Washington State Medical Programs (health coverage) for Children by mensahbansu

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									  Washington State Medical Programs (health coverage) for Children
The state of Washington continues to advocate for the health of its children by providing several
health coverage options to accommodate differing age, income, and/or citizenship status. The
Migrant Education Health Program worked with the Department of Social and Health Services Health
Recovery Services Administration to develop a simplified overview of children’s medical programs
including a list of regional contacts to provide technical assistance and guidance to individuals
assisting families seeking health coverage for their children.

*For purposes of income level an unborn child is counted in family size.

Children’s healthcare programs - No cost
    Children under the age of 19 and below 200% of the federal poverty level (FPL) (example:
      family of 4 with an income of $3,442/month).
    Once a child is enrolled they remain eligible for 12 months regardless of change of income.
    Citizen children are funded by state/federal matching funds; non-citizen children receive the
      same level of coverage using state only funding.
    12 month certification.

Children’s healthcare programs – Low cost
    Children under the age of 19 and below 250% of the federal poverty level (FPL) (example:
      family of 4 with an income of $4,303/month.
    Once a child is enrolled they remain eligible for 12 months regardless of change of income.
    Citizen children are funded by state/federal matching funds; non-citizen children receive the
      same level of coverage using state only funding.
    Coverage is premium based. $15/mo per child and a family maximum of $45/mo.
    Cannot have other health insurance through employment or other sources.
    12 month certification.

Medically Needy program – “Spenddown”
   Children under the age of 19 and above 250% of the federal poverty level (FPL).
   Children under the age of 19 and above 200% of FPL and not eligible for premium based
     children’s healthcare coverage because of other health insurance coverage.
   Must be a U.S. citizen or qualified alien.
   The family shares in the cost of medical expenses (“spenddown”).
   3 month certification.

Alien Emergency Medical (AEM)
    An emergency Medicaid program for persons who do not meet the citizenship requirements of
      other DSHS medical programs and are experiencing an emergent medical need.
    Must be a non-citizen (undocumented or a Legal Permanent Resident with less than 5 years
      legally in the country), and meet Medicaid eligibility requirements (a child, parenting a child,
      blind, aged, or disabled).
    Immigration status not an issue.
    Not eligible for any other medical assistance program.

Basic Health (state-funded program)
   Not Medicaid, managed by the Health Care Authority for children under age 19 and income
      below 200% FPL.
   Once a child is enrolled they remain eligible for 12 months regardless of change of income.
   Premiums are based on household income and family size.
   Immigration status is not an issue; citizen and non citizen children.
Charity Care
   Available through local hospitals at no charge or at a reduced charge to those who meet
      financial need requirements. It is generally available for persons considered “indigent”; if their
      family income is at or below 200% of the federal poverty level; and they do not have other
      financial resources available such as insurance, government programs, or regular income.
      Individuals need to contact their local hospital for further information.
   Immigration status is not an issue.

    It is critical that parents apply for services when they are income-eligible. Once a child is enrolled
in one of these programs (Children’s healthcare coverage or Basic Health), they remain eligible for 12
months, regardless of change in income.
    Program enrollment is available through community and migrant health clinics or at a Department
of Social and Health Services, Community Service Office (CSO).

                               State and Regional Contacts
Regional contacts available to provide families with technical assistance and guidance relating to
health insurance programs include:

                         Health Recovery Services Administration (HRSA)

Mary Beth Ingram                                        Kathy Johansen
Region 1 Medicaid Representative                        Region 4 Medicaid Representative
Health & Recovery Services Administration               Health & Recovery Services Administration
Department of Social and Health Services                Department of Social and Health Services
360-725-1327                                            360-725-1321
ingramb@dshs.wa.gov                                     johankj@dshs.wa.gov

Chris Stehr                                             Carole McRae
Region 2 Medicaid Representative                        Region 5 Medicaid Representative
Health & Recovery Services Administration               Health & Recovery Services Administration
Department of Social and Health Services                Department of Social and Health Services
360-725-1304                                            360-725-1250
stehrcb@dshs.wa.gov                                     mcraeca@dshs.wa.gov

Kevin Cornell                                           Catherine Fisher
Region 3 Medicaid Representative                        Region 6 Medicaid Representative
Health & Recovery Services Administration               Health & Recovery Services Administration
Department of Social and Health Services                Department of Social and Health Services
360-725-1423                                            360-725-1327
corneke@dshs.wa.gov                                     mailto:fishecl@dshs.wa.gov
                                       CSO Representatives


Herminia Esqueda, Program Manager/Trainer             Steve Fogo, Financial Supervisor
Department of Social and Health Services              Department of Social and Health Services
Sunnyside CSO                                         Aberdeen CSO
509-225-7942                                          360-537-3700
mailto:esqueh@dshs.wa.gov                             fogosw@dshs.wa.gov

Sonia Ortega, Financial Service Specialist            Berta Reynolds, Financial Worker
Department of Social and Health Services              Department of Social and Health Services
Othello CSO                                           Aberdeen CSO
509-932-0701                                          360-537-2600
mailto:segurs@dshs.wa.gvo                             mailto:ContrRL@dshs.wa.gov

