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Items in this list may be obtained from the sources cited. Contact information reflects the most current data about the source that has been provided to the MCH Digital Library.

Displaying records 1 through 20 (22 total).

Gross BJ, Turner W, Machledt D. 2018. Advocate's guide to MAGI (upd.). Washington, DC: National Health Law Program, 95 pp., plus appendices.

Annotation: This document describes the modified adjusted gross income (MAGI) methodology for evaluating eligibility for health care affordability program applicants and enrollees. It also provides guidance on implementing and governing the methodology. Topics include Medicaid and Children's Health Insurance Program (CHIP) populations and eligibility categories subject or exempted from MAGI, determination of countable income, household composition in the marketplace vs. Medicaid/CHIP, household scenarios, MAGI conversion for Medicaid and CHIP, state options for the transition to MAGI-based eligibility systems, and MAGI and the single streamlined application. An accompanying webinar, The World According to MAGI, covers the ins-and-outs of the rules by working through hypothetical family scenarios.

Contact: National Health Law Program, 1441 I Street, N.W., Suite 1105, Washington, DC 20005, Telephone: (202) 289-7724 E-mail: [email protected] Web Site: http://www.healthlaw.org Available from the website.

Keywords: Applications, Children, Eligibility determination, Families, Family income, Federal initiatives, Health care reform, Health insurance, Patient Protection and Affordable Care Act, State programs

Families USA and Children's Dental Health Project. 2014. Buying children's dental coverage through the marketplace. Washington, DC: Families USA, 7 pp. (What you need to know about health insurance)

Annotation: This guide for families uses frequently asked questions to explain the children’s dental benefit (a provision of the Affordable Care Act) and how it works. Topics include guidance on buying coverage through a state marketplace, eligibility, covered services, the difference between dental coverage sold separately vs. as part of a medical plan, premiums, deductibles, copayments, co-insurance, out-of-pocket limits, and consumer protections. Information on financial assistance, coverage requirements, and buying coverage for adults is also included.

Contact: Families USA, 1225 New York Avenue, N.W., Suite 800, Washington, DC 20005, Telephone: (202) 628-3030 Fax: (202) 347-2417 E-mail: [email protected] Web Site: http://www.familiesusa.org Available from the website.

Keywords: Children, Consumer education materials, Consumer protection, Costs, Dental insurance, Eligibility determination, Families, Financing, Health care reform, Oral health, Patient Protection and Affordable Care Act, State programs

Baudouin K, Weiss A, Hensley-Quinn M. . 2014. Paving the way to simpler: Experience from maximizing enrollment states in streamlining eligibility and enrollment. Portland, OR: National Academy for State Health Policy, 25 pp. (A maximizing enrollment report)

U.S. Government Accountability Office. 2013. WIC program: Improved oversight of income eligibility determination needed. Washington, DC: U.S. Government Accountability Office, 24 pp.

Annotation: This report describes a study on the determination of income eligibility for recipients of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program. Included in the report are answers to the following questions: (1) How do state and local criteria for determining WIC income eligibility vary? (2) To what extent are individuals who would otherwise be ineligible for WIC deemed eligible due to their participation in other programs? (3) How does the U.S. Department of Agriculture (USDA) assist and monitor state determination of WIC income eligibility? The report is based on the Government Accountability Office's (GAO's) review of federal laws and regulations; an analysis of USDA's national data from 2010, recent survey findings, and monitoring reports; reviews of WIC policy manuals from 10 states chosen to provide population size and geographic diversity; and interviews with federal, state, and local officials. Recommendations based on GAO's findings are included in the report.

Contact: U.S. Government Accountability Office, 441 G Street, N.W., Washington, DC 20548, Telephone: (202) 512-3000 E-mail: [email protected] Web Site: http://www.gao.gov Available from the website. Document Number: GAO-13-290.

Keywords: Accountability, Child nutrition, Eligibility determination, Infant nutrition, Maternal nutrition, Reports, Supplemental food programs, WIC Program

Levin M, Neuberger Z. 2013. Community eligibility: Making high-poverty schools hunger free. Washington, DC: Food Action and Research Center, Center on Budget and Policy Priorities, 38 pp.

