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Treatment Program

Purpose


CMH can cover services by CMH-approved providers to treat an eligible condition.  The family must also be financially eligible.

Although CMH covers a wide range of services, it is important to know CMH does not cover all the services a child with special health care needs may require, nor are all services eligible for every diagnosis.  Services must be related to the child’s CMH-eligible condition.

Eligibility


The applicant must:

  • Be under the age of 21
  • Be a resident of Ohio
  • Be under the care of a CMH-approved physician
  • Have an eligible medical handicap
  • The family must be financially eligible

Services


Services must be related to the suspected handicapping condition and provided by CMH-approved providers. If applicant is approved, services are authorized for one year.  If both medical and financial eligibility are maintained, services may be renewed up to age 21.  CMH requires the signature of the applicant if he/she is 18 to 21 years of age.  Documentation must be provided if there is legal guardianship of an individual 18 to 21 years of age.

Services include (this is not a complete list as it varies with each medically eligible condition):

  • Days in the hospital
  • Visits to BCMH-approved doctors (MD or DO)
  • Public health nurse services
  • Hearing aids
  • Glasses/contact lenses
  • Prescription drugs
  • Medical supplies/equipment
  • Physical, occupational and speech therapy
  • Nutrition consults/services
  • Surgery and anesthesia
  • Special formula

Examples of Eligible Conditions (not a complete list):

  • Birth defects
  • Chronic lung disease
  • Heart defects
  • Cerebral palsy
  • Spina bifida
  • PKU and other metabolic conditions\
  • Hearing loss
  • Epilepsy
  • Cancer
  • Sickle cell disease
  • Hemophilia
  • Congenital heart disease
  • Diabetes

Ineligible Conditions:

  • Learning disabilities
  • Behavior problems
  • Mental retardation
  • Allergies
  • Conditions that will improve through growth
  • Acute or infectious conditions
  • Psychological/emotional disorders
  • Routine orthodontic problems
  • Experimental care
  • Well child care
  • Developmental delay

Enrollment


A CMH-approved doctor (MD or DO) who will manage the child’s care must apply to CMH.  The parent, legal guardian or client (if 18 years of age or older) must sign the Medical Application Form or the Release of Information and Consent before the case can be started.  The parent or legal guardian must complete the forms in the income-eligibility packet they receive from CMH and return all required information to CMH.  These documents are used to determine financial eligibility.