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Missouri Application for the State Children’s Health Insurance Program Effective Date: 07/01/2011 Approval Date: Bold Italics Added Information Prior Approval Date: 05/01/2009 Strikethrough Deleted Information - 6I - Table 3: Type of Coverage among Insured Missouri Children < 300% FPL

Total Insured Health Insurance: Private Insurance Health Insurance: Employment-Based Insurance Totals

1,463,297

1,351,245

1,021,216

937,014 Below 100%

243,576

212,552 46,899 38,147 100% to below 200%

287,832

248,364

147,768

131,685 200% to below 300%

294,041

270,927

233,645

210,127 300% to below 400%

244,238

234,519

224,371

211,942 400% to below 500%

158,206

152,132

140,453

129,561 500% and above

235,404

232,751

228,080

215,552 Subtotal: < 300% FPL

825,449

731,843

428,312

379,959 Source: U.S. Census Bureau Current Population Survey, Annual Social and Economic Supplement, 2004 through 2006.

2.2 Health Services Initiatives- Describe if the State will use the health services initiative option as allowed at 42 CFR 457.10. If so, describe what services or programs the State is proposing to cover with administrative funds, including the cost of each program, and how it is currently funded (if applicable), also update the budget accordingly. (Section 2105(a)(1)(D)(ii)); (42 CFR 457.10)

Pursuant to Section 2105(a)(1)(D)(ii), Missouri will offer “Health Services Initiatives” under the plan. The Health Services Initiatives will be activities for improving the health of children that are administered by Local Public Health Agencies (LPHAs) and funded by local and state funds. Specific Health Services Initiatives may include the following programs:

Immunization programs

LPHAs provide a vital role in immunizing our children and promoting immunization among hard to reach families and communities. Immunization program costs are operational (staff related) costs only. The vaccines costs for CHIP 2 are funded through the Vaccines for Children (VFC) program, therefore the costs of the vaccines are not included in the CHIP claiming. The immunization program costs claimed under CHIP are net of revenue obtained from billing Medicaid and other insurers for administrative costs. Children enrolled in CHIP 1 are not eligible for vaccines through the VFC program.