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Health Care > Specialized Services and Treatment > Child Health and Disability Prevention (CHDP) Program

Child Health and Disability Prevention (CHDP) Program

0600-506.10 | Revision Date: 12/07/16

Overview

This policy guide provides information about the Child Health and Disability Prevention (CHDP) program and instructions on how to link court-involved children to it.

TABLE OF CONTENTS

Policy

Child Health and Disability Prevention (CHDP) Program

Eligibility

Out-of-County CHDP Program Eligibility

Out-of-State CHDP Program Eligibility

CHDP Services and Required Examination Timeframes

Medical Services

Dental Services

CHDP Periodicity Schedule

Non-Scheduled CHDP Program Examinations/Medically Necessary Interperiodic Health Assessment

CHDP Program Equivalent Examinations

Informing Out-of-home Caregivers about the CHDP Program

Public Health Nurses (PHNs)

Medical Consent

Parent/Guardian Rights in a Medical Examination

Procedure

Linking a Child/NMD to the CHDP Program

Case-Carrying CSW Responsibilities

Approvals

Helpful Links

Attachments

Forms

Referenced Policy Guides

Statutes

Version Summary

This policy guide was updated from the 05/16 version to update medical and dental examination requirements to align with new CHDP Program requirements.

POLICY

Child Health and Disability Prevention (CHDP) Program

The Child Health and Disability Prevention (CHDP) program provides complete health assessments for the early detection and prevention of diseases and disabilities for children. The CHDP program is California’s version of the federally mandated Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program and is administered by the California Department of Health Care Services (CDHCS). It seeks to increase knowledge, acceptance, and access to preventive health services through outreach services and through community, health education.

 

All children entering the first (1st) grade in a California school are required to have either a certificate of a CHDP program health examination or a waiver of such on file at the school in which they enroll. The CHDP program cooperates with the State Department of Education to administer and monitor this requirement.

Names and locations of the CHDP program health care and dental care providers can be found by calling 1-(800)-993-2437 or, by accessing the list of health care and dental care providers on the LA County Department of Public Health CHDP website.

 

CHDP program providers:

 

The CHDP program provider network does not include dentists. The CHDP program providers can refer Medi-CalCalifornia's federal Medicaid program. patients to dentists who accept Medi-Cal (Denti-Cal). CHDP program patients who are not Medi-Cal eligible should be referred to dentists who will accept non-eligible patients.

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Eligibility

The following children are eligible for the CHDP program, which includes medical and dental assessments as well as preventive care services:

 

Children who are under age twenty one (21) and who receive Medi-Cal are eligible for dental services, including preventive care through the Medi-Cal dental program, Denti-Cal. These dental services are provided by participating dentists

Out-of-County CHDP Program Eligibility

Every California local health jurisdiction (county/city health department) has a CHDP program that can assist out-of-home caregivers with accessing preventive health services, and, if necessary, connect to further diagnostic and treatment services. When a child resides in another California County, the CHDP program services are still available to him/her.

Out-of-State CHDP Program Eligibility

When a child is placed out-of-state per the Interstate Compact on the Placement of Children (ICPC), the CSW provides the out-of-home caregiver and the receiving state social worker with a copy of the CHDP Health and Dental Periodicity Schedules to use as a guideline for obtaining CHDP-equivalent program services. If the child is federally eligible, he/she will also be eligible for the federally mandated Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program within the state that he/she is placed. Non-federally eligible children should receive CHDP-equivalent program services.

 

If a child is federally eligible, the CSW should obtain a copy of the Consolidated Omnibus Budget Reconciliation COBRA letter from the Eligibility Worker (EW) via the DCFS 280, Technical Assistance Action Request to send to the out-of-home caregiver to request that he/she apply for Medicaid for the child. If a child is not federally eligible, the caregiver must apply for the CHDP program equivalent. EPSDT is a federal mandate and all states have a program. The program title varies, however, from state to state. The CSW should request that the receiving state social worker provide verification of the child’s EPSDT or the CHDP program equivalent in his/her quarterly reports to DCFS.

CHDP Services and Required Examination Timeframes

Federal regulations require that the CHDP program medical and dental assessments be completed and that any treatment services be initiated within 120 days of the date CHDP program services were requested.