Annotation: This paper provides information on the concept of community eligibility in making it easier for low-income children in high-poverty schools to get free meals. It describes how community eligibility works, presents data on its impact, and lists resources on best practices for implementing the option.

Contact: Food Research and Action Center, 1875 Connecticut Avenue, N.W., Suite 540, Washington, DC 20009, Telephone: (202) 986-2200 Fax: (202) 986-2525 Web Site: http://www.frac.org/ Available from the website.

Keywords: Child nutrition, Children, Community role, Eligibility determination, Hunger, Low income groups, School breakfast programs, School lunch programs

Dorn S, Isaacs S, Minton S, Huber E, Johnson P, Buettgens M, Wheaton L. 2013. Overlapping eligibility and enrollment: Human services and health programs under the Affordable Care Act. Washington, DC: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, 51 pp.

Annotation: This paper investigates opportunities for program integration and coordination in states that implement Medicaid expansion. The analysis shows how human services programs could benefit from linkages with insurance affordability programs and how health programs could benefit from linkages with human services programs. The appendices provide a framework for analyzing strategies that link programs to facilitate eligibility determination, enrollment, and retention; a program-by-program comparison of eligibility requirements and methods; a description of the microsimulation methodology; and additional results.

Contact: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Hubert H. Humphrey Building, 200 Independence Avenue, S.W., Room 415 F, Washington, DC 20201, Web Site: http://aspe.hhs.gov Available from the website.

Keywords: Data linkages, Eligibility determination, Enrollment, Health care reform, Health insurance, Patient Protection and Affordable Care Act, Program coordination, Retention, State programs

Mathematica Policy Research, Urban Institute, Health Management Associates. 2013. CHIPRA mandated evaluation of express lane eligibility: Final findings. Princeton, NJ: Mathematica Policy Research, 174 pp.

Annotation: This final report to Congress provides results of an examination of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) provision for express lane eligibility (ELE). It describes how ELE was implemented in eight states, its impact on enrollment, trends in enrollment and renewal, services used for ELE children compared to children enrolled through the traditional processes, key cross-state lessons learned, and other enrollment and renewal simplifications adopted in other states.

Contact: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Hubert H. Humphrey Building, 200 Independence Avenue, S.W., Room 415 F, Washington, DC 20201, Web Site: http://aspe.hhs.gov Available from the website.

Keywords: Access to health care, Children', Eligibility, Eligibility, Eligibility determination, Expanded eligibility, Legislation, Medicaid, Program evaluation, s Health Insurance Program

Hoag S, Orzol S, Colby M, Swinburn A, Blavin F, Kenney GM, Huntress M. 2012. CHIPRA mandated evaluation of express lane eligibility: First year findings-Final report. Princeton, NJ: Mathematica Policy Research, 88 pp.

Annotation: This report is the first of two reports that will fulfill a mandate for a comprehensive, independent, and rigorous evaluation of Express Lane Eligibility (ELE). ELE is a policy whereby a state's Medicaid and/or Children's Health Insurance Program can rely on another agency's eligibility findings to qualify children for public health coverage, despite their different methods of assessing income or determining eligibility. The report (1) describes exisiting ELE programs, including the costs and new enrollment trends associated with ELE implementation, (2) estimates the impact of ELE adoption on total enrollment, and (3) previews the issue that will be examined through future evaluation activities and presented in the final evaluation report, due to Congress in September 2013.

Contact: Mathematica , P.O. Box 2393, Princeton, NJ 08543-2393, Telephone: (609) 799-3535 Fax: (609) 799-0005 E-mail: [email protected] Web Site: http://www.mathematica-mpr.com Available from the website.

Keywords: Access to health care, Children', Eligibility, Eligibility, Eligibility determination, Expanded eligibility, Legislation, Medicaid, Program evaluation, s Health Insurance Program

Rosenbaum S. 2008. Medicaid portability in the context of oral health care for Head Start-enrolled children in migrant farmworker families. Washington, DC: George Washington University, School of Public Health and Health Services, 10 pp.

