Download Regional Healthcare Coverage Collaborative (RHCC) Dell

 Regional Healthcare Coverage Collaborative (RHCC)
Dell Children’s Medical Center
in the Pat Hays Conference Center Auditorium
April 5, 2011
9:00 a.m.-11:00 a.m.
Agenda
1. Welcome & Announcements
Kit Abney-Spelce
insure-a-kid, Director
Claudia Lindenberg
Central Health, Director of
Patient Services
2. Legislative Update
Stacy Wilson
Central Health, Director
Government Affairs
3. Panel Discussion
Paul Nguyen,
CommuniCare, Chief
Operations Officer
Julie Thorpe
CommUnityCare. Director
of Practice Development
Denise Esper
Lone Star Circle of Care,
Chief Revenue Officer
CommUnityCare
Julie Thorpe, M.A.
Director of Practice Development
CommUnityCare
History
Our Commitment
CommUnityCare Mission
Providing the right care, at the right time, at the right place
The Joint Commission
Goal: Provide safe,
effective, high quality care
to our patients = Right Care
Optimizing Comprehensive
Clinical Care (OC3)
Goal: See our own patients, don’t
make them wait = Right Time at
the Right Place
Who We Serve?
We provide primary care services for the
medically underserved in Travis County:
• In 2010, over 58,000 patients in care
• Approximately 249,000 appointments
• Prenatal care for one of every three
pregnant patients in Travis County
Range of Services
•Family Medicine
•Internal Medicine
•Women’s Health Services
•Pediatrics
•Clinical Pharmacists
•Behavioral Health Services
•Dental Services
•Pharmacy Services
•Nutrition Services
•Financial Screening
Our Philosophy of Care
CommUnityCare uses a team approach to provide
comprehensive primary care services to our patients.
We believe a patients’ overall health and well-being
depends on both their physical and mental health.
Our team of physicians, mid-level providers (Nurse
Practitioners and Physician Assistants), Dentists, Clinical
Pharmacists, Nutritionists, and Behavioral Health
Professionals all work in partnership with our patients
to achieve the best health outcomes possible.
Eligibility for Services
CommUnityCare serves residents living in Travis
County who are enrolled in:
• Medicaid
• Medicare
• CHIP
• Central Health Medical Assistance Program
(MAP)
• Sliding fee scale (Patients who are eligible for
services on a discounted fee scale based on family
size and income)
Our Health Centers
Providing the right care, at the right time, at the right place
A.K. Black
ARCH
Ben White Dental
UT Children’s Wellness
David Powell
Del Valle
East Austin
UT Family
Wellness
Manor
Montopolis
Northeast
Oak Hill
Pflugerville
RBJ Dental
Red River
Rosewood-Zaragosa
Rundberg
South Austin
William Cannon
Women’s Health
Current Medical Capacity
72,000
9,300
6,600
29,200
2,700
14,300
9,900
Coming Soon
North Central - Completion of Braker Lane site – estimated Fall
2011 (FY 2012 impact)
East • Addition of ATCIC integrated sites at Second Street and at
Rundberg (at HRSA for approval – FY 2011)
• East Austin - post-renovation increased capacity (FY 2012)
Southeast – William Cannon expansion – estimated Summer
2011
Planned Medical Capacity
92,600
20,000 9,300
6,600
2,700
14,300
27,900
11,800
CommUnityCare
Growing to serve our community
by providing the right care, at the
right time, at the right place.
Lone Star Circle of Care
Our Ser vic e s
Lone Star Circle of Care (LSCC) is a federally qualified community health center focusing on providing a health care
home for all Central Texans, including the uninsured and underinsured. We happily accept patients with no insurance,
CHIP, Medicaid, Medicare, MAP, as well as other private insurance. There are no residency restrictions for receiving
care at LSCC. Uninsured patients are placed on a sliding fee scale based on household size and income. Lone Star
Circle of Care provides the highest possible quality of care for our patients.
