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Help for Children With Special Needs

Most people know that CHIP — the Children’s Health Insurance Program — provides low cost health insurance for children in low income families. However, many children with health problems that aren’t covered by CHIP have another state assistance program to help them. Jim Bell explains.

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The Children with Special Health Care Needs program covers children with extraordinary medical needs, disabilities and chronic health conditions. Program Medical Director Dr. Lesa Walker says it pays for medical care, family support services and other services that aren’t covered by CHIP, Medicaid, private insurance or other third party payers. Eligible problems run the gamut.

“Examples would be congenital heart disease, children with cancer, we have cerebral palsy, cystic fibrosis, seizure disorders, asthma, pretty much you name it, as far as any kind of chronic health condition.”

Walker says the Special Health Care Needs program isn’t as well known as CHIP because it’s only available to a particular smaller group of families who’re referred to it if their child has a problem not covered by CHIP.

“Many times it’s through their physicians, or their nurse practitioners or their clinics or wherever they’re being seen for their chronic condition.
And so we get a lot of referrals through those providers who’re seeing the children.”

The bad news is this program’s limited funding, and the unpleasant fact that clients are dropped from the program when they reach the age of 21. They’re on their own at that point. It’s budget for health care benefits is only 27 million dollars a year, so it can afford to serve only about 2500 children at any given time, which means there’s always a waiting list.

“And that’s a hard thing to see, and we really are excited and happy and try to announce broadly when we have a removal of children from the waiting list, to make them able to receive services.”

The Children With Special Health Care Needs program is inside the Texas Department of State Health Services. Income requirements are the same as CHIP’s — 200 percent of the federal poverty level — so Dr. Walker urges low income families with special needs children to enroll in both.

Jim Bell, KUHF Houston Public Radio News.

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