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Cost Sharing

• There is no cost sharing.

Coordination between SCHIP and Medicaid

• Both Medicaid and SCHIP programs utilize the same application and eligibility determination process, and are administered by the same agency (DSS). Measures adopted by the State to simplify the enrollment of children in both programs include the development of a three-page application, dropping the requirement for face-to- face interviews, eliminating the assets test, reducing documentation requirements and directing DSS staff to actively participate in program outreach.

Crowd Out Strategy

• An eligibility screening is completed to detect the presence of other insurance coverage. In the State’s separate child health program, children are ineligible if they have been covered by a group health plan in the 3 months immediately preceding the application.

• The State monitors the number of SCHIP applicants who are denied, and the number of SCHIP cases closed, due to existing health insurance. This information describes the extent to which recipients are trying to substitute private health insurance for public assistance and is reported in the SCHIP annual report.

Outreach Activities

• SCHIP outreach in South Dakota was built on the successful outreach strategies already in place for the State’s medical assistance efforts. Outreach in South Dakota includes both statewide and local outreach strategies.

• Statewide outreach strategies include the participation of other programs offered by DSS, other State agencies, and the Indian Health Service. Statewide outreach relies on interagency agreements to facilitate referrals and automated systems for information sharing on potentially eligible children.

• DSS eligibility staff has effectively coordinated local outreach in communities and service areas by establishing connections with local resources to facilitate the identification and enrollment of children. Health care providers, schools, Tribal agencies, and many others, distribute materials, provide applications and information, and assist with enrollment.

• DSS has outreach efforts directed towards the Indian reservation areas of the state to help assure that SCHIP is provided to eligible Indian children. The Indian Health Service currently plays and will continue to play an important role in outreach to targeted, low income Indian children. Applications, enrollment assistance, and Page 3 of 4