Children's Health Insurance Program

To provide funds to States to enable them to maintain and expand child health assistance to uninsured, low¬ income children, and at a state option, low-income pregnant women and legal immigrants, primarily by three methods: (1) obtain health insurance coverage that meets the requirements in Section 2103

credit:
relating to the amount, duration, and scope of benefits; (2) expand eligibility for children under the State's Medicaid program; and (3)reduce the number of children eligible for Medicaid, CHIP and insurance affordability programs under the ACA, who are not enrolled and improve retention of those who are already enrolled..

This solicitation addresses the third objective and seeks applications for the Connecting Kids to Coverage Outreach and Enrollment Grants Focused on Increasing Enrollment of eligible children, as provided under the Section 2113 of the Social Security Act, amended by section 303of the MACRA.

A total of $29,800,000 million is available for grants to eligible entities, including states, local governments, schools, health care providers, community-based, non-profit organizations and Indian tribes or tribal consortiums, tribal organizations, urban Indian organizations receiving funds under title V of the Indian Health Care Improvement Act (25 U.S.C.

1651 et seq.), Indian Health Service providers; to the extent that a cooperative agreement awarded to such an entity is consistent with the requirements of Section 1955 of the Public Health Service Act (42 U.S.C.

300x-65) relating to a grant award to nongovernmental entities; and/or elementary or secondary schools.

These grants will support outreach strategies aimed at increasing enrollment of eligible children in Medicaid and the Children?s Health Insurance Program (CHIP), emphasizing activities tailored to communities where eligible children and families reside and enlisting community leaders and programs that serve eligible children and families.

They also will fund activities designed to help families understand new application procedures and health coverage
opportunities, including Medicaid, CHIP and insurance affordability programs under the ACA.

Refer to the funding opportunity announcement (Agency Funding Opportunity Number: CMS-XXX-XX-XXX, Competition ID Number: CMS-XXX-XX-XXX-XXXXXX) for additional information.

In addition the Centers for Medicare & Medicaid Services (CMS) will also be announcing a separate FOA exclusively for Indian health care providers and tribal entities under which $3.7 million will be made available for outreach and enrollment cooperative agreements.

Indian health care providers and tribal entities are permitted to apply for either or both funding opportunities as long as the work described is different in each proposal.

Agency - Department of Health and Human Services

The Department of Health and Human Services is the Federal government's principal agency for protecting the health of all Americans and providing essential human services, especially to those who are least able to help themselves.

Office - See Regional Agency Offices.

Contact the Regional Administrator, Centers for Medicare and Medicaid Services.

(See Appendix IV of the Catalog for addresses and telephone numbers).
Website Address

http://www.cms.gov


Relevant Nonprofit Program Categories





Selected Recipients for this Program


RecipientAmount Start DateEnd Date
Social And Health Services, Washington State Department Of $ 109,653,296   2018-10-012019-09-30
Department Of Public Health-d Iv. Of Ph $ 7,510,781   2018-10-012019-09-30
Medical Assistance Services, Virginia Department Of $ 548,706,002   2018-10-012019-09-30
Health And Hospitals, Louisiana Department Of $ 270,705,333   2018-10-012019-09-30
Government Of Guam- Department Of Administration $ 24,844,116   2018-10-012019-09-30
American Samoa Medicaid Agency $ 3,451,226   2018-10-012019-09-30
Indiana Family And Social Services Administration $ 193,532,667   2018-10-012019-09-30
Greater Flint Health Coalition $ 300,000   2016-09-282019-09-27
Native American Community Health Center, Inc. $ 452,490   2017-07-012019-06-30
Choctaw Nation Of Oklahoma $ 394,580   2017-07-012019-06-30



Program Accomplishments

Not Applicable.

Uses and Use Restrictions

No State is eligible for payments for child health assistance for coverage provided prior to October 1, 1997.

Standards used to determine eligibility may include those related to geographic areas to be served by the plan.

Age, income and resources, residency, disability status (as long as the standard does not restrict eligibility), access to or coverage under other health coverage, and duration of eligibility are factors.

Standards may not discriminate on the basis of diagnosis.

Eligibility standards must not cover higher-income children without covering lower-income children, and must not deny eligibility based on a child having a pre-existing medical condition.

The State must ensure that only targeted low-income children are furnished child health assistance under the plan.

Children found through screening to be eligible for Medicaid are to be enrolled in Medicaid.

The insurance provided using Federal funds under the State plan does may not substitute for coverage under group health plans.

