gayle lees sandlin, director bureau of children’s health insurance alabama department of
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The State Children's Health Insurance Program: Accomplishments and opportunities for Improvement at Renewal. Gayle Lees Sandlin, Director Bureau of Children’s Health Insurance Alabama Department of Public Health Bipartisan Congressional Health Policy Conference January 13, 2007. - PowerPoint PPT PresentationTRANSCRIPT
Gayle Lees Sandlin, DirectorBureau of Children’s Health
Insurance Alabama Department of
Public Health
Bipartisan Congressional Health Policy ConferenceJanuary 13, 2007
The State Children's Health Insurance Program: The State Children's Health Insurance Program: Accomplishments and opportunities for Accomplishments and opportunities for
Improvement at RenewalImprovement at Renewal
“Devolution” – give states the ability to design a program that best meets the needs of the children while fitting with each state’s environment for:
Political climate Insurance market Health care provider system Appropriate agency to administer Eligibility criteria that “fits” the demographics of the
State
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0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18Age
Fed
eral
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vert
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eve
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Alabama Children’s Health I nsurance Coverage
SOBRA MedicaidPhase I Title XXI MedicaidExpansion
Medicaid for Low Income Families
Alabama Child Caring Foundation235%
Phase ITitle XXIMedicaid Expansion
Phase II - ALL Kids
Insuring Alabama’s Children
0
50,000
100,000
150,000
200,000
250,000
300,000
350,000
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-Q1
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-Q3
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FISCAL QUARTER
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SOBRA MEDICAID KIDS CHIP PHASE I ALL KIDS ACCF
Since CHIP Phase 1 began in February 1998,the three programs providing health coverageto children in Alabama have seen a net increase of approximately 176,100 enrollees.
States were encouraged to “outreach” and find uninsured children and
facilitate enrollment in appropriate program
Joint application Find all uninsured children “Seamless” and “family friendly” enrollment and
referral processes “Destigmatize” publicly funded insurance Creative use of media and print advertising Use of enrollment brokers Woodwork effect Procedures to keep children insured
12 months continuous coverage Helpful renewal process
ALL Kids – “Administratively Simple”
(Program Issues)
Self declaration of eligibility criteria 3 program application Yearly premiums with 12 months to pay Co-pays collected by providers Centralized processing Mail-in application Web-based application Outreach designed to “Teach the People Who Reach
the People”
Provide Systems Coordinationto assist decentralized Medicaid workers in identifying problems, gaps, miscommunications, etc., that result in barriers to enrollment of children
Provide Staff Trainingsto offer contact hours fornurses and social workers Attend Meetings and Community Eventsto educate and distribute information about ALL Kids
Fiscal Issues State funds Capped federal allotment Administrative spending capped at
10% PERM
Enhanced match rate Inability for stand alone programs to
flip to Medicaid funding Enrollee cost sharing
PremiumsCo-paysMax 5% of family income
Payments are manageable and affordable for families
2-4 installments are available Decreases chance of loss or lapse of
coverage due to unpaid premiums
Leave no child behind
Contact Information
Gayle Lees Sandlin, DirectorBureau of Children’s Health InsuranceAlabama Department of Public Health
201 Monroe Street, Suite 250Montgomery, AL 36104
Phone: 334 – 206-5568FAX: 334 – 206-6433
Email: [email protected]