Medical Therapy Program
The
Medical Therapy Program (MTP) is a special program within California Children's Services (CCS)
that
provides physical therapy (PT), occupational therapy (OT), and Medical Therapy
Conference (MTC) services for children who have disabling conditions,
generally due to neurological or musculoskeletal disorders. MTC is comprised
of the interdisciplinary team including the client and caregiver/family, PT,
OT, and MTC physician.
Program Description
The CCS MTP provides medically necessary physical and occupational therapy services as well as medical therapy conference services to children and young adults under age 21 with CCS MTP eligible conditions. Examples of CCS MTP eligible conditions include cerebral palsy, neuromuscular disease (e.g., muscular dystrophy), musculoskeletal diseases (e.g., arthrogryposis), juvenile rheumatoid arthritis, spina bifida, brachial plexus injury, and acquired injury and illnesses such as burns and traumatic brain injuries.
The CCS MTP is administered as a partnership between county health departments and the California Department of Health Care Services (DHCS), in collaboration with local education partners. Most services are rendered within a Medical Therapy Unit (MTU), within a public school site, per CCR Title 2.
History of the Medical Therapy Program:
On May 17, 1927, the “California Crippled Children's Act" was signed, establishing the start of the unique program that would become CCS. It was originally established to provide services to children with conditions such as infantile paralysis that have since been eliminated through preventive health measures. The federal government passed the Social Security Act in 1935 establishing these programs on a national basis.
The Medical Therapy Program was established in 1945 by the state legislature to provide occupational and physical therapy services to children at public school sites instead of at local orthopedic hospitals. The Medical Therapy Program originally provided services to children with the orthopedic deficits associated with cerebral palsy, but in 1961, the Budget Act expanded eligibility to include other neuromuscular and musculoskeletal conditions. The Robert Crown Act of 1968 established the county responsibility for administering the Medical Therapy Program locally.
Physical Therapy (PT) and Occupational Therapy (OT) services are provided at Medical Therapy Units (MTUs). MTUs are outpatient clinics located in designated public schools. PT is provided primarily to address mobility and ambulation needs. PT is provided by a Physical Therapist who is licensed to practice Physical Therapy in California. OT is provided primarily to address self-help skills or Activities of Daily Living (ADLs). OT is provided by an Occupational Therapist who is licensed to practice Occupational Therapy in California.
The Medical Therapy Conference (MTC), comprised of the client and caregiver/family, PT, OT, and MTC physician, is an interdisciplinary team meeting where the child's medical case management regarding the MTP eligible condition is determined. This includes the discussion of physical and occupational therapy services as well as recommendations for specialized equipment, such as orthotics/braces, wheelchairs and other assistive devices.
Services provided in the Medical Therapy Program are determined by the results of professional assessment, including input from the client and their family. This evaluation includes physical assessment and may include home, classroom and community access assessment.
MTP staff attend Individualized Educational Plan (IEP) meetings, when requested, to make sure school staff is aware of the child's participation and current status in the MTP.
Eligibility
- Birth to 21
- Residential Eligibility
- Medical Eligibility
- Financial Eligibility- There is no financial eligibility requirement for the MTP; however, financial information may be needed to assist with the obtainment of equipment or specialty services through the general CCS program.
- Eligibility Criteria
- For further information or to apply for services, please contact your local CCS Administrative Office.
Legislative Authority
- California Code of Regulations, Title 22, § 41517.5 establishes the Medical Therapy Program for CCS applicants with one of the following conditions: Cerebral palsy, Neuromuscular conditions that produce weakness and atrophy, Chronic musculoskeletal and connective tissue diseases, degenerative neurological disease, etc.
- Government code section 7575 (b) defines medical eligibility for the MTP, what information a referral should include, and the responsibilities of the program with regards to medically-necessary therapy services for eligible children and young adults.
- Government code 7573 explains the relationship between Local Education Agencies and special education and its related services. It defines what the interagency responsibilities are, what the CCS responsibilities are to these children, and outlines timelines and joint management expectations for the medical management of qualifying children.
- Government code 7582 exempts recipients from any financial responsibilities for MTP services, as defined as services rendered under a program of DHCS, including those referred from an educations source.
- Health & Safety Code, Article 5, Section 123950 states the designated county agency shall administer the medical-therapy program in local public schools for physically handicapped children. The state and counties will share in the cost of support of therapist salaries in these schools. The director shall establish standards for the maximum number of therapists employed in the schools eligible for state financial support in this program, the services to be provided, and the county administrative services subject to reimbursement by the state.
Program Administration
- The Medical Therapy Program (MTP) is operated at the local level by local health departments for each county.
- Local MTPs provide physical therapy, occupational therapy, and medical therapy conference services for children and young adults age birth to 21 years old who have MTP eligible conditions.
- These services typically take place within a Medical Therapy Unit, located on a public school campus through a partnership between the CCS MTP and local special education. There is no financial responsibility on the part of the family or client for these services and there is no financial qualification for participation in the MTP.
Funding Description
- Funding for the CCS MTP includes State, local county, and some federal sources.
- Title XIX, also known as Medicaid or Medi-Cal in the state of California offers 50% Federal financial support.
- Title XXI covers some additional children, under age 19 years, formally known as the Healthy Families Plan, and is supported at 65% by the Federal Financial Program.
- CCS-only clients, or those without additional financial eligibility are covered by an equal split between the state and local county.
- There is never a charge to a family for therapy services under the MTP.
Whole Child Model
- CCS Services (except eligibility determination) have been transferred to Medi-Cal Managed Care plans in 21 counties. This excludes MTP therapy services and Medical Therapy Conference. For children in Whole Child Model counties, Durable Medical Equipment and Orthotics/Prosthetics are authorized by the managed care plans after the Medical Therapy Program approves the items as appropriate and meeting the guidelines of NL 09-0703.
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