Maryland Healthy Kids Program

Martin O'Malley, Governor   Anthony G. Brown, Lt. Governor   John M. Colmers, Secretary
 

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Maryland Healthy Kids Program Clinical and Administrative Manual

 

Links marked with This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. are PDF.  Download Adobe Acrobat Reader for viewing .pdf files

 

Title Page: Mission, Vision and Goal  This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.

Table of Contents  This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. - Updated 09/08

Section 1:  Introduction This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.                                                                             
A. Overview (page 1)
B. Healthy Kids Program Administration (page 2)
C. Provider Certification and Qualifications (page 2-4)
D. Local Health Department Role (page 5-6)
E. Medicaid Managed Care Organizations (page 7 - 8)
F. Healthy Kids Program Performance Improvement Standards (page 8)
G. HIPAA Privacy (page 8)

     Addendum This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. - Updated 2008
red arrow Provider Application for Certification and Participation This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Provider Certification Letter This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Provider Action Grid for MCO Newborn Coordinators This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow HIPAA Letter by Maryland Attorney General's Office This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. 

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Section 2:  Maryland Preventive Health Care Overview This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.

The Maryland Schedule of Preventive Health Care This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.- Updated 2008
A. Initial Screening Services (page 1)
B. Periodic Screening Services (page 1-2)
C. Additional Screening Services (page 2)
D. Hearing, Vision and Dental Screening Services (page 2)
E. Required EPSDT Components of Maryland Healthy Kids Program (page 2-4)

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Section 3:  Healthy Kids/EPSDT Screening Components This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. - Updated 2008 

A. Health and Developmental History (pages 1 - 7) - Updated 2008
B. Comprehensive Physical Examinations (pages 7 - 18)
C. Laboratory Tests (pages 18 - 24)
D. Immunizations (pages 24 - 27)
E. Health Education /Anticipatory Guidance (pages 27 - 32)
     Tables and Charts:  This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Table 1 - Blood Pressure Levels for Boys This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Table 2 - Blood Pressure levels for Girls This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Table 3 - Guidelines for Interpretation of Blood Pressure This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Table 4 - Guidelines for Objective Vision Screening This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. 
red arrow Table 5 - Dietary Fluoride Supplementation Schedule This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Table 6- Tooth Eruption Charts, Primary and Permanent  This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Table 7 - MD Newborn Metabolic Screen Disorders This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Table 8 - Hematocrit and Hemoglobin Values for Children This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Table 9a & 9b - MD Blood Lead Follow-up for Children  This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. - Updated 2008
red arrow Table 10 - Classification of Cholesterol Levels in Children and Adolescents This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Table 11 - Follow-up of Average LDL - Cholesterol Determinations This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. 
red arrow Table 12 - Targeted Testing and Treatment of Latent TB Infection (Children) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Table 13 - Tuberculin Skin Test Cut - Points by Age for Low Risk Persons This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Table 14 - Regimens for Treatment of Latent TB Infection This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.

     Addendum This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.

  red arrow WIC Referral Form - Updated 2008
red arrow Maryland Newborn Hearing Screen Guide This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
  red arrow Developmental Screening Tools - New 2008
  red arrow

Additional Evaluation/Intervention for Developmental Disorders - New 2008 

red arrow Selected Bibliography This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.  - Updated 2008
red arrow Web Sites This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. - Updated 2008

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Section 4:  Adolescent Preventive Health  This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. - Updated 2008
A. Introduction (pages 1 - 2)
B. Health and Developmental History (pages 2 - 8)
C. Comprehensive Physical Examination (pages 8 - 10)
D. Laboratory Tests (pages 10 - 13)
E. Immunizations (pages 13 - 16)
F. Health Education and Anticipatory Guidance (pages 15 - 17)

     Addendum This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Substance Abuse Protocol This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. - Updated 2008 
red arrow Informed Consent and Agreement to HIV Testing This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Adolescent Bibliography This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Web Sites This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. - Updated 2008

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Section 5:  Other Child Health Services This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.