Coordination with other public and private programs providing creditable coverage for low-income children should occur.

Child Health Assistance (other than Medicaid), must consist of any of the following: Benchmark coverage; benchmark equivalent coverage (which can be FEHBP-equivalent coverage); State employee coverage or coverage offered through the HMO with the largest insured commercial non-Medicaid enrollment in the State; existing comprehensive State-based coverage; or Secretary-approved coverage.

A State child health plan must include a description of the amount (if any) of cost-sharing and must be in accordance with a public schedule.

Cost-sharing may be varied in a way that does not favor higher-income children over lower-income children.

No cost-sharing is permitted for well-baby and well-child care, including age-appropriate immunizations.

Cost-sharing for children at 150 percent of poverty must be consistent with Medicaid; Cost-sharing for children at 150 percent of poverty and above must be based on an income-related sliding scale.

The aggregate cost sharing for all children in a family cannot exceed 5 percent of the family's income.

The State child health plan may not impose pre-existing condition exclusions for covered benefits.

Funds provided to a State under this Title may only be used to carry out the purposes of this Title.

Health insurance coverage provided may include coverage of abortion only if necessary to save the life of the mother or if the pregnancy is the result of an act of rape or incest.

States may spend up to 10 percent of their total CHIP expenditures (Federal and State) on non-benefit activities, including: outreach conducted to identify and enroll eligible children in CHIP; administration costs; health services initiatives; and other child health assistance.

These expenditures are matched at the enhanced CHIP matching rate and counted against both the 10 percent limit and the allotment.

Monetary amounts provided by the Federal government or services assisted or subsidized to any extent by the Federal government, may not be included in determining the amount of nonfederal contributions required for State matching purposes.

All Connecting Kids to Coverage- awardees must adhere to all HHS terms and conditions regarding uses and exclusions of funds.

All awardees will receive this information in their award packages.

Eligibility Requirements

Applicant Eligibility

States with an approved child health plan under this title [42 U.S.C.

Section1397aa et seq.];local governments; Indian tribes or tribal consortium, tribal organizations, urban Indian organizations receiving funds under title V of the Indian Health Care Improvement Act (25 U.S.C.

1651 et seq.), or Indian Health Service providers; federal health safety net organizations;national, state, local, or community-based public or nonprofit private organizations, including organizations that use community health workers or community-based doula programs; faith-based organizations or consortia, to the extent that a cooperative agreement awarded to such an entity is consistent with the requirements of Section 1955 of the Public Health Service Act (42 U.S.C.

300x-65) relating to a grant award to nongovernmental entities; and/or elementary or secondary schools may apply.

For eligibility requirements the Connecting Kids to Coverage project grants, refer to the funding opportunity announcement (Agency Funding Opportunity Number: CMS-XXX-XX-XXX, Competition ID Number: CMS-XXX-XX-XXX-XXXXXX) for additional information.

Beneficiary Eligibility

Targeted low-income children will benefit. These children are defined (for the purposes of Title XXI) as children who have been determined eligible by the State for child health assistance under their State plan; are low-income children as defined by each state and are not found to be covered under a group health plan or under other health insurance coverage.

Credentials/Documentation

States and Territories must submit and have approved by the Secretary of DHHS, a State Child Health Plan. Individuals must meet State requirements. 2 CFR 200, Subpart E - Cost Principles applies to this program.

Aplication and Award Process

Preapplication Coordination

For the Connecting Kids to Coverage- project grants' application and award process, refer to the funding opportunity announcement (Agency Funding Opportunity Number: CMS-XXX-XX-XXX, Competition ID Number: CMS-XXX-XX-XXX-XXXXXX) for additional information.

Environmental impact information is not required for this program.

This program is excluded from coverage under E.O.

12372.

Environmental impact information is not required for this program.

This program is excluded from coverage under E.O.

12372.

Environmental impact information is not required for this program.

This program is excluded from coverage under E.O.

12372.

Application Procedures

This program is excluded from coverage under 2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. This program is excluded from coverage under 2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. This program is excluded from coverage under OMB Circular No. A-102. This program is excluded from coverage under OMB Circular No. A-110. Title XXI plans and amendments are submitted by the State Governor, or designee, to the CMS Center for Medicaid and CHIP Services; Children and Adults Health Programs Group (CMCS/CAHPG). The Title XXI plan should be a stand alone document that fully addresses each relevant Section of the statutory requirements.

