FLORIDA MEDICAIDS CHILD HEALTH CHECKUP SERVICE Darcy Abbott September 7, 2005

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FLORIDA MEDICAIDSCHILD HEALTH
CHECK-UPSERVICEDarcy AbbottSeptember 7, 2005
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Child Health Check-Up formerly known as EPSDT
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What is the Child Health Check-Up Program?

• Early Periodic Screening, Diagnosis Treatment

is a federally mandated preventive health care
program for Medicaid-eligible children from birth
through 20 years of age.
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The Purpose of the Child Health Check-Up Program

• To identify and correct medical conditions in
  children and young people before the conditions
  become serious and disabling
• To provide entry into the health care system and
  access to a medical home for each child
• To provide preventive/well child care on a
  regularly scheduled basis

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Who is eligible for Child Health
Check-Ups?Medicaid eligible children Birth
through age 20 MediKids eligible children 1
year through age 4
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When should children have a Child Health Check-Up?

• Birth or neonatal examination
• Two to four days for newborns discharging less
  than 48 hours after delivery
  
• By one month
• Two months
• Four months

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Child Health Check-Up Schedule (continued)

• 6 months
• 9 months
• 12 months
• 15 months
• 18 months

• Once per year for2 to 6 year olds
• 8 and 10 years
• Once per year for 11through 20 year olds
• Florida Medicaid recommends check-ups at 7 and 9
  years of age for those children at risk

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Recommendations for Preventive Pediatric Health
Care
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Child Health Check-Up Required Components

• Comprehensive health and developmental history
• Nutritional assessment
• Developmental assessment
• Comprehensive unclothed physical examination
• Dental screening
• Vision screening

• Hearing screening
• Laboratory tests
• Appropriate Immunizations
• Health education, anticipatory guidance
• Diagnosis and treatment
• Referral and follow-up

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Optional Child Health Check-Up Tracking Forms
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Comprehensive Health andDevelopmental History
Includes

• Past medical history
• Developmental history
• Behavioral health status

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Optional Behavioral Health and Developmental
Screening Form
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Reimbursement for a Child Health Check-Up
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Why Child Health Check-Ups are Important !
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  FLME4500-R020
FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION
PAGE 1 AS OF
03/28/05 MEDICAID
MANAGEMENT INFORMATION SYSTEM
RUN DATE 03/28/05   A N N U A
L C H I L D H E A L T H C H E C K - U P P A R
T I C I P A T I O N R E P O R T C M S - 4 1 6

10/01/03 - 09/30/04   STATE FLORIDA FY
2004 CAT
A G E G R O U P S
TOTAL lt 1 1 - 2 3 -
5 6 - 9 10 - 14 15 - 18 19 -
20   1. TOTAL INDIVIDUALS CN
1,613,816 165,721 241,825 290,051
301,325 340,706 218,270 55,918
ELIGIBLE FOR CHCUP MN 13,019
1,984 1,598 615 1,541
2,310 2,137 2,834
TOTAL 1,626,835 167,705
243,423 290,666 302,866 343,016
220,407 58,752   2A. STATE PERIODICITY
SCHEDULE 6.00 4.00
3.00 2.00 5.00 4.00
2.00 2B. NUMBER OF YEARS IN AGE GROUP
1.00 2.00 3.00
4.00 5.00 4.00 2.00 2C.
ANNUALIZED STATE PERIODICITY
6.00 2.00 1.00 0.50
1.00 1.00 1.00 SCHEDULE 3A.
TOTAL MONTHS CN 14,992,640
1,073,630 2,369,464 2,910,592 2,866,000
3,274,081 2,048,431 450,442 OF
ELIGIBILITY MN 54,440
13,141 8,844 2,202 5,297
7,341 6,469 11,146
TOTAL 15,047,080 1,086,771
2,378,308 2,912,794 2,871,297 3,281,422
2,054,900 461,588   3B. AVERAGE PERIOD OF
CN 0.77 0.54 0.82
0.84 0.79 0.80 0.78
0.67 ELIGIBILITY MN
0.35 0.55 0.46 0.30
0.29 0.26 0.25 0.33
TOTAL 0.77
0.54 0.81 0.84 0.79
0.80 0.78 0.65   4. EXPECTED
NUMBER OF CN 3.24
1.64 0.84 0.40 0.80
0.78 0.67 OF SCREENINGS PER
MN 3.30 0.92
0.30 0.15 0.26 0.25
0.33 ELIGIBLE TOTAL
3.24 1.62 0.84 0.40
0.80 0.78 0.65   5.
EXPECTED NUMBER CN 1,777,983
536,936 396,593 243,643 120,530
272,565 170,251 37,465 SCREENINGS
MN 10,503 6,547
1,470 185 231 601
534 935
TOTAL 1,788,486 543,483 398,063
243,828 120,761 273,166 170,785
38,400   6. TOTAL SCREENS CN
1,174,883 365,289 371,191 180,625
95,126 109,121 47,634 5,897
RECEIVED MN 6,454
4,618 1,509 61 73
111 54 28
TOTAL 1,181,337 369,907
372,700 180,686 95,199 109,232
47,688 5,925   7. SCREENING RATIO
CN 0.66 0.68 0.94
0.74 0.79 0.40 0.28
0.16 MN
0.61 0.71 1.03 0.33
0.32 0.18 0.10 0.03
TOTAL 0.66
0.68 0.94 0.74 0.79
0.40 0.28 0.15   8. TOTAL
ELIGIBLES WHO CN 1,252,000 165,721
241,825 243,643 120,530 272,565
170,251 37,465 SHOULD RECEIVE AT
MN 5,940 1,984 1,470
185 231 601 534
935 LEAST ONE INITIAL OR TOTAL
1,257,940 167,705 243,295 243,828
120,761 273,166 170,785 38,400
PERIODIC SCREEN   9. TOTAL ELIGIBLES
CN 700,819 135,710 177,364
156,314 86,659 97,836 42,095
4,841 RECEIVING AT LEAST MN
2,372 1,361 700 59
70 102 52 28
ONE INTIAL OR TOTAL 703,191
137,071 178,064 156,373 86,729
97,938 42,147 4,869 PERIODIC
SCREEN   10. PARTICIPANT RATIO CN
0.56 0.82 0.73 0.64
0.72 0.36 0.25 0.13
MN 0.40
0.69 0.48 0.32 0.30
0.17 0.10 0.03
TOTAL 0.56 0.82 0.73
0.64 0.72 0.36 0.25
0.13
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FLME4500-R020 FLORIDA AGENCY
FOR HEALTH CARE ADMINISTRATION
PAGE 2 AS OF 03/28/05
MEDICAID
MANAGEMENT INFORMATION SYSTEM
RUN DATE 03/28/05   A N N U A
L C H I L D H E A L T H C H E C K - U P P A R
T I C I P A T I O N R E P O R T C M S - 4 1 6

