Services and Eligibility
Services
The Caring Program for Children with Special Health Care Needs enables families to gain needed services by providing family-centered, community-based care coordination services to children with special health care needs and their families in a number of ways and programs. Each of the programs is designed to assist families in the most appropriate way, with specific education and/or assistance. The programs include; Care Coordination services, Disease Management programs for children with Asthma, Diabetes, Obesity and Tobacco use prevention and cessation as well as Complex Case Management services for children with more acute or complex needs.
Eligibility
The Caring Program is available free of charge to children enrolled in Pennsylvania's Children's Health Insurance Program (CHIP) through Highmark Inc. in Highmark's 49-county service area Families' CHIP benefits or eligibility are NOT impacted by participation in the Caring Program.
More than 10,000 families have benefited from the Caring Program since its inception in early 2005. The following is a brief description of each program's services.
Caring Program — Care Coordination services
Level 1—Health Coaches, via telephone, e-mail or written correspondence, provide families with information, education and referrals that the families can independently access.
Level 2—Community-based care coordination is designed for families who need the more tailored and personal assistance of a community-based Health Coach due to the complexity of the child's condition and/or family circumstances. A Health Coach will meet with the family in their home, and at the family's request, can also attend physician appointments, school meetings, and community meetings.
Families enrolled in Level 2 of the program have reported:
"Without the services provided through my Health Coach, I can't imagine where our family would be at this time. This help has been priceless."
"Our Health Coach has opened many doors for us—doors that had remained closed for many years."
Read more stories from the families enrolled in the Caring Program or request enrollment.
Disease Management (for children with Severe-Persistent Asthma, Type 1 Diabetes, Obesity and Tobacco use)
Through a shared process that involves the children (when age appropriate), their families and their physicians, as well as other key community resources, the program's clinical staff work to ensure all of the information and services needed to promote health and maximize each child's well-being are accessible. For each disease management program, the staff works proactively and collaboratively with the child/family and practitioner to emphasize prevention, health improvement, and compliance with the plan of care by using evidence-based clinical practice guidelines and member self-management. Families receive telephonic support and literature to assist in the management of the child's chronic condition(s).
Families enrolled in the Disease Management program have reported:
"The time the staff gives explaining helpful tips & suggestions has made us more aware of flare-ups and precautionary situations."
"It is always helpful to talk to someone that understands & and has helpful suggestions for my child's conditions."
Complex Case Management
Complex case management is a collaborative process involving the program's clinical staff, the child when age appropriate, their families or caregivers and providers. Staff assess, plan, implement, coordinate, monitor and evaluate the options and services required to meet an individual's health needs using assessments, self management tools, communication, education and available resources to promote quality, cost-effective outcomes. The complex case management program assesses the child and family throughout the continuum of care, seeking to achieve short- and long-term goals. Systems support the sharing of clinical information to enhance the integration of all program components.
Families enrolled in the Complex Case Management program have reported:
"Having a case manager (nurse) was an extremely helpful part of our team for better health for my son!"
Request enrollment in one of the Caring Program's services.
Contact a staff member in or near your location for more information.