CSHCN 2009 > Claims Filing, Third-Party Resources, and Reimbursement > TMHP Claims Information

5.1.2 Claims Processed by the Department of State Health Services (DSHS)-CSHCN Services Program

Family Support Services (FSS) can help families care for clients with special health-care needs. FSS can also help a client be more independent and able to take part in family life and community activities.

FSS includes, but is not limited to:

•Respite care to allow caretakers a short break from caring for their child.

•Specialized childcare costs above and beyond the cost for typical childcare and related to the child's disability or medical condition.

•Vehicle modifications, such as wheelchair lifts and related modifications such as wheelchair tie-downs, a raised roof, and hand controls.

•Home modifications, such as ramps, roll-in showers, or wider doorways.

•Special equipment that is not listed as a possible benefit in the child's health insurance plan, such as porch lifts or stair lifts, positioning equipment, or bath aids.

There are limits on the FSS that the program can provide. Limited prior authorization of FSS may be considered while a client is on the CSHCN Services Program waiting list only when those services will prevent out-of-home placement of an eligible client and/or when a provision of the FSS is cost effective for the program. If the program offers limited services to clients on the waiting list, FSS may be a benefit. However, currently, only ongoing eligible CSHCN Services Program clients may receive FSS. In most cases, the total costs for FSS cannot be more than $3,600 per calendar year for each client. Exceptions may be made for vehicle modifications.

CSHCN Services Program case managers assist clients and their families with obtaining FSS. A list of DSHS Regional Health Service offices and contact information is provided in Chapter 1, "TMHP and DSHS Contact Information."