Award Procedures

The CMS Administrator exercises delegated authority to approve Title XXI plans and amendments. Letters of approval will be signed by the CMS Administrator.

Deadlines

Contact the headquarters or regional office, as appropriate, for application deadlines.

Authorization

Title XXI of the Social Security Act as amended by the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA; Public Law 111-003), the Affordable Care Act (ACA; Public Law 111-148 taken together with Public Law 111-152) and the Medicare Access and CHIP Reauthorization Act (MACRA) (Public Law 114-10).

Range of Approval/Disapproval Time

Section 2106 of the Law, specifies that a State plan is considered approved unless the Secretary notifies the State in writing, within 90 days after receipt of the plan, that the plan is disapproved (and the reasons for disapproval) or that specific additional information is needed. Informal clarification and discussion between the State and the DHHS review team is permitted and encouraged during the review period. This does not stop the '90-day clock.' The 90-day review period may be stopped by formal written requests for additional information and clarification. The 90-day review period may be stopped as many times as necessary to obtain completed information necessary to disapprove or approve the plan. The 90-day period will resume when the finalized additional information is received by CMS.

Appeals

If a State wishes to appeal a disapproval, it may petition for a reconsideration of this decision within 60 days after the date of receipt of the disapproval letter, by submitting a written request for reconsideration to the project officer and the regional office. States also have the option to submit a new application following the disapproval, starting a new 90-day review clock.

Renewals

An approved State child health plan shall continue in effect unless the State amends that plan or the Secretary finds substantial noncompliance of the plan in accordance with the requirements of Title XXI.

Assistance Considerations

Formula and Matching Requirements

Statutory Formula: Matching Requirements: Statutory Formula: The Connecting Kids to Coverage project grant program has no statutory formula. Matching Requirements: The Connecting Kids to Coverage project grant program has no matching requirements. This program has MOE requirements, see funding agency for further details. This program has MOE requirements, see finding agency for further details.

Length and Time Phasing of Assistance

Federal funds are obligated to the Connecting Kids to Coverage grantees by issuing grant awards. To ensure that all of the appropriated funds are available to States, CMS will issue cooperative grant awards for one year from the award date to all grantees selected. Awardees must meet all reporting deadlines and demonstrate strong performance to be eligible for a non-competing continuation award for subsequent budget periods. Method of awarding/releasing assistance: lump sum.

Post Assistance Requirements

Reports

No program reports are required.

No cash reports are required.

For the Connecting Kids to Coverage Outreach and Enrollment Grants, the following reports are required: Semi- Annual and a Final Progress Report with templates for grantee performance monitoring are provided by the evaluation contractor. Federal Financial Reports (FFR) report cash transaction data, expenditures, and any program income generated on a quarterly basis.

No expenditure reports are required.

No performance monitoring is required.

Audits

In accordance with the provisions of 2 CFR 200, Subpart F - Audit Requirements, non-Federal entities that expend financial assistance of $750,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Non-Federal entities that expend less than $750,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in 2 CFR 200.503. In accordance with the provisions of 2 CFR 200, Subpart F - Audit Requirements, non-Federal entities that expend financial assistance of $750,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Non-Federal entities that expend less than $750,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in 2 CFR 200.503.

Records

Grantees must include an assurance that they will collect and verify application and enrollment data as an important measure of program performance, in order to enable the Secretary to monitor grant program administration and compliance and to evaluate and compare the effectiveness of awardees.

Financial Information

Account Identification

75-0515-0-1-551.

Obigations

(Formula Grants (Apportionments)) FY 16 $13,958,271,478; FY 17 est $15,952,148,232; and FY 18 est $13,196,032,376

Range and Average of Financial Assistance

For the Connecting Kids to Coverage Cooperative Agreements, the projected awards will range from ($250,000 up to $1,000,000). FY 2017, the range is from $2,901,936 (American Samoa) to $2,668,626,138 (California). .

Regulations, Guidelines, and Literature

Regulations and guidance issued related to the Children's Health Insurance Program may be accessed through the World Wide Web at: www.medicaid.gov.

Information Contacts

Regional or Local Office

See Regional Agency Offices. Contact the Regional Administrator, Centers for Medicare and Medicaid Services. (See Appendix IV of the Catalog for addresses and telephone numbers).

Headquarters Office

Center for Medicaid and CHIP Services 7500 Security Boulevard, Baltimore, Maryland 21244 Phone: (410) 786-3870.

Criteria for Selecting Proposals

Not Applicable.



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