Interagency Agreement Between the Administration for Children and Families and the Health Care Financing Administration

ACYF Administration on Children, Youth and Families	U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families
	1. Log No. ACYF-IM-HS-96-13	2. Issuance Date: 06/20/96
	3. Originating Office: Head Start Bureau
	4. Key Word: Collaboration with Medicaid

INFORMATION MEMORANDUM [See Attachment at the bottom]

TO: Head Start Grantees and Delegate Agencies

SUBJECT: Interagency Agreement between the Administration for Children and Families and the Health Care Financing Administration

INFORMATION: For many years, the Head Start Bureau and the Health Care Financing Administration (HCFA) have worked together to ensure that low income children and families have access to needed health care services. In 1994, this partnership was expanded to include the newly formed Child Care Bureau within the Administration for Children, Youth and Families.

In 1995, the Commissioner for the Administration on Children, Youth and Families and the Director of the Medicaid Bureau signed the attached Interagency Agreement. The purpose of this Agreement is to improve outreach to and the overall health of entire families through enhanced access to quality medical care and preventive services. The goals of the Agreement are to establish and/or improve local, State, regional and national collaboration between the Administration for Children and Families (ACF) and the HCFA; to increase the Medicaid enrollment and participation rates of children enrolled in Head Start and Child Care and, where appropriate, to increase the number of Head Start programs and/or Child Care providers that are also Medicaid providers. The Agreement outlines activities that can be undertaken at each level that will support the Agreement and enhance program coordination and service delivery.

We recognize that many Head Start programs have already formed a collaborative relationship with State and/or local Medicaid agencies. Attached is a list of State Directors. This information will be useful to programs beginning the process of collaboration with State and/or local Medicaid agencies.

ATTACHMENTS: Interagency Agreement between ACF and the HCFA List of State Medicaid Directors

/S/
Helen H. Taylor
Associate Commissioner
Head Start Bureau

cc: Regional Administrators, ACF, Regions I-X American Indian and Migrant Programs Branch

INTRA-AGENCY AGREEMENT BETWEEN THE HEALTH CARE FINANCING ADMINISTRATION, MEDICAID BUREAU AND THE ADMINISTRATION, FOR CHILDREN AND FAMILIES, HEAD START BUREAU AND CHILD CARE BUREAU

I. Purpose and Goals

The purpose of this agreement between the Health Care Financing Administration (HCFA) and the Administration for Children and Families (ACF) is to improve outreach to and the overall health of entire families through enhanced access to quality medical care and preventive services. The Medicaid, Head Start, and Child Care Bureaus share similar program goals: To ensure that low income children have a medical home and to increase the Medicaid enrollment and participation rates for eligible children and families.

The goals of this Agreement are: 1) to establish and/or improve local, state, regional and national collaboration between ACF and HCFA; 2) to increase the Medicaid enrollment and participation rates of children enrolled in Head Start and Child Care; and 3) where appropriate, to increase the number of Head Start programs and/or Child Care providers that are also Medicaid providers.

II. Authority

This Agreement is made under the authority of Reorganization Plan No. 1 of 1953, 5 U.S.C. Appendix and 42 USC 9831 et seq. The Head Start Act as amended May 19,1994. The Social Security Act provides for sharing health resources under jurisdiction of the Secretary and encourages cooperative efforts. Section 6581(a)(1) of the Child Care and Development Block Grant provides for the coordination of all activities of the Department of Health and Human Services relating to child care, and, to the maximum extent practicable, coordination of such activities with similar activities of other Federal entities.

Section 402(g)(7) of the Social Security Act states that activities in subsection 402(g) (which provides for AFDC child care and Transitional Child Care) and subsection 402(i) (which provides for the At-Risk Child Care program) shall be coordinated in each State with existing early childhood education programs in that State, including Head Start programs funded under chapter 1 of the Education Consolidation and Improvement Act of 1981, and school and nonprofit child care programs (including community-based organizations receiving funds designated for preschool programs for handicapped children).

