NR = not reported   NA = not applicable      -- = the state was not required to complete this section of the state plan             template and did not volunteer the information.

Identifiers				Performance Measures
State	Program	Phase or Component	Amend.#	% Eligible Children Enrolled in Medicaid	% Children Uninsured	% Children w/Usual Source of Care	Progress on Health Problems	HEDIS Measures (All)	Other	Specify Other Measurement Set
AK	AK Denali KidCare		NA	Yes	Yes	Yes	Yes	No	No
AL	AL SCHIP	Phase 1
AL	AL SCHIP	Phase 1	NA	Yes	Yes	Yes	No	No	No
AL	AL SCHIP	All Kids (Phase 2)
AL	AL SCHIP	All Kids (Phase 2)	1	Yes	Yes	Yes	No	Yes	NR
AL	AL SCHIP	All Kids (Phase 2)	2					No
AL	AL SCHIP	Plus (Phase 3)
AL	AL SCHIP	Plus (Phase 3)	2	Yes	Yes	Yes	No	No	No
AR	AR SCHIP	Phase I - ARKids A
AR	AR SCHIP	Phase I - ARKids A	NA	Yes	Yes	Yes	No	No	No
AR	AR SCHIP	Phase II - ARKids B
AR	AR SCHIP	Phase II - ARKids B	1	Yes	Yes	Yes	No	No	No
AS	AS SCHIP		NA	NR	NR	NR	NR	NR	NR
AZ	KidsCare		NA	Yes	Yes	Yes	Yes	No	Yes	AHCCCS will report comparable quality indicators for KidsCare - separate report from Medicaid reports.
AZ	KidsCare		1
AZ	KidsCare		2
AZ	KidsCare		3
AZ	KidsCare		4
CA	Healthy Families	Medi-Cal Expansion
CA	Healthy Families	Medi-Cal Expansion	NA	Yes	Yes	Yes	No	Yes	No
CA	Healthy Families	Medi-Cal Expansion	1
CA	Healthy Families	Medi-Cal Expansion	2
CA	Healthy Families	Health Insurance Plan (MRMIB)
CA	Healthy Families	Health Insurance Plan (MRMIB)	NA	Yes	Yes	No	No	Yes	No
CA	Healthy Families	Health Insurance Plan (MRMIB)	2
CA	Healthy Families	Health Insurance Plan (MRMIB)	3
CA	Healthy Families	Health Insurance Plan (MRMIB)	4
CA	Healthy Families	Health Insurance Plan (MRMIB)	5
CA	Healthy Families	Access for Infants and Mothers (AIM)
CA	Healthy Families	Access for Infants and Mothers (AIM)	NA	Yes	Yes	No	No	Yes	No
CA	Healthy Families	Access for Infants and Mothers (AIM)	2
CA	Healthy Families	Access for Infants and Mothers (AIM)	3
CA	Healthy Families	Access for Infants and Mothers (AIM)	4
CA	Healthy Families	Access for Infants and Mothers (AIM)	5
CA	Healthy Families	Child Health and Disability Prevention Program
CA	Healthy Families	Child Health and Disability Prevention Program	NA	NR	NR	NR	NR	Yes	No
CA	Healthy Families	Child Health and Disability Prevention Program	2
CA	Healthy Families	Child Health and Disability Prevention Program	3
CA	Healthy Families	California Children`s Services
CA	Healthy Families	California Children`s Services	NA	NR	NR	NR	NR	Yes	No
CA	Healthy Families	California Children`s Services	2
CA	Healthy Families	County Mental Health Program
CA	Healthy Families	County Mental Health Program	NA	NR	NR	NR	NR	Yes	No
CA	Healthy Families	County Mental Health Program	2
CO	CHP+		NA	Yes	Yes	No	Yes	Yes	No
CO	CHP+		1
CO	CHP+		2
CT	HUSKY Program	Part A
CT	HUSKY Program	Part A	NA	Yes	Yes	Yes	No	Yes	Yes	Well-child periodicity compliance.
CT	HUSKY Program	Part A	0
CT	HUSKY Program	Part A	1
CT	HUSKY Program	Part B
CT	HUSKY Program	Part B	NA	Yes	Yes	Yes	No	Yes	Yes	Well-child periodicity compliance.
