Iowa's Early and Periodic Screening, Diagnosis and
Treatment (EPSDT) Care for Kids resources provide Medicaid coverage for
children from birth to age 21.
The role of EPSDT is
to promote the physical, mental, social, emotional, and behavioral health of
children. Through this program, children receive a regular schedule of
care that includes comprehensive preventive health screening, education,
diagnosis, and treatment.
As a result, each child has an integrated
plan of care based on the outcome of all recommended screenings and one
that considers the child within the context of the family and the family
in the context of the community.
Who is eligible to receive
services? All Iowa children birth to age 21
who are enrolled in Medicaid are automatically enrolled in EPSDT Care for Kids.
Who provides services?
All physicians, nurse
practitioners, and physician assistants in Iowa are considered
EPSDT Care for Kids providers if they accept Medicaid reimbursement.
A family may use their provider of choice, unless they are enrolled
in MediPASS or a Medicaid HMO. Then they are limited to providers within their provider panels.
E
arly
and
Periodic
Screening
EPSDT Care for Kids provides regularly scheduled, comprehensive
screenings that follow the
Iowa Recommendations for Scheduling Care for Kids Screenings.
Providers may also offer care between scheduled visits.
A review of
development
is an integral part of every periodic, comprehensive EPSDT
screening for children who participate in Medicaid. This review should
respond to parental concerns about the child’s growth and development.
It should also review:
-
Developmental milestones
-
Social, emotional, and behavioral health,
including PDD and autism
-
Family risk factors, including parental
stress
Health education and anticipatory guidance are required components of
each periodic health care visit. They can
help families understand what to expect in terms of the child's
development, and provide information about the benefits of healthy
lifestyles and practices, child safety, and disease prevention.
Diagnosis and
Treatment
Further
evaluation may be needed to identify a developmental or health problem, to formulate a plan for care,
and to provide specific intervention or treatment . This may take place in the primary
care office during the screening
process, or the child may require a
referral.
The EPSDT program requires Medicaid coverage for services that are
medically necessary to treat conditions identified during screening.
EPSDT support services
EPSDT Care Coordinators
are available in every county in Iowa to help families of children
enrolled in Medicaid to get the services they need. The local
EPSDT Care Coordinator (Healthy Families Line) can help:
