Families Encouraged to Take Advantage of Expansion in Well-Child Care

With the new changes taking place in the Medicaid program this January, families need help in accessing preventive health care. Without such help, simple health issues are exacerbated and become costly health emergencies. This need not be the case. By delivering key information about well-child care, the medical home concept, and how to access care, family service providers can help improve children’s health in Illinois.

Access to preventive health care will soon improve with increases in payment rates and other financial incentives for physicians as well as the new primary care case management system that will reinforce the medical home concept. Along with strong encouragement for health care providers to accept Medicaid, families on Medicaid should be encouraged to seek preventive care. By July 1, 2008, many service providers will have been trained to promote preventive health care for children, but they could be promoting it now.

Preventive health care and early and periodic screening, diagnostic, and treatment (EPSDT) services are fully covered by Medicaid and keep children healthy and avoid costly health crises. Besides having difficulty locating a doctor, many parents are not aware of the full services to which their children are entitled under Medicaid—a physical examination, health education, vaccinations, lead testing, and chronic disease management. Service providers can help educate the public by making parents aware of the services, what they are, and why they should take advantage of them.

A physician takes note, as a part of the well-child physical examination, of the progress of a child’s growth and development. Because children should reach certain benchmarks at specific intervals, parents should be urged to take their children in for the full schedule of well-child visits. A well-child visit is a time to discuss health history and to ask about growth, development, safety, or nutrition. If so informed, parents can be comfortable with the concept of well-child care and can decide better about their children’s health.

For example, some parents believe that vaccinations are not essential because many of the diseases they protect against, such as polio and measles, have all but disappeared. But this is far from true. Childhood vaccinations offer protection from serious diseases that cause fevers, coughing, brain injury, and even death. Declining immunization rates are responsible for several recent outbreaks of measles and polio. Parents must be made aware of the continuing need for immunizations and their safety and effectiveness.

Lead testing is another component of well-child care. Exposure to lead can happen in homes with lead paint or chemical substances such as gasoline and paint thinner. Lead poisoning causes serious problems—learning disabilities, behavioral problems, and developmental delays. Low-income children are especially vulnerable as they are eight times more likely to be exposed to lead. Children should have their blood screened for lead at 12 and 24 months. If they have elevated lead blood levels, sources of lead should be removed from their home. Medication is available to help lower lead levels.

For children with chronic illnesses, preventive health care consists in disease management. Many children have asthma or diabetes, and their health problems are compounded because they forgo proper care and suffer adverse health consequences. For example, low-income minority children living in urban areas have more emergency room visits, hospitalizations, and deaths from asthma, the leading cause of school absences. Preventive care is key because chronic illnesses are controllable with early and proper diagnoses, care, and medication.

Preventive services should be administered in a medical home. Even though care in a medical home is better, children on Medicaid overwhelmingly seek costly care in the emergency room. A medical home is a regular source of care in an office or a clinic, where doctors know and support the families with whom they work. Service providers should reinforce the medical home model when working with families. By visiting a medical home, families can avoid costly care and see improved health outcomes.

The Sargent Shriver National Center on Poverty Law is working to increase use of preventive health care by increasing public education and awareness of children’s health issues. The Shriver Center reaches out to health clinics, service providers, organizations, and other interested parties.