Medical Services

DCFS requires a medical examination to be done within ten (10) days of initial placement for infants, birth through three (3) years of age, or for “high-risk” children, regardless of how long they will be in out-of-home care. If the infant/child is placed directly from the hospital and has had a medical examination prior to being discharged, an additional exam is not necessary.

 

State regulations require that:

 

The CHDP program offers a full range of health assessment services, including:

 

An initial medical assessment must be ordered at a Detention Hearing. For children who are newly detained, the initial medical examinations should be obtained from the nearest Medical Hub. The Multidisciplinary Assessment Team (MAT) Coordinator and Service Linkage (SLS) will serve as the central coordinating point of the Coordinated Services Action Team (CSAT) process. They will receive and track results of the Initial Medical Examination and the Child Welfare Mental Health Screening Tool (CWMHST).

 

At the time of the medical health assessment, the CHDP program provider must make referrals to the following entities:

 

Referral

Reason

Dentists

  • For preventive or restorative care

Medical providers

  • As necessary

The Women, Infants, and Children (WIC) Nutrition Program

  • For a child up to the age of five (5)

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Dental Services

A dental screening/oral assessment is a required part of the CHDP program health assessment. It is not an examination by a dentist, and does not substitute for one, and may not include:

 

Foster children who are one (1) year of age and older must receive a CHDP program or CHDP program-equivalent dental examination within thirty (30) days of placement.

 

The dental examination requirement is considered met, however, for a child who has had a dental examination within one (1) year prior to the current placement/replacement, if both of the following have been done:

 

All foster children must be referred directly to a dentist, as follows:

CHDP Health Periodicity Schedule

The CHDP Health Periodicity Schedule specifies what each health assessment is to include and at what frequency. State regulations for medical examinations are aligned with the CHDP Health Periodicity Schedule and are, as follows:

 

Non-Scheduled CHDP Program Examinations/Medically Necessary Interperiodic Health Assessment

Additional DCFS-approved CHDP program examinations for children in out-of-home care will be considered “Non-Scheduled CHDP Examinations” or “Medically Necessary Interperiodic Health Assessments” once complete. Children in out-of-home care are considered at higher risk. Physical, social, and/or emotional factors may justify additional examinations or assessments (e.g. a child had run away and recently returned to his/her placement).

 

The CHDP program permits payments for “Non-Scheduled” CHDP examinations by CHDP program providers only. Additional DCFS-approved CHDP program examinations for children in out-of-home care will be considered “Non-Scheduled CHDP Examinations” or “Medically Necessary Interperiodic Health Assessments”.

CHDP Program Equivalent Examinations

A CHDP program equivalent examination is a health assessment that includes all of the components specified on the CHDP Health Periodicity Schedule but is instead given by a health care provider who is not a CHDP program provider.

 

If the caregiver has a non-CHDP program health care provider that he/she prefers to use, or if the child has previously received care from a particular health care provider, he/she may continue to use it. The caregiver can encourage the provider to either become a participant in the CHDP program or perform “CHDP-Equivalent” examinations.

Informing Out-of-home Caregivers about the CHDP Program

Through an inter-agency agreement between the Department of Health Services (DHS) and DCFS, CSWs are required to ensure that children and caregivers are informed about the services available through the CHDP program in the following three (3) ways:

 

  1. Inform out-of-home caregivers, relative caregivers, nonrelative extended family members (NREFM), and families of eligible children about the CHDP program.

 

  1. Assist caregivers with the transportation and scheduling of CHDP program connected children.

 

  1. Follow up with CHDP program connected children to ensure that necessary diagnostic and treatment services are provided.

Public Health Nurses (PHNs)

Public Health Nurses (PHNs) assist CSWs with the children in the CHDP program in the following ways:

 

PHNs will also enter the completed Confidential Screening/Billing Report (PM 160) into the Health Notebook Services that was submitted by the CHDP provider to the Department of Health Services. They will also evaluate the results of the PM 160 for any needed follow up, consult with the CSW on identified problems, and forward the PM 160 to the CSW.

Medical Consent

Consent of the parent or guardian must be obtained prior to having the child undergo any medical, dental and mental health screenings and examinations under the CHDP exam. If consent of the parent or guardian cannot be obtained via the DCFS 179, court authorization is required before allowing the child to undergo a CHDP exam. Parental consent or a court order is not required if during the CHDP exam it is discovered that there is a medical emergency or it is necessary to preserve evidence. This does not apply to NMDs.

