This project (U1TMC31757) is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $500,000, with no financing by nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government; HRSA Project Officer Sarah Beth McLellan.

Tips for Using the Data

This page outlines how to understand, interpret and use the data accurately. Chartbook users should be alert to two general points about the date:
  • 1. Comparable vs. Current

    Because we want to permit comparisons across states, we have tried to use data items that are defined and gathered consistently across states. As a result, some of the data presented may not be the most current data available for a particular state on a particular issue, but are the most current data available for all states on that issue. When sharing information about a single state, it may make sense to update particular items for which more timely, state-specific data are available. When comparing multiple states, however, we encourage you to use the data presented here, or turn to the sources of those data.
     
  • 2. A Caution on Comparisons

    There are data elements which, despite having been defined and gathered consistently, reflect substantial state-to-state differences in consumer attitudes or expectations. We try to indicate those items, and encourage caution in making state-to-state comparisons on those points.

Caution!Caution! Points like this, which highlight possible pitfalls in using particular data elements, are marked with this icon.

Demographics

Economics

Child Health Services

Factors Influencing Health Insurance Coverage

Title V Program

Experience with the System of Care for CSHCN

The makeup of a state’s population is the starting place for understanding health needs.

Child Population

Total child population is the backdrop for understanding the size of the CSHCN population. Note this data source represents children ages 0-18 while the 2016-2017 NSCH data represent children ages 0-17.

Race/Ethnicity

Percentage of children, by race/ethnicity
Children are ages 0-18. Persons of Hispanic origin may be of any race; all other racial/ethnic groups are non-Hispanic. Other includes Asians, Native Hawaiians and Pacific Islanders, American Indians, Aleutians, Eskimos. These groups have been combined by the Catalyst Center to make it feasible to compare these groups statistically to others in the population. Calculated by Catalyst Center staff by dividing the number of Asian/Native Hawaiian, Pacific Islander, and American Indian/Alaska Native children, by the total number of children.

Special Health Care Needs

These figures reflect parent responses to "screener" questions about the child's use of or need for services. Learn more about the screener at http://www.cahmi.org/projects/children-with-special-health-care-needs-screener/
Percentage of children, 0 -17 , who have special health care needs
CSHCN Status is determined using a validated instrument for identification of children with special health care needs as defined by the federal Maternal and Child Health Bureau. The CSHCN Screener asks whether a child currently experiences a health consequence and, if so, whether that specific health consequence is due to a medical, behavioral, or other type of health condition that has lasted, or is expected to last, 12 months or longer.
Percentage of children with reported special health care needs, by age group
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.
Percentage of children with reported special health care needs, by sex
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.
Percentage of children with reported special health care needs, by race/ethnicity
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.
Learn more about coverage and financing strategies that address inequities http://cahpp.org/project/the-catalyst-center/financing-strategy/inequities/.
Percentage of children with reported special health care needs, by primary household language
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.
Learn more about coverage and financing strategies that address inequities at http://cahpp.org/project/the-catalyst-center/financing-strategy/inequities/.
Percentage of children with reported special health care needs, by household income
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.
Learn more about coverage and financing strategies that address inequities at http://cahpp.org/project/the-catalyst-center/financing-strategy/inequities/.
Percentage of children with reported special health care needs, by number of functional difficulties
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in. This measure was scored as the count of difficulties children experience from a list of 12 functional difficulties, which do not include behavioral or mental health difficulties. The difficulties are asked about as two different types of questions: (a) During the past 12 months, whether the child had frequent or chronic difficulty with breathing or other respiratory problems; eating or swallowing; digesting food, including stomach/intestinal problems, constipation, or diarrhea; repeated or chronic physical pain, including headaches or other back or body pain; using his/her hands (0-5 years); coordination and moving around (0-5 years) , and (b) Whether the child has serious difficulty concentrating, remembering, or making decisions (6-17 years); serious difficulty walking or climbing stairs (6-17 years); difficulty dressing or bathing (6-17 years); difficulty doing errands alone, such as visiting a doctor’s office or shopping (12-17 years), deafness or problems with hearing; and blindness or problems with seeing, even when wearing glasses.

