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State Plan Checklist - CERTIFICATION, ELIGIBILITY & COORDINATION OF SERVICES 8/14/2026 Page 18

C. Health Care Agreements, Referrals, and Coordination

1. State Agency Referral Agreements and Coordination of Services

a. The State agency has written formal agreements that permit the sharing of participant information with the following programs/providers (indicate whether information is shared manually (M) or through ADP (A) by placing either an M or A in front of the appropriate service):

Manual (M) ADP (A) SNAP X Rural/migrant health centers TANF X Hospitals Medicaid X Childhood immunization X SSI Immunization registries X