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Model Application Template for the State Children’s Health Insurance Program

Effective Date:

Approval Date: September 19, 2002 17 standard for approving or denying requests for Medicaid under Title XIX is 45 days. This will also be the target for applications under Title XXI. The Department has established a central unit dedicated to processing KidCare applications and KidCare applications are also processed by eligibility staff working for the Illinois Department of Human Services at 129 local offices throughout Illinois. Most of the increase in applications resulting from KidCare outreach efforts are received centrally in the Department of Public Aid. The Department has hired 111 permanent and 55 temporary staff for its Bureau of KidCare in Springfield. This fall, a second site opened in Chicago to perform initial data input and currently has 37 staff. The State is committed to increasing staffing further as necessary to handle KidCare applications expeditiously. Note, all eligibility determinations are made by State employees.

The State has also streamlined the eligibility data system to make KidCare eligibility determination processing by the Department significantly more efficient.

4.3.1 Describe the state’s policies governing enrollment caps and waiting lists (if any). (Section 2106(b)(7)) (42CFR 457.305(b))

Check here if this section does not apply to your state.

The State does not have an enrollment cap for state fiscal year 2003. DPA staff monitor KidCare Share and Premium spending and compare spending to appropriated amounts. If spending is at a level close to the level that staff estimate could not be sustained throughout the state fiscal year, the Department will institute an enrollment cap. Similarly, if the Governor’s budget office or the legislature directs the Department to reduce KidCare Share and Premium spending because of fiscal problems, DPA will institute an enrollment cap. In either case, the cap will have no effect on current enrollees, unless they leave the program.

If KidCare Share/Premium enrollment approaches levels that cannot be sustained through the end of the year or if the state’s fiscal situation requires a slow down in new enrollments, Illinois will stop enrolling children into KidCare Share or Premium until the situation is resolved. Using the public notice timeframe options under Title XXI, Illinois will notify the public before starting an enrollment cap. Public notice of this change would be accomplished through statewide press, KidCare Application Agents, and community partners. Illinois will also notify the