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Cutting Through the Maze. Stacey Moody Eligibility Modernization Forum June 2009. Health Coverage for Kids and Families. Welcome to the Maze. Outreach Barriers. Outreach hasn’t reached some families. Outreach. Printed form outdated Doesn’t match online form Confusing language.

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cutting through the maze

Cutting Through the Maze

Stacey Moody

Eligibility Modernization Forum

June 2009

outreach barriers

Outreach Barriers

Outreach hasn’t reached some families


Printed form outdated

Doesn’t match online form

Confusing language

Application assistance unavailable

Application assistance inconsistent

eligibility determination barriers

Eligibility Determination Barriers

Data entry errors

Lost application

Processing delays


CBMS makes incorrect determination

Or sends conflicting notices

Eligibility Determination

Family must appeal to correct technician errors

enrollment barriers

Enrollment Barriers

CBMS and MMIS disconnect


CHP+ kids get “stuck” and are never enrolled in an MCO

Eligibility Determination


renewal barriers

Renewal Barriers

“Statement of Facts” confusing


Coverage dropped for eligible kids

Eligibility Determination



we can start right now

We Can Start Right Now

  • The Top 5
  • Leverage Community Partnerships
  • Simplify and Standardize Income Rules
  • Fix the Computers
  • Get the Data
  • Keep Eligible Kids Covered With Phone / Online Renewals
  • 20 Specific Action Steps
  • 5 Legislative
  • 5 Regulatory
  • 10 Administrative