Pediatrics & Adolescents:
child checks
• Well
Immunizations
• Sick care
• School & sport physicals
• Teen health care
• Counseling & therapy
•
Women’s Services:
care
• Prenatal
Labor
&
delivery
• Postpartum care
• Gynecological surgery
• Well woman exams
• Family planning
•
Psychiatry & Behavioral Health:
Family Medicine:
Senior Health:
Dentistry:
for all ages
• Care
Annual
• Sick careexams & physicals
• Immunizations
• Chronic disease management
• Family planning
• Counseling & therapy
•
counseling & therapy
• MSubstance
ental health
abuse
treatment
• Assessment of behavioral
problems
• Psychiatric
prescriptions
• Conveniently located at medical clinics
•
medicine
& emergency dental exams
• Internal
• Routine
Sick
care
Dental
fillings
• Immunizations
• Teeth cleaning && extractions
sealants
• Chronic disease management •
• Lab testing
• Geriatric psychiatry & therapy
• Screening & treatment for dementia
•
Pharmacy:
to LSCC patients
• Available
D
iscounted
medications for uninsured patients
•
LSCC is accredited by The Joint Commission, which is recognized
nationally as the gold seal of approval in health care. LSCC also
holds recognition from the National Committee on Quality
Assurance as a Level 3 Patient-Centered Medical Home,
a prestigious designation held by only 0.3% of primary
care practices in the nation.
CALL TOLL-FREE FOR AFFORDABLE, QUALITY HEALTH CARE: 1-877-800-5722
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Lone Star Circle of Care
Our Ser vice s
Locations
Lone Star Circle of Care (LSCC) is a federally qualified community health center focusing on providing a health care
home for all Central Texans, including the uninsured and underinsured. We happily accept patients with no insurance,
CHIP, Medicaid, Medicare, MAP, as well as other private insurance. There are no residency restrictions for receiving
care at LSCC. Uninsured patients are placed on a sliding fee scale based on household size and income. Lone Star
Circle of Care provides the highest possible quality of care for our patients.
Pediatrics & Adolescents:
Women’s Services:
child checks
• Well
• Immunizations
care
• Sick
& sport physicals
• School
Teen
health
• Counseling &caretherapy
•
care
• Prenatal
& delivery
• Labor
Postpartum
• Gynecologicalcaresurgery
• Well woman exams
• Family planning
•
Family Medicine:
Senior Health:
for all ages
• Care
exams & physicals
• Annual
Sick
care
• Immunizations
• Chronic disease management
• Family planning
• Counseling & therapy
•
Lone Star Circle of Care
Psychiatry & Behavioral Health:
health counseling & therapy
• Mental
abuse treatment
• Substance
Assessment
of behavioral problems
• Psychiatric prescriptions
• Conveniently located at medical clinics
•
Dentistry:
medicine
Routine & emergency dental exams
• Internal
•
care
fillings & extractions
• Sick
• Dental
Immunizations
Teeth
cleaning
& sealants
• Chronic disease management •
• Lab testing
• Geriatric psychiatry & therapy
• Screening & treatment for dementia
•
Pharmacy:
to LSCC patients
• Available
• Discounted medications for uninsured patients
Round Rock
Austin
Ben White Health Clinic (Family Medicine)
