HAR §17-1737-57. Screening

(a) Upon request from the recipient or family, the department shall assess the recipient's health status and needs through initial and periodic health examinations and evaluations of the general physical and mental health, growth, development, and nutritional status of infants, children, and youth. Screening shall include, but not be limited to: UNOFFICIAL 1737-73 (1) Comprehensive health and developmental history, including assessment of both physical and mental health development; (2) Comprehensive unclothed physical examination; (3) Appropriate immunizations according to age and health history; (4) Appropriate vision testing; (5) Appropriate hearing testing; (6) Appropriate laboratory tests, including lead blood level assessment appropriate for age and risk factors; (7) Routine dental examination furnished by direct referral to a dentist which includes bitewing x-ray, scaling and polishing, and topical application of fluoride as deemed necessary in accordance with section 17-1737-75; and (8) Health education including anticipatory guidance. (b) The dental screening, to be completed by the dentist, includes but is not limited to an oral examination, diagnosis and assessment of any oral disease or injuries, oral hygiene instructions, dietary counseling relating to dental health, and injury prevention counseling. Appropriate reading materials and a toothbrush, at no charge to the patient, are included in the screening fee. Preventive education and assessment shall be included as follows, by age: (1) Age twelve to twenty-four months - complete the clinical oral exam and appropriate diagnostic tests to assess oral growth and development and/or pathology; provide oral hygiene counseling for parents, guardians and caregivers; remove supra-and subgingival stains or deposits as indicated; assess the child's systemic fluoride status and provide fluoride supplementation if indicated, following drinking water analysis; assess appropriateness of feeding practices; provide dietary counseling relating to oral health; provide injury prevention counseling for orofacial trauma (play objects, pacifiers, car seats, etc.); provide counseling for oral habits (digit, pacifiers, etc.); provide diagnosis and required treatment for any oral disease or injuries; provide anticipatory guidance for parent/guardian; assess topical fluoride status and give parental counseling; provide injury prevention counseling for orofacial trauma (learning to walk, run, etc.); UNOFFICIAL 1737-74 (2) Age two to six years - repeat twelve to twenty-four month procedures every six months or as indicated by individual patient's needs/susceptibility to disease; provide age-appropriate oral hygiene instructions; complete a radiographic assessment of pathology and/or abnormal growth and development, as indicated for individual patient's needs; scale and clean the teeth every six months or as indicated by the individual patient's needs; provide topical fluoride treatments every six months or as indicated by the individual patient's needs; provide pit and fissure sealants for permanent teeth as indicated by the individual patient's needs; provide counseling and services (athletic mouth guards) as needed for orofacial trauma prevention; provide assessment/treatment or referral of developing malocclusion as indicated by individual patient's needs; treat any oral disease/habits/injuries as indicated; (3) Age six to twelve years - repeat two to six year procedures every six months or as indicated by individual patient's needs/susceptibility to disease; provide injury prevention counseling/services for orofacial trauma (sports activities); provide substance abuse counseling (smoking, smoke less tobacco, etc.); and (4) Age twelve to twenty years - repeat six to twelve year procedure every six months or as indicated by individual patient's needs/susceptibility to disease. [Eff 08/01/94; am 11/25/96 ] (Auth: HRS §346-14) (Imp: 42 C.F.R. §441.56; 42 U.S.C. §1396d)