PARTNERSHIP FOR HEALTHIER IDAHO KIDS (CHIPRA)

Through a partnership with the Idaho Primary Care Association (IPCA) and Idaho’s Community Health Centers, the Idaho CHIPRA Project, Partnership for Healthier Idaho Kids, reaches out to groups of rural and underserved Idaho children where significant gaps in health coverage exist. Project staff train health care providers and other professionals throughout the state to assist families in enrollment in public health insurance.

This project is funded by a Cycle II CHIPRA Outreach & Enrollment Grant Award from the Centers for Medicare & Medicaid Services (CMS), through funding set aside in the CHIP Reauthorization Act (2009).

Resources:

Below is a list of resources that Mountain States Group has developed for the use of CHIPRA Project partners and staff. NOTE: If you have problems accessing or downloading any of these files, contact us using the contact information provided.

You will need to download the Adobe Reader from the Adobe website to view these documents.

MOST USED

File Type	File Name
FOR PRINTING ONLY: Documents that you download from this section are PDFs. To download documents that you can customize, go to the next section.
	3-page Application for Assistance for Children’s Health Coverage (CHIP/Medicaid) – English
	3-page Application for Assistance for Children’s Health Coverage (CHIP/Medicaid) – Spanish
	Idaho CHIP/Medicaid Flyer – English/Spanish
	Basic Eligibility Screening Tool – English/Spanish
	Renewal Reminder Postcards – English

DOCUMENTS YOU CAN CUSTOMIZE: These will be either .doc, .docx, .xls, or .pub files that you will have the ability to download and customize for your center or site.
	Basic Eligibility Screening Tool – English/Spanish
	Stickers with 2012 Federal Poverty Guidelines (2″x4″ labels–use these on outdated brochures) – English
	Stickers with 2012 Federal Poverty Guidelines (2″x4″ labels–use these on outdated brochures) – Spanish

FULL CLINIC SITE TRAINING MANUAL

File Type	File Name
FOR PRINTING ONLY: Documents that you download from this section are PDFs. To download documents that you can customize, go to the next section.
	Full Clinic Training Manual for CHIP/Medicaid NOTE: This training manual was created by the Idaho CHIPRA Project staff to assist clinics and patients with the enrollment of children in Medicaid/CHIP. The Idaho CHIPRA Project is solely responsible for the content of this manual. It reflects current processes and procedures related to the Idaho Medicaid Program as presented by the Idaho Department of Health and Welfare. These processes and procedures are subject to change at any time and the information in this manual does not supersede information provided by the Department. Current information can be obtained by contacting the Idaho Department of Health and Welfare.

DOCUMENTS YOU CAN CUSTOMIZE: These will be either .doc, .docx, .xls, or .pub files that you will have the ability to download and customize for your center or site.
	01 List of Contents
	02 Overview of the CHIPRA 2 Project for Clinic Sites
	03 Basic Eligibility Screening Tool in English/Spanish
	04 Eligibility Determination
	05 About the Children’s CHIP/Medicaid Program in Idaho
	06 Application for Assistance for Children’s Health Coverage (CHIP/Medicaid) – English
	06 Application for Assistance for Children’s Health Coverage (CHIP/Medicaid) – Spanish
	07 The CHIP/Medicaid Enrollment Process
	08 Tips & Tricks to Maximize Success with Enrollment
	09 How to Overcome Barriers to Enrollment and Retention
	10 Renewal Process (“Re-evaluation”)
	11 How Clinic Staff Can Assist in Enrollment Efforts
	12 FAQ for Income Verification – Preguntas más frecuentes sobre verificación de los ingresos
	13 FAQ for Immigrant Families / Preguntas más frecuentes para las familias inmigrantes
	14 Role of Sites; Data Collection and Reporting
	15 Blank Clinic Log
	16 Sample Clinic Log
	17 Outreach / Public Education & Awareness
	18 Blank Outreach Activity Report
	19 Project Contact Information & Resources
	20 Map of Office Locations for Division of Welfare, Self Reliance Programs
	21 Idaho CHIP/Medicaid Flyer – English/Spanish
	22 “Connecting Kids to Coverage: Ten Things Community Health Centers Can Do”

BLANK CLINIC REPORTING DOCUMENTS

File Type	File Name
	Blank Clinic Log
	Blank Outreach Activity Report

File Type	File Name
Useful Links and Resources
	Idaho Primary Care Association (IPCA)
	List of Community Health Centers in Idaho
	InsureKidsNow.gov
	Idaho Department of Health & Welfare (DHW) Home Page
	Idaho DHW “Apply for Assistance” Home Page

Idaho DHW Downloadable Forms
	Full Application for Assistance
	Application for Re-Evaluation
	Application for Children’s Health Coverage
	Dependent Care Changes
	Work Verification
	Self Employment Verification: Sole Proprietorship or LLC, S-Corp, or Partnership
	Verification of Termination of Employment
	Add A Person
	Rent Verification
	Solicitud de Asistencia
	Solicitud de Re-evaluación
	Solicitud para el Seguro de Salud para Ninos
	Cargos Mensuales por Cuidado de Dependientes
	Verificación de Trabajo
	Reporte de la Verificación del Negocio Propio: Empresario Individual o LLC, S-Corp, o Asociación
	Verificación de Terminación de Trabajo
	Agregar a una persona
	Verificación del Alquiler