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Kansas Department of Health and Environment

Children With Special Health Care Needs Program

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Diagnostic services are available, without regard to family income, to Kansas youth under the age of 21 years who are suspected to have a severe disability, or chronic disease. Prior authorization is required and may be obtained by phone or letter from program staff.

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Treatment services include medical specialists, outpatient care, hospitalization, surgery, durable medical equipment, reimbursement for transportation to medical specialty care, and interpreter services. A limited amount of therapy (speech, PT, OT) is provided for eligible conditions.

All treatment services must be prior authorized. Conditions that are eligible for treatment include:

• Spina bifida
• Cleft palate/cleft lip
• Acquired or congenital heart disease
• Burns
• Major orthopedic problems
• Limited gastrointestinal or genitourinary conditions requiring surgery
• Genetic and metabolic conditions (PKU, sickle cell, cystic fibrosis, congenital hypothyroidism, galactosemia, hemophilia)
• Hearing loss
• Vision disorders
• Craniofacial anomalies (selected)
• Seizures
• JRA

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Outreach clinics bring specialty diagnosis, consultation, and follow-along care as close to the child's home as possible. Clinics are conducted for hearing loss, orthopedic conditions, neurological impairment, cardiac diseases, and genetic diseases.

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Special services include counseling and planning for health care needs, developing an individual plan of health care, and follow-along for each person accepted for services. Where Services for Children with Special Health Care Needs (Special Health Services, SHS) cannot provide the needed health services, an effort is made to identify other resources in the state.

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Who is eligible for treatment services?

• Youth who live in Kansas.
• Youth under the age of 21 years.
• Youth with a medical condition covered by the program.
• Those who meet the financial guidelines except for those with PKU, congenital hypothyroidism, or galactosemia.
• Kansas residents of any age who have congenital hypothyroidism, sickle cell disease, PKU, galactosemia, or hemophilia.

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What part of the cost does SHS pay?
SHS may pay for all or part of the cost of medical services. Each case is considered individually, and the amount paid is based on family income and the anticipated cost of the health services.

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How do you apply?
Contact one of the SHS offices listed or any local public health department or major hospital social service department for information, assistance, or application forms. Referral may be initiated by any concerned person.

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Information is needed about:

1. Family members,
2. Health insurance,
3. Financial status,
4. The youth's diagnosis or health problem, and
5. Names and addresses of doctors and hospitals providing care to the youth who is referred for the service.

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How is eligibility determined?
Each application is individually reviewed, and a decision is made according to guidelines established for financial and medical eligibility. The special needs of the person with the disability and those of the family are considered as part of each decision.

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Appeal
The family may appeal a decision to deny or to terminate services. The appeal should be addressed to the director of SHS. The director will review the application information and provide a response. Further appeal may be directed to the Secretary of the Department of Health and Environment.

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Jamey Kendall, Director