Chikoro Chekuita Kutongwa uye Ramangwana reMedicaid
Kana zvasvika pakuchengeta vana, Medicaid inotsanangura zvinotora kuti uchengetedze vane hutano. Muna 1967, hurumende yehurumende yakagadzira chirongwa chekutanga uye chekuongorora, chirongwa chekuongorora nekurapa (EPSDT), nemigumisiro inotevera:
- Kuongorora kwekutanga uye nguva nenguva : Mwana mumwe nomumwe ane ruzivo rwekuchengetedza uye kunyatsotarisirwa kunoitika panguva yakatemwa. Chinangwa ndechokuona matambudziko kare kuitira kuti vagone kururamiswa nokukurumidza. Zvirongwa zvinosanganisira asi hazvirevi kune mazino ekunyatsotarisa , kutariswa kwekunzwa , majekiseni, kutungamirira kuongorora , utano hwehutano hwepfungwa, nekuona kuonekwa kwemaonero.
- Kuongororwa : Kune chero upiedzo hwekuongororwa huri muganhu kana kuti hwakanaka, EPSDT inoda kuti Medicaid ipedze kuongororwa kwakawedzerwa kusimbisa kuongororwa.
- Chirapa : Chero chero chipi zvacho chakazivikanwa chinorwara, EPSDT inoda kuti nyika inobhadhara kurapa kunodiwa, pasinei kana kubatsirwa kwacho kusingawanzofukidzirwa neMedicaid.
EPSDT ibatsiro rinogamuchirwa rinoisa kuchengetedza kwekuchengetedza nekuchengetedza zvakanaka uye nzvimbo yevana. Iro mutoro wehurumende imwe neimwe kupa ruzivo kune vana nevechiri kuyaruka vakanyoresa muProgram Medicaid kusvikira vava nemakore makumi maviri nemashanu. Nyika dzinogonawo kusarudza kuishandisa seyero yekuchengetedza vana vakanyoresa muHana Health Health Program (CHIP) . Vamwe vanoti, zvisinei, vanoshandisa chimiro chakasiyana chepurogiramu yeCIP.
Zvaunoda Kuziva Pamusoro peCMS Form 416
Nyika inoshuma kubatanidzwa kwavo uye kutevedza EPSDT nekuzadza fomu inonzi Fomu Fomu 416 gore roga roga.
Chimiro chinoputsa pasi reMedicaid kuti vave mazera akasiyana-siyana uye inobvunza kuti vangani vevana ivavo vakagamuchira kuongorora kana kurapwa kwakadaro mugore iroro.
CMS Form 416 inobvumira hurumende yehurumende kuti ichengetedze pane humwe hurumende inoshanda. Mashoko aya anogona kushandiswa kuona (kana kana) inotaura kuti iri kuwira shure uye inogona kuva mukana wekuvatungamirira kune humwe hunovandudzwa pakupa kutarisirwa kwakakodzera.
Dambudziko nderokuti data inounganidzwa asi isingashandisi kune zvayo.
Kana nyika isati yazadza CMS Fomu 416 kana iyo isina kukwana mumusangano weEPSDT, haiporwi neCenters for Medicare neMedicaid Services (CMS).
Kuvandudza muEPSDT kunouya kwete nokuti hurumende yehurumende inosimudzira mitemo yayo. Kuvandudza kunouya nokuti vanhu vanozvimirira ivo pachavo. Mhosva dzakawanda dzechikoro dzakatorwa kune dzimwe nyika dzichitsvaka kutarisirwa kwavakavimbiswa. Kunyange zvazvo nzvimbo dzeEPSDT dzisina kukwana, kutarisira mazino, kutungamirira kutungamira, uye hutano hwepfungwa nderimwe iyo inonyanya kutorwa mutemo.
Ikoko EPSDT inokundikana muIndaneti
Muromo wakagwinya unokosha kuti uchengetedze kudya kwakakwana uye kugadzikana kwepfungwa. Zvinosuruvarisa, mapfupa emazino ndiyo imwe yenhau dzinowanzosangana nevana vana.
Muna 2014, 48 muzana chete yevana vakakodzera paMedicaid vakagadzirirwa kuchengetedzwa kwemazino uye apo dambudziko rakaonekwa, 22 chete chete muzana vakawana kurapwa kwechiitiko ichocho.
