340:70-9-5. Mandatory offer of Early and Periodic Screening, Diagnosis and Treatment (EPSDT)
(a) Section 1902 of Title XIX of the Social Security Act requires that all persons under 21 years of age who are determined eligible for SoonerCare must be informed of the availability of Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services:
- (1) within 60 days of the initial eligibility determination; and
- (2) on an annual basis.
(b) The Oklahoma Department of Human Services (OKDHS) mails at the time of each certification, and each year thereafter, a written notice to eligible SoonerCare recipients informing them of the availability of EPSDT services.
(c) Special arrangements must be provided for recipients who do not read or understand English.
- (1) Recipients unable to read or understand written English are informed through face-to-face contact by the worker of the availability of EPSDT services. • 1
- (2) When necessary, the worker arranges for the assistance of a second-language translator, either from among members of the recipient's family or other community resources. For visually handicapped or illiterate English-speaking recipients, the worker reads and explains the written notice of EPSDT availability. • 2
(d) Persons who apply at a SoonerCare outreach facility are advised of the availability of EPSDT services at the time their SoonerCare applications are processed or completed.
(e) When the offer of EPSDT services is made face-to-face to any eligible recipient, the worker provides the recipient with a copy of OKDHS Pub. No. 87-36, Early and Periodic Screening, Diagnosis and Treatment. The worker discusses preventive health services, including EPSDT in language appropriate for the recipient's level of understanding. • 3
(f) If the medical provider finds an abnormality at the time of the screening, the provider notes this when filing a claim for payment. The results of the screening and abnormal finding are provided to OKDHS and appears on the worker's CWA report. • 4
1.Families who are unable to read or understand English are identified on the Family Assistance/Client Services system (FACS).
2.The worker records in FACS Case Notes the contact and specific method used to explain and offer the service, for example, reading aloud in English or using a translator.The worker documents the recipient's response to the offer in FACS Case Notes, if applicable.
3. (a) As part of the outreach effort for Early and Periodic Screening, Diagnosis and Treatment (EPSDT), the computer system automatically codes every SoonerCare eligible individual under 21 years of age as accepting EPSDT services at time of application and review.The offer and acceptance or declination of EPSDT services and/or support services may be documented by the worker in the FACS system, Social tab of the Interview Notebook and by making a narrative entry in FACS Case Notes.
(b) The worker documents in FACS Case Notes that OKDHS Pub. No. 87-36, Early and Periodic Screening, Diagnosis and Treatment, was provided to the family.All attempted home visits and other attempted contacts that result in failure to locate the recipient are documented in FACS Case Notes.
4.(a) When a medical provider completes an EPSDT exam and determines that follow-up is necessary, this is posted on the worker'sCWA report entitled "EPSDT Screening Requires Follow-up."
(b) To clear the CWA report, the worker must make contact with the family and offer assistance in obtaining follow-up services.This contact may be in person, by phone, or by personalized letter.
(c) The worker must enter the results of the contact in the FACS Social tab of the Interview Notebook and in FACS Notes.The CWA report a 'real time report' and does not clear until the next update to the case.