Low Birth Weight

Percentage of live births that are low birth weight by race/ethnicity
Low birth weight is defined as newborn weight below 2500 grams (about 5 lbs).

Special Education

Percentage of public school students enrolled in Special Education
Caution! Age group of children served is 3 to 21-year-olds.

Income

Median Annual Household Income
In 2017 inflation-adjusted dollars. Data are limited to the household population and exclude the population living in institutions, college dormitories, and other group quarters. For information on confidentiality protection, sampling error, nonsampling error, and definitions, see www.census.gov/programs-surveys/acs/.
Percentage of CSHCN in families with income below 200% of the federal poverty level
For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.

Education

Highest level of education in families raising non-CSHCN
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.
Highest level of education in families raising CSHCN
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.

Employment

Unemployment rate
The unemployment rate measures unemployment within the civilian non-institutional population aged 16 years and older. Data refer to place of residence and are seasonally adjusted.
Percentage of families rasing non-CSHCN, who reported a family member avoided changing jobs because of concerns about maintaining health insurance for their child, in the past 12 months
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.
Percentage of families raising CSHCN, who reported a family member avoided changing jobs because of concerns about maintaining health insurance for their child, in the past 12 months
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.

Financial Impact of Caregiving

Percentage of families raising CSHCN who report they have stopped working or reduced work hours as a result of their child’s health condition(s), in the lat 12 months
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.
Learn more about the coverage and financing of relief funds at http://cahpp.org/project/the-catalyst-center/financing-strategy/relief-funds/
Percentage of families who report they have stopped working or reduced work hours as a result of their child’s health condition(s) in the past 12 months, by complexity of health care needs
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in
Percentage of families raising CSHCN who paid out-of-pocket medical expenses for their child, by amount
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in. This does not include premiums.
Out of pocket costs include co-pays and amounts from Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA), for medical, health, dental, and vision care during the past 12 months. This does not include premiums.
Percentage of families raising CSHCN who report problems paying for the child's health care bills
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.
Families raising CSHCN are more likely to experience housing instability (Rose-Jacobs, Cuba, Bovell-Ammon, Black, et al., 2019), difficulty paying utility and phone bills, and food insecurity (Stoddard-Dare, DeRigne, Quinn, & Mallett, 2015) than families who are not raising CSHCN. The data here focuses on problems paying for a child’s health care bills, but may not be an adequate indicator of financial hardship or well-being among families raising CSHCN because paying a child’s health care bills may be prioritized over other expenses (Allshouse, Comeau, Rodgers, & Wells, 2018; Bachman & Comeau, 2010).
Percentage of families who report problems paying for their child's health care bills, by complexity of health care needs
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in. Complexity of health care needs is determined by responses on the CSHCN screener. CSHCN with more complex health care needs are defined as having functional limitations (alone or in combination with other qualifying needs), above-routine use of services or use of specialized services (no other qualifying needs on CSHCN Screener), or using prescription medication AND above-routine use of services.

Medicaid Eligibility

Although they must meet or exceed a federally set standard, states have substantial discretion in setting income limits on Medicaid eligibility. States with higher maximum income limits cover a broader population.
Maximum allowed income for Medicaid enrollment, as a percentage of the federal poverty level, compared to the federal minimum requirement
Caution! Children's Medicaid eligibility includes Title XXI CHIP funding for states that expanded Medicaid with CHIP funds. All eligibility limits reflect the MAGI-converted income standards, which includes the five percentage point disregard applied to the upper limit for Medicaid coverage for each group.
Learn about the coverage and financing of Medicaid Buy-Ins at http://cahpp.org/project/the-catalyst-center/financing-strategy/medicaid-buy-ins/

Federal Match for Medicaid

Federal Medical Assistance Percentage (FMAP)
The federal government shares the cost of Medicaid with states. The federal share, or match, is determined by a formula in which the key variable is personal income. The Kaiser Family Foundation website defaults to the FY 2020 FMAP. Use the drop down box under TIMEFRAME to select FY 2019 FMAP.
Data in this section broadly characterize child health services in each state in terms of capacity and utilization. Use these data to understand the immediate context for services to CYSHCN in each state.

