Catalyst

Tip: Per pupil education expenditures include average combined local, state and federal education funds per pupil for all children in a state.

Federal per pupil IDEA expenditures for children aged 3-21 in Special Education

$1,774

Source: U.S. Dept. of Education, Office of Special Education and Rehabilitative Services (2010)

CHILD HEALTH SERVICES

Health Care	US
Number of children’s hospitals	245

Source: Children’s Hospital Association

Tip: 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

1.14

Source: American Board of Medical Specialties (2013-2014)

Number of family practitioners

85,279

Source: American Board of Medical Specialties (2013-2014)

Number of child and adolescent psychiatrists per 1,000 children

0.075

Source: American Board of Medical Specialties (2013-2014)

Early Intervention Eligibility	US
Eligibility for Early Intervention services includes infants and toddlers “at risk” of developmental delay	Yes=5

Source: Early Childhood Technical Assistance Center (2012)

Tip: Within federal guidelines, states have broad discretion in setting Early Intervention eligibility.

Mental Health	US
Percentage of children served by the state mental health agency
Aged 0-12	15.4%
Aged 13-17	11.9%
Aged 18-20	4.6%

Source: SAMHSA National Mental Health Information Center (2014)

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

59.10%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Oral Health	US
Percentage of children receiving preventive dental care in the past year	77.2%

Source: National Survey of Children’s Health (2011-2012)

Percentage of CSHCN receiving preventive dental care in the past year

83.1%

Source: National Survey of Children’s Health (2011-2012)

Percentage of children with teeth in excellent or very good condition

71.3%

Source: National Survey of Children’s Health (2011-2012)

Percentage of CSHCN with teeth in excellent or very good condition

64.9%

Source: National Survey of Children’s Health (2011-2012)

Foster Care	US
Number of children in foster care	402,378

Source: U.S. Dept. of Health and Human Services, Administration for Children and Families, Children’s Bureau (2014)

Percentage of children in foster care

0.5%

Source: U.S. Dept. of Health and Human Services, Administration for Children and Families, Children’s Bureau (2014)

FACTORS INFLUENCING HEALTH INSURANCE COVERAGE

Uninsured	US
Percentage of children without health insurance at some point in the past year	11.3%

Source: National Survey of Children’s Health (2011-2012)

Tip: 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 CYSHCN without health insurance at some point in the past year, by age groups
0-5 years	9.1%
6-11 years	9.2%
12-17 years	9.4%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN without health insurance at some point in the past year, by sex
Male	9.5%
Female	8.9%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN without health insurance at some point in the past year, by race/ethnicity
Hispanic	15.9%
White non-Hispanic	7.3%
Black non-Hispanic	9.9%
Other non-Hispanic	9.4%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN without health insurance at some point in the past year, by primary household language
Hispanic child/Spanish language household	22.2%
Hispanic child/English language household	12.6%
Non-Hispanic child	8.0%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN without health insurance at some point in the past year, by household income
0-99% FPL	14.2%
100-199% FPL	14.1%
200-399% FPL	8.5%
400% or more FPL	2.3%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN without health insurance at some point in the past year, by number of functional difficulties
No difficulties	4.4%
1 difficulty	5.9%
2 difficulties	9.0%
3 difficulties	9.9%
4 or more difficulties	11.7%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN without health insurance at some point in the past year

9.3%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Tip: *Estimates based on sample sizes too small to meet standards for reliability or precision.

