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RUMAR DEPARTMENT OF HEALTH & HUMAN SERVICES STATEMENT Washington, D.C. 20201 JAN 23 1998 Dear State Health Official: This letter highlights new and existing opportunities for outreach to uninsured children. We share a mutual interest in and commitment to enrolling uninsured children in both Medicaid and the new State Children's Health Insurance Program (CHIP). An estimated 3 million children are eligible for Medicaid, but remain uninsured. Millions more will be eligible for CHIP because of historic, bipartisan legislation passed by the Administration and Congress. Successfully enrolling these eligible but uninsured children is critical to both the success of these programs and the health of these children; as such, outreach is a high priority for the President, First Lady, and Department of Health and Human Services. In this letter, we describe examples of and options for successful outreach and enrollment and Federal funding available for these activities. Most of these provisions are currently options within Medicaid or reflect preliminary guidance for CHIP. Two of these provisions expanding the entities that can determine presumptive eligibility and expanding access to a special fund for outreach -- are proposals in the President's fiscal year 1999 Budget that would provide nearly $200 million a year in additional Federal dollars to States that choose to take advantage of these initiatives. If passed, they would be effective on October 1, 1998. I. Funding for Outreach States have several options for receiving Federal matching funds to find and enroll uninsured children in Medicaid and/or CHIP. Medicaid will match States' expenditures associated with outreach to Medicaid-eligible children. Similarly, CHIP funds may be used to pay for outreach to CHIP-eligible children (up to the 10 percent limit, described below). Because of the importance of outreach, the President's fiscal year 1999 Budget contains proposed legislation that, if enacted, would provide a higher matching rate for outreach activities for all children, regardless of their eligibility. This section describes these options. Federal Matching of Outreach under Medicaid There have been questions about what types of outreach activities Medicaid will fund. The Federal government matches State Medicaid expenditures for outreach activities that bring potential eligibles into the Medicaid system to determine if they qualify for Medicaid benefits. These activities include: informing families about Medicaid through brochures or other promotional material; assisting families in completing Medicaid applications; and providing the necessary forms and packaging for Medicaid eligibility determinations. These activities are considered allowable Medicaid administrative activities for the purpose of Federal matching. Since the Medicaid program is an open-ended entitlement program, there is no limit on the amount of allowable Medicaid outreach expenditures States may claim for Federal matching. 2 Federal Matching of Outreach under CHIP Title XXI places a strong emphasis on outreach. State child health plans cannot be approved without a description of how States will educate families, assist them in enrolling children in the appropriate program, and coordinate health insurance programs across the State. There are several ways that CHIP outreach expenditures may be matched. Non-Medicaid CHIP Option. Outreach activities related to a non-Medicaid CHIP program only would be matched from the State's CHIP allotment. States may spend up to 10 percent of their total CHIP expenditures (Federal and State) on non-benefit activities, including: outreach conducted to identify and enroll eligible children in CHIP; administration costs; health services initiatives; and other child health assistance. These expenditures are matched at the enhanced CHIP matching rate and count against both the 10 percent limit and the allotment. Medicaid CHIP Option. Outreach activities related strictly to a Medicaid expansion under CHIP can be matched either from the State's CHIP allotment or under regular Medicaid, at the State's option. If a State elects to claim Federal matching for its outreach expenditures from the CHIP allotment, such Federal payments will count against the State's 10 percent limit and allotment and will be matched at the enhanced CHIP matching rate. Once the State reaches its 10 percent limit and/or its CHIP allotment, it may then claim Federal matching for any additional Medicaid outreach expenditures under the Medicaid program. States may claim Federal matching for outreach expenditures under the Medicaid program only if such expenditures are for CHIP-related Medicaid expansion groups. Alternatively, a State may elect to claim Federal matching for outreach expenditures for CHIP-related Medicaid expansion groups under the Medicaid program at the regular Medicaid administrative matching rate. If claimed in this way, Federal payments for these expenditures would not count against the 10 percent limit or the CHIP allotment. Joint Medicaid-CHIP Option. Joint outreach efforts for Medicaid and CHIP may similarly be matched by either Medicaid or CHIP. Detailed guidance on these options was provided in a December 8, 1997 letter to State Health Officials on financial issues. Enhanced Matching for Children's Outreach Efforts [Proposed Legislation] In the welfare reform bill that created the Temporary Assistance for Needy Families (TANF) program, a $500 million Medicaid fund was established to help States ensure that children and parents losing welfare know about their continued eligibility for Medicaid. These funds, which are allotted to States, provide an enhanced Federal matching rate for outreach and administrative costs related to this narrow group of Medicaid-eligible people. Certain outreach activities are eligible to receive a 90 percent matching rate from the fund. (See the May 14, 1997 Federal Register notice for details.) Few States, however, have 3 taken advantage of this fund so far, in part, due to the difficulty of targeting outreach only to a subset of Medicaid-eligible children. The President's fiscal year 1999 Budget includes a legislative proposal that, if enacted, would expand the use of this fund. States would be able to receive a 90 percent matching rate for outreach activities for all uninsured children, not just those who would have been eligible for welfare. The Federal funds to cover the extra matching (above Medicaid's regular matching amount) would come from this fund. In addition, the proposal would remove the sunset on the fund in 2000 and add another $25 million to assist States with increased outreach activities. II. Expanding Sites for Enrolling Children In the wake of welfare reform, families often misunderstand their children's continued eligibility for Medicaid. They also may be unsure about differences between Medicaid and CHIP. Thus, it has become more important than ever that States have and pursue options to conduct educational activities and enrollment of children in a wider array of community settings. Allowing Immediate Medicaid Coverage Through Schools, Head Start, and Child Care Centers [Proposed Legislation] The Balanced Budget Act (BBA) of 1997 gave States a new option in Medicaid to grant "presumptive eligibility" to children. Certain children may receive immediate health care coverage without having to wait for a full Medicaid eligibility determination. Under this option, a "qualified entity"and/or its employees may presume that a child is temporarily eligible for Medicaid if, using preliminary information, family income does not exceed the State's applicable income eligibility level. The child's parent or guardian has until the end of the following month to submit a full Medicaid application for the child. Until a final eligibility determination on that application is made by the State, the child is covered for Medicaid services. Although the CHIP statute does not expressly provide for presumptive eligibility, States also could use this option in their eligibility for a CHIP separate State program. The BBA defines "qualified entities" as providers of health care items and services under the Medicaid State plan (including IHS, Tribal and urban Indian health care providers that participate in a Medicaid State plan) and entities that determine eligibility for Head Start, WIC and child care subsidies under the Child Care and Development Block Grant. It also requires that certain costs associated with presumptive eligibility be subtracted from the State's child health allotment (see the December 8, 1997 letter on financial issues). 4 The President's fiscal year 1999 Budget proposes to make this presumptive eligibility option more flexible and attractive to States. First, it would broaden the definition of "qualified entities" to include sites such as schools, child care resource and referral centers, child support enforcement agencies and CHIP eligibility workers. Second, it would eliminate the requirement that States subtract the costs of presumptive eligibility from their CHIP allotments. Instead, these costs would be matched as a regular Medicaid State plan option. Both of these changes would give States greater incentives and flexibility for using this important authority. "Outstationing" Eligibility Workers in Communities Outstationing eligibility workers is a promising outreach strategy for enrolling Medicaid and CHIP-eligible children. "Outstationing" means locating eligibility workers in places other than welfare offices to assist with the initial prccessing of applications. (The final Medicaid eligibility determination must be made by the appropriate State agency.) Current Medicaid law requires States to outstation eligibility workers in Federally qualified health centers and disproportionate share hospitals. States also can receive Federal matching for outstationing eligibility workers in other locations. We encourage States to consider outstationing eligibility workers at sites that are frequented by families with children such as schools, child care centers, churches, Head Start centers, WIC offices, community centers, Job Corps sites, GED programs, local Tribal organizations and Social Security offices. Using Mail-In Applications One option that allows States to ease the enrollment process is the use of mail-in applications. Mail-in applications, especially for Medicaid, can significantly reduce the barriers to enrollment that may occur with requiring in-person applications. Transportation costs are eliminated, the stigma of going to a social services office is removed, parents will not have to miss work, and community groups like PTAs and church organizations can assist in distributing applications and information regarding Medicaid and CHIP. Many, but not all, States use this option in Medicaid today. We encourage all States to adopt this option. III. Simplifying Enrollment A key to successfully enrolling children at a wide range of sites is a simple application and enrollment process. 5 Simplifying the Medicaid Application and Eligibility Process One barrier to enrollment in Medicaid is the complexity of the application. Some States have applications over 20 pages long, posing an often insurmountable challenge for families. We encourage States to develop strategies to simplify these processes by: preparing a simplified Medicaid application for the eligibility groups that include most children; using a "less restrictive" eligibility methodology that drops the Medicaid assets test for children; shortening the Medicaid application form generally; and allowing mail-in applications. Also, there are few verification requirements under Federal law that are mandatory. While it is important to maintain program integrity by verifying income, excessive requirements can deter families from completing the application process. Medicaid administrative funds can be used to redesign the Medicaid application form. Attached are some examples of shortened and simplified Medicaid applications used in some States (see attachment A). Using a Single Application for Medicaid and CHIP We encourage States to use one application for both Medicaid and CHIP. The advantages of a single application form include a reduction in paperwork for the State and a simplified process for families potentially eligible for Medicaid or CHIP. Attachment B includes a model joint application form and its instructions. We also encourage States to use single applications for health and non-health programs like TANF. Eligibility Screening and Enrollment for Medicaid and CHIP CHIP requires States to ensure that only targeted low-income children are furnished child health assistance and that children found eligible for Medicaid through screening are enrolled in Medicaid. At a minimum, State screening processes should assure that all children who are potentially eligible for Medicaid under the poverty-level-related groups are identified. The State may initially use a gross income test that compares total family income to the applicable Medicaid standard. The initial gross income test would immediately identify children whose family income is low enough that Medicaid eligibility would be almost certain. A second test would be needed, however, to detect those children whose gross family income exceeds the Medicaid standard but who are Medicaid- eligible when income disregards are applied. Without this second test, the State would not be meeting its responsibility to ensure that children eligible for Medicaid are identified and enrolled in Medicaid. (Some States have used this technique with simplified Medicaid applications.) Screening is not required for States that elect to expand Medicaid under CHIP, because the child's eligibility for regular Medicaid will be determined as part of the State's eligibility determination process. 6 The statute clearly says that States must include in their State child health plans a description of procedures to ensure that children found to be eligible for Medicaid must be enrolled in Medicaid; a simple referral procedure to Medicaid will not meet this requirement. The Department of Health and Human Services (DHHS) will be providing guidance on options to meet this requirement in the near future. Some examples include: - Single State agency for eligibility determination: States can use the Medicaid State agency to make eligibility determinations for non-Medicaid CHIP expansions as well as Medicaid CHIP expansions. Joint application for both CHIP and Medicaid: States can use a joint CHIP and Medicaid application. As noted earlier, DHHS has developed a model application form for CHIP and Medicaid (see attachment B). States could use interagency agreements to send applications to the appropriate place for processing. Presumptive eligibility: If the President's fiscal year 1999 Budget proposal is enacted, States will have the option of allowing their CHIP eligibility workers to make presumptive Medicaid eligibility determinations as well as CHIP eligibility determinations. (The final Medicaid eligibility determination must be made by the appropriate State agency.) Granting 12-Month Continuous Eligibility Another way to increase the number of children with health insurance is to grant children eligibility for Medicaid for a longer period of time. Many families fall in and out of income eligibility due to job changes or fluctuations in paychecks. The BBA provides States the option to provide individuals under age 19 with up to 12 months of continuous eligibility after they are determined eligible for Medicaid, even if there is a change in the family's income, assets, or size. Under this option, Medicaid eligibility is granted for a period of up to one year regardless of changes in circumstances. States that use their CHIP funds for separate State programs can also provide continuous eligibility, since they have the flexibility to determine how frequently follow-up screening (redetermination) will be conducted. IV. Other Outreach Strategies In addition to expanding sites for enrollment and simplifying the process, States have used a number of valuable approaches to help them locate children and facilitate their enrollment in Medicaid and other health programs. This has been especially true for children who are members of special populations, such as children with special health care needs, homeless children and migrant children. State strategies to reduce barriers to enrollment range from advertising on billboards to linking health with other types of public programs like Head Start. Promising examples of State outreach activities are described in attachment C. 7 Summary Every successful outreach model requires cooperation among diverse entities. Potential partners for outreach programs include school districts, community-based organizations, local health and human service providers, Head Start programs and child care centers. In addition, collaboration between the Federal and State governments, private businesses, foundations and advocacy groups could also produce creative and effective outreach initiatives. We believe that the new children's health insurance program provides a unique opportunity to ensure that the millions of eligible children are enrolled in public or private health insurance plans and receive essential health care services. We hope you will join us in meeting this challenge. Sincerely, Nancy-A Deparle Nancy-Ann Min DeParle Claude Earl Fox, M.D., M.P.H. Administrator Acting Administrator Health Care Financing Administration Health Resources and Service Administration Enclosures cc: HHS Regional Directors HCFA Regional Offices PHS Regional Offices TANF State Agencies Title IV-D Agencies Child Care Directors Child Welfare Directors Ms. Lee Partridge, American Public Welfare Association Ms. Jennifer Baxendell, National Governors' Association Ms. Joy Wilson, National Conference of