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820 First Street NE, Suite 510

Washington, DC 20002

Tel: 202-408-1080
Fax: 202-408-1056

center@cbpp.org
www.cbpp.org

Revised April 27, 2009

ONLINE INFORMATION ABOUT KEY LOW-INCOME BENEFIT PROGRAMS


Links to Policy Manuals, Descriptive Information, and Applications
for State Food Stamp, TANF, Child Care, Medicaid, and SCHIP Programs
Virtually all states have made information regarding the five main state-administered low-income
benefit programs — food stamps, Medicaid, SCHIP, TANF and child care — available to the public
via the internet. There is significant variation between what online information is provided across
states. Some provide a simple description of each program on their agencies websites. Others offer
additional information, such as application forms, eligibility screening tools, and policy and
procedure manuals used by state agency caseworkers. A number of states allow individuals to apply
for certain types of benefits online. This report also provides links to online government benefit
screeners and calculators. We have not included benefit screeners or calculators that have been
developed and are maintained by non-governmental agencies.

Below are links to online state information provided about these benefit programs. Individuals
seeking information about eligibility and benefits in a particular state will find these links a useful
place to start. Most state human service agencies also have information numbers where families can
seek additional information. In addition, individuals in most states (as well as the District of
Columbia and Puerto Rico) can call 2-1-1 on any type of telephone and get connected to someone
who can help them find out about many kinds of assistance, including emergency help with food,
housing or clothing, physical or mental health treatment, assistance for the aged, people with
disabilities, and families with children.

The links below also may be useful to those researching variations in states’ policies or
applications may find this resource helpful. There are several important caveats to consider when
using these resources. First, information may be presented differently across states and states may
use different terminology to represent similar concepts or terms. Second, this list was not developed
via a comprehensive survey of states and may not be complete. Finally, in some cases it was unclear
whether an application for multiple programs, including Medicaid, also served as an application for
SCHIP. When it was unclear whether the application served as an SCHIP application, this
document does not show the application as including SCHIP.

Please notify Tina Marshall at the Center to update or revise this listing.
Alabama Georgia Maryland New Jersey South Carolina
Alaska Hawaii Massachusetts New Mexico South Dakota
Arizona Idaho Michigan New York Tennessee
Arkansas Illinois Minnesota North Carolina Texas
California Indiana Mississippi North Dakota Utah
Colorado Iowa Missouri Ohio Vermont
Connecticut Kansas Montana Oklahoma Virginia
Delaware Kentucky Nebraska Oregon Washington
District of Columbia Louisiana Nevada Pennsylvania West Virginia
Florida Maine New Hampshire Rhode Island Wisconsin
Wyoming

ALABAMA

Policy Manuals/Materials

Food Stamp, TANF, Medicaid/SCHIP


http://www.alabamaadministrativecode.state.al.us/docs/hres/index.html

Medicaid
http://www.medicaid.alabama.gov/resources/admin_code.aspx?Tab=5

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS019554&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://www.dhr.state.al.us/page.asp?pageid=159

TANF
http://www.dhr.state.al.us/page.asp?pageid=351

Child Care
http://www.dhr.state.al.us/page.asp?pageid=255

Medicaid
http://www.medicaid.alabama.gov/

SCHIP
http://www.adph.org/allkids/default.asp?templatenbr=0&deptid=90&templateid=455

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Applications for Assistance

Food Stamps Application


http://www.dhr.state.al.us/large_docs/Food%20Stamp%20Application.PDF

Medicaid
http://www.medicaid.alabama.gov/apply/apply_application.aspx?tab=3

SCHIP/Medicaid (for families and children)


http://www.adph.org/allkids/index.asp?ID=575

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ARIZONA

Policy Manuals/Materials

Food Stamp, TANF, Medicaid


http://www.azdes.gov/aspnew/default.asp

Child Care State Plan


http://www.de.state.az.us/childcare/pdf/StatePlan.pdf

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS023534&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp, TANF, Medicaid


http://www.azdes.gov/aspnew/default.asp

Child Care
http://egov.azdes.gov/cmsinternet/main.aspx?menu=128&id=2670

SCHIP
http://www.azkidscare.gov/

Applications for Assistance

Food Stamp, TANF, Medicaid


https://egov.azdes.gov/cmsinternet/common.aspx?menuc=162&id=2520

SCHIP/Medicaid (families and children)


http://www.ahcccs.state.az.us/Members/HowToApply.asp
http://www.azahcccs.gov/Publications/Forms/Member/UniversalApp/ApplicationforAHCCCS
HealthInsurance.pdf Printable Application

Child Care Assistance


http://egov.azdes.gov/cms400min/internetfiles/internetprogrammaticforms/pdf/cc-001-pd.pdf

Online Benefit Screener/Calculator

Multi-Program
http://www.arizonaselfhelp.org/

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ARKANSAS
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamp, TANF, Child Care, Medicaid


http://www.accessarkansas.org/dhs/webpolicy/Index.htm

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du

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Food Stamp - Chapter 63-100 through 63-1436
http://www.dss.cahwnet.gov/ord/pg303.htm

TANF - Chapter 42-700 through 42-800

Child Care - Chapter 47-100 through 48-000

Medicaid / SCHIP Regulations


http://www.dhcs.ca.gov/formsandpubs/publications/Pages/Manuals.aspx

SCHIP Handbook
http://www.healthyfamilies.ca.gov/Downloads/HFP_Handbook.aspx

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS053475&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://www.dss.cahwnet.gov/foodstamps/

TANF
http://www.dss.cahwnet.gov/cdssweb/pg54.htm

Child Care
http://www.dss.cahwnet.gov/cdssweb/pg78.htm

Medicaid
http://www.medi-cal.ca.gov/

SCHIP
http://www.healthyfamilies.ca.gov/

Applications for Assistance

Food Stamp
http://www.dss.cahwnet.gov/foodstamps/entres/forms/english/DFA285A1.PDF

Medicaid
http://www.dhcs.ca.gov/services/medi-cal/pages/medicalapplications.aspx (this is a link to
applications in 12 languages)

Children’s Medicaid/SCHIP
http://www.healthyfamilies.ca.gov/downloads/applications.aspx Parents and adult caretakers may
have to submit additional information to complete eligibility process.

