Issues in Developing Programs for Uninsured Children: A Resource Book for States. H. Coordination With Other Programs to Enroll Children in the Children's Health Insurance Programs

03/02/1998

Seven of the nine states reported coordination between their children's health insurance program and other state programs with respect to enrolling children.

  • Other state programs in California have enrollment information for the CaliforniaKids program and can assist families in filling out the application.
  • In Colorado, children enrolled in the free meal program, Health Care Program (HCP), WIC, the state prenatal program, or either of the two food programs, can automatically enroll in CCHP if they are not enrolled in Medicaid. If children enter the CCHP program through any of these programs, CCHP requires the "enrolling program" to verify assets. A shorter application form was developed for this purpose, and is available through each of the aforementioned programs and schools.
  • In Massachusetts, WIC clinics and activity centers have on-site registration into the Children's Medical Security Plan (CMSP). In addition, any health or human services agency can assist in the enrollment of applicants to CMSP. Individuals in each department have been trained to assist with mail-in or phone-assisted enrollment for the CMSP or Mass Health (Medicaid) programs. Providers at community health clinics and outpatient clinics, school nurses and advocates have also been trained to enroll children into the program. Assisting this effort is a 45-day presumptive eligibility provision for the Children's Medical Security Plan allowing providers to fax an application to CMSP and treat children immediately.
  • Minnesota has developed a common enrollment form for MinnesotaCare and the state Medicaid program. This will assist with the enrollment process while reducing administrative efforts.
  • TennCare distributes applications at county health department offices, permitting families to enroll on site. The process requires approximately fifteen minutes, and applicant are interviewed face-to-face to ensure their understanding of the forms and the way in which TennCare operates. In addition, families may examine the provider networks for each plan before they make any choices. Health department staff are also trained to assist families through grievance and appeals processes if a claim is denied. Since working with local health departments, community acceptance of TennCare has increased dramatically in Tennessee.
  • In Washington, the Health Care Authority (which administers the Basic Health Plan for adults) coordinates with the Department of Social and Health Services (which administers Basic Health Plus for children) to provide a uniform application for parents and children applying to the two programs. In order to reduce confusion, children and parents may enroll into the two separate programs with the same application form. The Department of Social and Health Services is responsible for verifying eligibility for applicants to both programs. The Department of Social and Health Services then enrolls the children, then forwards the list of eligible adults to the Health Care Authority for enrollment.

Table 17: Summary of Linkages Between Children's Health Insurance Programs and Other State Programs

  CaliforniaKids Colorado Children's Basic Health Plan Florida Healthy Kids MA Children's Medical Security Plan MinnesotaCare New York Child Health Plus Pennsylvania CHIP TennCare Washington Basic Health Plus
Referral to Medicaid on Application  

x

 

x

x

x

x

   
Electronic/Administrative Coordination of Eligibility with Medicaid    

x

 

x

       
Referral to Medicaid/Other Program for Benefits Not Covered by CHI Program

x

     

x

 

x

   
Coordination with Medicaid as Families' Income Changes  

x

 

x

x

x

     
Coordination of Adult and Child Services                

x

Coordination of Provider Network with Other Children's Programs

x

 

x

 

x

       
Coordination of Care for Children with Special Health Care Needs    

x

       

x

x

Coordination for Outreach and Marketing

x

 

x

x

x

     

x

Coordination of Enrollment Efforts

x

x

 

x

x

x

 

x

x