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Navigating Systems of Navigating Systems of Care: Care: Finding the RIGHT Care for Finding the RIGHT Care for Your Child or Teen Your Child or Teen Developed by the LA Family to Family Health Information Center A statewide program of Bayou Land Families Helping Families

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  • 1. Navigating Systems of Care: Finding the RIGHT Care for Your Child or TeenDeveloped by theLA Family to Family Health Information CenterA statewide program of Bayou Land Families Helping Families

2. Who Can Help My Family?Feelings families can experience when they dont know where to go for help. ANXIETY ANGERFRUSTRATIONADVOIDANCE HELP!CONFUSIONSADNESS 3. Families Helping Families Network of Regional Resource Centers servingindividuals with disabilities and special needsand their families and the professionals whoserve them. Staffed by families who, through their ownexperiences, are committed to reaching out toother families who have members withdisabilities or special needs. 3 Core Servicesinformation & referraleducation & trainingpeer support 4. Families Helping FamiliesEach regional center is an independentnon-profit;Each provides a lending library;Computer available for families andprofessionals for research;Education and Medical Advocacyinformation and services;1-800-922-DIAL (3425)[email protected] 5. Families Helping FamiliesOrleans, Plaquemines, St. BernardAvoyelles, Concordia, Catahoula, Grant, LaSalle,1-877-243-7352 Rapides, Vernon, Winn 1-800-259-7200 Ascension, East & West B.R., East & West Feliciana, Bienville, Bossier, Caddo, DeSoto, Natchitoches, RedIberville, Pointe CoupeeRiver, Claiborne, Lincoln, Sabine, Webster 1-866-216-74741-877-226-4541 Assumption, Lafourche, St. James, St. John, Caldwell, East & West Carroll, Franklin, jackson, Terrebonne, St. Charles, St. MaryMadison, Morehouse, Ouachita, Richland, Tensas,1-800-331-5570Union1-888-300-1320Acadia, Evangeline, Iberia, Lafayette, St. Landry, St.St. Tammany, St. Helena, Livingston, Washington,Martin, Vermilion Tangipahoa 1-800-378-9854 1-800-383-8700Allen, Beauregard, Calcasieu, Jefferson Davis, CameronJefferson1-800-894-6558 1-800-766-7736These FHF Centers havestatewide programs. 6. Bayou Land Families Helping FamiliesServing St. Charles, St. James, St. John, St. Mary, Assumption, Terrebonne and Lafourche 286 Hwy 3185 Thibodaux, LA 703011-800-331-5570 or 985-447-4461Fax: 985-447-7988Web Site: www.blfhf.org Email Address: [email protected] 7. Bayou LandFamilies Helping Families 8. LA Family to Family HealthInformation Center Or C hildren and YouthS tatewide who Have an E xtendedIllnes s .C hildren and Provides Health and YouthHealth C are FinancingA ges 0-26 InformationWith S pecial C onnects to Health C are Res ources Needs or, Provides Training toAt Ris k for Families and Youth S pecial Health 9. Louisiana Family VoicesLouisiana Chapter of Family Voices Advocating for family centered care forchildren with special health care needs http://www.familyvoices.org/ 10. Additional Bayou Land FHF ProgramsearlySteps Community Outreach SpecialistsChildrens Special Health Services Parent LiaisonsEducation AdvocatesTransition SpecialistsVarious other programs that support individuals with disabilities, their families and the professionalswhoserve them. 11. State Programs 12. D e p a rtm e n t o f H e a lt h & H o s p it a ls O f f ic e o f C it iz e n s O f f ic e o f M e n t a lO f f ic e o f P u b lic O f f ic e o f H e a lthw / D e v e lo p m e n t a l H e a lthH e a lth S e r v ic e s D is a b ilit ie sF in a n c in gR e g io n a l R e s o u r c e C e n te rs C h ild /A d o le s c e n t R e s p o n s e T e a mC e n t e r fo r C o m m u n it y H e a l th M e d i c a idL a H IP Pe a r ly S te p s L a -Y E S C e n te r fo r C o m m u n ity P r e p a r e d n e s sK i d M E D & C o m m u n it y C A R E LaM O M s M e d ic a id W a iv e r S e r v ic e s ECSSC e n t e r f o r P r e v e n t a t i v e H e a l thL a C H I P , L a C H I P A f f o r d a b le M e d ic a id P u r c h a s e P la n C a s h S u b s id y P r o g r a m F O A M e d i c a idT a k e C h a rge C o m m u n ity H e a lth :C o m m u n ity P r e p : P r e v e n ta tiv e H e a lth :R e g io n a l E m e rg e n c y P rep S c h o o l B a s e d H e a lt h C t r sO P H C li n i c sH e a lth L A 2 0 1 0 CSHS I n ju r y P r e v e n t i o n / F lu H e a r in g , S p e e c h , V is io n F a m ily P la n n in gH I V /A I D S Im m u n iz a tio n P r o g r a m s S A F E K ID SW ICC o u n c il o n O b e s ity P r e v . 13. Human Services Authorities or Districts Legislatively defined and approved. Consolidate funding from Office of Citizens with Developmental Disabilities, Office of Behavioral Health(Mental Health and Addictive Disorder Services) Local governance by a Board of Directors for fundingallocations Same services provided with more flexibility.All OCDD services can be accessed through SCLaHSAexcept Resource Center services. 14. Office of Citizenswith Developmental Disabilities (Services provided through South Central Louisiana Human Service Authority) 15. Office for Citizens with DevelopmentalDisabilitiesServes Individuals who have disabilities that result in substantial functional limitations in 3 or more of the following areas of major life activity:(a) Self-care;(b) Receptive and expressive language;(c) Learning;(d) Mobility;(e) Self-direction;(f) Capacity for independent living;(g) Economic self-sufficiency;and, is not attributed solely to mental illness; Reflects the persons need for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services which are of lifelong or extended duration and are individually planned and coordinated, or A substantial developmental delay or specific congenital or acquired condition in a person from birth through age nine which, without services and support, has a high probability of resulting in those criteria listed above later in life that may be considered to be a developmental disability. 16. Office for Citizens with Developmental DisabilitiesOCDD within the Department of Health and Hospitals serves as the Single Point of Entry (SPOE) into the Developmental Disabilities (DD) Services System.Community services regional offices and human servicesauthorities/districts serve as the points of entry forindividuals to receive services from both the regionaloffices/human services authorities/districts and thesupports and services centers. 17. Office of Citizens with Developmental Disabilities Programs and ServicesThe Individual and Family Support Program providesresources to people with developmental disabilities to allowthem to live in their own homes or with their families in theirown community. Services include, but are not limited to:respite care, personal assistance services, specializedclothing, dental and medical services not covered by othersources, equipments and supplies, communication services,crisis intervention, specialized nutrition, and family education.The Cash Subsidy Program provides a monthly stipend tofamilies of eligible children with severe disabilities, until theage of 18. Funds are intended to help families meet theextraordinary cost associated with maintaining their child inthe home. Stipends are awarded on a first come, first servebasis to eligible children with exceptionalities identifiedthrough the Department of Educations Pupil AppraisalEvaluation. 18. Office of Citizens with DevelopmentalDisabilities Programs and Services Louisianas Early Intervention SystemFor Louisiana for families with children ages 0 to 3 yearswith a diagnosed physical or mental condition and/ordevelopmental delay. Early Steps provides acoordinated, family focused system of support andservices at no cost to families. earlySteps is designed tomeet the developmental needs of each eligible child andto enhance the familys ability to respond to their childsdevelopmental needs in a natural environment. Servicesmay include: occupational therapy, physical therapy,speech therapy and other services. 19. Office of Citizens with DevelopmentalDisabilities Programs and Services System Points of Entry for earlyStepsOrleans, Plaquemines, St. BernardVernon, Rapides, Winn, Grant, LaSalle, Catahoula,(877) 595-3408 Concordia, Avoyelles 1-866-445-7672East & West B.R., East & West Feliciana, PointeCaddo, Bossier, Webster, Claiborne, Bienville,Coupee, Iberville, Ascension Natchitoches, Sabine, De Soto, Red River1-866-925-2426 1-866-676-1695Assumption, St. John, St. Charles, St. James,Ouachita, Union, Jackson, Lincoln, Caldwell,Terrebonne, Lafourche, St. MaryMorehouse, East & West Carroll, Richland,1-866-891-9044 Franklin, Tensas, Madison 1-877-322-4788Lafayette, Iberia, St. Martin, Vermillion, St. Landry, St. Tammany, Livingston, St. Helena, Tangipahoa,Evangeline, Acadia Washington1-866-494-8900 1-866-640-0238Beauregard, Jefferson Davis, Allen, Cameron, Jefferson ParishCalcasieu1-866-296-07181-866-494-8900 20. Office of Citizens with Developmental Disabilities Programs and ServicesHome and Community-Based Waiver Services Available to individuals with developmental disabilities. These waivers are actual waivers of the usual Medicaid income and other requirements. Through waivers, a variety of services and supports are available to allow individuals to reside in community settings other than ICFs/DDs (Intermediate Care Facilities).NOW, ROW, Childrens Choice, Supports 21. Office of Citizens with Developmental Disabilities Programs and ServicesA word about Medicaid waivers...Medicaid has an entitlement to nursing home/institutional care. Institutional care is extremely costly. Waivers waive usual requirements for Medicaid allowing servicesto be provided in home and community based settings at lower cost withgreater outcomes for individuals with disabilities. Waivers are optional for states. States must file applications for waivers to Centers for MedicaidServices. Stakeholder input must be included. Waivers can have very long waiting lists if sufficient matchingstate funds are not provided for legislatively. 