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COLORADO

Policy Manuals/Materials

Food Stamp, TANF, Child Care


http://stateboard.cdhs.state.co.us:8008/CDHS/rule_volumes$.volumes

Food Stamps
http://stateboard.cdhs.state.co.us:8008/CDHS/rule_display$.DisplayVolume?p_vol_num=4

TANF
http://stateboard.cdhs.state.co.us:8008/CDHS/rule_display$.DisplayVolume?p_vol_num=3

Employment First/Workfare State Regulations


http://www.cdhs.state.co.us/employmentfirst/EFStateRegulations.htm

Medicaid
http://www.colorado.gov/cs/Satellite?c=Page&cid=1197969486289&pagename=HCPF%2FH
CPFLayout

SCHIP
http://www.chcpf.state.co.us/HCPF/titlexxi/StatePlan/Reports/2000framework.asp

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS026857&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://www.cdhs.state.co.us/fap/

TANF
http://www.colorado.gov/coloradoworks

Child Care
http://www.cdhs.state.co.us/childcare/

Medicaid
http://www.cchp.org/index.cfm?action=medicaid&language=eng

SCHIP
http://www.cchp.org/chpweb/mainpage.cfm?pageToLoad=applicants.cfm#q3

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Applications for Assistance

Food Stamp
http://www.cdhs.state.co.us/fap/howdoiapplyforfoodassistance.htm

CONNECTICUT

Policy Manuals/Materials

TANF
http://www.ct.gov/dss/LIB/dss/PDFs/TANFStPLAN2000-2002.PDF

Child Care
http://www.ct.gov/dss/cwp/view.asp?a=2353&q=305180

Jobs First Program Employment Services Policy and Procedures Manual


http://www.ctdol.state.ct.us/weltowrk/allpdf/completeversion.pdf

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS026880&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://www.ct.gov/dss/cwp/view.asp?a=2353&q=411676

TANF
http://www.ct.gov/dss/cwp/view.asp?a=2353&q=305158

Child Care
http://www.ctcare4kids.com/
http://www.ct.gov/dss/cwp/view.asp?a=2353&q=305178

Medicaid/SCHIP
http://www.ct.gov/dss/cwp/view.asp?a=2353&q=305218

Applications for Assistance

Food Stamp Application (English)


http://www.ct.gov/dss/lib/dss/pdfs/w-1food.pdf

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Child Care Application
http://www.ctcare4kids.com/pdf/C4KfinalApplication2.pdf

Medicaid (families and children)/SCHIP Application


http://www.huskyhealth.com/application.htm

DELAWARE
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamps

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SCHIP
http://www.dhss.delaware.gov/dhss/dmma/dhcp.html

Applications for Assistance

Food Stamp, TANF, Child Care, Medicaid


https://assist.dhss.delaware.gov/PGM/ASP/SC001.asp Online Application
http://www.dhss.delaware.gov/dhss/dss/files/dssapplicationenglish.pdf

SCHIP
http://www.state.de.us/dhss/dss/dhcpapply.html
http://www.dhss.delaware.gov/dhss/dss/files/chip_appl_engl.pdf Printable Application

DISTRICT OF COLUMBIA
The District of Columbia does not have a separate SCHIP program

Policy Manuals/Materials

State Child Health Plan


http://doh.dc.gov/doh/cwp/view,a,1370,q,573940,dohNav_GID,1807.asp

Medicaid State Plan


http://doh.dc.gov/doh/cwp/view,a,1371,q,602787,dohNav,%7C33345%7C.asp

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS026932&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp, TANF, Medicaid


http://dhs.dc.gov/dhs/cwp/view%2Ca%2C3%2Cq%2C492411.asp

Food Stamp Loan Office Information


http://www.dhs.dc.gov/dhs/cwp/view,a,3,q,492404.asp

Applications for Assistance

Food Stamp, TANF, Medicaid


http://www.dhs.dc.gov/dhs/cwp/view.asp?a=3&Q=568277&dhsNAV=|30980|

SCHIP
http://doh.dc.gov/doh/cwp/view,a,1371,q,575816.asp

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FLORIDA
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamp, TANF, Medicaid/SCHIP


http://www.dcf.state.fl.us/publications/policies.shtml

Medicaid/SCHIP
http://www.fdhc.state.fl.us/Medicaid/stateplan.shtml

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS026947&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp, TANF, Medicaid


http://www.dcf.state.fl.us/ess/

SCHIP
http://www.floridakidcare.org/eligibility.html

Applications for Assistance

Food Stamp, TANF, Medicaid


http://www.dcf.state.fl.us/ess/agencyforms.shtml (ACCESS Florida Application).

Medicaid (children only)/SCHIP


http://www.healthykids.org/apply/ Ages 5-18
http://www.floridakidcare.org/print-application.html

Online Benefit Screener/Calculator

Multi-Program
http://www.myflorida.com/accessflorida/

GEORGIA

Policy Manuals/Materials

Child Care State Plan


http://dfcs.dhr.georgia.gov/portal/site/DHR-
DFCS/menuitem.83054cda1a084d2f7da1df8dda1010a0/?vgnextoid=b70b2b48d9a4ff00VgnVCM
100000bf01010aRCRD

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Medicaid State Plan
http://dch.georgia.gov/00/channel_title/0,2094,31446711_80466652,00.html

TANF State Plan


http://dfcs.dhr.georgia.gov/DHR-DFCS/DHR-
DFCS_CommonFiles/10893209Georgia_TANF_Plan.pdf

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS028627&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp, TANF, Child Care, Medicaid/SCHIP


http://dfcs.dhr.georgia.gov/portal/site/DHR-DFCS/

Food Stamps
georgia.gov -- Division of Children and Family Services (DFCS) (in English)
georgia.gov - Division of Family and Children Services (DFCS) (in Spanish)

TANF
http://dfcs.dhr.georgia.gov/portal/site/DHR-
DFCS/menuitem.5d32235bb09bde9a50c8798dd03036a0/?vgnextoid=d8ea2b48d9a4ff00VgnVC
M100000bf01010aRCRD

Child Care
http://dfcs.dhr.georgia.gov/portal/site/DHR-
DFCS/menuitem.5d32235bb09bde9a50c8798dd03036a0/?vgnextoid=16fa2b48d9a4ff00VgnVC
M100000bf01010aRCRD

Medicaid
http://dfcs.dhr.georgia.gov/portal/site/DHR-
DFCS/menuitem.83054cda1a084d2f7da1df8dda1010a0/?vgnextoid=36ca2b48d9a4ff00VgnVCM
100000bf01010aRCRD

Medicaid (for Children)/SCHIP


http://www.peachcare.org/

Applications for Assistance

Food Stamp, TANF, Medicaid


http://compass.ga.gov/

Online Application for Medicaid (for children)/SCHIP


http://www.peachcare.org/Guidelines.aspx
http://www.georgia-families.com/en_US/news.htm Health plan selection

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HAWAII
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamp, TANF, Child Care, Medicaid


http://hawaii.gov/dhs/main/har/har_current/AdminRules/document_view

TANF State Plan


http://hawaii.gov/dhs/main/reports/TANF%205-Year%20Strategic%20Plan%20Final.pdf

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SCHIP State Plan and Factsheet
http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS028657&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamps
http://www.healthandwelfare.idaho.gov/site/3413/default.aspx

Child Care
http://www.healthandwelfare.idaho.gov/DesktopModules/ArticlesSortable/ArticlesSrtView.as
px?tabID=0&ItemID=87&mid=10274

