Monday, September 15, 2014

Services Provided

  • Nurses help you apply for BCMH.
  • Nurses help you get connected with resources that your child may need.

Children with Special Healthcare Needs (BCMH)

The Children with Special Healthcare Needs Program of Public Health, Dayton & Montgomery County provides case management and service coordination for families with children who have or potentially have special health care needs.

The program provides assistance to children with special health care needs and their families who meet the medical and financial eligibility criteria.  Assistance is provided to children under the age of 21 who have special health care needs (primarily chronic illnesses) and are residents of the Montgomery County. There are several programs that assist with the diagnostic services and treatment services that may be needed.

The program staff are physically located in the Job Center. This allows the staff to work very closely with several of our partner agencies. Help Me Grow (HMG) staff are also located in the Job Center and this allows both our staff and HMG staff to work closely with families of children age newborn to 3 years of age who may have developmental delays or chronic health conditions.

The program staff also work closely with the staff of the Montgomery County Department of Job and Family Services located in the Job Center to assist families to enroll their eligible children in the Healthy Start Program.

Medical Eligibility Criteria

For the BCMH Diagnostic Program, a child must:

  • Be under the age of 21
  • Be a permanent resident of Ohio
  • Be under the care of a BCMH-approved doctor (MD or DO)
  • Have a possible special health care need

For the BCMH Treatment Program, a child must:

  • Be under the age of 21
  • Be a permanent resident of Ohio
  • Be under the care of a BCMH approved doctor (MD or DO)
  • Be financially eligible
  • Have an eligible special health care need

For the Service Coordination Program, a child must:

  • Be under the age of 21
  • Be a permanent resident of Ohio
  • Be under the care of a BCMH-approved hospital specialty team approved for service coordination
  • Have a diagnosis eligible for service coordination

Financial Eligibility Criteria

The BCMH Treatment Program has a financial eligibility requirement.

Financial eligibility for BCMH is determined case by case based on:

  • Meeting federal estimated income guidelines
  • The family’s taxable income
  • The medical care the child needs
  • A calculation of the family’s maximum ability to pay for health care
  • Amount spent on private health insurance
  • Amount spent on weekly child care

BCMH does not count personal assets such as a home, car or savings account when determining financial eligibility. Also, income from child support, stepparent income or social security income (SSI) for the child is not counted.

When a child’s doctor applies to BCMH for treatment services, BCMH will send the parent or legal guardian a financial application packet (unless the child is active on the Medicaid program). It is important that all the instructions in the packet are followed. A form called the Combined Program Application (CPA) will be in the packet. The CPA is one of the financial application forms for BCMH. It must be filled out and mailed to BCMH along with pay stubs from each parent/adult client who is employed and a copy of their most recent federal income tax form (1040). A child receiving benefits through Medicaid, SSI or WIC is automatically financially eligible for BCMH treatment services, regardless of the parent’s income.

BCMH staff nurses help families with the BCMH application and renewal process. They assess family needs, teach about conditions and make referrals to health care providers and community resources. Common services covered by BCMH are physician fees, hospitalizations, prescriptions, surgery, laboratory tests, medical equipment, therapy and dental care. Families are linked to practical assistance and offered support and encouragement.

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