State Legislatures Ms. Cheryl Beversdorf, Association of State and Territorial Health Officials Ms. Mary Beth Senkewicz, National Association of Insurance Commissioners (Attachment A) EXAMPLES OF SIMPLE MEDICAID APPLICATION FORMS List of States that have Simplified the Medicaid Application Process Delaware's Application Georgia's Application South Carolina's Application States That Have Simplified the Medicaid Application Process The following States have taken steps to simplify their Medicaid application processes, by allowing mail-in applications, shortening the Medicaid application form, or eliminating the assets test for children or by using a combination of these techniques. Mail-In Applications (24) Short Application (29) ** No Assets Test (36) *** Alabama Alabama Alabama Alaska * Alaska Alaska Connecticut Arkansas Arizona Delaware Colorado Connecticut District of Columbia Georgia Delaware Hawaii * Hawaii District of Columbia Illinois * Illinois Florida Maine * Indiana Georgia Massachusetts Iowa Illinois Michigan (local decision) Kentucky Indiana Minnesota Michigan Kansas Mississippi Mississippi Kentucky Missouri Missouri Louisiana New Mexico * New Hampshire Maine North Dakota * New Mexico Maryland Ohio New York Massachusetts Oklahoma Ohio Michigan Oregon Oklahoma Mississippi Pennsylvania Oregon Missouri Utah * South Carolina Nebraska Vermont South Dakota New Hampshire Virginia Tennessee New Jersey Washington Texas New Mexico Wyoming * Utah New York Vermont North Carolina Virginia Ohio Washington Oklahoma West Virginia Pennsylvania Wyoming South Carolina South Dakota Tennessee Vermont Virginia Washington West Virginia Wisconsin * After the mail-in application is received, the Medicaid agency will conduct a telephone interview. Applications are the same length or shorter than the HCFA model application AR, CA, HI & UT count assets in determining Medicaid eligibility for some children. Source: Center on Budget and Policy Priorities, August 1997 DELAWARE HEALTH No AND SOCIAL SERVICES DIVISION OF SOCIAL SERVICES Wrong Door FAMILY AND COMMUNITY MEDICAL ASSISTANCE APPLICATION This form must be completed before we can see if you are eligible for medical assistance. If you need help completing the form, ask your worker. Return this application within 30 days of the date you asked for Medicaid. If you do not, this may change the date your Medicaid will start. We must take action on your application for Medicaid within 45 days from the date we receive your application in our office (90 days for disabled children or others who apply on the basis of disability). We need you to give us proof of the following items for you and your family: Birth (birth certificate, driver's license, marriage license) Social Security number (copy of card or proof you have applied for one) Lawful alien status (registration card, immigration papers) Current income (pay stubs, letter from employer, award letter or check) Child care costs (receipts or letter from provider) Delaware residency and address (enclosed household form, utility bill, lease) Medical insurance, such as Medicare (copy of card, benefit letter) Pregnancy and due date (statement by medical professional) Disability for Disabled Child Program (enclosed medical forms) Emergency medical condition for illegal aliens (enclosed medical forms) Resources for QMB, SLMB, Disabled Child and SSI related programs (bank statements, life insurance policies, burial fund, savings bonds, trust fund) You may need to give us more information. If you have already given this information to a Department of Health and Social Services office, let us know. You may not have to give it again. Failure to provide the above information may result in delayed or denied benefits. HEAD OF HOUSEHOLD: LAST NAME FIRST NAME M.I. STREET ADDRESS DEVELOPMENT OR APARTMENT NAME APT.NO CITY STATE ZIP CODE DAYTIME TELEPHONE NUMBER MAILING ADDRESS (IF DIFFERENT FROM ABOVE) PLEASE LIST ANY OTHER NAMES THAT YOU HAVE USED MAP-4 1 Revised 3/97 HOUSEHOLD MEMBERS Please list everyone in your household (including yourself) and complete each space by their name. ARE YOU LAST NAME FIRST NAME M.I. OFFICE USE ONLY APPLYING FOR THIS (MCI #) PERSON? YES NO YES NO YES NO YES NO YES NO YES NO YES NO 1. Have you ever been eligible for and received both a Social Security check and a Supplemental Security Income (SSI) check in the same month? Circle one: Yes No If yes, list the last month and year you were eligible for and received both benefits: 2. Does anyone in your family have unpaid medical bills from the last three months? Circle one: Yes No Was your income the same as it is now during those months? Circle one: Yes No 3. If you pay child care costs, please give names of the children and the monthly amount you pay for each child. Please also include any fees for summer camp or nursery school. NAME OF CHILD MONTHLY NAME OF CHILD MONTHLY AMOUNT AMOUNT MAP-4 2 Revised 3/97 HOUSEHOLD MEMBERS SOCIAL SECURITY NUMBER SEX RACE/ IS THIS ALIEN REGISTRATION NUMBER ETHNIC PERSON A U.S. GROUP CITIZEN OR A LEGAL ALIEN? YES NO YES NO YES NO YES NO YES NO YES NO YES NO YOUR RIGHTS AND RESPONSIBILITIES I have read or have had read to me all statements on this form. I understand the questions on this form and the information is true and complete to the best of my knowledge. I understand that the State of Delaware has a law that prohibits giving false information or withholding information to get any type of assistance, including Medicaid, or to get more assistance than I am entitled to get. I understand that if I give any false information or withhold any information, I may be prosecuted to the full extent of the law. I agree to help establish my eligibility by giving as much information as I can about my circumstances and by giving proof of statements on my application. I certify, under penalty of perjury, that I am a U.S. Citizen or alien in lawful immigration status. I must provide proof of lawful immigration status. Lawful alien status requires submission of certain information to the Immigration and Naturalization Service for verification. Nonlawful aliens may be eligible for emergency services only. All information and documentation gathered for determining my Medicaid eligibility is confidential. Medicaid has safeguards and limits disclosure of information about me. Disclosure of information concerning my Medicaid eligibility to anyone not authorized to receive the information is a violation of State and Federal laws and may result in legal sanctions. While Medicaid will keep my eligibility information confidential, these provisions do not affect my right to give specific written consent to release information to other persons or sources. MAP-4 3 Revised 3/97 YOUR RIGHTS AND RESPONSIBILITIES I understand that I am required by law to assign to the State all rights to medical support and other third party payments (hospital and medical benefits) and to cooperate with the State in establishing paternity and securing medical support. This assignment is a condition of Medicaid eligibility. Medicaid cannot be denied to eligible children because of their parent's refusal to establish paternity or secure support from absent parents. I understand that pregnant women are not required to cooperate in establishing paternity and securing medical support. I agree to allow the Department of Health and Social Services, or its representatives, to have access to all medical records that are related to payment and medical services by Medicaid. I agree to allow the Department of Health and Social Services, or its representatives, to act as my agent in recovering money spent by the Medicaid Program when other money from insurance, estates, etc., becomes available to pay my medical bills. I understand that I may appeal to the Division of Social Services or the U.S. Department of Health and Human Services if I am not satisfied with any decision on my application or if I feel that I have been discriminated against because of race, color, national origin, religion, sex or handicap. I understand that I may be represented by an attorney at a fair hearing, or any other person I choose. If I am not satisfied with the decision on my fair hearing, I understand that I may request a judicial review in Superior Court in the County where I live. I also understand that I must file for a judicial review within 30 days of the date of my fair hearing decision. I certify that I have had the services of the Division of Child Support Enforcement explained to me and have been offered an opportunity to participate in their program. I agree to enroll in a Managed Care Organization if I am required to by the Medicaid Program. I understand that pregnant or nursing women and children age five and under may apply for WIC benefits by contacting the Division of Public Health at 1-800-222-2189. I agree to report within ten days changes in my household situation that could affect my eligibility, such as a change in how many people live with me, a change in income, or if I move. This application must be signed by an adult household member (age 18 or over) or by an emancipated minor (under age 18). Sign, date and return the application as soon as possible. Include copies of all the items listed on page one that apply to your family. If you have questions, call your local Medicaid office. IMPORTANT REMINDER Signature of Applicant or Representative Date Signature of DSS Worker Date MAP-4 4 Revised 3/97 Allanta, Georgia 30334 Post Office Box 38420 Recipient Inquiry Unit Missicaid Program: Patient Rights and Responsibilities Georgia Department at Medical Assistance Right I agree 10 give correct information to see if I can receive Medicaid. from th 1 acree 10 provide the county information to prove Start any statements given in this application and hereby give permission 10 the county to get such proof. I understand that for Medicaid I must report any changes in my circumstance within Icn (10) days of becoming aware of the change. 150 Address To: I understand that if I DO NOT like the decision made on my case, I have the right to a fair hearing. I can request a hearing by writing or calling the State County Department of Family and Children Services county where I applied. FREE If you want AFDC for any family member, you A HEALTHY START IN LIFE will have 10 sign a different application form. I However, we will USC the date on this form to FOR YOU AND YOUR BABY. determine your cligibility. FACTS: RIGHT FROM THE START GET FREE PRENATAL CARE RIGHT NOW. SEE THE SAME DOCTOR FROM FIRST EXAMINATION TO DELIVERY. YOU CAN QUALIFY IF YOU'RE 70 Code APPLYING IS SIMPLE AND EASY. MARRIED OR SINGLE. FREE MEDICAL CARE IS AVAILABLE FOR ELIGIBLE CHILDREN BORN YOU DONT HAVE TO BE PREGNA AFTER SEPTEMBER 30, 1983. TO RECEIVE FREE MEDICAL CARI FOR YOUR CHILD. Here Stamp Place For more information, contact your county health YOUR LOCAL HEALTH DEPART- department or county Department of Family and MENT CAN GIVE YOU A MEDICAII Children Services. CARD THE SAME DAY YOU VISIT. Application Date. MEDICAID NOW HELPS ALMOST NAME 50,000 GEORGIA WOMEN LIKE YOU. First Initial Last Maiden Name Telephone # ADDRESS Married or single. Insured or uninsured. You and Street Apt. City County State Zip Code our children can receive FREE medical help immedi- 1.Is anyone in your house pregnant? Yes No If yes who? cly. Apply today, Medicaid forms are now simple 10 Is she on Medicaid? Yes No ad. The approval process is now faster. And more 2. Whom do you want 10 receive Medicaid? ctors than ever before will care for you and your hildren. Ask at your local health clinic how you can join List all people in your home (write your name first): Sex C Right from the Start program. Get the right care. Get First M.I. Last Social Security No. Date of Race Relationship U.S. Citizen Birth yes/no C right start. It's simple. It's casy. And it's smart. MYSELF Self Right from the Start has the right stuff. When you become pregnant you create life. It's a iracle. Suddenly, a little person lives within you. To help C baby grow inside, you must care for him or her from C outside. See a doctor early and regularly. Get prenatal rc. Only you can keep the baby inside happy. Eat right. juit smoking or cut back. Don't drink alcohol, including 3. INCOME: Do you or does anyone in your home get money from: eer or wine. Give your baby the right stuff Right from the Amount Before How Often Name of Person(s) cart. Any Deductions ; Received Receiving So, if you think you're pregnant but can't afford a Current Job Yes No octor we can help you. If you are pregnant but can't pay Employer's Name: our medical bills we can help you. And if you have Social Security Income/SSI Yes No bung children who have not seen a doctor regularly we AFDC Yes No in help you. Pensions or Retirement Benefits Yes No ET HELP NOW Right from the Start. Child Support or Contributions Yes No Apply for medical care inside and out. Unemployment Benefits Yes No Student Loan/Grant Yes No If you are pregnant or have a child under a year Id, you will qualify for Right from the Start Medicaid if Other Income Yes No our yearly income is about $14,000 or less. If you already ave 1wo children, you can earn almost $21,000 a year and 4. Do you have health insurance on anyone for whom you are qualifying? Yes No all qualify. (Provider: Complete Form 285) Health insurance company Your baby can stay in the Medicaid program until Policy number is first birthday. After that. the income requirements 5. Do you have any unpaid medical bills from the past three months? Yes No ecome a little stiffer. but most children will still be Medicaid Program I agree 10 give correct information to see if I can receive Medicaid. I agree to provide the county information to prove any statements given in this application and hereby give permission w the county 10 gel such proof. I overed unul age : understand that I am breaking the law if I give wrong information. I understand that for Medicaid, I must report any changes Getting medical care for you and your children is in my circumstance within ten (10) days of becoming aware of the change I understand that if I DO NOT like the decision made on my case. I have the right to a fair hearing. I can request a hearing by writing or calling the county where I applied. LSICE than ever before. If you think you might'qualify, / certify that the information / have provided is correct. JSL fill out this application and send it in or contact your / have read (or had read 10 me) and understand the information on this form. / agree 10 apply for a social security number if / do not have one. ounty health department or county Department of Family and Children Services Applicant's Signature Date Representative's Signature Date Title South Carolina Partners for Healthy Children Dear Parent, Welcome to Partners for Healthy Children, our new program of health coverage for children. Partners for Healthy Children provides free health care to children in families with low income. Health care can be expensive. I am pleased that South Carolina can offer this help to your family as you struggle to meet your child's needs. So I want to join in a partnership with you. We will provide Partners for Healthy Children and, if your family qualifies, your child's health care will be free. But you need to join us as a partner, too. You are in charge of the health care your child receives. You need to fill out and mail an application for Partners for Healthy Children. After you get your Partners for Healthy Children card in the mail, you will need to make appointments with a doctor and make sure your child gets the health care he needs. Look at the chart on the back of this letter. If your family income is no more than the amount shown for your family size, your children should qualify for Partners for Healthy Children. To apply, simply fill out the attached application form and mail it in. If your income is greater than the amount on the chart, your children may still qualify. In that case, go to one of the locations listed on the back of this letter and ask for assistance in applying for Partners for Healthy Children. I hope this will be a great year for your family and I hope Partners for Healthy Children will help you provide the health care for your children that you decide they need. Sincerely, David M. Beasley Office of the Governor Post Office Box 11369 Columbia, South Carolina 29211 Do Your Children Qualify for Free Health Care from Partners for Healthy Children? Number of people Income levels to qualify for Partners for Healthy Children in family (Income slightly above may still qualify. See NOTE below.) (Count parent(s) and children) Hourly wage Weekly income Monthly income Annual income 2 $7.65 $306 $1,327 $15,915 3 $9.63 $385 $1,667 $19,995 4 $11.58 $463 $2,007 $24,075 5 $13.53 $541 $2,347 $28,155 6 $15.50 $620 $2,687 $32,235 7 $17.45 $698 $3,027 $36,315 8 $19.43 $777 $3,367 $40,395 The number of people in the family includes the parents and the children. Add together all the income received by all family members and see if your income is not more than the amounts above. If so, your children should qualify. If more than 8 people live in your family, please call 1-888-549-0820 for assistance. NOTE: If your family income is slightly more than the amounts on the chart above, you may still qualify but you will need to apply in person, at one of the following offices. Call the phone number in your county to find out where and when to go to apply. Many county DSS offices have Medicaid eligibility workers located at hospitals, health departments, or federally qualified health centers where applications can be filed also. Abbeville County DSS Charleston County DSS Edgefield County DSS Lancaster County DSS Orangeburg County DSS 459-5481 792-0444 637-4040 286-6914 531-3101 Aiken County DSS Cherokee County DSS Fairfield County DSS Laurens County DSS Pickens County DSS 642-3650 487-2704 635-5502 833-0100 898-5810 Allendale