21 Million Children’s Health:
Our Shared Responsibility

The Medical Child Support Working Group’s Report to:

The Honorable
Donna E. Shalala
Secretary
Department of Health and Human Services

The Honorable
Alexis M. Herman
Secretary
Department of Labor

by
Department of Health and Human Services
Department of Labor

June 2000

This report is available on the Internet at:
http://fatherhood.hhs.gov/medsupport00/index.htm

How to obtain a printed copy.

Contents of Report

Background Material

• Medical Child Support Working Group Membership List
• Guide to Format of this Report
• Preface/Cover Letter from Co-Chairs

Executive Summary

List of Recommendations

Chapters:

1. Lack of Health Care Coverage
   • Children's Health Care Coverage is Critical
   • Government Efforts Have Helped But More Needs to be Done
   • Creation of the Medical Child Support Working Group
   • Organization of the Report
2. Partnership for a New Medical Child Support Paradigm
   • Introduction
   • Prior Assumptions and Inadequate Solutions
   • Assumptions for the New Medical Support Paradigm
   • Summary
3. Taking the First Step:  Establishing Health Care Coverage in Child Support Orders
   • State Child Support Guidelines
   • Role of the Desicion Maker:  Administrative Agency, Court, Other "Tribunal"
4. Implementing a New Tool:  The National Medical Support Notice and Related Issues
   • National Medical Support Notice
   • Recommendations of the Working Group on Making the Notice Work Better
   • Coverage for Children of Federal Employees and Military Personnel
5. Answering Hard Questions:  Providing Guidance to IV-D Agencies and Employers on Enforcement Issues
   • Introduction
   • Enforcement of Health Care Provisions of Child Support Orders
   • Consumer Credit Protection Act (CCPA) Limits
   • Priority of Withholding
6. Moving Towards Seamless Coverage:  Improving Coordination and Communication Among Private and Public Health Care Coverage
   • Outreach for Medicaid and the State Children's Health Insurance Program (SCHIP)
   • SCHIOP Barriers
   • SCHIP/Medicaid/IV-D Information Exchange
   • Increased Efficiency in the Coordination of Public and Private Coverage
   • ERISA Issues Related to Children Covered Under QMCSOs
7. The Question of Money:  Paying for the Expanded Role of the IV-D Program in Obtaining Health Care Coverage for Children
   • Introduction
   • Current IV-D Funding Structure
   • Policy Issues Related to IV-D Funding
8. Shaping the Future:  Strategies for Ensuring Ongoing Improvements
   • Intruduction
   • Finding New Solutions
   • Better Coordination of Policies and Programs
   • Review of Tax Policy
9. Conclusion/Postscript

Appendices

1. Next Steps — List of Recommendations Organized by Type/Category
2. Glossary
3. Legislation
4. Health Care Coverage for Chlid Support-Eligible Children
5. National Medical Support Notice
6. Washington State Model Notice of Release Form
7. Meeting Schedule
8. Model Joint Medicaid/SCHIP Application Form

Letter of Announcement to the President of the Senate
Letter of Announcement to the Speaker of the House of Representatives

Obtaining a Printed Copy

If you wish to print a copy from the Internet, you will obtain best results by printing the following files, which are in Portable Document Format (PDF) and require that you have the Adobe Acrobat Reader.  (The reader can be obtained direct from Adobe.):

Executive Summary   (PDF format, 221KB, updated: 2000/08/10)

Full Report   (PDF format, 1.43MB, updated: 2000/08/10)