Every child in foster care who is under DHS foster custody qualifies for the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program.What is EPSDT?
EPSDT is a federally mandated program under Title XIX of the Social Security Act that provides preventive and comprehensive health services for Medicaid-QUEST and Medicaid fee for service individuals under age 21. The EPSDT comprehensive health assessment determines whether a child has medical, dental, developmental, or behavioral health problems that should be referred for more definitive evaluation and/or treatment.
Why does a foster parent need to know about EPSDT?
Foster parents are usually the ones responsible for taking the child to the physician for an EPSDT health assessment.
How often does the foster child get an EPSDT health assessment?
The first one occurs as soon as possible after the child is removed from home and placed into a foster home. An EPSDT health assessment that was completed within 45 days prior to the child’s removal or within 45 days after the child’s removal satisfies that requirement.
After that initial assessment, there is a regular schedule to follow, called a periodicity schedule, for the on-going EPSDT exams. The EPSDT periodicity schedule for a child is as follows:
Age 1-30 days, 2 mos, 4 mos, 6 mos, 9 mos, 12 mos, 15 mos, 18 mos, 2 yrs, 3 yrs, 4 yrs, 5 yrs, 6 yrs, 8 yrs, 10 yrs, 12 yrs, 14 yrs, 16 yrs, 18 yrs, 20 yrs.
EPSDT health assessment can occur at other ages if necessary to meet the 45 day state law requirement for a comprehensive health assessment when a child enters foster care. For example, if a child is 7 years old and had an EPSDT exam at age 6 yrs, and the child is placed in a foster home, the child qualifies for another EPSDT comprehensive health assessment.
Is there special form to request EPSDT?
There is an EPSDT request form, available from the child’s CWS worker. The physician completes the form and faxes it to the CWS worker.
Can the foster parent receive a copy of the completed EPSDT request form?
The foster parent is entitled to receive medical information on their foster child. In order for the foster parent to receive the completed EPSDT request form from the physician, CWS worker must sign a consent form to release information from the physician to the foster parent.
Who does the foster parent call if the physician says that he or she cannot do the EPSDT exam?
The foster parent can contact the CWS worker who will contact the Health Plan’s EPSDT coordinator who will speak with the physician.
If you have further questions or concerns, call Susan Ogami-Van Camp, DHS CWS Program Development Assistant Administrator, at 587-3168.
