Chapter 8E. Uniform Child Health Screening Requirements.
§ 7–875.01. Purpose.
The purpose of this chapter is:
(1) To establish age-appropriate health screening requirements for all children, from birth to 21 years of age, in the District of Columbia, regardless of their insurance status, who:
(A) Reside in the District;
(B) Are wards of the District; or
(C) Are children with special needs who reside or are receiving services in another state;
(2) To improve the overall health status of all children by ensuring consistency in health screening and early detection of health problems and enabling children to obtain the necessary prevention, treatment, and intervention services at the earliest opportunity;
(3) To reduce parental stress and increase parental satisfaction and compliance with all child-related health, human or social services, and educational programs by using a uniform health assessment form; and
(4) To provide the Mayor with the information necessary to effectively plan, establish, and evaluate a comprehensive system of appropriate preventive services for children for early detection of potential health problems.
§ 7–875.02. Definitions.
For the purposes of this chapter, the term:
(1) “Child-related educational program” means public and private schools, including pre-kindergarten, Head Start, child care, and special education.
(2) “Child-related health program” means Medicaid, Children Health Insurance Program (“CHIP”), Healthy Start, Healthy Families, Early Intervention, and private health insurance.
(3) “Child-related human or social services program” means children in foster care and Women, Infants and Children.
(4) “Children with special needs who reside or are receiving care in another state” means children:
(A) With physical or mental disabilities or illnesses who reside or receive care in other states, because the District does not have the facilities, resources, or services to appropriately treat the child’s physical or mental disability or illness; and
(B) Whose parents or legal guardians reside in the District;
(5) “Health benefits plan” means any accident and health insurance policy or certificate, hospital and medical services corporation contract, health maintenance organization subscriber contract, plan provided by a multiple employer welfare arrangement, or plan provided by another benefit arrangement. The term “health benefit plan” does not mean accident only, credit, or disability insurance; coverage of Medicare services or federal employee health plans pursuant to contracts with the United States government; Medicare supplemental or long-term care insurance; dental only or vision only insurance; specified disease insurance; hospital confinement indemnity coverage; limited benefit health coverage; coverage issued as a supplement to liability insurance, insurance arising out of a workers’ compensation or similar law; automobile medical payment insurance; medical expense and loss of income benefits; or insurance under which benefits are payable with or without regard to fault and that is statutorily required to be contained in any liability insurance policy or equivalent self-insurance.
(6) “Health insurer” means any person that provides one or more health benefit plans or insurance in the District of Columbia, including an insurer, a hospital and medical services corporation, a fraternal benefit society, a health maintenance organization, a multiple employer welfare arrangement, or any other person providing a plan of health insurance subject to the authority of the Commissioner.
(7) “Uniform health form” means a standardized health assessment form developed by the Mayor for use when enrolling a child in child-related educational, health, and human or social services programs.
§ 7–875.03. Establishment of uniform health screening requirements and health assessment enrollment forms.
(a) The Mayor shall establish uniform, age-appropriate health screening requirements consistent with the standards and schedules of the American Academy of Pediatrics for all children, from birth to 21 years of age, in the District of Columbia, regardless of insurance status who are:
(1) Residents of the District;
(2) Wards of the District; or
(3) Children with special needs who reside in or who are receiving services in another state.
(b) The Mayor shall develop a uniform health assessment form for enrollment of children in child-related health, human or social services, and educational programs. Use of the form is not intended to supersede the enrollment requirements of child-related health, educational, and human or social services programs. The form may be supplemented by additional forms used for enrollment that are not related to health assessment.
(c) Uniform health screenings shall not be required under this chapter, if a minor’s parent or guardian or an adult youth submits in good faith a written notarized statement to the appropriate official affirming that the screening in question would violate the established tenets and practices of the parent’s or guardian’s church or religious denomination, or in the case of an adult youth, the adult youth’s church or religious denomination.
§ 7–875.04. Payment for health screenings.
(a) A health insurer’s health benefits plan shall include the uniform, age-appropriate health screening requirements for children from birth to age 21 years who are:
(1) Residents of the District;
(2) Wards of the District; or
(3) Children with special needs who reside or are receiving services in another state.
(b) The enrollments for Medicaid, Head Start, Healthy Families, and CHIP are expanded to include the requirement of uniform, age-appropriate health screenings for all children.
This chapter shall apply to all individual and group health benefit plans issued or renewed 120 days after the issuance of rules required under § 7-875.05.