Underinsured	US
Percentage of children with inadequate health care coverage	23.5%

Source: National Survey of Children’s Health (2011-2012)

Percentage of CYSHCN with inadequate health care coverage, by age groups
0-5 years	31.6%
6-11 years	34.6%
12-17 years	35.5%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with inadequate health care coverage, by sex
Male	34.5%
Female	34.1%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with inadequate health care coverage, by race/ethnicity
Hispanic	37.9%
White non-Hispanic	33.0%
Black non-Hispanic	35.9%
Other non-Hispanic	33.9%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with inadequate health care coverage, by primary household language
Hispanic child/Spanish language household	39.9%
Hispanic child/English language household	37.0%
Non-Hispanic child	33.6%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with inadequate health care coverage, by household income
0-99% FPL	34.3%
100-199% FPL	34.3%
200-399% FPL	36.9%
400% or more FPL	31.9%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with inadequate health care coverage, by number of functional difficulties
No difficulties	23.2%
1 difficulty	26.5%
2 difficulties	30.7%
3 difficulties	32.6%
4 or more difficulties	41.6%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with inadequate health care coverage

34.3%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Tip: Relatively few CYSHCN lack insurance completely. However, private coverage is often too limited to meet their health needs, Thus, in many states, underinsurance is the major financial barrier to health care access for CYSHCN.

*Estimates based on sample sizes too small to meet standards for reliability or precision.

Private Insurance Coverage	US
Percentage of children with private health insurance coverage	57.4%

Source: National Survey of Children’s Health (2011-2012)

Percentage of CYSHCN with private health insurance coverage, by age groups
0-5 years	46.1%
6-11 years	51.4%
12-17 years	56.6%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with private health insurance coverage, by sex
Male	51.9%
Female	53.0%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with private health insurance coverage, by race/ethnicity
Hispanic	35.7%
White non-Hispanic	63.4%
Black non-Hispanic	30.6%
Other non-Hispanic	49.8%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with private health insurance coverage, by primary household language
Hispanic child/Spanish language household	15.9%
Hispanic child/English language household	46.1%
Non-Hispanic child	55.7%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with private health insurance coverage, by household income
0-99% FPL	5.9%
100-199% FPL	27.7%
200-399% FPL	71.8%
400% or more FPL	90.2%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with private health insurance coverage, by number of functional difficulties
No difficulties	74.7%
1 difficulty	68.9%
2 difficulties	61.6%
3 difficulties	52.2%
4 or more difficulties	38.2%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with private health insurance coverage

52.4%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Tip: *Estimates based on sample sizes too small to meet standards for reliability or precision.

Public Coverage: Medicaid, CHIP and SSI	US
Number of children enrolled in Medicaid	32,931,900

Tip: Because 2011 data were unavailable, 2010 data was used for Florida, Kansas, Maine, Maryland, Montana, New Mexico, New Jersey, Oklahoma, Texas, and Utah.

Percentage of Medicaid enrollees who are children

48%

Source: Kaiser Family Foundation (2012)

Percentage of children enrolled in Medicaid or CHIP

37.1%

Source: National Survey of Children’s Health (2011-2012)

Percentage of CYSHCN enrolled in Medicaid or CHIP, by age groups
0-5 years	41.2%
6-11 years	36.9%
12-17 years	32.1%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN enrolled in Medicaid or CHIP, by sex
Male	36.1%
Female	35.5%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN enrolled in Medicaid or CHIP, by race/ethnicity
Hispanic	46.4%
White non-Hispanic	27.0%
Black non-Hispanic	56.0%
Other non-Hispanic	37.8%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN enrolled in Medicaid or CHIP, by primary household language
Hispanic child/English language household	40.6%
Non-Hispanic child	33.7%
Hispanic child/Spanish language household	57.5%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN enrolled in Medicaid or CHIP, by household income
0-99% FPL	77.9%
100-199% FPL	55.9%
200-399% FPL	17.2%
400% or more FPL	4.5%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN enrolled in Medicaid or CHIP, by number of functional difficulties
No difficulties	19.5%
1 difficulty	24.0%
2 difficulties	29.0%*
3 difficulties	36.6%
4 or more difficulties	45.9%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN enrolled in Medicaid or CHIP

35.9%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Tip: *Estimates based on sample sizes too small to meet standards for reliability or precision.

