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Children’s Health Programs



Early Periodic Screening, Diagnosis and Treatment Services (EPSDT) is for children from birth to age 21 who are eligible for Medicaid. Under the EPSDT program, children are checked for medical problems early. Specific tests and treatments are recommended as children grow older. The areas of health care that are checked include: preventative check-ups; growth and development assessments; vision; hearing; teeth; dental varnishings; immunizations; and laboratory tests. Children should receive health check-ups regularly or before the following ages: 1 month; 2 months; 4 months; 6 months; 9 months; 12 months; 15 months; 18 months; 24 months; 3 years; 4 years; 5 years; 6 years; 8 years; and once a year for ages 10-20.

If treatment is needed, this program provides Medicaid coverage for medically necessary special services, but may not otherwise be covered under the Kentucky Medicaid Program. Services may be preventative, diagnostic, or treatment, or rehabilitative.  All EPSDT special services require prior authorization.

Children who pay the KCHIP III Premium are not eligible for EPSDT Special Services or non-emergency transportation.

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First Steps

First Steps is a statewide early intervention system which provides services to children with developmental disabilities from birth to age 3 and their families.  First Steps is Kentucky’s response to the federal Infant-Toddler Program (ITP) established by Public Law 99-457 Part C.  First Steps offers comprehensive services through coordination with a variety of community agencies and service disciplines.  First Steps is administered by the Department for Public Health in the Cabinet for Health and Family Services.

Why Provide Services? 
Typically, children who participate in early intervention experiences significant improvement in development and learning.  Children with developmental delays or conditions likely to cause delays benefit greatly from First Steps during critical developmental years.

Who does First Steps Serve?
First Steps serves children from birth to age 3 and their families. Child eligibility for the program is determined two ways:

  1. By developmental delay- A child may be eligible for services if an evaluation shows that a child is not developing typically in at least five skill areas: cognition, communication, physical, social and emotional or self-help.
  2. Automatic Entry- A child may be eligible if he or she receives a diagnosis of physical or mental condition with a high probability of resulting developmental delay, such as Down Syndrome.

How are First Steps services provided?
First Steps is available in all Kentucky counties. Services may be provided in the home, at child development or other designated centers or in a clinical setting, depending on the needs of the child and family and the availability of services in a given area.

How can I learn more about First Steps Services?
Anyone can refer a child for the First Steps services by calling 800-442-0087 or (606) 439-1325.

Referrals are directed to teams at the district Point of Entry offices that help children and families access needed services. Services are available to any child and family who meet developmental eligibility criteria, regardless of income. A family’s participation in First Steps is always optional.

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HANDS logo

HANDS is a voluntary program for new and expectant parents. Families begin by meeting with a HANDS Parent Visitor who will discuss any questions or concerns about pregnancy or a baby’s first years. Based on this discussion, all families will receive information and learn about resources available in the community for new parents. Some families will receive further support through home visitation. That’s right information brought right to your home!

Who can participate in HANDS? First-time and/or dads residing in Kentucky.

When do HANDS services begin? Services can begin during pregnancy or anytime before a child is 3 months old.

Why participate in HANDS? Because parents are the most important people in a baby’s life. Parents are the first and most important teachers a child will ever have. And, parenting is a very demanding job, and all parents have questions and stress.

What can parents expect?

  • Support through your pregnancy and the early years of your baby’s life.
  • Ways to make your home safe for your baby.
  • Information on how to care for your baby
  • Facts that will let you know your baby is growing and developing in healthy ways.
  • Activities that you and your baby can enjoy together that can stimulate your child’s brain development.
  • Access to other community services.

What are the main goals of HANDS?  Healthy pregnancies and births; healthy child growth and development; healthy, safe homes; and self-sufficient families.

HANDS believes:

  • All families have strength.
  • Families are responsible for their children.
  • Families are the primary decision makers regarding their children.
  • Communities recognize their roles in children’s lives.
  • Communities recognize that all children must succeed.
  • Prevention and early intervention improves the community’s well being.
  • Public and private partnerships are vital to a successful program.
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Healthy Start In Child Care

The Kentucky River District Health Department can provide a child care health consultant to assist in the promotion of health of children in day care settings.

Areas of focus include:

  • Health, safety and nutrition information
  • Classes for children, families & staff
  • Playground safety consultation
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Regulations require The Cabinet for Health Services to implement a statewide program for the detection, prevention, and control of communicable diseases.  Therefore laws are established that mandate immunization schedules for attendance at day care centers, certified family child care homes, other licensed facilities which care for children, preschool programs and public and private primary and secondary schools.