Health Care

Number of children’s hospitals
The source of this data is a membership organization. Non-member hospitals are not reflected in the total number of children’s hospitals per state.
Number of pediatricians per 1,000 children
Child population estimates based on children ages 0 through 18. Physician numbers represent ABMS Member Board certified physicians with an active Pediatric specialty recorded in the ABMS database as of June 30, 2018. Physicians may hold certification in more than one specialty. These numbers include certificate holders who are retired and excludes physicians who are deceased.
Number of family practitioners
Physician numbers represent ABMS Member Board certified physicians with an active family medicine specialty recorded in the ABMS database as of June 30, 2018. Physicians may hold certification in more than one specialty. These numbers include certificate holders who are retired and excludes physicians who are deceased.
Number of child and adolescent psychiatrists per 1,000 children
Physician numbers represent ABMS Member Board certified physicians with an active psychiatric specialty recorded in the ABMS database as of June 30, 2018. Physicians may hold certification in more than one specialty. These numbers include certificate holders who are retired and excludes physicians who are deceased.

Early Intervention Eligibility

Eligibility for Early Intervention services includes infants and toddlers “at risk” of developmental delay
Within federal guidelines, states have broad discretion in setting Early Intervention eligibility.

Mental Health

Percentage of non-CSHCN, ages 3-17, that received any treatment or counseling from a mental health professional, in the past 12 months
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.
Learn more about the coverage and financing of Behavioral Health at http://cahpp.org/project/the-catalyst-center/financing-strategy/behavioral-health/ .
Percentage of CSHCN, ages 3-17, that received any treatment or counseling from a mental health professional, in the past 12 months
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.
Learn more about the coverage and financing of Behavioral Health at http://cahpp.org/project/the-catalyst-center/financing-strategy/behavioral-health/
Percentage of CSHCN with emotional, behavioral or developmental issues whose families have adequate private and/or public insurance to pay for the services they need
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.
This indicator reflects coverage and access to all needed care for children with emotional, behavioral, or developmental issues. Learn more about the coverage and financing of Behavioral Health at http://cahpp.org/project/the-catalyst-center/financing-strategy/behavioral-health/.
Percentage of non-CSHCN, ages 3-17, whose health insurance offers benefits or covers services that meet mental or behavioral health needs
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.
Private insurance plans are required by law to cover mental health services on par with physical health services. Medicaid is required to cover mental health services for enrollees under the age of 21 under the EPSDT benefit. However, not every mental or behavioral health service a child might require is covered, even if it is a plan benefit. Learn more about the coverage and financing of Behavioral Health at http://cahpp.org/project/the-catalyst-center/financing-strategy/behavioral-health/
Percentage of CSHCN, ages 3-17, whose health insurance offers benefits or covers services that meet mental or behavioral health needs
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.
Private insurance plans are required by law to cover mental health services on par with physical health services. Medicaid is required to cover mental health services for enrollees under the age of 21 under the EPSDT benefit. However, not every mental or behavioral health service a child might require is covered, even if it is a plan benefit. Learn more about the coverage and financing of Behavioral Health at http://cahpp.org/project/the-catalyst-center/financing-strategy/behavioral-health/

Oral Health

Percentage of CSHCN receiving preventive dental care in the past year
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.
Percentage of CSHCN with teeth in excellent or very good condition
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.

Foster Care

Number of children in foster care
Learn more about coverage and financing for CSHCN in foster care at http://cahpp.org/project/the-catalyst-center/financing-strategy/foster-care/
Percentage of children in foster care
Learn more about coverage and financing for CSHCN in foster care at http://cahpp.org/project/the-catalyst-center/financing-strategy/foster-care/
Health insurance coverage is the key to ongoing access to health care in the US. It is strongly associated with the likelihood that a child will receive basic primary and preventive care, that health problems will be identified and treated early and continuously and that a child with special health care needs will have a medical home that assures and coordinates access to specialty care and community resources. In general, the data elements presented here can form the foundation for any discussion of children’s health care financing and for financing of care for CYSHCN in a state.

