July 2006

Introduction

The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program provides comprehensive health services for infants, children, and adolescents enrolled in Medicaid. Under federal regulations, states are given some flexibility in determining the periodicity or timing of the health visits and screenings, but the content of screening services is mandated by law to include the following:

• Comprehensive health and developmental history, including a developmental assessment of physical and mental health
  
• Comprehensive physical examination
  
• Immunizations, based on the current approved Advisory Committee on Immunization Practices schedule
  
• Laboratory tests, including mandatory lead screening
  
• Vision, hearing, and dental screening
  
• Health education and anticipatory guidance (See the Centers for Medicare and Medicaid Services' (CMS') EPSDT fact sheet for program details).
  

Data indicate, however, that many children do not receive the EPSDT services for which they are eligible. Reasons include inadequate systems for reporting the provision of EPSDT services to ensure that services are fully and appropriately provided; limited health professional participation in Medicaid, particularly among dentists and mental health professionals; and a lack of awareness among some parents of eligible children about the availability of these services (General Accounting Office (GAO), 2001). In addition, the Deficit Reduction Act of 2006 weakened federal benefit and cost sharing standards for Medicaid and gave states increased flexibility in designing programs that could negatively impact EPSDT services for eligible infants, children, and adolescents (Center for Children and Families (CCF), 2006).

This knowledge path has been compiled by the Maternal and Child Health Library at Georgetown University. It offers a selection of current, high-quality resources about providing and strengthening EPSDT services. The path includes guidelines for the frequency, timing, and content of health-promotion and disease-prevention services for infants, children, and adolescents. It is aimed at health professionals, program administrators, policymakers, and families, and it will be updated periodically.

Related topics: Please see our knowledge paths about child and adolescent health insurance and access to care, children and adolescents with special health care needs, and locating community-based services to support children and families.

Please note: According to the Centers for Medicare and Medicaid Services (CMS), the "D" in "EPSDT" stands for "Diagnostic." However, "Diagnosis" is frequently used in the literature and therefore appears often below.

Overview

• See the Kaiser Family Foundation's fact sheet, Early and Periodic Screening, Diagnostic, and Treatment Services (2005), which gives an overview of the history and importance of the EPSDT benefit, the services covered, children's underutilization of EPSDT, costs, and increasing state flexibility over benefits and cost sharing.
  

  
  

Web Sites: A-Z

• American Academy of Pediatrics (AAP). Contains guidelines, schedules, health-education materials, and other resources for strengthening EPSDT services. Tools include

  Bright Futures: Guidelines for health supervision of infants, children, and adolescents, 3rd ed. (2007).

  Medicaid policy statement. (2005).

  Recommendations for preventive pediatric health care, rev. ed. (2007).

  Recommended childhood and adolescent immunization schedule: United States, 2006. (2006).

  Scope of health care benefits for children from birth through age 21, rev. ed. (2006).

• Center for Children and Families (CCF). Presents analyses of federal policy developments and state-based initiatives affecting the health care coverage of America's families that include analyses of EPSDT services. CCF is based at Georgetown University's Health Policy Institute. Publications include

  Deficit Reduction Act: A review of key Medicaid provisions affecting children and families. (2006).

  Why Medicaid matters: The frontline perspectives of people with chronic conditions. (2005). An executive summary is available.

• Center for Health Services Research and Policy (CHSRP). Contains issue briefs, reports, journal articles, and other publications for policymakers, program administrators, and health professionals about MCH delivery systems, including the implementation of SCHIP and EPSDT coverage policies. CHSRP is part of the George Washington University School of Public Health and Health Services. Recent publications include

  Medicaid's role in treating children in military families. (2005).

  National security and U.S. child health policy: The origins and continuing role of Medicaid and EPSDT. (2005).

• Centers for Disease Control and Prevention (CDC). Contains a number of resources relevant to the provision of EPSDT services, including

  CDC growth charts: United States. (2000). Contains tools and background information for plotting the growth of infants, children, and adolescents through age 20. Also links to interactive training modules for health professionals using the pediatric growth charts in clinical and public health settings. The growth charts are available in English, Spanish, and French.

  Childhood and adolescent immunization schedule. (2006). Contains the immunization schedule in various formats, a catch-up schedule, education materials, and other resources related to immunization services. The schedule is available in English and Spanish.

  Developmental Screening. Offers background information, screening tools, and recommendations for developmental screening.

