BUILDING BRIDGES WITH YOUR STATE’S MEDICAID EARLY AND PERIODIC SCREENING,
DIAGNOSIS, AND TREATMENT PROGRAM
Medicaid: Early and Periodic Screening, Diagnosis, and
Treatment (EPSDT)
Medicaid’s child health component, known as the Early and Periodic Screening, Diagnosis,
and Treatment (EPSDT) program, has been shaped to fit the standards of pediatric care and
to meet the special physical, emotional, and developmental needs of low-income children.
Since 1967, the purpose of the EPSDT program has been "to discover, as early as possible, the
ills that handicap our children" and to provide "continuing follow up and treatment so that
handicaps do not go neglected" (http://mchb.hrsa.gov/epsdt/overview.html).
EPSDT is a required benefit for all "categorically needy" children (e.g., those who have
poverty-level income, receive Supplemental Social Security Income, or receive federal foster
care or adoption assistance). EPSDT's rules reflect the greater health needs of low-income
children, as well as children whose special health needs qualify them for assistance.
In 1965, Congress enacted Medicaid, extending medical benefits to all children in households
receiving Aid to Families with Dependent Children. The original legislation also gave states
the option of extending coverage to all very poor children under age 21, regardless of welfare
status.
Most children in Medicaid are in managed care and remain entitled to the full EPSDT benefit.
In some states, managed care plans are responsible for providing all EPSDT services. In
others, the Medicaid agency may be responsible for covering supplemental services beyond
those listed in the managed care agreement. Certain children, such as those in foster care,
may receive all of their coverage on a fee-for-service basis.
RELATIONSHIP BUILDER: The link below provides you with information on finding your state’s
program information:
http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/By-State.html
POTENTIAL IDEAS FOR STATE LEADERSHIP TEAMS:
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Align early childhood system goals with EPSDT using a set of common indicators
Assess early screening and provision of supports for social emotional health in your
state's EPSDT
Assess opportunities for care coordination around early childhood systems
Provide EBCD education to those who work with your state’s Medicaid EPSDT
program
BUILDING BRIDGES WITH YOUR STATE’S MEDICAID EARLY AND PERIODIC SCREENING,
DIAGNOSIS, AND TREATMENT PROGRAM
TOOLS:
1. Sample email to your state’s Medicaid EPSDT Program Leaders
2. Foundational PowerPoint
Sample email to your state’s Medicaid EPSDT Program Leaders
Email Subject Heading: An Opportunity to Collaborate with Your AAP Chapter
Dear [insert name],
It is a pleasure to reach out to you as the Building Bridges State Early Brain and Child
Development (EBCD) Team Leaders (consisting of a member of our American Academy of
Pediatrics (AAP) Chapter and Early Childhood Systems Representative). As you may know, the
AAP has made EBCD a strategic priority. This is an incredible opportunity to ensure that
children are supported early with nurturing environments and relationships that promote
health and success.
We are interested in exploring how we can work together to incorporate EBCD efforts into the
work of our state’s Medicaid EPSDT services. In this regard, we would like to plan a meeting or
a call to identify collaborative efforts and opportunities.
Below are the days and times we are available during the next 2 weeks for your consideration.
[insert dates and times]
If you have any questions, please let us know. We are looking forward to speaking with you and
exploring ways that we can work together.
Sincerely,
Names
Contact Information