Express Enrollment in California: How it Works
Background
Express Enrollment (EE) is an optional program that
allows school districts to streamline and expedite the Medi-Cal
(California's Medicaid program) enrollment process for uninsured
children who receive free school meals through the National School Lunch
Program. California implemented EE following the passage of legislation
(AB 59, authored by Senator Cedillo) and the development of written
guidance by the California Departments of Education and Health
Services.
How EE Works
The implementation of EE entails a partnership between
school districts and county Medi-Cal departments. Under EE, families in
a participating school district can apply for Medi-Cal by authorizing
the use of their chilren's school lunch application (SLA) information
for a Medi-Cal eligibility determination. School districts review the
applications of children eligible for free school meals
and determine eligibility for Express Enrollment - immediate
temporary coverage - into Medi-Cal on the basis of the information
already contained in their SLAs. Families do not need to complete a full
Medi-Cal application or provide documentation of income since the SLA
meets these requirements. If the children are income-eligible for
Medi-Cal, they will immediately receive temporary health care coverage
while the county collects additional information, via a one-page form,
to make a final eligibility determination.
Counties are required to implement the program if a
school district decides to participate. However, a school district
cannot implement EE without first contacting their county Medi-Cal
office and establishing a Memorandum of Understanding with the
county.
If children are ultimately not eligible for Medi-Cal, but appear
eligible for Healthy Families (California's State Children's Health
Insurance Program) or a local Healthy Kids program (locally run programs
that provide health insurance to uninsured children who don't qualify
for Medi-Cal or Healthy Families), the county will forward the child's
application onto one of these programs.
The following summarizes the EE process:
- A school district modifies the SLA by adding a
section requesting parental consent to share the application with
Medi-Cal if their child is eligible for free school meals.
- School staff reviews the SLAs of children
eligible for free meals that have provided consent to determine
income-eligibility for Medi-Cal.
- School staff sends families a letter informing them
of the outcome and, within five working days, forwards all applications
to the county Medi-Cal office.
- County Medi-Cal checks all the applications and,
within five working days, enrolls into Medi-Cal those
children schools determine eligible for EE and not already
receiving Medi-Cal or Healthy Families. These children receive a
benefits card in the mail that they can use to receive care from a
Medi-Cal provider until a full Medi-Cal eligibility determination.
- Families complete a one-page follow-up
form, sent by the county, to collect the additional information they
need to finalize a Medi-Cal determination. Children who were not
eligible for EE do not receive temporary benefits but have their
eligibility for Medi-Cal evaluated if they complete the follow-up
form.
- County Medi-Cal forwards the Express
Enrollment application to Healthy Families or Healthy
Kids programs, where available, for who are not eligible for
no-cost full-scope Medi-Cal benefits.
Learn More about ELE in California
 How
It Works
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