1221 W. Ben White Blvd, Suite B200
Seton – Circle of Care Family Medicine
at A.W. Grimes Medical Offices
2051 Gattis School Rd, Suite 250
S
Belton
Sparta Road Pediatric Clinic
255 Sparta Road
Cedar Park
Dell Children’s – Circle of Care Pediatrics at Whitestone
1730 E. Whitestone Blvd., Suite 101
Dell Children’s – Circle of Care Pediatrics
at Round Rock Health Clinic
2120 North Mays, Suite 430
S
Behavioral Health at Round Rock Health Clinic
2120 North Mays, Suite 490
S
Round Rock Dental Center
905 North IH-35, Suite 109
512.733.2100
Georgetown
LSCC clinics at Lake Aire Medical Center
2423 Williams Drive
Lone Star Circle of Care OB/GYN
2300 Round Rock Ave, Suite 106 & 208
Dell Children’s – Circle of Care Pediatrics, Suite 103 S
Lone Star Circle of Care Family Medicine, Suite 105 S
Lone Star Circle of Care Senior Health, Suite 113
Lone Star Circle of Care Behavioral Health, Suite 108 S
LSCC clinics at the Texas A&M Health Science Center
3950 North A.W. Grimes Blvd.
Dell Children’s – Circle of Care Adolescent Health, Suite N202
Dell Children’s – Circle of Care Pediatrics, Suite N201
Seton – Circle of Care Family Medicine, Suite N301A S
Seton – Circle of Care Women’s Services, Suite N103
Seton – Circle of Care Behavioral Health, Suite N102 S
Seton – Circle of Care Senior Health, Suite N104
GCC Dental Center
2411 Williams Drive, Suite 111
512.864.1445
Harker Heights
Taylor
Family and Children’s Clinic at Harker Heights (Pediatrics)
200 Nola Ruth
Lone Star Circle of Care Health Center at Taylor (Family Medicine)
305a Mallard Lane
Lone Star Circle of Care Behavioral Health at Harker Heights
775 Indian Trail, Suite 200
Temple
Hutto
Lone Star Circle of Care at Santa Fe (Family Medicine)
600 South 25th St.
Dell Children’s – Circle of Care Pediatrics at Hutto
123 Ed Schmidt Blvd., Suite 140
LSCC is accredited by The Joint Commission, which is recognized
nationally as the gold seal of approval in health care. LSCC also
holds recognition from the National Committee on Quality
Assurance as a Level 3 Patient-Centered Medical Home,
a prestigious designation held by only 0.3% of primary
care practices in the nation.
Killeen
Family and Children’s Clinic at Clear Creek (Pediatrics)
2300 South Clear Creek, Suite 105
S Saturday Hours Available
CALL TOLL-FREE FOR AFFORDABLE, QUALITY HEALTH CARE: 1-877-800-5722
S
Evening Hours Available
CALL TOLL-FREE FOR AFFORDABLE, QUALITY HEALTH CARE: 1-877-800-5722
Lone Star Circle of Care
Nuestro s Se r vi c i os
Lone Star Circle of Care (LSCC) es un centro comunitario reconocido por el gobierno federal enfocado en proveer
cuidados de salud a todos los residentes de la zona central de Texas, incluyendo quienes no tienen suficiente seguro
médico y quienes no están asegurados. Con gusto aceptamos a pacientes que no tienen seguro, CHIP, Medicaid,
Medicare, MAP, ni ningún tipo de seguro privado. No tenemos restricciones de residencia legal para poder recibir
los cuidados médicos en LSCC. Los pacientes que no tienen seguro médico son colocados en una escala de pago de
acuerdo a sus ingresos.
de salud generales
• Exámenes
Vacunaciones
• Cuidado de enfermedades
• Exámenes físicos para la escuela
• o los deportes
• Aadolescentes
tención médica para
• Consejería y terapia
Servicios de la mujer:
prenatales
• Cuidados
• Partos
postnatales
• Cuidados
ginecológica
• Cirugía
E
xámenes
• para
la mujergenerales
• Planificación familiar
Siquiatría y salud del comportamiento
Medicina familiar:
Salud para las personas
mayores:
Odontología:
Pediatría y adolescentes:
para personas de todas
• Clasuidado
edades
anuales y físicos
• Exámenes
Cuidado
de
• Vacunacionesenfermedades
• Control de enfermedades crónicas
• Planificación familiar
• Consejería y terapia
•
en salud mental
• CTratamiento
onsejería y terapia
drogadicción
• Evaluación dedeproblemas
del
• comportamiento
siquiátricas
• Recetas
convenientes dentro
• Sdeervicios
las clínicas
• emergencia
general
• Medicina
y amalgamas
de enfermedades
• Extracciones
• Cuidado
Limpieza
de
dientes
y selladores
Vacunaciones
• Control de enfermedades crónicas •
• Pruebas de laboratorio
• Siquiatría y terapia
•
Exámenes dentales rutinarios y de
Farmacia:
para todos los pacientes de LSCC
• Disponible
M
edicinas
a
descuento para pacientes sin seguro
•
LSCC está acreditado por la Joint Commission, que otorga el
sello dorado de aprobación en cuidados de salud reconocido
a nivel nacional. LSCC también recibe el reconocimiento del
National Committee on Quality, un reconocimiento de prestigio
que solo recibe el 0.3% de los centros de cuidado médico
general en todo el país.
