By Dave Ranney
KHI News Service
TOPEKA, Feb. 12
On a slow day, the Kansas Family Medical Clearinghouse receives about 400 applications from parents wanting to get their children on Medicaid.
They”re supposed to include documents
birth certificates, for example
that prove the children are U.S. citizens and confirm their identity.
“Very few do,” said Carla Deckert, deputy project manager at the clearinghouse.
There”s a reason they don”t.
The one-page, front-and-back application form doesn”t say anything about including copies of school records or birth certificates.
The documentation requirements are mentioned in an insert that comes with the brochure that includes the application. But they”re not part of the application itself and the insert often is ignored or
not
well read by applicants.
“It is impossible for us to print all of the information on the form without making it multiple pages,” said Megan Ingmire, director of communication at the
Kansas Health Policy Authority.
“We want to keep the application as simple as possible,” Ingmire said, noting that inserts are used to highlight new requirements.
Printing new applications every time the rules change, she said, would be prohibitively expensive.
“The applications are in clinics, schools, doctors” offices, hospitals and SRS access points all across the state,” Ingmire said. “It is easier and more effective for us to send out an insert rather than to recall old forms and send out new ones.”
The health policy authority oversees
Medicaid
, the state”s health insurance program for low-income families.
Effective since July 1, 2006, the new requirements are designed to keep undocumented immigrants from receiving government-funded health care benefits.
Common Confusion
Though help is available through county health departments, charity clinics and welfare offices, most parents fill out the applications on their own.
“They don”t understand how the requirements apply to them,” said Jennine Marrone, a social worker at Community Health Center of Southeast Kansas. “They”ve always been a U.S. citizen, they”ve never had to prove their citizenship before.”
The confusion is hardly unique to Kansas.
“A lot of states use inserts
it”s not unusual at all,” said Donna Ross Cohen, a policy analyst who has
studied the effects of the new requirements for both the Kaiser Family Foundation and the Center for Budget and Policy Priorities.
“States can”t just dump their supply of forms every time there”s a change in policy,” she said. “I only know of one or two states that have revised their hardcopy forms.”
Before July 1, most states promoted online applications and used their respective Web sites to note changes in requirements.
Since the new rules require sending in hard copies of original documents, applying online is no longer practical.
“These are the kinds of things that the new law doesn”t contemplate and that the people who run the actual programs must contemplate,” Ross said.
Access to databases
Rather than sending back the tens of thousands of applications that lack the required documentation, the health policy authority arranged for the clearinghouse to have access to the state”s vital statistics, immunization, public assistance and school enrollment databases.
Before returning an application, clearinghouse workers try to find the required information on their own.
“We”re successful about 80 percent of the time,” Deckert said.
These efforts apply only to children born in Kansas. Clearinghouse workers do not have access to other states” databases.
Parents whose children were born outside Kansas are responsible for obtaining copies of their birth certificates. So, too, are parents of Kansas-born children whose names don”t show up in the state”s vital statistics database.
The search process is often complicated by names listed on an application not matching those on birth certificates.
“On the application, it may say “John Something,” but John isn”t the child”s first name, it”s his middle name,” said Christiane Swartz
, Medicaid operations director at the health policy authority.
Hispanic names, she said, can be especially difficult.
“Hispanic names are double,” she said. “Sometimes (a child) goes by his father”s last name, but his mother”s last name is on the birth certificate. It can be very confusing.”
Better than most
Few states can match Kansas” search efforts.
“You”re not the only state doing all that you”re doing,” Ross said. “But you”re certainly in the group
a relatively small group
of states that are really trying to minimize the burden this is putting on families.”
Dave Ranney is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at
dranney@khi.org
or at 785-233-5443, ext. 128.