Gayle Lees Sandlin, Director Bureau of Children’s Health Insurance Alabama Department of Public Health Bipartisan Congressional Health Policy Conference.

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Presentation transcript:

Gayle Lees Sandlin, Director Bureau of Children’s Health Insurance Alabama Department of Public Health Bipartisan Congressional Health Policy Conference January 13, 2007 The State Children's Health Insurance Program: Accomplishments and opportunities for Improvement at Renewal

“Devolution” – give states the ability to design a program that best meets the needs of the children while fitting with each state’s environment for: Political climate Insurance market Health care provider system Appropriate agency to administer Eligibility criteria that “fits” the demographics of the State

Insuring Alabama’s Children Since CHIP Phase 1 began in February 1998, the three programs providing health coverage to children in Alabama have seen a net increase of approximately 176,100 enrollees.

States were encouraged to “outreach” and find uninsured children and facilitate enrollment in appropriate program Joint application Find all uninsured children “Seamless” and “family friendly” enrollment and referral processes “Destigmatize” publicly funded insurance Creative use of media and print advertising Use of enrollment brokers Woodwork effect Procedures to keep children insured  12 months continuous coverage  Helpful renewal process

ALL Kids – “Administratively Simple” (Program Issues) Self declaration of eligibility criteria 3 program application Yearly premiums with 12 months to pay Co-pays collected by providers Centralized processing Mail-in application Web-based application Outreach designed to “Teach the People Who Reach the People”

Provide Systems Coordination to assist decentralized Medicaid workers in identifying problems, gaps, miscommunications, etc., that result in barriers to enrollment of children Provide Staff Trainings to offer contact hours for nurses and social workers Attend Meetings and Community Events to educate and distribute information about ALL Kids

Fiscal Issues State funds Capped federal allotment Administrative spending capped at 10%  PERM Enhanced match rate Inability for stand alone programs to flip to Medicaid funding Enrollee cost sharing Premiums Co-pays Max 5% of family income

Payments are manageable and affordable for families 2-4 installments are available Decreases chance of loss or lapse of coverage due to unpaid premiums

Leave no child behind Contact Information Gayle Lees Sandlin, Director Bureau of Children’s Health Insurance Alabama Department of Public Health 201 Monroe Street, Suite 250 Montgomery, AL Phone: 334 – FAX: 334 –