Almost 10 years after the program was begun, Ditrict of Columbia heals officials are attempting to enlist private physicians in the federal government's childhood Early and Periodic Screening, Diagnostic and Treatment program (EPSDT).
According to Albert P. Russo, director of the city's Department fo Human Resources, only about 10 percent of the 80,000 city children and teenagers served by Medicaid now are receiving the EPSDT screening.
The program is designed to test children for routine physical, vision and hearing problems, lead poisoning, sickle cell anemia and a host of other conditions, most correctable if caught
The District of Columbia is not the only jurisdiction where the national program has failed to live up to expectations.
"It's been a joke all over the country," said Dr. Frederick Green, associate director of Children's Hospital National Medical Center and a former director of the U.S. Department of Health, Education and Welfare's Children's Bureau.
"There've only been 2 million of a possible 11 million children screened (nationwide) in the last 10 years," said Green, who is chairman of the committee being named by D.C. Mayor Marion Barry to reduce the District's high infant mortality rate.
It is estimated that 10 percent to 12 percent of the children entering the nation's schools each year enter with correctable but undetected physical ailments, typically impaired hearing or vision. Green said he believes the percentage is even highter in the District of Columbia but does not have the statistics to prove his theory.
DHR has devised a plan to pay private physicians between $5 and $10 above standard Medicaid fees to screen children as part of the EPSDT program.
"We will pay them their regular Medicaid rate of reimbursement and pay them an additional amount" for the paperwork involved in the screening process, said city Medicaid administrator Peter Coppola.
Medicaid now pays $32 for a comprehensive physical examination and $13 for a follow-up visit, Coppola said. DHR has sent the proposed rates and rules for the program to a physician advisory committee for comment, and expects to publish the rates in the D.C. Register in the near future.