22. Office of Citizens with DevelopmentalDisabilities Programs and ServicesThe New Opportunities Waiver (NOW) is available forindividuals to be able to live in the community. NOW isintended to provide specific, activity focused servicesrather than continuous custodial care.The following are the services provided under the NOW:Individual and Family Support (IFS) Service-Day-Night;Center-Based Respite; Community Integration andDevelopment; Home adaptations; Specialized MedicalEquipment and Supplies; Supported Living; SubstituteFamily Care; Day Habilitation and Transportation;Supported Employment and Transportation; EmploymentRelated Training; Professional Services; PersonalEmergency Response System; Skilled Nursing Services;and One-Time Transitional Services. 23. Office of Citizens with DevelopmentalDisabilities Programs and Services The Residential Options Waiver (ROW) enables Money- Follows-the-Person strategies for people served in ICFs/DD (Intermediate Care Facilities for individuals with Developmental Disabilities) and nursing facilities to move to a comprehensive HCBS waiver option so that they can live in the community in a residential setting of their choice. 24. Office of Citizens with DevelopmentalDisabilities Programs and ServicesChildrens Choice is an intermediate level waiver service,is for Children under age 19. Individuals on the waitinglist for other long-term waivers may opt for ChildrensChoice and receive capped services until a full waiverslot is available or they turn 19.Medicaid services are provided with Childrens Choice andincluding EPSDT screenings and extended services, andup to $15,000 per year in Childrens Choice servicesincluding required Support Coordination (casemanagement).Children who age out (reach their 19th birthday) Transferwith their waiver to the most appropriate waiver optionfor them, as long as they remain eligible for waiverservices. 25. Office of Citizens with DevelopmentalDisabilities Programs and ServicesChildrens ChoiceEPSDT services MAY include respite assistance if the childis medically involved and needs assistance with dailyliving tasks or has other health needs. 26. Office of Citizens with DevelopmentalDisabilities Programs and Services Cash SubsidyCash Subsidy provides a monthly stipend to familiesof eligible children with severe or profounddevelopmental disabilities from birth to age 18.Funds are intended to help families meet theextraordinary costs associated with maintaining theirchild in the home. 27. Office of Citizens with DevelopmentalDisabilities Programs and Services Community Support TeamsIntensive treatment intervention allowing individuals withdevelopmental disabilities to remain in their community livingsetting.These supports and services include: initial and ongoingassessment, psychiatric services, family support andeducation, support coordination and any other services criticalto an individualt s ability to live successfully in the community. CST teams, consisting of psychologists, social workers,nurses, and psychiatrists, provide supports and services on a24-hour, 7 day a week basis. CST Team supports and services are provided in thecommunity rather than in an office-based practice andcombine skill teaching with clinical management. There are nine (9) CST Teams located in various regionsthroughout the state; they are managed through localdevelopmental centers and accessed through RegionalOffices. 28. Office of Citizens with DevelopmentalDisabilities Programs and Services Extended Family Living (EFL)Extended Family Living provides supports and servicesto people with developmental disabilities, regardless oftheir age, in the home of non-related persons. Thesehome settings are approved and routinely monitored bypublic and private providers. EFL supports and services are provided for the purposeof meeting the physical, emotional, educational,habilitative, and social needs of the individual in a familysetting. 29. Office of Citizens with Developmental Disabilities Programs and ServicesFive Resource Centers provideleadership, enhance communication andcollaboration, and increase the availabilityand capacity of support and services topeople with developmental disabilities.Services provided include trainingopportunities, training curriculumdevelopment, provision of resourcematerials, resource guides, peer reviews,and program reviews. 30. Office of Citizens with DevelopmentalDisabilities Programs and ServicesMedical, Dental and Allied Health SupportsEstablish training programs that educate medical and dentalstudents.(Operation House Call in New Orleans- exposes pediatric andfamily medicine residents to the daily routine of parents who have achild with a disability living at home. In an effort to educateprofessionals, the family has a chance to demonstrate not only theextraordinary challenges they face as a family caring for a child witha disability, but also the natural acceptance and dignity the familyhas in recognizing the child as a vital, important part of the family.)Identifying, publishing and disseminating available dentaland medical resources.Providing limited medical and dental services to people withdevelopmental disabilities living in the community through trainingmodules. 31. Office of Citizens with Developmental Disabilities Programs and ServicesNutritional,Physical & Nursing SupportsGeneral health and specialized care for people with developmentaldisabilities through community-based partnerships and collaborativerelationships with individuals, families, providers, educational institutions,and community professionals. Supports and services include, but are notlimited to educational/training events and materials, consultations, andtechnical assistance.Fills service gaps and improves service delivery efforts through partnershipsand collaborations connecting the person with systems and individualsupports.Training Topics May include: Nutritional/Physical Support; WheelchairSeating; Transfer/Handling Techniques; Fall Prevention; TherapeuticPositioning; Fracture Reduction; Gastroesophageal Reflux Issue; AspirationIssues; Health Risk Screening; ; Seizure Management; DiabetesManagement; Infection Control Practices; Basic Health Care Concepts;Emergency First Aid; Dysphagia (difficulty swallowing); Preventive HealthCare Strategies; and more. 32. Office of Citizens with DevelopmentalDisabilities Programs and ServicesPsychiatric and Behavior SupportsCommitted to increasing community capacity to support and include peoplewith developmental disabilities. The Resource Centers serve individualswith developmental disabilities experiencing psychiatric and/or behavioralchallenges and their families, community practitioners and private and non-profit providers who serve individuals with developmental disabilities anduniversity students.They may provide workshops on Psychiatric topics such as AAIDD Positive Behavior Support Training; In-Service Training for Community Providers/Supports and Services Centers; Program Review of Psychiatric and Behavioral Services; Individual Consultations; Library Consortium. 33. Office of Citizens with Developmental Disabilities Programs and ServicesCommunity InclusionThe Resource Centers explore and develop exemplary models ofservice delivery and promising practices which support communityinclusion, accessibility, personal choice and independence of peoplewith developmental disabilities. Initiatives and trainingopportunities focus on the following areas as they apply to CommunityInclusion: Personal Outcomes; Relationship/Friendship Building;Health and Wellness; Employment; Housing; and, Transportation. 34. Office of Citizens with DevelopmentalDisabilities Programs and ServicesAging with Developmental DisabilitiesProvide community resources and training on such topics as relationship building; care giving; housing; transportation; health and wellness; age- related diseases; long term planning, and; end of life care.Activities may include:Developing and providing community capacity building in the areas of aging with developmental disabilities through training events/educational materials, consultations, technical assistance, and limited direct services;Building partnerships and collaborative relationships with providers, community professionals, other state agencies, educational institutions, professional organizations, and other stakeholders to efficiently target gaps and improve multiple efforts;Recruiting and retaining highly qualified and capable professionals to maintain and increase the pool of expertise in Louisiana, andAccomplishing and promoting research and publication. 