III. Background

History
The Medicaid Bureau, HCFA, and the Head Start Bureau, ACF, have a long history of collaboration. In 1976 and again in 1980, HCFA, and the then Office of Human Development Services (OHDS) entered into agreements to collaborate on the use of Medicaid by Head Start enrollees. The purpose of these agreements was to facilitate collaboration between Head Start and Medicaid so that eligible children received Early and Periodic, Screening, Diagnostic, and Treatment (EPSDT) services. Eight activities were identified in previous agreements for joint efforts: outreach or case finding, informing families about EPSDT services, scheduling assistance, establishing uniform medical screening periodicity standards, provider resource development, establishing uniform medical screening components, providing transportation to medical services, and determining information sharing. Agreements were implemented on a national, regional, and State level, and were supported by Regional training and technical assistance staff who assisted Head Start grantees in negotiating local agreements. Section 6401 of the Omnibus Budget and Reconciliation Act (OBRA) of 1989, Pub. L. No. 101-239 expanded Medicaid eligibility to include pregnant women and children age 0-6 whose income is up to 133 per cent of the federal poverty level. It is estimated that over 90 per cent of children enrolled in Head Start and Child Care are Medicaid eligible due to this expansion.

Medicaid
The Medicaid program was created in 1965 under Title XIX of the Social Security Act. It is administered by HCFA; however, each State designs and administers its own Medicaid program, setting eligibility, service coverage and payment standards within broad Federal guidelines. As a result, there is wide variation among States' Medicaid programs. The EPSDT service has been a part of the Medicaid program since 1969. It is the mandatory and comprehensive preventive child health component of Medicaid, and requires States to provide screening services, immunizations, dental, vision, and hearing services to Medicaid eligible people under the age of 21. In addition, States must provide other necessary health care, diagnostic services, treatment, and any other measures found to be medically necessary and which are covered under Medicaid, whether or not such services are included in the State plan.

A new program, the Vaccines for Children program, will also provide free vaccines, through participating providers, to these groups of children: Medicaid eligible, Native American, and uninsured. Children whose insurance coverage does not include vaccines may also receive free vaccines from certain providers. Many Head Start and children enrolled in Child Care are included in these groups.

Head Start
The Head Start (HS) Program was created in 1965 under the Economic Opportunity Act and is based on the premise that all children share certain needs, and that children from low-income families, in particular, can benefit from a comprehensive developmental program to meet these needs. It is administered by the ACF which directly funds local HS projects. It consists of four integrated component: education, health, parent involvement, and social services. The health component emphasizes prevention, early intervention, parent involvement, and health education, and focuses on medical, nutritional, mental and dental health services. Children enrolled in Head Start are required to receive a thorough medical and dental examination, health screenings within 45 days of enrollment, an immunization assessment, necessary immunization services, and a nutritional assessment after they enter the program. A primary goal of the Head Start health component is to assist the family in securing an ongoing source of medical care when the child leaves Head Start.

In Fiscal Year 1994, 740,493 children were enrolled in Head Start. Most of these children were 3 to 5 years of age. Children 0-3 years of age were served by Migrant Head Start programs, the Parent and Child Centers, and The Comprehensive Child Development Program.

The 1994 Head Start Reauthorization Legislation included a provision for ACF to develop an initiative to serve pregnant women and children age 0-3. This new program, Early Head Start, will begin in 1995. It will provide early, continuous, intensive, and comprehensive child and family development services that aim to enhance child development, support parenting skills, and help parents move toward self-sufficiency. Programs will be designed to address four areas: child development; family development; community building; and staff development. Health and support services will be provided to children and pregnant women. It is expected that most pregnant women and children enrolled in Early Head Start will be Medicaid eligible.