County DSS Chester County DSS Florence County DSS Lee County DSS Richland County DSS 584-7063 377-8131 669-3354 484-5376 735-7048 Anderson County DSS Chesterfield County DSS Georgetown County DSS Lexington County DSS Saluda County DSS 260-4100 623-2150 546-5134 957-7333 445-2139 Bamberg County DSS Clarendon County DSS Greenville County DSS McCormick County DSS Spartanburg County DSS 245-4363 435-4305 467-7700 465-2627 596-3099 Barnwell County DSS Colleton County DSS Greenwood County DSS Marion County DSS Sumter County DSS 541-1210 549-6090 229-5258 423-4623 773-5531 Beaufort County DSS Darlington County DSS Hampton County DSS Marlboro County DSS Union County DSS 525-7861 398-4420 943-3641 479-4520 429-1660 Berkeley County DSS Dillon County DSS Horry County DSS Newberry County DSS Williamsburg County DSS 761-8044 774-8284 365-5565 321-2155 354-5411 Calhoun County DSS Dorchester County DSS Jasper County DSS Oconee County DSS York County DSS 874-3384 563-4337 726-7747 638-4400 684-8108 Kershaw County DSS 432-7676 South Caronna Partners for Healthy Children 1. Tell us who you are and where you live. If you have Medicaid, you do not need to fill out this form. Last name (Parent's) First Name (Parent's) Middle Initial Phone Street Address City State Zip Code County Mailing Address, if different City State Zip Code 2. Tell us who in your family lives with you. List the parent shown in item 1, on the first line below. Last name First Name Middle Sex Race Date of Social Security How is this Initial Birth Number person related List parent(s) and children List parent(s) and children to you? 3. Tell us how much income your family has. Fill in the amount of money you make. If you are married and your spouse works, fill in the amount of money your spouse makes, too. Check one box to show if the amount is hourly, weekly, monthly or yearly. Enter GROSS pay, not take home pay. Enter zero ("0") if you or your spouse have no earned income. Your Income Spouse's Income Amount you earn: $ Amount your spouse earns: $ Hourly Weekly Monthly Yearly Hourly Weekly Monthly Yearly Hours worked each week Hours worked each week Employer Name and Phone Number Employer Name and Phone Number 4. Tell us if you have any other income. List any additional income you or family members living with you may have from the sources listed below and tell us how often you get this income (for example, once each week, every three months, once a year, etc.) Source Amount How Often: Who Gets this Money? Interest from bank account $ Child support $ Alimony $ Social Security payment $ Other (Please explain) $ 5. Attach proof of income. We need proof of your income. For earnings, provide copies of pay stubs for the last four weeks. If you do not have pay stubs, you may provide a letter from your employer or a copy of your most recent state or federal income tax form. Other documents can be used to provide proof of income. If you are not sure what to send, call our toll-free number 1-888-549- 0820 and we will help you. 6. Tell us about any health insurance you already have. Tell us the name of your insurance company, the policy number and the insured persons name on the policy. Even if you already have health insurance, you can still qualify for Partners for Healthy Children. Insurance Company or Employer Phone Number of Insurance Policy Number or Insured (Name on Company or Employer Group Plan Number policy) 7. Tell us whether any child received medical services in the last three months. Did any of your children living with you receive medical services in the past 3 months: Yes No 8. Please sign this statement. I certify that the information I have provided above is true to the best of my knowledge and I give permission for the State of South Carolina to make any necessary contacts to check my statements. I have read the list of my rights and responsibilities that is printed below. I know that I could be penalized if I knowingly give false information. I certify that the children listed on this application are U.S. citizens or lawful immigrants. Signature of applicant: Date: 9. Mail this completed, signed form, together with proof of income, to: South Carolina Partners for Healthy Children Post Office Box 100101 Columbia, South Carolina 29202-3101 If you need more information, please call this toll-free number: 1-888-549-0820. Rights and Responsibilities Partners for Healthy Children is a program funded through a partnership with 5. 1 know that I may ask for a hearing if I am not satisfied with any action taken regional hospitals, state government and the federal government by the State of South Carolina in connection with the Partners for Healthy Children program. I may also ask for a hearing if I feel that I have been 1. 1 know that my children under age 19 who are eligible for Partners for discriminated against. Healthy Children can have free health checkups under a special Partners for Healthy Children prevention program called Early and Periodic Screening, 6. 1 know that the State of South Carolina will request and use information from a Diagnosis and Treatment (EPSDT) programs. computer system called the State Income and Eligibility Verification System (IEVS). This computer system compares the Partners for Healthy Children 2. I know that the information I have given is confidential. I agree that medical information about me and other members of my family with information from information about my children can be released only If needed to administer this other agencies. Other agencies may include the Internal Revenue Service, program. Social Security Administration and Employment Security Commission. 3. I know that any information I have given may be reviewed and verified by 7. 1 know that Partners for Healthy Children does not pay medical expenses that State of South Carolina staff. Also I understand that I must cooperate fully with a third party, such as a private health insurance company, is supposed to pay. If state and federal workers if my case is reviewed. No additional permission is my children get Partners for Healthy Children, 1 give my rights to any third party needed to get verification or other information. payments to the Department of Health and Human Services. These payments may include payments from hospital and health insurance policies. I know that if 4. I know that this application will be considered without regard to race, color, I refuse to give my rights to third party payments to the Department of Health sex, age, handicap, religion, national origin or political belief. and Human Services, my children will not be eligible'to receive a Partners for Healthy Children card. (Attachment B) MODEL JOINT APPLICATION FOR CHIP/MEDICAID FOR CHILDREN Purpose: The attached model joint application can be used for both the Children's Health Insurance Program (CHIP) and children's Medicaid eligibility (under the children's poverty level related groups). States could allow individuals to use this form to apply for both programs and the information on this form would be sufficient for determining which program a child is eligible for. It includes only that information which is required in all circumstances and is provided as a base form which a State can adapt to meet its own needs. As presented, the form is suitable for completion by an intake worker. Modifications would be required to make the form suitable for direct completion by the applicant. Screening: This application will meet the statutory requirement in Title XXI that States identify children who are eligible for Medicaid. NOTE: In situations where the State has contracted out the CHIP program eligibility (i.e., determinations will be made by non-State employees), this form can be modified to be used as a pure screening form (or a combination of an application for CHIP and screening form) by removing all references to Medicaid. The statement about the use of the Social Security number [33] would be required. Inclusion of the rights and responsibilities section (without reference to Medicaid), however, would be at State option. Non-State employees cannot make a determination of Medicaid eligibility. If the form is so modified, in order to permit the information on the form to be submitted for use in making a Medicaid determination, the non- State employees could have a separate page for those whom the screen indicates are Medicaid- eligible. On that page, the individual should consent to submission of the information as part of a Medicaid application, and accept the rights and responsibilities outlined on this draft (including a statement under penalty of perjury that the information provided on the "attached screening form" or "attached CHIP application" is correct). After this page is completed, the form could be forwarded to the State for a Medicaid eligibility determination. Mandatory Information About Medicaid: If a State uses a joint CHIP/Medicaid application and denies the Medicaid application, then the State must thoroughly inform the individual about the availability of Medicaid and his or her right to apply for Medicaid on a basis other than as a poverty-level child. This includes an explanation of the Medicaid program and the various eligibility groups, the advantages of Medicaid over CHIP and information about how and where to apply for Medicaid. Federal Verification Requirements: Under Federal law, there are no verification requirements pertaining to eligibility for the children's poverty-level-related groups under Medicaid other than those related to alien status of non-citizens, and the posteligibility requirements of §1137 pertaining to use of the individual's social security number and an income and eligibility verification system. Eligibility of a citizen child may be established on the basis of a declaration under penalty of perjury. States are permitted to require further verification as a condition of eligibility. Additional Simplification of Medicaid Eligibility Determination: If the total gross income of the family is at or below the applicable Medicaid income standard, the questions in the shaded areas need not be answered. The individual is obviously income eligible for Medicaid without further information. Explanation of Certain Fields: There are some questions on the application that may not elicit all the information needed to make a determination. Under certain circumstances, additional information will be required. For example: If the answer to the question about citizenship [18] is no, actual status will need to be determined, official documents submitted, etc. If the child has insurance [22] and is Medicaid-eligible, information about the insurance company and policy number will be needed; and If the child had medical bills in the last 3 months [32] and is Medicaid-eligible, eligibility information for the last three months will be needed to establish retroactive eligibility, in addition to information about the bills. In addition, the question concerning employment by a public agency in the State [25] is only needed for CHIP eligibility and is not needed for Medicaid. This field does not ask directly about the availability and nature of health insurance on the assumption that the eligibility worker would have access to a list of public agencies which offer State health insurance of the type which precludes CHIP eligibility. If this is not the case in your State, this field would need to be expanded. Examples of State Modifications: A State may wish to include voter registration; or A State may want to use this as an application for Medicaid for the adults which would require additional information about the adults and stock affidavits concerning assignment of rights and pursuit of support. A State will need to add a question concerning each individual's resources (assets) if: the State applies a resource test for the poverty level children; or - the State has not chosen to cover children born before 10/1/83 under the poverty level group AND the State applies a resource test for the optional group of categorically needy children ("Ribicoff children"). CHILDREN'S HEALTH INSURANCE PROGRAM / MEDICAID JOINT APPLICATION FORM I. Person Applying for the Child or Children Name [1] FIRST MIDDLE LAST Home Phone [2] Work Phone [3] Home Address [4] Street Apt. # [5] City [6] State [7] Zip [8] County [9] Mailing Address (if different from above) [10] Street Apt. # [11] City [12] State [13] Zip [14] County [15] II. Family Members Living in the Home (Attach extra sheet if needed) Children (under 19) living in the home Date of Citizen Social Security Number Mother's Name [20] Father's Name [21] Covered by Health NAMES [16] Birth [17] (Yes or No) [18] [19] Insurance other than Medicaid [22] Adults living in the home Social Security Number If employed by a public agency in the State, what agency? NAMES [23] [24] [25] Joint Application Page 2 III. Income and Child Care Payments List all the Income Received by Family Members Listed Above (Attach Extra Sheet if Needed) Name of person(s) working Who provides the money? [27] How Often? [28] What amount? [29] or receiving money* [26] Employer, program or person Weekly, twice a month, monthly Before taxes or any deductions 1. 2. 3. *Be sure to include all sources of gross income (before taxes) such as wages, dividends & interest, TANF, SSI annuities, pension, disability, child support, alimony, cash gifts, & other unearned income. List the payments made for child care (or care for an adult who cannot care for himself) so that someone in your household can work. [30] Name of person(s) who works Name of Person Care For Under Age 2? How Often? What amount? Yes No IV. Medicaid Questions is any child: [31] Pregnant Yes No In an Institution: Yes No Do any of the children have unpaid medical bills from the last 3 months? [32] Yes No Social Security Number (SSN) [33] You must give us your SSN in order to receive Medicaid This is required by section 1137(a)(1) of the Social Security Act and the Medicaid regulations of 42 CFR 435.910. The Medicaid agency will use the SSN to verify you Income, eligibility, and the amount of medical assistance payments we will make on your behalf It is possible that we will also use the SSN to determine another person's right to Medicaid or to comply with Federal law requiring that we release information from Medicaid records. The information may be matched with the records in other agencies, such as the Social Security Administration or the Internal Revenue Service. These matches may be done by computer or on an individual basis Rights and Responsibilities [34] I agree to the release of personal and financial information from this application form and supporting I understand that this application is an application for one kind of children's health benefits under documents to the agencies that run these programs so that they can evaluate it and verify eligibility. I Medicaid and IS not a full Medicaid application. I understand that if I am not found eligible for this kind of understand that the agencies that run the programs will determine confidentiality of this information children's health benefits under Medicaid, I may be eligible for Medicaid benefits on some other basis and according to the federal laws, 42CFR 431.300-431 307.1, and any applicable federal and state laws and have a right to complete a full Medicaid application. regulations. I have the right to appeal any decisions made by a local Medicaid program. Information on the Officials from the programs that I, or members of my household, have applied for may verify all appeals process can be obtained from the local Medicaid agency. information on this form. I understand that anyone who knowingly lies or misrepresents the truth or arranges for someone to I understand that I must immediately tell the Medicaid agency about any changes in information on knowingly lie or misrepresent the truth is committing a crime which can be punished under federal law, state this form. law, or both. I understand that I may also be liable for repaying in cash the value of the benefits received I understand that I may be asked to provide additional information. and my be subject to civil penalties. I understand my eligibility will not be affected by my race, color, national origin, age, disability, or sex, I certify under penalty of perjury that everything on this application form is the truth as best I know. except where this is restricted by law Signature [35] Date Date Received by Agency [38] (Attachment C) DISCUSSION OF PROMISING OUTREACH STRATEGIES Significant barriers exist to providing health care coverage for uninsured children and enrolling them in Medicaid. States and local communities are implementing a variety of approaches to reducing these barriers. Many States are simplifying the complicated application forms and enrollment processes, as well as allocating more resources to developing innovative outreach activities. The Department of Health and Human Services (DHHS) is prepared to assist States and local communities by facilitating the exchange of information regarding successful outreach endeavors and information related to enrollment simplification. The following are examples of promising outreach strategies currently practiced or being considered in various places. Implement an 800 hotline number for enrollment information in each State, to provide information (in appropriate languages) on child health insurance programs, referrals, and telephone assistance in completing application forms. To the extent possible, publicize a single number; several 800 numbers may lead to confusion. Most States already have an effective toll-free hotline through their Title V Maternal and Child Health offices that could be serve as a base for disseminating information relating to Medicaid and CHIP. Streamline the eligibility process, have simplified application forms in appropriate languages, and allow application by mail. Ask only for necessary information. Allow