Bureau for Children with Medical Handicaps

Overview

Bureau of Children with Medical Handicaps (BMCH) is a state-administered program which operates within the Ohio Department of Health. The Bureau receives funding for services from the federal Maternal and Child Health Block Grant, state general revenue funds, county tax funds, third party reimbursements and donations.

The Bureau promotes the early identification of children with handicapping conditions and treatment of those children by appropriate health care providers. Components of the program include: funding services for the diagnosis and treatment of medically eligible conditions, collaborating with public health nurses and local health departments to assist in increasing access to care, supporting service coordination for children with selected diagnosis, and assisting families to access and utilize appropriate sources of payment for services for their child.

The Diagnostic Program

The Diagnostic Program provides funds for an evaluation of a potentially handicapping condition, establishment of a diagnosis, and development of a plan of treatment. By state law any Ohio resident under 21 years of age who may have a medical handicap is eligible for the Diagnostic Program. The child must be under the care of a BMCH-approved physician.

There are no financial eligibility requirements for the Diagnostic Program; however, families must apply their health insurance to the cost of services.

Only one diagnostic assessment may be authorized for a suspected handicapping condition unless a substantial change occurs in that condition or a change is made in their physician. The length of eligibility for the Diagnostic Program is three months. Examples of eligible services include laboratory tests, x-rays, special diagnostic test, biopsies and inpatient hospitalization up to five days.

In support of early identification of handicapping conditions, the Bureau guarantees payment for the first office visit to a BCMH-approved physician when a child has been appropriately referred by a public health nurse and the physician submits the medical application to BCMH.

The Treatment Program

The Treatment Program provides payment for ongoing services related to the handicapping condition for eligible children. As with the Diagnostic Program, the child must be under 21 years of age and a resident of Ohio. In addition, the child must have an eligible medical handicap, be under the care of a BCMH-approved physician, and the family must be financially eligible.

Medically eligible conditions are those that are chronic, physically handicapping, and amenable to treatment. Examples of eligible diagnoses are cerebral palsy, hearing loss, cystic fibrosis, cleft lip and palate, diabetes, hemophilia, cancer, heart defect, scoliosis, birth defects, spinal injuries, paralysis and AIDS.

The BCMH program does not cover all services that a child with a handicapping condition may require, nor are all services eligible for all conditions. All approved services must be related to the child's handicapping condition. Examples of services that may be authorized on the Treatment Program include laboratory tests, x-rays, special tests, inpatient hospitalization, surgery, anesthesia, prescriptions for medication, medical supplies, hearing aids, physical, occupational and speech therapy, and public health nurse services.

Some conditions and services are not medically eligible for the BCMH program. These ineligible conditions and services include well child care, treatment of acute or infectious conditions, allergies, common refractive errors, routine dental problems, mental retardation, developmental disorders, psychological and emotional disorders, learning disabilities, pregnancy and pregnancy related diagnosis.

Financial eligibility is based on adjusted gross income. Un-taxed income and family resources, such as savings, stock, and property are not considered.