Child Care Bureau
In 1995, the Child Care Bureau was established within ACF to administer the four ACF child care programs: the Child Care and Development Block Grant (CCDBG), and three Title IV-A programs: At-Risk Child Care (ARCC), Aid to Families with Dependent Children Child Care (AFDC-CC), and Transitional Child Care (TCC). The CCDBG and ARCC programs were created by sections 5081 and 5082 of OBRA 1990, Pub. L. No. 101-508 respectively. The AFDC-CC and TCC programs were created by the Title III of the Family Support Act of 1988, Public Law 100-485. Placing the responsibility for all child care programs within this Bureau allows for increased coordination of child care services, enhanced consistency in policy-setting, planning, and reporting across diverse programs as well as streamlined program operations.

Child Care assistance in available through the States to families in the following manner:

1) AFDC-CC provides child care to AFDC families who are working or in State-approved education or training programs;

2) TCC provides up to 12 months of child care to working AFDC recipients upon loss of eligibility for AFDC due to increase in earnings from employment;

3) ARCC provides child care to low-income working families that do not receive AFDC but need child care assistance in order to remain employed; and

4) The CCDBG provides child care to low-income families who are working, attending a Job training or educational program, or who receive or need to receive protective services. Funding is also available to improve the availability and quality of child care and for early childhood development and before and after-school services.

These programs serve children 0 to 13 years of age and may also serve children up to age 18 or 19 who are under court supervision or incapable of caring for themselves. Data for FY 1993 indicate that the majority of children served by Title IV-A and the CCDBG programs were under age 6.

In FY 1993, 67% of the children in CCDBG funded child care lived in families that were at or below the federal poverty level. Another 23% of the children in this program lived in families with incomes between 100 and 150 percent of the poverty level. Children enrolled in AFDC are Medicaid eligible and may also be eligible for Medicaid during the transitional period after the family leaves AFDC.

In FY 1993, Title IV-A funds (AFDC-CC, ARCC and TCC) provided child care for an average of 642,943 children per month. In FY 1993, CCDBG funds were used to provide some portion of child care for 755,904 children.

IV. Scope of Work and Responsibilities

A. National Collaboration between the Medicaid Bureau (MB) the Head Start Bureau (HSB) and the Child Care Bureau (CCB):

A HSB/MB/CCB intra-agency workgroup will be established and will conduct regular, preferably semi-annual, meetings to support activities of this agreement, such as:
Develop a strategic plan with Regional Office (RO) involvement within 3 months of signing this agreement to include specific strategies to assist States, Child Care, and HS programs to increase Medicaid enrollment and participation rates.
Exchange program information, policy updates, information about conferences, related demonstration projects and approved waivers, and other efforts of mutual interest.
Develop strategies that will improve MB support of health services provided in HS and child care settings.
Assist and encourage the development of agreements between managed care entities, HS and/or Child Care programs where appropriate.
Encourage support of the collaborative efforts described in this agreement through inclusion in the Central Office MB, CCB and HSB work-plans.
Support and encourage inter-agency and intraagency collaboration between HSB, CCB, MB, and other agencies of mutual interest including: Department of Agriculture, Department of Education, Environmental Protection Agency, and Public Health Service.
The HSB will keep the MB informed about the Early Head Start program and will seek MB assistance in developing collaborative strategies to improve access to care for pregnant women and children 0-3 enrolled in the Early Head Start program.
MB and HSB will direct the development and dissemination of a guide entitled: EPSDT: A Guide for Head Start Programs.
MB and CCB will direct the development and dissemination of a guide entitled : A Guide to Medicaid and Child Care.
MB will issue joint information memoranda with HSB and/or CCB which will discuss ways to improve Medicaid outreach activities, case management services and screenings.
MB, CCB and HSB will encourage and/or facilitate joint Regional, State, and/or local training and technical assistance events on becoming Medicaid/EPSDT providers.
MB, HSB, and CCB will work together to promote the development of materials for parents about Medicaid/EPSDT services.
MB, HSB, and CCB will develop and/or disseminate materials that focus on public health issues of early childhood in collaboration with other agencies.
MB, HSB, and CCB will encourage the development by State/local programs of joint application processes for multiple services.
MB, HSB and CCB will collect and share examples of effective practices and share with Regional Offices.
MB, HSB and CCB will explore the possibility of joint demonstration projects on issues related to young children and their families such as improving access to health care, immunizations, and lead poisoning prevention.
MB, CCB and HSB will facilitate policy coordination by inviting ACF representatives to attend MB's Maternal and Child Health Technical Advisory Group (MCH-TAG) meetings.
HSB and CCB will include in any appropriate publications information about accessing health care services including Medicaid EPSDT and the Vaccines for Children Program.
HSB and CCB will support and facilitate MB activities established to increase Medicaid enrollment, such as becoming Medicaid providers or conducting outreach.
MB will include appropriate Head Start and child care topics in its MCH conference calls with Regional Offices for sharing with their states.
MB, HSB and CCB will identify State/regional/national data sources that can provide information about Early Head Start, Child Care and Head Start participation in Medicaid.
MB, HSB and CCB will develop a mechanism for ACF to be kept informed about State health care reform and Medicaid managed care efforts that will impact on Medicaid beneficiaries enrolled in Child Care, Early Head Start or Head Start.

