The CHDP program is administered by the Integrated Systems of Care Division (ISCD) of the Department of Health Care Services (DHCS). The program is operated by local county health departments and offices in the cities of Berkeley, Long Beach and Pasadena. The CHDP program is designed to ensure that eligible children and youth receive periodic health assessments and have access to ongoing health care from a medical and dental home.
As of July 1, 2016, all Medi-Cal managed care plans (MCPs) are capitated for EPSDT services. The expansion of the Medi-Cal program resulted in the majority of EPSDT-eligible children enrolled in an MCP.
The local CHDP program continues to provide care coordination for EPSDT-eligible children who are enrolled in the Medi-Cal fee-for-service health care delivery system. Managed care plans provide care coordination for MCP-enrolled members.
CHDP Program Responsibilities:
- The local county CHDP programs are responsible for day-to-day program operations, including the following:
- Provider recruitment, review and approval
- Provider education and quality assurance
- Liaison with schools and various community agencies
- Education and outreach to eligible families
- Assistance to families in obtaining services, including transportation for medical appointments and services
- Assistance to providers in contacting patients and scheduling appointments with other providers
- Collaboration with the Department of Education to assist families with children entering kindergarten or the first grade to obtain a health assessment and/or a signed certification of health assessment
CHDP providers must:
- Participate in the Vaccines For Children (VFC) program.
- Successfully complete a medical record review by the local CHDP program. The medical record review is performed to assess format, documentation, coordination and continuity of care in order to ensure that children and youth receiving EPSDT/CHDP services are receiving the appropriate level of care.
- Successfully complete a facility site review to ensure each service location is safe and readily accessible to individuals with disabilities. This does not mean CHDP providers must make each of their existing facilities or every part of the facility accessible to and usable by people with disabilities if other methods are effective in achieving compliance. A facility review may also include, but is not limited to, the review of licensure and or certification, personnel qualifications, site management, Clinical Laboratory Improvement Amendments of 1988 (CLIA) compliance, and the availability of emergency medical equipment and examination equipment appropriate to the population served.
- Utilize clinicians that meet CHDP standards.
CHDP Health Assessment Guidelines
The CHDP Health Assessment Guidelines incorporate the Bright Futures recommendations and include policies and procedures for provision of EPSDT/CHDP services. The guidelines include a detailed explanation of what is expected of a CHDP provider. A copy of the guidelines is available from local CHDP programs or may be accessed on the Child Health and Disability Prevention Program page of the DHCS website at www.dhcs.ca.gov/services/chdp.
Providers are responsible for informing patients about the availability of EPSDT/CHDP services and assisting recipients, in coordination with the local CHDP program, to obtain preventive health services for which they are eligible. Additional information about EPSDT informing requirements is located in the EPSDT section of this manual.
Lead Poisoning Prevention Informing Requirement
In accordance with California Health and Safety Code (H&S Code), Section 105286, health care providers must inform parents and guardians about all of the following:
The risks and effects of childhood lead exposure.
The requirement that children enrolled in Medi-Cal receive blood lead tests at specified ages.
The requirement that children not enrolled in Medi-Cal who are at high risk of lead exposure receive blood lead tests.
Obtaining Consent: Providers must obtain voluntary written consent prior to examination and treatment, with appropriate regard to the recipient’s age and following State and Federal laws. Consent also must be obtained prior to release of recipient information.
Minors (recipients younger than 18 years of age) may provide their own legal consent for EPSDT/CHDP health assessment services, if:
- The minor is emancipated, as determined by the court.
- The minor is, or has been, married.
- Parental consent for the service is not necessary under State or Federal law.
Medi-Cal Managed Care Plans
Managed care plans (MCPs) that contract with the State to render care to Medi-Cal recipients must provide EPSDT services for Medi-Cal recipients younger than 21 years of age. The MCP may contract with providers to render those services and may require those providers to enroll as CHDP providers.
Providers not required by their contractual arrangements with a Medi-Cal managed care plan to be CHDP providers are encouraged to enroll as CHDP providers. Enrollment helps ensure continuity of care for children that exit a Medi-Cal MCP and enables providers to deliver expected levels of care to Medi-Cal fee-for-service recipients and children enrolled in Medi-Cal through the CHDP Gateway.