January 14, 2015

Perspectives on the Building Blocks of a Comprehensive Systems of Care for CYSHCN: EPSDT Coordinators, Title V, CYSHCN Directors


Perspectives on the Building Blocks of a Comprehensive Systems of Care for CYSHCN: EPSDT Coordinators, Title V, CYSHCN Directors

A current look at how CYSHCN and their families are faring under today's health care systems

Read Washington DC UpdateAs part of its 2014 State Health Policy Conference in October, the National Academy for State Health Policy (NASHP) convened a select group of Early Periodic Screening, Diagnosis, and Treatment (EPSDT) Coordinators and Title V children and Children and Youth with Special Health Care Needs (CYSHCN) directors for a daylong meeting, supported by the Lucile Packard Foundation for Children's Health. The meeting was intended to provide a platform to share best practices and exchange ideas.  The information below is summarized from the NASHP blog.

Universal Themes Identified:

  • Care coordination is an integral part of primary care services for CYSHCN and an area where Medicaid, public health and other groups want to improve coordination of services within the system of care.
  • Efforts to reform the health care delivery system, while typically focused on the adult population, are increasingly beginning to address children, particularly CYSHCN.
  • Cross-agency partnerships are key to delivering comprehensive, coordinated care and avoiding duplicating services from multiple agencies.
  • Certain Medicaid policies that inadvertently hinder families' abilities to care for their children remain a challenge for many states

Issues Identified:

  • A need for a ‘coordinator of the care coordinators' for families whose children receive services from multiple programs
  • Medicaid policies that prohibit billing from multiple provider in the same day - necessitating that families set up needed appointments over a span of days

Good News:

  • EPSDT is a powerful tool for benefit design since it covers a wide variety of medically necessary services
  • The recently released National Standards for Systems of Care for CYSHCN is a useful tool that describes the structure and process components of an effective system of care for CYSHCN.