B. Regional Collaboration
A HCFA-ACF regional intra-agency workgroup (with representatives from HSB and CCB) will meet regularly, and will consider developing strategies to support activities of this agreement in the following suggested ways:

Develop regional intra-agency agreements and initiatives where they do not exist and update existing agreements and initiatives that are currently in effect.
Assist State Medicaid agencies Child Care Programs and HS programs in developing agreements and collaborative strategies with each other.
Assist and encourage the development of Agreements among managed care entities, HS, and Child Care programs.
Encourage that the HCFA-ACF Regional work-plans include support of the collaborative efforts described in this agreement.
Monitor State agreements and provide technical assistance where appropriate.
Provide information on "Effective practices" to the national workgroup for national dissemination, and to States, Child Care and HS programs.
Share information on collaborative efforts, demonstration projects, and approved waivers impacting the common population served by both agencies.
Document Medicaid/HS collaboration on regional Head Start on-site program review instruments (OSPRI) when applicable.
Encourage the development by State/local programs of joint application processes for multiple services.
Encourage State Medicaid Agencies to allow a Child Care and HS representative to serve as a full member or ax-officio member of a state's Medical Care Advisory Committee.
Upon request, the Regional ACF will provide State Medicaid Agencies with data from the HS Program Information Report (PIR) highlighting EPSDT enrollment rates by grantee and by State.

C.Enhancing State/Local Collaboration
The Regional Offices of the HCFA and ACF will assist and encourage the development of State/local agreements to support the activities of this Agreement such as:

Medicaid agencies can assist HS and/or Child Care programs in becoming Medicaid providers, if permitted by State and Federal law and other regulations.
Child Care and/or HS programs can work with State/local Medicaid offices to coordinate eligibility identification and determination, and to improve case management and outreach activities.
Medicaid agencies, HS and Child Care programs can develop strategies which will facilitate information exchange within the constraint. of applicable confidentiality regulations.
Encouraging Medicaid representation on the HS Health Services Advisory Committee and other HS Component Advisory Committees, (i.e. Disabilities, Social Services, etc.)
Encouraging Medicaid representation on a State/local Child Care Advisory Committee or working group.
HS programs can invite a local Medicaid or Managed Care representative to participate at Head Start Policy Council meetings, Health Fairs, and other parent meetings and events to provide information on Medicaid services.
Encouraging State and local Medicaid representatives to participate in early intervention meetings to share information on needs, issues and concerns regarding services Child Care and/or HS children and families.
State and local Medicaid representatives and ACF/HS/Child Care Regional Training/Technical Assistance (T/TA) providers will work together to coordinate and provide workshops and training sessions at State Child Care and local and State Head Start conferences.
Encourage local Medicaid agencies to participate in HS and/or Child Care recruitment and enrollment activities.
HS and Child Care programs can collaborate with Medicaid State Agencies to develop and field test new EPSDT enrollment informational materials.
In States where Medicaid State Agencies are instituting "managed care/coordinated care systems," they can plan and work with HS and Child Care to educate and transition families from fee-for service to coordinated care options.