Medicaid
http://www.healthandwelfare.idaho.gov/site/3629/default.aspx

SCHIP / Children’s Medicaid


http://www.healthandwelfare.idaho.gov/site/4299/default.aspx

Applications for Assistance

Food Stamp, TANF, Child Care, Medicaid / SCHIP


http://www.healthandwelfare.idaho.gov/DesktopModules/ArticlesSortable/ArticlesSrtView.aspx
?tabID=0&ItemID=2219&mid=10569&wversion=Staging
http://www.healthandwelfare.idaho.gov/DesktopModules/DocumentsSortable/DocumentsSrtVi
ew.aspx?tabID=0&ItemID=185&MId=10385&wversion=Staging Printable Application

ILLINOIS
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamp, TANF, Medicaid/SCHIP


http://www.dhs.state.il.us/page.aspx?item=4107

Child Care
http://www.dhs.state.il.us/page.aspx?item=9877

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS028669&intNumPerPage=2000

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Descriptive Program and Eligibility Information

Food Stamp
http://www.dhs.state.il.us/page.aspx?item=30357

TANF
http://www.dhs.state.il.us/page.aspx?item=30358

Child Care
http://www.dhs.state.il.us/page.aspx?item=30355

Medicaid
http://www.familycareillinois.com/ For parents living with children
http://www.hfs.illinois.gov/medical/apply.html

SCHIP
http://www.allkids.com/

Applications for Assistance

Food Stamp, TANF, Medicaid/SCHIP


http://www.dhs.state.il.us/page.aspx?item=33698

Medicaid (children only)/SCHIP


http://www.allkidscovered.com/application.html

Online Benefit Screener/Calculator

Multi-Program
City of Chicago
http://www.ci.chi.il.us/WorkforceDevelopment/ssc/ss_calc.html

INDIANA
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamp, TANF, Medicaid/SCHIP


http://www.in.gov/legislative/iac/title470.html

Child Care
http://www.in.gov/legislative/iac/title407.html

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS029684&intNumPerPage=2000

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Descriptive Program and Eligibility Information

Food Stamp
http://www.in.gov/fssa/dfr/2691.htm

TANF
http://www.in.gov/fssa/dfr/2684.htm

Child Care
http://www.in.gov/fssa/2552.htm

Medicaid
http://www.in.gov/fssa/ompp/2544.htm
http://www.in.gov/fssa/2408.htm Office of Medicaid Policy and Planning

SCHIP
http://www.in.gov/fssa/ompp/2545.htm

Applications for Assistance

Food Stamp, TANF, Medicaid


Print: http://www.in.gov/icpr/webfile/formsdiv/30465.pdf
Online Screener: http://www.in.gov/fssa/2954.htm

Medicaid (for children)/SCHIP


http://www.in.gov/fssa/ompp/2998.htm
http://www.in.gov/icpr/webfile/formsdiv/43202.pdf Printable Application

IOWA
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamp, TANF, Child Care, Medicaid/SCHIP


http://www.dhs.state.ia.us/policyanalysis/PolicyManualPages/IncomeMaint.htm#Food%20Stam
ps Child Care found under “Other IM Programs”

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS029717&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://www.dhs.state.ia.us/Consumers/Assistance_Programs/FoodAssistance/index.html

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TANF
http://www.dhs.state.ia.us/Consumers/Assistance_Programs/CashAssistance/FamilyInvestment
Program.html

Child Care
http://www.dhs.state.ia.us/Consumers/Child_Care/CCAssistance/CCAforConsumers.html

Medicaid
http://www.dhs.state.ia.us/Consumers/Health/Medical_Insurance/WhatsAvailable.html

SCHIP
http://www.hawk-i.org/en_US/index.html

Applications for Assistance

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KANSAS

Policy Manuals/Materials

Food Stamp, TANF, Child Care, Medicaid/SCHIP


http://www.srskansas.org/KEESM/KEESM.htm

Medicaid/SCHIP (for children and pregnant women)


http://www.khpa.ks.gov/kfmam/

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS029779&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp, TANF, Child Care, Medicaid/SCHIP


http://www.srskansas.org/srseescomm.html

Food Stamps
http://srskansas.org/ISD/ees/food_stamps.htm

Child Care
http://www.srskansas.org/ISD/ees/childcare_main.htm

TANF
http://www.srskansas.org/ISD/ees/successful_families.htm

Medicaid / SCHIP
http://www.kansashealthwave.org/
http://www.khpa.ks.gov/healthwave/about.html

Applications for Assistance

Online Application for Food Stamps, TANF, Child Care, Medicaid/SCHIP


http://www.srskansas.org/onlineapp/index.html

Food Stamp, TANF, Child Care, Medicaid


http://www.srskansas.org/KEESM/Forms/ES-3100_assist_for_families_02_07.pdf

Food Stamp
http://www.srskansas.org/KEESM/Forms/ES-3100.6_10-01.pdf

SCHIP
http://www.kansashealthwave.org/apps/english.pdf

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Online Benefit Screener/Calculator

Multi-Program
http://www.srskansas.org/onlineapp/index.html

Print Application
http://srskansas.org/ISD/ees/applications_main.html

Medicaid
http://www.khpa.ks.gov/medical_assistance/apply_for_assistance.html

KENTUCKY
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamp, TANF, Child Care, Medicaid/SCHIP


http://manuals.chfs.ky.gov/dcbs_manuals/DFS/

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=no
ne&filterByDID=-
99&sortByDID=2&sortOrder=ascending&itemID=CMS029799&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://chfs.ky.gov/dcbs/dfs/foodstampsebt.htm

TANF
http://chfs.ky.gov/dcbs/dfs/KTAP.htm

Child Care
http://chfs.ky.gov/dcbs/dcc/

Medicaid
http://chfs.ky.gov/dms/Eligibility.htm

SCHIP
http://kidshealth.ky.gov/en/kchip/

Applications for Assistance

Food Stamp, TANF (Cash Assistance), Medicaid


http://chfs.ky.gov/NR/rdonlyres/0A81E704-89FB-42BD-9EB4-
8DEC8843D773/16100/KIM77.doc

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SCHIP
http://kidshealth.ky.gov/NR/rdonlyres/4DCB7825-6877-46B5-9CA3-
5BF40196D680/0/KCHIP_v148_033109_printversion.pdf

Child Care
http://chfs.ky.gov/dcbs/dcc/apply.htm

LOUISIANA
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamp, TANF, Child Care, Medicaid


http://doa.louisiana.gov/osr/lac/67v01/67v01.pdf

TANF State Plan


http://www.dss.state.la.us/assets/docs/searchable/OFS/TANF/TANFStatePlanAmended10-
08.pdf

Child Care State Plan


http://www.dss.state.la.us/assets/docs/searchable/OFS/ChildcareDevelopmentFund/CCDF_Pl
an_Amended_06.pdf

