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36 services, and whether the State uses the same application form for Medicaid and/or other public benefit programs. (Section 2102)(b)(2)) (42CFR, 457.350)

CA RESPONSE:

The state’s eligibility and enrollment processes operate in a manner consistent with the requirements of 42 CFR 457, subpart C. These processes are applied at the time of initial application and at redetermination, and ensure that eligible targeted low-income children are identified and appropriately enrolled in the California separate CHIP programs. California determines whether children are eligible for Medicaid (no-cost Medi-Cal) or other CHIP programs via the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS). CalHEERS is a computer system that contains California’s Single Streamlined Application, which can be used for both CHIP and the OTLICP, as well as other Medicaid populations. California’s Single Streamlined Application is consistent with ACA requirements.

DHCS and the county programs are responsible for reviewing eligibility determinations and establishing continued enrollment.

Please also reference the approved CS15 template.

Guidance: The box below should be checked as related to children and pregnant women. Please note: A State providing dental-only supplemental coverage may not have a waiting list or limit eligibility in any way.

4.3.1. Limitation on Enrollment Describe the processes, if any, that a State will use for instituting enrollment caps, establishing waiting lists, and deciding which children will be given priority for enrollment. If this section does not apply to your state, check the box below. (Section 2102(b)(2)) (42CFR, 457.305(b))

Check here if this section does not apply to your State.

Guidance: Note that for purposes of presumptive eligibility, States do not need to verify the

citizenship status of the child. States electing this option should indicate so in the

State plan. (42 CFR 457.355)

If DHCS determines that sufficient funds are not available to cover the estimated cost of program expenditures and it is necessary to limit enrollment, DHCS will place children on a waiting list until adequate funding becomes available to resume enrollment. This determination will be made in a public meeting, pursuant to State law. DHCS will notify the Center for Medicare and Medicaid Services prior to implementation of a waiting list in writing (by email, fax, letter or other appropriate means).