Maximum allowed income for CHIP eligibility as a percentage of the FPL

N/A

Source: Kaiser Family Foundation (2015)

Tip: MAGI Adjusted

Number of children enrolled in CHIP

8,129,426

Source: Kaiser Family Foundation (2014)

Tip: Accounts for churn

Percentage of children enrolled in CHIP

10.4%

Source: Kaiser Family Foundation (2014)

Number of children enrolled in Supplemental Security Income (SSI)

1,321,681

Source: Kaiser Family Foundation (2011)

Percentage of children enrolled in Supplemental Security Income (SSI)

1.8%

Source: Kaiser Family Foundation (2013) and U.S. Census Bureau (2010)

TEFRA Medicaid state plan option/Katie Beckett waiver for children

Yes=23

Source: American Journal of Law and Medicine (2011)

Tip: 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. For more information about this indicator, see the Catalyst Center article “Making It Possible to Care for Children with Significant Disabilities at Home” at http://hdwg.org/catalyst/tefraindicator.

Premium Assistance Programs

Yes= 36

Source: Employee Benefits Security Administration (2014)

Tip: 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.

Dual Public and Private Coverage	US
Percentage of CYSHCN with a combination of public and private health insurance, by sex
Male	8.4%
Female	7.8%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with a combination of public and private health insurance, by race/ethnicity
Hispanic	11.1%
White non-Hispanic	6.9%
Black non-Hispanic	9.7%
Other non-Hispanic	3.7%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with a combination of public and private health insurance, by age groups
0-5 years	9.7%
6-11 years	8.4%
12-17 years	7.2%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with a combination of public and private health insurance, by household income
0-99% FPL	11.1%
100-199% FPL	11.1%
200-399% FPL	7.1%
400% or more FPL	4.6%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with a combination of public and private health insurance, by number of functional difficulties
No difficulties	4.3%
1 difficulty	4.7%
2 difficulties	5.9%
3 difficulties	7.3%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with a combination of public and private health insurance, by primary household language
Hispanic child/English language household	8.1%
Non-Hispanic child	7.6%
Hispanic child/Spanish language household	16.7%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CYSHCN with a combination of public and private health insurance

8.2%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Tip: 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.

*Estimates based on sample sizes too small to meet standards for reliability or precision.

Health Care Reform	US
Exchange overview
Exchange decision	State run=17; State/fed partnership=7; Fed run=27
Type of exchange	N/A

Source: Kaiser Family Foundation (2014)

Tip: The term Health Insurance “Exchange” is also used interchangeably with Health Insurance “Marketplace.”

Recommended benchmark plan

N/A

Source: Center for Consumer Information and Insurance Oversight (2012)

Plan type

N/A

Source: National Academy for State Health Policy (2014)

Approved Section 2703 Health Home State Plan Amendments (SPAs)
Approved SPA	Yes= 20; No= 31
Target population	N/A
Geographic area	N/A

Source: Kaiser Family Foundation (2015)

State Mandated Insurance Benefits (for private ins	US
Autism	Yes=35

Source: Autism Speaks (2014)

Bone Marrow Transplants	Yes=9
Cleft Palate	Yes=17
Congenital Bleeding Disorders	Yes=3
Dental Anesthesia	Yes=31
Diabetes Self-Management	Yes=38
Diabetic Supplies	Yes=47

Source: Center for Affordable Health Insurance (2010)

Early Intervention

Yes=9

Source: Catalyst Center communications with state agency contacts and review of state statutes (2011)

Emergency Services	Yes=45
Hearing Aids	Yes=17
Home Health Care	Yes=20
Hospice Care	Yes=12
Kidney Disease Treatment	Yes=2
Mental Health, General	Yes=42

Source: Center for Affordable Health Insurance (2010)

Mental Health Parity

Yes=23

Source: National Conference of State Legislatures (2014)