LLAME GRATIS PARA EL CUIDADO DE SALUD ASEQUIBLE Y DE CALIDAD: 1-877-800-5722
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Lone Star Circle of Care
Sucursales
Round Rock
Austin
Clínica Salud de Ben White (Medicina familiar)
1221 W. Ben White Blvd, Suite B200
S
Seton – Circle of Care Medicina familiar
en A.W. Grimes Medical Offices
2051 Gattis School Rd, Suite 250
Belton
Sparta Road Pediatría
255 Sparta Road
Cedar Park
Dell Children’s – Circle of Care Pediatría en Whitestone
1730 E. Whitestone Blvd., Suite 101
Dell Children’s – Circle of Care Pediatría
en Round Rock Health Clinic
2120 North Mays, Suite 430
S
Salud del comportamiento en Round Rock Health Clinic
2120 North Mays, Suite 490
S
Centro de Odontología de Round Rock
905 North IH-35, Suite 109
(512) 733-2100
Georgetown
Clínicas LSCC en el Centro Médico Lake Aire
2423 Williams Drive
Lone Star Circle of Care Ginecología y obstetricia
2300 Round Rock Ave, Suite 106 & 208
S
Dell Children’s – Circle of Care Pediatría, Suite 103
S
Lone Star Circle of Care Medicina familiar, Suite 105
Lone Star Circle of Care Salud para las personas mayores, Suite 113
Lone Star Circle of Care Salud del comportamiento, Suite 108 S
Clínicas de LSCC en el Texas A&M Health Science Center
3950 North A.W. Grimes Blvd.
Dell Children’s – Circle of Care Salud para los adolescentes, Suite N202
Dell Children’s – Circle of Care Pediatría, Suite N201
Seton – Circle of Care Medicina familiar, Suite N301A
S
Seton – Circle of Care Servicios de la mujer, Suite N103
Seton – Circle of Care Salud del comportamiento, Suite N102 S
Seton – Circle of Care Salud para las personas mayores, Suite N104
Centro de Odontología de GCC
2411 Williams Drive, Suite 111
(512) 864-1445
Harker Heights
Taylor
Clínica familiar e infantil en Harker Heights (Pediatría)
200 Nola Ruth
Centro de salud de Lone Star Circle of Care en Taylor (Medicina familiar)
305 Mallard Lane
Lone Star Circle of Care Salud del comportamiento en Harker Heights
775 Indian Trail, Suite 200
Temple
Lone Star Circle of Care en Santa Fe (Medicina familiar)
600 South 25th St.
Hutto
Dell Children’s – Circle of Care Pediatría en Hutto
123 Ed Schmidt Blvd., Suite 140
Killeen
Clínica familiar e infantil en Clear Creek (Pediatría)
2300 South Clear Creek, Suite 105
S Abierto los sábados
S
Abierto las tardes
LLAME GRATIS PARA EL CUIDADO DE SALUD ASEQUIBLE Y DE CALIDAD: 1-877-800-5722
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Legislative Update
Regional Healthcare Coverage
Collaborative
Stacy E. Wilson
Director of Government Affairs
April 5, 2011
Presentation Overview
✚ Political
environment
✚ Budget challenges
at the federal and
state level
✚ Legislative
opportunities
2
Political Environment
✚
✚
✚
✚
Impact of
- political aspirations
- economy
- Tea Party/Leftist
response
Republican supermajority in the Texas
House; majority in the
Senate: budget votes
along party lines
De-funding of family
planning
Disparity between the
House and Senate
3
Federal Budget
Final 2011 budget not
yet adopted
✚ Funding government
through continuing
resolutions
✚ House seeking $61
billion in cuts
✚ May end up with about
half of those proposed
cuts
✚ Even worse in 2012?
