SD21 - Report of the Joint Subcommittee Studying Lead-Poisoning Prevention


Executive Summary:
As requested by Senate Joint Resolution 43, we are submitting the final report of the task force on delegation to registered nurses of screening and testing in the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program. Pursuant to the resolution, a task force was established to examine the issues and assist the Joint Subcommittee Studying Lead-Poisoning Prevention in its work. The task force consisted of representatives from several agencies within this Secretariat, as well as the Department of Education, pediatricians who care for Medicaid patients, advocacy groups and professional associations. The task force was organized by and the final report prepared by the Department of Health Professions.

In its final report, the task force concluded that certain screening and testing components of EPSDT, including blood-level testing, can be safely delegated to registered nurses, but the comprehensive physical examinations are not within their scope of practice and should not be delegated. Such examinations should only be performed by licensed health care practitioners who have specialized training in the physical assessment and diagnosis of the pediatric population. Delegation of the physical examination portions of EPSDT to a registered nurse would not result in cost savings to Medicaid but could result in the long-term costs of failure to provide early detection and intervention.