Uninsured

Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.
Percentage of children without health insurance at some point in the past year
The percent of all children without coverage at any point in the year may be the most important indicator we have of social investment in child health. Across states, this figure captures differences in parental employment status and associated private coverage levels, as well as state funding for public coverage of children through Medicaid and CHIP.
Percentage of CSHCN without health insurance at some point in the past year
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.
Learn more about the coverage and financing of CHIP at http://cahpp.org/project/the-catalyst-center/financing-strategy/chip/
Percentage of children without health insurance at some point in the past year, by complexity of health care needs
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.

Complexity of health care needs is determined by responses on the CSHCN screener. CSHCN with more complex health needs are defined as having functional limitations (alone or in combination with other qualifying needs), above-routine use of services or use of specialized services (no other qualifying needs on CSHCN Screener), or using prescription medication AND above-routine use of services.

Underinsured

Caution! Relatively few CYSHCN are uninsured. However, private coverage is often limited in the scope of benefits, the depth at which they are covered and the amount of associated cost-sharing. Thus, in many states, underinsurance is the major financial barrier to health care access for CYSHCN.
Percentage of children with inadequate health care coverage
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.

Relatively few CSHCN are uninsured. However, private coverage is often limited in the scope of benefits, the depth at which they are covered and the amount of associated cost-sharing. Thus, in many states, underinsurance is the major financial barrier to health care access for CSHCN.
Percentage of CSHCN with inadequate health care coverage
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.

Relatively few CSHCN are uninsured. However, private coverage is often limited in the scope of benefits, the depth at which they are covered and the amount of associated cost-sharing. Thus, in many states, underinsurance is the major financial barrier to health care access for CSHCN.

Learn more about the coverage and financing of Medicaid Buy-Ins at http://cahpp.org/project/the-catalyst-center/financing-strategy/medicaid-buy-ins/
Percentage of children with inadequate health care coverage, by complexity of health care needs
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.

Complexity of health care needs is determined by responses on the CSHCN screener. CSHCN with more complex health needs are defined as having functional limitations (alone or in combination with other qualifying needs), above-routine use of services or use of specialized services (no other qualifying needs on CSHCN Screener), or using prescription medication AND above-routine use of services.

Relatively few CYSHCN are uninsured. However, private coverage is often limited in the scope of benefits, the depth at which they are covered and the amount of associated cost-sharing. Thus, in many states, underinsurance is the major financial barrier to health care access for CYSHCN.

Private Insurance Coverage

Percentage of children with private health insurance coverage
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.
Percentage of CSHCN with private health insurance coverage
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.
Percentage of children with private health insurance coverage only, by complexity of health care needs
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.

Complexity of health care needs is determined by responses on the CSHCN screener. CSHCN with more complex health needs are defined as having functional limitations (alone or in combination with other qualifying needs), above-routine use of services or use of specialized services (no other qualifying needs on CSHCN Screener), or using prescription medication AND above-routine use of services.

Public Coverage: Medicaid, CHIP and SSI

Number of children ever enrolled in Medicaid annually
Caution! Children are individuals age 18 and younger.The enrollment totals represent the unduplicated number of children ever enrolled in Medicaid and CHIP at any point during the fiscal year. Therefore, enrollment totals may seem higher than other sources of enrollment data that use a different methodology.
Percentage of children enrolled in Medicaid
Caution! Children are individuals age 18 and younger. The enrollment totals represent the unduplicated number of children ever enrolled in Medicaid and CHIP at any point during the fiscal year. Therefore, enrollment totals may seem higher than other sources of enrollment data that use a different methodology.
Percentage of children enrolled in Medicaid or CHIP only
Caution! The enrollment totals reported in this table represent the number of children ever enrolled in Medicaid and CHIP at any point during the fiscal year. Therefore, enrollment totals may seem higher than other sources of enrollment data that use a different methodology, such as the CMS Performance Indicator data. While the CMS Performance Indicator data represent a monthly point-in-time count, the SEDS enrollment totals are not point-in-time estimates and may not be representative of the number of children currently enrolled in a state’s Medicaid or CHIP program. SEDS enrollment totals are a useful data source for illustrating how many individual children are enrolled annually in Medicaid and CHIP.
Percentage of CSHCN enrolled in Medicaid or CHIP only
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.
Percentage of children enrolled in Medicaid or CHIP only, by complexity of health care needs
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.

