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Model Application Template for the State Children’s Health Insurance Program

Effective Date:

Approval Date: 36 (1) Strategic Objectives (2) Performance Goals for each Strategic Objective (3) Performance Measures and Progress (specify data sources, methodology, time period, etc.) Progress Summary: The number of Title XXI children decreased this year for the first time in 4 years. The number decreased by 1,022 in FFY03 resulting in an 8.5% decline. It is believed that with the downturn in the economy, children applying for assistance are qualifying for Title XIX instead of Title XXI. The statistics bear this out. As of 9/30/03, overall Idaho had increased enrollment since 1999 by 7,219 children, a 193% increase. Objectives Related to Increasing Medicaid Enrollment To increase the number of children enrolled in Title XIX health programs The targeted increase in enrollment is 6,000 children annually.

New/Revised

Continuing X Data Sources: Enrollment data from the Division of Medicaid AIM system.

• Methodology: Annual increase in enrollment of uninsured children in Title XIX programs compared to the previous federal fiscal year. • The total number of new uninsured children enrolled in Title XIX programs compared to the base number of enrollees as of 9/30/99 • Numerator: Number of enrollees on 9/30/03: 101,724 • Denominator: Number of enrollees on 9/30/99: 51,089 Progress Summary: The number of children enrolled in Title XIX increased by 9,023 or nearly 10% in FFY03. As of 9/30/03, Idaho had increased enrollment by 50,635 children, an increase of 99%.

Objectives Related to Increasing Access to Care (Usual Source of Care, Unmet Need) To ensure that enrolled children have a medical home. There will be a 10% annual increase in the number of children participating in Healthy Connections and having a primary care provider as a “medical home”. New/Revised

Continuing X

Data Sources: Division of Medicaid, Healthy Connections (PCCM) Program • Methodology: Baseline data on the number of children in the Healthy Connections is known. The data system will track new enrollees in the program • Numerator: Number of children enrolled in HC at the end of the FFY 9/30/03: 88,415 • Denominator: Number of children enrolled in HC at the beginning of the FFY 10/1/00: 25,661 Progress Summary: Healthy Connections enrollment increased by 37,058 children in FFY 03, a 72% increase for the year and a 244% increase over the baseline. Percent of children participating rose from 49% to 80%. Objectives Related to Use of Preventative Care (Immunizations, Well Child Care) To ensure that enrolled children receive appropriate and necessary medical care. 90% of enrolled children will have up- to-date, age- appropriate vaccinations.

80% of enrolled children age 12 months and younger will have received New/Revised

Continuing X

Data Sources: Division of Medicaid information system, Division of Health Immunization Registry • Methodology: Claims data will be reviewed for immunization and preventive care visits. The immunization registry is being used to track immunization levels. • Numerator: Number of children with up-to-date immunizations and preventive care visits. • Denominator: Total number of Title XIX and XXI children.