Nancy Maldonado, FSS 3                                Dee Dee Brenner, Financial Supervisor
Department of Social and Health Services              Department of Social and Health Services
Omak CSO                                              Othello CSO
509-846-2015                                          509-331-2100
mailto:gomezno@dshs.wa.gov                            mailto:brenndk@dshs.wa.gov

Adele Snyder, Financial Supervisor                    Kami Kruzich, Financial Service Supervisor
Department of Social and Health Services              Department of Social and Health Services
Wenatchee CSO                                         Bellingham CSO
509-667-6001                                          360-714-4000
snydeam@dshs.wa.gov                                   mailto:kruzikm@dshs.wa.gov

John Paquette, Leadworker 4
Department of Social and Health Services              Shelba Marracci, Branch Office Admin.
Wenatchee CSO                                         Department of Social and Health Services
509-667-6154                                          Long Beach CSO
mailto:johnp@dshs.wa.gov                              360-642-6206
                                                      mailto:marrasj@dshs.wa.gov
Erin Mooney, Financial Services Leadworker
Department of Social and Health Services              Audrey Ike, Financial Leadworker
Wenatchee CSO                                         Department of Social and Health Services
509-667-6026                                          Vancouver- (Columbia River CSO)
seafoea@dshs.wa.gov                                   360-759-2984
                                                      mailto:richaam@dshs.wa.gov
Denise Stark, FSS 3
Department of Social and Health Services              Diane Sinclair, Financial Supervisor
Chehalis CSO                                          Department of Social and Health Services
360-740-3806                                          Chehalis CSO
starkdm2@dshs.wa.gov                                  360-740-3810
                                                      sincldl@dshs.wa.gov
Mike Rhoads, Financial Supervisor
Department of Social and Health Services              Richard Dominguez, FFS
Mt. Vernon CSO                                        Department of Social and Health Services
360-416-7350                                          White Salmon CSO
rhoadme@dshs.wa.gov                                   509-493-6140
                                                      dominrj@dshs.wa.gov
Bea Wilson, Financial Services Specialist 3
Department of Social and Health Services
White Salmon CSO
509-493-6140
roberbr@dshs.wa.gov


 Jorge Rodriguez, SB 5093                         Marsha Roos, Cover All Kids Medical Outreach
 Department of Social and Health Services         Department of Social and Health Services
 Community Outreach, Region 2                     Seattle, WA
 Yakima, WA                                       253-372-5876
 509-249-6453                                     roosmp@dshs.wa.gov
 RodriJA@dshs.wa.gov

 Alma Rojas, Financial Services Supervisor        Rocio Loera, Community Relations Coordinator
 Department of Social and Health Services         Department of Social and Health Services
 Region 2 Yakima CSC                              Region 2 DEAP
 509-249-6401                                     Sunnyside, WA
 rojasal@dshs.wa.gov                              509-839-7215
                                                  loerarc@dshs.wa.gov

 Lisa Pan, Financial Supervisor                   June Fritz, Outstation/Outreach Financial Services
 Department of Social and Health Services         Supervisor
 Seattle CSO                                      Department of Social and Health Services
 206-568-5688                                     Bellingham CSO
 mailto:panlh@dshs.wa.gov                         360-714-4080
                                                  FritzPJ@dshs.wa.gov


 CLINIC BASED OUTREACH WORKERS

 Martha Rocha, Financial Service Specialist       Orlando Gonzalez, Outreach Coordinator,
 Department of Social and Health Services         Department of Social and Health Services
 Outreach Worker, La Clinica Pasco                Family Health Centers-Okanogan
 Region 2 Yakima CSO                              Okanogan, WA
 509-545-2654                                     509-422-5700 x 2920
 RochaMT@dshs.wa.gov                              ogonzalez@myfamilyhealth.org

 David D. Ames, Outreach Worker                   Erika Torres, Outreach Worker
 Department of Social and Health Services         Department of Social and Health Services
 Columbia Basin Health-Mattawa Clinic             Columbia Basin Health-Othello Clinic
 Mattawa, WA 99349                                Othello, WA
 (509) 932-3535 x 6808                            509-488-5256
 amesdd@dshs.wa.gov                               torreer@dshs.wa.gov

 Mike Geary, FSS3, Financial Service Specialist   Isaac Heist, Outreach Worker
 Department of Social and Health Services         Department of Social and Health Services
 Columbia Valley Community Health-Wenatchee       Sea Mar Community Health Ctr.-Bellingham Clinic
 Wenatchee, WA                                    Bellingham, WA
 509-661-3651                                     360-788-7114
 gearymp@dshs.wa.gov                              heistir@dshs.wa.gov
 Karen Van Brunt, Outreach Worker                       Nicole Davidson, Outreach Worker
 Department of Social and Health Services               Department of Social and Health Services
 Family Health Centers-Tonasket                         Whatcom Alliance for Healthcare Access-
 Tonasket, WA                                           Bellingham
 509-422-7640                                           360-788-6542
 mailto:vanbrks@dshs.wa.gov                             mailto:davidsonn@dshs.wa.gov


This document will be electronically disseminated via the Migrant Education Health Program office. It will be
updated as change dictates. NOTE: See Migrant Health Program website (www.msdr.org (click “Health” on
map), “Migrant Health Internet Links” for hot links to Washington State Medical programs for children.

								
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