Information Memorandum
ADD-IM-98-4
Issued: 4/24/98
TO:
Directors, Designated State Agencies
Executive Directors, State Developmental Disabilities Councils
Chairpersons, State Developmental Disabilities Councils
Directors, State Protection and Advocacy Systems
Directors, University Affiliated Programs
SUBJECT:
Children's Health Insurance Program - Children with Disabilities
DISCUSSION:
This memorandum is intended to provide you with information and to support your active involvement in ongoing State planning geared toward implementing the State Child Health Insurance Program (CHIP), which expands affordable health coverage to many previously uninsured, low-income children. State planning officials are seeking to reach as many potentially eligible, uninsured children as possible through joint outreach and enrollment efforts carried out in coordination with Federal partners. CHIP was established to provide Federal matching funds beginning in 1998 to enable States to initiate and expand the provision of child health care assistance to low-income children.
Low-income children are defined as those who meet eligibility standards as determined by a State, reside in families with income below 200% of the Federal poverty level or level set by State, and are not eligible for Medicaid or are covered under a group health plan or other health insurance program. Low-income children may include those covered under a health insurance program in operation before July 2, 1997, and which receive no Federal funds.
Eligibility standards could include geography, age, income, residency, disability status, access to other health insurance and duration of eligibility. The eligibility standards can never cover children with higher family incomes before covering those with lower family incomes and cannot deny coverage to a child based on pre-existing conditions.
The law authorizes for the State CHIP a total allotment for each fiscal year from 1998 through 2001 of $4.275 billion; for 2003 and 2004, $3.15 billion; for 2005 and 2006, $4.05 billion; and for 2007, $5 billion. Funds would be allocated based on the number of low-income uninsured children for the State for the fiscal year and the State cost factor.
States can use these funds to provide Medicaid benefits to uninsured children, obtain coverage under individual or group plans, purchase services from providers or use other methods to make health coverage accessible to children.
States can also use some or all of their CHIP allotments for an enhanced Federal Medicaid matching rate for expansion of coverage of Medicaid for low-income children.
States are eligible for payment once their plan has been submitted and approved by HHS. No more than 10% of funds can be used for non-coverage items such as administration, outreach and other services in a given quarter.
State child health plans are required to include descriptions of child health assistance provided under the plan, including the proposed methods of delivery and utilization control systems, eligibility standards and outreach activities.
A State plan must describe the procedures to be used to accomplish outreach and enrollment assistance to families of eligible children, and to coordinate with other public and private health insurance programs. Children with disabilities in your State may be eligible for the expanded health care assistance. Additionally, CHIP State plans must describe outreach activities, and such activities should include State Developmental Disabilities Programs.
If you have not done so already, I urge you to discuss CHIP's outreach activities with your State and region ( listings attached below). Involvement could include such activities as:
- Obtaining CHIP information and applications from CHIP officials and provide for their on-site display and distribution at prominent locations throughout local offices;
- Including information on the CHIP program in routine mailings; and
- As appropriate, arranging with CHIP officials to provide training and possible on-site processing of CHIP applications for the benefit of interested and potentially eligible recipients.
Additional information on the program can be found on the CHIP website of the Health Care Financing Administration.
/signature/
Reginald F. Wells, Ph.D.
Acting Commissioner
Administration on Developmental Disabilities
- CHIP Status Report and Contact Information from CHIP website
- CHIP Federal Project Officer list and Regional Office Contact list available from Elsbeth Wyatt (see below) or HCFA upon request.
INQUIRIES TO:
Elsbeth Wyatt - Program Specialist
ADD-IM-98-4