Annotation: This analysis examines opportunities and challenges in addressing Medicaid eligibility and enrollment for children of migrant and seasonal farmworkers. It examines Medicaid portability, that is, the ability of Medicaid to follow children from one state to another. The analysis presents an overview of Medicaid eligibility and enrollment and approaches to increasing Medicaid enrollment and portability for children in Migrant and Seasonal Head Start programs, using Head Start programs as a mechanism for identifying and enrolling children in Medicaid. [Funded by the Maternal and Child Health Bureau]

Contact: National Maternal and Child Oral Health Resource Center, Georgetown University, Washington, DC 20057, E-mail: [email protected] Web Site: https://www.mchoralhealth.org Available from the website.

Keywords: Access to health care, Child health services, Eligibility determination, Enrollment, Farm workers, Head Start, Medicaid, Migrant health programs, Migrants, Oral health, Young children

Burghardt J, Gleason P, Sinclair M, Cohen R, Hulsey L, Milliner-Waddell J. 2004. Evaluation of the National School Lunch Program Application/Verification Pilot Projects: Volume I—Impacts on deterrence, barriers, and accuracy. Princeton, NJ: Mathematica Policy Research, 96 pp.

Annotation: This report, the first of two volumes, presents the results of an evaluation of two approaches tested in the National School Lunch Program Application/Verification Pilot Projects. Topics include the impacts of upfront documentation and graduated verification methods on deterrence of ineligible families, barriers for eligible families, and accuracy among certified students in school lunch programs. The report, which includes an executive summary and a summary of findings, is divided into the following sections: (1) study background, (2) characteristics of the pilot and comparison districts, and (3) impacts of the pilot project. Statistical information is presented in figures and tables throughout the report. The report concludes with a list of references.

Contact: Mathematica , P.O. Box 2393, Princeton, NJ 08543-2393, Telephone: (609) 799-3535 Fax: (609) 799-0005 E-mail: [email protected] Web Site: http://www.mathematica-mpr.com $8.25, plus shipping and handling; also available from the website.

Keywords: Barriers, Child nutrition programs, Data, Eligibility determination, National programs, Pilot projects, Program evaluation, School food services, School lunch programs

Hill I, Lutzky AW. 2003. Getting in, not getting in, and why: Understanding SCHIP enrollment. Washington, DC: Urban Institute, 25 pp. (Assessing the new federalism occasional paper; no. 66)

Annotation: This report discusses state efforts to enroll and retain children in the State Children's Health Insurance Program (SCHIP). The report identifies important challenges states have faced, explores the availability of data to analyze these issues, provides initial analysis of the effects of alternative policies and implementation strategies, and raises further questions for study. Section topics include findings related to SCHIP enrollment processes and application outcomes, and their implications on future federal and state SCHIP policies. The appendix describes the limitations of state data and data systems. Statistical tables are presented throughout the report and endnotes are also provided.

Contact: Urban Institute, 500 L'Enfant Plaza, SW, Washington, DC 20024, E-mail: https://www.urban.org/about/contact-us Web Site: http://www.urban.org Available at no charge; also available from the website.

Keywords: Eligibility determination, Enrollment, Program evaluation, State children', s health insurance program

Schwalberg R, Mathis SA, Giffen M, Mohamadi L, Zimmerman B, Sines E. [2001]. Medicaid coverage of perinatal services: Results of a national survey. Menlo Park, CA: Henry J. Kaiser Family Foundation, 61 pp.

Annotation: This report, based on a national survey of state Medicaid programs, documents state policies on coverage of perinatal care. Topics include Medicaid services and eligibility, perinatal services and Medicaid managed care, payment and financial issues, and monitoring access and availability. It also summarizes the respondents' perspectives. Tables presenting data on individual states' Medicaid policies and statistics on perinatal services are included throughout the report. A list of references is provided.

Contact: Henry J. Kaiser Family Foundation, 2400 Sand Hill Road, Menlo Park, CA 94025, Telephone: (650) 854-9400 Secondary Telephone: (202) 347-5270 Fax: (650) 854-4800 Web Site: http://www.kff.org Available at no charge; also available from the website.