Parent/Guardian Rights in a Medical Exam

A parent/guardian has a right to be present during the examination of their child, under the age of eighteen (18) years old. Officials (CSWs, law enforcement , etc.) cannot completely exclude parents from the location of their child's physical examination absent parental consent, a legitimate basis for exclusion, or an emergency requiring immediate medical attention.

 

If there is a "Valid ReasonAuthorities, e.g. CSWs, law enforcement, etc, have reasonable evidence that a parent is abusive, cannot provide love and support to the child, or will in some significant way interfere with the examination." to exclude family members from the examination during the medical procedure, a family's right to be with each other during potentially traumatic medical examinations may be limited to being near the examination (e.g. in the waiting room or another nearby area). If a CSW determines that he/she needs to exclude a parent/guardian from the medical examination, even if that medical examination was ordered by the court, the CSW should consult with his/her SCSW for guidance. The SCSW will consult with the Warrant Liaison or County Counsel as needed.

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PROCEDURE

Linking a Child to the CHDP Program

Case-Carrying CSW Responsibilities

  1. For a child who is receiving court-ordered or voluntary family maintenance services complete the following:
  1. If the family is not eligible for the CHDP program, assist the parent(s)/legal guardian(s) in obtaining consistent medical and dental care for the child through his/her private insurance or through a county health facility.
  1. If the child is eligible for the CHDP program, inform the child’s parent(s)/legal guardian(s) about the CHDP program and give him/her a state-approved CHDP Brochure.
  1. Explain the advantages of the CHDP program.
  1. Stress the importance of maintaining regular medical and dental examinations based on the CHDP Health and Dental Periodicity Schedules.
  1. Have a general understanding of the child’s health status at the start of the case, regardless of whether the child is residing in the parent’s home.

 

  1. During the initial placement or replacement of a child/NMD, complete the following with the caregiver:
  1. Provide a copy of the state-approved CHDP Brochure (included in the Placement Packet).
  1. Explain the advantages of participating in the CHDP program.

 

  1. Based on the table below, inform the caregiver whether or not to schedule a CHDP exam.

 

Medical Consent

CSWs Next Steps

Schedule CHDP Exam

Obtained via:

  • DCFS 179 or
  • Court Authorization

 

Provide Caregiver with:

  • DCFS 179 or
  • Court Authorization

Yes*

Not Obtained

Obtain medical consent from:

  • Parent via DCFS 179 or
  • Court Authorization

No, until consent is obtained.

*CSW or caregiver must inform the parent(s) of the date, time and location of the exam, and inform the parent(s) of the opportunity to be present. It is not necessary to reschedule the exam if the parent(s) does not respond or cannot attend.  Notice may be provided orally, text, email, mail, in-person, or by leaving a message on the parent's phone.

 

  1. If the NMD/parent/caregiver declines the CHDP program, ensure that the selected health care provider will complete CHDP program equivalent examinations.

 

  1. If the child/NMD is not participating in the CHDP program, inform the caregiver/NMD every twelve (12) months of the availability of CHDP program services. The annual informing must be done both verbally and in writing.
  1. Provide the caregiver/NMD with a copy of the state-approved CHDP Brochure.
  1. Offer transportation and scheduling assistance to the caregiver/NMD.

 

  1. Make the final decision as to whether the CHDP program or CHDP program equivalent services should be provided.

 

  1. Explain the following to the NMD/parent/caregiver:

 

  1. Stress the importance of obtaining regular medical and dental examinations according to the CHDP Health and Dental Periodicity Schedules or annually, whichever is more frequent, or more frequently if needed, or as recommended or required by a health care professional.
  1. Provide the NMD/parent/caregiver with a supply of the following forms to be completed by a health care provider whenever services are obtained:
  1. DCFS 561(a) Medical Examination Form
  1. DCFS 561(b) Dental Examination Form
  1. DCFS 561(c) Psychological/Other Examination Form

 

  1. Ask the NMD/parent/caregiver if he/she needs assistance with transportation to or scheduling of CHDP program services.
  1. For assistance with transportation, either provide information about dial-a-ride and local bus services, or a Service Funded Activities (SFA) request for transportation assistance.
  1. For assistance with scheduling:
  1. Instruct the NMD/parent/caregiver to use the toll free telephone number in the CHDP Brochure to obtain the names of at least three (3) CHDP program providers.
  1. If further assistance is required, work with the PHN to help locate a convenient CHDP program provider. PHNs have copies of the CHDP program provider roster and will make the initial phone call, if necessary.