  Early Hearing Detection and Intervention (EHDI) Program: Organizational Recommendations and Screening Guidelines. Contains links to guidelines for newborn hearing programs and audiologic screening for infants, children, and adolescents.

  Recommendations for blood lead screening of young children enrolled in Medicaid: Targeting a group at high risk. (2000). This report provides recommendations for improved screening strategies and relevant background information to improve the delivery of lead-related services to children served by Medicaid.

  Also see CDC's Pediatric Nutrition Surveillance System (PedNSS).

• Centers for Medicare and Medicaid Services (CMS). Contains general information about Medicaid with links to eligibility information. Offers an overview of the EPSDT program and a fact sheet that describes the required services for EPSDT within each state's Medicaid program. Also provides an overview of state Medicaid agency responsibilities regarding EPSDT with links to the annual EPSDT report, reporting instructions, and state and national summaries from the reports. Publications include

  Guide to children's dental care in Medicaid. (2004).

• Children's Dental Health Project (CDHP). Contains program information and resources about children's oral health, particularly issues involving access to care, financing programs, and health disparities. Several reports detail actions taken by federal and state governments that may affect access to oral health care for infants, children, and adolescents who receive EPSDT services, as follows:

  Dental benefits in the Medicaid/CHP+ streamlining HIFA waiver. (2005). This report outlines a proposed benefit design that honors the nature of pediatric oral health and respects legal requirements in EPSDT and SCHIP.

  Does flexibility spell loss of dental benefits? (2005).

  Pressure builds to cut $10B. Policy shifts in Medicaid programs for children. (2005).

  Protecting kids' dental benefits in Medicaid. (2005).

  Understanding Medicaid state waivers and their impact on children's dental coverage. (2006).

• Commonwealth Fund. Contains program information and an extensive collection of reports about children's health and development that can be used for improving EPSDT-related services. The Commonwealth Fund is a private foundation working to improve health coverage and quality. Recent publications include

  Comparing EPSDT and commercial insurance benefits. (2005).

  Early child development in social context: A chartbook. (2004).

  EPSDT and children's coverage costs. (2005).

  EPSDT: An overview. (2005).

  How Medicaid and EPSDT promote healthy child development among children with special health care needs. (2005).

  How medical claims simplification can impede delivery of child developmental services. (2005).

  Promoting healthy development survey-PLUS (PHD-PLUS) implementation guidelines. (2006).

  Quality of preventive health care for young children: Strategies for improvement. (2005).

  Role of states in improving health and health care for young children. (2005).

  Studying and tracking early child development from a health perspective: A review of available data sources. (2005).

  Using external quality review organizations to improve the quality of preventive and developmental services for children. (2005).

  Also see the learning modules, Practical Guide for Healthy Development, and the webcast, Health Services for Children: The Role of Medicaid and Its Benefit Package. See too the National Academy for State Health Policy (NASHP) for information about the program, Assuring Better Child Health and Development (ABCD). The learning modules, Webcast, and program are funded by the Commonwealth Fund.

• Department of Health and Human Services: Office of the Inspector General. Offers a series of reports about studies conducted in eight states to assess whether sampled children in foster care are receiving health care services that fulfill federal and state requirements, including EPSDT medical and dental examinations and an initial health examination upon entry into foster care. The state reports are Georgia (2005), Illinois (2004), Kansas (2003), New Jersey (2003), New York (2005), North Dakota (2004), Oregon (2004), and Texas (2004).
  
  
• Developmental Behavioral Pediatrics Online (dbpeds.org). Contains screening tools and other resources for health professionals to promote better care and outcomes for children, adolescents, and families affected by developmental, learning, and behavioral problems. dbpeds.org is affiliated with AAP's Section on Developmental and Behavioral Pediatrics. See the dbpeds.org online tutorial about screening children for developmental, behavioral, and emotional problems.
  
  
• Health Resources and Services Administration/Maternal and Child Health Bureau (MCHB). Offers the following set of EPSDT resources:

  EPSDT and Title V Collaboration to Improve Child Health. Provides information about EPSDT and about opportunities for collaboration between Title V and Medicaid to improve EPSDT screening and treatment rates. Also offers information about how the EPSDT benefit is administered, the reporting process, family support strategies, and specific policy and legislative issues. This tool is presented by MCHB in partnership with George Washington University's Department of Health Policy.