Complexity of health care needs is determined by responses on the CSHCN screener. CSHCN with more complex health needs are defined as having functional limitations (alone or in combination with other qualifying needs), above-routine use of services or use of specialized services (no other qualifying needs on CSHCN Screener), or using prescription medication AND above-routine use of services.
Medicaid to Foster Youth from other states
Learn more about coverage and financing of care for children in foster care at http://cahpp.org/project/the-catalyst-center/financing-strategy/foster-care/
Maximum allowed income for CHIP eligibility as a percentage of the FPL
Caution! MAGI Adjusted
Number of children ever Enrolled in CHIP Annually
Caution! The enrollment totals represent the unduplicated number of children ever enrolled in Medicaid and CHIP at any point during the fiscal year. Therefore, enrollment totals may seem higher than other sources of enrollment data that use a different methodology.
Distribution of Supplemental Security Income (SSI) Beneficiaries by Age
Caution! Children under age 18
TEFRA Medicaid state plan option/Katie Beckett waiver for children
The TEFRA state plan option allows states to enroll CYSHCN who require the equivalent of an institutional level of care (pediatric nursing home, hospital, intermediate care facility for persons with intellectual disabilities) in Medicaid even if family income exceeds Medicaid limits. TEFRA programs are sometimes called Katie Becket waivers. These waivers also deemed parental income and served a similar population of children with the same intention of providing home and community-based services rather than institutional placement but historically preceded the TEFRA state plan option.

Learn more about the coverage and financing of TEFRA at http://cahpp.org/project/the-catalyst-center/financing-strategy/tefra/
Premium Assistance Programs
In premium assistance programs, a state agency pays all or part of the premiums for an eligible family who has access to private health insurance coverage. In premium assistance programs, a state agency pays all or part of the premiums for an eligible family who has access to private health insurance coverage.

Learn more at http://cahpp.org/project/the-catalyst-center/financing-strategy/premium-assistance/.

Dual Public and Private Coverage

Percentage of CSHCN with a combination of public and private health insurance
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.
Dual coverage is an option in states which permit privately insured families to enroll their children in Medicaid in order to receive supplemental coverage, sometimes known as "wrap-around" coverage. This type of secondary Medicaid enrollment may be offered free or through the payment of premiums based on a sliding scale. Dual coverage helps address underinsurance, which is a significant problem for many privately insured CYSHCN whose coverage is too limited to meet their health needs.
Percentage of children with a combination of public and private health insurance, by complexity of health care needs
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.

Complexity of health care needs is determined by responses on the CSHCN screener. CSHCN with more complex health needs are defined as having functional limitations (alone or in combination with other qualifying needs), above-routine use of services or use of specialized services (no other qualifying needs on CSHCN Screener), or using prescription medication AND above-routine use of services.

Health Care Reform

Marketplace overview
Caution! The term Health Insurance “Exchange” is also used interchangeably with Health Insurance “Marketplace.”

Financing

Total Title V Block Grant Expenditures, FY 2017
For a fuller picture of the source and amount of both state and local funds that contribute to the Title V block grant partnership view https://mchb.tvisdata.hrsa.gov/. Learn more about the coverage and financing of family supports at http://cahpp.org/project/the-catalyst-center/financing-strategy/family-supports/
Percentage of Title V Block Grant Budget From State, Federal, and Local Funding Sources
States receive federal funds for Title V activities which they must match at the rate of 75 cents for each federal dollar, however, in many states there are additional sources of funding. For a fuller picture of the source and amount of both state and local funds that contribute to the Title V block grant partnership view https://mchb.tvisdata.hrsa.gov/

Learn more about the coverage and financing of family supports at http://cahpp.org/project/the-catalyst-center/financing-strategy/family-supports/

National Performance Measures Chosen by State

According to the MCHB website, fifteen National Performance Measures (NPMs) across six population health domains were established for the Title V MCH Services Block Grant program. Based on its identified priority needs, states select five of the 15 NPMs for programmatic focus. For each of these selected NPMs, States develop at least one related Evidence-based or –informed Strategy Measures (ESMs) to assess and demonstrate the impact of its State Title V strategies on the NPM. To learn more about the NPMs, go to https://mchb.tvisdata.hrsa.gov/PrioritiesAndMeasures/NationalPerformanceMeasures

