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Cost-Related Community Integration Barriers in Medicaid

A Review of the EPSDT Program and Home and Community-Based Waivers

By Sarah Jane Somers

Both a home and community-based waiver program and the Early and Periodic Screening, Diagnosis, and Treatment program can be used to create a package of services to enable a child to live in the community rather than in an institution. However, advocates should be wary about potential conflicts between the two programs. Under a waiver program states may try to limit services to those that fall under a cost cap, but states may not cap the cost of EPSDT services. Advocates may need to assess any limitations on services by sorting through the interplay between the programs and considering the requirements of the Americans with Disabilities Act.

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