CT	HUSKY Program	Part B	1
CT	HUSKY Program	HUSKY Plus Plan for Children with Special Physical Health Needs	NA	Yes	Yes	Yes	No	Yes	Yes	Husky Plus Medical Record Audit Tool
CT	HUSKY Program	HUSKY Plus Plan for Children with Special Physical Health Needs	1
CT	HUSKY Program	HUSKY Plus Behavioral Health Plan	NA	Yes	Yes	Yes	No	Yes	Yes	Well-child periodicity compliance.
CT	HUSKY Program	HUSKY Plus Behavioral Health Plan	1
DC	DC Healthy Kids		NA	Yes	Yes	Yes	Yes	No	No
DE	Delaware Healthy Children`s Program		NA	No	Yes	Yes	Yes	No	No
DE	Delaware Healthy Children`s Program		1
FL	FL KidCare	Medicaid expansion
FL	FL KidCare	Medicaid expansion	NA	Yes	Yes	Yes	Yes	No	Yes	FL will use a variety of encounter data, and data from focus groups and surveys.
FL	FL KidCare	Medicaid expansion	1
FL	FL KidCare	Healthy Kids
FL	FL KidCare	Healthy Kids	NA	Yes	Yes	Yes	Yes	No	Yes	FL will use a variety of encounter data, and data from focus groups and surveys.
FL	FL KidCare	Healthy Kids	1
FL	FL KidCare	Healthy Kids	3
FL	FL KidCare	Healthy Kids	4
FL	FL KidCare	Medi-Kids	1	Yes	Yes	Yes	Yes	No	NR
FL	FL KidCare	Medi-Kids	4
FL	FL KidCare	CMS	1	Yes	Yes	Yes	Yes	No	NR
FL	FL KidCare	CMS	4
GA	Peach Care for Kids		NA	Yes	Yes	Yes	Yes	No	No
GA	Peach Care for Kids		0
GA	Peach Care for Kids		1
GU	Guam SCHIP		NA	Yes	Yes	Yes	Yes	No	Yes	Missing/not specified
HI	HI SCHIP	Phase I	NA	Yes	Yes	Yes	Yes	No	Yes	Missing/not specified
HI	HI SCHIP	Phase I	1
IA	Hawk-I	Medicaid Expansion	NA	Yes	Yes	Yes	Yes	No	Yes	Missing/not specified
IA	Hawk-I	Medicaid Expansion	4
IA	Hawk-I	Separate State Program	1	Yes	Yes	Yes	Yes	No	NR
IA	Hawk-I	Separate State Program	2
IA	Hawk-I	Separate State Program	3
IA	Hawk-I	Separate State Program	4
ID	ID SCHIP		NA	Yes	Yes	Yes	No	No	No
ID	ID SCHIP		1
ID	ID SCHIP		2				Yes
IL	Kidcare	Phase 1	NA	Yes	Yes	Yes	Yes	No	NR
IL	Kidcare	Phase 2	1	NR	NR	NR	NR	NR	NR
IN	Hoosier Healthwise	Phase 1	NA	Yes	Yes	Yes	Yes	No	No
IN	Hoosier Healthwise	Phase 1	0
IN	Hoosier Healthwise	Phase 2	2	No	Yes	Yes	Yes	No	No
KS	HealthWave		NA	Yes	Yes	Yes	Yes	No	No
KS	HealthWave		1
KY	KCHIP	Medicaid Expansion
KY	KCHIP	Medicaid Expansion	NA	Yes	Yes	Yes	Yes	Yes	No
KY	KCHIP	Medicaid Expansion	1
KY	KCHIP	Insurance Product
KY	KCHIP	Insurance Product	NA	Yes	Yes	Yes	Yes	Yes	No
KY	KCHIP	Insurance Product	1
KY	KCHIP	Insurance Product	2					No
LA	LaCHIP		NA	Yes	Yes	Yes	Yes	No	Yes	Quality indicators for the appropriate age group comparable to those scheduled to Louisiana Health Access-Region 3, the Medicaid managed care pilot; and CommunityCare, the PCCM program.
