Performance Improvement 2004. State practices in medical child support cross program coordination


This report documents current policies and practices in Connecticut, Minnesota, and Texas in which the child support enforcement program (IV-D), Medicaid, and the State Children’s Health Insurance Program (SCHIP) coordinate in order to secure and sustain appropriate health care coverage for child support- eligible children. By coordinating their work, child support enforcement, Medicaid, and State Children’s Health Insurance Program (SCHIP) agencies can ensure that children are enrolled in the health care coverage that is most appropriate for them, maximizing private coverage for those children to whom it is available and affordable and reserving public resources for those who do not have access to affordable private coverage. Among the state initiatives documented, medical child support coordination was facilitated by: having common goals and objectives; specific legislation; training; previous collaboration; coordination among top program officials; shared staff responsibilities among the programs; automated data tools; collaborative design of the Medicaid/SCHIP application; cost savings to Medicaid; and a specific funding source. Cross-program coordination was challenged by a preference for the noncustodial parent, rather than the custodial family, to provide private coverage; the current regulatory requirement that any insurance available through a noncustodial parent’s employer is defined as being of “reasonable cost” and therefore must be ordered; a lack of automation; court backlogs and case continuances; lack of a federal medical child support performance incentive for child support enforcement agencies; and stigma issues.

PIC ID: 7236
Agency Sponsor: ASPE-OHSP, Office of Human Services Policy
Federal Contact: Burnszynski, Jennifer, 202-690-865
Performer: Urban Institute, Washington, DC


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