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

Effective Date:

Approval Date: 47 applications, and presumptive eligibility June 22: Jane and Lorelee met with Sherriann Moore, Administrator of the Ponca Health and Wellness Center in Omaha and her staff; they discuss Kids Connection, outreach, applications, and presumptive eligibility. July 20: Jane met with Dr. Hieu and staff at the Shelton Medicaid Clinic in Shelton to discuss Kids Connection and presumptive eligibility

This is not an all-inclusive list; other HHSS staff have also participated in meetings related to Kids Connection that are not listed in this document.

Staff in the Governor’s Policy Research Office have also participated in outside meetings related to Kids Connection. Jennifer Williams Brinkman participated in the following meetings: 9/11-9/12 - National Governor's Association Children's Health Insurance Program Conference in Washington, D.C. 9/19 - Meeting with Senators Chris Butler, Don Wesely and David Landis, Tim Becker, Don Leuenberger, Steve Frederick 11/07 - Commission for the Protection of Children 11/14 - Child Care and Early Childhood Education and Coordinating Committee (CCECECC) 11/17 - Meeting with Randy Boldt of Blue Cross/Blue Shield 11/20 - Head Start State Collaboration Team 1/9 - HHS Regional Conference on Children's Health Insurance Program in Kansas City, MO 2/3 - NGA Title XXI Conference Call 2/17 - Meeting with HHS Representatives and Senator Beutler 3/6 - Meeting with HHS and Senator Beutler 4/30 & 5/1 - NGA Children's Health Conference in Chicago, IL

9.9.1 Describe the process used by the state to ensure interaction with Indian Tribes and organizations in the state on the development and implementation of the procedures required in 42 CFR 457.125. (Section 2107(c)) (42CFR 457.120(c))

Response included in 9.99.9.2 For an amendment relating to eligibility or benefits (including cost sharing and enrollment procedures), please describe how and when prior public notice was provided as required in 457.65(b) through (d).

Response included in 9.9