Title 16
18000 Delaware Healthy Children Program
The Balanced Budget Act of 1997, enacted on Augusts 5, 1997, establishes a new “State Children’s Health Insurance Program by adding a new Title XXI to the Social Security Act. The purpose of this program is to provide funds to States to enable them to initiate and expand the provision of child health assistance to uninsured, low-income children in an effective and efficient manner that is coordinated with other sources of health benefits coverage for children.
The new law does not create any entitlement on the part of children to child health assistance. The law creates a capped allotment to the funds on the part of the states. The law “constitutes budgetary authority in advance of appropriations and represents the obligation of the Federal Government to provide for the payment to States of the amounts specified for each of the fiscal years 1998-2007." Because Title XXI is not an entitlement program, enrollment and expenditures will be monitored closely against the allotment. Enrollment will be stopped when total expenditures are projected to equal the available funding level.
The rules in this section set forth the eligibility requirements for coverage under the Delaware Healthy Children Program (DHCP) as authorized under Title 19, Chapter 99, Section 9905 of the Delaware Code. The DHCP is implemented January 1, 1999, with benefits for children beginning February 1, 1999.
18100 General Eligibility Requirements
The Medicaid rules at Section 14000 of the Division of Social Services Manual (DSSM 14000) also apply to DHCP except as provided in this section.
18100.1 State Residency
The child must be actually residing in Delaware.
18100.2 Alien Status
The DHCP does not provide state-funded benefits to qualified aliens subject to the 5 year PRWORA bar or to legally residing nonqualified aliens. The DHCP does not provide coverage of emergency and labor and delivery services to illegally residing and ineligible aliens.
Receipt of DHCP benefits cannot be considered by the Immigration and Naturalization Service (INS) when making public charge determinations.
18100.3 Limitations on Retroactive Coverage
Retroactive coverage is not available to any child eligible under DHCP. The rules on retroactive eligibility at DSSM 14920 through 14920.5 do not apply to DHCP.
