Thursday, March 25, 2010

EPSDT and our kids' "best possible functional level"

If you're a parent like me who has been told (by either the schools or Medicaid) that your child doesn't need the best treatment, only enough to get by, then you are going to be very happy about new federal regulatory language.

Federal regulatory law makes it clear that the purpose of EPSDT is to restore out children to their "best possible functional level."

EPSDT stands for Early Periodic Screening Detection and Treatment.   It requires that children on Medicaid under the age of 21 receive all medically necessary screening, preventative, diagnostic, and rehabilitatve services" that are medically necessary.

Section 440.130 of Title 42 defines "preventative services" as "services provided by a physician or other licensed practitioner of the healting arts to...prolong life; and promote physican and mental health and efficiency."

It defines "rehabilitative services" as "any medical or remedial services recommended by a physician or other licensed practitioner of the healing arts...for maximum reduction of physical or mental disability and restoration of a recipient to his best possible functional level."

Wow.  That does not leave states a lot of wiggle room in denying services under EPSDT.

No comments:

Post a Comment

About Me

My photo
I'm the mom of a child with disabilities. Hannah's first neurologist said she might never develop beyond the level of a 2 month old infant, and there wasn't anything I could do about it. The brain damage was just too severe. Nine years later, she walks, uses a touchscreen computer and I've just been shown she can learn to construct sentences and do simple math with the right piece of technology. Along the way, I discovered I needed to teach myself what Hannah's rights to services really were. Learning about early intervention services led to reading about IDEA and then to EPSDT. I've been waiting for the Obama administration to realize the power and potential of EPSDT for the medical rights - including the right to stay at home with their families - of children with disabilities. The health reform people talk about long term care, and the disability people talk about education and employment, but nobody is talking about EPSDT. So I am.