Want the quick scoop on the Health4All Kids transition? Below are some quick bullet-point updates to keep you informed about the status of the Health4All kids transition, based on information obtained from CCHI’s partners in the process.
Numbers of Undocumented Children, Identified by Program and County
For county-specific numbers, please download the .xls chart by clicking here.
Healthy Kids Programs
About 83% of HK children were enrolled into Restricted Medi-Cal in preparation for the transition. About 9% still need to transition, and 8% will be over-income.
In San Francisco, Santa Clara, and San Mateo counties, over-income children will remain in Healthy Kids programs. In all other counties, kids will be transitioned to Medi-Cal.
A chart of updated information on Healthy Kids programs can be found here. Yellow-highlighted rows are CHIs with HK programs slated to close in 2016.
Kaiser Child Health Program (KCHP)
About 90% of current KCHP members appear to fall within 0-266% of FPL and will no longer qualify
There are about 5,500 KCHP members who will turn 19 by year end
Members with income at 267-300% of FPL will remain in program as long as they continue to qualify
As of 4/1/2016, stopped enrolling anyone who qualifies for expanded Medi-Cal
Special Enrollment Period (SEP) continues for applicants who qualify
All KCHP members will be allowed to stay in the program until December 31st, 2016 to allow time for MC application process
Kaiser estimates about 70,000 KCHP members will transition to Full Scope Medi-Cal, 50,000 of them to Kaiser Medi-Cal.
Restricted Medi-Cal Transition
The Department of Healthcare Services (DHCS) has issued about 130,000 letters to inform consumers about the expansion of Medi-Cal to individuals under age 19 without satisfactory immigration status but who are otherwise eligible for the program.
CalHEERS changes became active May 15, 2016, with eligibility effective as of May 1, 2016 (assuming implementation of system changes occurs in May; effective eligibility will be pushed back according to when CalHEERS changes).
SB 75 does not implement new aid codes (the DHCS letter includes a crosswalk of aid codes as a reference), nor does it change any requirements to verify citizenship under federal regulations or state law. Counties, however, must not request verification from children who do not claim satisfactory immigration status.
The SB 75 determination and transition does not reset a beneficiary’s annual redetermination date.
Batch process for the aid code switch ran on May 16th said to take a few days—most Restricted Medi-Cal enrollees transitioned automatically.
SAWS will provide a list of cases that were skipped in the initial batch process, this list will be provided on the regularly scheduled exception reports to counties
DHCS will also run data reports from MEDS to identify SB75 individuals who failed to transition this report will be provided on a county by county basis as necessary
About 15% of Restricted Medi-Cal kids did not transition automatically because of errors and pre ACA aid codes in all counties except LA.
In LA county, there was a 52% success rate in transition. It should be at a 65% success rate by June 1st.
Children in MyHealthLA will not be dropped automatically, they will stay on MyHealthLA until transitioned onto Medi-Cal – they have until Dec 31, and then they will be dropped.
MyHealthLA has transitioned 3,000 out of the 10,000 of their kids successfully.
For individuals living in a County Organized Health System (COHS) county, they will be automatically enrolled in the COHS plan on the first of the month following their eligibility determination
Beneficiaries will receive Fee-for-service (FFS) full scope Medi-Cal coverage during the transition month
COHS Letter to Consumers (English)
For new enrollees living in a Non-COHS county, they will receive a Health Care Options (HCO) choice packet. They will have 30 days to choose a plan.
New enrollees will receive FFS Medi-Cal until a plan choice is made
If no plan choice is made, DHCS will assign them to a plan in their county effective the first of the next month
Non-COHS Letter to Consumers (English)
Pre-MAGI Aid Codes – small population requiring “manual work” by county enrollers (about 7% of Restricted Medi-Cal kids transitioning)
These children must provide additional information to be transitioned.
For questions regarding any of this information, please contact email@example.com.