<?xml version='1.0' encoding='utf-8'?>
<baltimore-city-law heading="§ 3-601 Definitions.">
  <section prefix="§" num="3-601" heading="Definitions.">
    <para num="(a)" heading="In general.">In this subtitle, the following terms have the meanings indicated.</para>
    <para num="(b)" heading="Abnormal EPSDT screening.">“Abnormal EPSDT screening” means a medical screening done as part of an EPSDT regimen that produces:<para num="(1)">inconclusive results;</para>
      <para num="(2)">ambiguous results; or</para>
      <para num="(3)">results that require further testing.</para>
    </para>
    <para num="(c)" heading="Baltimore City Public School System.">“Baltimore City Public School System” or “BCPSS” means the public school district of the City of Baltimore.</para>
    <para num="(d)" heading="Early and Periodic Screening, Diagnosis, and Treatment.">“Early and Periodic Screening, Diagnosis, and Treatment” or “EPSDT” means the provision of preventive health care under 42 CFR Subpart B {“Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) of Individuals Under Age 21”}, including medical and dental services to assess growth and development and to detect and treat health problems in Medicaid beneficiaries under 21 years old.</para>
    <para num="(e)" heading="Family Planning.">“Family planing” means providing individuals with the information and means to prevent an unwanted pregnancy and to maintain reproductive health.</para>
    <para num="(f)" heading="Follow-up care.">“Follow-up care” means:<para num="(1)">any treatment or practice recommended as medically necessary to address abnormal or positive results of an EPSDT screening by a licensed healthcare professional; and</para>
      <para num="(2)">the process of attempting to ascertain if the recommended services have been obtained.</para>
    </para>
    <para num="(g)" heading="Maryland Healthy Kids Preventive Health Schedule.">“Maryland Healthy Kids Preventive Health Schedule” means the schedule set by the State Department of Health’s Healthy Kids Program as a minimum EPSDT practice for all Maryland Medicaid recipients under 21 years of age, consisting of:<para num="(1)">standard health screenings;</para>
      <para num="(2)">physical exams;</para>
      <para num="(3)">laboratory tests;</para>
      <para num="(4)">immunizations; and</para>
      <para num="(5)">health education.</para>
    </para>
    <para num="(h)" heading="Medically necessary.">“Medically necessary” means that a health service is:<para num="(1)">directly related to diagnostic, preventive, curative, palliative, rehabilitative, or ameliorative treatment of an illness, injury, disability, or health condition;</para>
      <para num="(2)">consistent with currently accepted standards of good medical practice;</para>
      <para num="(3)">the most cost efficient service that can be provided without sacrificing effectiveness or access to care; and</para>
      <para num="(4)">not primarily for the convenience of the consumer, family, or provider.</para>
    </para>
    <para num="(i)" heading="Positive EPSDT screening.">“Positive EPSDT screening” means a medical screening conducted by a licensed health professional as part of an EPSDT regimen that produces positive results indicating the presence of the tested-for condition.</para>
    <para num="(j)" heading="Preventive Health Services.">“Preventive Health Services” means proactive care to detect potential health problems and protect and maintain a patient’s current health, including:<para num="(1)">screenings for health conditions;</para>
      <para num="(2)">counseling for chronic conditions;</para>
      <para num="(3)">regular health checkups; and</para>
      <para num="(4)">immunizations.</para>
    </para>
    <para num="(k)" heading="Primary health services.">“Primary health services” means a basic level of health care, including diagnostic, treatment, consultative, referral, and preventive health services, generally rendered by 1 or more:<para num="(1)">general practitioners;</para>
      <para num="(2)">family practitioners;</para>
      <para num="(3)">internists;</para>
      <para num="(4)">gynecologists;</para>
      <para num="(5)">pediatricians;</para>
      <para num="(6)">physician assistants; and</para>
      <para num="(7)">nurse practitioners.</para>
    </para>
    <para num="(l)" heading="School-based health center.">“School-based health center” means a facility providing medical care that:<para num="(1)">is located on the grounds of a BCPSS facility;</para>
      <para num="(2)">provides on site primary and preventive health care, referrals, and follow-up services;</para>
      <para num="(3)">may provide on site dental care or behavioral health care, referrals, and follow-up services; and</para>
      <para num="(4)">has been approved by the Maryland Department of Health.</para>
    </para>
    <para num="(m)" heading="School health services professional.">“School health services professional” or “school health professional” means a physician, certified nurse practitioner, or registered nurse with experience, special training, or both in working with children and families in community or school health programs and practices in accordance with the current State medical and nursing standards of care.</para>
    <annotation type="History" />
  </section>
</baltimore-city-law>