✚
4
Possible Local Impact
✚ Cuts
to FQHCs - $1
billion cut proposed
to $2.19 billion total
budget
✚ Family planning cuts
✚ Medicaid block
grants?
✚ Revamping of
Medicare?
5
State Budget
✚ $27
billion deficit
✚ $10 billion deficit in
Medicaid
✚ Use of rainy day
fund only for
current biennium
$4.3 billion deficit
✚ Two budget bills –
one in House and
one in Senate
6
Proposed Health and Human
Services Cuts
✚ Medicaid
provider
reimbursement – 3% 10% but actually
higher without
additional revenue
✚ Family planning
services
✚ Mental health service
funding
✚ HIV/AIDS drugs
7
through ADAP
Potential Local Impact
✚
✚
✚
✚
Less access to care,
especially primary care
and preventive services
Decreased funding for
family planning – more
births/less pre-natal
care
Greater demand on our
emergency departments
where care is more
expensive
Cost-shifting to local
governments
8
Potential Impact – Central Health
✚
✚
✚
✚
✚
Appraisal/revenue caps
Medicaid managed care
rolling out statewide
Ability to serve all
residents
Cost-shifting
- mental health
- ADAP
Continued viability of
safety net
9
✚
✚
✚
Proposed elimination or
reduction of FQHC
incubator fund at DSHS
Proposed elimination or
reduction of funding for
the physician education
loan repayment
program
Elimination of ADAP
(AIDS Drug Assistance
Program) $6,700/person vs.
$12,000/person
10
Bills Filed
15000
10000
5000
0
2003
2007
2009
2011
House
Senate
Total
Passed
✚ Fewer
bills filed than in previous two sessions
✚ Between 5,000 and 6,000 bills pass each
session
✚ Education had the most bills filed - 803
11
Opportunities
✚
✚
✚
✚
Re-authorization of
Women’s Health
Program
Expansion of
telemedicine,
telehealth, and
telemonitoring in
Medicaid
Expansion of scope of
practice of advanced
practice nurses
Greater flexibility
around physician
employment
12
Questions?
www.centralhealth.net
www.communitycaretx.org
[email protected]
(512) 978-8179
Texas Health Steps
An Overview of Medicaid and
THSteps
Objectives
Attendees will learn about the Health
Care Orientation (HCO) requirement for
Simplified Medicaid
Attendees will learn about the benefits
and services available to Medicaid
recipients through age 20 (THSteps)
06/01/11
THSteps Presentation Overview
2
Medicaid Simplification SB43
Medicaid was simplified in 2002
Simplified application, apply by mail, no
face-to-face requirement
Six months continuous eligibility
To avoid further face-to-face interviews:
•
•
Complete Health Care Orientation, and
Keep child current with their THSteps medical and
dental checkups
06/01/11
THSteps Presentation Overview
3
What is included in an HCO?
General Medicaid Information
THSteps Benefits and Services
Responsibility of the Recipient
NOTE: Medicaid simplification is for children
under age 19, but THSteps benefits are
for all Medicaid recipients through age
20
06/01/11
THSteps Presentation Overview
4
How do I get my
Health Care Orientation?
Call THSteps toll-free line at 1-877-847-8377
Home visits by THSteps Outreach & Informing
staff
Visit Texas STAR Representatives
(in managed care area/HHSC offices)
06/01/11
THSteps Presentation Overview
5
What is a Health Care Orientation
or HCO?