for enrollment on certain evenings and Saturdays at convenient sites. Allow appropriate entities, especially in remote areas, to determine eligibility presumptively. Use billboards in bus and subway stations and radio stations to publicize the programs, including information that uninsured children of low-income working parents may also qualify for Medicaid or CHIP. Place posters (that have been field-tested in that community ) at locations frequented by target families -- e.g., thrift shops, discount stores, fast-food restaurants, laundromats, and ethnic festivals. Encourage prenatal care and child health through unified State-wide public service outreach campaigns which are advertised with an identifiable logo and reader-friendly materials that appeal to lower-income families. Distribute information about child health insurance programs through child care centers, Head Start programs, schools, child support enforcement agencies, community action programs, refugee resettlement programs, TANF offices, family preservation and support programs, Special Education and Social Security offices -- with materials in simple, appropriate languages. Also, verbally ask the children in the above settings (as they take the literature home) to tell their families that they may be eligible for health care. Provide enrollment opportunities at local sites where children receive health care; school- based health centers are a particularly good vehicle for identifying and enrolling children in insurance programs. Station eligibility workers in hospitals to assure prompt enrollment of newborns, in health centers, and at locations where immunizations are provided. Coordinate with other programs, such as TANF, child support enforcement agencies, family support councils, local Tribes, WIC, food stamps, Title V, free or reduced-price lunch programs, Head Start, Special Education and Social Security offices. Establish a State-wide computer program, wherein applications for any one public assistance program will (with the client's permission) be automatically "cross-referred". Develop outreach strategies with local community-based organizations, and have them assist in outreach efforts, including at events such as community fairs. Word-of-mouth can be the best outreach tool in communities where there is mistrust of the system. Provide speakers and program information to community, school and religious programs. Use trained, trusted persons within the local community to do eligibility outreach and to provide assistance to their neighbors in completing application forms. De-stigmatize Medicaid to the extent possible. Some States have addressed this issue by renaming the program with names such as "Dr. Dynasaur", or "KIDMED" or "Child Health Plus." Encourage eligibility workers to treat clients with courtesy and respect. Ensure that the card issued to the family is free of any perceived "welfare stigma." Have posters reflect a positive image of Medicaid and those who use Medicaid. Enlist the support of businesses and foundations to provide incentives (e.g., gift certificates, coupons for free meals or merchandise, movie passes) for families who apply for and/or use services. 18chip.wpd Page 1 DRAFT REMARKS BY HILLARY RODHAM CLINTON CHILDREN'S HEALTH OUTREACH ANNOUNCEMENT CHILDREN'S HOSPITAL FEBRUARY 18, 1998 Thank you. I am so honored to join you today as we take another important step forward in putting quality health care within the reach of every child in America. None of this would have been possible without the people in this room and I want to especially thank the President, Secretary Shalala, [other acknowledgments] One of my favorite children's folktales is the one about Stone Soup -- where travelers arrive in a village with nothing to eat, but with a clever plan. In the center of town, they boil a pot of water with a stone in it. And soon, the curious villagers come by and are encouraged one by one, to add a carrot here, a cabbage there -- ultimately transforming a stone into a wonderful "stone soup" created by all and benefiting all. what is Citip Like this fable, the success story that we celebrate today is really the $24 billion timeless story of what works in meeting our biggest challenges. Last August, when the President signed into law the largest expansion of health care in 30 years, he made not only a major federal commitment, but an historic promise to millions of uninsured children and their parents: As a nation, we said: Whether your children need check-ups or immunizations, broken bones healed or deadly diseases treated, you shouldn't have to choose between caring for your kids and bankrupting your family. We knew that keeping that promise would be the hard part...and that the hard work would come in the years ahead. We knew we needed a massive- national outreach effort to give parents the information and other tools they need to sign campaign up their children for Medicaid and the new Children's Health Insurance Program. And, like the villagers making stone soup, we knew that our magic stone will always be collaboration, everyone bringing something unique to the pot to make the whole richer than any single ingredient. effor too As the President will announce today, that's exactly what's happening. The Federal government is stepping up to the plate with new resources. States are devising local solutions to fit their local needs. Businesses are working to reach parents with information about insuring their children. Foundations are supporting innovative outreach initiatives. Doctors and teachers are learning how to be front-line soldiers in the battle to enroll kids. And today, the NGA is sending the states a best practices report on CHIP to shine a spotlight on what's working around the country. As I've traveled the nation, talking to parents and meeting children in 18chip wpd Page 2 need, I've often been struck by the fact that there isn't a problem in America that isn't being solved by someone somewhere. Our challenge to do what we're doing today - to find out what works for our children and then come together as a nation to replicate At in every state and every community, in every use it as school and every child care center. As we approach the next century, there is no greater gift we can give to our children, to our parents, to our future. a model Now it is my great honor to introduce can me slightly different 13:45 FAX NATL ECONOMIC COUNCIL 005 UPDATE 126 Page 4 STATE CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) IMPLEMENTATION UPDATE February 10, 1998 FEDERAL UPDATE Public Information. The following is a list of the releases of information to da : Program announcement (State Medicaid Directors' letter, August 27): Informed the states of the organization of the program at HHS its basic parameters, and a summary of the statute. State allotments (Federal Register notice, September 10): Announces he states' preliminary allotments from the over $4 billion appropriation fo fiscal year 1998. Qs and As #1 (September 10): Responses to some of the most fr equi ntly asked questions. State plan template (September 15): Guide on the minimum requ irer ents for a state children's health insurance plan Qs and As #2 (October 3): Responses to some of the most frequent. asked questions. Medicald issues (State Medicaid Directors' letter, October 10): Desci Des the Medicald provisions in the children's health program and includes m: del state plan amendments for these options as well as a set of q.s. and iis Ci Medicaid issues. Qs and As #3 (November 26): Responses to some of the most "regi ently asked questions. State plan approval (State Medicaid Directors' letter, December 2): Describes the process for filing from the states and review and approval by - is. State financial reporting (December 8): Details the financial rules a: 1 reporting requirements for CHIP. Legal immigrants (January 14): Describes rules regarding financing health care for legal immigrant children. Outreach (January 23): Describes options for receiving Federa fur Bing for outreach as well as options that are effective. 10 FAI NATL ECONOMIC COUNCIL 006 UPDATE 126 Page 5 All documents can be found on the internet; www.hcfa.gov. 19:46 FAI NATL ECONOMIC COUNCIL 007 UPDATE 126 Page 6 STATES UPDATE STATE ACTIVITIES UPDATE STATES WITH APPROVED CHILD HEALTH PLANS Alabama PLAN: Medicaid expansion for poor children up to age 19 STATUS: Plan submitted: 11/3/97; plan approved: 1/30/98. Implemer ition: 2/1/98 BACKGROUND After a contentious special legislative session, $5 millio was budgeted for health with a contingent $10 million if revenues are iffice it. The Governor signed the state plan on November 1. Although the plan nly includes Medicaid benefits for children at or below 100 percent of the 1: verty line, 8 State commission voted to create a non-Medicald program for ct: dren between 100 and 200 percent of poverty. However, since they also p posed to fund this expansion through a tobacco tax, the Governor is obje sting STATES WITH SUBMITTED CHILD HEALTH PLANS (in chronological order) Missouri PLAN: Medicald expansion for children up to 200 percent of poverty STATUS: Plan submitted: 9/26/97 (including Medicaid 1115 waiver TE jest); request for additional information: 11/12/97; additional information su: hitted: 2/6/98. Expected implementation: 7/98. BACKGROUND: The State has been seeking a Medicaid 1115 wei " at combines children with adults. The proposal would expand Medicaid 200 percent of poverty through CHIP and from 200 to 300 percent of pov: ty through a Medicaid 1115 walver. The State wants to waive Medicaid ; requirement to cover non-ernergency medical transportation and 10 US' illegal provider taxes as their source of State share. Colorado PLAN: Non-Medicaid expansion for children up TO 185 percent of pov: ty STATUS: Plan submitted: 10/14/97; request for Information: 11/97; aditional information submitted: 1/21/98. Expected implementation: 3/1/98. BACKGROUND: The State had funded a State program expansio 1 the ugh "Child Health Plan Plus" prior to the passage of the Balanced Builget ct. It intends to build upon this expansion in a second phase, to be applied or next year. Colorado's benefits are actuarially equivalent to the State emp. yee health plan. The State is planning a second phase of the expansion subsidize children in employer health plans. Pennsylvania PLAN: Non-Medicaid expansion for children up to 185 percent cf PC' arty STATUS: Plan submitted: 11/3/97; request for additional information : 12/97: additional information received: 2/4/98. BACKGROUND: Governor announced on October 1 that he will exp. nd the state's existing Children's Health Insurance Program (CHIP); its ben: its are grendfathered in the statute. It would fully subsidize premiums up i 185 percent of poverty. and allow for enrollment of children on current atting list. New York PLAN: Non-Medicaid expansion for children up to 222 percent of P: erty STATUS: Plan submitted: 11/5/97; request for Information: 1,6/98 additional information received: 1/31/98. Implementation: 10/1/97. BACKGROUND: Governor plans to expand Child Health Plus; CS be efits are grandfathered in the statute. Democratic Assembly proposed an el emative plan on 2/9/98 to cover children up to 300 percent of poverty wit more generous benefits. 13:47 FAX NATL ECONOMIC COUNCIL 008 UPDATE 126 Page 7 California PLAN: Medicaid expansion for children up to 100 percent of poverty; non-Medicaid expansion for children up to 200 percent of poverty STATUS: Plan submitted: 11/20/97; additional information requeste 198; some additional Information received: 2/10/98. Expected implementa 7/1/98. BACKGROUND: The "Healthy Families" plan passed the State legislature n 10/2/97. It expands Medicaid to 100 percent of poverty for all children nd creates a new program for children 100 to 200 percent of poverty equiv ent to benefits offered to State employees through the State group purchas 3 coop or employers. Florida PLAN: Medicaid expansion for poor children; non-Medicaid expansion fc children between 100 and 185 percent of poverty STATUS: Plan submitted: 12/4. Implementation: 1/1/98. BACKGROUND: Expanding the Healthy Kids program whose benef IS ar grandfathered in the statute. Uses school-based enrollment to facilitate access to health services. Tobacco settlement money may be used as the sta: contribution. South Carolina PLAN: Medicaid expansion for children up to 150 percent of poverty STATUS: Plan submitted: 12/9; additional information requested: 1/98 additional information received 1/28/97. Implementation: 10/1/97. BACKGROUND: "Partners for Healthy Children". State passed Medical expansion over the summer, will cover children up to 19 to 150 percer OT poverty through Medicaid on October 1. Uses simple mail-in appl cati: 15 distributed through schools, doctors' offices, neighborhood phann acie and hospitals. May add a second, non-Medicaid expansion for children w' income between 150 to 200 percent of poverty. Ohio PLAN: Medicaid expansion for children up to 150 percent of pov crty STATUS: Plan submitted: 12/24/97; request for additional inform atto 1/26/98. Implementation: 1/98 BACKGROUND: The State had already planned this Medicaid ansh i and the Governor has appointed support for expanding Medicaid to childri , UD to 200 percent of poverty and appointed a task force to make recomme dations by 7/1/98 Michigan PLAN: Non-Medicaid expansion to children up to 200 percent of po arty STATUS: Plan submitted: 12/30/97. Expected impiementation: 4/9: BACKGROUND: Michigan's Department of Community Health as c veloped a non-Medicaid program called "MiChild". Tennessee PLAN: Medicaid expansion for children up to 200 percent of po vert STATUS: Plan submitted 1/3/98 (expanding Medicaid 1115 wa ver); equest for additional information: 1/26/98. Implementation: 4/1/97 BACKGROUND: Re-opaned enrollment in TennCare to uninsured cl dren in April 1997 and again on 1/1/98 for a limited period (through 3/30. : nce the State may use enrollment capsi. State has removed $250 deductib : and lowered copayments to 2 percent (still may be out of compliance W. h CHIP guidelines). Illinois PLAN: Medicaid expansion for infants up to 200 percent of poverty for children 1 to 18 up to 133 persent of poverty. STATUS: Plan submitted: 1/6/98. Implementation: 1/5/93. BACKGROUND: Governor announced plan in early 12/97, and also ppointed an 8-member, bipartisen legislative task force to look at additional ptions. The Governor also announced an outreach effort that includes sig ng up children tor Medicaid at schools, clinics, neighborhood center an : other settings. 19:47 FAX NATL ECONOMIC COUNCIL 008 UPDATE 126 Page 8 Rhode Island PLAN: Medicald expansion for children up to 250 percent of poverty STATUS: Plan submitted 1/6/98. Implementation: 5/1/97. BACKGROUND: The State expanded its Medicaid RiteCare program in Mil and wants to receive enhanced Federal match for this group. Oklahoma PLAN: Medicaid expansion for children up to 185 percent of poverty STATUS: Plan submitted: 1/12/98. Implementation: 12/1/97. BACKGROUND: Implementing SoonerCare program under an 1115 waive Part of the expension planned under SoonerCare would be covered throu h CHIP. Connecticut PLAN: Medicaid expansion for children up to 185 percent of poverty; non-Medicaid expansion for children between 185 and 300 percent of P verty STATUS: Plan submitted: 1/15/98, Expected implementation: 4/1/98. BACKGROUND: Governor Rowland signed e law creating HUSKY: Healthcare for Uninsured Kids and Youth" on 10/30/97. Builds on 3 Me icaid outreach effort funded earlier in 1997. The non-Medicaid program's be: efits would be modeled on the State employee health plan. The State Inten: to use a single application for both programs, the presumptive eligibility 0: ion to facilitate enrollment; and schools and child care sites for enrollment. Massachusetts PLAN: Medicaid expansion for infants up to 200 percent of poverty, ch dren ages 1 to 18 up to 150 percent of poverty; non-Medicaid expansion to children between 150 and 200 percent of poverty. STATUS: Plan submitted: 1/16/98 (including Medicaid 1115 waiver re: lest). Expected implementation: 3/98. BACKGROUND: State wants to expand its Medicaid 1115 waiver prop sal "MassHealth" and its non-Medicaid program. the Children's Medic at SI curity Plan. State funds are appropriated and supported by a tobacco tax. Wisconsin PLAN: Medicaid expansion for children (and parents) up to 185 peroe of poverty STATUS: Plan submitted: 1/21/98 (including Medicaid 1115 waiver ri juest). Expected implementation: 7/1/98 BACKGROUND: Requesting a Medicaid 1115 for "BadgerCare" hich would cover all children in uninsured families up to 185 percent of poverty : 15 their parents. Premiums will be charged to children in newly eligible famil 3. ACTIVITIES IN OTHER STATES Alaska PLAN: Medicaid expansion and non-Medicaid expansion for dren p to 200 percent of poverty (Governor's proposal) STATUS: Proposal submitted to State legislature in session beginn ; 1/98. Plan to submit plan 7/98. Expected implementation: 10/98. BACKGROUND: Informal working group has been meeting; expecte to meet with the Governor on October 3 to discuss their proposal. Governor appears TO want to expand to 200 percent of poverty by the end of 1998. Arizona PLAN: None yet STATUS: BACKGROUND: Governor has stated that getting a children's healt program going soon is a priority and included State funds in her projected b. get, She will work with State legislature to fund the State contribution and : I plans for the use of those funds. FAB NATL ECONOMIC COUNCIL 010 UPDATE 126 Page 9 Arkansas PLAN: None yet STATUS: Debating whether to seek CHIP funding for its Medicaid 1 15 waiver expansion that began in October 1997. BACKGROUND: Within weeks of the passage of CHIP, Arkansas received Medicaid 1115 waiver to expand coverage to children up to 200 per cent i poverty. Benefits in this waiver are below the standards outlined in CHIP