(A) The department of medicaid shall do all of the following with regard to the application procedures for the healthy start component of the medicaid program:

1. (1) Establish a short application form for the component that requires the applicant to provide no more information than is necessary for making determinations of eligibility for the component, except that the form may require applicants to provide their social security numbers. The form shall include a statement, which must be signed by the applicant, indicating that she does not choose at the time of making application for the component to apply for assistance provided under any other program administered by the department or the department of job and family services and that she understands that she is permitted at any other time to apply at the county department of job and family services of the county in which she resides for other assistance administered by the department or the department of job and family services.

2. (2) Do one or both of the following:

   1. (a) Distribute the application form for the component to each public or private entity that serves as a women, infants, and children clinic or as a child and family health clinic and to each administrative body for such clinics and train employees of each such clinic or administrative body to provide applicants assistance in completing the form;
   2. (b) In cooperation with the department of health, develop arrangements under which employees of county departments of job and family services are stationed at public or private entities selected by the department of medicaid that serve as women, infants, and children clinics; child and family health clinics; or administrative bodies for such clinics for the purpose both of assisting applicants for the component in completing the application form and of making determinations at that location of eligibility for the component.
3. (3) Establish performance standards by which a county department of job and family services' level of enrollment of persons potentially eligible for the component can be measured, and establish acceptable levels of enrollment for each county department.

4. (4) Direct any county department of job and family services whose rate of enrollment of potentially eligible enrollees in the component is below acceptable levels established under division (A)(3) of this section to implement corrective action. Corrective action may include but is not limited to any one or more of the following:

   1. (a) Establishing formal referral and outreach methods with local health departments and local entities receiving funding through the bureau of maternal and child health;
   2. (b) Designating a specialized intake unit within the county department for healthy start applicants;
   3. (c) Establishing abbreviated timeliness requirements to shorten the time between receipt of an application and the scheduling of an initial application interview;
   4. (d) Establishing a system for telephone scheduling of intake interviews for applicants;
   5. (e) Establishing procedures to minimize the time an applicant must spend in completing the application and eligibility determination process, including permitting applicants to complete the process at times other than the regular business hours of the county department and at locations other than the offices of the county department.