• Kaiser Family Foundation (KFF): Medicaid/SCHIP. Contains news, publications, program information, and data about Medicaid, including EPSDT services. KFF is an independent philanthropy focusing on national health care issues. Publications include

  Medicaid resource book. (2003). This comprehensive reference tool describes Medicaid eligibility, benefits, financing, and administration and includes discussion of EPSDT, among other components of the Medicaid program.

  Early and Periodic Screening, Diagnostic, and Treatment Services. (2005). [Fact sheet].

• National Academy for State Health Policy (NASHP): Assuring Better Child Health and Development (ABCD) Program. Contains program information and resources to help states improve the delivery of early childhood development services, including EPSDT-related services, for children with low incomes and their families. ABCD is funded by the Commonwealth Fund. Resources and publications include

  ABCD Reading Room. This collection of resources for state policymakers focuses on (1) relevant findings from the science of early childhood development, (2) preventive health care guidelines and new directions, (3) promoting young children's mental health, (4) measurement and quality improvement in early childhood services, (5) comprehensive and systematic approaches to early childhood services, and (6) early childhood services costs and financing strategies.

  How states are working with physicians to improve the quality of children's health care. (2006).

  Improving the delivery of health care that supports young children's healthy mental development: Early accomplishments and lessons learned from a five-state consortium. (2006).

  Key measurement issues in screening, referral, and follow-up care for young children's social and emotional development. (2005).

  State approaches to promoting young children's healthy mental development: A survey of Medicaid, maternal and child health, and mental health agencies. (2005).

  Using Medicaid to support young children's healthy mental development. (2003).

  Washington state well child exam forms, rev. ed. (2004). This set of forms was developed as an EPSDT charting tool designed to promote standardization in the delivery of developmental services for children with low incomes and to enhance the state's capacity to review patient records for quality. The charting forms (available in seven languages and covering age groups from infancy through adolescence) furnish guidance and information to both physicians and parents and address age-specific development issues. The set of forms is currently available to all primary care providers statewide and has been mandated for the care of children in foster care.

• National Center for Hearing Assessment and Management (NCHAM). Contains a wealth of resources for health professionals, policymakers, program administrators, and families about early identification and management of hearing loss. NCHAM assists hospital-based Universal Newborn Hearing Screening and state-based Early Hearing Detection and Intervention programs in their efforts to ensure that all infants and toddlers with hearing loss are identified as early as possible and provided with timely and appropriate audiological, educational, and medical intervention. NCHAM is located at Utah State University.
  
  
• National Health Law Program (NHeLP). Offers manuals, issue briefs, case dockets, and other resources about EPSDT. NHeLP is a national public interest law firm that aims to improve health care for families with low incomes, minorities, the elderly, and people with disabilities. Publications include

  Children’s health under Medicaid: A national review of Early and Periodic Screening, Diagnosis and Treatment, 3rd ed. (2005). This chartbook provides an overview of the successes and shortcomings of the EPSDT program and notes some of the innovative methods being tried across the country to improve children's health through EPSDT.

  Medicaid Early and Periodic Screening, Diagnosis, and Treatment: Recent case developments, rev. ed. (2005).

  Toward a healthy future: Early and Periodic Screening, Diagnostic and Treatment services for poor children and youth. A comprehensive overview of Medicaid's EPSDT program, rev. ed. (2003).

  
  

Additional Electronic Publications

• Bertness J, Holt K. 2003. Head Start: An opportunity to improve the oral health of children and families. Washington, DC: National Maternal and Child Oral Health Resource Center (OHRC). This fact sheet discusses the role Head Start programs can have in providing access to oral health services, including education, screening, and examination for Head Start participants, many of whom are enrolled in the EPSDT program.
  
  
• Center for Best Practices. 2005. Funding for children's mental health services: Making the most of Medicaid. Washington, DC: National Governors Association. This issue brief discusses ways in which states can expand coverage for children with mental disorders. The brief provides a summary of the problems (which includes a list of steps states can take to expand coverage) and discusses the cost of care; the cost of unmet needs; coverage options (private vs. public insurance); Medicaid-related services and options including EPSDT; Home and Community-Based Services waivers; and the Tax Equity and Financial Responsibility Act option. In addition, the brief provides information about why states are not using these options to the fullest extent possible and offers suggestions for what can be done.
  