Keywords: Access to health care, Eligibility determination, Health care financing, Low income groups, Managed care, Medicaid, National surveys, Perinatal services, Provider participation

Children's Partnership and Kaiser Commission on Medicaid and the Uninsured. 2000. Putting express lane eligibility into practice: A briefing book and guide for enrolling uninsured children who received other public benefits into Medicaid and CHIP. Santa Monica, CA: Children's Partnership; Washington, DC: Kaiser Commission on Medicaid and the Uninsured, 60 pp.

Ross DC, Cox L. 2000. Making it simple: Medicaid for children and CHIP income eligibility guidelines and enrollment procedures—Findings from a 50-state survey. Washington, DC: Kaiser Commission on Medicaid and the Uninsured, 34 pp.

Annotation: This report describes the strategies states were using as of July 2000 to increase health insurance coverage for children through Medicaid and SCHIP-financed separate programs. This report includes state-by-state tables presenting information on selected child health coverage program features for every state and the District of Columbia. The tables include income eligibility guidelines and selected simplification and redetermination strategies, adopted as of July 2000. Additional sections discuss why simplification matters; why program alignment matters; policy implications; notes; and explanation of terms.

Contact: Kaiser Program on Medicaid and the Uninsured, 1330 G Street, N.W., Washington, DC 20005, Telephone: (202) 347-5270 Fax: (202) 347-5274 E-mail: http://www.kff.org/about/contact.cfm Web Site: http://kff.org/about-kaiser-commission-on-medicaid-and-the-uninsured/ Available from the website.

Keywords: Access to health care, Eligibility determination, Enrollment, Medicaid, National surveys, Program descriptions, State Children', State programs, s Health Insurance Program

Nicholson K. 1999. Retention and reenrollment of children in SCHIP and Medicaid. Washington, DC: National Governors' Association Center for Best Practices, Health Policy Studies Division, 8 pp. (Issue brief)

Annotation: This report summarizes the findings of a meeting convened in 1999 by the National Governors' Association Center for Best Practices. Attendees were representatives from states with stand-alone State Childrens Health Insurance Programs (SCHIP). The meeting topic was challenges and successes in re-enrollment and eligibility determination. [Funded by the Maternal and Child Health Bureau]

Contact: National Governors Association, 444 North Capitol Street, Suite 267, Washington, DC 20001-1512, Telephone: (202) 624-5300 Secondary Telephone: Contact Phone: (202) 624-3644 E-mail: [email protected] Contact E-mail: [email protected] Web Site: http://www.nga.org Available at no charge; also available from the website.

Keywords: Children, Eligibility determination, Enrollment, Medicaid, State Children', State programs, s Health Insurance Program

Clark J, Manes J. 1998-. The advocate's guide to SSI for children: A manual for working with the laws, regulations, policies and procedures governing children's eligibility for Supplemental Security Income. (3rd. ed.). Washington, DC: Mental Health Law Project, ca. 300 pp.

Annotation: This manual is designed to help families, disability advocates, and others learn about the Supplemental Security Income (SSI) program and how it can help children who have mental and physical disabilities. After a general overview of SSI in part one, the next two sections examine how the Social Security Administration (SSA) decides if a child meets the fundamental criteria of financial eligibility and disability. Two more sections discuss what occurs after SSA's decision, whether denial or award of benefits. Part six looks at the Sullivan v. Zebley decision, both how to apply for back benefits under it and what they will mean to a family receiving other public benefits. Finally, part seven offers an overview of other benefits and resources for which children with disabilities may qualify. The manual includes a set of fact sheets that summarizes the key topics discussed in the guide.

Contact: Judge David L. Bazelon Center for Mental Health Law, 1101 15th Street, N.W., Suite 1212, Washington, DC 20005, Telephone: (202) 467-5730 Secondary Telephone: (202) 467-4232 Fax: (202) 223-0409 E-mail: [email protected] Web Site: http://www.bazelon.org Available in libraries.

Keywords: Children with special health care needs, Disability evaluation, Eligibility determination, Supplemental Security Income

National Association of Child Advocates and Families USA. 1998. Good ideas from state plans: State child health plan provisions that can benefit children. (Rev. ed.). [Washington, DC]: Families USA, 19 pp.

