County General Relief Directors FAQ

Q: What does the DHS expect General Relief directors to do?
A: General Relief directors have a long history of helping needy people within their counties. DHS would like to build on that history by asking them to help residents access IowaCare by distributing applications and helping individuals access DHS offices. While we have tried to keep the application process simple, it's likely that some people would also appreciate assistance in completing the application. General Relief directors will not be determining IowaCare eligibility.
Q: Are General Relief directors required to establish contracts with the DHS?
A: No. The legislation directs the DHS to enter into a contract with General Relief directors at their request. The DHS does not believe that a contract is necessary to allow GR directors to distribute applications and refer individuals to DHS offices.
Q: What's the application process?
A:
  • DHS Central Office will send a letter and a copy of the application form to all recipients of State Papers. Central Office will also send a letter to all county general relief directors, explaining the new law and urging them to assist in making applications available and helping people to fill them out.
  • Applications will be accepted at DHS offices beginning July 1. Applications will be available at any of the expansion population provider network, including Broadlawns, U of I Hospitals, and the four MHIs.
  • People may apply in person and DHS will help people answer the application form, but no interview is required.
  • The IowaCare program allows for one month retroactive eligibility if the individual requests this at the time of application.
    Q: How is the IowaCares program different from State Papers?
    A: There are a couple of differences. First, some counties required State Papers recipients to "spend down" or incur a minimum amount of medical expenses before they are provided papers to be seen at the University of Iowa Hospitals and Clinics. Under the IowaCare program, this is not a requirement except for the 300% OB and newborn group. Generally, individuals will be eligible for IowaCare based on their income level as it relates to the Federal Poverty Level. Most of them will also pay a premium based on income.

    The second difference is that not all State Papers recipients will receive IowaCare. Note the eligibility section below:
    • Everyone receiving State Papers benefits who have incomes below 200 percent of poverty will remain eligible.
    • If they are not eligible for IowaCare because income is over 200% FPL, they will still be eligible for services if they are former State Paper recipients who received services for chronic conditions, thus ensuring continuity of care. Funding will come from a different federal/state source. Assuming privacy issues can be addressed, the local DHS offices will be given a listing of State Paper recipients who have been treated for chronic health problems.
    • If the applicant received State Papers care for non-chronic conditions, the applicant is not eligible for continued services.
    Finally, a major change in IowaCare from the State Papers Program is that Iowa will be receiving federal matching funding for the IowaCare expenditures.
    Q: Will General Relief officials determine eligibility?
    A: No. They may help applicants with questions, but eventually they'll refer applicants to the DHS, which determines eligibility. The DHS will make a determination within three working days.
    Q: Who's eligible for IowaCare?
    A: Generally, eligible people have low incomes and are not eligible for regular Medicaid. Specifically:
    1. People ages 19 - 64 who:
      • Have adjusted income at or below 200% of the Federal Poverty Level (FPL).
      • Do not have access to other health insurance.
      • Are not otherwise eligible for Medicaid (childless adults, single adults, parents of Medicaid children or hawk-i children who are over income for Medicaid).
      • Meet all other conditions of participation, including requirements to pay a premium.
    2. People who are eligible for the Family Planning waiver may also receive benefits under IowaCare.
    3. Pregnant women and newborn infants in families with household incomes of 300% FPL or less, assuming deductions for medical bills reduce family income to 200% FPL or less.
    4. People who do not meet the 200% FPL test but who receive State Papers services for chronic health problems.
    Q: Where can IowaCare members receive service, and what services are provided?
    A: People living in Polk County may receive services at either Broadlawns Hospital or University Hospitals in Iowa City. Residents of other counties must receive services at University Hospitals in Iowa City. The state's four mental health institutes will offer mental health services.

    Expansion population benefits include hospital, physician, limited pharmacy, and limited dental services that are provided by the expansion population provider network.
    Q: When we advise potential customers, what do we say about the premium?
    A:
    • To receive services, IowaCare members must pay a premium. The premium is calculated on the amount of adjusted household income. The premium will be between $1-14 a month per person for people whose adjusted household income is below 100% FPL, and between $34-75 a month per person for households with adjusted income of between 100% and 200% FPL. As of June 2005, 100% FPL is $1,613/month for a family of four.
    • There will be no premium for anyone whose adjusted income is below 10% of FPL. There will be exceptions for hardship cases.
    • The amount of any hawk-i premium will be deducted from the IowaCare premium.
    Q: Who is our DHS contact for questions?
    A: If GR Directors have questions related to the IowaCare eligibility requirements or process, they should contact their local DHS office. If GR Directors have questions related to specific services or prescriptions medications that are covered, they should contact Deb Johnson at 515-725-1012.
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