Kunyangwe paunotarisisa zvakanakisisa zvekunakisisa, nehurumende dzose neDunhu reColumbia rinoparidza, 13 chete inotaura-Arkansas, Colorado, Connecticut, District of Columbia, Georgia, Illinois, Maryland, Massachusetts, Nebraska, South Carolina, Texas, Vermont, neWashington-yakaitwa zvakaderera 51 kusvika ku 62 muzana yehutano hwekuvhara mazino.
Kana zvasvika pakurapa, nhamba idzi dzisinganyanyi kunakidza. Ikokuita kwepamusoro, kubva ku25 kusvika ku5 muzana muzana kuterera, inosanganisira Arkansas, Colorado, Connecticut, Idaho, Massachusetts, Mississippi, New Jersey, New Mexico, Oklahoma, Texas, Virginia, Virginia, uye West Virginia.
Apo EPSDT inokundikana muKuongorora Kuongorora
Kufungidzira kutungamira kunogona kutungamirira kumigumisiro yehutano yakakomba kubva pane chirwere chemapfupa ehutano kusvika kuhutano uye neurological disorders. EPSDT inoda kuti vana vanyoresa muMedicaid vaongororwe kutungamirirwa muropa ravo mwedzi gumi nemaviri nemwedzi miviri.
Zvinosuruvarisa, mushure mokunge mari yezvemari yeCent for Disease Control and Prevention's Healthy Homes uye Lead Lead Poisoning Prevention Program yakaguma muna 2012, mashoma masangano akagovera zvinyorwa zvakanyorerwa kuhurumende.
Medicaid data yegore ra2015 inoratidza kuti 38 muzana chete yevana vakanga vaongororwa nekuda kwekutungamira ropa sezvinodiwa nehurumende yeEPSDT.
Sangano reNational Committee for Quality Assurance (NCQA), sangano risina purogiramu, rakabudisa dunhu kuongororwa kuti 66% chete vevana vane makore maviri vakanyoresa muMedicaid vakaongororwa kuti vatungamirirwe mumakore maviri akapfuura.
Ikoko EPSDT inokundikana muZvipatano zveMental Mind
Kana imwe mwana ari pakati pemakore matanhatu nemakumi maviri akange ari muchipatara nekuda kwehutano hwepfungwa, kuwana rubatsiro rwehupenyu hunoenderera mberi uye hutano hwepfungwa hunokosha. EPSDT inoda kuti vana ava vaonekwe mukutevera mushure memazuva manomwe kubva pakubviswa kwavo kuchipatara.
Kwegore ra2014, pamusana pega, 44 muzana yevana chete vakaonekwa mukutevera mukati memazuva manomwe uye 65 muzana mumazuva makumi matatu ekurapwa kwechirwere chepfungwa.
Nyika dziri kuita nepamusoro pekirasi yekutsvaga kwemazuva manomwe kusvika 62 kusvika ku76 muzana dzinosanganisira Iowa, Kansas, Maine, Massachusetts, Nevada, New York, Oregon, Rhode Island, uye Vermont, asi kana zvasvika kune 30 -zuva rekutevera-shandura, shandura Iowa kuIndia. Gwaro rekupedzisira rakabata 78 kusvika 91 muzana.
Mishonga yakawanda, kunyanya zvinokurudzira, zvinoshandiswa kuratidza kukanganisa kwehutano hwehutano husina matambudziko. EPSDT inoda kuti vana varayirire mishonga iyi ionekwe mukati memazuva makumi matatu kubva pakutanga mishonga (Initiation Phase) uye kuti iyo inozoonekwa kaviri mukati memwedzi 9 inotevera (Kuenderera mberi uye Maintenance Phase).
Kwegore ra2014, nyika yacho inongoresa 44 muzana yehubudiro yehutano yeChitatu Phase uye 57 muzana yeKuchengetedza uye Maintenance Phase.
Kwekutanga Phase, Arkansas, Connecticut, Maine, New York, Ohio, Oklahoma, Oregon, neRhodde Island, uye Vermont yakave yakakwirira kupfuura makumi mashanu nemakumi manomwe nezana makumi manomwe kubva muzana apo Chigumisiro chekuenderera mberi nekugadzirisa chikafu chakawana kubudirira kwepamusoro kubva 63 kusvika 84 muzana muA Arkansas , Connecticut, Maine, New York, Ohio, Rhode Island, Vermont, uye West Virginia.
