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What is CMH?

The Children with Medical Handicaps (CMH) is a program administered by the Ohio Department of Health that links families of children with special health care needs with health care providers to obtain payment for the medical services their child needs.  Our office helps those families who live in our jurisdictions.  If you wish to visit the Ohio Department of Health’s CMH web page, you can find additional information here.

Proposed Changes to the CMH Program - April 2017

On April 11, 2017, the Speaker of the House of Representatives Cliff Rosenberger hosted a press conference regarding the Children with Medical Handicaps (CMH) Program.  Franklin County Public Health was pleased to learn that the House has decided to remove the budget line from the state budget bill that would change the CMH program from the Ohio Department of Health to Medicaid Managed Care.  They want to ensure predictability, certainty and support for families throughout Ohio who face these challenges.  They stated that they want to further study the program for sustainability outside the scope of the budget bill.

Click here to watch the news conference.

March 2017

Governor Kasich’s two year budget proposal includes changes to the Children with Medical Handicaps Program.  The Ohio Department of Health currently operates the program and the proposal would move it to Medicaid Managed Care effective July 1. 2017.  Under the current program, families with income up to 500 percent of the federal poverty level ($123,000 for a family of four) are eligible.  The change to Medicaid would cut eligibility to 225% of the poverty level for babies born after July 1.

In addition, the program has provided care coordination by a local public health nurse (RN) to assist families with navigating through complex medical and social service needs.  Franklin County Public Health is very proud of that care coordination we provide to the approximately 3,100 children in Franklin County currently enrolled on the program. 

While it sounds like the proposal may be removed from the budget bill, a new bill may be introduced later this year to continue the conversation.

Franklin County Public Health concerns:

  • Although the eligibility for services would be set at 225% of FPL, proposed changes to the program would reduce the number of families who will be eligible for services.  This will cause undue hardship for many working, middle class families currently served by the CMH program.  It may also unintentionally cause strain on other local safety net services.  Raising the eligibility to 400% or higher with a cost share would protect those most vulnerable middle class families.

  • If the model of care for the program is changing, parent choice becomes critically important.  We believe that allowing public health nurses to remain a viable option and guaranteed provider of care coordination services would allow families the choices in the market they need to make good decisions about their child’s care.

What is a Public Health Nurse?

A Public Health Nurse (PHN) is a registered nurse hired by Franklin County Public Health to work with children (ages 0 – 21 years).  A PHN can be an important resource for families who may be working with many agencies and providers of care for their child. The information below will help explain how PHNs can help your family and how PHNs work with CMH. 

A PHN is skilled in working with children and their families. She is also an expert on what assistance is available in your community.

PHNs work with CMH to:

  • Help identify children with special health care needs;
  • Make sure children with special needs are referred to appropriate doctors and other services and supports;
  • Help your family find and use the services needed for your child;
  • Provide you with health care information.

What Services Can a PHN Provide?

PHNs can provide the following services at no cost:

  • Help you learn about your child’s growth and development;
  • Explain the CMH program, the Letter of Approval and other CMH paperwork;
  • Help you understand your child’s plan of treatment;
  • Help you fill out forms for CMH;
  • Refer your child to doctors, other services, supports and resources;
  • Work with other agencies to make sure your child’s needs are met;
  • Help you understand and work with your medical insurance plan;
  • Help you with appeals of denied services;
  • Keep in touch through phone calls, letters, and home visits.
  • Locating CMH providers for your child's needs and services.
  • Linking your child to services and supports through times of transition.

How Can CMH Help My Child?

CMH has three programs to help children with special health care needs: Diagnostic Program, Treatment Program, and Service Coordination Program.  All services must be given by CMH-approved providers.

Diagnostic Program

Children can receive services from CMH-approved providers, to rule out or diagnose a special health care need or establish a plan of treatment. These services may include:

  • Tests and x-rays
  • Visits to CMH-approved doctors
  • Up to five days in the hospital
  • Public health nursing services
  • Therapy evaluations

Treatment Program

Children can receive services from CMH-approved providers for treatment of an eligible condition. Both medical and financial eligibility are required for the Treatment Program. Treatment services may include:

  • Laboratory tests and x-rays
  • Physician visits
  • Prescription medications
  • Therapies
  • Medical equipment and supplies
  • Surgeries and hospitalizations
  • Service coordination
  • Public health nursing services

Service Coordination

This program helps families locate and coordinate services for their child. This is a limited program, available to children with specific conditions, who are seen by a team of providers at hospitals approved by CMH for service coordination.