LA	LaCHIP		1
MA	MassHealth	Standard	NA	Yes	Yes	Yes	Yes	Yes	No
MA	MassHealth	Family Assistance Direct Coverage	NA	Yes	Yes	Yes	Yes	Yes	No
MA	MassHealth	Family Assistance Premium Assistance	NA	Yes	Yes	Yes	Yes	Yes	No
MA	MassHealth	Common Health	NA	Yes	Yes	Yes	Yes	Yes	No
MD	Maryland Children`s Health Program	Phase I	NA	Yes	Yes	Yes	Yes	Yes	Yes	State is in the process of developing these measures.
MD	Maryland Children`s Health Program	Phase I	1
MD	Maryland Children`s Health Program	Phase II	2	Yes	Yes	No	No	No	No
MD	Maryland Children`s Health Program	Phase II- ESI	2	Yes	Yes	No	No	No	No
ME	ME CHIP Medicaid Expansion		NA	Yes	Yes	Yes	Yes	Yes	No
ME	Cubcare		NA	Yes	Yes	Yes	Yes	Yes	No
ME	Cubcare		1
MI	MI SCHIP	MI CHILD	NA	Yes	Yes	No	Yes	Yes	No
MI	MI SCHIP	MI CHILD	1
MI	MI SCHIP	MI CHILD	2
MI	MI SCHIP	Medicaid Expansion	1	Yes	Yes	No	Yes	Yes	No
MI	MI SCHIP	Medicaid Expansion	2
MN	Minnesota Medical Assistance Program		NA	Yes	No	No	No	No	No
MO	MC+ for Kids		NA	Yes	Yes	No	No	No	No
MO	MC+ for Kids		1
MP	CNMI SCHIP		NA	Yes	Yes	No	No	No	No
MS	MS SCHIP	Phase I
MS	MS SCHIP	Phase I	NA	Yes	Yes	Yes	No	Yes	No
MS	MS SCHIP	Phase II
MS	MS SCHIP	Phase II	1	Yes	Yes	Yes	Yes	Yes	No
MS	MS SCHIP	Phase II	2
MS	MS SCHIP	Phase II	3
MS	MS SCHIP	Employer-sponsored coverage	1	Yes	Yes	Yes	Yes	Yes	No
MT	MT SCHIP		NA	Yes	Yes	No	No	No	No
MT	MT SCHIP		1
NC	NC SCHIP		NA	Yes	Yes	Yes	Yes	Yes	No
NC	NC SCHIP		1
NC	NC SCHIP		2
NC	NC SCHIP		3
NC	NC SCHIP		4
NC	NC SCHIP		5
ND	Healthy Steps	Phase I
ND	Healthy Steps	Phase I	NA	Yes	Yes	Yes	Yes	No	No
ND	Healthy Steps	Phase II
ND	Healthy Steps	Phase II	1	NR	Yes	NR	Yes	NR	NR
NE	Kid`s Connection		NA	No	Yes	Yes	No	No	Yes	Participation rate of providers; vision care check-ups; number of children with prescription lenses.
NE	Kid`s Connection		1
NH	Healthy Kids	Gold	NA	Yes	Yes	Yes	Yes	Yes	No
NH	Healthy Kids	Gold	1
NH	Healthy Kids	Silver	NA	Yes	Yes	Yes	Yes	Yes	No
NJ	KidCare	Plan A	NA	Yes	Yes	Yes	Yes	No	No
NJ	KidCare	Plan B	NA	Yes	Yes	Yes	Yes	No	No
NJ	KidCare	Plan B	1
NJ	KidCare	Plan B	3
NJ	KidCare	Plan B	4
NJ	KidCare	Plan C	NA	Yes	Yes	Yes	Yes	No	No
NJ	KidCare	Plan C	1
NJ	KidCare	Plan C	3
NJ	KidCare	Plan C	4
NJ	KidCare	Plan D	2	Yes	Yes	Yes	Yes	No	No
NJ	KidCare	Plan D	3
NJ	KidCare	Plan D	4
NJ	KidCare	1115 Demonstration	NA
NM	NM SCHIP		NA	Yes	Yes	Yes	No	Yes	Yes	Consumer surveys, focus groups
NM	NM SCHIP		2
NM	NM SCHIP	1115 Demonstration	NA
NV	Nevada Check-Up		NA	Yes	Yes	No	No	Yes	No
NV	Nevada Check-Up		1
NY	NY SCHIP	CHPLUS
NY	NY SCHIP	CHPLUS
NY	NY SCHIP	CHPLUS	NA	Yes	Yes	Yes	Yes	No	No
NY	NY SCHIP	CHPLUS	2					No
NY	NY SCHIP	Medicaid Expansion	2	Yes	Yes	Yes	Yes	No	No
OH	OH Child Health Plan		NA	Yes	Yes	No	No	No	Yes	Missing/not specified
OH	OH Child Health Plan		1
OK	SoonerCare		NA	Yes	Yes	Yes	Yes	Yes	Yes	Consumer Assessment of Health Plan Survey; Oklahoma State Immunization Information System.