Neurodevelopment Therapy	Yes=1
Newborn Hearing Screening	Yes=18
Newborn Sickle-Cell Testing	Yes=4
PKU/Formula	Yes=33
Prescription Drugs	Yes=4
Rehabilitation Services	Yes=6
Telemedicine	Yes=9

Source: Center for Affordable Health Insurance (2010)

Tip: For updated information on each state’s specific mandated benefits, go to http://www.cms.gov/cciio/resources/data-resources/ehb.html

Mandated benefits are benefits that private insurers must cover, by law, in a given state. Note that self-insured health plans are exempt from such mandates. For a more in-depth discussion of state mandated benefits for CYSHCN, see the Catalyst Center website at http://www.hdwg.org/catalyst/close-benefit-gaps/mandated-benefits

Catastrophic Coverage	US
High-Risk Pool Programs	Yes=34

Source: Kaiser Family Foundation (2011)

EXPERIENCE WITH THE SYSTEM OF CARE FOR CSHCN

Federal MCHB Core Outcomes for CSHCN	US
Percentage of CSHCN whose families are partners in shared decision-making for child’s optimal health, by primary household language
Hispanic child/English language household	65.6%
Non-Hispanic child	71.6%
Hispanic child/Spanish language household	59.5%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Tip: 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 (outcome successfully achieved).

Percentage of CSHCN whose families are partners in shared decision-making for child’s optimal health, by household income
0-99% FPL	61.8%
100-199% FPL	67.3%
200-399% FPL	72.6%
400% or more FPL	77.2%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN whose families are partners in shared decision-making for child’s optimal health, by number of functional difficulties
No difficulties	84.8%
1 difficulty	79.6%
2 difficulties	76.4%
3 difficulties	73.2%
4 or more difficulties	60.8%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN whose families are partners in shared decision-making for child’s optimal health, by sex
Male	69.5%
Female	71.5%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN whose families are partners in shared decision-making for child’s optimal health, by race/ethnicity
Hispanic	63.5%
White non-Hispanic	74.2%
Black non-Hispanic	64.7%
Other non-Hispanic	66.8%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN whose families are partners in shared decision-making for child’s optimal health

70.3%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who receive coordinated, ongoing, comprehensive care within a medical home, by age groups
0-5 years	44.2%
6-11 years	42.1%
12-17 years	43.1%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Tip: Corresponds with the MCHB Block Grant Performance Measure: The percent of CSHCN age 0 to 18 who receive coordinated, ongoing, comprehensive care within a medical home (outcome successfully achieved).

Percentage of CSHCN who receive coordinated, ongoing, comprehensive care within a medical home, by sex
Male	42.6%
Female	43.6%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who receive coordinated, ongoing, comprehensive care within a medical home, by race/ethnicity
Hispanic	33.2%
White non-Hispanic	48.8%
Black non-Hispanic	33.5%
Other non-Hispanic	39.1%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who receive coordinated, ongoing, comprehensive care within a medical home, by primary household language
Hispanic child/English language household	37.4%
Non-Hispanic child	44.9%
Hispanic child/Spanish language household	24.9%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who receive coordinated, ongoing, comprehensive care within a medical home, by household income
0-99% FPL	30.9%
100-199% FPL	37.5%
200-399% FPL	47.4%
400% or more FPL	52.2%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who receive coordinated, ongoing, comprehensive care within a medical home, by number of functional difficulties
No difficulties	64.1%
1 difficulty	58.3%
2 difficulties	53.3%
3 difficulties	43.2%
4 or more difficulties	28.9%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who receive coordinated, ongoing, comprehensive care within a medical home

43.0%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Tip: Corresponds with the MCHB Block Grant Performance Measure: The percent of CSHCN age 0 to 18 who receive coordinated, ongoing, comprehensive care within a medical home.

Percentage of CSHCN whose families have consistent and adequate private and/or public insurance to pay for the services they need, by age groups
0-5 years	63.2%
6-11 years	60.3%
12-17 years	59.4%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Tip: Corresponds with the MCHB Block Grant Performance Measure: The percent of CSHCN age 0 to 18 whose families have adequate private and/or public insurance to pay for the services they need (outcome successfully achieved).