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS029820&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamps, TANF, Child Care


http://www.dss.state.la.us/index.cfm?md=pagebuilder&tmp=home&pid=9

Food Stamps
http://www.dss.state.la.us/index.cfm?md=pagebuilder&tmp=home&pid=93

Child Care
http://www.dss.state.la.us/index.cfm?md=pagebuilder&tmp=home&pid=136

TANF
http://www.dss.state.la.us/index.cfm?md=pagebuilder&tmp=home&pid=139

Medicaid
http://www.dhh.louisiana.gov/offices/?ID=92

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SCHIP
http://www.dhh.state.la.us/offices/?ID=119

Applications for Assistance

Food Stamp, TANF


http://www.dss.state.la.us/assets/docs/searchable/OFS/Applications/OFS004APPApplication_
rev0109.pdf

Child Care Application


http://www.dss.state.la.us/assets/docs/searchable/OFS/Applications/CCAP2Application.pdf

21
Descriptive Program and Eligibility Information

Food Stamp
http://www.maine.gov/dhhs/OIAS/snap/index.html

TANF
http://www.maine.gov/dhhs/OIAS/services/home.html

Child Care
http://www.maine.gov/dhhs/ocfs/ec/occhs/payingchildcare.htm

Medicaid/SCHIP
http://www.maine.gov/dhhs/OIAS/services/cubcare/CubCare.htm

Applications for Assistance

Food Stamp, TANF, Medicaid


http://www.maine.gov/dhhs/OIAS/snap/APP-01-07.doc

Child Care Application


http://www.maine.gov/dhhs/voucherapp.doc

Medicaid (for families and children) Application/SCHIP


http://www.maine.gov/dhhs/OIAS/services/cubcare/Getting%20an%20Application.htm
http://www.maine.gov/dhhs/OIAS/services/mainecare/mainecareapplication.pdf Printable
Application

MARYLAND
Maryland does not have a separate SCHIP program

Policy Manuals/Materials

Food Stamp
http://www.dhr.state.md.us/manuals/fstamp.php

TANF
http://www.dhr.state.md.us/manuals/tca.php

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS029913&intNumPerPage=2000

Descriptive Program and Eligibility Information

All Economic Assistance Programs


http://www.dhr.state.md.us/economic.php

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22
Food Stamp
http://www.dhr.state.md.us/fiaprograms/fstamp/rules.php

TANF
http://www.dhr.state.md.us/fiaprograms/tca/index.php

Child Care
http://www.dhr.state.md.us/how/chldprnt/chldcare.htm

Medicaid
http://www.dhr.state.md.us/fiaprograms/medical.php

SCHIP
http://www.dhmh.state.md.us/mma/mchp/

Applications for Assistance

Food Stamp, TANF, Medicaid, Child Care


Online: https://www.marylandsail.org/WhatIsSail.aspx
Print: http://www.dhr.state.md.us/fia/forms.htm Excludes Child Care

Medicaid (children / families only) Application


http://dhmh.state.md.us/mma/mchp/pdf/2008/Final-Application_MAEnglish8-01-08.pdf

MASSACHUSETTS
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamps
http://www.mass.gov/?pageID=eohhs2terminal&L=4&L0=Home&L1=Government&L2=Law
s%2c+Regulations+and+Policies&L3=Department+of+Transitional+Assistance+Regulations+a
nd+Legal+Notices&sid=Eeohhs2&b=terminalcontent&f=dta_g_106cmr_309_367&csid=Eeohh
s2 Scroll down to Food Stamp Program

TANF
http://www.mass.gov/?pageID=eohhs2terminal&L=4&L0=Home&L1=Government&L2=Law
s%2c+Regulations+and+Policies&L3=Department+of+Transitional+Assistance+Regulations+a
nd+Legal+Notices&sid=Eeohhs2&b=terminalcontent&f=dta_g_106cmr_203_208&csid=Eeohh
s2
State Plan: http://www.mass.gov/Eeohhs2/docs/dta/r_reform_stateplan.pdf

Child Care
http://www.eec.state.ma.us/kr_subsidy.aspx

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Medicaid
Regulations:
http://www.mass.gov/?pageID=eohhs2subtopic&L=5&L0=Home&L1=Government&L2=Law
s%2c+Regulations+and+Policies&L3=MassHealth+Regulations+and+Other+Publications&L4
=MassHealth+Regulations&sid=Eeohhs2
General Laws: http://www.mass.gov/legis/laws/mgl/gl-111m-toc.htm

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS029939&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp, TANF


http://www.mass.gov/?pageID=eohhs2modulechunk&L=4&L0=Home&L1=Government&L2
=Departments+and+Divisions&L3=Department+of+Transitional+Assistance&sid=Eeohhs2&b
=terminalcontent&f=dta_c_foodnut_foodstamps&csid=Eeohhs2

TANF
http://www.mass.gov/?pageID=eohhs2modulechunk&L=4&L0=Home&L1=Government&L2
=Departments+and+Divisions&L3=Department+of+Transitional+Assistance&sid=Eeohhs2&b
=terminalcontent&f=dta_c_finassist_cashassist&csid=Eeohhs2

Child Care
http://www.eec.state.ma.us/ Click on Find Early Education and Care Programs and Other Resources

Medicaid/SCHIP
http://www.mass.gov/portal/index.jsp?pageID=eohhs2terminal&L=4&L0=Home&L1=Govern
ment&L2=Departments+and+Divisions&L3=MassHealth&sid=Eeohhs2&b=terminalcontent&f
=masshealth_government_about_programs&csid=Eeohhs2

Applications for Assistance

Food Stamp
Online: https://service.hhs.state.ma.us/ier/jsp/screening/LoginServlet?Application=Screening
Paper: http://www.mass.gov/Eeohhs2/docs/dta/c_foodstampapp_eng.pdf

Medicaid
http://www.mass.gov/?pageID=eohhs2subtopic&L=4&L0=Home&L1=Consumer&L2=Insura
nce+(including+MassHealth)&L3=Apply+for+MassHealth+Coverage&sid=Eeohhs2

Medicaid (families and children)/SCHIP


http://www.mass.gov/portal/index.jsp?pageID=eohhs2terminal&L=5&L0=Home&L1=Consu
mer&L2=Insurance+(including+MassHealth)&L3=Apply+for+MassHealth+Coverage&L4=Ap
plicants+Under+Age+65+and+Families&sid=Eeohhs2&b=terminalcontent&f=masshealth_con
sumer_applicant_under65_apply&csid=Eeohhs2

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MICHIGAN
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamp
http://www.michigan.gov/documents/dhs/Pub_0016_206544_7.pdf
http://www.michigan.gov/documents/dhs/DHS-Pub-16-SP_216482_7.pdf Spanish

TANF
Work Requirements: http://www.michigan.gov/dhs/0,1

25
Applications for Assistance

Food Stamp, TANF, Child Care, Medicaid


http://www.michigan.gov/dhs/0,1607,7-124-5453_5529_9306-69226--,00.html

Medicaid (for children)/SCHIP


http://www.michigan.gov/mdch/0,1607,7-132-2943_4845_4931-20628--,00.html
http://www.michigan.gov/mdch/0,1607,7-132-2943_4845_4931-37347--,00.html Online
Application

