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Title 5: Centrally Administered Programs Page 1 Iowa Department of Human Services Employees’ Manual Chapter E: Healthy and Well Kids in Iowa (hawk-i) General Administration Revised July 3, 2009
General Administration Legal reference: Public Law 105-33, Iowa Code 514I, 441 IAC Chapter 86 The federal Balanced Budget Act of 1997, Public Law 105-33, added Title XXI to the Social Security Act. Title XXI establishes the State Children’s Health Insurance Program (SCHIP) that enables states to provide health care coverage to uninsured targeted low- income children. “Targeted low-income children” are those who are under 19 years of age, who reside in families with income below 200% of the federal poverty level, and who are not eligible for Medicaid or covered under a group health plan or other health insurance. Iowa’s SCHIP program is a combination program, consisting of both a Medicaid expansion and a separate child health insurance program. The Medicaid expansion covers uninsured children ages 6 through 18 years whose family income exceeds 100% of the federal poverty level but is below 133% of the federal poverty level. Coverage is provided through the Mothers and Children (MAC) coverage group. See 8-F, Mothers and Children (MAC) Program, for information on the MAC coverage group. The separate child health insurance program, known as the Healthy and Well Kids in Iowa (hawk-i) program, is a non-Medicaid program for children who are not Medicaid eligible and whose family income does not exceed 300% of the federal poverty level. The policies and procedures covered in this chapter are used: ♦ By the Department’s third-party administrator to determine hawk-i eligibility, and ♦ By income maintenance staff as reference information about the program. This manual presents information on the hawk-i program organized as follows: ♦ General administration ♦ Application processing ♦ Nonfinancial eligibility ♦ Income ♦ Types of income ♦ Approval of coverage ♦ Premiums and copayments ♦ Case maintenance ♦ Disenrollment ♦ Recovery