Children’s Medical Services (CMS) is a public health program striving to provide a community-based comprehensive system of medical/health care for children birth to age 21 with chronic medical conditions.

Eligibility for CMS

Eligibility for enrollment in CMS is based on the following:

• Type(s) of medical problem(s) – see the “Medical Eligibility” section below
• Age – CMS covers children from birth to 21 years of age
• Residency – child must live in Georgia
• Family income – see the “Financial Eligibility” section below

Citizenship and enumeration are not required for CMS services, and staff members do not request such information from families.

Medical Eligibility

Medically eligible conditions for CMS include a broad spectrum of chronic medical/surgical conditions affecting children. In general, the conditions must:

• Impair normal function
• Require long term specialized medical or surgical care
• Cost beyond the family’s resources; and/or
• Be amenable to treatment, habilitation, and rehabilitation

Examples of conditions treated by CMS include:

• Asthma, cystic fibrosis, and other lung disorders
• Diabetes mellitus
• Gastrointestinal disorders
• Craniofacial anomalies including cleft lip/palate
• Some hearing disorders
• Neurological and neurosurgery disorders including seizures, benign tumors, hydrocephalus, and others
• Orthopedic and/or neuromuscular disorders including cerebral palsy, scoliosis, clubfeet, congenital or traumatic amputations of limbs, and others
• Visual disorders including cataracts, glaucoma, strabismus, and others
• Genetic disorders including Down syndrome, metabolic disorders, sickle cell disease, and some chromosomal disorders

A more extensive list of eligible conditions is available upon request.

Financial Eligibility

To be financially eligible for CMS, total family income must be below 236% of the federal poverty level. Any child who is eligible for Medicaid is also eligible for CMS. All families enrolled in CMS must complete a financial analysis form to determine if they will cost participate in the child’s care. Families at or below 150% of the federal poverty level do not cost participate. CMS staff works with families to make paying the cost participation amount as easy as possible for the family.

Referral

Referrals are accepted via phone, fax, or letter, and can be from any source, including self-referral by families. CMS attempts to contact the child’s primary care physician prior to their initial visit if the referral comes from any source other than that physician. Staff may also evaluate to see if the child may be eligible for other public health or community services. Upon contact with the family, CMS staff will determine if the child is eligible to be enrolled in the CMS program. Once enrolled, a plan of care will be completed to help identify the services the child and family will receive, the referrals needed, and the major outcomes to work towards achieving.

Services Provided

Families are encouraged to continue medical care with providers that they currently see. In addition, CMS offers case management by the nursing staff for every enrolled child.Medical/surgical treatment and therapy services may be available through private providers during on-site clinic or through telemedicine consult. Services may include hospitalization, physician services, surgical services, durable medical equipment, genetic and nutritional counseling, and medicines for chronic conditions.

Clinic Information

On-site clinics are held at Ware CMS. Traveling medical specialists from other parts of the state provide care to children locally to ease the burden of travel on families. A general listing of clinics includes Orthopedic, Pulmonology, Asthma/Allergy, Neurosurgery, Urology, Genetics, and Hematology.