The State is considering whether it should submit its Medicaid expansior thr: gh a Medicaid 1115 waiver or convert its Medicaid to a non-Medicaid pro gran for the purposes of CHIP. Delaware PLAN: None vet STATUS: BACKGROUND: State Health Care Commission will submit a propos ai to the legislature during this session. DC PLAN: Medicaid expansion for children up to 200 percent of poverty (tentative) STATUS: Plan to submit a plan 3/98. BACKGROUND: in review process with Mayor, City Council and pt notin final approval by the Financial Authority. Georgia PLAN: Medicaid expansion for children under age 6 up to 200 percen. if poverty; non-Medicaid expansion for children ages 6 to 18 up to : 100 ircent of poverty (Governor) STATUS: Plan to submit plan by 7/1/98. BACKGROUND: Health Policy Center Et Georgia State University the fficial task force, recommended Medicaid expansion for children between 0 1: , and 200 percent of poverty Legislature meets in January Hawaii PLAN: None yet. STATUS: BACKGROUND: Considering expanding Its 1175 Medicaid waive whi h covers children UP to 300 percent of povery. Ideho PLAN: Medicaid expansion to: children up to 160 percent of poverty STATUS: Working on a state plan. Implementation: Medicaid: 10/1 7 BACKGROUND: Expanded Medicaid 10 children up to 160 percent poverty in 10/97. Committee to discuss other long-term options beginn ng I 98. Indiana PLAN: None yet STATUS: Plan to submit a plan 3/7/98. BACKGROUND: Governor created a children's health task force. Iowa PLAN: None yet STATUS: Working on a plan to submit by 7/98 BACKGROUND: Nine public forums occurred in 10/97. The State ublic Policy Group, 8 task force, recommended in 11/97 a Medicaid exp: sion for children up to 133 percent of poverty, and a non-Medicaid prograr for children between 133 and 200 percent of poverty. A legislati to K force will also present options. Kansas PLAN: Medicaid expansion for children up to 150 percent of JOVE Y. and a non-Medicaid program for children berween 150 to 200 percent o' poverty (tentative). STATUS: Plan to submit plan In the Spring of 1998. BACKGROUND: Two planning groups (Insurance Department and Department of Social and Rehabilitation Services) to report to Governor a rd 3. te legislature in 1/98. Prellminary recommendation described above PAI NATL ECONOMIC COUNCIL 011 UPDATE 126 Page 10? Kentucky PLAN: Medicaid expansion for poor children; non-Medicaid program for children between 100 end 200 percent of poverty (Governor announc 1/7/98) STATUS: Governor announced plan on 1/7/98, plan to submit a plan on 4/1/98. Expected implementation: 7/1/98. BACKGROUND: Set up work group; considering a range of options, inclu ing implementing and expanding their 1115 Medicaid waiver. Health Service Secretary proposes to expand Medicaid to cover children ages 14 to 18 hose family incomes are at 100 percent of poverty and a non-Medicaid 8) pan: on for children between 100 and 200 percent of poverty. Louisiana PLAN: None yet STATUS: BACKGROUND: Governor-appointed and legislative task forces held pu: C meetings; developing costs of options. Maine PLAN: Medicaid expansion for children up to 150 percent of poverty; non-Medicaid program for children between 160 to 185 percent of pov: ty (Commission) STATUS: Plan submitted to State legislature; plan to submit Spring 199 ; BACKGROUND: Governor & State legislature-appointed Maine Commin on on Children's Health Care, which made its recommendations on 12/21/97. The State already has sufficient State share funding reserved. Maryland PLAN: Medicaid expansion for children up to 200 percent of poverty (Governor); STATUS: Debate in the early part of the year BACKGROUND: Maryland's Children's Health Program would have no JST sharing for families up to 200 percent of poverty. The Legislature has, proposed a Medicaid expansion for children up to 185 percent of pov: ty and non-Medicaid expansion for children between 185 and 250 percent of poverty. There is some question about how the State's current Medicaid 1115 program will be integrated or cordoned off from the new program. Minnesota PLAN: None yet STATUS: BACKGROUND: State already covers children up to 275 percent of : iverty. May seek a waiver to cover children at current levels (e.g., outre ach. or create a new program. Mississippi PLAN: None yet STATUS: BACKGROUND: interagency task force is developing proposal. Montana PLAN: STATUS: BACKGROUND: Health officials plan to submit a funding plan durin 1999 Legislature session. Public hearing were held in November and Dec nber. Nebraska PLAN: Non-Medicaid program up TO 185 percent of poverty (Gover ; announced on 1/12/98) STATUS: Proposal still being developed. Plan to submit plan 3/30 98. Expected implementation: 9/98 BACKGROUND: "Kids Connection". State working group will give recommendations to Governor. Members agree that expandin 3 M.: icaid would be the simplest approach, but are concerned that there won I be a welfare stigma. NATL ECONOMIC COUNCIL 012 UPDATE 126 Page 11 Nevada PLAN: Non-Medicaid expansion for children up to 200 percent of pov arty (Governor announced on 1/7/98) STATUS: Plan in development. Expected implementation: 6/98. BACKGROUND: "Nevada Check-Up". Governor working with state healt agency to plan non-Medicaid program based on the most common HMO the state; he has announced plans to use Family Resource Centers, school bi ed clinics and Early Children programs to deliver services. New PLAN; None yet Hampsnire STATUS: BACKGROUND: Governor announced intention to develop plan on 1/7/91 State legislature may appoint a special panel to develop options. New Jersey PLAN: Medicaid expansion for children up to 133 percent of powerty are non-Medicaid expansion for children between 133 and 200 percent of 11 verty. STATUS: Governor signed legislation on 12/19/97; developing state 1 n. Expected implementation: 2/1/98 for Medicald, 3/1/98 for non-Me lical: BACKGROUND: "New Jersey KidCare". Governor has committed Ste share and has appointed a commission to come up with recommendations to permanently funding the program. Benefits based on the most comme HMO in the State. Plan Includes outreach through schools, Scout groups, t ad Start programs child-care agencies, and other community organization New Mexico PLAN: Medicaid expansion for children up to 235 percent of poverty STATUS: Legislature working on the proposal. Expected impleme nta n: 3/1/98 BACKGROUND: May expand through a Medicaid 1115 waiver funde: by 8 16-cent tobacco tax. North Carolina PLAN: Non-Medicaid expansion for children up to 200 percent 01 pm ty STATUS: Legislature working on a plan. Expected implementation: $ mimer 1998. BACKGROUND: Task force recommended non-Medicaid expansi on 01 11/17/97. On 12/15/97, the Governor proposed this recommer dati: 1. North Caroline is putting emphasis on providing coverage to children with lecial needs. Also likely to be included in the naw package are denta and earing coverage, North Dakota PLAN: None yet STATUS: BACKGROUND: No planning process in place Oregon PLAN: Non-Medicaid expansion for children up to 170 percent of p: rerty (pending) STATUS: State still in the planning process BACKGROUND: Likely to build on existing 1115 Medicaid program and a recently passed State subsidy program for low-income families It: Medicaid expansion will begin in 1/98; its state program requires A waiv et si ce they want to use children's health subsidies to purchase family policies The State held a public hearing 10/21/97. South Dakota PLAN: None yet STATUS: BACKGROUND: Heslth advisory committee reviewing State optio: Texas PLAN: None yet STATUS: State plans to submit a plan by 3/1/98 BACKGROUND: Working group of state agency and legislative gi ff to brief lawmakers on present options in mid-October. Public hearing he! 1/7/98 Considering 1115 Medicaid waiver and ! or new program. The 161 stature doesn't meet until January 1999. 19:49 FAI NATL ECONOMIC COUNCIL 013 UPDATE.126 Page 12 Utah PLAN: Non-Medicaid expansion for children up to 200 percent of poverty STATUS: Close to submitting a plan. Impleme ntation: 4/1/98 BACKGROUND: Governor's Health Policy Commission planning on building on State insurance program. Benefits actuarially equivalent to Public Employer 3 Health Plan for state workers. On 12/6/97, the Governor proposed a bud; it that Included $16 million for State matching funds and on 12/23/97 announced that the State health department would administer the pregra: Vermont PLAN: Medicaid expansion for children up to 300 percent of poverty (tentative) STATUS: Plans to submit a plan in 2/98 BACKGROUND: State officials will probably request an expansion it Me loaid 1115 waiver ("Dr. Dynasaur") to 300 percent of poverty. Virginia PLAN: Non-Medicaid expansion to 175 percent of poverty (Governol's proposal 2/9/98) STATUS: BACKGROUND: The former Governor recommended on 12/15/97 that he State expand coverage through a non-Medicaid program called "KidsCar- for children up to 175 percent of povertv. Legislative committee recor me led on 1/6/98 that the State expand through Medicaid to 200 percent of po erty. Washington PLAN: Non-Medicaid expansion to children up TO 250 percent of vert, (Governor announced on 12/15/97) STATUS: Disagreement in the State legislature BACKGROUND: State already covers children up to 200 percent cf po. irty. The State wants TO be able to access its allotment for newly covered i ildren below 200 percent of poverty because the state legislature does not V' nt to expand higher. The Washington Congressional delegation may introdu e legislation to support this approach. West Virginia PLAN: None yet STATUS: BACKGROUND: Governor appoint task force and legislative leaders ar looking at options for both expansion and the State share of the program Wyoming PLAN: None yet STATUS: BACKGROUND: Work group to plan for legislative session in Fotruar, Looking at new program with implementation in the summer of 1998 PLANNING.818 Page 1 CHILDREN'S HEALTH IMPLEMENTATION Non-Government Activities ACTIVITY IDEAS COORDINATION Administration work WH: Like NEC meetings, have a monthly principals meeting on kids group implementation. Include key Secretaries, White House staff, etc. The goal would be to both oversee HHS activities as well as consider big ideas, interdepartmental collaboration, and external activities. External steering Foundation-funded: Encourage development of a nonprofit organization to group oversee the implementation and operation of the kids program (kind of like Kaiser Commission on the Future of Medicaid). Include very public figures with connections to businesses, providers, entertainment & sports, etc. Possibly include President and / or First Lady. Goal would be to be a shadow group to ensure that the goals of the program are fulfilled. Nationwide town Administration: Set a particular day to be national kids' town meeting day meeting (probably some time in November or December). Goal is discuss local problems and solutions to kids' coverage. Note: state plans require public process. Work with Congressmen, governors, mayors and town managers to organize in local areas. Have a national message from the President at prescribed time. We could produce fact sheets for each state on the problems and process in that state. We could also connect this effort with a town-by-town census of uninsured children conducted through schools. Monthly Newsletter Foundation-funded: Develop a monthly newsletter which contains: (1) latest information from HCFA on implementation issues; (2) state updates on who is doing what; (3) research / analysis / facts of interest; (4) announcements of upcoming meetings, events, etc. Have NGA and NCSL endorse the newsletter as well as some advocacy groups like CDF and Families. DESIGN Targeting Researchers: Fact sheets on groups of uninsured children; paper on kids of workers between jobs (Foundations, researchers). Policy brief on combined program: Medicaid to 133%, kids grant program above it. Simple application VP: In the spirit of ReGo, have the VP lead working group to coordinate process simple, single application form for public benefits (Medicaid, kids health insurance and, if possible, school lunch programs, Food stamps, WIC). Could also work on internet information dissemination for applications and eligibility. RWJ has funded a $13 million demonstrating some of these ideas. Benefits Children's groups: Assist in advocating for strongest package possible (e.g., identifying option in the state that covers the most benefits and promoting it) Researchers/actuaries: Conference on actuarial value in October / November. Pediatricians: Encourage to develop recommendations and "seal of approval" for plans that meet minimum criteria. Managed care plans: Develop coalition with providers like Pediatricians to encourage particular benefits packages. Delivery systems Researchers / Foundations: Get some up-front, externally validated set of guidelines for waiver for purchasing group coverage. PLANNING.818 Page 2 Quality NCQA: Ask if they would conduct voluntary accreditation for children's plans Quality commission: Ask to focus on strategy for developing recommendations for states. State contribution NPR-like challenges / fundraisers: Get business groups to match local contributions toward state share of program. Children's groups & state researchers: Monitor state contributions (Center on Budget). Act as watchdogs. Preventing crowd Researchers: Develop and disseminate fact sheet / guidance on what works out (e.g., waiting period for uninsured). Businesses: Encourage development of coalition to encourage employer-sponsored insurance. Could be done through some sort of public directory to employers offering basic coverage or some other public OPERATION Education & National information hotline: Work with AT & T (Charlotte Hayes is there) to enrollment develop a national phone bank that refers people to appropriate state numbers / agencies. Also will allow us to document the number / location of families calling so that we can track process. Schools/teachers: Work with NEA or other groups on education on options through schools, including collecting information on uninsured children; distributing information on available insurance options, etc. Business contributions: Get McDonalds, Disneyland, Microsoft or Pizza Hut or other nationwide businesses to put information on coverage options on trays, boxes, Happy Meals, etc. Providers: Chain drug stores may be interested in putting prompts on prescriptions. Applications could be distributed with vaccinations. Oversight Reporter education: Public scrutiny is the best way to hold states accountable. Perhaps engaging with reporters via a conference, fact sheet, etc would education them on what the program's intent is and how to monitor. Foundations: Fund groups like the Center for the Study of States and consumer groups to oversee design, implementation, and operation of the programs. Encourage Concord Coalition or similar groups to be active. MONITORING Baseline: State employee Unions, Advocates: Work with AFSCME to gather all information on state plans employee plans State HMO AAHP may be interested in conducting a survey to determine most popular HMO. State Medicaid HHS/ Foundations: Carefully document states' eligibility in 1997. State Spending HHS/ Foundations: Review of state budgets. Coverage School survey: Empower groups like Teachers, Boy Scouts, Girl Scouts, Junior Chamber of Commerces, etc. to use a single form to assess children's health coverage in their towns / communities. Researchers: Conference on how to modify existing data sets to evaluate coverage trends Process PLANNING.818 Page 3 Technical Foundation-funded: Clearinghouse with easily accessible information on past assistance and present activities. Conference: Multi-faceted presentation of HHS interpretation, Congressional expectation, governors' plans, and researchers' understandings. October to November. Outcomes Researchers: Set up a public-private work group to develop the best strategy to gather data and evaluation programs. Jennifer L. Klein ANN 09/04/97 05:02:09 PM Record Type: Record To: Christopher C. Jennings/OPD/EOP, Sarah A. Bianchi/OPD/EOP CC: Subject: Misc It seems as though you two are having a crazy day, so please page me when you have a chance if I'm not in the office. Three issues for you: 1. What should we do about 48 hour mastectomies? Should Chris and I write a memo to the First Lady about the problems with the issue? Can she call together women Members to discuss it? 2. What should HRC do for Child Health Day? 3. Where can she give a speech on quality? When? Help. JEN- WE'RE THINKING ABOUT A POSSIBLE OCT 1 Release ON THIS? Guidance on Targeting Uninsured Children through the State Children's Health Insurance Program Jeanne Effective October 1, 1997, Federal funds will be available for the State Children's Health Insurance Program (SCHIP). The President and Congress created this program to provide meaningful health coverage for millions of uninsured children. This draft report is intended to assist states in accomplishing this goal by addressing one specific topic: targeting. "Targeting" means efficiently finding and enrolling uninsured children without inadvertently replacing existing private or state coverage with the new Federal funds. Targeting is essential to the success of this program. This draft report begins by describing why children lack insurance since states' first task is identifying which group of uninsured children to target. It then suggests policies that can be effective in three areas: Preventing "crowd out", or use of new funds to cover children who would other have private coverage; Coordination with Medicaid, to ensure that children eligible for Medicaid are enrolled in that program; and Outreach ideas for both programs. OUTLINE 1. BACKGROUND [extract from kids report] No access to employer-based coverage Access but unaffordable [possibly; depends on what we do with group waiver] Job changes Medicaid eligibles 2. CROWD OUT Summary of bill requirements Summary of literature Summary of state experience IDEAS 3. COORDINATION WITH MEDICAID Summary of bill requirements Examples of state programs (eg, Pennsylvania) IDEAS 4. OUTREACH Summary of bill requirements Examples of successful Medicaid and state programs IDEAS KIDCARE FREE OR LOW-COST HEALTH INSURANCE IS NOW HERE FOR KIDS WHO NEED IT. You love your children and work hard to help them grow up strong and healthy. But like many parents, you haven't been able to give them health insurance. Now you can do something about it because there's a new national initiative called KIDCARE. With KIDCARE, your children may be eligible for free or low-cost health insurance. Call our toll-free number. Don't let your kids go another day without health coverage. 