CHILDREN (up to age 21) ENTITLEMENT TO SERVICES

[Guest guest]

Attorney H. Farley,Jr. of Naperville, IL who presently has a federal

class action lawsuit (on behalf of medically fragile persons) against the State

of Illinois with assistance from the United States Department of Justice is

sharing additional information with IPADD members and their legal rights. For

further info, please call Farley at 630-369-0103.

FACT SHEET

CHILDREN (up to age 21) ENTITLEMENT TO SERVICES

The " Early and Periodic Screening Diagnostic and Treatment " (EPSDT) federal law

is an entitlement to medically necessary services for children (up to age 21)

who need services to correct or ameliorate the child's physical or mental

conditions. These provisions would apply to children with behavioral or

emotional disorders who need intensive services to correct or ameliorate their

conditions. These provisions would often apply to children who are autistic,

developmentally disabled and children who have a mental illness.

FREQUENTLY ASKED QUESTIONS:

Q. Do the children have to qualify for Medicaid ? Answer: Yes, and if

the child is under the age of 18, then family income is considered. HOWEVER, if

the child is 18 years or older (18-20), then family income is not considered and

then you only look at the child's assets and income.

Q. Is my child, who I adopted through DCFS, eligible for intensive home

based or residential treatment through EPSDT as part of the subsidy agreement

regardless of my income ? Answer: Yes.

* * *

Q. Can the State have a " Waiting List " for this program ? Answer: No.

Every child who has a medical need for these services must be served.

* * *

Q. If my child has Medicaid and is on the PUNS list waiting services, is

he or she legally entitled to immediate services ? Answer: Yes.

* * *

Q. If my child has Medicaid and has been denied an ICG-Illinois Care

Grant for intensive community based or residential treatment, can he receive

these same services immediately through EPSDT ? Answer: Yes.

* * *

Q. If a child qualifies for funding at age 18 and since the EPSDT

program ends at age 21, will the child lose ongoing services ? Answer: Courts

have ruled that if the child still needs the services, then the Americans with

Disabilities Act (ADA)requires the State to continue to provide these services.

FOR MORE INFORMATION: Call Attorney H. Farley, Jr., at

630-369-0103