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12.1.1 Eligibility
To be eligible for services, a person must:
• Be eligible for the Texas Medicaid Program.
•Be a pregnant woman with a high-risk condition, or a child (birth through 20 years of age) with a health condition or health risk.
•Be in need of services to prevent illnesses or medical conditions, to maintain function, or to slow further deterioration.
•Want to receive case management services.
Pregnant women with a high-risk condition are defined as women who are pregnant and have one or more high-risk medical and/or personal/psychosocial conditions during pregnancy. Children with a health condition are defined as children with a health condition/health risk or children who have, or are at risk for, a medical condition, illness, injury, or disability that results in limitation of function, activities, or social roles in comparison with healthy same-age peers in the general areas of physical, cognitive, emotional, or social growth and development.
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