V. Duration of Agreement

This agreement, when accepted by both parties, shall become effective immediately. Representatives of both administrations will review the agreement at least annually, to determine progress towards developing State level agreements and the impact of such agreements. Appropriate modifications will be made to reflect the changing environment. Any modification to or termination of this Agreement must be agreed to by both parties in writing.

VI. EVALUATION OF AGREEMENT

In order to determine the results of this Agreement, HCFA and ACF agree to look at the changes in the enrollment and participation of Medicaid eligible children enrolled in Head Start and/or Child Care.

VII. CONTACT PERSONS

Administration for Children and Families

Head Start Bureau:
Robin Brocato
Head Start Bureau
P.O. Box 1182 Washington, D.C. 20013

Child Care Bureau:
Moniquin Huggins
Child Care Bureau
HHH Building, Room 352-G
200 Independence Ave SW
Washington, DC 20201

Health Care Financing Administration

Medicaid Bureau:
Barbara Marmion
Medicaid Bureau
Room 233 EHR
6325 Security Boulevard
Baltimore, MD. 21207-5187

VIII. Funding

This Agreement does not involve a transfer of funds

IX. Duplication

Full implementation of this Agreement will not duplicate any existing agreements.

X. Privacy Act

Not applicable.

XI. Signatures:

/S/
Olivia A. Golden
Commissioner
Administration on Children, Youth
and Families
Signed-7/7/95

/S/
Sally Richardson
Director
Medicaid Bureau
Health Care Financing Administration
Signed-8/29/95

/S/
Norman Thompson
Chief Financial Officer/ACF
Signed-7/14/95

SEPTEMBER 18, 1995

NATIONAL ASSOCIATION OF STATE MEDICAID
DIRECTORS LISTING

ALABAMA
Ms. Gwendolyn H. Williams
Commissioner
Alabama Medicaid Agency
501 Dexter Avenue
P.O. Box 5624
Montgomery, AL 36103-5624
(205) 242-5600
Fax Number (205) 242-5097

ALASKA
Mr. Bob Labbee
Director
Division of Medical Assistance
Department of Health and Social Services
P.O. Box 110660
Juneau, AK 99811-0660
(907) 465-3355
Fax Number (907) 465-2204

AMERICAN SAMOA
Mr. Aneterea Puletasi
Medicaid Program Director
Department of Health
LBJ Tropical Medical Center
Pago Pago, AS 96799
011-684-633-4590
Fax Number 011-684-633-1869

ARIZONA
Mabel Chen, M.D.
Director
Arizona Health Care Cost
Containment System (AHCCCS)
801 East Jefferson
Phoenix, AZ 85034
(602) 271-4422 ext. 4053
Fax Number (602) 252-6536

ARKANSAS
Mr. Ray Hanley
Director
Division of Medical Services
Department of Human Services
P.O. Box 1437, Slot 1100
Little Rock, AR 72203-1437
(501) 682-8292
Fax Number (501) 682-8013

Mrs. Shirley Gamble
Director
Office of Long-Term Care
Division of Medical Services
Department of Human Services
P.O. Box 1437, Slot 400
Little Rock, AR 72203-1437
(501) 682-8486
Fax Number (501) 682-6955

CALIFORNIA
Mr. John Rodriguez
Deputy Director of Programs
Medical Care Services
Department of Health Services
714 P Street, Room 1253
Sacramento, CA 95814
(916) 657-1425
Fax Number (916) 657-1156

COLORADO
Mr. Richard Allen
Director
Health and Medical Services
Department of Health Care
Policy and Financing
1575 Sherman Street, Fourth Floor
Denver, CO 80203-1714
(303) 866-6092
Fax Number (303) 866-2803

CONNECTICUT
Mr. David Parrella, Acting
Deputy Commissioner, Health Care
Financing Administration
Department of Social Services
25 Sigourney Street
Hartford, CT 06106-5033
(203) 424-5167
Fax Number (203) 951-9544

