Medical Eligibility Criteria for the MTP:
These are guidelines that the Chief Therapist and CCS Medical Director apply during the individual review of each child referred to the MTP. The State CCS Office has established detailed criteria. Eligibility is generally accepted if a child meets one of the following conditions:
- The child has been diagnosed with cerebral palsy and exhibits certain neurological signs consistent with the diagnosis.
- The child has been diagnosed with muscular dystrophy, polio, myasthenia gravis or a similar condition, that produces weakness or atrophy.
- The child has been diagnosed with a chronic musculoskeletal or connective tissue condition such as osteogenesis imperfecta, arthrogryposis or juvenile rheumatoid arthritis.
- The child has limb, muscle, connective tissue or joint abnormalities or contractures resulting in disability or functional impairment. Examples include amputation of a limb or joint contractures due to previous burn injury.
- The child has a neurological condition that manifests the same findings as cerebral palsy, such as ataxia-telangiectasia.
- A child under three years of age who has physical findings suggestive of cerebral palsy but not yet conclusively diagnosed and who needs therapeutic services.
If a Child has Physical Problems that may need Therapy but the Diagnosis is Unknown:
If a child has an unknown condition that appears similar to those mentioned, the child can be referred to the CCS Diagnostic Program for a medical specialty evaluation.
Types of Therapy Children Receive at the MTU:
Each child undergoes an initial physical and/or occupational therapy evaluation to determine the nature and extent of the physical concerns. The physical therapist (PT) focuses on the large movements of the body, such as rolling, crawling and walking. The occupational therapist (OT) studies the fine movements, such as hand and facial control, as well as typical activities of daily living (ADLs). They work together to develop a Treatment Plan that meets the needs of the child & family and collaborates with other services a child is receiving. All eligible children and their families receive consultation for activities that promote physical development outside of the MTU. All children are monitored for the progression of their physical development over time. Some children come to the MTU regularly (1-2 times/week) to work directly with one or both therapists on specific activities. Other children only need services occasionally (1-12 times/year).
Who Decides on the Treatment Plan for the Child:
The therapists propose a Treatment Plan after their evaluations and discussions with the family regarding the family's concerns and goals. Finally, the child's doctor or the MTU Conference/Clinic doctor must sign the plan as a medical prescription.
About MTU Conference/Clinic:
Many of the children who receive therapy services are offered an opportunity to come to the MTU Conference/Clinic. The Clinic Team includes some combination of the following: Pediatrician, Orthopedist, or Neurologist, a CCS Social Worker, a CCS Public Health Nurse, the CCS Supervising Therapist and the child's treating therapists. This group seeks to affirm with the family the child's diagnosis and Treatment Plan. It also seeks to understand how CCS MTP services fit with the family and other professionals involved with the child.
Steps in the Application Process to Obtain MTP Services:
To receive services, a family must complete an intake process with CCS. A team, including the Chief Therapist for Santa Clara County, the nurse case manager, and CCS caseworkers, gathers information from the family and child's physicians to determine eligibility. The intake process includes the following steps:
- Initial CCS Referral by hospital, physician, community organization or family.
- The family submits a CCS Family Application.
- The hospital or physician submits medical records to CCS.
- The family may consider a simultaneous application for the Diagnostic Program or Treatment Program.
- CCS Supervising Therapist and/or CCS Medical Director review and determine medical eligibility.
- CCS informs the family of the child's eligibility.
- CCS sends a letter to the child's physician regarding eligibility.
- CCS initiates the initial evaluation at MTU for the medically eligible child.
If a child is determined to be not medically eligible, the family may appeal that decision through the CCS Due Process.