Health Care Orientation includes
information on:
• General Medicaid Program
client shouldn’t receive bills,
pays for most health services,
renewal through mail, look for renewal
letters from HHSC
06/01/11
THSteps Presentation Overview
6
Health Care Orientation
includes information on: (continued)
Access to Care
•
•
•
•
STAR / Medicaid Managed Care
1-800-964-2777
•
Enrollment in a Health Plan and Select a PCP
PCCM-Primary Care Case Management
1-888-302-6688
STAR Health
1-866-912-6283
Fee for Service - 1-877-847-8377
06/01/11
THSteps Presentation Overview
7
THSteps - Who Is Eligible?
All clients in the Medicaid Service
Delivery System through age 20
including:
Fee-For-Service
Managed Care (STAR/STAR+PLUS, STAR
Health)
Primary Care Case Management (PCCM)
As certified by HHSC, DFPS, or SSA
06/01/11
THSteps Presentation Overview
8
Goals of the Program
Emphasize early detection and treatment of
medical and dental problems.
Link recipients with primary health care
providers who can meet future health care
needs.
Link recipients with a dental home or primary
dental provider
Bring more infants into health supervision
earlier.
Reach more adolescents.
06/01/11
THSteps Presentation Overview
9
Purpose of Outreach & Informing
Educate Medicaid clients about the benefits of
preventive health care for children
Encourage Medicaid clients to participate in
THSteps benefits and services
Assist Medicaid clients in accessing services and
overcoming barriers to participation.
06/01/11
THSteps Presentation Overview
10
Outreach and Informing
(Continued)
Outreach Counselors
Are actively involved in the community through
participation in Inter-Agency Meetings, Health
Fairs, and presentations at Schools/Head Starts
and other community events.
Employ Targeted Outreach to families needing a
Health Care Orientation, teens/parenting teens,
migrants and other identified populations with
phone calls and home visits.
06/01/11
THSteps Presentation Overview
11
How Do Clients Access
Services?
Certified for Medicaid
Receive Your Texas Benefits Medicaid
card
Checkup reminder letters mailed to each
client
Outreach and informing services from
central office and regional staff
THSteps toll-free line 1-877-847-8377
06/01/11
THSteps Presentation Overview
12
Your Texas Benefits Medicaid card
06/01/11
THSteps Presentation Overview
13
What Happens During a
THSteps Medical Checkup?
Medical History
Physical
Assessment of nutritional,
developmental, and mental health
Lab tests
Vaccines
Health Education
Vision and hearing screening
Referrals as needed
06/01/11
THSteps Presentation Overview
14
Periodic Schedule for THSteps
Medical Checkups
3-5 days, 1-2 weeks,
2, 4, 6, 9, 12, 15, and 18 months
2 and 2 ½ years
3 years and older - every year through
age 20 (on or about the child’s birthday)
Available wallet cards (show checkup
schedule)
06/01/11
THSteps Presentation Overview
15
Dental Services Provided
Routine checkups can start at 6 months of
age and continue every 6 months after that
checkup
More frequent dental checkups for children 6 through
35 months of age can occur based on risk of Early
Childhood Caries (ECC)
Services include
Cleanings/examinations
Sealants
Oral Health Education
Follow up services as necessary
Orthodontia (Braces) if medically necessary
Emergency services at any time, no referral needed
06/01/11
THSteps Presentation Overview
16
Child sick or in pain:
Only go to
Emergency
Room in an
emergency.
problem or condition,
including severe pain, that is
so severe that waiting for
routine care might result in
serious harm. In an
emergency you might not
have time to call a PCP, in
that case call 911 or take
them to the nearest
emergency room.
