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Darius, age 9, was born with periventricular leukomalacia, a brain injury that causes frequent seizures, as well as central apnea, a condition that often causes him to stop breathing. He also has mild cerebral palsy, which impairs his mobility, balance, and reflexes. Since Darius was born, Medicaid has covered his specialist care, hospital care, prescription drugs, oxygen regulator and other medical equipment, and other services that have saved his life and significantly mitigated the neurological and developmental problems that often come with his conditions. Medicaid also covered early intervention services for Darius, including speech, occupational, and physical therapy, which were crucial to his high functioning today.
Darius is able to receive health services at school because of a provision in the Medicare Catastrophic Coverage Act of 1988. Before that law was enacted, Medicaid funding for school-based services was limited to routine screenings and treatment of acute, uncomplicated problems. Since 1988, Medicaid pays for school-based medical services provided to Medicaid-eligible children with special health care needs. In order for Medicaid to pay for a child’s school-based care, the child must have an Individualized Education Plan (IEP) in accordance with the Individuals with Disabilities Education Act. These services provided at school enable Darius and other children with special needs to go to school with their peers, while ensuring that they get the care they need.
He is on that machine every time he has a seizure…Without [Medicaid] paying for the medication and the machines, my son would not make it 12 hours. – Darius' mother, Stephanie