Skip to content Skip to main navigation Skip to footer

Children with Medical Handicaps

Families who have children with a chronic illness or physical disability may be receiving services from BOTH Medicaid and the Bureau for Children with Medical Handicaps (CMH) program. You do NOT have to receive services from Medicaid to be eligible for CMH.

What is the CMH Program? The CMH program is administered by the Ohio Department of Health. It provides medical coverage for children with special health care needs.

Who is eligible for the CMH Program? Children under the age of 21, who are residents of Ohio, under the care of a CMH approved physician and have a chronic, physically handicapping condition. Some examples are: Asthma, Cerebral Palsy, Seizure Disorder, Diabetes, Hearing Loss, Heart Conditions, Cleft Lip/Palate, Arthritis, Sickle Cell, Brain Injuries, Childhood, Cancers, Spina Bifida, Metabolic Disorders, Muscular Dystrophy.

To receive additional information about the CMH Program contact the the CMH Public Health Nurse located at the Health District, Susie Traud, R.N., CMH Coordinator, 513-695-1535.

There are two main CMH programs

Diagnostic Program

Purpose

Children can receive services from BCMH-approved providers to rule out a special health care need, diagnose a condition or develop a plan of treatment.

Although BCMH covers a wide range of services, it is important to know that the BCMH program does not cover all the services a child with special health care needs may require, nor are all services eligible for every diagnosis.  Services must be related to the child’s BCMH-eligible condition.

Eligibility
The applicant must:

  • Be under the age of 21
  • Be a resident of Ohio
  • Be under the care of a BCMH-approved physician
  • Have a suspected special health care need

There is no financial eligibility required for this program; however, information on third-party coverage (Medicaid or insurance) must be supplied.

Services
Services must be related to the suspected handicapping condition and provided by BCMH approved providers.  Services are authorized for a maximum of six months.  BCMH requires the signature of the applicant if he/she is 18 to 21 years of age.  Documentation must be provided if there is legal guardianship of an individual 18 to 21 years of age

Services include:

  • Tests and X-rays
  • Visits to BCMH-approved doctors (MD or DO)
  • Up to five days in the hospital
  • Public health nursing services
  • Occupational, physical and speech therapy evaluations
  • Dental consults
  • Community nutrition consults

Ineligible Services/Conditions:

  • Acute conditions
  • Assessment of emotional or behavioral problems
  • Routine well child care/physical exams
  • Physical and psychological exams for school or adoptive placement/sports physical exams
  • Evaluation for learning disabilities
  • Any service considered to be research or experimental in nature
  • Out-of-state services, unless comparable services not available to Ohio

Enrollment
A BCMH-approved doctor (MD or DO) must apply to BCMH.  The parent, legal guardian or client (if 18 years of age or older) must sign the Medical Application Form or the Release of Information and Consent before the case can be started.  A public health nurse can also begin the process by referring the child to a BCMH-approved doctor.

Treatment Program

Purpose

BCMH can cover services by BCMH-approved providers to treat an eligible condition.  The family must also be financially eligible.

Although BCMH covers a wide range of services, it is important to know BCMH does not cover all the services a child with special health care needs may require, nor are all services eligible for every diagnosis.  Services must be related to the child’s BCMH-eligible condition.

Eligibility

The applicant must:

  • Be under the age of 21
  • Be a resident of Ohio
  • Be under the care of a BCMH-approved physician
  • Have an eligible medical handicap
  • The family must be financially eligible

Services
Services must be related to the suspected handicapping condition and provided by BCMH-approved providers. If applicant is approved, services are authorized for one year.  If both medical and financial eligibility are maintained, services may be renewed up to age 21.  BCMH requires the signature of the applicant if he/she is 18 to 21 years of age.  Documentation must be provided if there is legal guardianship of an individual 18 to 21 years of age.

Services include (this is not a complete list as it varies with each medically eligible condition):

  • Days in the hospital
  • Visits to BCMH-approved doctors (MD or DO)
  • Public health nurse services
  • Hearing aids
  • Glasses/contact lenses
  • Prescription drugs
  • Medical supplies/equipment
  • Physical, occupational and speech therapy
  • Nutrition consults/services
  • Surgery and anesthesia
  • Special formula

Examples of Eligible Conditions (not a complete list):

  • Birth defects
  • Chronic lung disease
  • Heart defects
  • Cerebral palsy
  • Spina bifida
  • PKU and other metabolic conditions\
  • Hearing loss
  • Epilepsy
  • Cancer
  • Sickle cell disease
  • Hemophilia
  • Congenital heart disease
  • Diabetes

Ineligible Conditions:

  • Learning disabilities
  • Behavior problems
  • Mental retardation
  • Allergies
  • Conditions that will improve through growth
  • Acute or infectious conditions
  • Psychological/emotional disorders
  • Routine orthodontic problems
  • Experimental care
  • Well child care
  • Developmental delay

Enrollment

A BCMH-approved doctor (MD or DO) who will manage the child’s care must apply to BCMH.  The parent, legal guardian or client (if 18 years of age or older) must sign the Medical Application Form or the Release of Information and Consentbefore the case can be started.  The parent or legal guardian must complete the forms in the income-eligibility packet they receive from BCMH and return all required information to BCMH.  These documents are used to determine financial eligibility.