Annotation: This document highlights decisions made by states in developing their Children's Health Insurance Programs. It presents information about eligibility criteria, benefit packages, access-to-care issues, cost-sharing requirements, outreach and enrollment, coordination with Medicaid, crowd-out concerns, and family coverage. For each decision, the document identifies one or more states implementing or proposing to implement that approach, briefly describes the policy decision made by the state(s), and supplies, in many cases, relevant language from state child health plans or authorizing legislation that can provide a model for advocates in other states.

Contact: Families USA, 1225 New York Avenue, N.W., Suite 800, Washington, DC 20005, Telephone: (202) 628-3030 Contact Phone: (202) 628-3030 Fax: (202) 347-2417 E-mail: [email protected] Contact E-mail: [email protected] Web Site: http://www.familiesusa.org

Keywords: Access to health care, Cost sharing, Eligibility determination, Enrollment, Medicaid, Outreach, State Children', s Health Insurance Program

National Governors' Association. 1997. State [Medicaid] coverage of pregnant women and children. Washington, DC: National Governors' Association, semi-annual. (MCH Update)

Annotation: These periodic reports focus on current state activities to broaden Medicaid coverage to pregnant women and children. Included are descriptions and tables on: raising income eligibility thresholds; streamlining eligibility programs; improving provider participation; implementing Medicaid managed care programs; and enhancing prenatal care services. [Funded by the Maternal and Child Health Bureau]

Contact: National Governors Association, 444 North Capitol Street, Suite 267, Washington, DC 20001-1512, Telephone: (202) 624-5300 Secondary Telephone: E-mail: [email protected] Web Site: http://www.nga.org Available from the website.

Keywords: Child health services, Eligibility determination, Expanded eligibility, Infant health services, Medicaid, Prenatal care, Provider participation, State MCH programs, State health care reform

Aron LY, Loprest PJ, Steurle E. 1996. Serving children with disabilities: A systematic look at the programs. Washington, DC: Urban Institute Press, 182 pp.

Annotation: This book provides a comprehensive accounting of public expenditures on children and families. It compares expenditures across all the major programs. It develops guiding principles about how to allocate resources in order to simplify programs, integrate efforts and find more cost-effective ways to respond to families' and children's needs.

Contact: University Press of America, 4501 Forbes Boulevard, Suite 200, Lanham, MD 20706, Telephone: (410) 459-3366 Secondary Telephone: (800) 462-6420 Web Site: http://www.univpress.com Available in libraries. Document Number: ISBN 0-87766-651-2, paper; 0-87766-650-4, cloth.

Keywords: CSHCN programs, Children with developmental disabilities, Children with special health care needs, Eligibility determination, Entitlements, Head Start, Program coordination, Program evaluation, Special education, Statistics, Supplemental Security Income

National Academy of Sciences, Institute of Medicine, Food and Nutrition Board, Committee on Scientific Evaluation of WIC Nutrition Risk Criteria. 1996. WIC nutrition risk criteria: A scientific assessment. Washington, DC: National Academy Press, 377 pp.

Annotation: This report analyzes the nutritional risk assessment criteria used to determine eligibility and priority for WIC. The report evaluates whether the criteria identify most people who are at risk and target those whom the program can help best. The report recommends methods for evaluating the need for nutritional help and suggests ways to assign priorities so that both nutritional need and ability to benefit from the program are taken into account.

Contact: National Academies Press, 500 Fifth Street, N.W., Keck 360, Washington, DC 20001, Telephone: (202) 334-3313 Secondary Telephone: (888) 624-8373 Contact Phone: (800) 624-6242 Fax: (202) 334-2451 E-mail: [email protected] Web Site: http://www.nap.edu Available from the website. Document Number: ISBN 0-309-05385-4.

Keywords: Access to health care, Child health, Eligibility determination, Guidelines, Hunger, Infant health, Infant nutrition, Maternal health, Maternal nutrition, Needs assessment, Nutrition assessment, Nutrition policy, Poverty, Risk assessment, WIC Program
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The MCH Digital Library is one of six special collections at Geogetown University, the nation's oldest Jesuit institution of higher education. It is supported in part by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under award number U02MC31613, MCH Advanced Education Policy with an award of $700,000/year. The library is also supported through foundation and univerity funding. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.