  
• Ferebee A. 2004. Childhood vision: Public challenges and opportunities. Washington, DC: Center for Health and Health Care in Schools. This policy brief provides a framework for policymakers, educators, and parents to assess the adequacy of current strategies to identify children with vision problems. The brief outlines issues in vision testing for children, describes programs and policies currently in place, summarizes select state and federal initiatives, and discusses policy options for ensuring that children's vision problems are identified and treated in a timely manner.
  
  
• Fox H, McManus P. 2005. 50-state analysis of Medicaid benefit coverage for children without EPSDT. Washington, DC: Maternal and Child Health Policy Research Center. This memorandum provides an analysis of limits on the amount, duration, and scope of Medicaid coverage that would be available to children in 50 states (excluding Oregon and including the District of Columbia) if the EPSDT benefits requirement were eliminated and states applied the coverage policies currently in effect for categorically needy adults. The analysis was based on a review of coverage descriptions found in each state's Medicaid plan and state plan amendments, current as of April 2005.
  
  
• Government Accountability Office (GAO). 2001. Medicaid: Stronger efforts needed to ensure children's access to health screening services. Washington, DC: Government Accountability Office. This report examines the extent to which children enrolled in Medicaid are receiving EPSDT services; efforts states have made to improve delivery of EPSDT services, particularly within managed care; and federal efforts to ensure that state Medicaid programs provide covered EPSDT services.
  
  
• Grason H, Hess C, Van Landeghem K, Silver G, Brown B, Schor E. 2004. Integrating measures of early childhood health and development into state Title V maternal and child health services block grant plans. Baltimore, MD: Johns Hopkins University. This issue brief provides information about measures of preventive health and developmental services for children from birth to age 5 and how those measures can be integrated into MCH plans. The brief also outlines opportunities for partnerships between Medicaid (particularly EPSDT) and state Title V programs.
  
  
• Johnson K. 2006. Maximizing the use of EPSDT to improve the health and development of young children. New York, NY: National Center for Children in Poverty. This issue brief reviews research about the role of EPSDT in improving early childhood health and development and identifies opportunities for Early Childhood Comprehensive Systems leaders to use EPSDT in collaborative efforts to improve child health.
  
  
• Johnson K, Knitzer J. 2005. Spending smarter: A funding guide for policymakers and advocates to promote social and emotional health and school readiness. New York, NY: National Center for Children in Poverty. This report is designed to help policymakers, agency officials, families, and other advocates maximize the impact of existing funding streams, including EPSDT services, to support positive social and emotional development, early intervention, and treatment strategies that can improve school readiness.
  
  
• Keyser D, Firth R, Richardson A, Townsend MZ. 2006. Improving childhood blood lead level screening, reporting, and surveillance in Allegheny County, Pennsylvania. Santa Monica, CA: RAND Corporation. This report examines the current status of childhood blood-lead-level screening, reporting, and surveillance in Allegheny County, Pennsylvania, and offers recommendations for improving these processes, including those carried out by the EPSDT program.
  
  
• Rosman EA, Perry DF, Hepburn KS. 2005. Best beginning: Partnerships between primary health care and mental health and substance abuse services for young children and their families. Washington, DC: Georgetown University National Technical Assistance Center for Children's Mental Health. This report features eight innovative medical home practices that integrate behavioral health screening for the whole family, facilitate referrals to community services, and offer follow-up care to clients, many of whom are enrolled in the EPSDT program.
  
  
• Schneider D, Hayes KL, Crall JJ. 2005. CMS Form-416 report: Understanding its use in assessing dental care utilization in Medicaid's Early Periodic Screening, Diagnostic and Treatment (EPSDT) Service for children. Los Angeles, CA: National Oral Health Policy Center. This issue brief provides an overview of EPSDT and Medicaid-eligible children's ability to access oral health services; data on children's utilization of oral health services in Medicaid; and the CMS Services Form-416 report, which is the most common source of such data. The brief outlines concerns about using Form-416 data and derived utilization rates and proposes additional adjustments to Form-416 data.
  
  
• Schneider D, Crall JJ. 2005. EPSDT periodicity schedules and their relation to pediatric oral health standards in Head Start and Early Head Start. Los Angeles, CA: National Oral Health Policy Center. This issue brief provides a historical overview and analysis of the requirements for EPSDT oral health services and state EPSDT oral health periodicity schedules, the problems inherent in locating information relevant to the periodicity of EPSDT oral health services in current state data sources, and the policies developed by prominent organizations involved in providing pediatric oral health services regarding age of first dental visit and periodicity of services. The brief also presents recommendations for steps that Head Start and Early Head Start can take in collaboration with federal and state agencies and professional organizations to address these challenges and enhance oral health care for children.
  