35. Office of Citizens with DevelopmentalDisabilities Programs and Services Resource CentersOCDD Resource CenterOCDD Resource CenterOCDD Resource45439 Live Oak Drive3501 5th Avenue, Suite C2 CenterHammond, LA 70401 Lake Charles, LA 706075401 Shed RoadPhone: (225)567-7391Phone: (337) 475-8084 Bossier City, LA 71111Phone: (318) 741-5327OCDD Resource CenterOCDD Resource Center4460 General Meyer Avenue P.O. Box 5191New Orleans, LA 70131 Pineville, La 71360Phone: (504) 364-6600Phone: (800) 584-8511 36. Office for Citizens withDevelopmental DisabilitiesHow Do I Apply for Services?Contact your regional OCDD or Human Service Authority.http://new.dhh.louisiana.gov/index.cfm/subhome/11/n/8 1.866.783.5553 37. Office for Citizens with DevelopmentalDisabilities Metropolitan Human ServiceCapitol Area Human Service South Central Louisiana HumanDistrictDistrictServices Authority1010 Common Street, 5th Floor4615 Government St., 2nd Floor690 East First Street New Orleans, LA 70113Baton Rouge, LA 70806 Thibodaux, LA 703011-800-889-2975 1-800-768-88241-800-861-0241 Community Services Office Community Services OfficeCommunity Services Office214 Jefferson Street, Ste. 301 3501 Fifth Avenue, Ste. C2 429 Murray Street - Suite BLafayette, LA 70501 Lake Charles, LA 70605Alexandria, La 713011-800-648-14841-800-631-8810 1-800-640-7494 Community Services Office Community Services OfficeFlorida Parishes Human Service3018 Old Minden Road - 122 St. John StreetAuthoritySuite 1211Rm. 343 21454 Koop Drive - Suite 2HBossier, LA 71112Monroe, LA 71201Mandeville, La 70471 1-800-862-1409 1-800-637-31131-800-866-0806 Jefferson Parish Human ServiceAuthority 3300 W. Esplanade, Ste 213 Metairie, LA 70002 (504) 838-5357 38. Office of Mental Health (OMH)Services provided throughSouth Central Louisiana Human Service Authority 39. Office of Mental Health Programs & ServicesOMH family support services assure that families have the necessary personal support, information and skill to cope, to maintain family integrity, and to enhance the likelihood that children with serious emotional disturbance can successfully remain at home. Service elements include respite care, care and education, telephone trees, parent support groups, parent case manager training, home aide services, transportation, and advocacy services. 40. Office of Mental Health Programs & Services Supported living services, either through specialized residential programs or through case management and other services which support persons living in their own homes, are available throughout the State. Individuals with serious psychiatric disabilities are provided with services necessary to address both their housing and mental health/rehabilitative needs. The types of housing resources available for adults include group homes, supervised apartments, respite apartments, board and care homes, foster care, and individual residences with support. For adolescents, housing is limited to group homes and foster care. 41. Office of Mental Health Programs & Services Day Programs & PsychosocialRehabilitation Programs Provide opportunities for teaching new rehabilitative skills related to community living and work activities; build networks of peer support; teach self-help community activities; and provide a place where individuals can learn how to relate to persons and communicate their needs and desires successfully. In addition, day programs provide secure, structured environments where individuals experiencing disruption in routine behaviors brought on by their illness can receive treatment and support. Day programs also provide structured activities which allow children and adolescents with severe emotional disturbances to remain in school. Each of the nine mental health planning regions has at least one psychosocial program which provides for the development of both social and vocational rehabilitative needs of each person who utilizes the programs resources. The number of hospital days experienced annually by persons before and after coming to these programs typically drops from a pre-program average of 60 days to six to ten days post-program enrollment. 42. Office of Mental Health Programs &ServicesDay Programs & Psychosocial Rehabilitation ProgramsMagnolia Family Services, LLC For Medicaid Patients Only Psychiatric evaluations medication management, family and individual therapy, parenting skills development, child skills development, psychosocial skills training, behavior modification,educational interventions.Services are available to children and adolescents with a recenthistory of behavior and/or emotional problems, adults with a recenthistory of emotional/psychological conflicts, those receiving or whohave received help with little or no success and individuals needinglong-term treatment to make positive changes in their lives. 43. Office of Mental Health Programs & ServicesDay Programs & Psychosocial Rehabilitation ProgramsMagnolia Family Services, LLC 106 Hickory StreetThibodaux, LA 70301 Phone: 985-449-4055 Fax: 985-449-4178 Emergency: 985-447-1319magnoliafamiliyservices.com 44. Office of Mental Health Programs & ServicesCrisis Management ServicesCrisis services are provided on a 24-hour basis. These services are designed to provide a quick and appropriate response to individuals who are experiencing acute distress. Care services include telephone counseling and referrals, face-to-face screening and assessment, community housing for stabilization and crisis respite.REGION 3 CRISIS LINE CHILDREN OR ADULTS1-800-535-3694 AFTER 4:30PM OR WEEKENDS 45. Office of Mental Health Programs & ServicesChild/Adolescent Response TeamThe Child and Adolescent Response Team is a response toyour request for support services during times when achild or adolescent appears to be in crisis. Any childbelow the age of 18 may receive services. Any child orchilds guardian may call CART to request services,regardless of income level or insurance.The Child and Adolescent Response Team was designedto assist children and their parents during times of crisisby providing support for the family in their own resolutionof the crisis. A variety of services are available, and arepersonally tailored to suit your needs. CART services areavailable 24 hours a day, 7 days a week. 46. Office of Mental Health Programs & ServicesEarly Childhood Supports and Services Program (ECSS)ECSS is a group of parents, advocates, interested community members as wellas public and private agencies. These agencies provide services to childrenages 0-5 and their families.This group meets, at least monthly to discuss children and their families who have been referred for service coordination. If you can answer yes to any one of the following questions, then you may want to ask about participating in the ECSS program: Are you worried about the effects of arguing on your young child? Are family needs getting in the way of you working, returning to school, or achieving your life goals? Are you worried about other family members because of a seriousproblem that has not been corrected? Do you have problems getting help for your child or family? Does your young child (age 0-5) and family need assistance due to adevelopmental delay, diagnosed medical condition, family history ofmental illness or substance abuse? 47. Office of Mental Health Programs & ServicesEarly Childhood Supports and Services Include: Referral to appropriate supports and services Case Management Clinical Case Management Behavior Modifications Counseling Parent Support Groups Training and Technical Assistance Consultation to other providers and/or agencies Infant Mental Health Screening Infant Mental Health Assessment Emergency Intervention Funds to purchase supports and services Other services specified in service plan such as domestic violence;child abuse; advocacy on behalf of the parent and child; referral toaddress medical needs; referral to public assistance; medication referral; referral for parent/family/peer support; and educationalopportunity referral for parents. 48. Office of Mental Health Programs & Services Early Childhood Supports and ServicesEligibility: Families of children who are 0-5 and who are at- risk of removal from home or school due to behavioral problems. Families of children who have multiple risk factors such as abuse, neglect, exposure to violence, poverty, developmental disability, etc which have been documented by one of the participating agencies. 