Children's Special Services

The Children's Special Services (CSS) Program may provide coverage for comprehensive medical care and other non-medical resources for children with physical disabilities and special health care needs from birth to 21 years of age. Diagnostic and financial eligibility criteria must be met to participate in the program.

The CSS program is coordinated through the local health department in all 95 Tennessee counties and provides resources for medical and non-medical services. For more information about eligibility, transition planning and other resources, please click on the links below.

The CSS program has two components; medical services and care coordination.

The medical services component provides for reimbursement of medical services, i.e., physician/clinic visits, hospitalizations, medical supplies, pharmaceuticals, durable medical equipment, and therapies for children who meet medical and financial eligibility requirements.

The care coordination component assists families of eligible children with coordinating primary and specialty care through the designated primary care physician and corresponding managed care organization networks.  Care coordinators assist the family in accessing many services (educational, medical, social, transportation, support and advocacy).

For more information about your child’s eligibility for CSS, please contact Tennessee Department of Health, Family Health and Wellness Division. The office is located in the Andrew Johnson Tower, 710 James Robertson Parkway, 8th Floor, Nashville, TN 37243.  You may also call the program at (615) 741-7353.

• Diagnostic Eligibility
• Financial Eligibility
• Transition Planning
• Additional Resources
• Vendor Agreement
• Resource Directory

Diagnostic Eligibility

A child/youth is eligible for the program if s/he is under the age of 21, and has been diagnosed with a physical disability which requires medical, surgical, dental or rehabilitative treatment.

Services Available:

The CSS Program has an approved diagnostic list of over 500 eligible diagnoses. This list is not all inclusive. The most common diagnoses are:

Financial Eligibility

Financial eligibility is based on family size and income level. The family’s adjusted gross income must be at or below the 225% federal poverty level.

Tennessee Department of Health Children's Special Services Program Financial Eligibility Requirements Effective January 21, 2022.

Guidelines based on the HHS Federal Poverty Guidelines, Federal Register, 2022, Vol. 87, No. 14, January 21, 2022, pp. 3315-3316.

https://www.federalregister.gov/documents/2022/01/21/2022-01166/annual-update-of-the-hhs-poverty-guidelines

Transition Planning

Transition planning is a process that is personal, individualized, deliberate, coordinated, developmentally appropriate, age appropriate and culturally competent.

Children, young adults, and their families experience many transitions, large and small, over the years. Transition for children and youth with special health care needs and physical disabilities is a continuum of change. Each transition is an opportunity to help the child, young adult, and family gain the skills to optimize success and manage future transitions. As young adults reach adulthood, they need information to help make their transitions smooth and effective.

Transition planning assures that your child receives services necessary to make appropriate transition to:

• Adult health care
• Work
• Independence

Your child’s Transition Plan would include services necessary to assure transition to all aspects of adult life which include:

• Medical
• Independent living
• Financial
• Legal (conservatorship/guardianship)
• Educational / Vocational
• Employment
• Social/Recreation
• Family resources
• Additional resources

Additional Resources

Asthma Management Toolkit

http://tn.gov/health/health/health-program-areas/fhw/cd/asthma

Medical Home Toolkit

http://tn.gov/health/health-program-areas/mch/mch-mh

Disability Resources

https://www.dol.gov/odep/topics/disability.htm

Tennessee Disability Pathfinder

https://vkc.vumc.org/vkc/pathfinder/

Tennessee Chapter American Academy of Pediatrics

http://www.tnaap.org

State of Tennessee Department of Education Special Services

http://tn.gov/education/student-support/special-education

State of Tennessee Department of Intellectual and Developmental Disabilities

http://www.tn.gov/didd/

State of Tennessee Department of Mental Health and Substance Abuse Services

http://tn.gov/behavioral-health

Vanderbilt Kennedy Center

 https://vkc.vumc.org/vkc/

Family Voices

https://www.familyvoicestn.org/

Resource Directory by County

https://vkc.vumc.org/vkc/pathfinder/

Reports and Publications

·         Family-Centered Care

·         America’s Children in Brief: Key National Indicators of Well-Being, 2021

·         Accessibility of State and Local Government Websites to People with Disabilities

·         Oral Health for Children with Special Health Care Needs

·         Promoting Health for Children and Youth with Special Health Care Needs

·         Promoting Healthy Weight and Nutrition

·         Health and Safety Activity Book for Children

·         Bright Futures Resources and Toolkit

·         Promoting Physical Activity

·         National Center for Health Statistics

·         Data Resource Center for Child and Adolescent Health

Vendor Agreement

Children’s Special Services authorizes health care providers and durable medical equipment vendors/suppliers to provide services to CSS clients.

Authorization to Vendors and CSS Letters of Agreement are effective for a three-year period.

The vendor agreement packet includes:

• Letter of Agreement
• Authorization to Vendor Agreement Form
• W-9 Form
• Supplier Direct Deposit Authorization Form

Please click on the link below to access the vendor agreement packet:

1.  Vendor Instructional Letter (New)
2.  Vendor Instructional Letter (Renewal)
3. Letter of Agreement
4. Authorization to Vendor Agreement Form
5. W-9 Form
6. Supplier Direct Deposit Authorization Form

If there is a change of personal/company information, provider/facility representative must complete the Change of Personal/Company Information Form and submit it to the CSS Central Office.

Please click on the link below to access this form:

• Change of Personal/Company Information Form