Search Frequenty Asked Questions

Please note it is important to view the materials in each approved plan file collectively and in their entirety to ensure that all aspects of the approved SCHIP plan are understood. The Department of Health and Human Services (DHHS) works with the States to obtain complete information in the initial plan submission and during the review and approval process.

For more information about the documents comprising an approved plan file, click here.

Each State or Territory with an approved child health plan is required to submit an annual report in each fiscal year, by January 1 following the end of the fiscal year. In addition, each State or Territory with an approved plan was required to submit an evaluation by March 31, 2000. Title XXI requires the Secretary to evaluate and compare the effectiveness of State plans and to submit a report to Congress based on States' evaluations by December 31, 2001. The basis of this report will be the information provided by the States.

The requirements for State evaluations and annual reports are outlined in Section 2108 of the Social Security Act. For more information about the purpose and content of the annual report and evaluation, please click here.

Because Section 2108 required States with an approved child health plan to submit both an Annual Report and an Evaluation in 2000, States were permitted to submit their FY 1999 Annual Report and their State Evaluation on March 31, 2000, together as one comprehensive document. Please see the October 6, 1999, State Health Official letter for more information on this policy.

For purposes of the SCHIP website, please be aware that electronic versions of plan materials, annual reports and State evaluations may not contain all the referenced attachments, some of which are not yet available for online viewing. In addition, many of the requests for additional information and State responses, as well as some of the annual reports and State evaluations, have not yet been added. This webpage will be updated on an ongoing basis.

Note: Information available only for States with active links.

Written correspondence between DHHS and the State becomes part of the approved SCHIP plan. By reading the entire file, interested parties will be able to obtain the most accurate and up-to-date information about the approved plan. The documents in the approved SCHIP plan file are described below in more detail.

The schipial Plan Submission
In order to be approved, Title XXI plans must contain all the information required by statute, as described in the model application template (http://www.cms.hhs.gov/schip/chi915nt.asp). Therefore, the first item that constitutes the approved plan file is the State's original application.

Responses to Requests for Additional Information
As outlined in the statute and as stated in the 12/2/97 letter to State officials on the Title XXI Approval Process (http://www.cms.hhs.gov/schip/ch122ltr.asp), DHHS must review, and CMS either approve or disapprove, the Title XXI plan within 90 days of receipt. Informal clarification and discussion between the State and the DHHS review team are permitted and encouraged during the review period and these activities do not affect the "90-day clock." The 90-day review period may, however, be stopped by formal written requests for additional information. The 90-day review period resumes when the finalized additional information is received by HCFA. Written requests for additional information, whether formal or informal, and the States' written responses to these requests, are considered part of the approved plan file. The State responses modify the original submission.

Information received from States in response to requests for additional information supersedes any contrary information that is included in the original plan. Moreover, if there are several responses from the State, the latest submission is the governing document. Most often the information in the additional responses clarifies or adds to the language of the original submission.

Subsequent Plan Amendment
If a plan amendment is submitted by the State, another 90-day review period begins. Documents pertaining to the plan amendment are also components of the approved SCHIP plan file.

The purpose of the State's Annual Report is to provide a brief description of the operation of their State SCHIP plan, including the following items:

1. A baseline estimate of low-income, uninsured children and a rationale for the methodology used to develop the baseline estimate;
2. Progress made at reducing the number of low-income, uninsured children in the State;
3. A description of the issues that a State has agreed to monitor in its State plan (e.g., outreach and crowd-out), including an assessment of progress toward the State's identified strategic objectives, performance goals and performance measures;
4. Barriers to effectively implement States' plans that are associated with program design, planning and implementation and the proposed approaches to address such problems;
5. Any need for technical assistance from the Department;
6. Other areas the State may identify as relevant.

The evaluation provides States with an important opportunity to document program achievements and to assess program effectiveness in achieving the goals of SCHIP. Section 2108(b)(1) indicates that an evaluation must include each of the following:

1. An assessment of the effectiveness of the State plan in increasing the number of children with creditable health coverage.
2. A description and analysis of the effectiveness of elements of the State plan, including:

   a. The characteristics of the children and families assisted under the State plan including age of the children, family income, and the assisted child's access to or coverage by other health insurance prior to the State plan and after eligibility for the State plan ends,
   b. The quality of health coverage provided including the types of benefits provided,
   c. The amount and level (including payment of part or all of any premium) of assistance provided by the State,
   d. The service area of the plan,
   e. The time limits for coverage of a child under the State plan,
   f. The State's choice of health benefits coverage and other methods used for providing child health assistance, and
   g. The sources of non-Federal funding used in the State plan.

3. An assessment of the effectiveness of other public and private programs in the State in increasing the availability of affordable quality individual and family health insurance for children.
4. A review and assessment of State activities to coordinate the plan under this title with other public and private programs providing health care and health care financing, including Medicaid and maternal and child health services.
5. An analysis of changes and trends in the State that affect the provision of accessible, affordable, quality health insurance and health care to children.
6. A description of any plans the State has for improving the availability of health insurance and health care for children.
7. Recommendations for improving the program under this title.
8. Any other matters the State and the Secretary consider appropriate.