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Title 5: Centrally Administered Programs Page 36 Iowa Department of Human Services Employees’ Manual Chapter E: Healthy and Well Kids in Iowa (hawk-i) Nonfinancial Eligibility Factors Revised July 3, 2009 Preferred Language

1. Mrs. D applies for hawk-i for two of her three children. The third child has child support income that makes the family’s countable income over the limit for a family size of four. Mrs. D voluntarily excludes the third child so that the child support will not be counted in the hawk-i eligibility determination. The eligibility determination is based on a three-member family (Mrs. D and the other two children) and only the income of those three people is counted. 2. Mr. and Mrs. E apply for hawk-i for their four children. One of their children receives waiver services under Medicaid. Normally, children receiving Medicaid are counted in the family size but do not receive coverage under hawk-i. However, the child also receives income from a trust. Mr. and Mrs. E can choose to voluntarily exclude this child from the hawk-i eligibility determination so that the income from the trust will not be counted. If Mr. and Mrs. E voluntarily exclude the child, the hawk-i eligibility determination will be based on a five-member family (Mr. E, Mrs. E, and the other three children) and only the income of those five people will be counted. Waiting List Legal reference: 441 IAC 86.3(10) When the Department has established that all of the funds appropriated for the hawk-i program are obligated, a waiting list shall go into effect as follows:

1. The third-party administrator shall deny all subsequent applications for hawk-i coverage unless Medicaid eligibility exists. The third-party administrator mails a notice of decision, which states either that: ♦ The applicant meets the eligibility requirements but that no funds are available and that the applicant will be placed on a waiting list, or ♦ The person does not meet eligibility requirements (in which case, the applicant is not put on a waiting list).

2. Before an applicant is denied or placed on the waiting list, the third-party administrator refers the application to the Medicaid program for an eligibility determination. If Medicaid eligibility exists, the Department approves the child for Medicaid coverage.