26
Descriptive Program and Eligibility Information

Food Stamp
http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&Revi
sionSelectionMethod=LatestReleased&dDocName=id_002557

Food Stamp Eligibility Screening Tools


http://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-3529-ENG
http://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-3530-ENG

TANF
http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&Revi
sionSelectionMethod=LatestReleased&dDocName=id_004112

Child Care
http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&Revi
sionSelectionMethod=LatestReleased&dDocName=id_008688

Medicaid
http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&Revi
sionSelectionMethod=LatestReleased&dDocName=id_006972

Applications for Assistance

Food Stamp, TANF, Medicaid


http://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-5223-ENG

Medicaid
http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&Revi
sionSelectionMethod=LatestReleased&Redirected=true&dDocName=id_006294
http://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-3417-eng Printable Application

Child Care
http://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-3550-ENG

MISSISSIPPI

Policy Manuals/Materials

Food Stamp, TANF, Medicaid


Mississippi Code [Title 43 – Public Welfare]
http://www.mscode.com/free/statutes/43/

Food Stamp State Plan


http://www.mdhs.state.ms.us/ea_fssplan.html

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TANF State Plan
http://www.mdhs.state.ms.us/eatanfstplan.pdf

Child Care
http://www.mdhs.state.ms.us/ocy_apply.html

Medicaid
Health Benefits Manual: http://www.medicaid.ms.gov/MhbPolicyManual/TOC.aspx
Eligibility: http://www.medicaid.ms.gov/Eligibility%20Policy%20Volume%20III/TOC.aspx

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS030064&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp, TANF, Medicaid/SCHIP


http://www.mdhs.state.ms.us/ea.html

Food Stamp
http://www.mdhs.state.ms.us/ea_fs.html

TANF
http://www.mdhs.state.ms.us/ea_tanf.html

Child Care
http://www.mdhs.state.ms.us/ocy_apply.html

Medicaid
http://www.medicaid.ms.gov/

SCHIP
http://www.medicaid.ms.gov/CHIP.aspx

Applications for Assistance

Food Stamp, TANF


http://www.mdhs.state.ms.us/agencyapps.htm

Medicaid (aged, blind, disabled)


http://www.medicaid.ms.gov/ApplicationForms/dom300.pdf

Medicaid (for children)/SCHIP


http://www.medicaid.ms.gov/ApplicationForms/MHB-CHIPApp.pdf Parents and adult caretakers
may have to submit additional information to complete eligibility process.

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MISSOURI
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamp, TANF, Child Care, Medicaid


http://www.dss.mo.gov/fsd/iman/index.html

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du

29
SCHIP State Plan and Factsheet
http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS030523&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://www.dphhs.mt.gov/hcsd/snap/index.shtml

TANF
http://www.dphhs.mt.gov/hcsd/tanf/tanfeligibility.shtml

Child Care
http://www.dphhs.mt.gov/hrd/childcare/bestbeginnings/index.shtml

Medicaid
http://www.dphhs.mt.gov/programsservices/medicaid.shtml

SCHIP
http://chip.mt.gov/index.shtml Will change name to “Healthy Montana Kids Plan” in October 2009

Applications for Assistance

Food Stamp, TANF, Medicaid


http://vhsp.dphhs.mt.gov/publicassistance/index.shtml

Food Stamp
http://www.dphhs.mt.gov/formsapplications/foodstamp.pdf

Medicaid (for children)/SCHIP


http://chip.mt.gov/howtoapply.shtml

NEBRASKA
Nebraska does not have a separate SCHIP program

Policy Manuals/Materials

Food Stamp, TANF, Medicaid


http://www.hhs.state.ne.us/fia/fiarules.htm

Food Stamp
http://www.hhs.state.ne.us/reg/t475.htm

Child Care
http://www.hhs.state.ne.us/reg/t392.htm

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SCHIP State Plan and Factsheet
http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS030534&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://www.hhs.state.ne.us/fia/fstamps.htm

TANF
http://www.hhs.state.ne.us/fia/adc.htm

Child Care
http://www.hhs.state.ne.us/chc/ccsubsypa.htm

Medicaid
http://www.hhs.state.ne.us/med/medindex.htm

Applications for Assistance

Food Stamp, TANF, Child Care, Medicaid


http://www.hhs.state.ne.us/fia/EA-117.pdf

Food Stamp Application


http://www.hhs.state.ne.us/fia/fstamps.htm

Medicaid (for children) Application


http://www.hhs.state.ne.us/med/kidsconxapp.htm
http://www.hhs.state.ne.us/med/kidsconx.pdf Printable Application

NEVADA

Policy Manuals/Materials

Food Stamp, TANF, Child Care, Medicaid/SCHIP


http://dwss.nv.gov/index.php?option=com_docman&task=cat_view&gid=63&Itemid=287

TANF State Plan


http://dwss.nv.gov/index.php?option=com_docman&task=doc_download&gid=549&Itemid=2
87

Child Care
http://dwss.nv.gov/index.php?option=com_docman&task=cat_view&gid=42&Itemid=287

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SCHIP State Plan and Factsheet
http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS030594&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp, TANF, Medicaid


http://dwss.nv.gov/index.php?option=com_content&task=view&id=79&Itemid=189

SCHIP
http://nevadacheckup.state.nv.us/index.htm
Child Care
http://dwss.nv.gov/index.php?option=com_content&task=view&id=40&Itemid=71

Applications for Assistance

Food Stamp, TANF, Medicaid


http://dwss.nv.gov/dmdocuments/Forms_2905-EG.pdf

Food Stamp
http://dwss.nv.gov/index.php?option=com_content&task=view&id=86&Itemid=236

Online Application for Medicaid (for children)/SCHIP

Medicaid (for children)/SCHIP


https://nevadacheckup.nv.gov/SecureOnlineAppEnglish.htm Online Application
http://www.nevadacheckup.state.nv.us/Applications/NCU-
0111%20Check%20Up%20App%203-26-08.pdf Printable Application

NEW HAMPSHIRE
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamp, TANF, Medicaid/SCHIP


http://www.dhhs.state.nh.us/FAM_htm/NEWFAM.HTM

Food Stamp
http://www.dhhs.state.nh.us/fsm_htm/whgdata/whlstt1.htm#1

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS030807&intNumPerPage=2000

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Descriptive Program and Eligibility Information

Food Stamp, TANF, Medicaid/SCHIP


http://www.dhhs.state.nh.us/DHHS/DFA/ELIGIBILITY/default.htm

Food Stamp
http://www.dhhs.state.nh.us/DHHS/FOODSTAMPS/default.htm

Child Care
http://www.dhhs.state.nh.us/DHHS/CDB/LIBRARY/Fact+Sheet/cc-payment-rate.htm