Federal MCHB Core Outcomes for CSHCN

Percentage of families raising CSHCN who usually or always feel that they are partners in decision making for child's optimal health
Corresponds with the MCHB Block Grant Performance Measure: The percent of CSHCN age 0 to 18 whose families partner in decision-making at all levels and are satisfied with the services they receive.
Percentage of families who usually or always feel that they are partners in decision making for child's optimal health, by complexity of health care needs
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in. Complexity of health care needs is determined by responses on the CSHCN screener. CSHCN with more complex health care needs are defined as having functional limitations (alone or in combination with other qualifying needs), above-routine use of services or use of specialized services (no other qualifying needs on CSHCN Screener), or using prescription medication AND above-routine use of services.
Percentage of CSHCN who receive coordinated, ongoing, comprehensive care within a medical home
Caution! For certain states, estimates are based on sample sizes too small to meet standards for reliability or precision. Please check the original data source to confirm whether this applies to the state data you are interested in.
Corresponds with the MCHB Block Grant Performance Measure: Percent of children with and without special health care needs, ages 0 through 17, who have a medical home.
Learn more about the coverage and financing of care coordination at http://cahpp.org/project/the-catalyst-center/financing-strategy/care-coordination/
Percentage of children who receive coordinated, ongoing, comprehensive care within a medical home, by complexity of health care needs
Corresponds with the MCHB Block Grant Performance Measure: Percent of children with and without special health care needs, ages 0 through 17, who have a medical home.
Percentage of CSHCN whose families have continuous and adequate private and/or public insurance to pay for the services they need
Corresponds with the MCHB Block Grant Performance Measure: The percent of children, ages 0 to 17 who are continuously and adequately insured.
Adequacy of insurance is measured using three items: Health insurance benefits met child's needs, coverage allowed child to see needed provider, and reasonable out-of-pocket health care expenses.
Percentage of children, ages 0 through 17, who are continuously and adequately insured, by complexity of healthcare needs
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.
Complexity of health care needs is determined by responses on the CSHCN screener. CSHCN with more complex health care needs are defined as having functional limitations (alone or in combination with other qualifying needs), above-routine use of services or use of specialized services (no other qualifying needs on CSHCN Screener), or using prescription medication AND above-routine use of services.

Corresponds with the MCHB Block Grant Performance Measure: The percent of children, ages 0 to 17 who are continuously and adequately insured.
Percentage of youth with special health care needs who receive the services necessary to make appropriate transitions to adult health care, work, and independence -- CSHCN ages 12-17 only
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.
Corresponds with the MCHB Block Grant Performance Measure: Percent of adolescents with and without special health care needs, ages 12 through 17, who received services necessary to make transitions to adult health care.
Learn more about the coverage and financing of transition services at http://cahpp.org/project/the-catalyst-center/financing-strategy/transition-services/
Percentage of youth with special health care needs, ages 12 through 17, who received the services necessary to make transitions to adult health care, by complexity of health care needs
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.

Complexity of health care needs is determined by responses on the CSHCN screener. CSHCN with more complex health care needs are defined as having functional limitations (alone or in combination with other qualifying needs), above-routine use of services or use of specialized services (no other qualifying needs on CSHCN Screener), or using prescription medication AND above-routine use of services.

Corresponds with the MCHB Block Grant Performance Measure: Percent of adolescents with and without special health care needs, ages 12 through 17, who received services necessary to make transitions to adult health care.
Percentage of families who report their child's doctors or other health care providers are sensitive to the family's values and customs
Caution! Proceed with caution: For a substantial number of states, estimates are based on sample sizes too small to meet standards for reliability or precision. We highly recommend checking the source (National Survey of Children's Health, 2016-2017) to confirm whether this applies to the state data you are interested in.

This project (U1TMC31757) is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $500,000, with no financing by nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government; HRSA Project Officer Sarah Beth McLellan.