System of Care for Children and Youth with Special Health Care Needs

Coordinating care for children and youth with complex medical conditions has long been seen as an essential component of practice to manage fragmented services and high health care costs.

Programs that prove to improve healthy development for children and youth with disabilities and complex medical conditions, increase the family’s satisfaction with services and reduce health care costs provide coordinated care; comprehensively assess patients’ risk and needs; use evidence-based care planning strategies; promote patient and family engagement; coordinate communications between patients and providers; support transitions from pediatric to adult care; provide linkages and referrals to community-based services.

Children’s Medical Services provides care coordination and other needed medical/health services for eligible children and their families. CMS may provide , arrange for and/or pay for comprehensive physical evaluations, diagnostic tests, inpatient/outpatient hospitalization, medications and other medical treatments, therapy, durable medical equipment, hearing aids related to the child’s CMS-eligible condition, and genetic counseling. CMS offers care coordination by nursing and professional staff for every child enrolled in the program. Every child enrolled in CMS may receive periodic home visits from CMS staff. CMS works closely with primary care providers to coordinate services.

Eligibility for enrollment for services depends on the child’s medical diagnosis, click here for a list of diagnoses and the family’s household income.

To refer a family with a child with complex medical needs and needing assistance with the coordination of care and navigating the health care system and community resources, submit the Children 1st referral click here

Click here to view Children’s Medical Services (CMS) website.