EPSDT (Early and Periodic Screening, Diagnosis and Treatment) is a federally mandated Medical Assistance Program that benefits infants, children, and adolescents. Since the late 1970's Automated Health Systems has prided itself in developing, implementing, and managing quality EPSDT programs.

Through our programs in six states (see Exhibit 1), we have been able to help over 2 million children receive preventive health services.

Exhibit 1. EPSDT Contracts
Time Period	Location	Contracting Agency	Program
1979 - 1985	Maryland	Department of Health and Mental Hygiene	EPSDT consumer outreach and appointment scheduling
1980 - Present	Pennsylvania	Department of Public Welfare	EPSDT program administration (provider and consumer outreach, appointment scheduling, tracking, etc.)
1982 - 1987	Erie, Pennsylvania	PA Department of Health	Childhood Lead Poisoning Prevention Project
1983 - 1986	Indiana	Department of Public Welfare	EPSDT program development and administration
1993 - 1995	Hartford, CT	Department of Income Maintenance	Hartford HealthTrack (EPSDT) administration
1993 - 1996	Michigan	Department of Community Health	EPSDT consumer outreach for providers
1994 - 1998	Georgia	Department of Medical Assistance	Health Check (EPSDT) provider recruitment and consumer outreach
1998 - Present	Various	Various HMOs	EPSDT program development and administration

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Exhibit 2 illustrates all of the elements of a complete EPSDT program. Because of the success of the Pennsylvania program, it has become a model for other states. In Pennsylvania, AHS has coordinated and centralized all elements of the program, utilizing a fully computerized system along with telemarketing capabilities. Detailed descriptions of these activities are listed below.

Exhibit 2. EPSDT Services Provided
KEY AREAS	PA	CT	MI	IN	MD	GA
Family Outreach and Education	X	X	X	X	X	X
Consumer Support Services	X	X		X	X	X
Community Awareness	X	X		X	X	X
Program Advocacy via Interagency Networking	X	X	X	X		X
Staff Recruitment Training and Supervision	X	X	X	X	X	X
Provider Recruitment Training and Monitoring	X	X		X	X
Quality Assurance	X	X
Case Management (automated information & scheduling)	X	X	X	X	X	X
Referral and Follow-up	X	X	X	X	X	X
Statistical Analysis and Research	X	X	X	X	X	X
Report Generation	X	X	X	X	X	X

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Client Outreach and Education
Over the years, AHS has designed and implemented a host of creative approaches to outreach potential consumers, such as:

• Face-to-face interactions in consumers' homes
• Face-to-face interactions in welfare offices
• Networking with other agencies (i.e., Head Start and WIC)

We focus on cultural competency and assure that our consumer materials are produced at an appropriate literacy level. Our more than twenty years of direct EPSDT experience has resulted in a proven outreach and education model that helps assure that the maximum number of consumers eligible for the program receive the services to which they are entitled. We have successfully applied this experience to a variety of Programs across the country.

While outreaching is a fundamental component of the EPSDT program, our call center also specializes in assisting and educating clients who call in.

The top three services provided to clients on either inbound/outbound calls include:

• EPSDT outreach assistance
• EPSDT Program education
• General information on related program services

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Tracking System
A mechanism that coordinates the activities of consumers, providers, and Program administrators is crucial to meeting the goals of the EPSDT Program. The mechanism used to do this is the consumer eligibility and periodicity tracking system AHS has developed. This proven approach provides AHS staff with the ability to access a variety of eligibility and participation data on consumers, whole families, and providers at the touch of a button. Both EPSDT periodicity (including the provider and date of the exam) along with current and historical eligibility can be checked and the outcomes of outreach and appointment scheduling efforts can be documented. Our EPSDT management system also routinely generates a wide variety of time sensitive mailings to consumers that remind and educate them about EPSDT and follow-up services as well as satisfy Federal informing requirements.

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Provider Recruitment and Network Maintenance
An important segment of our program administration has been the ability to recruit medical providers to participate in these efforts and also to monitor their adherence to stated protocols. This has required extensive training on all levels, ranging from group presentations to one-on-one training sessions involving a wide range of health professionals. After considerable cultivation and public relations, AHS staff has developed a network of trained EPSDT providers with whom we interact on a routine basis for:

• Quality Evaluation
• Refresher Training
• Problem Solving
• Technical Assistance

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Allied Agency Relations
Even before the enactment of OBRA '89 and widespread growth of mandatory Medicaid Managed Care Programs, AHS realized the importance of networking with community based agencies. We have been successful at establishing functional linkages with allied agencies that serve the Medical Assistance population and have similar goals and objectives (e.g., Head Start, WIC, Healthy Start, Healthy Mothers/Healthy Babies, March of Dimes, United Cerebral Palsy, ARC, etc.) Our objective in networking with other health and human service agencies is to enlist their help in "spreading the word" about the program, thus cost effectively multiplying our community outreach efforts and creating new sources of referral for our consumers. We, in turn, fulfill the same role for these other programs. As a result, services are promoted and better utilized, duplication of effort is reduced and service gaps are identified.

We maintain relationships with agencies at the state and local level, and offer in-service trainings which help agency staff more fully understand the workings of EPSDT and how they can effectively use the Program to help the families they serve. This includes:

• Advocacy of the Program to consumers
• Linking potentially eligible families to us via our toll-free number
• Promoting the Program to health providers
• Directly delivering screening, diagnostic, and/or treatment services
• Helping to provide case management (especially for hard-to-reach consumers), tracking, or referral to Program participants
• Working toward the creation of needed services.

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Program Analysis and Reporting
The capability to process large quantities of data and generate accurate statistical reports is also essential to efficient program management, accountability, and evaluation. Through continual refinement, we have developed a comprehensive data processing system capable of satisfying Federal requirements and of streamlining state programs. Recognizing the need to be even more responsive to our customers and to provide more in-depth and detailed information about Program activities and outcomes, AHS is continuously developing new applications and incorporating new technology for use in its ongoing administration of the Pennsylvania EPSDT Program and in our other multi-state contracts.

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Referral and Follow-Up
Referral and follow-up are the end result of the EPSDT screening process and are perhaps the most critical and difficult components to administer. The efficient and smooth operation of this effort is enabled by our customized and all-inclusive computer-based care coordination and follow-up system. This system ensures that the highest possible percentage of children needing follow-up promptly receive the medical care they require. We maintain a complete tracking history on thousands of children who need further diagnosis and/or treatment and referrals. This sophisticated design ensures that every child is given the opportunity to receive needed follow-up care and does not get lost in the system.

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