Medicaid’s EPSDT Benefit: An Opportunity to Improve Pediatric Screening for Social Determinants of Health

2019 ◽  
pp. 107755871987421
Author(s):  
Nisha A. Malhotra ◽  
Ann Nevar ◽  
Ruqaiijah Yearby ◽  
Lawrence C. Kleinman ◽  
Sarah D. Ronis
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Screening ◽  
Determinants Of Health ◽  
Factors Affecting ◽  
Pediatric Health Care ◽  
Well Child Care ◽  
Semistructured Interviews ◽  
Medicaid Policy ◽  
Essential Set

The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit is a key component of Medicaid policy intended to define an essential set of services provided to patients younger than age 21. Given increasing attention to social determinants of health in pediatric health care, this qualitative review examines the extent to which EPSDT might be used to implement structured screening to identify environmental and social factors affecting children’s health. Themes derived from semistructured interviews conducted in 2017 were triangulated with a review of the recent literature to describe how states currently consider the EPSDT benefit with respect to social determinants of health screening. Our findings suggest that, with sufficient stakeholder advocacy given the evidence supporting social determinants of health screening as “medically necessary,” EPSDT benefits could be considered as a funding source to incentivize the incorporation of social determinants of health screening into the basic package of well-child care.

scholarly journals How 6 Organizations Developed Tools and Processes for Social Determinants of Health Screening in Primary Care

2018 ◽  
Vol 41 (1) ◽  
pp. 2-14 ◽  
Author(s):  
Kate LaForge ◽  
Rachel Gold ◽  
Erika Cottrell ◽  
Arwen E. Bunce ◽  
Michelle Proser ◽  
...  
Keyword(s):  
Primary Care ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Screening ◽  
Determinants Of Health

scholarly journals Lessons Learned: Social Determinants of Health Screening Pilot in 2 Urology Clinics

2021 ◽  
Author(s):  
Emily Roebuck ◽  
Brisa Urquieta de Hernandez ◽  
Mellisa Wheeler ◽  
Gillian Stearns ◽  
Manish Patel ◽  
...  
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Screening ◽  
Lessons Learned ◽  
Determinants Of Health

scholarly journals Addressing Social Determinants of Health at Well Child Care Visits: A Cluster RCT

PEDIATRICS ◽  
2015 ◽  
Vol 135 (2) ◽  
pp. e296-e304 ◽  
Author(s):  
A. Garg ◽  
S. Toy ◽  
Y. Tripodis ◽  
M. Silverstein ◽  
E. Freeman
Keyword(s):  
Child Care ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Cluster Rct ◽  
Well Child Care

scholarly journals The Mitigating Toxic Stress study design: approaches to developmental evaluation of pediatric health care innovations addressing social determinants of health and toxic stress

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julie S. McCrae ◽  
Jo Ann L. Robinson ◽  
Angeline K. Spain ◽  
Kaela Byers ◽  
Jennifer L. Axelrod
Keyword(s):  
Health Care ◽  
Young Children ◽  
Social Determinants Of Health ◽  
Chronic Stress ◽  
Study Design ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Toxic Stress ◽  
Developmental Evaluation ◽  
Pediatric Health Care

Abstract Background Health care administrators must establish and promote effective partnerships with community agencies to address social determinants of health, including reducing exposure of infants and young children to chronic stress. Because infants’ experiences are inextricably tied to their caregivers, an important target for mitigating “toxic” stress exposure in early childhood is through reducing parents’ experiences of chronic stress in addition to protecting children from direct experiences of harm such as physical or sexual abuse. Conducting screening to identify when children are exposed to early life adversity is a first step; connecting families to needed support services is an essential component to addressing identified challenges. This paper presents the methodology of a three-year study of health care systems innovations designed to engage and support parents of infants to prevent and mitigate children’s toxic stress exposures. Methods Key study features included: 1) multi-component study in five U.S. communities and nine pediatric health care clinics and the families they serve, 2) a developmental evaluation approach to describe how innovations are experienced over time at three levels—community systems, pediatric providers, and families, and 3) rapid cycle feedback conducted with communities, clinics and families to co-interpret data and findings. Data sources included: 1) focus groups and interviews with community stakeholders, clinic staff, and families, 2) electronic health record and Medicaid services data extracted to assess health care quality, utilization, and financial impact, and 3) clinic-recruitment of 908 parents of infants in a longitudinal survey. Results. The sample is briefly characterized based on responses to the enrollment phase of the parent survey. Conclusions We discuss the study design elements’ contribution to generating evidence needed by innovators, communities, and clinics to modify and sustain investments in these innovations to prevent or mitigate the effects of exposure to toxic stress on young children.

scholarly journals Using Social Determinants Screening/Mapping Tools to Identify Needs and Resources for Student-Run Free Clinic Patients

2021 ◽  
Vol 4 (1) ◽  
pp. 38-44
Author(s):  
Akanksha Dadlani ◽  
Cooper T. Johnson ◽  
Rebecca Fischbein ◽  
Stacey L. Gardner-Buckshaw ◽  
Amy Lee ◽  
...  
Keyword(s):  
Health Care ◽  
Social Determinants Of Health ◽  
Health Care Delivery ◽  
Social Determinants ◽  
Care Delivery ◽  
Health Screening ◽  
Determinants Of Health ◽  
Free Clinic ◽  
Community Resource ◽  
Patient Reported

Background: Social determinants of health have been well accepted as contributing to health outcomes. They are a vital aspect of health care delivery and must be a consideration, especially among free clinic populations. Social determinants of health have also become a required element of medical school curricula. The Student Outreach to Area Residents Student-Run Free Clinic based out of Northeast Ohio Medical University piloted a student-led program that implemented social determinants of health screening and community resource referral as a part of integrated health care delivery for all its patients. Methods: We described the development of a screening tool, protocol, and creation of community resource referral materials. We also described the tracking of patient-reported needs and mapping of location and accessibility of community resources. One hundred patients were surveyed through convenience sampling, and results were used for program improvement. Results/Conclusion: After collecting and analyzing survey results, it was found that the 2 most frequently requested determinants were mental health and utilities services, and the most available community resource was emergency food services. We also mapped these results by zip code and found gaps between need and distribution of services. We demonstrated the utility of mapping to identify points of improvement for the future. We also provided lessons learned related to effective social determinants of health screening, community resource referral, and overall program implementation in student-run free clinics. We further explained the benefits of including similar student-led programs as a way for students to gain practical experience related to social determinants of health.

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