1. Anything and Everything Care Coordination: Let’s Put It into Action!

2. Children are like…

3. They require lots of…to navigate their world

4. EPSDT/Centennial Care
PCP/BH
School Nurses
SBHC
Community
Family

5. EPSDT Early Periodic Screening Diagnosis Treatment
The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid. EPSDT is key to ensuring that children and adolescents receive appropriate preventive, dental, mental health, and developmental, and specialty services.
Early: Assessing and identifying problems early
Periodic : Checking children's health at periodic, age-appropriate intervals
Screening: Providing physical, mental, developmental, dental, hearing, vision, and other screening tests to detect potential problems
Diagnostic: Performing diagnostic tests to follow up when a risk is identified, and
Treatment: Control, correct or reduce health problems found.
The majority of medicaid services
come under the EPSDT benefits

6. Care Coordination Care Coordinators Are the single point of contact
NMAC:
Care Coordination
Care Coordinators
Are the single point of contact
For members and providers.
Care Coordinators assist members with their families with complex needs.
Care is member centered, family focused and culturally competent.
Care Coordinators assists in locating services to meet the health and social needs of the member.
The Care Coordination team consists of an integrated BH and PH clinicians and Health Coordinators
The Centennial Care contract tells us the things that have timelines tied to them. Like assessements and careplans, It also tells the CC who they should reach out like schools, doctors, therapists, communities, natural resources, CYFD, probation officers. It doesn’t give specific as the contract is built on the relationshipo between CC and member be memberccentric. The idea being the CC can help the member lead as independent life as possible. To regain or maintain health.

7. Pediatric Care Coordination
EPSDT benefits:
Well Child exams
Dental
Vision
Personal Care Services
Private Duty nursing
Therapies
Behavioral Health
Centennial Care/EPSDT
Centennial Care/EPSDT
Pediatric Medicaid benefits:
Care Coordination
Environmental Modifications-conditional
Home Health Aide-18 years and older
Durable medical equipment
Medical Care/Medication
Respite-conditional
Transportation/lodging
Self-direction-conditional/limited

8. What does this actually look like?
At each table together
The student health plan is the integral plan that allows the student to stay in school as do the EPSDT services, the Centennial Care plan brings in the member what is important in his or her world to work on like going to camp or a new wheelchair or communication device.
Part One: Use the provided scenarios and develop student health plan
Use the provided tools to create the plan
Once we are done then we’ll chat about it.

9. Any provider can make a referral for care coordination
At each table together
Part Two: Use the provided scenarios and tools and decide what kind
Care Coordination the members need.
Remember the majority of benefits and services come from EPSDT
Don’t be timid! Be bold!
Part three: Now bring them together. How do they work together?
Are there gaps or overlaps
Any provider can make a referral for care coordination
This is where you use the tools provider, the parts from the NMAC, and the EPSDT guide and the school health plan

10. EPSDT/Centennial Care Resources
EPSDT MANUAL:
BRIEFER VERSION:
MCO CONTACT INFORMATION:
EPSDT regulations:
MCO policy manual:
MCO CONTRACTS:
NMAC:
Care Coordination and Medicaid: