Children & Youth With Special Health Care Needs (CYSHCN)
CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS (CYSHCN)
The CYSHCN Program provides assistance statewide for children and youth with special health care needs from birth to age 21. The program focuses on early identification and service coordination for children and youth who meet medical eligibility guidelines. As payer of last resort, the program provides limited funding for
medically necessary diagnostic and treatment services for children whose families also meet financial eligibility guidelines. Children with special health care needs are those who have, or are at increased risk for a disease, defect or medical condition that may hinder their normal physical growth and development. These children require health and related services that go beyond those required by children in general.
Eligibility
The participant must:
Be a Missouri resident
Be birth to age 21
Have an eligible special health care need (conditions such as Cerebral Palsy, Cystic Fibrosis,Cleft Lip and Palate, Hearing Disorders, Hemophilia, Paraplegia, Quadriplegia, Seizures, SpinaBifida, and Traumatic Brain Injury)
Meet financial eligibility guidelines for funded services (family income at or below 185% of the Federal Poverty Guidelines)
Service coordination is provided to all participants, regardless of financial status.
Outreach/Identification and Referral/Application
Eligibility Determination
Assessment of Needs
Resource identification, referral and access
Family support
Service Plan Development/Implementation
Monitoring and Evaluation
Transition/Closure
Limited funding for medically necessary diagnostic and treatment services for participants whose families meet financial eligibility guidelines.
Funded services may include but are not limited to: doctor visits, emergency care, inpatient hospitalization, outpatient surgery, prescription medication, diagnostic testing, orthodontia and prosthodontia (cleft lip/palate only), therapy (physical, occupational, speech and respiratory), durable medical equipment, orthotics, hearing aids, specialized formula, and incontinence supplies.
CYSHCN is payer of last resort. The Service Coordinator will assist the participant/family with resource identification and referral. All third party liability must be exhausted prior to accessing CYSHCN funds
Financial Eligibility
Financial eligibility is based on family income and size.
The HCY Program provides service coordination and authorization for medically necessary services for MO HealthNet recipients with special health care needs from birth to age 21.