Children through 18 years of age that meet certain criteria are eligible to receive vaccines at little or no cost through the Kentucky Vaccine Program.

For the Immunization Schedule please visit:

If your child needs to be immunized, please call your county health department.

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Nutrition Counseling

The Kentucky River District Health Department provides: Basic nutrition counseling to caregivers and patients from birth through adolescence. Infant feeding guidance is provided following the recommendations of the American Academy of Pediatrics, progression of counseling through age 21 following guidance of the USDA MyPyramid.

Individualized nutrition planning is provided for the following:

  • diabetes
  • overweight prevention management
  • other counseling provided with physician referral

 School Health Program

The Kentucky River District Health Department offers the option to work in cooperation with each school district to place a Registered Nurse at the school site. 

Nurses are available to provide the following services:

  • Daily medications
  • Procedures such as: blood sugar monitoring, catherizations, first aid, sick visits, injections, health education, etc.

School health nurses have access to Registered Dieticians, Nutritionists, and Health Educators as a resource if needed.

Problems of acute or chronic illness, health promotion, disease prevention and health education are the focus of the school health program.

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Well Child Care

Children of all ages need complete health check-ups on a regular basis to protect their health and their future.

With scheduled check-ups, minor health problems in children can be caught before they become serious. Diseases like chickenpox, mumps, and measles can be prevented by immunizations. Any physical or mental developmental problems can be found and treated early.

These services are available at The Kentucky River District Health Department, and are provided at no cost to families with Medicaid or KCHIP coverage.

  • Well Child Care is available to children (income eligible) up to 21 years of age with medical assistance card or on a sliding scale fee.
  • Well Child Care includes a complete physical exam (meets requirements for pre-school and sixth grade).
  • Also included are developmental and lead screening for children 0-6 years of age.
  • Parents will be provided with counseling on nutrition, safety, and age related issues.
  • Well Child Care provides dental varnishings.
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Special Supplemental Nutrition Program for:
Women, Infants, & Children

WIC provides nutrition education and healthy foods to:

  • Women who are pregnant, who are breastfeeding their babies, or who have given birth in the last six months.
  • Infants to 12 months of age; and
  • Children age 1 to 5 years of age.


Contact your county health department for an appointment. Our staff will:

  1. Request that you show proof of your identity and residence, (several methods can be used).
  2. Determine if you meet income guidelines of the program.  To qualify you must show proof that:
  • You receive KTAP, Food Stamps or Medicaid, or
  • A pregnant woman or infant in your household receives Medicaid, or
  • A member of your household receives KTAP, or
  • Your household income is at or below 185% of poverty.
1 $1,604 $19,240
2 $2,159 $25,900
3 $2,714 $32,560
4 $3,269 $39,220
5 $3,824 $45,880
6 $4,379 $52,540

Effective April 1, 2008-March 31, 2009

Household size includes unborn baby.

Persons who receive medicaid or Food Stamp benefits automatically meet income requirements.


HEALTHY FOODS –  WIC checks will be given to you monthly for the purchase of specific foods.  Foods you can receive are:

  • Milk and Cheese
  • Vitamin C-Rich Juices
  • Iron-Rich Cereals
  • Eggs
  • Dried Beans or Peanut Butter
  • Tuna Fish/Carrots (Breastfeeding Mother Package)
  • Iron Fortified Infant Formula

NUTRITION EDUCATION – you will receive nutrition information to help you choose nutritious foods to improve your and your family’s health.  WIC helps mothers make infant feeding choices such as encouragement to breastfeed and proper introduction of solid foods into the infants diet the first year of life.  Dietary guidance and promotion of physical activity is offered to all qualifying individuals.

HEALTH CARE – WIC can help you find regular health care and childhood shots if needed.


  • Healthy foods help children grow and develop normally.
  • Good nutrition helps to protect your whole family against health problems.
  • WIC helps your community by building strong, healthy families.


WIC Breastfeeding Peer Counseling Program

The Breastfeeding Peer Counseling Program is a new WIC service to our community. Breastfeeding Peer Counselors are WIC moms who have successfully breastfed their children and can offer new moms advice and encouragement! The program offers moms someone to talk to about their new baby and how to provide him/her with the best nutrition available. Every new WIC mother will want to be part of this program!

Contact Peer Counselors

  • Ashley Bramble: 606-438-6117 - Perry and Leslie Counties
  • Bethany Morris: 606-634-9491 - Knott and Letcher Counties
  • Loretta Birchfield: 606-568-8254 – Lee, Owsley and Wolfe Counties
  • April Sandlin, LPN, Program Coordinator, 606-785-3144

Breastfeeding Friends Blog

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