program. This is applicable to all medically eligible individuals, regardless of income. Contact the SHCN program at 785-296-1313 for more information.
Care Coordination 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. Care coordination is available for all eligible applicants and may also be available for individuals receiving SSI benefits.
What part of the cost does SHCN pay?
Services must be prior approved before any cost-sharing can be determined. Cost-sharing is determined based upon financial eligibility determination. All services must be provided by a contracted provider with SHCN. Private and public insurance must be billed, if applicable, prior to SHCN payment.