Children's Health Insurance Program
To provide funds to States to enable them to maintain and expand child health assistance to uninsured, low-income children, and at a state option, low-income pregnant women and legal immigrants, primarily by three methods: (1) obtain health insurance coverage that meets the requirements in Section 2103 relating to the amount, duration, and scope of benefits; (2) expand eligibility for children under the State's Medicaid program; and (3)reduce the number of children eligible for Medicaid, CHIP who are not enrolled and improve retention of those who are already enrolled.. This solicitation addresses the third objective and seeks applications for additional rounds of the Connecting Kids to Coverage grants. These new funding opportunities, the Connecting Kids to Coverage HEALTHY KIDS Outreach and Enrollment Cooperative Agreements, as provided under the Section 2113 of the Social Security Act, amended by Section 3004(a) of the Helping Ensure Access for Little Ones, Toddlers and Hopeful Youth by Keeping Insurance Delivery Stable Act (referred to as the HEALTHY KIDS Act and included in Pub. L. 115-120) and by Section 50103 of the Advancing Chronic Care, Extenders, and Social Services Act (referred to as the ACCESS Act and included in Pub. L. 115-123). These HEALTHY KIDS cooperative agreements will support outreach strategies similar to those conducted in previous Connecting Kids to Coverage (CKC) grant cycles and CMS anticipates awarding approximately $108,000,000 million in total funding through four separate notice of funding opportunities from 2019 through 2022. Eligible entities, will include; states, local governments, Indian tribes, tribal consortium, urban Indian organizations receiving funds under title V of the Indian Health Care Improvement Act, federal health safety net organizations, community-based organizations, faith-based organizations, and schools. These grants will be in the form of cooperative agreements funding activities/strategies aimed at educating families about the availability of free or low-cost health coverage under Medicaid and CHIP, identifying children likely to be eligible for these programs, and assisting families, including parents, to apply for coverage. Funds will also support efforts to assist families with the annual renewal process. Refer to the website https://www.InsureKidsNow.gov under the Campaign Information tab for more information about each funding opportunity announcement.
General information about this opportunity
Last Known Status
Centers For Medicare and Medicaid Services, Department of Health and Human Services
Type(s) of Assistance Offered
A - Formula Grants
Title XXI of the Social Security Act as amended by the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA; Public Law 111-003), the Affordable Care Act (ACA; Public Law 111-148 taken together with Public Law 111-152), the Medicare Access and CHIP Reauthorization Act (MACRA) (Public Law 114-10), the Healthy Kids Act of 2018 (Public Law 115-120) and the Advancing Chronic Care, Extenders, and Social Security (ACCESS) Act (Public Law 115-123).
Who is eligible to apply/benefit from this assistance?
The following entities are eligible to apply for this program funding: State (includes District of Columbia, public institutions of higher education and hospitals), Local (includes State-designated lndian Tribes, excludes institutions of higher education and hospitals, U.S. Territories and possessions (includes institutions of higher education and hospitals), Native American Organizations (includes lndian groups, cooperatives, corporations, partnerships, associations) States with an approved child health plan under this title [42 U.S.C. Section1397aa et seq.];local governments; Indian tribes or tribal consortium, tribal organizations, urban Indian organizations receiving funds under title V of the Indian Health Care Improvement Act (25 U.S.C. 1651 et seq.), or Indian Health Service providers; federal health safety net organizations; national, state, local, or community-based public or nonprofit private organizations, including organizations that use community health workers or community-based doula programs; faith-based organizations or consortia, to the extent that a cooperative agreement awarded to such an entity is consistent with the requirements of Section 1955 of the Public Health Service Act (42 U.S.C. 300x-65) relating to a grant award to nongovernmental entities; and/or elementary or secondary schools may apply. For eligibility requirements the Connecting Kids to Coverage project grants, refer to the website https://www.InsureKidsNow.gov under the Campaign Information tab for more information about each funding opportunity announcement.
