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Annual Childhood Developmental and Behavioral Screening Tool Survey

Thank you for being part of the MHS Health Wisconsin provider network.

Wisconsin Medicaid HMOs participating in BadgerCare Plus must comply with the federal SUPPORT Act by ensuring that network primary care practitioners providing care to members ages 0–18 utilize standardized developmental and behavioral health screening tools. Health plans are required to monitor provider compliance with these screening requirements and submit an annual report to the Wisconsin Department of Health Services (DHS) identifying the screening tools used across their provider network.

Does your TIN serve pediatric patients?

If you do not provide care to children, aged 0-18, the form ends here.
Thank you.

Please provide any additional TINs that should be represented on this form.

Please let us know which screening tools you use in each of the following categories.
Check all that apply.

General Development

General Development

Child Depression

Child Depression

Tobacco Alcohol or Drug Use

Tobacco Alcohol or Drug Use

Autism Spectrum Disorder

Autism Spectrum Disorder

Social Determinants of Health

Social Determinants of Health

Maternal Depression

EPDS (Edinburgh Postnatal Depression Scale)

If you have questions, please reach out to your Provider Relations Representative at WI_Provider_Relations@mhswi.com