What is Texas Health Steps?
Children in DFPS conservatorship, including children in foster care and kinship care, must get Texas Health Steps medical and dental checkups. Known in federal law as Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services, Texas Health Steps is the name for EPSDT services in Texas. Texas Health Steps is health care for children, teens, and young adults age 20 and younger who receive Medicaid. Texas Health Steps checkups are designed to find and treat medical and dental problems.
How often the child gets Texas Health Steps medical checkups depends on the child’s age. Children and youth age three through 20 years need medical checkups every year. Children under three years of age need more frequent medical checkups.
Texas Health Steps medical checkups must include regularly scheduled examinations and screenings of the general physical and mental health, growth, development, and nutritional status of infants, children, and youth. Texas Health Steps medical checkups must occur in accordance with the Texas Health Steps Periodicity Schedule. There are 11 checkups before three years of age (excluding the newborn exam) and annually from three through 20 years of age.
A Texas Health Steps medical checkup must include the following age-appropriate components:
- Comprehensive health and developmental history (includes nutritional, developmental, mental health, and tuberculosis (TB) screenings).
- A comprehensive unclothed physical examination.
- Immunizations appropriate for age and health history.
- Oral health screening and referral to a dental home.
- Age-appropriate and risk-based laboratory testing.
- Health education and anticipatory guidance.
Dental services provided through Texas Health Steps include preventive, treatment, emergency, and orthodontic care for children six months through 20 years of age. Texas Health Steps dental checkups are recommended every six months, starting at six months of age. Texas Health Steps dental services include the following:
- Dental examinations (initial or periodic).
- Cleaning (prophylaxis)
- Oral health education.
- Application of topical fluoride.
- Application of sealants to certain teeth.
- Maintenance of space.
- Restorations (fillings, crowns).
- Endodontic treatment (pulp therapy, root canals).
- Periodontic treatment (gum disease).
- Prosthodontics (full or partial dentures).
- Oral surgery (extractions).
- Implant services and maxillofacial prosthetics.
- Procedures necessary to control bleeding, relieve pain, and eliminate acute infection.
- Procedures that are required to prevent imminent loss of teeth.
- Treatment of injuries to the teeth or supporting structures.
- Correction of cleft palate.
- Crossbite therapy.
- Treatment for severe, handicapping malocclusion.
- Treatment for facial accidents involving severe traumatic deviation.
Comprehensive Care Program (CCP)
In accordance with federal law, the Texas Health Steps Comprehensive Care Program (CCP) provides all medically necessary treatment for correction of any physical or mental health problems for everyone from birth to age 20 who receives Medicaid. CCP covers medically necessary benefits and services even they are not available within the Medicaid State Plan. There isn’t a separate applications process. Children and young adults automatically receive CCP, although providers must establish medically necessity.
CCP services are automatically included in the STAR Health Program for children in DFPS care and for young adults enrolled through Medicaid for Transitioning Foster Care Youth (MTFCY).
- For more information regarding Texas Health Steps caretakers and guardians can: Call STAR Health at 1-866-912-6283 or visit the STAR Health website.
- Call a Texas Health Steps outreach representative at (877) 847-8377 (877-THSTEPS) or visit the Texas Health Steps page for Medicaid members.
Members can call Texas Health Steps if they:
- Need help finding a doctor or dentist.
- Need help setting up a checkup.
- Have questions about checkups or Texas Health Steps.
- Need help getting a ride to a checkup.
- Need a case manager to help find and get other services.
Requirements for Medical and Dental Checkups
A child’s first Texas Health Steps medical checkup must occur within 30 days after the child comes into DFPS conservatorship, regardless of the child’s age. The checkup is considered overdue 31 days after removal.
After that, children and youth age three to 20 years old must receive a Texas Health Steps medical checkup annually. Children who are younger than three years of age must get Texas Health Steps medical checkups more often, as outlined in the Texas Health Steps Periodicity Scheduleand as shown below.
Children need Texas Health Steps medical checkups at these ages:
- Up to 5 days old
- Two weeks old
- Two months old
- Four months old
- Six months old
- Nine months old
- 12 months old
After the 1st Year:
- 15 months old
- 18 months old
- Two years old
- Two and half years old
- *Children three years and older need Texas Health Steps checkups once a year.
For children enrolled in STAR Health who are six months and older, the first Texas Health Steps dental checkup must occur within 60 days after the child comes into DFPS conservatorship. The checkup is considered overdue 61 days after removal.
Children who turn six months old while in DFPS care must have their first Texas Health Steps Dental Checkup within 30 days of turning six months old. The checkup is considered overdue 31 days after turning six months old.
After that, children should get Texas Health Steps dental checkups every six months. The checkup is due six months after the month in which the child received the previous checkup.
Children six through 35 months of age who are identified by their dentist as being a moderate to high risk for the development of early childhood caries (cavities) may get regular dental checkups on a more frequent basis such as every three months.