Children’s Medical Services is part of the Family Health Bureau in the Public Health Division of the Department of Health, and is federally funded through Title V and State General Funds to serve as a safety net for medical management, payment for medical services, diagnostic studies and service coordination for Children and Youth with Special Health Care Needs (CYSHCN).
CMS is committed to accessible, available and appropriate health care for all children living in New Mexico, regardless of race, ethnicity, socioeconomic status or culture. The program creates a system of care that is family centered, community-based, culturally competent and coordinated.
Children’s Medical Services is comprised of several programs, including the Newborn Metabolic Screening Program, the Newborn Hearing Screening Program, and Children and Youth with Special Health Care Needs (CYSHCN).
This program provides comprehensive medical care and care coordination for children with chronic medical conditions, birth to 21 years of age, who are uninsured or underinsured and are not eligible for Medicaid. Clients must have an eligible medical diagnosis (“medical eligibility”) and also meet income guidelines of family income under 200% of poverty level (“financial eligibility”). CMS has almost 60 medical social workers housed in 32 health offices throughout the state.
Financial Eligibility: General financial eligibility is based on a family’s gross income and assets. In general, family income must be less than 200% of the Federal Poverty Level. Other factors taken into account include family size and the number of children in the family with special health care needs.
Families whose income exceeds the financial eligibility criteria may still attend specialty outreach clinics, are still eligible for care coordination provided by social workers throughout the state, and are also eligible for diagnostic services to rule out eligible medical conditions.
CMS serves as the last payer after insurance and does not provide financial coverage for Medicaid clients.
The Newborn Hearing Screening program administered by CMS began in January 1996. This partnership between public and private physicians, hospitals, audiologists, and the Department of Health was implemented to ensure that newborns would be screened before they leave the hospitals, and that a system of follow-up would be developed and put in place for those children who are referred for further hearing testing.
Mandated newborn hearing screening is now in effect for all children born in New Mexico. All birthing hospitals in NM are required to screen newborns for hearing loss prior to discharge from the hospital. Any infant who does not pass the newborn hearing screening is referred to CMS and followed by a CMS worker. The CMS worker provides resources to the family and ensures that the child has access to a follow-up hearing exam.
The New Mexico Newborn Screening Program (NMNBSP) screens all babies born in NM for certain genetic, metabolic, hematologic and endocrine disorders. In 2006 the NM Legislature mandated expanded screening, which was rolled out in January 2007 and now includes testing for 27 different conditions. The NMNBSP provides services to over 29,000 babies annually, with each baby receiving two newborn screens, one done in the first 48 hours of life (before leaving the hospital) and the second within the first two weeks of life.
CMS has partnered with Mountain States Genetic Network, Oregon State Public Health Laboratory, and UNM to provide expanded screening and follow-up services for children with identified metabolic and genetic disorders. CMS provides follow-up of all children identified on newborn screening as having a genetic, metabolic, endocrine or hemoglobin disorder, including cystic fibrosis. Children are followed to age 21, and those diagnosed with cystic fibrosis and certain metabolic disorders are given lifelong follow-up and care coordination.
Children's Medical Services (CMS)
State Program Manager