Applications for Assistance

33
Descriptive Program and Eligibility Information

Food Stamp
http://www.state.nj.us/humanservices/dfd/foodstamp.html

TANF
http://www.state.nj.us/humanservices/dfd/wfnjws.html

Child Care
http://www.state.nj.us/humanservices/dfd/statesubchildcare.html

Medicaid/SCHIP
http://www.state.nj.us/humanservices/dmahs/index.html

Applications for Assistance

Food Stamps
http://www.state.nj.us/humanservices/dfd/FSapply.html

Medicaid (children and parents)/SCHIP


http://www.njfamilycare.org/pages/apply_njfc.html
https://fc.dhs.state.nj.us/forms/NJFC_0.aspx Online Application

Online Benefit Screeners/Calculators

Food Stamp Only


http://www.oel.state.nj.us/FoodStampTool/index.html

Multi-Program
http://www.newjerseyhelps.org

NEW MEXICO
New Mexico does not have a separate SCHIP program

Policy Manuals/Materials

Food Stamp
http://www.hsd.state.nm.us/isd/policies/fs.html

Food Stamp Regulations


http://www.nmcpr.state.nm.us/nmac/_title08/T08C139.htm

Medicaid
http://www.hsd.state.nm.us/mad/policymanual.html

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SCHIP State Plan and Factsheet
http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS030975&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp, TANF


http://www.hsd.state.nm.us/isd/

Food Stamp
http://www.hsd.state.nm.us/isd/fs.html

Child Care
http://www.newmexicokids.org/#.pages.childcare.assistance.

Medicaid
http://www.hsd.state.nm.us/mad/geninfo.html

SCHIP
http://www.hsd.state.nm.us/mad/newmexikids/

Applications for Assistance

Food Stamp, TANF, Medicaid


http://www.hsd.state.nm.us/isd/apply.html

Child Care
http://www.newmexicokids.org/pages/library/resources/Child_Care_Application_July_2007_fin
al.pdf

Medicaid
http://www.hsd.state.nm.us/mad/applymedicaid.html

SCHIP
http://www.hsd.state.nm.us/mad/newmexikids/

NEW YORK

Policy Manuals/Materials

Food Stamp
http://www.otda.state.ny.us/main/foodstamps/FSSB.pdf

TANF
State Plan: http://www.otda.state.ny.us/main/tanf/default.asp
Temporary Assistance Source Book: http://www.otda.state.ny.us/main/ta/TASB.pdf

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Medicaid/SCHIP
http://www.health.state.ny.us/health_care/medicaid/reference/mrg/index.htm

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS031018&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://www.otda.state.ny.us/main/foodstamps/

TANF
http://www.otda.state.ny.us/main/ta/default.asp

Child Care
http://www.ocfs.state.ny.us/main/childcare/paying.asp

Medicaid
http://www.health.state.ny.us/health_care/medicaid/index.htm

SCHIP
http://www.health.state.ny.us/nysdoh/chplus/

Applications for Assistance

Food Stamp, TANF, Child Care, Medicaid


http://www.otda.state.ny.us/main/apps/default.asp

Food Stamps
List of sites with online applications: http://www.otda.state.ny.us/main/foodstamps/map.asp

TANF
http://www.otda.state.ny.us/main/apps/2921.pdf

Medicaid
http://www.health.state.ny.us/health_care/medicaid/index.htm#apply

Medicaid (children and parents)/SCHIP


http://www.health.state.ny.us/nysdoh/chplus/application.htm

Online Benefit Screener/Calculator

Multi-Program Screening Tool


http://mybenefits.ny.gov/

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Food Stamp Only
Madison County Only
https://www.madisoncountyfoodstamps.org/Prescreen.asp

NORTH CAROLINA
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamp
http://info.dhhs.state.nc.us/olm/manuals/dss/ei-30/man/index.htm

TANF

37
Applications for Assistance

Food Stamp
http://info.dhhs.state.nc.us/olm/forms/dss/dss-8207.pdf

Child Care
http://info.dhhs.state.nc.us/olm/forms/dcd/dcd-0456.pdf

Medicaid / SCHIP
http://www.dhhs.state.nc.us/dma/medicaid/applications.htm

NORTH DAKOTA
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamp, TANF, Medicaid/SCHIP


http://www.legis.nd.gov/information/acdata/html/75-02.html

Food Stamp
http://www.state.nd.us/robo/projects/foodstamp/foodstamp.htm

Child Care
http://www.legis.nd.gov/information/acdata/pdf/75-04-04.pdf

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS032393&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://www.nd.gov/dhs/services/financialhelp/foodstamps.html

TANF
http://www.nd.gov/dhs/services/financialhelp/tanfjobs.html

Child Care
http://www.nd.gov/dhs/services/financialhelp/childcare.html

Medicaid
http://www.nd.gov/dhs/services/medicalserv/medicaid/

SCHIP
http://www.nd.gov/dhs/services/medicalserv/chip/

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Applications for Assistance

Food Stamp, TANF, Child Care, Medicaid/SCHIP


http://www.nd.gov/dhs/info/pubs/application.html
http://www.nd.gov/dhs/info/pubs/docs/sfn-405-application-for-assistance.pdf

Child Care
http://www.nd.gov/eforms/Doc/sfn00598.pdf

Medicaid / SCHIP
http://www.nd.gov/dhs/services/medicalserv/chip/apply.html
http://www.nd.gov/eforms/Doc/sfn00502.pdf Printable Application

Online Benefit Screener/Calculator

Food Stamp Only


http://www.ndhealth.gov/dhs/foodstampcalculator.asp

OHIO
Ohio does not have a separate SCHIP program

Policy Manuals/Materials

Food Stamp State Plan


http://jfs.ohio.gov/ofam/fsStateplan.stm

TANF
http://jfs.ohio.gov/owf/plan_new.stm

Child Care
http://www.odjfs.state.oh.us/lpc/mtl/#CCMTL

Medicaid
http://jfs.ohio.gov/OHP/infodata/publications.stm

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS032410&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://jfs.ohio.gov/factsheets/foodstamps.pdf

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39
TANF
http://jfs.ohio.gov/factsheets/OWF.pdf

Child Care
http://jfs.ohio.gov/cdc/page4.stm

Medicaid
http://jfs.ohio.gov/OHP/consumer.stm

Applications for Assistance

Food Stamp, TANF, Child Care, Medicaid


http://www.odjfs.state.oh.us/forms/file.asp?id=53924

Child Care Application


http://jfs.ohio.gov/cdc/docs/JFS%2001138%201-2008.pdf

Medicaid / SCHIP
http://jfs.ohio.gov/OHP/consumers/Application.stm

OKLAHOMA
Oklahoma does not have a separate SCHIP program

Policy Manuals/Materials

Food Stamp
http://www.okdhs.org/library/policy/oac340/050/

TANF
http://www.okdhs.org/library/policy/oac340/010/

Child Care
http://www.okdhs.org/library/policy/oac340/040/

Medicaid
http://www.okdhs.org/library/policy/oac317/035/

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS039220&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://www.okdhs.org/programsandservices/food/snap/docs/fsreqs.htm