06/01/11
Emergencies include a
If it is not an emergency,
call your doctor first
THSteps Presentation Overview
17
Medical Transportation Program (1)
For Medicaid recipients with no
other means of transportation
Rural - Van Services
Urban - Public Transportation
Gasoline reimbursement
06/01/11
THSteps Presentation Overview
18
Medical Transportation Program (2)
Clients must:
•
•
•
•
•
Have no other means of transportation
Identify special needs (e.g., use of
wheelchair, attendant, etc.) when
scheduling services
Provide information about the health
care service they are to receive
Utilize MTP only for health care services
that are covered under their program.
Call 2 - 5 days ahead of scheduled
appointment
06/01/11
THSteps Presentation Overview
19
Medical Transportation Program (3)
MTP needs the following information
when scheduling transportation
services:
Client Name
Medicaid Number, SSN or CSHCN Number
Pick up Address and Home Phone Number
Name, Address and Phone # of the health
care service provider
Date, Time and Type of Appointment
Any special needs
06/01/11
THSteps Presentation Overview
20
Medical Transportation Program
Resources
1-877-633-8747 (1-877 MED TRIP)
email at [email protected]
Website:
www.hhsc.state.tx.us/QuickAnswers/index.shtml
06/01/11
THSteps Presentation Overview
21
Case Management
Children and Pregnant Women (CPW)
case management is for high risk pregnant
women and children with a health risk or
health condition.
Case management is provided by social
workers or registered nurses who help an
eligible child/pregnant woman and family
receive services they need such as:
Medical or Dental, Educational, Financial,
Community Resources and Equipment, and
Other issues that affect a child’s health
List of active providers is available at:
http://www.dshs.state.tx.us/caseman/default.shtm
06/01/11
THSteps Presentation Overview
22
Scheduling Assistance
If the family has already chosen a Texas
Health Steps medical, dental, or case
management provider, our staff is
available to help schedule an
appointment for them.
The importance of keeping scheduled
appointments or calling to reschedule
the appointment is also emphasized to
the client.
06/01/11
THSteps Presentation Overview
23
OTHER RESOURCES
Uninsured Children
Children’s Health Insurance 1-800-647-6558 screens for both Medicaid
and Children’s Health Insurance Program (CHIP) eligibility
Simplified process with one application
Children can only receive one of the two programs
www.chipmedicaid.org
WIC
The Women, Infants, and Children Program is a supplemental nutrition
program for pregnant, postpartum, or breastfeeding women, and children
under age 5.
Receive nutrition education, nutritious foods, breastfeeding support,
referrals
1-800-942-3678 (1-800-WIC FOR U)
06/01/11
THSteps Presentation Overview
24
Women’s Health Program
(WHP)
Provides low-income women with gynecological exams,
related health screenings, and birth control through Texas
Medicaid.
Women’s Health Program participants do not receive full
Medicaid benefits. As a result, they are:
Not eligible to enroll in any managed care programs.
Not eligible for services through the THSteps program.
Women’s Health Program toll-free number 1-866-9939972.
www.hhsc.state.tx.us/WomensHealth.htm
06/01/11
THSteps Presentation Overview
25
WHP Eligibility
The Medicaid Women’s Health Program is for women who
meet the following qualifications:
Ages 18 to 44. Women can apply the month of their 18th birthday
through the month of their 45th birthday.
U.S. citizens and qualified immigrants.
Reside in Texas.
Do not currently receive full Medicaid benefits, CHIP, or Medicare Part
A or B.
Are not pregnant.
Are not sterile, infertile or unable to get pregnant due to medical
reasons.
Do not have private health insurance that covers family planning
services, unless filing a claim on the health insurance would cause
physical, emotional or other harm from a spouse, parent, or other
person.
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Contact Information
THSteps toll-free line
Monday through Friday
8:00 a.m. - 8:00 p.m. (Central Time)
1-877-847-8377
Paula Capello, Regional Manager
512-533-3415
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Resources
Health and Human Services Commission
www.hhsc.state.tx.us
THSteps home page:
www.dshs.state.tx.us/thsteps/
THSteps Online Provider Education modules:
http://txhealthsteps.com/
Order THSteps literature:
www.thstepsproducts.com
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