Child Health and Disability Prevention CHDP Program California Head Start Association Summer Manager Director Institu

1. Child Health and Disability Prevention (CHDP) ProgramCalifornia Head Start Association Summer Manager & Director Institute August 2, 2007Sacramento, CA

2. 2 CHDP

3. 3 CHDP and EPSDT In 1973 California implemented the federal EPSDT mandate. The purpose of the EPSDT program is to provide complete health care and rehabilitation services to all low income children. It is an entitlement benefit for Medicaid eligible children and youth under the age of 21.

4. 4 CHDP and Head Start Share the same child health and development goals as EPSDT. Share many of the same children, providers, and concerns for child health. Eligibility for both programs are nearly the same: Eligibility for both programs are nearly the same:

5. 5 CHDP/Head Start IAA Overall goal is to improve the health status of children by assuring the provision of preventive services and necessary treatment from comprehensive, continuing care providers (medical home).

6. 6 CHDP and EPSDT EPS (Early and Periodic Screening) provided through the Child Health and Disability Prevention (CHDP) Program DT (Diagnosis and Treatment) provision of these services is through Medi-Cal

7. 7 CHDP

8. 8 CHDP

9. 9 CHDP

10. 10 CHDP Periodicity Schedule The CHDP program periodicity schedules for health assessments and dental referrals standardize assessment intervals and promote continuity of care for eligible children and youth. Medi-Cal Managed Care contractors and the Healthy Families plan contractors use the American Academy of Pediatrics periodicity schedule which have additional visits. The periodicity schedule offers CHDP providers a tracking mechanism for the provision of pediatric preventive health care services and is a reminder for when to deliver recommended services. assessing a child’s health at regular recommended intervals in the child’s life to assure continued healthy development.

11. 11 Medical Necessity Complete health assessments may be performed before the next regularly scheduled physical examination when the following situations exist: There is a need for a sports or camp physical examination The individual is in foster care or out-of-home placement There is a need for a school or preschool entrance examination There is a need for providing additional anticipatory guidance to the individual or the parent or legal guardian There is a history of perinatal problems There is evidence of significant developmental disability

12. 12 CHDP Diagnosis and Treatment Children identified with suspected problems as a result of a health assessment are referred for necessary diagnosis and treatment

13. 13 CHDP Screening Services

14. 14 Support Services

15. 15 CHDP in Local Communities Local Programs in 58 counties and 3 cities with health departments Local Program Responsibilities enroll providers visit offices provide assistance to families to access services follow-up of problems identified during exam

16. 16 What is the CHDP Gateway? A process to maximize enrollment of uninsured low-income children into comprehensive health care services Medi-Cal Healthy Families The Gateway process enables CHDP Providers to electronically pre-enroll CHDP-eligible children into full-scope Medi-Cal at time of a CHDP visit.

17. 17 How do patients benefit? A single online application event determines eligibility for temporary enrollment Pre-enrollment provides immediate temporary fee-for-service Medi-Cal for month of application and subsequent month

18. 18 Additional Benefits Provider office If pre-enrolled into Medi-Cal and condition identified during health assessment, provider can refer for follow-up prescribe medications order additional medically necessary tests refer for dental care

19. 19 In the providers office . . . families complete the pre-enrollment application provider gives brochure which explains the process provider enters information on-line to determine child’s pre-enrollment eligibility automated pre-enrollment process will establish temporary eligibility effective immediately authorize BIC (Benefits Identification Card) Print an immediate eligibility document

20. 20 Who is eligible for Gateway? Children and youth under 19 years of age family incomes at or below 200% of the FIG residents of California Includes children and youth eligible for limited scope Medi-Cal Medi-Cal with a Share of Cost

21. 21 The CHDP Gateway process An opportunity for families to continue health care coverage by: Completing a joint Med-Cal/Healthy Families application Head Start staff can encourage families to apply for continuing coverage

22. 22 Safety Net for Children Provider office If pre-enrollment process identifies child to be eligible for CHDP services ONLY, the provider can still perform a CHDP health assessment And if a condition is identified during the course of health assessment, provider can: refer to county’s children’s treatment program refer to California Children’s Services request assistance from local CHDP program

23. 23 What if family is over income? If income over 200% of FIG, may be eligible for Healthy Families or other local health care programs Providers are encouraged to keep supply of joint application and provide to families

24. 24 What can I do to help? Promote the advantages of health care coverage and preventive health services Encourage them to apply for Medi-Cal/Healthy Families Reassure and educate

25. 25 For more information Contact the local CHDP program in your county or city Consider a MOU with local program Go to the CHDP website at: www.dhs.ca.gov/chdp