Getting the Message Out
and Getting Children In!
Boots on the
Ground
School Based
Pilot Project
Miami-Dade County
Public Schools
Who Is Uninsured?
Uninsured Children: A
National Problem
Uninsured Floridian Children
Florida ranks 3rd in U.S. for
the number of uninsured
children.
• 42% of Florida’s children live in
families 200% under FPL
• 40% of these are uninsured
Florida ranks second in the
nation for the percentage of
children in the state without
health insurance.
• 70% of uninsured children are
eligible for CHIP
Myth Busters – Uninsured
Children
Working Families
College Students
Working Poor
Working Mothers
Absenteeism
Health Implications for
Uninsured
30% less likely to
receive medical
attention for injuries
Uninsured
newborns have
lower birth
weights
Less likely to
have regular
medical doctor
No
immunizations
or medical
treatment for
common
childhood
illnesses
Uninsured
newborns higher
rates of
premature
deaths
Delay health
care until in
crisis
Forgo
prescription
medicines
Benefits to Your School
Children
with
insurance
have fewer
preventabl
e diseases.
Insured
children
have
fewer sick
days home
from
school &
parents
are less
absent
from
work.
Quality of
life is
improved
for
children in
the
communit
y.
•
Florida KidCare is Florida's own Child Health
Insurance Program (CHIP).
•
Florida KidCare combines the best of public and
private insurance into one affordable and
comprehensive insurance program for children.
•
There is ONE family friendly application!
•
If a child was previously enrolled in Florida
KidCare, parents may not need to complete a new
application. They can call 1-800-821-5437 for
additional information.
•
12-month continuous coverage for birth through
age 18.
•
A single application for all programs
 English, Spanish, and Creole.
What is Florida KidCare?
Medicaid
CMS
N
MediKid
s
FL Healthy
Kids
Florida
KidCare
MediKids
Full Pay
>200%
Florida Healthy Kids Full Pay > 200%
200
%
Federal Poverty Level
185
%
MediKids
(AHCA)
Florida Healthy Kids
(Title XXI Administration/Enrollment,
3rd Party Administrator Contract)
133
%
100
%
Medicaid for Children
(DCF, Eligibility; AHCA, Program Administration)
Ages
0 to
1
Ages
1 through 4 Age 5
Medicai
d:
Title XIXFunded
Title XXIFunded
Ages 6 through 18
CMS Network
Title XIX and Title
XXI
(Dept. of Health)
Financial Eligibility
Florida Healthy Kids
Florida Healthy Kids Benefits
Office visits for Minor Illness, Accident are (Primary Care Provider)
$5 Co-Pay
Well Child Care
No Co-Pay
Routine Vision and Hearing Screening (Primary Care Provider)
No Co-Pay
Specialist Office Visit (Referred)
$5 Co-Pay
Behavioral Health Services (Pre-authorized, Outpatient - 40 visits per year,
Inpatient/Residential - 30 days per year)
$5 Co-Pay
Substance Abuse Rehabilitation and Treatment (Pre-authorized, 40
No Co-Pay
outpatient visits, 7 inpatient days for detox, 30 residential days)
Diagnostic Testing (Laboratory, X-rays,
No Co-Pay
Emergency Services
$10 Co-Pay
Emergency Ambulance Services
$10 Co-Pay
Hospital Inpatient Medical and Surgical Care (Pre-Authorized, includes 15
day rehabilitation stay for non-acute confinement)
No Co-Pay
Semi-private room
Surgeon Fees (Pre-authorized)
No Co-Pay
Maternity Services and Delivery
No Co-Pay
Children’s Medicaid
Children’s Medical Services CMS
MediKids
BOOTS ON THE GROUND SCHOOL
ACTION PLAN CHECKLIST
1. _______ Designate school liaison by September 2, 2011
2. _______ Direct liaison to create opportunities for parents to learn
about and enroll in Florida KidCare.
3. _______ Have computers available for parents to use for
application enrollment and renewal.
4. _______ Place a link to Florida KidCare on School website:
www.floridakidcare.org
5. _______ Request and display posters in visible areas.
6. _______ Request and place fliers in front office, Parent Resource
Center, health clinic, and student services area.
7. _______ Add Florida KidCare to EESAC Agenda to discuss ways to
increase awareness.
8. _______ Ask PTA and Health Connect teams to partner in this
effort.