  
• Smith AD. 2005. Medicaid EPSDT and AOD treatment services. Boston, MA: Resources For Recovery. This policy brief examines the federal requirements of EPSDT; explores three states' coverage of child and adolescent alcohol and other drug (AOD) treatment services under Medicaid; identifies components of state EPSDT practices that may be applicable to other states; and discusses considerations for states interested in developing Medicaid-reimbursable AOD services for children and adolescents.
  
  
• Smith PK. 2005. Enhancing child development services in Medicaid managed care: A best clinical and administrative practices toolkit. Hamilton, NJ: Center for Health Care Strategies, Inc. This toolkit illustrates experiences from 11 Medicaid managed care organizations in piloting activities to improve early childhood screening and anticipatory guidance, with an emphasis on preventive pediatric care. It reviews the Best Clinical and Administrative Practices Quality Framework and highlights strategies to improve the delivery of child development services, including early identification of developmental disabilities, improving outreach to members, enhancing provider partnerships, improving reimbursement and referral practices, and recognizing potential returns on investment.
  

  
  

Distance Learning

• Bright Futures at Georgetown University. Develops Web-based curricula, training tools, and other resources for health professionals and families for a practical developmental approach to providing health supervision for infants, children, and adolescents that support EPSDT program requirements. Resources and initiatives include

  Well-Child Care: A Bright Futures Curriculum for Providers in MCH and Medicaid/EPSDT Settings. Presents a comprehensive training curriculum for health professionals who provide well-child care for infants, children, and adolescents, especially those served by state MCH programs or by EPSDT. This curriculum is funded by the Maternal and Child Health Bureau (MCHB).

  HealthCheck Provider Education System. Offers an online curriculum and resources for delivering and documenting EPSDT services to Medicaid-eligible children and adolescents in Washington, DC. This system was developed in collaboration with the District of Columbia's Medical Assistance Administration.

  What to expect and when to seek help: Bright Futures developmental tools for families and providers. (2006). Based on Bright Futures in practice: Mental health (2002), this set of four tools aims to help professionals and families begin important conversations together on how best to support the social and emotional development of children, from infancy through adolescence. A companion referral tool helps professionals identify resources in their own communities.

  Bright Futures in practice: Nutrition pocket guide (2002).

  Bright Futures in practice: Oral health pocket guide (2004).

  Also see AAP's Bright Futures: Guidelines for health supervision of infants, children, and adolescents, 3rd ed. (2007).

• Developmental Behavioral Pediatrics Online (dbpeds.org): Introduction to Developmental and Behavioral Screening. Provides an online tutorial with information about techniques for screening children for developmental, behavioral, and emotional problems that can be used effectively and efficiently in the pediatric office setting. The tutorial includes background information on screening, an annotated list of screening tools, and parent handouts.
  
  
• Managed Care and Poor Children. Presents a learning module about the interaction between managed care and children from families with low incomes, how managed care operates to serve children, and how managed care programs provide children's health services, including EPSDT services. This module, developed by Jane Perkins, J.D., M.P.H., at the University of North Carolina at Chapel Hill School of Social Work, is part of the Maternal and Child Health Leadership Training Program.
  
  
• Minnesota Department of Health: Child and Teen Checkups Online Training. Contains an online training program for health professionals and program administrators about Minnesota's EPSDT program. Includes a program description, eligibility requirements, screening schedules, and links to materials for parents. The program is a joint venture of the Minnesota Department of Human Services and the Minnesota Department of Health.
  
  
• Practical Guide for Healthy Development. Presents a set of six online learning modules designed to help primary care health professionals develop office systems to ensure that services provided to families are timely and appropriate. Topics include developmental screening and surveillance, family psychosocial screening and surveillance, eliciting parents' concerns, anticipatory guidance and parental education, and linking with the community. The modules were developed by the Healthy Development Learning Collaborative and funded by the Commonwealth Fund.
  
  
• Promoting Child and Adolescent Health: Bright Futures and EPSDT. Offers an online training program for pediatric health professionals to encourage the integration of the Bright Futures guidelines into daily practice. The program provides an overview of Bright Futures and links the use of Bright Futures teachings and tools to meeting EPSDT requirements. The program is sponsored by the School of Medicine, Virginia Commonwealth University, Medical College of Virginia Campus and the Virginia Department of Health.
  