A. Expanded EPSDT-Related Services (pages 1 - 2)
B. HealthChoice Self-Referred Services (page 2)
C. Children in State-Supervised Care (page 2 - 3)
D. Other Programs for Children with Special Needs (page 4 - 5)
E. Specialty Mental Health System (page 5 - 6)

     Addendum This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.

red arrow Maryland Uniform Consultant Referral Form This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Local Health Services Request Form and Instructions HTML document - Updated 2008
red arrow MD Infants and Toddlers Referral and Feedback Form  This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. - Updated 2008
red arrow REM Referral Form  This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. - New 2008

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Section 6:  Billing and Encounter Data Reporting This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. - Updated 2008
A. Introduction (page 1 )
B. Verifying Eligibility (page 1 - 2)
C. Newborn Information (page 2 -3)
D. Billing for Services to Children in MCOs (page 3)
E. Billing Medical Assistance for Services to Children Not in an MCO (page 4 - 10)

Section 7:  Appendices
          Appendix I:  Preventive Care Forms This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Medical and Family History Form (English) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.  This is a Microsoft Word document
red arrow Medical and Family History Form (Spanish) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.  This is a Microsoft Word document
red arrow Age-Specific Encounter Forms This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. - Updated 2008
red arrow CDC Growth Charts (2000) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Body Mass Index (BMI) Calculator – Child & Teen  This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Objective Hearing and Vision Form This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.

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          Appendix II:  Risk Assessments Forms  This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Preventive Screen Questionnaire: Tb, Lead, Cholesterol and STD/HIV (English) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.  This is a Microsoft Word document
red arrow Preventive Screen Questionnaire: Tb, Lead, Cholesterol and STD/HIV (Spanish) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.  This is a Microsoft Word document
red arrow Mental Health Questionnaire: Age 3-5 (English) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.  This is a Microsoft Word document
red arrow Mental Health Questionnaire: Age 3-5 (Spanish) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.  This is a Microsoft Word document
red arrow Mental Health Questionnaire: Age 6-9 (English) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.  This is a Microsoft Word document
red arrow Mental Health Questionnaire: Age 6-9 (Spanish) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.  This is a Microsoft Word document
red arrow Mental Health Questionnaire: Age 10-12 (English) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.  This is a Microsoft Word document
red arrow Mental Health Questionnaire: Age 10-12 (Spanish) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.  This is a Microsoft Word document
red arrow Mental Health Questionnaire:  Age 13-20 (English) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.  This is a Microsoft Word document
red arrow Mental Health Questionnaire:  Age 13-20 (Spanish) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.  This is a Microsoft Word document
red arrow Edinburgh Postnatal Depression Scale (EPDS) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. - New 2008
red arrow CRAFFT Adolescent Substance Abuse Assessment (English) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.  This is a Microsoft Word document
red arrow CRAFFT Adolescent Substance Abuse Assessment (Spanish) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.  This is a Microsoft Word document
red arrow SEEK Parent Questionnaire (Abuse Assessment) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. 
red arrow Nutrition Questionnaires (Infant, Child, Adolescent) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.  - Updated 2008

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          Appendix III:  Immunization Forms and

          Resources  This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. - Updated 2008
red arrow Recommended Childhood and Adult Immunization Schedules HTML document - Updated 2008
red arrow Vaccine Administration Record HTML document - Updated 2008
red arrow VFC Eligibility Screening Record HTML document - Updated 2008
red arrow Maryland Immunization Certificate This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. - Updated 2008
red arrow Vaccine Storage Temperature Log  This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents. - Updated 2008
red arrow VFC Vaccine Inventory Form HTML document - Updated 2008
red arrow VFC Vaccine Return Form HTML document - Updated 2008
red arrow Parental Delegation Form for Minors This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.

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       Appendix IV:  Health Education Materials This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Food Guide Pyramid This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow General Child Seat Use and MD Child Safety Seat Law This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow National Safe Kids Campaign Materials (Fire, Poison, Home) This is a PDF document. Adobe Acrobat Reader download is required to view PDF documents.
red arrow Communicable Disease Fact Sheet  HTML document<