The Texas Center for the Study of Children with Special Health Care Needs was established in 1994 in response to the implementation of Medicaid Managed Care (MMC) in Texas.
Texas began implementing Medicaid Managed Care (MMC) in 1993. All of the state’s large urban areas have implemented some form of MMC – usually a mix of HMOs (Health Maintenance Organization) and PCCM (Primary Care Case Management) models. The only model targeting members with special health care needs began operating in the Houston/Harris County area in March 1998. This “wrap-around” model integrated preventive, primary, acute care and long-term care into a single demonstration program. The Center operates in an area that is a mixed HMO PCCM model.
In 1997, the Texas Legislature passed Senate Bill (SB) 1165. This legislation recognized the need to address concerns about CSHCN in MMC. The bill charged the Texas Health and Human Services Commission (HHSC) with developing a definition, identification, and monitoring approaches of CSHCN. The Center was part of the SB 1165 Working Group created by HHSC to help guide policy development.
This background describes the activities in Texas which helped to identify the projects goals and objectives. The following grants were awarded by the Maternal and Child Health Bureau.
Identifying and Monitoring Children with Special Health Care Needs in Medicaid Managed Care (1998-2002)
The project aims to access and describe the impact of Medicaid Managed Care upon CSHCN and their families in the San Antonio/Bexar County Area.
A project supported in part by 5 H93 MC 00059-02 from the Maternal and Child Health Bureau (title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services.
Texas Medicaid Managed Care and Children with Special Health Care Needs (1994-1998)
The project addressed the problem of the absence of universal access to services for CSHCN and their families in five South Texas counties.
A project supported in part by MCJ-48RO24-01-0 from the Maternal and Child Health Bureau (title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services.
As part of consumer education, the Center has provided information for users of the Medicaid Program with a quick reference on what Medicaid delivery models (e.g. traditional Medicaid, PCCM, or HMO) are currently in effect in Texas. The Center has provided information through developing tools and presentations to help consumers to better understand the complex delivery system for children with special health care needs under Medicaid.