49. Office of Mental Health Programs & ServicesPARTICIPATING AGENCIES:Early Childhood Programs: Head Start, HIPPY, Early Steps, Child Care AssistanceEducational Needs: Speech, Occupational or Physical Therapy, Special InstructionMental Health: Counseling, Medicine Management, Community SupportPublic Health Programs: WIC, Family Planning, ImmunizationsFamily Support: Financial NeedsParenting Center: Parenting ClassesOther Community ServicesContact any one of the participating agencies or call (800) 342-2629 50. Office of Mental Health Programs &Services Metropolitan Human ServiceOffice of Mental HealthSouth Central Louisiana HumanDistrictMonroe Area Services Authority New Orleans Area1-318-362-33391-985-857-3615 After Hours: 800-256-2522 After Hours: 1-504-556-97301-800-535-3694Jefferson Parish Human ServiceOffice of Mental Health Office of Mental HealthAuthority Shreveport Area Alexandria AreaEast Bank: 504-838-5257 1-318-676-51111-318-487-5611 West Bank: 504-349-8833Adult Crisis: 1-866-416-5370 After Hours:1-800-654-1373After Hrs.: 504-832-5123Child Crisis: 1-800-820-6143Office of Mental HealthOffice of Mental Health Capitol Area Human ServiceLake Charles Area Lafayette AreaDistrict1-337-475-8022 1-337-262-4100 Baton Rouge Area 1-225-922-2700 Florida Parishes Human Service Mandeville Area 1-985-748-222-0 51. Office of Public Health 52. Office of Public Health Programs & ServicesCommunityCARE is a comprehensive health delivery system or MedicalHome for linking Medicaid recipients to a Primary Care Physician (PCP). ThePCP manages the care of each CommunityCARE enrollee by providing healtheducation, preventive care, and acute care and refers the enrollee tospecialists when needed. The PCP also admits enrollees to the hospital. ThePCP shares medical information with the emergency room and otherauthorized health care providers. The CommunityCARE PCP arranges formedical care coverage 24-hours a day, seven days a week.This Medical Home is the first place enrollees turn to for their health careneeds. The PCP establishes an on-going relationship with eachCommunityCARE enrollee. 53. Office of Public Health Programs & ServicesWho is eligible for CommunityCARE?Most low-income families with children, disabled adults and children whoare Medicaid recipients are required to participate in CommunityCARE withsome exceptions. Certain medically high risk patients may warrant the direct care and supervision of a non-primary care specialist. Requests for medical exemptions are reviewed for approval on a case by case basis. Requests must be submitted in writing, along with supporting medical documentation of the recipients medical condition(s). Requests for medical exemption should be mailed to: DHH- CommunityCARE Program, P.O. Box 91030, Baton Rouge, LA 70821, Attention: Angela Mastainich, Program Coordinator. A preprinted request form is available on the CommunityCARE web site, www.la-communitycare.com . 54. Office of Public Health Programs & ServicesChildrens Special Health ServicesCSHS is a program of services provided through the Louisiana Office of Public Health for children in Louisiana who have special health care needs.The CSHS program provides services for children with certain chronic physical illnesses or serious disabilities which cause significant limitations in major life activities.Children Who Are Eligible:Live in Louisiana and are under 21 years of age;Have a condition which can benefit from rehabilitation services, is coveredby CSHS and requires long term treatment by specialists, physicians andmulti-disciplinary staff.Meet financial guidelines established by CSHS. 55. Office of Public Health Programs & ServicesChildrens Special Health ServicesServices include:Doctors and other health care workersMedical tests and proceduresHospital careTherapiesHome health servicesMedical equipment and suppliesParent/family support servicesMedications and special dietsNursing, nutrition and social services follow-upCare coordination, case management, and resource development 56. Office of Public Health Programs & ServicesChildrens Special Health ServicesHow Does a Family Apply For CSHS?The application process starts at your local parish health unit. Aparent can contact the parish health unit or the CSHS RegionalOffice where the child lives for further information. A referral from aphysician or audiologist is needed. 57. Childrens Special Health Services REGIONAL OFFICESREGION Resource Center 504-896-1340REGION II 225-242-4890(No Direct Services) 353 N. 12th St., Room 95200 Henry Clay Ave., Suite 2016Baton Rouge, LA 70802New Orleans, LA 70118Ascension, E. Baton Rouge, E. Feliciana, Iberville, PointeJefferson, Orleans, Plaquemines, St. Bernard Coupee, W. Baton Rouge, W. FelicianaREGION III 985-447-0896REGION IV337-262-5616, Ext 1062535 Veterans Blvd.220 West Willow St., Building AThibodaux, LA 70301Lafayette, LA 70508Assumption, Lafourche, St. Charles, St. James, St. John, Acadia, Evangeline, Iberia, Lafayette, St. Landry, St.St. Mary, Terrebonne Martin, VermilionREGION V337-480-2552 REGION VI 318-487-52823236 Kirkman Street (P.O. Box 3170), 5604 A Coliseum Blvd.Lake Charles, LA 70602 Alexandria, LA 71303Allen, Beauregard, Calcasieu, Cameron, Jefferson Davis Avoyelles, Catahoula, Concordia, Grant, LaSalle, Rapides, Vernon, WinnREGION VII 318-676-74881035 Creswell Avenue REGION VIII318-361-7282 1650 Desiard StreetShreveport, LA 71101Bienville, Bossier, Caddo, Claiborne, DeSoto,Monroe, LA 71201Natchitoches, Red River, Sabine, Webster Caldwell, E. Carroll, Franklin, Jackson, Lincoln, Madison, Morehouse, Ouachita, Richland, Tensas, Union, W. CarrollREGION IX15481 W. Club Deluxe Rd.Hammond, LA 70403985-543-4165 Livingston, St. Helena, St. Tammany, Tangipahoa, Washington 58. Office of Public Health Programs & ServicesShots for TotsIn 1992, Shots for Tots was created in response to the low levels of immunizations among preschool children and the epidemic outbreaks of measles in Louisiana. Children are required to be fully immunized when entering school, however, by waiting until they enter school, we leave our children susceptible to vaccine preventable diseases for two or three years. The vision of Louisianas Infant Immunization Initiative is to see 90% of all children immunized with their primary series by age two. Unfortunately, the National Immunization Survey 2007 reflects that among Louisiana children 19-35 months of age only 77.0% (+6.1) are fully immunized. Clearly, our goal has not been met.Shots for Tots is a network of public and private entities workingcooperatively to update and educate both parents and providersalike in order to ensure the highest level ofimmunizations possible because Louisianasmost valuable assets are its children. 59. Office of Public Health Programs & Services Shots for TotsPolio VaricellaMumps HepatitisMeasles InfluenzaChickenpoxRubellaWhooping CoughRotovirusBacterial MeningitisPneumococcalIt is veryimportant for yourDiphtheriababy to get theseLock Jawshots on time. 60. Office of Public Health Programs & Services Shots for TotsCheck with your babys Doctor or Health Unit to see that your child is up-to-date.Write Shots for Tots 1450 L & A Road Metairie , LA 70001Call 1-800-251-BABY 61. Office of Public Health Programs & ServicesKIDMED is the screening component of one ofLouisianas Early Periodic Screening,Diagnosis and Treatment (EPSDT) Programs.EPSDT provides preventive health screening,diagnosis, and treatment services for suspectedvision, hearing, dental and medical problems.Louisiana has been nationally recognized ashaving one of the top five EPSDT programs in thenation, exceeding goals for EPSDT participationset by the Center for Medicare and MedicaidServices (CMS). EPSDT services are available toMedicaid-eligible children under the age of 21.EPSDT benefits end on the childs 21st birthday. 62. Office of Public Health Programs & Services AIDS Drug Assistance Program (ADAP)ADAP provides assistance to individuals living with HIV/AIDS to purchase HIV-related prescription medications. ADAP provides this assistance for persons who do not have private health insurance, do not qualify for Medicaid or are awaiting Medicaid coverage and cannot afford to pay for medications.Current Eligibility Criteria * Documented HIV infection; * Documented Louisiana residence; *Documented household income at or below 200% of the Federal Poverty Level; * No third partyprovider for protease inhibitors or antiretroviral outpatient medications (including privateinsurance and Medicaid. See below for information regarding Medicare Part D); * Currentprescription for medication(s) covered by the Louisiana ADAP formulary, written by a licensedphysician; and * No financial assets exceeding $4,000 (excluding a house and a car)Enrolled in the program at all regional LSU Medical Centers which are the charity hospitals inLouisiana. Potential program candidates can be screened for eligibility status and enrolled on thesame day. The medical and financial eligibility screening process takes approximately two weeks.For more information contact; Heather Weaver LCSW Louisiana ADAP Coordinator, HIV/AIDS Program 1010 Common St, 11th Floor, New Orleans, LA 70112 Direct Phone 504-568-5489, Direct Fax 504-568-7042 Main Office Phone [email protected] http://www.dhh.louisiana.gov/offices/page.asp?ID=264&Detail=7901 63. Office of Public Health Programs & Services School-Based Health CentersWHY ON A SCHOOL CAMPUS?Students spend a significant portion of their day on school grounds. SBHCs are accessible, convenient, encourage family and community involvement, reduce student absenteeism, reduce parental leave from work for doctor visits, and work with school personnel to meet the needs of the students and their families.Parental consent must be obtained prior to seeing a student as a patient.ADOLESCENT SCHOOL HEALTH INITIATIVE ACT (R.S. 40:31.3)This law authorizes the Office of Public Health to facilitate and encourage the development of comprehensive health centers in Louisiana public schools. It specifically prohibits counseling or advocating for abortion and the distribution of contraception. 