DELAWARE
Mr. Philip Soule, Sr.
Medicaid Director
Department of Health and Social Services
1901 North DuPont Highway
New Castle, DE 19720
(302) 577-4901
Fax Number (302) 577-4899

WASHINGTON, D.C.
Mr. Paul Offner
Commissioner
Commission on Health Care Finance
Department of Human Services
2100 ML King, Jr., Ave., S.E.
Suite 302
Washington, DC 20020
(202) 727-0735
Fax Number (202) 610-3209

FLORIDA
Mr. Gary Crayton
Director of Medicaid
Agency for Health Care Administration
P.O. Box 13000
Tallahassee, FL 32317-3000
(904) 488-3560
Fax Number (904) 487-2520

GEORGIA
Ms. Marjorie P. Smith
Commissioner
Department of Medical Assistance
2 Peachtree Street, N.W.
27th Floor, Suite 100
Atlanta, GA 30303-3159
(404) 656-4479
Fax Number (404) 651-6880

GUAM
Ms. Adoracion Solidum
Administrator, Bureau of Health Care Financing
Department of Public Health and Social Services
P.O. Box 2816
Agana, GU 96910
011-671-734-7269
Fax Number 011-671-734-5910

HAWAII
Ms. Winifred N. Odo, Administrator
Med QUEST Division
Department of Human Services
P.O. Box 339
Honolulu, HI 96809-0339
(808) 586-5391
Fax Number (808) 586-5389

IDAHO
Ms. Tresa Newman
Acting Administrator
Division of Welfare - Administrative Office
Department of Health and Welfare
Towers Building, Second Floor
P.O. Box 83720
Boise, ID 83720-0036
(208) 334-5747
Fax Number (208) 334-0657

ILLINOIS
Mr. George Hovanec, Administrator
Medical Operations
Department of Public Aid
201 South Grand Avenue, East
Third Floor
Springfield, IL 62763-0001
(217) 782-2570
Fax Number (217) 524-7232

INDIANA
Mr. James M. Verdier
Assistant Secretary
Medicaid Policy and Planning
Family and Social Services
Administration, Room W382
402 W. Washington Street
Indianapolis, IN 46204-2739
(317) 233-4455
Fax Number (317) 232-7382

IOWA
Mr. Donald Herman, Administrator
Division of Medical Services
Department of Human Services
Hoover State Office Building
Fifth Floor
Des Moines, IA 50319
(515) 281-8794
Fax Number (515) 281-4597

KANSAS
Ms. Joyce Sugrue, R.N.
Director
Medical Services
Department of Social and Rehabilitation Services
Docking State Ofc. Building
Room 628 South
915 Harrison Street
Topeka, KS 66612
(913) 296-3981
Fax Number (913) 296-4813

KENTUCKY
Mr. Masten Childers, II
Commissioner
Dept. for Medicaid Services
Third Floor
275 East Main Street
Frankfort, KY 40621
(502) 564-4321
Fax Number (502) 564-3232

LOUISIANA
Mr. Thomas D. Collins
Director
Bureau of Health Svcs. Financing
Department of Health and Hospitals
P.O. Box 91030
Baton Rouge, LA 70821-9030
(504) 342-3891
Fax Number (504) 342-3893

MAINE
Mr. Francis T. Finnegan, Jr.
Director
Bureau of Medical Services
Department of Human Services
State House Station 11
Augusta, ME 04333
(207) 287-2674
Fax Number (207) 287-2675

MARYLAND
Martin P. Wasserman, M.D., J.D.
Secretary
Dept. of Health & Mental Hygiene
Herbert R. O'Connor Building
201 West Preston St., Fifth Floor
Baltimore, MD 21201
(410) 225-6505
Fax Number (410) 225-6489

MASSACHUSETTS
Mr. Bruce Bullen
Commissioner
Division of Medical Assistance
Medicaid Division
600 Washington Street
Boston, MA 02111
(617) 348-5690
Fax Number (617) 348-8590