Percentage of CSHCN whose families have consistent and adequate private and/or public insurance to pay for the services they need, by sex
Male	60.2%
Female	61.0%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN whose families have consistent and adequate private and/or public insurance to pay for the services they need, by race/ethnicity
Hispanic	53.6%
White non-Hispanic	62.8%
Black non-Hispanic	58.9%
Other non-Hispanic	61.5%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN whose families have consistent and adequate private and/or public insurance to pay for the services they need, by primary household language
Hispanic child/Spanish language household	48.8%
Hispanic child/English language household	56.1%
Non-Hispanic child	61.9%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN whose families have consistent and adequate private and/or public insurance to pay for the services they need, by household income
0-99% FPL	57.8%
100-199% FPL	58.0%
200-399% FPL	58.5%
400% or more FPL	67.0%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN whose families have consistent and adequate private and/or public insurance to pay for the services they need, by number of functional difficulties
No difficulties	74.1%
1 difficulty	69.8%
2 difficulties	63.9%
3 difficulties	62.0%
4 or more difficulties	52.6%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN whose families have consistent and adequate private and/or public insurance to pay for the services they need

60.6%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Tip: Corresponds with the MCHB Block Grant Performance Measure: The percent of CSHCN age 0 to 18 whose families have adequate private and/or public insurance to pay for the services they need.

Percentage of CSHCN who are screened early and continuously for special health care needs, by age groups
0-5 years	64.8%
6-11 years	83.8%
12-17 years	80.6%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Tip: Corresponds with the MCHB Block Grant Performance Measure: The percent of screen positive newborns who received timely follow up to definitive diagnosis and clinical management for condition(s) mandated by their State-sponsored newborn screening programs (outcome successfully achieved).

Percentage of CSHCN who are screened early and continuously for special health care needs, by sex
Male	78.5%
Female	78.8%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who are screened early and continuously for special health care needs, by race/ethnicity
Hispanic	74.9%
White non-Hispanic	79.6%
Black non-Hispanic	78.8%
Other non-Hispanic	78.7%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who are screened early and continuously for special health care needs, by primary household language
Hispanic child/English language household	80.3%
Non-Hispanic child	79.3%
Hispanic child/Spanish language household	64.3%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who are screened early and continuously for special health care needs, by household income
0-99% FPL	73.2%
100-199% FPL	75.0%
200-399% FPL	78.6%
400% or more FPL	85.8%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who are screened early and continuously for special health care needs, by number of functional difficulties
No difficulties	79.5%
1 difficulty	81.5%
2 difficulties	79.8%
3 difficulties	76.7%
4 or more difficulties	77.3%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who are screened early and continuously for special health care needs

78.6%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who can easily access community-based services, by age groups
0-5 years	65.9%
6-11 years	64.8%
12-17 years	65.0%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Tip: Corresponds with the MCHB Block Grant Performance Measure: Percent of CSHCN age 0 to 18 whose families report that community-based service systems are organized so they can use them easily (outcome successfully achieved).

Percentage of CSHCN who can easily access community-based services, by sex
Male	65.4%
Female	64.7%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who can easily access community-based services, by race/ethnicity
Hispanic	59.2%
White non-Hispanic	67.6%
Black non-Hispanic	64.1%
Other non-Hispanic	60.8%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who can easily access community-based services, by primary household language
Hispanic child/English language household	60.2%
Non-Hispanic child	66.3%
Hispanic child/Spanish language household	57.3%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who can easily access community-based services, by household income
0-99% FPL	59.4%
100-199% FPL	59.2%
200-399% FPL	65.6%
400% or more FPL	74.0%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who can easily access community-based services, by number of functional difficulties
No difficulties	86.5%
1 difficulty	81.9%
2 difficulties	74.6%
3 difficulties	66.9%
4 or more difficulties	50.4%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of CSHCN who can easily access community-based services

65.1%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Tip: Corresponds with the MCHB Block Grant Performance Measure: Percent of CSHCN age 0 to 18 whose families report that community-based service systems are organized so they can use them easily.