64. Office of Public Health Programs & Services School-Based Health Centers(Minimum) STAFF Primary Care Provider (Physician, Physician Assistant, or Nurse Practitioner) Physician Medical Director Registered Nurse Masters Level Mental Health Provider Administrator Office AssistantSERVICES Primary and preventive health care including, comprehensive exams and sports physicals, immunizations, health screenings, acute care for minor illness and injury, and management of chronic diseases such as asthma Mental health services Health education and prevention programs Case management Dental services Referral to specialty care Louisiana Childrens Health Insurance Program (LaCHIP) application centers 65. Office of Public Health Programs & ServicesSchool-Based Health Centers2008-2009 SCHOOL-BASED HEALTH CENTER SITESLouisiana is in the forefront in the SBHC movement, with 62 SBHCs in 26 Louisiana Parishes serving 95 public schools and providing access to nearly 60,000 students in the 2008-09 school year. http://www.dhh.louisiana.gov/offices/reports.asp?ID=255&Detail+808 All information on School Based Health Centershttp://www.dhh.louisiana.gov/offices/?ID=255 66. Office of Public Health Programs & Services Sound Start Louisianas Hearing, Speech and Vision ProgramThe Sound Start Program began in 1994 with a handful of volunteers who successfully sponsored legislation mandating newborn hearing screening on all infants at-risk for hearing loss. Further legislation passed in 1999 and signed into law in 2000 mandated hearing screening on all infants born in or transferred to a facility in Louisiana. No state funding was appropriated for this effort.The mission of this program is to assure that all infants who are deaf or hard of hearing can achieve their maximum potential in life. That is accomplished by assuring that early intervention services are secured as soon as possible. Early intervention may include the fitting of hearing aids and early developmental services before the child reaches six months of age.The Advisory Council will be developing guidelines for screening pass/ refer criteria, appropriate hospital supervision guidelines, protocols and procedures for pediatric diagnostic audiology assessment.Regional directories for the eight other regions of the state will be completed.Continuing education in pediatric testing and hearing aid fitting will be provided statewide. 67. Office of Public Health Programs & ServicesLouisianas Hearing, Speech and Vision ProgramThe Sound Start Program is working towards helping each hospital in the statereach 100% compliance law. The professionals involved with this project include:The Advisory Council made up of representatives from many disciplines wasappointed by the Governor to serve three-year terms. This council advises theOffice of Public Health on the rules and regulations, quality assurance, and programplanning and evaluation.Two State Coordinators and nine Regional Task Force Coordinators areavailable to help each hospital create and manage the highest quality hearing-screening program.An Epidemiologist is involved in collecting, analyzing, and managing the data fromthe birthing and screening programs, tracking the follow-up data from diagnosticsources and early intervention programs, and developing reports. 68. Office of Public Health Programs & Services Louisiana Childhood Lead Poisoning Prevention Programhttp://www.dhh.louisiana.gov/offices/?ID=360 69. Office of Public Health Programs & Services Louisiana Comprehensive Hemophilia Care CenterThe Louisiana Comprehensive Hemophilia Care Center diagnoses,evaluates and treats patients with congenital and acquired conditionsof bleeding such as hemophilia, von Willebrand disease and otherrare factor deficiencies. Located at the Tulane University School ofMedicine in New Orleans, La. with an outreach clinic in Lafayette, La.This multi-disciplinary clinic is open to all ages. Patients fromLouisiana and the gulf coast region may be referred by their physicianor may self-refer. The Center is the only federally-funded hemophilia treatment center (HTC) in Louisiana and offers a comprehensive model of care which includes evaluation and treatment recommendations from hematology, nursing, physical therapy, social work, dental and orthopedic services. This approach has been proven to address health and emotional issues of patients with this chronic disease. 70. Office of Public Health Programs & ServicesLouisiana Comprehensive Hemophilia Care CenterThe HTC also offers a home infusion program that allows for prompt therapy to reduce bleeding complications, as well as access to new therapies through numerous clinical research trials. In addition, the HTC operates a 340B program by which patients can obtain their clotting factor concentrates at reduced costs to help maintain insurance coverageThrombosis clinic The HTC thrombosis clinic serves patients who are genetically predisposed to clotting, as well as those patients with acquired thrombophilia. They offer genetic testing, counseling, the most recent advances in anticoagulation management, patient education, and patient advocacy to those who are affected by thrombosis. Thrombosis patients are seen by Dr. Cindy Leissinger and Dr. Rebecca Kruse- Jarres. Both are hematologists that specialized in hemostasis, thrombosis and platelet dysfunctions. 71. Office of Public Health Programs & ServicesLouisiana Comprehensive Hemophilia Care CenterReferrals can be made by contacting Alicia Cole RN, BSN at 504 988-5433 or [email protected] Louisiana Center for Bleeding and Clotting DisordersTulane University Health Sciences Center1430 Tulane AvenueNew Orleans, LA 70112-2699504-988-5433hhttp://www1.omi.tulane.edu 72. Office of Public Health Programs & Services WIC (Women, Infants and Children)Special Supplemental Nutrition Program for pregnant,breastfeeding, and postpartum women, infants, andchildren (under 5 years old). WIC providesnutritious foods, nutrition information, and referralsto other health and social services. The foodsprovided may include: infant formula and cereal,adult cereals low in sugar and high in iron, milk(and lactose-reduced milk), cheese,juice, eggs, peanut butter or driedbeans/peas carrots, and canned tuna. 73. Office of Public Health Programs & ServicesWIC Income Eligibility Levels 2011-2012Your gross income cannot exceed:For more than 10 householdHouseholdGross Annual Gross Monthly members, or for incomequestions, call 1-800-251-BABY 1$20,147$1,679or your WIC Clinic. Individuals 2$22,214$2,268 with proof of Medicaid, FoodStamps, or TANF automatically 3$34,281$2,857meet income requirements. 4$41,348$3,446**O ne pregnant woman 5$48,415$4,035counts as 2 household 6$55,482$4,624 members. 7$62,549$5,213 8$69,616$5,802 9$76,683$6,391 10 $83,750$6,980 74. Office of Public Health Programs & Services WIC Locationshttp://www.dhh.louisiana.gov/offices/page.asp?id=320&detail=7658 75. LA Bureau of Protective ServicesReport neglect, abuse, extortion orexploitation of adults with disabilities, ages18-59. 1-800-898-4910 1-225-342-9057 P.O. Box 3518, BIN#11Baton Rouge, LA 70821 76. Office of HealthServices Financing 77. Health Services Financing Programs F a mil y Op p o r t u n it yLaMOMS LaHIPPAc tM e d ic a id B u y - I n 78. Health Services Financing Programs & ServicesInpatient Hospital Services.Outpatient Hospital Services.Prenatal Care.Vaccines for Children.Physician Services.Nursing Facility Services for persons aged 21 or older.Family Planning Services and Supplies.Rural Health Clinic Services.Home Health Care for persons eligible for Skilled-NursingServices.Laboratory and X-ray Services.Pediatric and Family Nurse Practitioner Services.Federally qualified Health-Center (FQHC) Services, andAmbulatory Services of an FQHC that would be available inother settings. 