Purpose of the Program
To ensure that there is a community-based, coordinated, family focused, culturally appropriate, comprehensive system of quality specialty health care services available for Georgia’s children with chronic medical conditions from birth to 21 years of age and live in low income households. CMS (Children's Medical Services) works to provide improved health outcomes for children with special health care needs by coordinating their access to affordable quality specialty health care in our communities and by using the resources in a responsible manner.
What does the program do?
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.
How many people are helped by the program?
Approximately 8,870 Georgia children (birth to 21 years) received specialized medical/health care and care coordination services through this program during FY13.
Why is the program important?
Children and youth with special health care needs (i.e. chronic medical conditions) require multiple services from a number of health providers. CMS provides access to specialty health care for children through a longstanding successful public/private partnership including over 400 providers. The program enables children to receive quality medical services and may assist with payment for services. More than 11% of Georgia’s children and youth with special health care needs are without health insurance coverage. About one third of children and youth with special health care needs (CYSHCN) and their families are underinsured. The insurance benefits do not cover medically necessary costs including but not limited to durable medical equipment (DME), medical supplies and diagnostic testing. Families who are insured may have extremely high co-payments and deductibles that must be paid before accessing benefits. The services provided by CMS prevent complications due to untreated condition(s) and promote healthy growth and development. CMS standards promote quality, cost effective care that meet the unique needs of children with special health care needs and their families.
Where are services located?
Children’s Medical Services Program offers statewide community-based services through a network of 18 public health districts.