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In addition, states may use up to 10 percent of actual or estimated Federal expenditures for targeted low-income children to fund other forms of child health assistance, including contracts with providers for a limited range of direct services; other health services initiatives to improve children’s health; outreach expenditures; and administrative costs (See 2105(c)(2)(A)). Describe which, if any, of these methods will be used.

Examples of the above may include, but are not limited to: direct contracting with school-based health services; direct contracting to provide enabling services; contracts with health centers receiving funds under section 330 of the Public Health Service Act; contracts with hospitals such as those that receive disproportionate share payment adjustments under section 1886(d)(5)(F) or 1923 of the Act; contracts with other hospitals; and contracts with public health clinics receiving Title V funding. If applicable, address how the new arrangements under Title XXI will work with existing service delivery methods, such as regional networks for chronic illness and disability; neonatal care units, or early-intervention programs for at-risk infants, in the delivery and utilization of services. (42CFR 457.490(a))

3.1. Delivery Standards Describe the methods of delivery of the child health assistance using Title XXI funds to targeted low-income children. Include a description of the choice of financing and the methods for assuring delivery of the insurance products and delivery of health care services covered by such products to the enrollees, including any variations. (Section 2102)(a)(4) (42CFR 457.490(a))

CA RESPONSE:

Overview of the Delivery Systems

POPULATION 1/CCHIP: Delivery System. Service delivery in the CCHIP component of California’s separate CHIP exists in three counties and is provided by health plans contracted by each county. These health plans are health maintenance organizations (HMOs) that also contract with DHCS to participate in the CHIP and Medi-Cal Program. Having these same plans available is an asset to families in that they may assume continuity of care should they go from enrollment in CCHIP to other CHIP or Medicaid programs and vice versa.

Administration. CCHIP is administered by the county on behalf of DHCS. The health plans are directly responsible for CCHIP enrollment in the Local Initiative Health Plan (LI) or County Organized Health System (COHS), distribution of written materials including correspondence, billing statements, Evidence of Coverage booklet, and premium collection, etc. DHCS will oversee program activities to assure compliance with federal Title XXI regulations.