79. Health Services FinancingPrograms & ServicesEarly Periodic Screening, Diagnostic, and Treatment(EPSDT) Services for children under age 21.Diagnostic Services.Clinic Services.Intermediate Care Facilities for individuals withcognitive disabilities (ICFs/MR).Prescription Drugs and Prosthetic Devices.Optometrist Services and eyeglasses.Nursing Facility Services for children under age 21.Transportation Services.Rehabilitation Services.Home and Community-Based care tocertain persons with chronicimpairments.Continued 80. Health Services Financing Programs & Services LA Medicaids Friends & Family Transportation ProgramPays your friend or family member to take you to the doctor.To qualify, you must already receive Medicaid benefits ANDYour friend/family member must:Have a current LA Drivers LicenseHave a current LA State Inspection StickerHave minimum liability care insurance as required by the Stateof LAFill out an application and receive an approval letter from theFriends & Family Transportation Program. 81. Health Services FinancingPrograms & ServicesLA Medicaids Friends & Family Transportation Program YOU NO LONGER NEED TOHAVE THE APPLICATION NOTARIZED!All thats needed is 2 witnessesto the signature. 82. Health Services FinancingPrograms & ServicesLA Medicaids Friends & Family Transportation ProgramTo get an application, call the transportation contractor inyour area or visit the web atwww.Medicaid.DHH.Louisiana.govBaton Rouge 1-800-259-1944New Orleans 1-800-836-9587AFTER Qualifying:Call the Transportation Contractor at least 24 hrs. beforeeach appointment to let them know the date and time ofyour appointment. Call ASAP after emergency visits. 83. Health Services Financing Programs & ServicesF a mil y Op p o r t u n it y Ac t M e d ic a id B u y - I n For families with children with disabilities includingmental health and behavioral disabilities as well asdevelopmental; Parents may buy-in to the Medicaid program at low ratepremiums ($15-$35 per month); Premium covers all children in family who havedisabilities; Gives more children with disabilities access to the fullrange of Medicaid services 84. Health Services FinancingPrograms & ServicesMonthly Income Levels Income Limits through# of FamilyMonthly Income March 2012 Members ------------1$2,708 Add $935 for each2$3,643additional family member3$4,578over 94$5,513F a mil y Op p o r t u n it y5$6,448Ac t6$7,383M e d ic a id B u y - I n 85. Health Services FinancingPrograms & Services 86. Health Services Financing Programs & ServicesLouisiana provides health benefits for eligible children from birth up to age 19 using special income amounts and fewer requirements than other Medicaid programs. Even if your income is more, your children may still qualify. You can receive deductions from your total income for: Earned Income, Childcare Payments, Child Support Received, Child Support Payments to someone outside the home.Services Provided By LaCHIP: Doctor Visits Hospital, Dental, Hearing and Vision Care Lab Work & Tests Immunizations (shots) Prescription Medicines Medical Equipment & Supplies Medically Necessary Transportation Speech & Language Therapy Physical Therapy Occupational Therapy Mental Health Clinic Services Psychological Tests & Therapy Appointment Scheduling Assistance 87. Health Services Financing Programs & ServicesMust be under age 19Eligibility must first be explored for more generous benefitsMedicaid if income is below 100% or 133% FPL Regular LaCHIP if too high for Medicaid up to 200% FPLEligible for LaCHIP Affordable Plan up to 250% FPL12 month waiting period for households who drop insurance withoutgood cause**Call #1-877-252-2447 for information on good cause reasons 88. Health Services FinancingPrograms & ServicesGood Cause Reasons Divorce or death of parent Lifetime maximum reached COBRA coverage ends Lay-off or business closure Changed jobs & new employer does not offerdependent coverageEmployer stops providing dependent coverage Monthly premium > 10% of gross income 89. Health Services FinancingPrograms & Services$50 monthly premium per familyNo deductible except a $200 mental health deductibleCo-pay levels like State Group Benefits PPO$150 Emergency Room co-pay (if not admitted) Prescription co-pays A percent of charges (e.g. 10% or 20% or between $8 to $16 for most visits)Annual cap on out-of-pocket cost is 5% of family grossincome. 90. Health Services FinancingPrograms & ServicesCoverage begins the month following approval after firstpremium payment has been receivedOnce a family pays out-of-pocket costs equaling 5% ofannual income, no additional co-pays or premiums forremainder of plan yearNo cost sharing for Native Americans who are members of afederally recognized tribeNo Dental or Vision Benefits. 91. Health Services FinancingPrograms & Services Same services as Medicaid Same services and Providers as Operated under the State Workers BenefitsMedicaid Program Operated under the Louisiana Income eligibility up toOffice of Group Benefits200% FPL Income eligibility up to 250% FPL 92. Health Services FinancingPrograms & Services# in HouseholdLaCHIP LaCHIP Affordable1$1,805$2,2572$2,429$3,0363$3,052$3,8154$3,675$4,5945$4,299$5,3736$4,922$6,153Add $624 for each Add $780 for each additional family additional family member member in householdin household 93. Health Services Financing Programs & Services Common Questions regarding LaCHIP and LaCHIP Affordablehttp://www.dhh.state.la.us/offices/faq.asp?ID=119 94. Health Services Financing Programs & ServicesAny pregnant woman, married or single, may apply forhealth coverage. Income limits are higher soworking couples can make more money and still beeligible. Resources like bank accounts, cash onhand, cars or property are not counted. You canhave other insurance coverage in addition to thiscoverage. Your other insurance will pay first; thenLaMoms will cover the amount that is left, up to theMedicaid allowed amount.Covered Services:Pregnancy-Related ServicesDelivery and care up to 60 days after your LaMOMSpregnancy endsDoctor VisitsLab Work/ TestsPrescription MedicinesHospital Care 95. Health Services FinancingPrograms & ServicesTo Apply You Will Need: Social Security Number Proof of the total family income Proof of expected date of delivery Health Insurance cards if you have other health insurance Proof of child support payments made to someone outside of your home Receipts for the care of a child or an adult with a disability LaMOMS You may be eligible to be paid back for medical services received up to 3 months before you applied if you are eligible on the date the services was received and you used a Medicaid provider and the service is covered by the Medicaid Program. You may use any doctor who is enrolled as a Medicaid Provider.For more information about the LaMoms Program contact 1-888-342-6207 96. Health Services FinancingPrograms & ServicesFamily SizeMonthly Income Amount2 $2,4293 $3,0524 $3,6755 $4,2996 $4,9227 $5,5458 $6,169 LaMOMS 97. Health Services Financing Programs & ServicesLouisiana Health InsurancePremium Payment Program(LaHIPP)May provide assistance for the cost ofprivate health insurance through LaHIPPyour employer.Call 1-866-362-5253www.LaHIPP.DHH.Louisiana.gov 98. Health Services FinancingPrograms & ServicesLaHIPP may pay some or all of the health insurance premiums foran employee and their family if they have insurance availablethrough their jobs and someone in the family has Medicaid. Thosegetting Medicaid will also be able to have health insurance.People who get Medicaid and have group health insurance availablefrom a job, and working parents or guardians and their children ordependents who get Medicaid may be eligible.Even if employment ends, the continuing health insurance that maybe available from your employer (also known as COBRA) may alsobe paid.LaHIPP 99. Health Services Financing Programs & ServicesHow LaHIPP works:People who have Medicaid and can get healthinsurance from a job may qualify for LaHIPP. Otherpeople in the home who can join the health plancould also qualify.LaHIPP will send the family a letter, an application forLaHIPP, and a copy of the Employer HealthInsurance Information Form that must be filled out LaHIPPby a human resource representative where the adultin the family works.After getting this information, the LaHIPP program looks Send the at how much it would cost to join the health plan. If completed this is less than what Medicaid would pay for medical services for the person on Medicaid, then forms to LaHIPP will pay some or all of the cost of theLaHIPP within insurance from the job. 30 days. 100. Health Services Financing Programs & ServicesThe TAKE CHARGE/ Family Planning programcovers services such as:4 Yearly physical examinations or necessary re-visitsLaboratory tests for the purpose of FamilyPlanningApproved medications and supplies (example:birth control pills, patches, IUDs diaphragms, etc.)There is a limit of FOUR visits per calendar year (includinginitial visit and revisits). Primary care services are NOTcovered by the TAKE CHARGE program. When a need forprimary care treatment is identified during a family planningwaiver visit, the waiver participant will be given informationabout primary care providers. 