TMPPM 2010 >3. Medicaid Children's Services (CCP)

3. Medicaid Children's Services (CCP)

3.1 Early Childhood Intervention (ECI) (CCP)

ECI providers are eligible to enroll as CCP providers rendering service to clients birth through 35 months of age with a disability or developmental delay as defined by ECI criteria.

ECI CCP services end on the child's third birthday.

To participate in Texas Medicaid, an ECI provider must comply with all applicable federal, state, and local laws and regulations about the services provided.

PT, OT, ST, and nutrition services are benefits for clients enrolled in ECI through CCP. CCP guidelines apply, including the requirement for evaluations.

The Texas ECI program is available statewide to families of children who are birth through 35 months of age and have disabilities or developmental delays. The state agency responsible for ECI services is the Department of Assistive and Rehabilitative Services (DARS). DARS contracts local ECI program providers who take referrals, determine eligibility for ECI, and provide services to eligible children.

ECI programs determine eligibility based on evaluations and assessments. Eligibility is determined by a team that includes ECI professionals and family members. The team works together to develop an Individualized Family Service Plan (IFSP) and case management plan to determine the appropriate services based on the unique needs of the child and child's family. Children are eligible if they meet one or more of the following criteria:

•They have delays in one or more areas of development (cognitive, motor, communication, social-emotional or self-help skills)

•They have atypical development (children whose patterns of development are unusual or different from their peers)

•They have a medically diagnosed condition (children who have a condition, such as Down syndrome or spina bifida, that has a high probability of resulting in a developmental delay)

The ECI Developmental Rehabilitation Services (DRS) are reimbursed through the DARS ECI programs reimbursement process in accordance with 1 TAC §355.113 and DRS requirements in 40 TAC §108.501-§108.505.

ECI professionals are licensed or credentialed specialists, including early intervention specialists, speech and language pathologists, physical and occupational therapists, nurses, dieticians, social workers, counselors, and hearing and vision specialists.

Medicaid professionals can assist families by promptly scheduling appointments for well-child exams and providing documentation of the well-child exam and prescription (when necessary).

Other ECI services include physical, occupational, and speech therapy; nursing services; visions services; audiology services; developmental services; nutrition services; psychological services; social work; counseling; education and training; behavioral intervention; transportation; socialization services; health services; and assistive technology services and devices.

For more information on ECI services, providers may visit the EDI website at www.dars.state.tx.us/ecis/index.shtml.

Refer to: Subsection 3.10, "Therapy Services (CCP)" in this handbook for more information.

Subsection 3.6, "Medical Nutrition Counseling Services (CCP)" in this handbook for more information.