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

Effective Date:

5 Approval Date:

2.3. Describe the procedures the state uses to accomplish coordination of SCHIP with other public and private health insurance programs, sources of health benefits coverage for children, and relevant child health programs, such as title V, that provide health care services for low-income children to increase the number of children with creditable health coverage. (Previously 4.4.5.) (Section 2102)(a)(3) and 2102(c)(2) and 2102(b)(3)(E)) (42CFR 457.80(c))

There are no public programs in the state, except MaineCare, that provide health care coverage for low-income children. The coordination of MaineCare with public health programs is accomplished through two major venues. The coordinator of SCHIP within the Bureau of Medical Services is an active participant on two major committees whose focus is the promotion of access to health care. The first, MaineCare Benefits for Members Under 21 Committee, meets periodically and is comprised of staff from the Bureau of Medical Services and Bureau of Health child-related programs such as: WIC, Public Health Nursing, Oral Health, and the Teen and Young Adult Health. The purpose of the group is to coordinate outreach and planning activities for promoting access to services across all programs. The second group, the Managed Care Implementation Task Force, is comprised of staff from the Bureau of Medical Services, Bureau of Family Independence, Bureau of Health and various advocacy groups within the State. The primary focus of the task force is on implementation of MaineCare managed care as well as other service delivery issues.

The SCHIP coordinator is also a participant on the Steering Committee and Statewide Coalition for the Robert Wood Johnson Covering Kids and Families Outreach Campaign. The Covering Kids and Families grantee in Maine is the Maine Primary Care Association and its partner agencies, Maine Equal Justice Partners, and Consumers for Affordable Health Care. The Steering Committee meets 6-8 times per year and provides overall direction to the Covering Kids and Families Outreach Campaign. The Statewide Coalition meets 3 times a year. The Coalition meetings are an opportunity for Coalition members to alert other members as to events taking place within the State, for local groups to apprise the group on activities occurring in their particular areas and for the group to discuss recommendations for future activities.

Section 3. Methods of Delivery and Utilization Controls (Section 2102)(a)(4))

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 4.