Methods of Coordination Between Title V and Medicaid

There are many common strategies in which Title V works with Medicaid to increase access to care. These strategies can be organized in terms of the four-tiered MCH Pyramid of Health Services.

Ways in Which Title V and Medicaid Can Coordinate
Infrastructure Building Services: These include evaluation, policy development, coordination, standards development, training, and information systems.
  • Title V provides funding and experience for development and implementation of model programs that benefit Medicaid beneficiaries.
  • Title V and Medicaid develop jointly agreed upon policies and standards of care for Medicaid beneficiaries (especially relevant with EPSDT services).
  • Title V provides expertise to Medicaid in analyzing utilization patterns and recommending ideas for services provided such as more effective treatment services or options for families.
  • On a State level, Medicaid utilizes Title V population data collected through such systems as the Title V Information System to provide key population and service statistics, performance and outcome measures, and benchmarks.
  • Medicaid uses materials developed by Title V grantees, either directly or with modifications for Medicaid audiences.
  • Title V and Medicaid collaborate in planning activities such as designing benefit packages, application forms, enrollment procedures, and referral and follow-up protocols.
Population-based Services: These include screenings, immunizations, oral health, nutrition and outreach, and public education.
  • Title V programs and Medicaid perform EPSDT services for infants, children, and adolescents, including CSHCN.
  • Title V programs coordinate services such as lead screening and referral to Title V programs for additional evaluation and management, if necessary.
  • Title V programs provide public education to Medicaid beneficiaries on nutrition and oral health issues, stressing the need for such services from an early age.
Enabling Services: These include outreach, health education, family support services, case management, and coordination with Medicaid.
  • Title V programs provide outreach and enrollment services to eligible beneficiaries, allowing Medicaid funds to pay for those services.
  • Medicaid performs outreach to audiences traditionally supported by Title V programs and vice-versa.
  • Title V agencies administer programs that support Medicaid beneficiaries, not only to ensure enrollment but to track and/or provide follow-up treatment.
  • Medicaid utilizes Title V programs for care coordination and assistance in accessing treatment services (e.g., facilitating transportation).
Direct Health Care Services: These include basic health services and health services for CSHCN.
  • Title V pays for gap-filling services to Medicaid benefic-iaries.
  • Title V provides funds for services needed by uninsured children and pregnant women and for necessary services not covered by Medicaid or other sources.
  • Medicaid coordinates with Title V programs to pay for community specialists who provide appropriate care for CSHCN.

Author: John Richards, M.A., 2008