9. _______ Request KidCare presence at school/community events.
Communicating with
Families
One-on-one assistance
Easy to understand information
Be sensitive to fear and
mistrust
Keep information shared
confidential
Florida KidCare,
Confidentiality & HIPAA
• HIPPA- The Health Insurance
Portability and Accountability Act
• As a Florida KidCare community
partner families entrust you to
not only help them navigate the
Florida KidCare system but to
keep the information they share
with you confidential and safe.
Florida KidCare, Confidentiality
& HIPAA
Florida KidCare requires a properly
completed Florida Healthy Kids
Release of Information (ROI) be
on file prior to the release of any
account related personal health
information.
Release of Information
(ROI) A ROI form
should be
voluntarily
completed by
application
parent or
guardian.
One ROI must
be properly
completed and on
file for each
enrollee (child)
prior to
disclosure.
Makesure to
initial where
indicated.
Signature is
required.
Levels of Disclosure
• Florida KidCare staff are limited to the type of
information they are allowed to disclose to third
parties. Such as:
Full disclosure – All account information
provided
Minimum disclosure – Information needed to
resolve a family’s concerns if provide
Limited disclosure – Confirmation of coverage,
and dates of coverage, and name of child’s
health & dental plan, amount of premium being
paid are provided
No disclosure – No information is provided
without a completed ROI on file
Personal Health Information
(PHI)
•
•
•
•
•
•
•
•
•
•
•
Name
Address
Phone Number
Social Security Number (SSN)
Date of Birth (DOB)
Premium Payment
Relatives
Email Address
Health/Dental Plan #
Employer
Account Number
HIPAA Compliance
Prevent unauthorized Prevent loss of
access and disclosure information
Secure electronic
information
Secure paper
records
Avoid overheard
conversations
Never leave
information in
public view
Always check the
credentials of a
requester
Always check a
client’s
authorizations
Report incidents to
your organization’s
HIPAA Compliance
Officer
Use encryption
when sending an
email with PHI
Do not copy others on an email with PHI
without written consent from the client
HIPAA & Non-Applicant
Parents
Under new legislation a non-applicant parent
can have limited disclosure to Florida KidCare
account information. In other words, a nonapplication parent can contact Florida
KidCare (with the child’s information such as
DOB and SSN) and are able to receive the
following types of account information
without a ROI on file:
–
–
–
–
Confirmation of Coverage
Dates of coverage
Name of child’s health & dental plan
Amount of premium being paid
Bookmark the
website for quicker
access to the
application
Don’t forget to
review these
materials!
Pay Special
Pay Special
Attention
Attention toto
Required
Required
Fields Fields
Parent Two does not
have required fields,
but fill in as much
information as
possible if Parent Two
exists
Utilize the Help
bars for
questions you
may have
Make sure all income
documents are sent in
immediately to ensure
application processing
You have 30
minutes to
complete each
section before the
website times out
and all information
is lost!
The application ends here – you will
have one last chance to review all the
information provided on the next page
and make changes before electronic
submission
FL-CKF Application Assistance
Code
This is
the
electro
nic
signatu
re
Documents
List
Fax
Mail
Personal
Copies
When the family
finishes the
online application
Copies Only
Confirmation
Number
Upon Completion
Internet & Telephone
•
•
•
•
24 hours a day, 7 days a week
Visa, MasterCard and Discover accepted
Direct from checking or savings account
Fee may be charged
Mail
• Mail a check or money order with payment coupon to
Florida KidCare
• Write your family account number on check or money
order
Cash Payments
• 600 Fidelity Express Locations
• $2.00 Service Fee
Non-Payment
• Not making a payment will result in a cancellation of
coverage
• Nonpayment cancellation: Cannot reactivate for
coverage for one month (30 Days)
• Enrollees have 10 working days to request a dispute
resolution & benefits reinstated
Monthly Premium Payments
Enrollees must renew
their coverage once every
12 months
About two months before
the renewal date, parents
receive a reminder letter
Pre-populated renewal
forms are included in
letters
Very important that
parents respond to the
renewal letter and provide
the needed information in
a timely manner.
Income documentation is
required with completed
renewal form
Renewal Process
For More
Information
Contact the Parent
Academy
(305) 995-2680
Informational Web Sites
◦ www.floridakidcare.org
◦ www.healthykids.org
◦ www.coveringkids.org
◦ www.insurekidsnow.org