ARTICLE 4

 

                                                               SECTION 10

                                                                                                

                      CHILD HEALTH AND DISABILITY PREVENTION PROGRAM (CHDP)

 

 

1.        GENERAL

 

The Child Health and Disability Prevention Program (CHDP) is a State program of health screening for children in California which incorporates the federally mandated program known as Early and Periodic Screening, Diagnosis and Treatment (EPSDT).  CHDP is available to all Medi-Cal beneficiaries under the age of 21.  The CHDP unit also handles the prenatal care guidance program.  This program provides for obstetrical case management for Medi-Cal eligible pregnant women.  This section provides an explanation of the purpose and provisions of CHDP.  Additionally, this section describes procedures to be followed by the worker in order to meet CHDP informing, documentation and referral requirements.

 

 

2.        SCOPE

 

A.       Purpose

 

1)      CHDP

 

                        The purpose of screening is the earliest possible detec­tion, correction and prevention of problems in health and development, which are potentially handicapping to people, or could lead to more serious medical problems.

 

 

2)      Prenatal Care Guidance Program

 

                        The purpose of this program is to inform, motivate and assist pregnant women with early and appropriate prenatal care.  The long range goal is to maximize the number of healthy full-term infants and thereby help to reduce future medical costs for care of these infants.

 

 

B.       Provisions

 

Health screening is a series of evaluations by physicians or paramedical personnel, such as pediatric nurses or nurse practitioners, supervised by a physician.  The screening evaluation includes a health and development history, physical examinations and developmental assessment, vision and hearing tests, a dental inspection, lab tests appropriate for age and population groups, immunizations, nutritional assessment, and other tests as needed.  In addition, children 3 years of age and older can be referred to a dentist for a yearly checkup, preventive dental care and needed treatment.

 

 

Under EPSDT, the above tests are done at "periodic" intervals according to the age of the child.  The screener must explain the results of screening tests to the parent/caretaker of the child and make a referral for diagnosis and treatment to the appropriate source of medical care when necessary.

 

 

C.       Availability

 

Lists of CHDP providers of medical and dental screenings by geographical area are available to each district office.  The lists include private physicians and dentists who provide CHDP services as well as the local health department.  Contracted Health Care Plan (HCP) providers are required to provide CHDP services to all eligible children who are enrolled in HCP.

 

 

3.        ELIGIBILITY TECHNICIAN RESPONSIBILITIES

 

MEM 50184 requires that all Medi-Cal applicants who are under 21 years of age or are responsible for persons under 21 years of age and all eligible pregnant women be informed of CHDP services.  Workers are responsible for informing all eligible Medi-Cal applicants/ beneficiaries of CHDP services, for making referrals to CHDP, and for the documentation of the informing/referral requirements.

 

 

A.       Preapplication

 

The CHDP informational brochure, "Free Health Checkups", is included in packet D and is given to all Medi-Cal and AFDC applicants at the preapplication interview.

 

 

B.       Orientation

 

The Orientation worker has the responsibility of informing applicants/beneficiaries of their right to a referral to the CHDP program and explains the information included in the "Free Health Checkups" brochure.

 

 

C.       Intake

 

The intake worker is responsible for ensuring that the applicant has been informed of CHDP benefits and for making referrals to CHDP on all eligible persons who request CHDP services.

 

 

1)      Referrals

 

                        The intake worker will enter the appropriate CHDP code (IM-EDP Manual, Section 5) on deprivation screen MICCIOOO for AIS intakes, or in Box 50, Line B of the 278 LM document for manual intakes, in order to make a referral to CHDP or to indicate that the applicant has rejected CHDP services.  The CHDP code will appear on the turnaround document but will automatically be deleted on the next turnaround document.  The entry of any CHDP codes (except code 9) will automatically generate a referral (Form CDS-286) to CHDP.  Referrals received on Prepaid Health Plan (PHP) participants will be forwarded to the PHP provider by CHDP.

 

 


 

2)      Documentation

 

                        The worker will check the CHDP box under "Medi-Cal" on the lower section of Form 07-33 DSS and will sign the "signature of worker" line to document that the applicant has been informed of CHDP services.  Additionally, the worker will document on the County Use section of the 16-2 DSS (page 8) or MC 210 (page 9) that the applicant has been referred to or has rejected CHDP services.

 

 

D.       Granted

 

The CHDP informational brochure is included in all Medi-Cal and AFDC redetermination packets.  The Orientation worker will explain the information contained in the brochure as part of the redetermination process.  During the redetermination interview, the Medi-Cal granted worker will review Question A of the Social Services section of the 16-2 DSS with the beneficiary.  The worker will document in the County Use section that the beneficiary has been referred to or has rejected CHDP services.