 

  1. Within three (3) business days of the placement or replacement, complete the DCFS 39, CHDP Documentation Checklist, as thoroughly as possible.
  1. Document that the NMD/parent/caregiver was informed of the CHDP program and was offered transportation and scheduling assistance.
  1. If the NMD/parent/caregiver chooses to participate in CDHP, complete parts D and E of the DCFS 39 as the information becomes available.
  1. Do not complete the signature block until all information has been obtained.
  1. If the NMD/parent/caregiver chooses not to participate in the CHDP program, check “no” on C.2 and complete the signature block.
  1. File the completed DCFS 39 in the Psychological/Medical/Dental/School Reports folder of the child’s/NMD's case file.

 

  1. Document the NMD/parent/caregiver’s response to the offer of CHDP program services in the CHDP program area of the Identification Page in the Placement Notebook.

 

  1. During each contact, discuss the medical and dental needs of the child/NMD with the parent/caregiver, including all required immunizations.

 

  1. Ensure that these needs are being met and documented appropriately in the Case Plan and that the child/NMD is receiving all necessary follow-up treatment.

 

  1. Document the CHDP program examination in the Associated Services tab of the Contact Notebook.
  1. Proper recording of the examinations will be automatically populated into the Well Child page of the Health Notebook.

 

  1. Upon receipt from the PHN, file the PM 160, Confidential Screening/Billing Report in the Psychological/Medical/Dental/School Reports folder of the child’s case file.

 

  1. Notify the NMD/parent/caregiver, either in writing or verbally, of the due date for the next CHDP program examination.

 

  1. Ensure that the child/NMD receive a CHDP program or a CHDP program equivalent medical and dental examination three (3) months prior to being emancipated.

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APPROVALS

SCSW Approval

HELPFUL LINKS

Attachments

CHDP Health Periodicity Schedule

CHDP Health Care Providers

CHDP Dental Periodicity Schedule

CHDP Dental Care Providers

Forms

CWS/CMS

Health and Education Passport (HEP)A document that is generated on CWS/CMS that contains a summary of a child's health and education information. The caregiver keeps a current copy of the Passport, along with the health and education forms in a binder provided by DCFS. This binder shall follow the child to all placements. The Passport shall accompany the child to all medical, dental and educational appointments. The Passport binder in its entirety is given to the child upon emancipation.

LA Kids

CHDP Brochure (Armenian, Cambodian, Chinese, Farsi, Hmong, Korean, Lao, Russian, Spanish, Vietnamese)

DCFS 39, CHDP Documentation Checklist

DCFS 179, Parental Consent and Authorization for Medical Care (Spanish)

DCFS 280, Technical Assistance Action Request

DCFS 561(a), Medical Examination Form

DCFS 561(b), Dental Examination Form

DCFS 561(c), Psychological/Other Examination Form

Referenced Policy Guides

0070-516.15, Screening and Assessing Children for Mental Health Services and Referring to the Coordinated Services Action Team (CSAT)

0080-502.10, Case Plans

0080-505.10, Youth Development: Transitional Independent Living Planning

0080-505.20, Health and Education Passport (HEP)

0100-510.46, Out-Of-County Placements

0100-510.60, Placement Considerations for Children

0100-510.61, Placement Responsibilities

0600-500.00, Medical Hubs

0600-501.10, Medical Consent

0600-506.00, Promoting Children’s Physical Health

0900-521.10, Service-Funded Activities (SFA)

Statutes

California Department of Social Services (CDSS) Manual of Policies and Procedures (MPP) Division 31, Chap 206.36 – States, in part, that a child’s case plan will ensure that he/she receives medical and dental care which places attention on preventive health services through the Child Health and Disability Prevention (CHDP) program or equivalent health services. Also states that each child in placement shall receive this examination preferably prior, but no later than, thirty (30) calendar days after placement.

 

California Code of Regulations (CA COR) Title 22, Section 51184 – Provides, in part, definitions relating to the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program.

 

California Health and Safety Code Section 124040(6)(D) - States, in part, that, as part of the CHDP Program, children are to be referred to a dentist beginning at age one (1).

 

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