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DELAWARE HEALTHY CHILDREN PROGRAM (DHCP) 10

Transmittal # DHCP SPA #5 Approval Date July 28, 2009 Supersedes Transmittal # DHCP SPA #4 Effective Date April 1, 2009

Section 4. Eligibility Standards and Methodology (Section 2102(b))

Check here if the State elects to use funds provided under Title XXI only to provide expanded eligibility under the State’s Medicaid plan, and continue on to Section 5.

4.1 The following standards may be used to determine eligibility of targeted low-income children for child health assistance under the plan. Please note whether any of the following standards are used and check all that apply. If applicable, describe the criteria that will be used to apply the standard. (Section 2102(b)(1)(A)) 42 CFR 457.305(a) and 457.320(a))

4.1.1

Geographic area served by the Plan: All of Delaware

4.1.2

Age: Children from ages 1 to 19. This amendment moves infants previously covered into a Medicaid expansion.

4.1.3

Income: Eligibility will be established using gross income of all immediate family* members living in the same household with a standard $90 disregard per earner, a disregard for the amount of actual child care expenses up to $175 for children age 2 and above and $200 for children under age two. In addition, there will be a disregard of the first $50 of child support for any potentially eligible children. The resultant countable income will be compared to 200% of the FPL for a family the size of those in the immediate family with one exception (a pregnant woman will count as two [2] people for determining the FPL level to use). Income less than or equal to 200% of the FPL will qualify the children for eligibility for The Delaware Healthy Children Program. (The State is considering allowing a buy-in for families with incomes between 200% and 300% of the FPL with payment of the full capitation amount as their premium as part of a State-supported initiative.) * ”Immediate family” is defined a unit (living in the same household) comprised of various adults who are legally/financially responsible for each other, and various children (related or unrelated) for whom the adults have legal responsibility or for whom the adults have accepted parental-like responsibility. This is the same definition that is used for Medicaid eligibility.

All wages paid by the U. S. Census Bureau for temporary employment related to Decennial Census activities are excluded in years in which there is a federal census.

4.1.4 Resources (including any standards relating to spend downs and disposition of resources):