Targeted low-income children will benefit. These children are defined (for the purposes of Title XXI) as children who have been determined eligible by the State for child health assistance under their State plan; are low-income children as defined by each state and are not found to be covered under a group health plan or under other health insurance coverage.
States and Territories must submit and have approved by the Secretary of DHHS, a State Child Health Plan. Individuals must meet State requirements.
What is the process for applying and being award this assistance?
Preapplication coordination is required. Pre-application coordination is required. Environmental impact information is not required for this program. This program is excluded from coverage under E.O. 12372. For the Connecting Kids to Coverage- project grants' application and award process, refer to the website https://www.InsureKidsNow.gov under the Campaign Information tab for more information about each funding opportunity announcement. Environmental impact information is not required for this program. This program is excluded from coverage under E.O. 12372. Environmental impact information is not required for this program. This program is excluded from coverage under E.O. 12372.
2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards applies to this program. This award is subject to 45 CFR Part 75, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS awards, which implements 2 CFR Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards ("Uniform Guidance") effective December 26, 2014.
The CMS Administrator exercises delegated authority to approve Title XXI plans and amendments. Letters of approval will be signed by the CMS Administrator.
Application deadlines for the Connecting Kids to Coverage Cooperative Agreements are dependent on the final release date for the Notice of Funding Opportunity Announcement (NOFO). Refer to the website www.insurekidsnow.gov for NOFO and application deadline updates.
Approval/Disapproval Decision Time
Section 2106 of the Law, specifies that a State plan is considered approved unless the Secretary notifies the State in writing, within 90 days after receipt of the plan, that the plan is disapproved (and the reasons for disapproval) or that specific additional information is needed. Informal clarification and discussion between the State and the DHHS review team is permitted and encouraged during the review period. This does not stop the "90-day clock." The 90-day review period may be stopped by formal written requests for additional information and clarification. The 90-day review period may be stopped as many times as necessary to obtain completed information necessary to disapprove or approve the plan. The 90-day period will resume when the finalized additional information is received by CMS.
If a State wishes to appeal a disapproval, it may petition for a reconsideration of this decision within 60 days after the date of receipt of the disapproval letter, by submitting a written request for reconsideration to the project officer and the regional office. States also have the option to submit a new application following the disapproval, starting a new 90-day review clock.
An approved State child health plan shall continue in effect unless the State amends that plan or the Secretary finds substantial noncompliance of the plan in accordance with the requirements of Title XXI. The CMS Administrator exercises delegated authority to award cooperative agreements. Successful applicants will receive a Notice of Award (NoA) signed and dated by the CMS Grants Management Officer that will set forth the amount of the award and other pertinent information including the Terms and Conditions. Once an award is made, the funds are posted in recipient accounts established in the Payment Management System (PMS). Grantees may then access their funds by using the PMS funds request process. The funds are then delivered to the recipient via Electronic Funds Transfer..
How are proposals selected?
How may assistance be used?
