Getting Children’s Physical Examinations and Health Information Required for Child Care Enrollment: Resources for Parents, Child Care Operators and Partners

The PA Health Access Network (PHAN) and the Pennsylvania Developmental Disabilities Council report that many individuals on Medical Assistance are currently impacted by waiting for a medical appointment for longer than 4 months New Report: Healthcare Provider Networks Inadequate to Serve All – Pennsylvania Health Access Network (pahealthaccess.org).

Why does this matter to the early learning community in Pennsylvania?

Pennsylvania wants to enroll more young children in licensed child care programs, so the inability to get timely child physical examinations is a problem for families and child care operators who must meet child health information requirements within 60 days following the first day of attendance at the facility (see below).  Here are some resources to help address this issue.

 The Regulations:

• 3270.131, 3270.131, and 3290.131 Health information.

(Excerpts follow…)

55 Pa. Code § 3270.131. Health information. (pacodeandbulletin.gov)

• The operator shall require the parent of an enrolled child, including a child, a foster child and a relative of an operator or a facility person, to provide an initial health report no later than 60 days following the first day of attendance at the facility.

(1)  The initial health report for an infant must be dated no more than 3 months prior to the first day of attendance at the facility.

(2)  The initial health report for a young toddler must be dated no more than 6 months prior to the first day of attendance at the facility.

(3)  The initial health report for an older toddler or preschool child must be dated no more than 1 year prior to the first day of attendance at the facility.

(4)  The initial health report for a school-age child must be dated in accordance with the requirements for medical examinations for school attendance in 28 Pa. Code §  23.2 (relating to medical examinations).

(e)  The facility may not accept or retain an infant 2 months of age or older, a toddler or a preschool child at the facility for more than 60 days following the first day of attendance at the facility unless the parent provides written verification from a physician, physician’s assistant, CRNP, the Department of Health or a local health department of the dates (month, day and year) the child was administered immunizations in accordance with the recommendations of the ACIP.

Link to child care forms (e.g. Child Health Report/CD 51): Child Care Forms (pa.gov)

Resources

Child without health insurance?

• How to Apply for Medical Assistance (Medicaid): Please inform the parents or caregivers how to access healthcare services: How to Apply (pa.gov)

Problems getting timely physical exam appointments? 

• Please inform the family or caregivers to get friendly help and support by calling the Special Needs Unit Hotline Number for the child’s HealthChoices Insurance Plan: PhysicalHealthChoices-Publications (pa.gov)

Special Needs Units Hotline Flyer (download):

• MCO Special Needs Units (SNUs) are available for anyone with a need who is enrolled in the Plan (no specific diagnosis is required). SNUs help their plan members with more assistance of any kind (e.g. arranging transportation, making appointments, finding doctors and/or dentists, finding medical equipment, coordinating skilled nursing services etc.).

More Information about Physical HealthChoices and the Medicaid Managed Care Insurance Plans in Pennsylvania: 

• PhysicalHealthChoices-Main (pa.gov)

Information about Well-Child Care Schedules

• Resources from the American Academy of Pediatrics (AAP): AAP Schedule of Well-Child Care Visits – HealthyChildren.org

Special resources for underserved areas and families needing dental services:

Dental Mobile Units

Mobile units which are being funded by the MCOs to provide dental services to children under 5 years of age.

• Geisinger Health Plan uses a Mobile Dental Unit for Annual Dental Visits (ages 2-20), fluoride varnish, and dental sealants. The mobile unit was specifically purchased to provide dental services in underserved areas where there are transportation issues.
• Highmark Whole Care uses a Mobile Dental Unit during the summer months. Services provided are cleaning, fluoride, x-rays, sealants and dental exams.
• UPMC partners with Miracle Dental and Big Smiles to schedule overdue members for preventative visits at mobile dental events.