Reports:

A 50-State Analysis of Medicaid Benefit Coverage for Children without EPSDT.  Memorandum to the March of Dimes and National Association of Children's Hospitals, September 2005.

This memorandum provides an analysis of the Medicaid coverage that would be available to children in each state if the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit requirement was eliminated and states applied the coverage policies in effect for categorically needy adults. It examines 12 benefits of particular importance to children with chronic physical and developmental conditions, including physician services, inpatient hospital services, outpatient hospital services, prescription drugs, physical therapy, occupational therapy, speech therapy, home health services, private duty nursing, personal care services, durable medical equipment, and medical supplies.  Detailed state tables are included.  Information is based on state plans and state plan amendments, current as of April 2005.  Findings show that absent EPSDT, all children with chronic or disabling conditions, but especially those residing in Southern states, could face exclusions or restrictions in coverage for specialized therapeutic services.

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States' Use of Medicaid Options for Expanding Children's Eligibility

by Harriette B. Fox and Stephanie J. Limb, Fact Sheet No. 6, 11 pages, May 2005.

This fact sheet reports on states' options for expanding Medicaid eligibility to children who do not quality for mandatory coverage.   It examines 13 major options provided to states for expanding children's Medicaid eligibility and presents current information on states' use of these options, including SCHIP coverage, 1115 research and demonstration waivers, home- and community-based waivers, and coverage of legal immigrants, the medically needy, and older adolescents, and is based on information from the Centers for Medicare and Medicaid Services, reports from private organizations, state plan documents, and telephone and e-mail interviews with state Medicaid agency staff.   It shows that all states use at least one of the major options, and most use at least 7, with the most common being coverage of children in state-subsidized adoptions and children in home- and community-based waiver programs.

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Children Not the Target of Major Medicaid Cuts but Still Affected by States' Fiscal Decisions.

by Harriette B. Fox, Stephanie J. Limb, Ruti G. Levtov, and Margaret A. McManus, Fact Sheet No. 5, 8 pages, June 2004.

This fact sheet reports on Medicaid program affecting children in  states '  fiscal years 2003 and 2004.   It examines policy changes in eligibility, managed care enrollment, benefits, cost sharing, authorization, fee-for-service  provider payments, and home- and community-based waivers and is based on extensive interviews with Medicaid staff and analyses of state plan amendments, managed care contracts, and provider bulletins.   It shows that a few states have made reductions in children's income or categorical eligibility, a few have pursued new cost-sharing requirements for children, and a handful have tightened their home- and community-based waivers serving children with disabilities. States have been more likely to lower or freeze pediatric provider payments and to impose greater controls on service authorization.

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SCHIP Programs More Likely to Increase Children's Cost Sharing than Reduce Their Eligibility or Benefits to Control Costs.

by Harriette B. Fox and Stephanie J. Limb, Fact Sheet No. 4, 6 pages,

April 2004.

This fact sheet reports on the SCHIP program changes that states have made over the last 16 months in response to budget shortfalls.   It examines policy changes in eligibility and enrollment, covered benefits, and cost-sharing requirements and is based on information from SCHIP directors in all 50 states with SCHIP programs in March 2004.   It shows that despite difficult financial circumstances, nearly all states are protecting their SCHIP programs from cuts in eligibility and benefits but many are asking parents to contribute more to the cost of children's coverage, usually in the form of new or higher premiums.   Importantly, also, some states have taken steps to increase either enrollment or benefits.

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Many States Reporting Cost-Cutting Measures for Children´s Mental Health Services
by Harriette B. Fox, Margaret A. McManus, Harry Schmidt, and Mary Reichman, Fact Sheet No. 3, 4 pages, June 2002, $10.00.

This fact sheet examines state changes affecting children´s mental health services in fiscal years 2002 and 2003 resulting from state budget shortfalls. Administrative spending reductions and service delivery changes are summarized. These service changes include cuts in inpatient hospital care, residential treatment, and community-based services. The findings are based on a brief survey of each state´s mental health authority staff person responsible for children´s services conducted in March and April of 2002.
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Program Cuts Affecting Half of All State Title V Programs for Children with Special Health Care Needs
by Margaret A. McManus, Harriette B. Fox and Stephanie Etienne, Fact Sheet No. 2, 4 pages, March 2002, $10.00.

This fact sheet examines state Title V CSHCN program changes resulting from state budget shortfalls in fiscal year 2002. States reported on reductions in administrative spending, enrollment, eligible conditions and services, and planned program expansions. The findings are based on a brief survey of Title V CSHCN program directors conducted in December of 2001 and January of 2002.
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Few States Report S-CHIP Program Cuts Before the End of FY 2002
by Harriette B. Fox, Mary B, Reichman, and Margaret A. McManus, Fact Sheet No. 1, 4 pages, January 2002.

This fact sheet provides information on SCHIP program changes in fiscal years 2002 and 2003 as a result of federal and state budgetary reductions. The information, which covers cost-saving measures pertaining to both administrative functions and enrollment, benefit, cost sharing, and other program policies, is based on a brief survey of SCHIP program directors conducted in November and December of 2001.
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