1-877-KIDCARE Affordable Health Insurance Is Now Here for Kids Who Need It NEW! This year, a new nationwide health insurance program is beginning. Now, most families who work hard to make ends meet can get low-cost or free health insurance for their children. Each State is developing its own Children's Health Insurance Program to make health care more affordable. In addition, Medicaid now provides free health coverage to most low-income children. HEALTH INSURANCE MATTERS. Children with health insurance are more likely to: Be healthy as newborns, Receive needed immunizations as toddlers, and Get treatment for illnesses such as recurring ear infections and asthma. Without treatment, these diseases can slow a child's learning and have lifelong consequences. Too MANY KIDS ARE UNINSURED. One out of every seven children in America is uninsured. This could be the child who plays with yours at school, the child next door, or your own child. Why? Too expensive: Private insurance can cost families thousands that they cannot afford. Don't know about options: Even though affordable health care is available to many working families, too few parents know about their options. THESE CHILDREN NEED YOUR HELP. We encourage all concerned Americans to join this public- private campaign to insure American children. You can help. Please: Learn about your State programs. All States have Medicaid programs for children and most States have begun their new Children's Health Insurance Programs. Find out who is eligible for assistance and how families can apply. Educate others. Tell friends, relatives, parents you meet at work, and all other working families whose children or grandchildren may be uninsured about these options. Community efforts. There are many groups around the nation that are involved in children's health outreach. If you are interested, you may wish to contact one of these organizations for information and ideas on how you and your community can become more involved. FOR MORE INFORMATION, SEE NUMBERS ON THE BACK OF THIS FLYER The White House (July 1998) WHERE YOU CAN GET MORE INFORMATION FEDERAL CONTACTS OTHER SOURCES OF INFORMATION * AT THE NATIONAL LEVEL National Governors' Association (www.nga.org) Health Care Financing Administration (HCFA) National Conference of State Legislatures Lillian Gibbons - 410-786-8705 (www.stateserv.hpts.org) (www.hcfa.gov/init/children.htm) National Association of State Medicaid Directors (medicaid.apwa.org) Health Resources & Services Administration (HRSA) Center on Budget and Policy Priorities Marcia Brand - 301-443-4619 (www.cbpp.org) (www.hrsa.dhhs.gov/childhealth) Children's Defense Fund (www.childrensdefense.org) Families USA (www.familiesusa.org) National Academy of State Health Policy (www.nashp.org) Southern Institute on Children and Families (www.kidsouth.org) FEDERAL CONTACTS AT THE REGIONAL LEVEL I. Boston Regional Office VI. Dallas Regional Office (CT, ME, MA, NH, RI, VT) (AR, LA, NM, OK, TX) HCFA - Maureen Farley - 617-565-1248 HCFA - Art Pagan - 214-767-6278 HRSA - Barbara Tausey - 617-565-1433 HRSA - Marianne Davenport - 214-767-3903 II. New York Regional Office VII. Kansas City Regional Office (NJ, NY) (IA, KS, MO, NE) HCFA - Jane Salchli - 212-264-3125 HCFA - Nan Foster Reilly - 816-426-3406 x3305 HRSA - Gilberto Cardona-Perez - 212-264-2566 HRSA - Bradley Appelbaum - 816-426-5292 III. Philadelphia Regional Office VIII. Denver Regional Office (DE, DC, MD, PA, VA, WV) (CO, MT, ND, SD, UT, WY) HCFA - Rosemary Feild - 215-861-4278 HCFA - Dee Raisl - 303-844-2121 x454 HRSA - Frank Heron - 215-861-4407 HRSA - Joyce Borgmeyer - 303-844-5955 IV. Atlanta Regional Office IX. San Francisco Regional Office (AL, NC, SC, FL, GA, KY, MS, TN) (AZ, CA, HI, NV) HCFA - Andriette Johnson - 404-562-7410 HCFA - Karen Fuller - 415-744-3600 HRSA - Dr. Ketty Gonzalez - 404-562-7980 HRSA - Irma Honda - 415-437-8078 V. Chicago Regional Office X. Seattle Regional Office (IL, IN, MI, MN, OH, WI) (AK, ID, OR, WA) HCFA - Barbara England - 312-353-8720 HCFA - Liz Trias - 206-615-2400 HRSA - Dorretta Parker - 312-353-4042 HRSA - Margaret West - 206-615-2518 Note: By August I, the phone numbers for where you can get State-specific information will be available from both the Federal and Regional Contacts and at the Federal Contacts' websites. * These are examples and do not represent all of sources of information. The White House does not endorse these organizations or their positions. Numbers are from HCFA and HRSA are subject to change. U.S. Government Printing Office: 1998 - 443-113/89128 Responsibility: Women's office. 1 Foundations and their partners - Annie E. Casey Foundation. Responsibility: Jeanne/Jen. ADCOUN.828 Page 1 DRAFT AGENDA FOR DISCUSSION Goal: To plan the radio campaign in the 10 target states in October States: Colorado Delaware Florida Idaho Indiana Massachusetts Oklahoma Ohio Pennsylvania Utah Questions: In this test of the media campaign, do we want to use taped ads, have local announcers read scripts, or both If we use taped ads, who do we want to read them: - First Lady - General Powell - State and local politicians - Local athletes - Celebrities - Ordinary people Can and how would we get these taped and produced What mix of free and paid advertising do we want - Radio Disney may be interested in running the spots at prime time - What are the Ad Council distribution options - What type of niche could the paid ads fill Do we want to try different strategies in different states to compare the outcomes KPLAN. 827 Page 1 CHILDREN'S HEALTH OUTREACH PLAN For the month of October, we would test the basics of a national media campaign in a subset of states. This test would involve using the toll-free number, tagline and a consistent message in: Pro bono radio spots, distributed through the Ad Council (checking today) and Radio Disney (they have tentatively committed to running spots at good times, but we need to finalize this; their stations are listed in parentheses below) Paid radio spots in communities with at-risk populations Corporate and community group promotional material and efforts: a number of corporations have said that they could target their efforts to particular states and would be interested in this test; community groups are willing to provide on-the-ground assistance to families in these states NGA recommends the following states for testing based on two main criteria: willingness to participate and the efficient operation of their current telephone system (e.g., able to give both CHIP and Medicaid information and to send out applications to callers). Colorado (Radio Disney: Denver) Delaware Florida Georgia (Radio Disney: Atlanta, Savannah) Idaho Indiana Massachusetts (Radio Disney: Boston) Oklahoma Ohio (Radio Disney: Cleveland) Utah (Radio Disney: Salt Lake City) Jeanne Lambrew 08/18/98 08:44:16 PM Record Type: Record To: See the distribution list at the bottom of this message CC: Subject: Summary of Kids' Outreach Meeting Hello, Ann, thank you very much for coming by -- as usual, your vision set the stage for a constructive conversation. Chris, thanks for guiding this meeting to a successful closure. Neera and Barbara, let me know if I missed some details or if there is something else to do. Jen, we are making progress! Today, we agreed to: 1. Hook up the toll-free number in all states in September to test it technically. 2. Conduct a "Phase I" media campaign. This includes running the media campaign like we had originally planned in 8 to 10 states beginning in late September. We would use the toll-free number (but not tell people that it is national) and get as many corporations, groups, etc as possible to focus on those states. Some type of monitoring and evaluating will be built in. 3. Conduct a "Phase II" in mid-November to add another 15 or so states to the campaign. 4. Go nationwide in early January. Everyone agreed that this is enough time to work on infrastructure, to work out the kinks in the toll-free number, and prepare for a nationwide push. We will pick the 8 to 10 states for the Phase I by Thursday. We will also know by then what America's Promise can do. Specifically, we want to know whether America's Promise will produce the First Lady's radio spot and one with General Powell for testing in these states; whether the Ad Council is willing to help distribute these spots; and which corporations can target these states. We also want to get the camera-ready taglines in the next few days. Once we have this information, we will (a) send a letter to kids' groups, the faith communities, corporate friends etc. to inform them of this plan and see if they are interested in helping in these states; (b) work with Megan on what Radio Disney can do; (c) work with Jon Jennings to get sports teams in the targeted states helping out; (d) build HHS's funds and paid ads around what America's Promise, Ad Council and Radio Disney are doing; and (e) consider what type of event (if any) we want to launch this Phase I. Again, please let me know if there are different or additional ideas of next steps, and thanks to all for your help. Barbara D. Woolley 08/03/98 02:16:28 PM Record Type: Record To: Jennifer L. Klein/OPD/EOP, Neera Tanden/WHO/EOP, Jeanne Lambrew/OPD/EOP, Ann F. Lewis/WHO/EOP CC: Ruby Shamir/WHO/EOP Subject: Kids Health - Camera Ready - Final Question - ASAP We need to make a decision on the 2 options ASAP. Americas Promise folks like Option 2 because they think Option 1 does not motivate folks (ie. bold is the part they would want removed). And, they are concerned that those folks calling for a new initiative will hang up when they get the Medicaid line. Option 1: Original. "You love your children and work hard to help them grow up strong and healthy. But like many parents, you haven't been able to give them health insurance. Now you can do something about it because there's a new national initiative called INSURE KIDS NOW. With INSURE KIDS NOW, your children may be eligible for low-cost or free health insurance. Call our toll-free number. Don't let your kids go another day without health coverage. Low-cost or free health insurance is here now for kids. Option 2: "You love your children and work hard to help them grow up strong and healthy. But like many parents, you haven't been able to give them health insurance. Now you can do something about it. Don't let your kids go another day without health coverage. Low-cost or free health insurance is here now for kids. Children's Health Outreach Initiative There is another important role for child care centers like the one we saw today. At least 10 million children are uninsured in America. Over 3 million of these children are already eligible for Medicaid. Millions more will become eligible for the historic, new Children's Health Insurance Program, enacted by the President and the bipartisan Congress last year. Clearly, one of the best places to sign up uninsured children is child care centers. To encourage this, the President's 1999 Budget will allow States to enlist child care referral centers, teachers, and others who work with children to help enroll children in health insurance. We will also give States the tools and the funding to simplify enrollment, link children's health programs, and conduct aggressive outreach campaigns. I am pleased that Connecticut's plan to cover uninsured children includes innovative ideas like outreach at child care centers and school-based clinics. We look forward to working with you so that, together, we can help children get the basic health care that they need to reach their full potential. The President's Children's Health Outreach Initiative Over 3 million children are uninsured but eligible for Medicaid. Millions more will become eligible for the Children's Health Insurance Program (CHIP) created by historic, bipartisan legislation passed last year. It is critical to the success of these programs and the health of uninsured children to find and enroll children in health insurance. To this end, the President's 1999 Budget invests nearly $200 million per year in children's health outreach. Fund for outreach. In welfare reform, a special $500 million pool was set aside to fund activities to improve Medicaid enrollment of families affected by welfare reform. The President's 1999 Budget includes a proposal that would expand the use of this fund. States would be able to receive a 90 percent matching rate for outreach activities for all uninsured children, not just those who would have been eligible for welfare. The Federal funds to cover the extra matching (above Medicaid's regular matching amount) would come from this fund. In addition, the proposal would remove the sunset of the fund in 2000 and add another $25 million to assist States with increased outreach activities. Allowing immediate Medicaid coverage through schools, Head Start, and child care referral centers. The Balanced Budget Act (BBA) of 1997 gave States a new option in Medicaid to grant "presumptive eligibility" to children. Certain children may receive immediate health care coverage without having to wait for a full Medicaid eligibility determination. The President's 1999 Budget proposes to make this presumptive eligibility option more flexible and attractive to States. First, it would broaden the definition of who can determine eligibility to include sites such as schools, child care resource and referral centers, child support enforcement agencies and CHIP eligibility workers. Second, it would eliminate the requirement that States subtract the costs of presumptive eligibility from their CHIP allotments. Instead, these costs would be matched as a regular Medicaid State plan option. Both of these changes would give States greater incentives and flexibility for using this important authority. In addition, the Department of Health and Human Services (HHS) has identified a number of ideas and options for States to simplify enrollment and integrate Medicaid and CHIP. Model joint application form. The use of one application form for all health programs would streamline enrollment and increase the number of children insured by Medicaid and CHIP. HHS has developed a simple, two-page model application that meets Federal requirements for both programs. It encourages States to develop similar applications. Examples of successful outreach. HHS has worked with states to identify approaches that are successful in identifying and enrolling uninsured children. The Administration will promote these ideas and work with States on an on-going basis to remove Federal barriers, encourage private sector involvement, and educate families about their options (see letter to State Health Officials from HHS, dated January 23, 1998 for details). Jeanne Lambrew 12/11/97 12:49:31 PM Record Type: Record To: Jennifer L. Klein/OPD/EOP CC: Subject: kids' outreach I don't know I told you but we missed our deadlines for the coverage and Medicare memos, so that the kids' ideas, listed below, are not final. But, since we have a little extra time, it would be great if you could take a look at it for us. Any additions? I may add Head Start sites as presumptive eligiblity sites as well. Thanks, Jeanne CHILDREN'S HEALTH OUTREACH The Children's Health Insurance Program (CHIP) provides funds for coverage of millions of working families' uninsured children, a population that previously had trouble affording coverage. It also builds upon the Medicaid program, which covers nearly 20 million children. But important work remains to be done. In particular, we need to work with states to enroll the millions of uninsured children in these programs. Medicaid eligible children are especially at risk of remaining uninsured. Over three million uninsured children are eligible for Medicaid. Educating families about their options and enrolling them in Medicaid has always been a problem, but it has recently become even more challenging. The number of children covered by Medicaid leveled off in 1995 and, according to the Census, dropped by 6 percent in 1996. While some of this decline may be due to the lower number of children in poverty, another part may result from families' misunderstanding of their children's continued eligibility for Medicaid in the wake of welfare reform. Options to Increase Outreach for Medicaid and the Children's Health Insurance Program To address the need for children's health outreach, we propose a series of policy options. Together, these initiatives could cost $1 to 2 billion over five years (or more depending on policy choices about the enhanced match). Preliminary discussions with NGA and some children's advocates suggest they strongly support these efforts. In addition, the Administration is developing partnerships to encourage a complementary range of private outreach activities. Enhanced match for outreach. One option for improving state outreach is to provide an enhanced match to enroll children who are eligible for but not previously enrolled in Medicaid. At the end of each year, if a state can document that it has increased its enrollment over its baseline, it would receive an increased matching amount per newly covered child (possibly through administrative payments). This policy rewards states only if they succeed in outreach, rather than matching activities that may or may not work. Depending on the amount of the incentive and the administrative design, this option could cost to $0.5 to 1 billion over five years. Moving outreach to schools and child care sites. We could build upon the " presumptive eligibility" provision in the Balanced Budget Act to make it easier to enroll children in Medicaid and CHIP. The BBA option allows limited sites (e.g., hospitals) to give low-income children temporary Medicaid coverage on the spot while they are formally enrolled in CHIP or Medicaid. This proposal would broaden these sites to include schools and appropriate child care sites, at the state's option. HCFA actuaries preliminarily estimate that this proposal would cost $400 million over 5 years. Also, under the BBA, states that use presumptive eligibility must pay for its costs out of the CHIP allotment, reducing the amount available for other coverage. States have advised us that this requirement discourages them from taking advantage of the presumptive eligibility provision. HCFA actuaries preliminarily estimate that dropping this requirement would cost $25 million over 5 years. Accessing 90 percent matching funds for outreach. A third way to increase funding for children's health outreach is to increase states' flexibility in using a special Medicaid fund set aside in TANF for outreach for children losing welfare. This $500 million fund is currently allocated to states with a 90 percent matching rate for outreach activities to certain children. We could expand its use to all children, not just welfare children. HCFA actuaries preliminarily estimate that this policy would cost $100 million over 5 years. NGA supports this change. Simplifying enrollment. A simple, accessible enrollment process could encourage more families to enroll their children in Medicaid or CHIP. To help create such a process, we propose several actions, all of which are inexpensive. First, we could streamline the application process by simplifying Medicaid eligibility and by encouraging the use of simple, mail-in applications. HCFA has already developed a model single application form for both Medicaid and CHIP. We could condition some of the financial incentives described above on using a single or simple application. Second, we are reviewing the feasibility and cost of a nationwide 1-800 number that will link families with their state or local offices. Such a number could be placed in public service announcements, on the bottom of school lunch program applications, and on children's goods like diaper packages. Discussion There is unanimous support across agencies for focusing on children's health outreach. HHS and Treasury believe that such outreach should be the Administration's first priority. NEC/DPC and OMB believe that aggressive outreach will be needed to meet or exceed the Administration's goal of covering 5 million uninsured children. Although OMB is supportive, it points out that because some children may be impossible to reach and some states may not use these options, we are unlikely to enroll all 3 million children. NEC, also supportive, raises the concern that spending on an outreach initiative may be a communications challenge so soon after the enactment of the $24 billion base children's health program. However, policy experts, Governors, and children's advocates alike will endorse this initiative. One great challenge is the difficulty of finding savings from Medicaid to offset the costs of this initiative. With this in mind, your advisors are considering the tobacco settlement as a financing source. Specifically, we are exploring the advisability of allowing states to retain the Federal share of the tobacco funds if they dedicate those funds to high-priority Administration initiatives like child care, education, and health care. Governor Chiles would support such an approach if we dedicate the funds to children's health care, not just outreach. February 10, 1998 MEMORANDUM FOR JENNIFER KLEIN FROM: ASHLEY RAINES Spaines DIRECTOR OF OPD OPERATIONS SUBJECT: Cellular Telephone Bill Attached is the January telephone bills for the cellular telephone assigned to you. Please review the calls listed and certify these calls were made for official business purposes. You are responsible for reimbursing the government for the cost of calls made for other than official business. Please review the list, highlight any calls that were not made for official business and return this memorandum to me by Tuesday, February 17th with a check payable to the U.S. Treasury for the cost of those calls. Please note that this bill cannot be paid until your certification of official calls and reimbursement check (if applicable) has been returned to me. Please call me at x62023 with any questions. Thank you for your attention to this matter. Attachments All calls listed are for official government business. Attached is my check for non-official calls. The remaining calls were for official government business. Signature Date Bell Atlantic A Bell Atlantic Mobile PAGE 47 TELEPHONE DETAIL Klein CUSTOMER ACCOUNT NO: 000815136-00001 INVOICE NO: 0153384078 MOBILE TELEPHONE NO: 202-395-2131 INVOICE DATE: JANUARY 16, 1998 PHONE USER NAME: SERVICE FEE 7.99 MONTHLY SERVICE FEE (FROM 01/17/98 TO 02/16/98) 7.99 EQUIPMENT CHARGES 0.00 ENHANCED SERVICES AND BELL ATLANTIC® IQ® SERVICES 0,00 CALL DELIVERY 0.00 ADDITIONAL CHARGES AND CREDITS 0.00 AIRTIME CHARGES 4.70 LANDLINE CHARGES 0.50 ROAMER AIRTIME CHARGES 0.00 ROAMER LANDLINE CHARGES 0.00 FEDERAL EXCISE TAX 0,00 STATE AND LOCAL TAXES 0.00 OTHER FEES AND SURCHARGES 0.95 DIST. OF COLUMBIA GROSS RECEIPTS SURCHARGE 0.95 TOTAL CURRENT CHARGES FOR 202 395-2131 $14.14 Bell Atlantic Mobile PAGE 48 CUSTOMER ACCOUNT NO: 000815136-00001 INVOICE NO: 0153384078 MOBILE TELEPHONE NO: 202-395-2131 INVOICE DATE: JANUARY 16, 1998 USAGE DETAILS FOR 202 395-2131 ON GOVT 100+PLAN 0873: LONG DISTANCE SERVICE PROVIDED BY: BAM ORIG ORIGINATING TELEPHONE AIRTIME LANDLINE TOTAL DATE TIME BAND LOCATION CALLS TO NUMBER RATE MIN AMOUNT RATE TYPE AMOUNT CHARGES 12/18 10:28 PM 1 WASHINGTON DC WASHINGTON DC 202 965-4234 OFFPK 1 0.15 LCL 0.10 0.25 12/24 09:01 AM 1 WASHINGTON DC WASHINGTON DC 202 965-4234 PEAK 1 0.35 LCL 0.10 0.45 01/13 02:28 PM 1 ROCKVILLE MD WASHINGTON DC 202 662-3583 PEAK 6 2.10 LCL 0.10 2.20 01/13 02:35 PM 1 FERNWOOD MD WASHINGTON DC 202 662-3583 PEAK 4 1.40 LCL 0.10 1.50 01/16 02:31 PM 1 WASHINGTON DC WASHINGTON DC 202 872-9860 PEAK 2 0.70 LCL 0.10 0.80 TOTAL AIRTIME FOR 202 395-2131 ON GOVT 100+PLAN 0873: LONG DISTANCE SERVICE PROVIDED BY: BAM BAND 1 MINUTES AIRTIME ALL W/B CELLS CALLS USED AMOUNT PEAK 4 13 4.55 OFFPEAK 1 1 0.15 TOTAL 5 14 4.70 TOTAL ACTIVITY FOR ALL BANDS ON GOVT 100+PLAN 0873: TOTAL INCOMING CALLS: 0 DIRECTORY ASSIST/INFOASSIST CALLS: 0 TOTAL OUTGOING CALLS: 5 TOTAL PRIOR MONTH CALLS: 0 TOTAL NUMBER OF CALLS: 5 PRIOR MONTH AIRTIME AMOUNT: $0.00 TOTAL LANDLINE FOR 202 395-2131: RATE LOCAL LEC TOTAL PERIOD CALLS AMOUNT CALLS AMOUNT CALLS AMOUNT DAY 5 0.50 0 0.00 5 0.50 TOTALS 5 0.50 0 0.00 5 $0.50 Bell Atlantic Mobile provides billing services for AT&T Communications and Sprint Communications. Services provided by AT&T and Sprint are indicated as "AT&T" and "SPT" respectively, in the landline TYPE column. There is no connection between Bell Atlantic Mobile and these inter-exchange carriers. PLEASE RECYCLE 550161210002022 A NATIONAL EFFORT TO INSURE AMERICA'S CHILDREN: WORKING TOGETHER FOR A HEALTHIER FUTURE February 18, 1998 To meet the challenge of insuring millions of children, health care providers, foundations, corporations, teachers, child care providers, advocates, and public health officials are coming together to inform families about insurance options for their children. The following is a list of some major activities. Enlisting Health Care Providers: The American Medical Association, the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Physicians, the American College of Obstetricians and Gynecologists, and the American Nurses Association are educating physicians and nurses throughout the country on how to enroll low-income uninsured children in CHIP and Medicaid. Engaging Hospitals and Health Centers: The American Hospital Association has launched the Campaign for Coverage.. A Community Health Challenge to expand health care coverage to 4 million more Americans through outreach and education efforts designed to bolster participation in CHIP, Medicaid, and other programs. The National Association of Children's Hospitals and the National Association of Public Hospitals are identifying and promoting innovative models of outreach and enrollment to uninsured children within hospital facilities and throughout the community. The Catholic Health Association has launched the Children's Health Matters campaign to provide support to local hospitals and social service agencies in 23 states in their efforts to enroll Medicaid eligible children. The National Association of Community Health Centers is working through its 700 centers to identify and enroll low-income uninsured children - including the 1.3 million such children they now serve - through Medicaid/CHIP enrollment services at Community Health Centers. Making Children's Health Insurance a Public Health Priority: The National Association of County and City Health Officials, the American Public Health Association, and the Association of Maternal and Children Health Programs are working to inform all their members on ways to increase health insurance coverage for the children that they treat. Investing in Innovative National, State and Local Outreach: The Robert Wood Johnson Foundation will spend $13 million over the next 3 years to fund innovative state-local coalitions to design and conduct outreach initiatives, simplify enrollment processes, and coordinate existing coverage programs. The Kaiser Family Foundation will spend up to $10 million over the next 5 years on studies to help understand why eligible children are uninsured, how best to provide insurance coverage for them, and which outreach initiatives work. America's Promise, with support from the Robert Wood Johnson Foundation and in collaboration with the American Academy of Pediatrics, will mobilize corporations and local communities nationwide in children's health outreach efforts. Already, two of the nation's major pharmaceutical companies have joined this effort -- SmithKline Beecham and Schering Plough. The David and Lucile Packard Foundation will spend over a million dollars on children's health programs such as the Children's Health Collaborative Project, a joint project of the National Association for State Health Policy, the National Governors' Association, and the National Conference of State Legislatures. Mobilizing Major Corporations: Bell Atlantic, in collaboration with the nation's Governors, will establish and support a single toll free phone number that directs families to their local eligibility offices. Pampers will distribute information on available health insurance options, including the toll-free number, in its childbirth education packages, which are given to 90 percent of first-time mothers. Safeway will display the toll-free number and information on children's health programs on their shopping bags. The National Association of Chain Drug Stores and the National Community Pharmacists Association will distribute the toll-free number to more than 150,000 pharmacists in over 60,000 pharmacies and will provide them with information so that they may refer parents to state health insurance programs. Involving Teachers and Child Care Referral Centers: The National Education Association is launching an unprecedented campaign to educate teachers on how they can inform children and their families about health insurance, through national newsletters, conferences, and special training sessions. The National Association of Child Care Resource and Referral Agencies, which help over 1.5 million parents a year to find child care, will launch a campaign to inform parents of health insurance options for their children. Strengthening Grassroots Efforts to Sign Up Uninsured Children: The Children's Defense Fund is disseminating information to over 10,000 individuals and organizations on state plans to enroll more children in coverage. The Center on Budget and Policy Priorities has increased its Start Healthy, Stay Healthy campaign, which works with community organizations, schools, child care programs, health clinics, and hospitals on ways to identify eligible children and get them enrolled in Medicaid and CHIP. Families USA is providing technical assistance to advocates nationwide to devise innovative strategies to enroll more children. The March of Dimes has committed funds to support demonstration projects to help states plan or implement creative outreach initiatives to reach and enroll children. The Children's Health Fund is organizing a major outreach campaign designed to enroll eligible children in Medicaid and CHIP, in order to reach an additional 50,000 uninsured children. PRESIDENT CLINTON ANNOUNCES A SERIES OF NEW EFFORTS TO ENROLL UNINSURED CHILDREN IN HEALTH INSURANCE PROGRAMS February 18, 1998 Today, the President is announcing the first major state coverage expansions under the recently enacted Children's Health Insurance Program (CHIP) and released information showing that many States will soon follow. He also unveiled an unprecedented set of public/private initiatives designed to enroll the millions of uninsured children who are eligible but not enrolled in Medicaid and other state-based children's health programs. These initiatives have been designed in partnership with Governors, health care providers, children's health advocates, foundations, businesses and many others who are committed to providing health care coverage for the nation's uninsured children. Over 10 million children in America are uninsured. Nearly 90 percent of these children have parents who work, but do not have access to or cannot afford health insurance. Over 3 million of these uninsured children are already eligible for Medicaid. However, many families are not aware that their children are eligible for Medicaid, and others have difficulty filling out the application. Similar problems could undermine the new Children's Health Insurance Program's goal to enroll millions of uninsured children. With these challenges in mind, the President: ANNOUNCED THAT COLORADO AND SOUTH CAROLINA HAVE JOINED ALABAMA AS THE FIRST COVERAGE EXPANSIONS UNDER THE NEW CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP). Today, the President is announcing that Colorado and South Carolina join Alabama as the first states to come into the children's health program. In late January, Alabama received approval to expand its Medicaid program to children ages 14 to 18 up to 100 percent of poverty. South Carolina will expand its Medicaid program to provide coverage to all children up to 150 percent of poverty. And, Colorado builds upon its current non-Medicaid program to cover children up to 185 percent of poverty. The President is also announcing that many more States are well on their way to expanding coverage to more uninsured children. Currently, 14 additional states have submitted plans to HHS for approval, and another 18 States have active working groups or task forces to design plans to address the needs of uninsured children. RELEASED A NEW PRESIDENTIAL DIRECTIVE TO LAUNCH A GOVERNMENT-WIDE EFFORT TO ENROLL UNINSURED CHILDREN. In an executive memorandum to eight Federal agencies with jurisdiction over children's programs - the Departments of Agriculture, Interior, Education, HHS, HUD, Interior, Labor, and Treasury and the Social Security Administration -- the President is directing the establishment of a multi-agency effort to enroll uninsured children. These agencies run programs such as WIC, Food Stamps, Head Start, and public housing that cover many of the same children who are uninsured and eligible for Medicaid or other health insurance. The memorandum instructs these agencies: (1) to identify all their employees and grantees who might come into contact with these children and ensure that these individuals are aware of the health insurance programs available to children; (2) to develop an intensive children's outreach initiative, such as distributing information, coordinating toll-free numbers, and simplifying and coordinating application forms; and (3) to report back in 90 days on their plan to help enroll uninsured children. HIGHLIGHTED BUDGET PROPOSALS THAT PROVIDE MEDICAID ENROLLMENT INCENTIVES TO STATES. The President's FY 1999 budget invests $900 million over 5 years in children's health outreach policies, including the use of schools and child care centers to enroll children in Medicaid. The budget provides states with the option of automatically enrolling children in Medicaid even before having received all of the complicated eligibility and enrollment forms (a provision known as "presumptive eligibility"). It also expands the use of a Federally-financed administrative fund so that it can underwrite the costs for all uninsured children - not just the limited population allowed under current law. ANNOUNCED A HISTORIC PRIVATE SECTOR COMMITMENT TO PROVIDE OUTREACH. To complement the public outreach effort, the President is announcing unprecedented new contributions from the private sector to help ensure that all children who are eligible for health insurance receive it, including: - A new toll-free number that directs families around the nation to their state enrollment centers. The President is announcing that Bell Atlantic will establish and operate a toll-free number to help states enroll uninsured children. The number, which will be put in place during the upcoming months, will be developed in cooperation with the nation's Governors. This will help millions of families around the nation by directing them automatically to their local state Medicaid enrollment agency. - Over $23 million in commitments from private foundations across the country. The Robert Wood Johnson Foundation will spend $13 million over the next 3 years to fund innovative state- local coalitions to design and conduct outreach initiatives, simplify enrollment processes, and coordinate existing coverage programs. The Kaiser Family Foundation will spend up to $10 million over the next 5 years on studies to help understand why eligible children do not enroll in existing programs and how best to provide insurance coverage for these children. America's Promise, with support from the Robert Wood Johnson Foundation and in collaboration with the American Academy of Pediatrics, will mobilize corporations such as SmithKline Beecham and Sheering Plough and local communities nationwide in children's health outreach efforts. - New initiatives from corporate and advocacy organizations to reach out to uninsured children. Pampers has volunteered to include a letter in its child birth education packages, given to 90 percent of first-time mothers, providing families information about available health insurance options. Grocery stores and chain drug stores across the country will provide information about the new Bell Atlantic toll-free number to their customers. The National Education Association is launching an unprecedented effort to educate teachers on how they can inform children and their families about health insurance, through national newsletters, conferences, and special training sessions. The American Hospital Association's Campaign for Coverage will increase its nationwide initiative to engage hospitals in helping uninsured Americans, including children. ISSUED A CHALLENGE ACROSS AMERICA TO FIND NEW WAYS TO REACH OUT TO UNINSURED CHILDREN. The President is challenging every physician, nurse, health care provider, business, school, parent, grandparent, and community across the nation, to find new ways to ensure that uninsured children eligible for health insurance are enrolled in Medicaid or CHIP. This national commitment should not stop until every eligible child across the country is enrolled in one of the existing health care programs. 