Key Features of CPW:
● Part of Texas Health Steps: CPW falls under the broader umbrella of Texas Health Steps, which ensures comprehensive preventive healthcare services for children and youth enrolled in Medicaid.
● Comprehensive and Family-Centered: CPW takes a holistic approach by considering the medical and non-medical needs of the client and their family.
● Client Choice-Driven: Participation in case management services is voluntary. Clients must choose to receive help.

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Eligibility Requirements:
To qualify for CPW services, the individual must:
1. Be eligible for Texas Medicaid (even if not actively enrolled at intake).
2. Have a health condition, health risk (for children), or high-risk pregnancy (for pregnant women).
3. Need assistance accessing medical, social, or educational services related to that condition.
4. Choose to receive case management services.

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What CPW Case Managers Do:
CPW case managers are licensed professionals (e.g., RN, LCSW, LMSW with supervision, CHW, or Doula) who:
● Assess and document the client’s needs and strengths.
● Develop a personalized Service Plan and Family Needs Assessment.
● Identify and connect clients with local resources.
● Empower families to navigate healthcare and social service systems.
● Provide culturally sensitive support.
● Advocate for school services and coordinate with schools or MCOs.

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Examples of Services and Support:
● Linking to pediatricians, OB/GYNs, dental providers, and therapy services.
● Helping families access Medicaid transportation, housing assistance, or educational support.
● Supporting ARD meetings for special education planning.
● Coordinating care with Medicaid Managed Care Organizations (MCOs).
● Following up to ensure needs are being met and adjusting plans accordingly.

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Important Considerations:
● CPW does not provide direct healthcare, diagnoses, or treatment.
● Case managers do not replace physicians but serve as connectors and advocates.
● CPW services must be documented carefully and follow Medicaid billing and compliance rules.

● Services are billable only when there is an active, current need tied to the health condition or risk.

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Why CPW Matters:
CPW helps bridge the gap for families and pregnant women navigating complex systems. It improves health outcomes by ensuring early intervention, proper referrals, and community-based support, making a real difference in the lives of vulnerable populations.

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Brief Introduction:
What is CPW?
CPW (Children and Pregnant Women) is a Texas Medicaid case management benefit that helps eligible clients—children (birth through age 20) and pregnant women—gain access to essential medical, social, educational, and community services related to a health condition, health risk, or high-risk pregnancy.

CPW is:
● A component of Texas Health Steps, the state’s comprehensive healthcare program for children on Medicaid.
● Family-centered and comprehensive, focusing on a wide range of client needs.
● Designed to support those who need help accessing services and choose to receive case management.

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Eligibility requires that a client:
1. Is Medicaid eligible in Texas?
2. Has a health condition, health risk, or high-risk pregnancy.
3. Needs assistance accessing related services.
4. Chooses to receive case management support.