No State is eligible for payments for child health assistance for coverage provided prior to October 1, 1997. Standards used to determine eligibility may include those related to geographic areas to be served by the plan. Age, income and resources, residency, disability status (as long as the standard does not restrict eligibility), access to or coverage under other health coverage, and duration of eligibility are factors. Standards may not discriminate on the basis of diagnosis. Eligibility standards must not cover higher-income children without covering lower-income children, and must not deny eligibility based on a child having a pre-existing medical condition. The State must ensure that only targeted low-income children are furnished child health assistance under the plan. Children found through screening to be eligible for Medicaid are to be enrolled in Medicaid. The insurance provided using Federal funds under the State plan does may not substitute for coverage under group health plans. Coordination with other public and private programs providing creditable coverage for low-income children should occur. Child Health Assistance (other than Medicaid), must consist of any of the following: Benchmark coverage; benchmark equivalent coverage (which can be FEHBP-equivalent coverage); State employee coverage or coverage offered through the HMO with the largest insured commercial non-Medicaid enrollment in the State; existing comprehensive State-based coverage; or Secretary-approved coverage. A State child health plan must include a description of the amount (if any) of cost-sharing and must be in accordance with a public schedule. Cost-sharing may be varied in a way that does not favor higher-income children over lower-income children. No cost-sharing is permitted for well-baby and well-child care, including age-appropriate immunizations. Cost-sharing for children at 150 percent of poverty must be consistent with Medicaid; Cost-sharing for children at 150 percent of poverty and above must be based on an income-related sliding scale. The aggregate cost sharing for all children in a family cannot exceed 5 percent of the family's income. The State child health plan may not impose pre-existing condition exclusions for covered benefits. Funds provided to a State under this Title may only be used to carry out the purposes of this Title. Health insurance coverage provided may include coverage of abortion only if necessary to save the life of the mother or if the pregnancy is the result of an act of rape or incest. States may spend up to 10 percent of their total CHIP expenditures (Federal and State) on non-benefit activities, including: outreach conducted to identify and enroll eligible children in CHIP; administration costs; health services initiatives; and other child health assistance. These expenditures are matched at the enhanced CHIP matching rate and counted against both the 10 percent limit and the allotment. Monetary amounts provided by the Federal government or services assisted or subsidized to any extent by the Federal government, may not be included in determining the amount of nonfederal contributions required for State matching purposes.
All Connecting Kids to Coverage- awardees must adhere to all HHS terms and conditions regarding uses and exclusions of funds. All awardees will receive this information in their award packages.
What are the requirements after being awarded this opportunity?
In accordance with the provisions of 2 CFR 200, Subpart F - Audit Requirements, non-Federal entities that expend financial assistance of $750,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Non-Federal entities that expend less than $750,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in 2 CFR 200.503.
Grantees must include an assurance that they will collect and verify application and enrollment data as an important measure of program performance, in order to enable the Secretary to monitor grant program administration and compliance and to evaluate and compare the effectiveness of awardees.
Other Assistance Considerations
Formula and Matching Requirements
Statutory formula is not applicable to this assistance listing.
Matching is voluntary. Statutory Formula: The Connecting Kids to Coverage project grant program has no statutory formula. Matching Requirements: The Connecting Kids to Coverage project grant program has no matching requirements.
This program has MOE requirements, see funding agency for further details. Additional Information: This program has MOE requirements, see finding agency for further details.
Length and Time Phasing of Assistance
Federal funds are obligated to the Connecting Kids to Coverage grantees by issuing grant cooperative agreement awards. To ensure that all of the appropriated funds are available to States, CMS will issue cooperative grant awards for one year from the award date to all grantees selected. Awardees must meet all reporting deadlines and demonstrate strong performance to be eligible for a non-competing continuation award for subsequent budget periods. Method of awarding/releasing assistance: lump sum Method of awarding/releasing assistance: Lump.
Who do I contact about this opportunity?
Regional or Local Office
Contact the Regional Administrator, Centers for Medicare and Medicaid Services. (See Appendix IV of the Catalog for addresses and telephone numbers).
7500 Security Boulevard
Baltimore, MD 21244 US
(Formula Grants (Apportionments)) FY 18$17,309,197,911.00; FY 19 est $17,415,604,629.00; FY 20 est $18,366,180,998.00; FY 17$15,952,148,232.00; FY 16$13,958,271,478.00; -
Range and Average of Financial Assistance
For the Connecting Kids to Coverage Cooperative Agreements, the projected awards will range from ($250,000 up to $1,000,000). FY 2018, the range is from $3,072,998 (American Samoa) to $2,825,935,404 (California). .
Regulations, Guidelines and Literature
Regulations and guidance issued related to the Connecting Kids to Coverage (CKC) Outreach and Enrollment Cooperative Agreements may be accessed at: www.insurekidsnow.gov/campaign/funding/index.html. Regulations and guidance issued related to the Children's Health Insurance Program may be accessed through the World Wide Web at: www.medicaid.gov.
Examples of Funded Projects
Fiscal Year 2018
See www.insurekidsnow.gov/campaign/funding/index.html for more information about the history of the Connecting Kids to Coverage grants and an overview of current and past grantees.