1 Health Care PulseLine: Preliminary Results prepared for America's Promise WIRTHLIN WORLDWIDE 21 May 1998 2 RESEARCH METHODOLOGY Two PulseLine Groups - Parents of 'at risk' children - Social Workers / Health Care Professionals that deal with parents of 'at risk' children Approximately 20 respondents per group First hour of each group consisted of extensive quantitative evaluation of potential promotional materials - 'Ballot Box' technology for instantaneous data display on multiple promotional iterations Second hour consisted of in-depth qualitative Focus Groups W WIRTHLIN WORLDWIDE 3 RESEARCH METHODOLOGY Ten different 'story board' iterations Each story board included: - Potential initiative name - Tagline - Toll-free phone number - Program descriptive Respondents provided preferences for and against each component of each story board Given the instantaneous data display, the subsequent qualitative follow-up was fluid, allowing exploration of key issues unearthed in the quantitative portion W WIRTHLIN WORLDWIDE Preference for Name of Initiative 4 (Among both groups) KidCare 22% Healthy Kids Matter 25% Get All Kids Insured 14% 1-877-KIDCARE 4% Healthy Kids Now 4% America Cares For Kids 4% HealthPromise for Kids Insure Our Future 4% Insure America's Children Now 7% 1-877-US4KIDS 4% 0% 10% 20% 30% 40% First Preference Second Preference W WIRTHLIN WORLDWIDE 5 Preference for Tagline (Among both groups) Free or low-cost health insurance is now 24% available for millions of kids who need it. Health insurance for children is now available 26% for millions who need it. Because all kids deserve to have health 16% insurance. If your child doesn't have health insurance, you 11% need to call. Sign up SO your kids are covered. 8% At last, health coverage for America's kids Because every child deserves the promise of a healthy future 5% Because health insurance is waiting for 5% millions of kids who need it. New health coverage for our kids. A better 3 3% future for our families. Because every child deserves to have health 3 3% insurance. 0% 20% 40% 60% 80% First Preference Second Preference I'll WIRTHLIN WORLDWIDE Preference for Toll Free Number 6 (Among both groups) 1-877-KIDCARE 12% 1-877-KIDSNOW 30% 1-877-US4KIDS 1 24% 1-877-456-CARE 1 24% 1-877-ALLKIDS 6% 1-877-USCHILD 1 6% 1-877-234-KIDS 0% 20% 40% 60% 80% 100% First Preference Second Preference W WIRTHLIN WORLDWIDE 7 Preferences for Initiative Spokesperson Oprah Winfrey 23% Bill Cosby 11% Hillary Clinton 5% Rosie O'Donnell 5% Colin Powell Janet Jackson 5% Jimmy Smits 4% Medical Professional 0% 5% 10% 15% 20% 25% 30% 35% 40% Parents Social Workers/HCP's W WIRTHLIN WORLDWIDE 8 Do you (your clients/patients) feel that it is valuable to take children in for check-ups if they are not sick? Yes Yes 47% 90% No 10% No 53% Parents / Caregivers Social Workers / HCP's W WIRTHLIN WORLDWIDE 9 Would you (your clients/patients) rather the government provide access to free health insurance for your (their) kids, or would you (they) prefer to pay a small portion, say $10 per month? Free 22% Free 73% Pay Portion Pay Portion 27% 78% Parents / Caregivers Social Workers / HCP's W WIRTHLIN WORLDWIDE 10 COMMUNICATIONS IMPERATIVES Cost will be the number one concern among this audience. We absolutely must mention that this initiative is 'free' or 'low-cost' Emphasize that this initiative is something that is available NOW or available TODAY Acknowledge the efforts of these people despite their difficult situation Provide assurance that our target audience is eligible for this program W WIRTHLIN WORLDWIDE 11 COMMUNICATIONS IMPERATIVES Emphasize that this program is 'new'. The fact that this is not something that they've seen or heard about before is appealing Somewhat less important, but still on the mental radar screen of these respondents, was the quality of this health care. We should emphasize that this is not a watered-down version of the insurance that middle-class America receives Our target audience lives from day to day - any references to the future make them distrustful (again, confirming the need to include the term 'today' or 'now' in our messages) W WIRTHLIN WORLDWIDE 12 COMMUNICATIONS IMPERATIVES Avoid any terminology that connotes a 'Federal Program'. Pride will influence many of the individuals we are targeting into non-action. The term 'National Initiative' is a good alternative. Avoid limits such as millions and ten million. These people are eternal pessimists. The majority of the group voiced the opinion that 'if there are ten million slots, my child would be number ten million and one.' Avoid tone that 'we know what's best you.' Pride is very important and they prefer to make up their own mind about issues concerning their child. Phrases such as "you need to call" or "don't risk your child's health" can be a turn-off. They are, however, open to good advice. W WIRTHLIN WORLDWIDE SEP-29-97 MON 10:36 HCFA-EXECUTIVE SEC. FAX NO. 2026907675 P.02 cc: Melanne Cluis SUMAR DEPARTMENT OF HEALTH & HUMAN SERVICES Jen Health Care Financing Administration Deputy Administrator Washington, D.C. 20201 SEP 28 1997 MEMORANDUM FOR THE FIRST LADY FROM: Nancy-Ann Min DeParle NMD Deputy Administrator SUBJECT: Status of State Children's Health Insurance Program I wanted to provide you with an update on the Department of Health and Human Services' (HHS) efforts to implement the State Children's Health Insurance Program. We started organizing even before the President signed the bill into law and already have provided States with a significant amount of information to assist them in developing the State Plans required by the law. In addition to several written communications, we have been talking with the States through face-to-face meetings'in Washington, including the National Governors Association (NGA) - sponsored summit on September 12th, and through informal contacts made by our regional offices. Implementation of the new program involves a team effort throughout the HHS. The new program will be administered by the Center for Medicaid and State Operations (CMSO) within the Health Care Financing Administration (HCFA). We are working with the Health Resources and Services Administration (HRSA), which also administers programs such as the Maternal and Child Health Services Block Grant, to implement and monitor the new program as a part of our overall strategy to coordinate outreach to uninsured children Among other things, HRSA's involvement help to underscore that we are not trying to push States into using Medicaid as the expansion model. Guidance to States We have provided States with a number of documents that will help them in developing their child health plans: On August 27th, we sent a letter to State officials providing an overview of the new program, describing our implementation plans, and enclosing a detailed summary of the law. On September 10th, we published a Federal Register notice that set forth the fiscal year 1998 State allotments available to States, Commonwealths, and Territories for expenditures on the new program. This notice also provided State-by-State information on the enhanced Federal matching available to States. Page 2 - The First Lady In conjunction with the NGA meeting on September 11th, we provided States with the first set of responses to the highest priority, most frequently asked questions about the program. (We will release additional sets of questions and answers on a regular basis as we resolve key policy issues.) On September 12th, we provided States with a draft template and instructions to provide information on the requirements and options in the law to assist States in submitting their plans and relieve them from having to search through the law to ensure that they have made the proper assurances. We also created a WEB page to help States (and others) answer immediate questions about the new law and its implementation. (The address is http://www.hcfa.gov/init/children.htm) For your information, I have appended these materials in a notebook that accompanies this memorandum. In addition, we are developing materials to guide the review and approval of Title XXI plans. These will include instructions to States for the submission, approval and amendment of Title XXI plans, as well as instruction for HCFA Central Office, Regional Offices and DHHS partners on the process to follow for review of States' plans. We will also provide more payment information to States on the claims processing procedures and State matching requirements. We also are preparing instructions and guidance for States to access Title XXI funds through Medicaid expansions. Our goal is to provide these materials to the States in early October We also are working to assist States in developing strategies to find and enroll uninsured children without inadvertently replacing existing private or State coverage of children with the new Federal program. We plan to provide examples of strategies or best practices used by States in three areas: Preventing "crowd out" of current coverage to ensure that the new funds cover children who would otherwise have private coverage; Coordination with Medicaid to ensure that children eligible for Medicaid are enrolled in that program and to simplify the eligibility process; and Outreach ideas for both programs. Finally, we are planning to invite States to a conference in early December to provide them with additional technical assistance. We think that early December is a good time for such a meeting because by then, States will have had time to more fully explore their options, and also because many States will need to be prepared to work with their State legislatures in developing their plans beginning in January 1998. TO: Katie, Emily, Jennifer, Barbara FROM: Jeanne me RE: OUTLINE OF BIWEEKLY UPDATE DATE: September 17 Attached is a draft format for our biweekly update? Are there additional categories? Missing information? Another thought that I had is that we get a 50-state table that shows whatever we know is going on in each state in a box. We'll discuss at 12:30. Thanks! Children's Health Insurance Program Update DRAFT September 17, 1997 News / Releases Last week, Administration officials and staff attended a National Governors' Association (NGA) meeting on children's health. The two-day meeting included panel discussions and round tables about the new program. At that time, we released two documents: The Federal Register containing the state allotments A first set of questions and answers about major issues On Monday, September 15, DHHS sent to states and other interested parties a draft state plan "template" to help guide states as they develop their state plans. The next planned release of information is possibly October 1, the first effective date of the program, including general guidance (on targeting. Other works in progress include: a second set of q.s. and as; a letter outlining financial reporting forms; a letter describing the state plan approval process; and a description of how the Medicaid option would work. State News Wisconsin intends to submit a concept paper [when] California held a special session of their state legislature in August to discuss its state plan. Meetings / Speeches A series of regular meetings have been set up. These include: [biweekly NGA, groups, etc]. Chris Jennings and Nancy Ann Min DeParle spoke at the NGA meeting. NCSL? Upcoming Events Secretary Shalala, March of Dimes, September 26 First Lady, October 6 P.02/05 1997 Children's Health September 1997 SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY I 2 HHS Steering Committee 3 HCFA Center on Beneficiary 4 5 6 Services, Baltimore, MD (Fenton) 7 HHS Steering Committee 8 WH /DPC/HHS Meeting 9 HHS Steering Committee 10 MGA Meeting II HGA Meeting 12 D CSG/Southern Gov's Annual Advacacy Group Meeting at Meeting, 9/7-9, Hot Springs, VA HHS APWA-Information Systems I4 -HHS Steering Committee 15 WH/DPC/RHS Meeting 16 HHS Steering Committee 17 18 19 Mat'l Association of Insurance 20 Management Annual -NCSL/Assembly of Federal Will/WAND mtg Commisioners Fall Meeting., Conference, 9/14-19. SL Issues Chairs meeting. DC CHIP KA Meeting (biweekly) 9/20-24. DC Louis, NO -N3t'l Advisory Committee on OEOB Rural Health, DE (Sertitte) Wat'l (oalition on Health Care -AHCPR, User Linison Program, meeting 9/13-17, Charlottesville, VA IGA -Nat'l Latino Child. (speech) 21 HHS Steering Committee 22 WH/DPC/HHS Meeting 23 HHS Steering Committee 24 CSG/Nidwestern Legis.ative 25 Sec'ty sprech-March of Dimes, 26 27 Conference, 9/25-27, Lincoln, NYC,HT ASTHO 1993 Annual Meeting, ME 9/23-26, Scottsdale, AI SEP-15-1997 18:04 28 HHS Steering Committee 29 WH/DPC/HHS Meeting 30 P.03/05 October 1997 Children's Health 1997 SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY HHS Steering Committee I 2 3 4 CHIP IGA Meeting 5 HHS Steering Committee 6 WH/DPC/HHS Meeting 7 HHS Steering Committee 8 Mat'l Commission on 9 to II Partnerships for Children's APWA-Organizational and Health meeting (Sec'ty's Professional Development calendar) Seminar, 10/6-7, Derrer, CO (child care and other issues) CHILDREN'S HEAL TH DAY 12 HOLIDAY I3 WH/DPC/HHS Meeting 14 HHS Steering Committee 15 16 NCSL Health Seminar, 10/17- 17 18 19, Haples, FL (HHS invited) CHIP IGA Meeting IGA 19 HHS Steering Committee 20 WH/DPC/HHS Meeting 21 HHS Steering Committee 22 23 24 25 SEP-15-1997 18:04 APWA-Nat'l Association of 26 HHS Steering Committee 27 WH/DPC/HHS Meeting 28 HIS Steering Committee 29 30 31 State Medicaid Directors, Annual Conference, 10/26-29, CHIP IGA Meeting Alexandria, YA P.04/05 November 1997 Children's Health 1997 SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY 30 American Academy of I Pediatrics Annual Meeting, II/I-S, New Orleans, LA 2 HHS Steering Committee 3 WH/DPC/HHS Meesing 4 HHS Steering Committee 5 6 7 8 NCSL, Assembly on Fed'l Issues, and Assembly on State Issues joint meeting, 11/5-7, DC (Election Day) CSG/Southern Legislative 9 HHS Steering Committee Ю HOLIDAY II HHS Steering Committee 12 HACO, Employment-Horman B 14 IS Conference Fall Issues Conf.., Services Conference, 11/13-17, 11/9-12, Oklahoma City, OK Veterans" Day CHIP IGA Meeting Tulsa, OK American Public Health Assoc. Annual Meeting, U.S. 13, Indianapolic, IN IGA 16 HHS Steering Committee 17 WH/DPC/HHS Meeting 16 HHS Steering Committee 19 20 NOSL Health Seminar, 11/21- 21 22 23, Newport, RI (HHS invited) KCSL Sr. legislative Drafting Seminar, 11/19-22, Sacramento, CA SEP-15-1997 18:05 23 HMS Steering Committee 14 WH/DPC/HHS Meeting 25 HHS Steering Committee 26 HOLIDAY 27 28 29 CHIP IGA Meeting THANKSGIVING P.05/05 December 1997 Children's Health 1997 TOTAL P.05 TOTAL P.05 SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY HHS Steering Committee I WH/DPC/HHS Meeting 2 HHS Steering Committee 3 National League of Cities 4 CSG 1997 Annual Meeting $ 5 APWA-Mat'l Council of State 6 annual meeting, 12/4-7, State Leadership forum, 12/5- Human Svc Admin. & Mat'1 --CSG-WEST-50th Pacific Annir. Philadelphia, PA 9, Honolulu, Hawaii Council of Local Public Meeting, 12/3-S,KohalzCoast, Wellare Admin. Winter Island of Hawai meeting. 12/6-10, San --American Legislative Exchange Francisco, CA Council,Freshman Legislator Orientation, 12/3-6, DC 7 HHS Steering Committee 8 WH/DPC/HHS Meeting 9 HHS Steering Committee 10 II 12 B CHIP IGA Meeting 14 HHS Steering Committee IS WH/DPC/HHS Meeting 16 HHS Steering Committee 17 18 19 20 IGA 21 HHS Steering Committee 22 WH/DPC /HHS Heeting 23 HHS Steering Committee 24 HOLIDAY 25 26 27 CHIP IGA Meeting CHRISTMAS SEP-15-1997 18:05 28 KHS Steering Committee 29 WH/DPC/HHS Meeting 30 HHS Steering Committee Il HOLIDAY NEW YEAR'S DAY