The Future of Medicaid
EPSDT iri kutotambura. Nyika dziri kuperevedza pakupa vana kuchengetedza kubva kumhuri dzakaderera-pfuma uye nheyo dzinoda uye dzinokodzera, uye hurumende yehurumende inofanira kutora matanho.
Zvinoratidzika sezviitiko izvi hazvibviri kuvandudza chero nguva pfupi.
Mutungamiri weTrump ane mari yehurumende yekubhadhara Medicaid mumakona ayo. Sangano reAmerican Health Care Act , iro rakarondedzerwa muUnited States House of Representatives, raizoderedza kudyidzana kwehurumende kuMedicaid ne $ 800 mabhiriyoni kwemakore gumi, zvichiita kuti hurumende isakwanisa kupa EPSDT zvigaro asi Medicaid inobatsira zvikuru. Kunyange zvazvo mutemo uyu, wakazonzi Better Care Reconciliation Act, wakakundikana kupfuudza vheti muSeneti, inoratidza muenzaniso wekutsvaga Medicaid. Mumwe mutemo unogona kurongedzwa munzvimbo yawo.
Izvi zvinosiya maAmerica kuzvidzivirira pachavo. Kutongwa kwechikoro chechikoro kwakamanikidza maoko ehurumende kuti aite chinhu chakanaka. Heano mamwe emhosva dzakakurumbira dzinowanikwa mumakore achangopfuura.
- Emily Q vs. Bonta (California)
- Florida Pediatric Society / The Florida Chitsauko cheAmerican Academy of Pediatrics v. Levine (Florida)
- GD vs. Riley (Ohio)
- NB vs. Norwood (Illinois)
- Salazar vs. Dunhu reColumbia (District of Columbia)
NeMedicaid mari iri pangozi, tarisira zvimwe zvidzidzo zvechikoro mune ramangwana.
Shoko Rinobva
Hurumende yehurumende yakaronga gwaro reEPSDT kuvimbisa kuti vana paMedicaid vanowana zvakakosha, kunaka kwekuchengetedza kuchengetedza. Zvisinei, pane zvishomanana zviri kuitwa kuti vatsigire kuti nyika inorarama maererano nechipikirwa ichocho. Kana mwana wako akarambwa kunze kweMedicaid, ita izvi izvi kuDhipatimendi reHurumende. Kana iwe uchiramba uchiwana kushayikwa, zvingava pane zvaunofarira kuona kana pane chikwata chechikoro chekuita iwe muhurumende yako kutarisa nyaya yacho.
> Sources:
> 2015 Annual Report pamusoro pehutano hwekutarisira vana mu Medicaid uye CHIP . Medicaid website. https://www.medicaid.gov/medicaid/quality-of-care/downloads/2015-child-chart-pack.pdf. Yakabudiswa muna August 2016.
> Kuvhara ropa rekutengesa ropa Kuongororwa kwevana Vakanyoresa muMedicaid uye neHana Health Health Program. Medicaid.gov website. https://www.medicaid.gov/federal-policy-guidance/downloads/cib113016.pdf.
> Kutanga uye Kuongorora Periodic, Kuongorora uye Kurapa neHurumende. Kubva Vana Vechidiki Kudzidza neZivo Centre webhusaiti. https://eclkc.ohs.acf.hhs.gov/hslc/states/epsdt. Yakapedzwa musi waApril 19, 2017.
> Raymond J, Brown MJ. Ropa Rokutungamirira Nhanho Muvana Vakwegura <5 Makore & mdash United State, 2007-2013. Kuipa uye Kufa Kwemavhiki Gwaro (MMWR). October 2016, 63 (55); 66-72. doi: https://www.cdc.gov/mmwr/volumes/63/wr/mm6355a6.htm.
> Kushandisa Dental Services mu Medicaid uye CHIP . Medicaid website. https://www.medicaid.gov/medicaid/benefits/downloads/secretarys-report-dental-excerpt.pdf. Yakabudiswa muna January 2015.