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The EPSDT set of services helps make sure that Medicaid eligible children
get their regular check-ups or exams. Children 20 or younger enrolled in
Oklahoma Medicaid should take part in the free EPSDT preventive health
care package.
Regular EPSDT exams will help your child stay healthy and may prevent any
serious health problems down the road. Children should get EPSDT exams at
regular times, even when your child is feeling well.
School Based Services are an integral part of EPSDT services. The District
Medicaid program bills Medicaid for Medicaid compensable services provided
to the District’s children enrolled in the SoonerCare program. Permission
is given in the enrollment process for any eligible provider, including
School Based Services to bill Medicaid for compensable services. Under
EPSDT School Based Services a wide range of services are offered to
Medicaid eligible children who are also eligible for services under the
Individuals with Disabilities Education Act (IDEA). The Individualized
Education Program (IEP) is a treatment plan for a successful education of
students with disabilities. The Individualized Health Plan (IHP) is a
treatment plan for children that have medical conditions, but do not
qualify for an IEP. The IEP and IHP outline the treatment plan and OHCA
funds any Medicaid compensable health services recommended in the IEP or
IHP for Medicaid eligible children. Current compensable health services
under the EPSDT School Based Services program are:
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Nursing Services,
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Psychological
Services,
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Hearing and Vision
Services,
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Occupational
Therapy Services,
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Physical Therapy
Services,
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Speech Language
Services, and
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Personal Care
Services.
Tulsa Public School’s EPSDT School Based Services program is vital part of
Oklahoma Medicaid’s efforts to reach and enroll uninsured children in the
state’s Managed Care Program called SoonerCare. Since 2000 the District
has assisted families to enroll their children in the SoonerCare program.
The number of District children enrolled in the SoonerCare program has
increase from a total of about 12,000 in 2000 to about 16,000 in 2005,
which is about a 33 percent increase in enrollment. Still, based on the
District’s Child Nutrition figures there is a significant population who
have not enrolled in the SoonerCare program. Based on Child Nutrition
figures the range of students who are eligible for the SoonerCare program
but are not currently enrolled are from 6,000 to 10,000 children. That is
a significant number of students who do not have ready access to medical
care. The District’s goal is to enroll every child in the District who is
eligible for the SoonerCare program. The District’s Medicaid program will
continue to work toward increasing the number of eligible children
enrolled in the SoonerCare program.
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