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TANF
http://www.okdhs.org/programsandservices/tanf/

Child Care
http://www.okdhs.org/programsandservices/cc/asst/docs/faq.htm#4

Medicaid
http://www.okdhs.org/programsandservices/health/med/docs/elig.htm#eligibility

SCHIP
http://www.okhca.org/individuals.aspx?id=52&column=true&part1=152&part2=154

Applications for Assistance

41

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Medicaid/SCHIP
http://www.oregon.gov/DHS/healthplan/app_benefits/main.shtml

Family Health Insurance Assistance Program


http://www.oregon.gov/OPHP/FHIAP/member.shtml

Applications for Assistance

Food Stamps, TANF, Child Care, Medicaid


http://dhsforms.hr.state.or.us/Forms/Served/DE0415FS.pdf

Medicaid / SCHIP
http://dhsforms.hr.state.or.us/Forms/Served/HE7210pkt.pdf

Online Benefit Screeners/Calculators

Food Stamp Only


http://fsestimate.hr.state.or.us/

Multi-Program
http://www.oregonhelps.org/

PENNSYLVANIA

Policy Manuals/Materials

Food Stamp, TANF, Child Care, Medicaid/SCHIP


http://www.dpw.state.pa.us/oimpolicymanuals/

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS039899&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://www.dpw.state.pa.us/ServicesPrograms/FoodStamps/

TANF
http://www.dpw.state.pa.us/ServicesPrograms/CashAsstEmployment/003676612.htm

Child Care
http://www.dpw.state.pa.us/ServicesPrograms/ChildCareEarlyEd/

Medicaid
http://www.dpw.state.pa.us/ServicesPrograms/MedicalAssistance/

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SCHIP
http://chipcoverspakids.com/

Applications for Assistance

Food Stamp, TANF, Medicaid, SCHIP


http://www.dpw.state.pa.us/Resources/Documents/Pdf/FillInForms/APPL-FOR-
BENEFITS.pdf

Online Cross-Program Application


https://www.humanservices.state.pa.us/COMPASS/PGM/ASP/SC001.asp

Food Stamp
http://www.dpw.state.pa.us/Resources/Documents/Pdf/FillInForms/oimPA600FSO.pdf

Online Benefit Screener/Calculator

Multi-Program
https://www.humanservices.state.pa.us/COMPASS/PGM/ASP/SC001.asp

RHODE ISLAND
SCHIP program for unborn children only; otherwise, SCHIP implemented as Medicaid expansion

Policy Manuals/Materials

Food Stamp, TANF, Child Care, Medicaid


http://www.ridhscode.org/

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS039918&intNumPerPage=2000

Descriptive Program and Eligibility Information

Child Care, Food Stamp, Medicaid, and TANF


http://www.dhs.ri.gov/dhs/dserfch.htm

Applications for Assistance

Medicaid (Managed Care Program)


http://www.dhs.state.ri.us/dhs/famchild/shcare.htm 

43
SOUTH CAROLINA
South Carolina does not have a separate SCHIP program

Policy Manuals/Materials

Food Stamp, TANF, Child Care, Medicaid


Search South Carolina Code of Regulations: http://www.scstatehouse.gov/coderegs/statmast.htm
Search South Carolina Code of Laws: http://www.scstatehouse.gov/code/statmast.htm

TANF State Code


http://www.scstatehouse.net/code/t43c005.htm

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS040094&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamps, TANF


http://www.state.sc.us/dss/services/index.html

Food Stamp
http://dss.sc.gov/content/customers/ftp:5/cus([[5iuCx.aspx)4F>]TJET82.8 106.302248.94 0.6 refBT0 g/C2_0 1 Tf1

44
Online Benefit Screeners/Calculators

Food Stamp Only


http://www.healthyhelpings.org/benefitcalc.htm

Child Support Obligation Only


http://www.state.sc.us/dss/csed/calculator.htm

SOUTH DAKOTA
Combination SCHIP / Medicaid program

Policy Manuals/Materials

45
Child Care
http://dss.sd.gov/childcare/

Applications for Assistance

Food Stamps, TANF, Medical Assistance


http://dss.sd.gov/formspubs/docs/FOODSTAMP/EAApplication.pdf

Child Care
http://dss.sd.gov/formspubs/docs/CCS/CCSApplication.pdf

Online Child Care


https://www.state.sd.us/applications/ss45/ChildCareAssistance.asp

Medicaid (parents and children)/SCHIP


http://dss.sd.gov/formspubs/docs/MEDELGBLTY/DSS-EA-301MCHIP.pdf

TENNESSEE
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamp, TANF, Child Care, Medicaid


http://www.state.tn.us/sos/rules/1240/1240-01/1240-01.htm

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS040265&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://tennessee.gov/humanserv/adfam/afs_fsp.html

TANF
http://tennessee.gov/humanserv/adfam/afs_tanf.html

Child Care
http://tennessee.gov/humanserv/adfam/cc_main.html

Medicaid
http://tennessee.gov/humanserv/adfam/afs_med.html

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SCHIP
http://www.covertn.gov/web/cover_kids.html

Applications for Assistance

Food Stamp, TANF, Medicaid


https://fabenefits.dhs.tn.gov/vip/website/signupservlet?pagename=homepage

Medicaid
http://state.tn.us/humanserv/forms/hs-0169.pdf

SCHIP
http://www.coverkids.com/

TEXAS

Policy Manuals/Materials

Food Stamp, TANF, Medicaid/SCHIP


http://www.dads.state.tx.us/handbooks/TexasWorks/

Child Care
http://info.sos.state.tx.us/pls/pub/readtac$ext.ViewTAC?tac_view=4&ti=40&pt=20&ch=809

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS040290&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp, TANF, Medicaid/SCHIP


http://www.hhsc.state.tx.us/Help/index.html

Medicaid/SCHIP
http://www.hhsc.state.tx.us/Help/index.html

Applications for Assistance

Food Stamp, TANF, Medicaid/SCHIP


https://www.yourtexasbenefits.com/wps/themes/html/SSPortal/downloads/H1010_April2008E
nglish.pdf

Medicaid (for children)/SCHIP


http://www.chipmedicaid.com/english/apply.htm

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Online Benefit Screeners/Calculators

Food Stamp Only


http://www.hhsc.state.tx.us/programs/FoodStamps/estimator/index.html

Multi-Program
https://www.yourtexasbenefits.com/

UTAH

Policy Manuals/Materials

Food Stamp, TANF, Child Care


http://www.rules.utah.gov/publicat/code/r986/r986.htm

TANF State Plan


http://jobs.utah.gov/edo/stateplans/

Medicaid
http://utahcares.utah.gov/infosourcemedicaid/

SCHIP
http://utahcares.utah.gov/infosourcechip/

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS040463&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://jobs.utah.gov/opencms/customereducation/services/foodstamps/index.html