MICHIGAN
Vernon K. Smith, Ph.D.
Director
Medical Services Administration
Department of Social Services
P.O. Box 30037
Lansing, MI 48909
(517) 335-5001
Fax Number (517) 335-5007

MINNESOTA
Ms. Patricia MacTaggart
Assistant Commissioner
Health Care Administration
Department of Human Services
444 Lafayette Road, Sixth Floor
St. Paul, MN 55155-3852
(612) 297-3374
Fax Number (612) 297-3230

MISSISSIPPI
Ms. Helen Wetherbee
Executive Director
Division of Medicaid
Office of the Governor
Suite 801, Robert E. Lee Bldg.
239 North Lamar Street
Jackson, MS 39201-1399
(601) 359-6056
Fax Number (601) 359-6048

MISSOURI
Ms. Donna Checkett, Director
Division of Medical Services
Department of Social Services
615 Howerton Court
P.O. Box 6500
Jefferson City, MO 65102-6500
(314) 751-6922
Fax Number (314) 751-6564

MONTANA
Ms. Nancy Ellery
Administrator
Medical Services Division
Department of Social and Rehabilitation Services
P.O. Box 4210
111 N. Sanders
Helena, MT 59604-4210
(406) 444-4540
Fax Number (406) 444-1861

NEBRASKA
Mr. Robert Seiffert
Administrator
Medical Services Division
Department of Social Services
301 Centennial Mall South
Fifth Floor
Lincoln, NE 68509-5026
(402) 471-9718
Fax Number (402) 471-9092

NEVADA
Ms. April Townley
Deputy Administrator
Welfare Division
Department of Human Resources
2527 North Carson Street
Carson City, NV 89710
(702) 687-4867
Fax Number (702) 687-5080

NEW HAMPSHIRE
Ms. Lee Bezanson, Administrator
Office of Medical Services
Division of Human Services
Department of Health and Human Services
6 Hazen Drive
Concord, NH 03301-6521
(603) 271-4353
Fax Number (603) 271-4376

NEW JERSEY
Ms. Velvet G. Miller
Director
Division of Medical Assistance and Health Services
Department of Human Services
CN-712, 7 Quakerbridge Plaza
Trenton, NJ 08625
(609) 588-2600
Fax Number (609) 588-3583

NEW MEXICO
Mr. Bruce Weydemeyer
Director
Medical Assistance Division
Human Services Department
P.O. Box 2348
Santa Fe, NM 87504-2348
(505) 827-3106
Fax Number (505) 827-3185

NEW YORK
Mr. Richard T. Cody
Acting Deputy Commissioner
Division of Health and Long-Term Care
Department of Social Services
40 North Pearl Street
Albany, NY 12243
(518) 474-9132
Fax Number (518) 473-4232

NORTH CAROLINA
Ms. Barbara Matula, Director
Division of Medical Assistance
Department of Human Resources
1985 Umstead Drive
P.O. Box 29529
Raleigh, NC 27626-0529
(919) 733-2060
Fax Number (919) 733-6608

NORTH DAKOTA
Mr. David J. Zentner
Director, Medicaid
Department of Human Services
600 East Boulevard
Bismarck, ND 58505-0261
(701) 328-2321
Fax Number (701) 328-2359

NORTHERN MARIANA ISLANDS
Mr. Galo P. Tudela
Medicaid Administrator
Department of Public Health and Environmental Services
Commonwealth of the Northern Mariana Islands
P.O. Box 409 CK
Saipan, MP 96950
011-670-234-8950 ext. 2905
Fax Number 011-670-234-8930

OHIO
Mr. William T. Ryan, Deputy
Director, Office of Medicaid
Department of Human Services
30 East Broad St., 31st Fl.
Columbus, OH 43266-0423
(614) 644-0140
Fax Number (614) 752-3986

OKLAHOMA
Mr. Michael Fogarty
State Medicaid Director
Health Care Authority
4545 North Lincoln Boulevard
Suite 124
Oklahoma City, OK 73105
(405) 530-3374
Fax Number (405) 528-4786

