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76 • Technical assistance by the state American Indian Health Program, Federal Indian Health Services, and tribes in tracking of services to American Indians. • Inclusion of American Indian ethnicity using the federal definition on the application form for tracking purposes. • Training to local American Indian clinic staff for outreach and referral to the program. • Use of the 30 American Indian primary care clinics (which are CHDP providers) to screen low-income youth, provide initial treatment and referral either to Medi-Cal or the appropriate CHIP program. • Implementation of a provision to exempt American Indian and • Alaska Native (AI/AN) families that meet the cost sharing waiver requirements, from monthly premiums and benefit copayments. This exemption is implemented the same in CCHIP as it is in the other CHIP populations. The exemption from premiums will be made at the time of application submission when a family declares AI/AN status consistent with the documentation requirements listed below. The family will have two months to submit the required documentation to continue the premium waiver. If documentation is not submitted within two months from enrollment, premiums will be charged prospectively. When acceptable documentation is submitted, the copayment waiver will also be applied. Acceptable documentation for the applicant or the child includes:

1. An American Indian or Alaskan Native enrollment document from a federally recognized tribe; or 2. A Certificate Degree of Indian Blood (CDIB) from the Bureau of Indian Affairs; or 3. A Certificate of Indian Heritage from an Indian Health Service facility operating in the State of California.

• Education to Certified Application Assistants about the cost sharing exemption for AI/AN families that meet the cost sharing waiver requirements. • CCHIPs will provide the same cost sharing waivers as the other CHIP programs. • CCHIP will include this cost sharing exemption notice in their member handbooks.

8.7. Provide a description of the consequences for an enrollee or applicant who does not pay a charge. (42CFR 457.570 and 457.505(c))