  
  

Webcasts and Workshops

• Enhancing Partnerships Between Title V, Medicaid, and Local Health Departments Through EPSDT. Contains an audio broadcast, slides, and transcript from this September 2003 webcast that was sponsored by the MCHB. The discussion featured multiple presenters from federal, state, and local agencies and focused on experiences and recommendations for improving EPSDT rates through state and local partnerships.
  
  
• Health Services for Children: The Role of Medicaid and Its Benefit Package. Contains a webcast, transcript, agenda, speakers biographies, and links to background material for this September 2005 briefing about children and Medicaid sponsored by the Alliance for Health Reform and the Commonwealth Fund. Discussion topics include Medicaid reform proposals and EPSDT benefits.
  
  
• State Leadership Workshops On Improving EPSDT: An Opportunity for MCH Leaders. Describes a workshop available to administrators of state Title V Maternal and Child Health and Children with Special Health Care Needs programs and Medicaid programs to foster successful coordination between agencies regarding the EPSDT benefit. These workshops are sponsored by the MCHB.
  

  
  

Databases

The databases listed below are excellent tools for identifying data, additional literature and research, and programs about EPSDT. Many of the entries below contain tips on how to use the databases efficiently. Please note that databases vary in how terms should be entered; for example, some require quotation marks and others don't. Enter search phrases as shown in bold below.

Data

• National Quality Measures Clearinghouse™ (NQMC). Contains evidence-based health-care-quality-measures and measure sets for physicians, hospitals, and health plans to evaluate and improve the quality of health care for consumers. Search for measures that target a particular disease/condition, treatment/intervention, age range, vulnerable population, setting of care, or contributing organization. To identify EPSDT-related measures, enter Medicaid AND (infants OR children OR adolescents) in the search box. The database is sponsored by the Agency for Healthcare Research and Quality (AHRQ).
  
  
• Pediatric Nutrition Surveillance System (PedNSS). Monitors the nutritional status of children from birth to age 5 in federally funded maternal and child health programs, such as EPSDT. Data on birthweight, short stature, underweight, overweight, anemia, and breastfeeding are collected for those who visit public health clinics for routine care and nutrition services. PedNSS is administered by the Centers for Disease Control and Prevention (CDC).
  
  
• State Health Facts Online. Contains state-level data on demographics, health, and health policy, including health coverage, access, financing, and state legislation. Information is displayed as bar graphs, tables, or color-coded maps. View individual state profiles or compare data for all states by category. Click on the Medicaid and SCHIP category for information such as enrollment, eligibility requirements, managed care participation, spending and federal matching amounts, and enrollment practices. This system is provided by the Kaiser Family Foundation. Kaiser also offers customizable state Medicaid fact sheets. For detailed information about the Medicaid benefit packages in each state, see Kaiser's Medicaid Benefits Online Database.
  
  
• Title V Information System (TVIS). Contains data from annual Title V Block Grant applications and reports submitted by all 59 U.S. states and jurisdictions. To identify EPSDT-related services provided by states, select Program Data: Screening and Treatment Information for Infants, Women, and Children and Program Data: Standard Screening Tests Performed by States. In addition, select Program Data: State Priority Needs Keyword Search and choose keywords such as Health Screening, Immunization, and Oral Health from the list (each term must be searched separately). Also select State Performance Measures: Search By Keyword/Population and choose keywords such as those used above (e.g., Health Screening). TVIS is a service of the MCHB.
  

Literature and Research

• Maternal and Child Health Library at the National Center for Education in Maternal and Child Health (NCEMCH), Georgetown University. Maintains several databases to collect, manage, and disseminate knowledge about MCH, with special emphasis on knowledge gained from initiatives and programs supported by the MCHB. The library's bibliographic database is

  MCHLine®. Comprises an online catalog of materials in the Maternal and Child Health Library that includes items from the William McConway Hiscock Collection about the federal EPSDT program. The Hiscock collection consists of over 100 items, primarily reports and articles published in the 1970s and 1980s. Search the database for these and more recent items by entering epsdt in the keyword field of the search form. To limit your search, add a publication date range and/or additional keywords (e.g., "head start").

  The Maternal and Child Health Library also offers organizations and programs databases.

