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

Effective Date:

Approval Date: 9 pregnant women can apply for presumptive Medicaid eligibility. Staff from these sites have ongoing communications during the PE process with local office staff and are familiar with Medicaid and how it can be accessed for other family members. These include the state’s two federally qualified health centers (FQHCs) and the two teaching hospitals and several community action agencies. Approximately 2,000 PE applications for pregnant women were completed annually at these qualified provider sites. Regular Medicaid applications are available at most sites.

• Of the 13 presumptive eligibility providers, ten are recipients of Title V/Maternal and Child Health Block Grant funds. Through a Medicaid-MCH partnership, these community-based agencies already conduct outreach to low-income children and pregnant women for Medicaid. In addition, all Title V grantees in Nebraska identify and refer potentially eligible children and pregnant women to the Medicaid program whenever possible. Services for prenatal health care, pediatric primary care, health education, lead screening, and adolescent pregnancy prevention and support are all provided to low- income and other at-risk populations in Nebraska through Title V funds. A large proportion of recipients of these services are identified as uninsured and are provided either the support necessary to pursue health care coverage, or primary health care services and case management paid for by Title V.

• In addition, all Title V grantees in Nebraska are provided state-level support to identify and refer potentially eligible families to the Medicaid program whenever possible. Services for prenatal health care, preventive and primary care for children, health education, lead screening, and adolescent pregnancy prevention and support are all provided to low-income and other at-risk populations in Nebraska through Title V funds. A large proportion of recipients of these services are identified as uninsured and are provided the support necessary to pursue health care coverage.

• Children with special health care needs who do not have health care coverage are often identified through the Medically Handicapped Children’s Program (MHCP), which is Nebraska’s Title V program dedicated specifically to providing specialty and subspecialty services to this population of children. MHCP services are commonly promoted by communities as a means for getting children with special health care needs into the publicly-funded health care system, particularly Medicaid. All children referred to MHCP clinics or services are screened for Medicaid eligibility.

• In addition, the hospitals, schools, and community-based organizations that provide Early Intervention (EI) services to children with special health care needs up to three years of age are an excellent resource for identification and