Appendix A Well Child Check-Up (EPSDT)

More documents

Recommendations

Info

Well Child Check-Up • * Documentation of sickle cell test results • * Recorded results of hemoglobin/hematocrit • *urine test for protein and sugar ( Effective 10/01/2008, urine screening needs to be performed only if clinically indicated) • * Lead testing/results (according to age) • Tb skin test • Height, weight, temperature, pulse, and blood pressure • * Vision and hearing assessment/testing (Considered as two critical components) • * Documentation of the unclothed physical examination • * Dental referral/status for recipients 1 year of age and above • * Failure to make appropriate referral, when required (i.e., medical, vision, hearing) • * Referral follow-up on conditions related to medical, vision, or hearing problems A.5 Off-site Screenings Children are our state’s most important assets and yet many of them arrive at school generally in poor health. The healthier a child, the greater his or her learning potential. The Alabama Medicaid Agency is committed to helping ensure that children are healthy and ready to learn. To that end, the Alabama Medicaid Agency has developed protocols for off-site EPSDT screenings. These services must be accessible to all children, not just Medicaid-eligible children. NOTE: EPSDT screening providers must also contact the recipient’s primary medical provider (Patient 1 st ) to receive prior authorizations to perform the screening. Off-site screenings are defined as screenings that are provided off-site from a medical facility, which is limited to hospitals, physician offices, Department of Public Health (DPH) clinics, and Federal/State certified clinics. Off-site screenings occur in schools, day care centers, head start centers, and housing projects. A-38 January 2011
Well Child Check-Up A An off-site EPSDT screening provider must develop and adhere to confidentiality policies set out by the respective agencies and should be submitted to the agency. Information pertinent to the child’s performance may be shared. Information pertinent to infectious disease shall be released only by the County Health Officer. Sharing information with others outside the local agency may take place only if parental consent has been given. Provider is defined as and will include only a county health department clinic, hospital, FQHC, IRHC, PBRHC, or a physician’s office. A provider must be located within the county or within 15 miles of the county in which the off-site screenings occur. Medical personnel performing the physical examination are limited to physicians, certified registered nurse practitioners (CRNP), certified nurse midwives (CNM), physician assistants (PA), and registered nurses (RN) employed by the facilities listed above. Clinic is defined as a certified medical facility, under the supervision of a physician that provides a full range of medical services on a regular basis. A clinic must be equipped to handle acute care situations and provide treatment and/or management of chronic diseases. Licensed medical personnel must perform medical services. Medical facility is defined as a Federal/State certified clinic, hospital, physician’s office, or a DPH clinic where diagnosis of health problems are rendered and treatment of diseases occur. The medical facility must have a permanent location, regularly scheduled hours of operation, and a published telephone number. Medical services and supplies must also be available for treatment of abnormal conditions identified at the time of an EPSDT screening. Physician’s office is defined as a place staffed by physician(s) and other medical professionals where medical activities, such as the practice of medicine, is conducted. This office is specifically designed and set up to provide medical diagnosis and treatment of medical conditions. This office is open and operating on a published, regularly scheduled basis with a published telephone number and regularly scheduled appointments. A.5.1 Enrollment for Off-site providers To be considered as an EPSDT screening provider for off-site screenings, potential providers must submit the following criteria: • A letter documenting the ability to complete all components of a screening. The physical exam portion of the screening must be completed by an approved EPSDT screening provider: physician, nurse practitioner, physician assistant, or a registered nurse. All registered nurses, except BSNs, must complete a Medicaid-approved Pediatric Assessment course or show proof of having completed a similar program of study in their professional training that prepared them to perform pediatric health assessments. January 2011 A-39
Page 1 and 2: A A Well Child Check-Up (EPSDT) The
Page 3 and 4: Well Child Check-Up A NOTE: Medicai
Page 5 and 6: Well Child Check-Up A A.3.1 Becomin
Page 7 and 8: Well Child Check-Up A A.3.3 Outreac
Page 9 and 10: Well Child Check-Up A A.3.5 Schedul
Page 11 and 12: Well Child Check-Up A Component Des
Page 13 and 14: Well Child Check-Up A • Behavior
Page 15 and 16: Well Child Check-Up A A periodic or
Page 17 and 18: Well Child Check-Up A The following
Page 19 and 20: Well Child Check-Up A NOTE: The hgb
Page 21 and 22: Well Child Check-Up A Venous Sample
Page 23 and 24: Well Child Check-Up A By performing
Page 25 and 26: Well Child Check-Up A SCREENING COD
Page 27 and 28: Well Child Check-Up A Assistive tec
Page 29 and 30: Well Child Check-Up A Topic Intensi
Page 31 and 32: Well Child Check-Up A A.4 Providing
Page 33 and 34: Well Child Check-Up A A.4.3 Treatme
Page 35 and 36: Well Child Check-Up A NOTE: The PMP
Page 37: Well Child Check-Up A A.4.8 Consent
Page 41 and 42: Well Child Check-Up A • Informati
Page 43 and 44: Well Child Check-Up A A.6.3 Vaccine
Page 45 and 46: Well Child Check-Up A A.7 Required
Page 47 and 48: Well Child Check-Up A Adolescent Sc
Page 49 and 50: Well Child Check-Up A January 2011

Appendix A Well Child Check-Up (EPSDT)

Create successful ePaper yourself

Delete template?

Save as template?