OK	SoonerCare		1
OR	OR SCHIP		NA	Yes	Yes	Yes	Yes	Yes	Yes	Missing/not specified
OR	OR SCHIP		2
OR	OR SCHIP		3
PA	PA SCHIP		NA	Yes	Yes	No	Yes	No	NR
PA	PA SCHIP		1
PA	PA SCHIP		2
PA	PA SCHIP		3
PA	PA SCHIP		4
PR	PR SCHIP		NA	Yes	Yes	No	Yes	No	No
RI	RIte Care		NA	Yes	Yes	Yes	Yes	No	No
RI	RIte Care		1
RI	RIte Care	1115 Demonstration	NA
SC	Partners for Healthy Children		NA	NR	NR	NR	NR	NR	NR
SD	SD SCHIP		NA	Yes	Yes	Yes	Yes	No	NR
SD	SD SCHIP		1
SD	SD SCHIP		2
SD	SD SCHIP	CHIP NM	3	Yes	Yes	Yes	Yes	No	NR
TN	Tennessee`s CHIP	Phase I	NA	Yes	Yes	Yes	Yes	No	Yes	Infant mortality rates; infant case fatality rate; percent of prenatal care starts; percent of babies with low birthweight; percent preterm deliveries; well-child visits for children ages 3-6; dental visits for children under 21; inpatient admissions for all ambulatory care-sensitive diagnoses; inpatient admissions for pediatric asthma; immunizations.
TX	Texas Healthy Steps	Phase I
TX	Texas Healthy Steps	Phase I	NA	Yes	Yes	No	No	No	No
TX	Texas Healthy Steps	Phase II
TX	Texas Healthy Steps	Phase II	1	No	Yes	No	No	Yes	No
UT	UT SCHIP		NA	Yes	Yes	Yes	No	Yes	No
VA	VA SCHIP	Children's Medical Security Insurance Plan/Family Access to Medical Insurance Security Plan	NA	Yes	Yes	Yes	No	No	Yes	Enrollment data; survey data; data generated by contractor review of services; administrative data; encounter data.
VA	VA SCHIP	Children's Medical Security Insurance Plan/Family Access to Medical Insurance Security Plan	1						No
VA	VA SCHIP	Family Access to Medical Insurance Security Plan (FAMIS) - ESI	1	Yes	Yes	Yes	No	No	No
VI	Virgin Island`s SCHIP		NA	Yes	Yes	No	Yes	No	Yes	Missing/not specified
VI	Virgin Island`s SCHIP		1
VT	VT SCHIP		NA	Yes	Yes	Yes	Yes	No	Yes	Minimum data set as approved for VHAP 1115 Waiver Program.
VT	VT SCHIP		1
VT	VT SCHIP		2
VT	VT SCHIP		3
WA	WA SCHIP		NA	Yes	Yes	No	No	No	Yes	May track number of births to CHIP enrollees.
WA	WA SCHIP		1
WI	BadgerCare	Medicaid expansion
WI	BadgerCare	Medicaid expansion	NA	No	No	No	No	No	Yes	Contracts with HMOs require additional reporting requirements.
WI	BadgerCare	Medicaid expansion	1
WI	BadgerCare	Employer-sponsored Coverage	1	NR	NR	NR	NR	NR	--
WI	BadgerCare		NA
WV	WV SCHIP	Phase I	NA	Yes	Yes	Yes	Yes	Yes	No
WV	WV SCHIP	Phase I	2
WV	WV SCHIP	Phase II	1	Yes	Yes	Yes	Yes	Yes	No
WV	WV SCHIP	Phase II	2					No
WV	WV SCHIP	Phase II	3
WY	WY SCHIP	CHIP One	NA	Yes	Yes	No	Yes	No	No