Program helps children with special requirements
It was known as the Crippled Children’s Program decades ago, but the services were broadened and it was renamed Children’s Special Health Care Services in the 1980s.
Nearly 30 years later, the state program still exists, administered by county health departments.
“This is the only state program that a child needs to have a medical diagnosis to get in. Most state programs are all about the income, but for us, they have to have a medical condition,” said Chris Buczek, who has directed the program for the Kent County Health Department since 1995.
Buczek is very familiar with the program and not just because of her position at the county: She had a son enrolled in it. She said having that double perspective, as an administrator and a consumer, has instilled a lot of passion for the program.
There are roughly 2,600 chronic medical conditions that can qualify a child for CSHCS. All must be of a physical nature, such as cancer or diabetes.
“The major thing the program does is it helps pay for the medical care and treatment needs related to the diagnosis. Most of the kids in the program have another type of insurance. Some have Medicaid. Some have private insurance, or private insurance and Medicaid,” said Buczek.
Having some coverage is key because CSHCS will pay the co-pays for physician visits, medication, lab work or X-rays for those who have private insurance. “They would not have to pay any of those if they’re on the Children’s Special Health Care Program,” said Buczek. “Think of it as an additional insurance.”
Children up to the age of 21 are eligible. So are adults 21 and older who are afflicted with cystic fibrosis and hemophilia. In most cases, Buczek said a child has to be under the care of a pediatric specialist, who files a report on the child’s health status with the state’s physicians, and they decide whether a child meets the CSHCS enrollment criteria.
“They look to see if there is a need for specialty care. It’s usually more than one tier, and they look at the chronicity and what the care and medical needs are.”
There are 2,263 Kent County children and adults enrolled in the program this year; about 55 percent are covered by Medicaid. Buczek said the enrollment number has been creeping up by a few hundred each year over the past few years, partly because of the recession and partly because kids are coming into the program earlier, some directly from neo-natal units.
The program’s budget is $354,000, with $285,000 coming from the state and $69,000 from the Kent County general fund. Last year, the county’s CSHCS budget was $343,000.
“All the counties’ Children Special Health Care Services got a little bump, which was unbelievable,” said Buczek.
Fees aren’t charged for children covered by Medicaid. The state does, however, charge an income-based fee for children covered through a private insurer.
If parents don’t have insurance coverage for their children, they should still look into CSHCS. Buczek said the health department can possibly link them up with MI Child or Medicaid. In fact, she emphasized that the department’s staff can help parents develop a plan for their children’s health care regime.
“We really do help them hook up to other community resources that might be appropriate for them.”
The information gathering should begin online at Michigan.gov/cshcs or by calling 800-359-3722. HQ