101. Health Services FinancingPrograms & ServicesFamily Size Monthly Income Limit1$1,6692$2,2463$2,8234$3,3995$3,9766$4,5537$5,1298$5,706 102. Health Services FinancingPrograms & ServicesTo get health coverage through Medicaid Purchase Plan, you must have a severe disability work be at least age 16 but not yet age 65 have COUNTABLE monthly income that is less than $2,257 have COUNTABLE assets that are less than $25,000 take other health insurance coverage, if you can get it at no cost to you pay a premium when your COUNTABLE monthly income is more than $1,354.MPP COUNTS less than half of the money you earn (work for) and all but $20 of any other money you get.NOT COUNTED: Home, one vehicle,life insurance policy, medical savings,retirement accounts, spouses share ofany community property. 103. Health Services FinancingPrograms & ServicesAccessing State Health Services Assistance LaMOMSF a mil y Op p o r t u n it yLaHIPPAc tM e d ic a id B u y - I n 104. Health Services FinancingPrograms & Services Louisiana Online ApplicationCenterhttps://bhsf2eb.dhh.louisiana.gov/onlineapppublic/secure/ 105. Health Services Financing Programs & Services Accessing LaCHIP & LaCHIP AffordableInformation you will need: Social Security number for anyone applying for coverage, proof of family income, proof of child support payments, receipts for the care of a child or disabled adult, proof of expected date of delivery for anyone who is pregnant.Download instructions and paper application at:http://www.dhh.louisiana.gov/offices/publications.asp?ID=119&Detail=607 106. Health Services Financing Programs & ServicesAccessing Family Opportunity Act MedicaidApplication available at:http://bhsfweb.dhh.la.gov/onlinemanualspublic/mfmpublicnonfill able/1-foa.pdf F a mil y Op p o r t u n it yAc tM e d ic a id B u y - I n 107. Health Services FinancingPrograms & ServicesAccessing Other Medicaid ProgramsApplication Web Links:LaMomshttp://www.dhh.louisiana.gov/offices/publications.asp?ID=137&Detail=99Medicaid Purchase Planhttp://www.dhh.louisiana.gov/offices/publications.asp?ID=136&Detail=486Take chargehttp://www.dhh.louisiana.gov/offices/publications.asp?ID=291&Detail=1385 108. Community and Provider Specific Programsand Additional Resources 109. Provider Specific Programs Childrens Healthcare Assistance Plan (CHAP) assists families with income too high to qualify for Medicaid, but whose lack of resources limit their access to quality healthcare. Includes children whose family income is between 200% (Medicaid limit) and 350% of the Poverty Income Guidelines Covered services include Inpatient, Short Stay Services, Outpatient Clinics, Emergency Room, Therapies provided by Childrens Hospital and The Toothbus visits. Limited to participating physician services performed at Childrens Hospital 110. Provider Specific ProgramsACCESSING CHAPS:Applications can be completed upon registration or admission to Childrens Hospital or can be received via mail by calling (504) 894-5166 or by visiting:http://www.chnola.org/PageDisplay.asp?p1=4294Eligibility RequirementsProof of Income must be submittedReview of Medicaid Eligibility*Appropriate proof of income must be submitted with your application. Copies of pay stubs, forms approving or denying unemployment compensation or workmens compensation, written verification of wage from agencies (e.g. SSI, AFDC, Private Employer) are examples of income. 111. Provider Specific Programs # in ABHousehold 1$21,780 $38,115 2$29,420 $51,485 3$37,060 $64,855 4$44,700 $78,255 5$52,340 $91,595 6$59,980 $104,965 7$67,620 $118,335 8$75,260 $131,705 112. Provider Specific ProgramsDental care at substantiallyreduced fees at StudentClinicsPayment plans are not available because of the reduced fees;therefore, patients are expected to pay for services at the time of theappointment. Any treatment that involves laboratory costs must bepaid in advance of the procedure. Private dental insurance is notaccepted in lieu of payment; however, the students can assist incompleting claim forms for the reimbursement of out-of-pocketexpenses. For questions regarding private insurance please call(504) 941-8116. Medicaid, which covers most dental care forchildren under 21 and dentures for adults, is accepted and thepatient will incur no out-of-pocket expenses if the care is pre-authorized. 113. Provider Specific Programs Patient Information / AppointmentsNew Orleans Campus Clinic Telephone (504) 619-8700 or 619-8770 *(Dental appointments are not given through email.) Appointments for ChildrenTelephone 941-8201 (age 0-6) 941-8196 (age 7-13) or 896-1337 (clinic at Childrens Hospital) Endodontics AppointmentsTelephone 941-8402 (referral by a dentist required) Fax 941-8400 Orthodontics AppointmentsTelephone Numbers (504) 619-8572Faculty Dental Practice(504)619-8721 Baton Rouge South Campus Clinic Telephone (225) 334-4934 114. Provider Specific Programs Sickle Cell Anemia ClinicsSickle Cell Center of Southern LA Childrens Hospital1415 Tulane Avenue200 Henry Clay AvenueNew Orleans, LA 70112 New Orleans, LA 70118504-988-5413504-896-9740Adult Sickle Cell Day Hospital:504-988-1250Ochsner Foundation Hospital Earl K. Long Sickle Cell Clinic1516 Jefferson Hwy(LSU Pediatric Medical Home)Jefferson, LA 70121 1401 North Foster DrivePediatrics: 504-842-3900 Ext. 63037 Baton Rouge, LA 70806Adult: 504-842-3910 225-987-9061St. Jude Affiliated Clinic 7777 Hennessy Blvd., Suite 312Baton Rouge, LA 70808 225-763-6337 115. Federally Funded Health CentersFederally-funded health centers care for you, even if you have no health insurance. You pay what you can afford, based on your income. Health centers provide2. checkups when youre well3. treatment when youre sick4. complete care when youre pregnant5. immunizations and checkups for your children6. dental care and prescription drugs for your family7. mental health and substance abuse care if you need itHealth centers are in most cities and many rural areas.http://findahealthcenter.hrsa.gov/ 116. Federally Funded Health CentersBayou CountryTECHE ACTION CLINICTECHE ACTION CLINICTECHE ACTION CLINIC809 W. Tunnel Boulevard189 Mozart Drive (DULAC)PIERRE PARTHouma, LA 70360-5555 Houma, LA 70363-7990 3617 Hwy 70 S.985-851-1717 337-282-2550 x 104 Pierre Part, LA 70339-4455985-252-6211TECHE ACTION CLINICTECHE ACTION CLINICTECHE ACTION CLINIC1115 Weber Street159 E. 3rd Street471 Central AvenueFranklin, L a 70538-4124 Edgard, LA 70049-2450Reserve, LA70084-5509337-828-2550x 104337-828-2550 x 104 337-828-2550 x 104 TECHE ACTION CLINIC 471 Central Avenue Reserve, LA70084-5509 337-828-2550 x 104 117. Federally Funded Health Centers River ParishesST. CHARLES COMMUNITY ST. CHARLES COMMUNITY JEFFERSON COMMUNITYHEALTH CENTER HEALTH CENTERHEALTH CARE CENTERKENNER PEDIATRICS MOBILE UNIT 11312 Jefferson Hwy200 W. Esplanade Ave., Ste. 310 4105 David DriveRiver Ridge, L A 70123-1709Kenner, LA 70065-2474 Kenner, LA 70065504-463-3002985-785-5800x 5803985-785-5800ST. CHARLES COMMUNITY ST. CHARLES COMMUNITY JEFFERSON COMMUNITYHEALTH CENTER HEALTH CENTER HEALTH CARE CENTER843 Milling Avenue15464 River Road4028 US Hwy 90Luling, LA 70070-4442 Norco, LA 70079-2530Avondale, LA 70094985-785-5800 x 5803 985-785-5800504-463-3002 118. LATANLA Assistive Technology Access NetworkLow-interest, long-term assistive technologyloans for items like computers with adaptiveinput/output devices, closed circuit TV for sightimpaired, Brailling machines, new and usedvehicle loans for modified vehicles, vehiclemodifications, augmentative or alternativecommunication devices, telecommunicationdevices, adaptive home modifications likeramps, prosthetics and/or orthotics,environmental control units, wheelchairs bothpowered and manual, and more. 119. LATANLA Assistive Technology Access Network 3042 Old Forge RoadBaton Rouge, LA 70808 1-800-270-6185/ 225-925-9500 Fax 225-925-9560 www.latan.org 120. CEREBRAL PALSY OF LAGrants up to $2,000 per individual per year to be used for:Equipment purchasesTherapies 2380 Barataria Blvd., Suite 5Marrero, LA 70072 (504)341-06761-800-375-8275Email: [email protected] 121. Prescription Drug AssistanceCenla Medication Access Program helps with free prescriptions forLouisiana residents.Must be a resident of Louisianawith income at or below 200% of Federal Poverty Leveland no prescription coverage, Insurance or Medicaidand 18 years old or older. 1-888-443-7494 or visit www.cmaprx.org 122. Prescription Drug AssistanceThe Partnership for Prescription Assistance brings together Americaspharmaceutical companies, doctors, other health care providers, patient advocacyorganizations and community groups to help qualifying patients who lackprescription coverage get the medicines they need through the public or privateprogram thats right for them. Many will get them free or nearly free. Its mission isto increase awareness of patient assistance programs and boost enrollment ofthose who are eligible. Through this site, the Partnership for PrescriptionAssistance offers a single point of access to more than 475 public and privatepatient assistance programs, including more than 180 programs offered bypharmaceutical companies. To access the Partnership for Prescription Assistanceby phone, you can call toll-free, 1-888-4PPA-NOW (1-888-477-2669).https://www.pparx.org/Intro.php 123. Prescription Drug AssistancePrescription Drug Assistance ListingsExtensive list of medications and the contactinformation for the companies that make them.http://www.nami.org/Content/ContentGroups/Helpline1/Prescription_Drug_Patient_Assistance_Programs.htm Free or low-cost medications provided by pharmaceuticalcompanies Some pharmaceutical companies offer medication assistanceprograms to low-income individuals and families. These programstypically require a doctors consent and proof of financial status.They may also require that you have either no health insurance, orno prescription drug benefit through your health insurance. Pleasecontact the pharmaceutical company directly for specific eligibilityrequirements and application information. 