Health Care and Screening Guidelines

Early and Periodic Screening, Diagnostic and Treatment Services (EPSDT)

The Medicaid program’s benefit for children and adolescents is known as EPSDT. This benefit provides comprehensive and preventive health care services to children enrolled in Medicaid. The Health Department holds the primary responsibility for determining Vermont’s periodicity schedules (a schedule for when children and adolescents should receive preventive care and recommended screenings for both medical and dental care).  In addition, the Health Department works closely with health care providers and other state and community partners to reduce barriers to accessing health care services for children, and help ensure families are aware of their benefits and the age-appropriate health care recommendations.  Please visit the Health Department’s Find Health Insurance page for more information about how to apply for insurance and to learn more about Vermont’s Medicaid benefit.   

Bright Futures – Guidelines for Health Supervision of Infants, Children, and Adolescents

States must provide schedules for periodic screening, vision, and hearing services for the Medicaid benefit for children under 21. These screenings must be provided at intervals that meet reasonable standards of medical practice. States must consult with recognized medical organizations involved in child health care in developing these “periodicity schedules”. Alternatively, states may elect to use a nationally recognized pediatric periodicity schedule. 

Vermont has chosen to use a national health promotion and prevention guideline known as Bright Futures for Vermont’s EPSDT periodicity Schedule.  These guidelines are led by the American Academy of Pediatrics and supported by the Maternal and Child Health Bureau, Health Resources and Services Administration. These guidelines provide evidence-driven and theory-based guidance for all preventive care screenings and well care visits. Ideally, these services would be accessed in the child’s medical home. Bright Futures recommendations align well with many of Vermont’s public health initiatives.

Vermont’s Dental Periodicity Schedule

Promotion of oral health is considered a joint responsibility between oral health professionals and other health care professionals. This periodicity schedule is established to reflect the intervals which meet reasonable standards of practice.

Partnering with Schools

The Health Department recognizes schools as important partners in our effort to ensure all students have health insurance as well as medical and dental homes, and that families understand and are receiving age-appropriate health care as recommended by the American Academy of Pediatrics’ Bright Futures -Guidelines for Health Supervision of Infants, Children, and Adolescents.  Some of the many ways schools can support these efforts are:

  • Identify families that are uninsured and help them to get health insurance
  • Encourage all school-aged children to have a medical and dental home and to visit them each year to receive appropriate preventive health care, screenings, and services according to Vermont’s periodicity schedules 
  • Include the Bright Futures recommendation of an annual well care visit on the school’s website or within handbooks (e.g. student, parent, or teacher)
  • Use social media, including the school website, to provide information about annual well care visits
  • Educate families by helping them understand the difference between annual well care visits and other health care visits, including sick or injury-related visits and or sports clearance
  • School Nurses (and other health professionals or educators) can talk about the benefits of annual well care visits, and share this information with school administrators, teachers, coaches, and school counselors
  • School Nurses can monitor their student population, at least annually, to identify students who do not have a current annual well care visit documented and provide notification and recommendation to students and families; electronic Health Records are an excellent way to track this information
  • Periodically screen students for hearing and vision according to the Standards of Practice: School Health Services Manual (Screening), refer students to their medical home as needed, and coordinate with health care providers on outcomes
  • Refer students with suspected or actual health needs to providers in a timely manner, to correct or ameliorate conditions as soon as possible for the best possible outcomes
  • Help students to receive needed health-related services that are of sufficient amount, duration, and scope to correct, ameliorate, and manage any diagnosed condition
  • Collaborate with local primary care providers to establish relationships that could decrease barriers to accessing care, and support your school’s work toward increasing annual well care visit rates
  • Collaborate with school nurses and athletic directors to require an annual well care visit as part of sports clearance requirements for participation in team sports
  • Participate in the Health Department’s Tooth Tutor Dental Access Program