Puerto Rico

The Puerto Rico ABCD Screening Academy Project built upon the efforts of the Puerto Rico-Early Childhood Comprehensive Systems (PR-ECCS) initiative to increase the number of providers implementing structured developmental screening for children ages 0 to 5 years old. The Administración de Seguros de Salud de Puerto Rico (ASES) implemented training sessions for providers and parents at pilot practice sites aimed at enforcing the EPSDT handbook standards and reimbursing primary care providers for conducting a screen with an objective, validated tool.

Specifically, the ABCD Screening Academy activities in Puerto Rico included:

• Revising the EPSDT schedule to follow the Bright Futures recommendations, including a developmental screening visit using the Ages and Stages Questionnaire (ASQ) for age 9, 18, and 24 months, and including a screening for autism at 18 months using The Modified Checklist for Autism in Toddlers (M-CHAT).
• Training primary care physicians in the three pilot sites on developmental screening using the ASQ, selecting the ASQ Spanish version as the required developmental screening tool for all Medicaid enrolled children between the ages of 9 and 60 months, and developing and distributing the provider manual “Protocol for the Administration of ASQ Questionnaire,” to assist providers in the use of the ASQ and billing policies.
• Sustaining and spreading these improvements by obtaining a multisite license from Brooks Publishing Company for the statewide use of the ASQ.