How Do I Get Started?

  • Apply at your child’s CMH-approved doctor’s office

- or -

  • Contact our office at (614) 525-5960 or email us.

Frequently Asked Questions

What are special health care needs?

Special health care needs may be caused by a condition a child is born with or develops later.

Which children are eligible for CMH?

Those children who are:

  • Age 0 – 21
  • Permanent residents of Ohio
  • Under the care of a CMH-approved doctor and who have or may have a chronic medical condition


What medical conditions are eligible for CMH?

Some of the eligible conditions include, but are not limited to:

  • Diabetes
  • Cerebral palsy
  • Hearing loss
  • Spina bifida
  • Chronic lung disease
  • Cystic fibrosis
  • Hemophilia
  • Metabolic disorders
  • Sickle cell disease
  • Cancer
  • AIDS
  • Severe vision disorders
  • Cleft lip/palate
  • Scoliosis
  • Juvenile arthritis
  • Congenital heart disease


What medical conditions are NOT eligible for CMH?

  • Allergies
  • Acute or infectious conditions
  • Conditions that are self-correcting through growth
  • Developmental delay
  • Learning disabilities
  • Behavioral conditions
  • Nearsightedness/farsightedness
  • Psychological or emotional disorders

Forms & Brochures

Annual Newsletter
Resource List
What is a PHN?
CMH Informational Brochure
HIPAA/ FCPH’s Privacy Practice Summary in English | Spanish | Somali
Family Handbook for Families of Children with Special Health Care Needs in Ohio

Keeping Current

Submit the following changes to us by phone, fax or email. It is VERY important to keep this information current:

  • ADDRESS
  • PHONE NUMBER(S)
  • INSURANCE
  • NAME (YOURS OR YOUR CHILD’S)
  • NEW MEDICAL SERVICES, NEEDS OR DIAGNOSES
  • MANAGING CMH DOCTOR

Your PHN will contact you to verify the changes in your information. If you don’t hear from her, please call (614) 525-5960 or email us.

Renewal Process

  • Your child must see their managing physician at least once per year to be eligible to apply for renewal of CMH services for the next year.
  • Renewal for the CMH Treatment program is on a yearly basis. It is not automatic!
  • You should receive your renewal packet approximately two months before the Letter of Approval (“LOA”) will expire. Call your PHN when you receive your packet! She will help you with the renewal application and take care of referrals and services needed prior to the LOA expiring.
  • If your child is covered by Medicaid or Medicaid managed care plans, you will not receive a renewal packet. Your financial eligibility will be automatically renewed.
  • If your child loses Medicaid benefits because you did not show up for your Medicaid appointment, or failed to turn in the necessary paperwork, you may lose your CMH coverage.

Reminders

  • Your child must see their CMH-approved managing physician at least once per year to be eligible for CMH.
  • If you lose Medicaid coverage due to financial reasons, contact your PHN.  You will NOT lose CMH coverage for this reason until your current LOA expires.
  • Your LOA is like an insurance card. Take it to all medical appointments so that all specialists are aware of CMH coverage.
  • All services must be given by CMH-approved providers. Care from a non-CMH provider will result in you having to pay the bill for those services.
  • If your child begins seeing a new specialist, contact your PHN to discuss if additional services can be added to the LOA.
  • Costshare is a CMH financial assistance program that may be available to families that are determined to be over income for CMH services and have received a Denial of Service letter. Call (614) 525-5960 and your PHN can help you with this program.
  • If you receive a Denial of Service letter, please call your PHN at (614) 525-5960.
  • If you ever have any questions about the CMH program, please call your PHN at (614) 525-5960 or email us.

Frequently Asked Questions

Who is my Public Health Nurse?

Call (614) 525-5960 to be connected to your PHN or email us.

Having problems with medical bills, services or prescriptions?

Call (614) 525-5960 to be connected to your PHN or email us and we’ll help resolve your problems.

Would you like a Home Visit for your child?

Call (614) 525-5960 to be connected to your PHN or email us to request a home visit.

I lost my Letter of Approval!

Call (614) 525-5960 to be connected to your PHN or email us. We’ll help you obtain a new copy.