Association for Public Policy Analysis & Management

The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit mandates full coverage of healthcare for children in Medicaid. The EPSDT benefit provides the access, framework, resources, and financing for children with complex healthcare needs. When fully implemented, following the EPSDT program leads to improved health outcomes. The purpose of this analysis is to examine the EPSDT benefit as an essential healthcare resource for vulnerable children, notably children in foster care. The majority of children in foster care receive Medicaid health coverage and have complex healthcare needs. According to the most recent research, many children in foster care are not receiving this mandated benefit. Improved implementation of the EPSDT benefit is key to improving outcomes. This policy analysis reviews the EPSDT benefit, evidence for its effectiveness, issues challenging full implementation for children in foster care, examples of successful implementation, and recommendations. Specific recommendations include coordination of healthcare and child welfare services (eg with health services coordinators), increased accountability for implementers, and adequate numbers of qualified, trauma-informed providers. Compliance with EPSDT guidelines should be mandated and enforced for all children in foster care.