Texas Health Steps

Courtney Bindel, LMSWTexas Health Steps Provider Relations

Texas Department of State Health Services817-264-4902 or courtney.bindel@dshs.state.tx.us

What is the THSteps Program?

Preventative portion of Medicaid Federal Name is EPSDT

3 Components of THSteps Medical Dental Case Management

THSteps Medical Checkup

Periodicity Schedule: Newborn, 3-5 Days, 2 weeks 2,4,6,9,12,15,18,24,30 Months Yearly from 3-21 Yrs of Age

Comprehensive and periodic evaluation of: Medical history Current health status Developmental and mental health assessment Nutritional status Vision and Hearing Immunizations and Lab work Anticipatory guidance

THSteps Dental Services

Dental services begin at 6 Months Checkups every 6 months Dental coverage includes:

Preventive Services Treatment Services Emergency Services Orthodontic Services

To Find a THSteps Medical or Dental Provider….

Contact Child’s Health Plan

or

Texas Health Steps Hotline:1-877-THSteps (1-877-847-8377)

* Some Medicaid Doctors may not provide Texas Health Steps

Children and Pregnant Women Case

Management (CPW) Service provided by licensed social

worker or registered nurse To assist Medicaid eligible children and

high-risk pregnant women with medically needed services in their community

Goals-Maximize possibility of healthy births-Reduce or slow the deterioration of health conditions

CPW Eligibility

Medicaid eligible High-risk pregnant woman of any

age Child 0-21 with health condition or

health risk Case Management is required to

maintain health status or prevent deterioration

Requirements for Children

Health condition or health risk Limitation of function, activities or social roles when

compared to healthy same age peers Areas of physical, cognitive, emotional or social growth

and development Examples-

Prematurity Low Birth Weight Birth Defects Developmental Delay Mental Retardation Autism Neurological Disorders (seizures, cerebral palsy) Severe Respiratory Problems (asthma)

Examples of High-Risk Pregnancies

History of premature delivery Multiple births (twins, triplets) Gestational hypertension Gestational diabetes History of substance abuse History of domestic violence Teenage pregnancy

Benefits of Case Management

Helps families Identify and address family problems and access services in their community by

Conducting face to face comprehensive family needs assessmentsDeveloping an individualized family service planPeriodic Follow-up

Referrals may come from anywhere: Physicians Schools Hospitals Agencies Self-referrals

Referrals

Texas Health Steps Hotline

877-THSteps (877-847-8377)

How to Make a Referral

CPW website for a list of providers in your area:

www.dshs.state.tx.us/caseman

How Do You Become a Case Manager?

Program information available online: www.dshs.state.tx.us/caseman/default.shtm

Attend an informational seminar at DSHS to receive application

Contact Courtney Bindel at 817-264-4902

for further information

Medical Transportation Program

Provides free transportation to any Medicaid appointment Bus tokens Cab rides Mileage Reimbursement Airlines

Medical Transportation

Must be Medicaid recipient Must have no other transportation available to

get to appointment Call at least two workdays in advance 1-877-633-8747 1-877-MED-TRIP

Additional Web Information

www.yourtexasbenefits.com (HHSC offices and Program Eligibility)

www.thstepsproducts.com (Free Brochures)

http://txhealthsteps.com (THSteps Training Modules with Free CEUs)

www.chipmedicaid.org (Medicaid/Chip Info and Applications

Your Assistance is Needed

Encourage Texas Health Steps Medical Checkups every year Verify that Medicaid Doctor is also a

Texas Health Steps Provider Encourage Dental Checkups Every 6 Months Referrals to the CPW program for Medical

Case Management