OREGON
Mr. Hersh Crawford, Acting
Director, Office of Medical Assistance Programs
Department of Human Resources
500 Summer Street, N.E.
Human Resources Building
Third Floor
Salem, OR 97310-1014
(503) 945-5772
Fax Number (503) 373-2897

PENNSYLVANIA
Ms. Darlene C. Collins, Deputy
Secretary for Medical Assistance
Programs, Room 515
Department of Public Welfare
P.O. Box 2675
Health and Welfare Building
Harrisburg, PA 17105-2675
(717) 787-1870
Fax Number (717) 787-4639

PUERTO RICO
Ms. Margarita Latorre
Medicaid Director
Office of Economic Assistance to the Medically Indigent
Department of Health
G.P.O. Box 70184
San Juan, PR 00936
(809) 765-1230
Fax Number (809) 766-2240

RHODE ISLAND
Mr. Lewis Treistman
Acting Associate Director for Medical Services
Department of Human Services
600 New London Avenue
Cranston, RI 02920
(401) 464-3575
Fax Number (401) 464-1876

SOUTH CAROLINA
Eugene Laurent, Ph.D.
Executive Director
Health and Human Services Finance Commission
P.O. Box 8206
Columbia, SC 29202-8206
(803) 253-6100
Fax Number (803) 253-4137

SOUTH DAKOTA
Mr. David M. Christensen
Program Administrator
Medical Services
Department of Social Services
Richard F. Kneip Building
700 Governors Drive
Pierre, SD 57501-2291
(605) 773-3495
Fax Number (605) 773-6834

TENNESSEE
Mr. Rusty Siebert
Assistant Commissioner
Bureau of Medicaid
Department of Health
729 Church Street
Nashville, TN 37247-6501
(615) 741-0213
Fax Number (615) 741-0882

TEXAS
Michael McKinney, M.D.
State Medicaid Director
Health and Human Services
Commission
4807 Spicewood Springs Road
Building #4
Austin, TX 78759
(512) 502-3224
Fax Number (512) 502-3289

UTAH
Mr. Michael Deily, Director
Div. of Health Care Financing
Department of Health
288 North 1460 West
Third Floor
Salt Lake City, UT 84116-0580
(801) 538-6406
Fax Number (801) 538-6478

VERMONT
Mr. Kent Stoneman, Director
Medicaid Division
Agency of Human Services
Department of Social Welfare
103 South Main Street
Waterbury, VT 05671-1201
(802) 241-2880
Fax Number (802) 241-2974

VIRGINIA
Mr. Robert C. Metcalf
Director
Department of Medical
Assistance Services
600 East Broad Street
Suite 1300
Richmond, VA 23219
(804) 786-8099
Fax Number (804) 371-4981

VIRGIN ISLANDS
Ms. Priscilla Berry
Director Bureau of Health Insurance and Medical Assistance
Department of Health
210-3A Altona, Suite 302
Frostco Center
Charlotte Amalie, VI 00802
(809) 774-4624
Fax Number (809) 774-4918

WASHINGTON
Ms. Jane Beyer
Assistant Secretary
Medical Assistance Admit
Department of Social and Health Services
P.O. Box 45080
Olympia, WA 98504-5080
(206) 753-1777
Fax Number (206) 586-5874

WEST VIRGINIA
Ms. Ann Stottlemyer
Commissioner
Bureau for Medical Services
Department of Health and Human Resources
Building 6, State Capitol
Complex
Charleston, WV 25305
(304) 926-1700
Fax Number (304) 926-1776

WISCONSIN
Mr. Kevin Piper
Director
Burl of Health Care Financing
Division of Health
Department of Health and Social Services
1 West Wilson Street, Room 250
P.O. Box 309
Madison, WI 53701
(608) 266-2522
Fax Number (608) 266-1096

WYOMING
Ms. Cheryl McVay
Administrator
Division of Health Care Financing
Department of Health
6101 Yellowstone Road
Cheyenne, Wyoming 82002
(307) 777-7531
Fax Number (307) 777-6964