TANF
http://jobs.utah.gov/services/financial/fep.asp

Child Care
http://jobs.utah.gov/opencms/occ

Medicaid
http://health.utah.gov/medicaid/ 
http://jobs.utah.gov/opencms/customereducation/services/medicaid/fmo.html

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SCHIP
http://health.utah.gov/chip/
http://jobs.utah.gov/opencms/customereducation/services/medicaid/chip.html

Applications for Assistance

Food Stamp, TANF, Child Care, Medicaid


http://jobs.utah.gov/opencms/forms/61APP.pdf

Online Application for Food Stamp, TANF, Child Care, Medicaid


http://www.utahhelps.utah.gov/

Medicaid (all categories)/SCHIP


http://jobs.utah.gov/opencms/forms/61MED.pdf

49

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Medicaid/SCHIP
http://dcf.vermont.gov/esd/health_insurance
http://www.greenmountaincare.org/about/green_mountain_care_programs.html

Applications for Assistance

Food Stamp, TANF, Child Care, Medicaid/SCHIP


http://dcf.vermont.gov/sites/dcf/files/pdf/esd/Form202.pdf

VIRGINIA
Combination SCHIP / Medicaid program

Policy Manuals/Materials

Food Stamp
http://www.dss.virginia.gov/benefit/foodstamp.html

TANF
http://www.dss.virginia.gov/benefit/tanf/manual.cgi

Child Care
http://www.dss.virginia.gov/family/cfs_plan.html

Medicaid/SCHIP
http://www.dss.virginia.gov/benefit/me_famis/manual.cgi

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS040543&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://www.dss.virginia.gov/benefit/foodstamp.html

TANF
http://www.dss.virginia.gov/benefit/tanf/

Child Care
http://www.dss.virginia.gov/family/cc/

Medicaid
http://www.dss.virginia.gov/benefit/me_famis/

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SCHIP
http://www.famis.org/welcome.cfm?lang=English

Applications for Assistance

Food Stamp, TANF, Medicaid/SCHIP


Part I: http://www.dss.state.va.us/form/pdf/032-03-875.pdf
Part II: http://www.dss.state.va.us/form/pdf/application_for_benefits.pdf

Child Care
http://www.dss.virginia.gov/form/pdf/032-02-109_3.pdf

Medicaid (children only)/SCHIP


http://www.famis.org/apply.cfm?lang=English
http://www.famis.org/materials/HealthInsuranceApplicationForChildrenAndPregnantWomen.p
df Printable Application

Online Benefit Screener/Calculator

Multi-Program
http://dssiad.dss.state.va.us/EligibilityScreening/

WASHINGTON

Policy Manuals/Materials

Food Stamp, TANF, Medicaid/SCHIP


http://www1.dshs.wa.gov/esa/eazmanual/

TANF/WorkFirst Handbook
http://www1.dshs.wa.gov/ESA/wfhand/

Child Care
http://www1.dshs.wa.gov/esa/wccc/

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS040815&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp, Child Care, Medicaid/SCHIP


https://fortress.wa.gov/dshs/f2ws03esaapps/onlinecso/services.asp

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Food Stamp
https://fortress.wa.gov/dshs/f2ws03esaapps/onlinecso/food_assistance_program.asp

TANF
https://fortress.wa.gov/dshs/f2ws03esaapps/onlinecso/tanf_support_services.asp

Child Care
https://fortress.wa.gov/dshs/f2ws03esaapps/onlinecso/wccc.asp

Medicaid / SCHIP
https://fortress.wa.gov/dshs/f2ws03esaapps/onlinecso/medical.asp

Applications for Assistance

Online Application for Food Stamps, TANF, Child Care, Medicaid/SCHIP


https://fortress.wa.gov/dshs/f2esaapps/esaosa/

SCHIP
https://fortress.wa.gov/dshs/maa/CHIP/Howtoapply.html

Food Stamp Printable Application


http://www1.dshs.wa.gov/pdf/ms/forms/14_001.pdf

Online Benefit Screener/Calculator

Multi-Program
http://www1.dshs.wa.gov/esa/TEC/

WEST VIRGINIA

Policy Manuals/Materials

Food Stamp, TANF, Medicaid/SCHIP


http://www.wvdhhr.org/bcf/family_assistance/policy.asp

Child Care
http://www.wvdhhr.org/bcf/ece/earlycare/policy.asp

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS040836&intNumPerPage=2000

Descriptive Program and Eligibility Information

Food Stamp
http://www.wvdhhr.org/bcf/family_assistance/fs.asp

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TANF
http://www.wvdhhr.org/bcf/family_assistance/wvworks.asp

Medicaid
http://www.wvdhhr.org/bcf/family_assistance/medicaid.asp

SCHIP
http://www.wvchip.org/

Applications for Assistance

Online Application for Food Stamps, Medicaid (children and pregnant women only),
SCHIP
https://www.wvinroads.org/

Medicaid (for children)/SCHIP

53
Descriptive Program and Eligibility Information

Food Stamp
http://dhs.wisconsin.gov/foodshare/index.htm

TANF
http://dcf.wisconsin.gov/tanf/

Child Care
http://dcf.wisconsin.gov/childcare/WISHARES/default.htm

Medicaid
http://www.dhfs.state.wi.us/medicaid/index.htm

SCHIP
http://www.badgercareplus.org/

Applications for Assistance

Food Stamp, Medicaid, SCHIP


http://access.wisconsin.gov/access/

TANF
http://dcf.wisconsin.gov/w2/apply_for_services.htm Not an application, just agency listing.

Medicaid (families and children)


http://dhs.wisconsin.gov/medicaid/applications.htm

Online Benefit Screener/Calculator

Multi-Program
http://access.wisconsin.gov/access/

WYOMING

Policy Manuals/Materials

Food Stamp, TANF, Child Care, Medicaid/SCHIP


http://www.thresholdcomputer.net/dfs/training.htm

SCHIP State Plan and Factsheet


http://www.cms.hhs.gov/LowCostHealthInsFamChild/CHIPASPI/itemdetail.asp?filterType=du
al,%20keyword&filterValue=Current%20State%20Plan&filterByDID=0&sortByDID=2&sortOr
der=ascending&itemID=CMS041160&intNumPerPage=2000

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Descriptive Program and Eligibility Information

Food Stamp
http://dfsweb.state.wy.us/foodstampinfo.html

TANF
http://dfsweb.state.wy.us/POWER.HTML

Child Care
http://dfswapps.state.wy.us/

Medicaid
http://wdh.state.wy.us/healthcarefin/equalitycare/index.html

SCHIP
http://www.health.wyo.gov/healthcarefin/chip/about.html

Applications for Assistance

Food Stamp
http://dfsweb.state.wy.us/pdf/FoodStampDFS100.pdf

Medicaid (children and parents)/SCHIP


http://www.health.wyo.gov/healthcarefin/chip/apply.html

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