Coordinating Publicly Funded Healthcare Coverage for Children

Coordinating SCHIP and Medicaid

The application procedures in Florida's Medicaid program have been revised substantially, in large part as a result of the need to coordinate enrollment between Florida's Healthy Kids program and Medicaid. This description of the changes is excerpted by permission from the Florida Healthy Kids Corporation annual report, Healthy Kids 1999, available online at http://www.healthykids.org/

The Medicaid Eligibility Process Reborn

Prior to 1998, the processing time for determining Medicaid eligibility for children included two personal visits to the local social service office, with numerous pieces of unnecessary documentation, for a face-to-face personal interview lasting on average 90 minutes, during which all members of the family were reviewed for a litany of programs whether the family wanted them or not. The process was difficult for the family and time consuming.

With its initial State plan to implement a State Children's Health Insurance Program (SCHIP), the [Healthy Kids] corporation proposed changes to its operations which have had far-reaching effects. To meet the Federal requirement that SCHIP programs screen and refer all applicants for potential Medicaid eligibility, the corporation and the Florida Department of Children and Families entered into a joint venture. The changes effected were as follows:

• The Department of Children and Families installed terminals with access to the Medicaid Eligibility system on the [Healthy Kids] corporation's premises. Eligibility staff of the State agency were plucked from their social service environment and given instructions to "think differently, find a way to make this easy for families."
• The Healthy Kids single-page application form was modified to facilitate its use as an application for Medicaid as well. This would enable families to complete one form and qualify for either program.
• The Healthy Kids corporation developed an electronic tool which reviews household size and gross monthly income and assumes certain income disregards. Those children that appear to be likely candidates for the Medicaid program are referred to Medicaid eligibility workers for a full determination.
• The co-location of agencies relieves the family from any additional action on their part. Mail-in applications, when referred [to Medicaid] are simply walked over—and handed over—to Medicaid eligibility staff.
• The new process involves a single page, mailed-in form, which requires only 15 minutes for the eligibility worker to perform the eligibility process for all of the children in the family. Redeterminations are also handled via the mail.

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