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B-164031(4) 1 (1974-03-12)

handle is hein.gao/gaobabkna0001 and id is 1 raw text is: RF9P 11VZ ,ciiebe reoned outsk5o the 0,n- _11 s /(L_0 1 'H th CI, - 7c :: m o~e, a a ' eced0 m~ch ___________ COMPTROLLER r.ENEEhAL tF THIFUNITED -7~S.)f ..'' WASHINGTON D C 20548 RELEASED B-164031(4) 6 MAR 12 1974 The Honorable Ralph H Metcalfe C House of Representatives Dear Mr Metcalfe: In response to your July 17, 1972, letter we have reviewed the [administration of the Early and Periodic Screening, Diagnosis, and Treatment program (EPSDT) by Illinois under its Medicaid program. Medicaid is administered at the Federal level by the Social and Rehabilitation Service of the Department of Health, Education, and Welfare (HEW). This report summarizes the matters discussed in a meeting with representatives of your office on September 13, 1973, and includes additional information requested during that meeting The 1967 amendments to the Social Security Act (42 U.S.C. 1396) added EPSDT as a required Medicaid service effective July 1, 1969. This service was intended to provide preventative health care to children through age 20. In November 1971--more than 2 years after EPSDT became a required service--HEW issued regulations which required the States to have ongoing programs by February 1972 for eligible children through age 5 and by July 1973 for eligible children through age 20. SCOPE OF REVIEW We reviewed Illinois' progress in implementing the program, including outreach activities, screening activities, and the system for followup to help insure that eligible children receive pre- scribed examinations and needed treatment We reviewed pertinent records and discussed the program with officials of HEW's Chicago regional office, the Illinois Departments of Public Health and Public Aid, Cook and Sangamon County Departments of Public Aid, and the Chicago Board of Health. We visited eight providers of early screening and diagnostic services, including five doctors, one dentist, one professional corporation, and one county health depart- ment. (The latter two were demonstration projects.) Also, we sent questionnaires to 10 families who had received aid to families with dependent children (AFDC) for more than 1 year and C / had at least 1 child under age 6. IMPLEMENTATION OF EPSDT Initially the Illinois Department of Public Health was to design, develop, and operate this program with Public Aid serving as the State agency for billing only. The Illinois legislature refused to appro- priate funds for the program to Public Health; instead, in June 1972,

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