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, by age groups
12-14 years	40.7%
15-17 years	39.4%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Tip: Corresponds with the MCHB Block Grant Performance Measure: The percentage of youth with special health care needs who received the services necessary to make transitions to all aspects of adult life, including adult health care, work, and independence (outcome successfully achieved).

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, by sex
Male	37.1%
Female	43.8%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

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, by race/ethnicity
Hispanic	25.3%
White non-Hispanic	45.7%
Black non-Hispanic	28.1%
Other non-Hispanic	40.2%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

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, by primary household language
Hispanic child/English language household	31.6%
Non-Hispanic child	42.4%
Hispanic child/Spanish language household	12.4%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

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, by household income
0-99% FPL	25.4%
100-199% FPL	31.0%
200-399% FPL	43.3%
400% or more FPL	52.2%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

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, by number of functional difficulties
No difficulties	57.4%
1 difficulty	55.7%
2 difficulties	48.3%
3 difficulties	42.0%
4 or more difficulties	28.3%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Percentage of families who report their child’s doctors or other health care providers are sensitive to the family’s values and customs
Always	69.6%
Usually	19.3%
Sometimes or Never	11.1%

Source: National Survey of Children with Special Health Care Needs (2009-2010)

Tip: *Estimates based on sample sizes too small to meet standards for reliability or precision.

TITLE V PROGRAM

Financing	US
Percentage of Title V Block Grant Partnership Budget from State Funds	45.3%

Source: U.S. Dept. of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau (2015)

Tip: States receive federal funds for Title V activities which they must match at the rate of 75 cents for each federal dollar. Seeing a zero reported for this Catalyst Center state page indicator does not mean the match isn’t being met. Some states’ match comes from local sources other than the state budget. For a fuller picture of the source and amount of both state and local funds that contribute to the Title V block grant partnership, follow the link to “See State Notes for Form 2” in the original source at https://mchdata.hrsa.gov/tvisreports/FinancialData/FinancialSearch.aspx?FinSearch=A

Family Involvement	US
Family Participation in Title V CYSHCN Program Score (Maximum Possible = 18)	13.9

Source: U.S. Dept. of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau (2015)

Tip: Title V programs are required to conduct a self-assessment and report to the federal government annually on the extent to which they involve families in state program planning, implementation and evaluation. While there is a risk of bias here (high performing states may assess their own performance more rigorously than others) this is one marker of family participation in CYSHCN state-level programs and policies.

* Estimates based on sample sizes too small to meet standards for reliability or precision.

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TIPS FOR USING THE DATA

DATA SOURCES

State-at-a-Glance Coverage and Financing Charts

DEMOGRAPHICS

Child Population

Race/Ethnicity

Household

Urban/Rural

Special Health Care Needs

Low Birth Weight

Special Education

ECONOMICS

Income

Unemployment

Financial Impact of Caregiving

Employer Size

Employer-Sponsored Health Insurance

Medicaid Eligibility

Federal Match for Medicaid

Education Expenditures

CHILD HEALTH SERVICES

Health Care

Early Intervention Eligibility

Mental Health

Oral Health

Foster Care

FACTORS INFLUENCING HEALTH INSURANCE COVERAGE

Uninsured

Underinsured

Private Insurance Coverage

Public Coverage: Medicaid, CHIP and SSI

Dual Public and Private Coverage

Health Care Reform

State Mandated Insurance Benefits (for private ins

Catastrophic Coverage

EXPERIENCE WITH THE SYSTEM OF CARE FOR CSHCN

Federal MCHB Core Outcomes for CSHCN

TITLE V PROGRAM

Financing

Family Involvement