124. Prescription Drug AssistanceNeedyMeds, Inc.Web site: www.needymeds.com Phone: 1-215-625-9609Provides info on drug assistance programs, including requirements andapplication forms.If You Are Not Eligible for Medicare, Do Not Have Drug Coverage, and Have Limited Income Together Rx Access Card Web site: www.together-rxaccess.com Phone: 1-800-444-4106 Created to help people who do not have prescription drug coverage save on brand-name prescription drugs, other prescription products, and a wide range of generic drugs. To get a card, you must meet all of the following criteria: not eligible for Medicare; have no prescription drug coverage (public or private); household income equal to or less than $30,000 for a single person, $40,000 for a family of two, $50,000 for a family of three, $60,000 for a family of four, and $70,000 for a family of five (income limits may be higher in Alaska and Hawaii); legal United States resident. Information in English and Spanish. 125. Prescription Drug AssistanceIf You Have Health InsuranceHealthWell FoundationWeb site: www.healthwellfoundation.org Phone: 1-800-675-8416HealthWell Foundation is a non-profit, charitable group that helps certainpeople who cannot pay for their prescription drug costs, insurancepremiums, and co-payments of private insurance, employer-sponsoredinsurance plans, Medicare, or Medicaid. It also can help with some otherout-of-pocket health care costs. The program serves only those with certainhealth conditions, which are posted on the Web site. Only certain cancersare included in their coverage.Patient Advocate Foundation Co-Pay Relief Assistance Program Web site: www.copays.org Phone: 1-866-512-3861 The Patient Advocate Foundations Co-Pay Relief Assistance Program helps patients who meet certain requirements pay for the prescriptions and treatments they need. This program is available only to people with certain medical conditions who also have insurance (including Medicare or Medicaid). Only certain cancers are included in their program. (Spanish and English.) 126. Prescription Drug Assistance If You Have Health InsurancePatient Services Incorporated (PSI) Web site: www.uneedpsi.orgPhone: 1-800-366-7741 A national, non-profit helping patients with certain chronic illnesses and their families with health insurance premiums and medicine co-payments. Assistance is based on severity of the medical and financial need. PSI also helps locate and purchase health insurance coverage. Only a few cancers are included in this program.Patient Access Network Foundation Web site: www.patientaccessnetwork.org Phone: 1-866-316-7263 A non-profit helping under-insured patients who cant afford out-of-pocket costs for their treatment. The program helps patients with certain medical conditions who meet their financial, insurance, and medical requirements. (Only certain cancers are included in their program. 127. Prescription Drug AssistanceContact the Louisiana Family to FamilyHealth Information Center for acomprehensive Prescription Drug Assistance Packet1-800-331-5570 128. Federal Pre-Existing Condition Insurance Apply at www.pcip.govCovers range of health benefits including primary and specialty care,hospital care and prescription drugs.Premiums are not higher because of your medical condition.Does not base eligibility on income.Must be a citizen or national of the US or lawfully present.You must have been uninsured for at least 6 months.You must have had a problem getting insurance due to a pre-existingcondition. 129. La Health Plan InsuranceHigh Risk PoolResident of LA for at least 6 monthsIneligible for other major health insurance2 written denials of coverage within last yearIneligible for Medicaid, Medicare, COBRACannot be terminated due to non-payment6 month waiting period for pre-existing conditionsincluding prescription drugs. 130. La Health Plan Insurance HIPAAResident of LA for at least 6 monthsIneligible for other major health insuranceMust apply before or within 63 days of last day of coverageMust have 18 months creditable coverageMust elect and exhaust COBRARecent coverage must have been groupIneligible for Medicaid, Medicare, COBRACannot be terminated due to non-paymentNo pre-existing condition for children who are special enrollees thatenroll within 63 days of birth, adoption or placement for adoption12 month pre-existing condition for other special enrollees (ex.Spouse)NO WAITING PERIOD FOR PRE-EXISTING CONDITIONS FORELIGIBLE ENROLLEES UNDER HIPAA. 131. La Health PlanInsuranceLouisiana Health Plan 1-800-736-0947www.lahealthplan.org 132. Pre-Existing Condition InsuranceContact the Louisiana Family to FamilyHealth Information Center for acomprehensivePre-Existing Condition Insurance Packet1-800-331-5570 133. Anger Management GroupsBayou Council on Alcoholism446-0643 134. Grants for Medical ServicesUnited Health Care Childrens Foundation Assistance grants for medical services not fully covered by private insurance. (Ex. Speech therapy, physical therapy, psychotherapy, wheelchairs, braces, hearing aids and eye glasses www.uhccf.orgDisabled Childrens Relief Fund Provides children with disabilities with assistance for wheelchairs, orthopedic braces, walkers, lifts, hearing aids, eye glasses, medical equipment, therapy and surgery.www.dcrf.com 135. Other Mental Health ServicesCenter for Child and Family Development 873-7221 Takes children as young as 3 years old. 136. Support GroupsCHADD TGMC Outreach Center (Houma Mall)858-7020La Federation of Families for Childrens Mental Health THIBODAUX REGIONAL MEDICAL CENTER, 602 N. Acadia Rd.Support groups are confidential. Always held 5-6pm. Reservations are required: CHRISTINE HYMEL @ 985-870-8811B.R.I.D.G.E.S. For individuals recovering from mental illness1-877-274-3446FathersNetwork www.fathersnetwork.orgFor fathers raising children with special healthcare needs ordevelopmental disabilities. 137. Eye Glasses$25 Eye Glasses www.25dollareyeglasses.netVision USA Eye health/vision services free of charge to families who do not qualifyfor government aid or private insurance due to income. 1-800-766-4466Kellum Eye Center Provides free eye exams, glasses, medications and eye surgeries.(Assists only 4 people per week. 872-5577 138. Eye GlassesNew Eyes for the Needy Must meet poverty guidelines of program-provides vouchers foreyeglasses. 1-973-376-4903 or www.neweyesfortheneedy.orgSight for Students Eye Exams and glasses to children 18 or younger whose parents meetthe poverty guidelines and have no insurance. 1-888-290-4964Knights Templar Eye Foundation Assistance for eye surgery for those with no insurance and unable topay. 1-847-490-3838 139. Eye GlassesLions Clubs Lions Club Phone: Bayou BlueCoteau Lions Club 856-0448 Bourg Lions Club 594-2054 Chauvin Lions Club 594-8276 East Houma Lions Club851-1810 Evergreen Lions Club 876-6935 Evergreen sunset Lions Club851-3141 or 868-2901 Golden Meadow Lions Club 693-3308 Houma Lions Club 879-4663 Lockport Lions Club532-2554 Montegut Lions Club594-5454 or 594-5960 or 594-7789 Raceland Lions Club537-76332 Terrebonne Lions Club876-3047 Thibodaux Lions Club 446-6329 or 447-3017 West Houma Lions Club868-3152 140. Hearing AidsAudient Hearing aid assistance for all ages with hosehold income up to 250% offederal poverty level. 1-866-956-5400 or www.audientalliance.orgStarkey Hear Now Program Assistance for low income families with hearing aids at reduced costs.1-800-328-8602 or www.starkeyhearingfoundation.orgUnited Health Care Childrens FoundationAssistance grants for medical services not fully covered by privateinsurance. (Ex. Speech therapy, physical therapy, psychotherapy,wheelchairs, braces, hearing aids and eye glasses 1-800-3289-5979 ext. 24459 (11a-3p, M-F)www.uhccf.orgwww.betterhearing.orgAdditional financial resources. 141. Any Questions? 142. F2FHIC Website http://www.blfhf.org/f2fhic/index.phpHIC Home PageMedical DiaryAdvocacy Medical HomeFact SheetsPagePage Paying forFamily VoicesMedical CostsLink TransitioningHC Providersand Info Youth. 143. Reminder Bring your childs IEP, last evaluation and medical information. Call the local FHF center. (www.fhfla.org) McKinney-Vento Homeless Act your child is entitled to attend any school anywhere if you are homeless. 144. PLEASEComplete your evaluations! 145. Karen ScallanProgram DirectorLouisiana Family to Family Health Information CenterA Statewide Program of Bayou Land Families Helping [email protected] Hwy 3185Thibodaux, LA 70302985-447-4467 or 800-331-5570