10/01/03 - 09/30/04 STATE FLORIDA FY 2004
CAT A G E
G R O U P S
TOTAL lt 1 1 - 2 3 - 5
6 - 9 10 - 14 15 - 18 19 -
20   11. TOTAL ELIGIBLES CN
169,252 26,075 55,620 37,023
16,860 20,761 10,548 2,365
REFERRED FOR MN 16
7 4 0 2
1 1 1 CORRECTIVE
TREATMENT TOTAL 169,268 26,082
55,624 37,023 16,862 20,762
10,549 2,366   12A. TOTAL ELIGIBLES
CN 372,446 131 10,543
86,860 102,364 106,256 56,474
9,818 RECEIVING ANY DENTAL MN
738 1 10 52
156 215 118 186
SERVICES TOTAL 373,184
132 10,553 86,912 102,520
106,471 56,592 10,004   12B. TOTAL
ELIGIBLES CN 269,095 44
6,819 61,496 77,114 80,031
38,092 5,499 RECEIVING PREVENTIVE
MN 486 0 5
40 113 159 69
100 DENTAL SERVICES TOTAL
269,581 44 6,824 61,536
77,227 80,190 38,161
5,599   12C. TOTAL ELIGIBLES CN
176,766 33 4,340 37,147
48,437 50,550 30,605 5,654
RECEIVING DENTAL MN 356
0 6 24 68
90 63 105 TREATMENT
SERVICES TOTAL 177,122 33
4,346 37,171 48,505 50,640
30,668 5,759   13. TOTAL ELIGIBLES
CN 1,430,263 101,313 222,266
272,934 279,774 313,537 192,904
47,535 ENROLLED IN MN
22 19 1 0
1 0 1 0
MANAGED CARE TOTAL 1,430,285
101,332 222,267 272,934 279,775
313,537 192,905 47,535   14. TOTAL
NUMBER OF CN 75,086 3,168
42,027 29,891 SCREENING BLOOD
MN 171 33 128
10 LEAD TESTS TOTAL
75,257 3,201 42,155 29,901  
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Child Health Check-UpParticipation Rates(the
percentage of children receiving a check-up)
Based on federal CMS-416 reports
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Medicaid Area Child Health Check-Up
Coordinators
(Formerly known as EPSDT)
Area 2A Debra Cornelius [phone] x118
Area 2B Mehran Abbey [phone] x200
Holmes
Jackson
Okaloosa
Escambia
Santa Rosa
Nassau
Gadsden
Walton
Washington
Hamilton
Jefferson
Madison
Leon
Calhoun
Bay
Duval
Baker
Columbia
Suwannee
Wakulla
Taylor
Liberty
Union
Clay
Bradford
Gulf
Franklin
Lafayette
St. Johns
Gilchrist
Putnam
Alachua
Dixie
Flagler
Levy
Marion
Volusia
Lake
Citrus
Sumter
Seminole
Hernando
Orange
Brevard
Pasco
Osceola
Polk
Hillsborough
Pinellas
Indian River
Area 5 - Mary Ann Hauckes [phone] x131
Hardee
Manatee
Okeechobee
St. Lucie
Highlands
De Soto
Sarasota
Martin
Area 6 Glorybell Ramirez [phone] x107
Glades
Charlotte
Area 10 - Lisette Rodriguez [phone]
Hendry
Palm Beach
Lee
Broward
Collier
Area 11 Rhea Gray [phone]
http//ahca.myflorida.com
Dade
Monroe
Medicaid information and Child Health Check-Up
posters are available from your area coordinator
listed above.
Updated 05/05
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Child Health Check-UpsThe Formula For
Success!
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Information Sites

• Agency for Health Care Administrationwww.ahca.myf
  lorida.com
• Department of Children and Familieswww.dcf.state.
  fl.us
• Centers for Medicare and Medicaid
  Serviceswww.cms.hhs.gov

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Medicaid Web Address
www.ahca.myflorida.com
Anne Boones e-mail boonea_at_ahca.myflorida.com