• National Guideline Clearinghouse (NGC). Contains evidence-based clinical practice guidelines and related materials for health professionals. Identify guidelines by entering Medicaid AND (infants OR children OR adolescents) in the Search field. The database is an initiative of the Agency for Healthcare Research and Quality (AHRQ).
  
  
• PubMed. Contains over 17 million citations for biomedical articles that date back to the 1950s. These citations are from MEDLINE and additional life sciences journals. PubMed includes links to many sites providing full-text articles and other related resources. To identify citations on the topic, type Medicaid in the search box. Click on Limits and select Date (e.g., Published in the last year); Ages: All Child (0-18 years); and Tag Terms: MeSH Major Topic. PubMed is a service of the National Library of Medicine (NLM).
  
  
• State Reports. Contains a collection of reports written by states about their health coverage programs and expansion strategies. Search by state and/or enter EPSDT in the keyword field. The database is provided by State Coverage Initiatives (SCI).
  

Programs

• Maternal and Child Health Library at the National Center for Education in Maternal and Child Health (NCEMCH), Georgetown University. Maintains two databases to identify organizations and programs that address EPSDT:

  MCH Organizations Database. Lists over 2,000 government, professional, and voluntary organizations involved in MCH activities, primarily at a national level. To identify organizations on this topic, go to Search the Maternal and Child Health Library Databases; click on MCH Organizations Database; type epsdt in the search field; and click on Search.

  MCH Projects Database. Comprises an online catalog of projects funded by the Maternal and Child Health Bureau (MCHB). To identify projects that focus on EPSDT, enter epsdt in the abstract field of the database search form.

• Also see the Bureau of Primary Health Care (BPHC) Service Delivery Sites.
  

  
  

EPSDT Resources for Families

• Bureau of Primary Health Care (BPHC) Service Delivery Sites. Offers contact information for community health centers that provide free or low-cost care to underserved populations. The database is searchable by geographic area, clinic name, and type of service provided, including oral health care, primary medical care, and mental health services. BPHC is part of the Health Resources and Services Administration (HRSA).
  
  
• Families USA: Medicaid and Children's Health. Presents legislative news and tools for families and advocates to keep track of changes in the Medicaid program. Includes resources for families who may need assistance with establishing their eligibility for Medicaid and to get Medicaid to cover their health care needs. Families USA advocates at the national, state, and local levels for high-quality, affordable health care for all Americans.
  
  
• Family Voices. Offers information for families about public health payment systems and services such as Medicaid and EPSDT, contact information for state programs, and grassroots organizing tips. Family Voices is a national grassroots organization working on behalf of infants, children, and adolescents with special health care needs and their families. Initiatives include

  Bright Futures for Families. Offers a family guide to raising healthy infants, children, and adolescents; a health care visit checklist; and other resources for families to promote and improve the health and well-being of all children.

  Family to Family Health Information Centers (F2F HICs). Presents program information and materials about this initiative in states for providing information to families about the medical home concept; health insurance availability; early screening and intervention; appropriate transition services for adolescents and young adults; and improving leadership and decision-making capacity for all families.

• Federation of Families for Children's Mental Health. Provides program and training information for this national family advocacy organization working to change the way systems such as Medicaid respond to children with mental health care needs and their families. Offers contact information for state and local chapters, publications, and links to additional mental health resources.
  
  
• Ramowski SK. 2004. EPSDT: Supporting children with disabilities. Tualatin, OR: National Center for Family Support. This guide for families who have a child with a disability describes EPSDT and how it can help their child.
  
  
• Also see the American Academy of Pediatrics (AAP), Bright Futures at Georgetown University, the Centers for Disease Control and Prevention (CDC), the Centers for Medicare and Medicaid Services (CMS), the National Center for Hearing Assessment and Management (NCHAM), and the National Health Law Program (NHeLP).
  

  
  

Author: Susan Brune Lorenzo, M.L.S., Maternal and Child Health Library.
Reviewers: Lauren Agoratus, M.A., Parent and N.J. Coordinator for Family Voices and the Family-to-Family Health Information Resource Center at the Statewide Parent Advocacy Network; Jeanne Anastasi, Bright Futures at Georgetown University; Olivia K. Pickett, M.A., M.L.S., Maternal and Child Health Library; Sarah Knipper Ramowski, M.S.W., Oregon Office of Family Health; James A. Resnick, M.H.S., Health Resources and Services Administration; John Richards, M.A., Bright Futures at Georgetown University; Tisha Valle, Parent.