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West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 9 Chapter 23 Specific Medicaid Requirements

23.7 RELATIONSHIP WITH THE CHILDREN WITH SPECIAL HEALTH CARE NEEDS PROGRAM (CSHCN) (FORMERLY OFFICE OF HANDICAPPED CHILDREN) The Children with Special Health Care Needs (CSHCN) program provides specialized medical care and care coordination services to children under 21 with certain chronic, debilitating conditions who meet financial and medical eligibility criteria. A child may be simultaneously eligible for, and receiving services from, the Medicaid Program and CSHCN. A child may be a CSHCN client when he applies for a Division of Family Assistance (DFA) Program. The West Virginia Children’s Health Insurance Program (WVCHIP) uses the same policies and procedures with respect to CSHCN as Medicaid does. See Chapter 22 for further details about WVCHIP. When an applicant’s eligibility for, or enrollment in, this program is pending, he must not be refused the right to apply for DFA Programs due to his pending status with the CSHCN Program, but must be evaluated for any or all DFA Programs. 23.7.1 NON-CSHCN CLIENTS WHO ARE APPLICANTS FOR DFA PROGRAMS During the application process, when a Worker refers a child to the CSHCN Program, he gives the applicant the CSHCN-1 application form. A referral to the CSHCN Program must include the Medicaid eligibility status. If Medicaid is approved, the referral includes eligibility dates and, and if denied, it includes the reason for the denial. If the child is approved for CSHCN and the Medicaid eligibility status changes from the time of referral, the Worker calls the CSHCN Program with the reason for the change. Any time a Worker determines that a child may benefit from CSHCN services, the Worker makes a referral by telephone at (304) 558-5388, or toll-free at 1-800-642-9704 or 1-800-642- 8522. The eligibility determination for CSHCN services is made by a CSHCN Specialty Consultant. Covered CSHCN medical conditions are listed in the table below. Covered CSHCN Medical Conditions Acute Fractures Diabetes ADHD Hearing Loss Asthma Heart Defects