CHIP Enrollees and Disenrollees

CHIPRA_ Children Health Insurance

0990-CHIP Part A_Attachment B2_Data Elements and Question Sources

CHIP Enrollees and Disenrollees

OMB: 0990-0384

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ATTACHMENT B2
CHIP DATA ELEMENTS AND SOURCE TABLE

PAGE INTENTIONALLY LEFT BLANK FOR DOUBLE—SIDED COPYING

QNum

Data Element

Source

Section 1. Application, Enrollment, Redetermination, Disenrollment
1.1

Child currently covered?

2001 CHIP 3.2

1.2

Not enrolled_disenrollment date

2001 CHIP 3.3

1.3

Not enrolled_N months disenrolled

2001 CHIP 3.4

1.4

Not enrolled_confirm disenrollment date

2001 CHIP 3.5

1.5

Not enrolled_estimate disenrollment date

2001 CHIP 3.5.1a & 3.5.1b modified

1.6

Not enrolled_reasons coverage ended

2001 CHIP 3.26 modified

1.7

Not enrolled_why not reenroll?

2001 CHIP 3.26 modified

1.8

New enrollee_how heard about C/M

2001 CHIP 2.1.15 modified

1.9

New enrollee_most useful source re C/M

2001 CHIP 2.2.1 modified

1.10

New enrollee_why enrolled

2001 CHIP 2.14 modified

1.11

New enrollee_why else enrolled

2001 CHIP 2.14 modified

1.12

New enrollee_why wanted C/M coverage

2001 CHIP 2.14 modified

1.13

New enrollee_how completed application

2001 CHIP 2.17 modified

1.14

New enrollee_ where completed application

2001 CHIP 2.17 modified using 2001 CHIP
2.18 response categories

1.15

New enrollee_ease of compiling application
documents

2001 CHIP 2.29 modified

1.16

New enrollee_ application language

2001 CHIP 2.29 modified

1.17

New enrollee_translator helped with
application

2001 CHIP 2.20

1.18

New enrollee_other help with application

2001 CHIP 2.21 modified

1.19

New enrollee_who helped

2001 CHIP 2.22 modified

1.20

New enrollee_how helpful

2001 CHIP 2.24.1 modified

1.21

New enrollee_ease of application

2001 CHIP 2.29.1 modified

1.22

New enrollee_time btn application &
enrollment

2001 CHIP 2.30 modified

1.23

New enrollee_estimate time btn application &
enrollment

2001 CHIP 2.30.1

1.24

Knowledge of renewal requirement

2001 CHIP 2.34 modified

1.25

Frequency of renewal requirement

2001 CHIP 2.34 modified

1.26

Estab enrollee/recent disenrollee_ received
renewal form?

2001 CHIP 2.34 modified

1.27

Estab enrollee/recent disenrollee_how
renewal forms received

New

1.28

Estab enrollee/recent disenrollee_completed
renewal form?

2001 CHIP 2.43 modified

1

QNum

Data Element

Source

1.29

Estab enrollee/recent disenrollee_why did not
return renewal form?

New

1.30

Estab enrollee/recent disenrollee_got help
with renewal form

New

1.31

Estab enrollee/recent disenrollee_ease of
getting help with renewal forms

New

1.32

Estab enrollee/recent disenrollee_who helped
with renewal form

New

1.33

Estab enrollee/recent disenrollee_how useful
was help

New

1.34

Estab enrollee/recent disenrollee_told of
missing renewal information

New

1.35

Estab enrollee/recent disenrollee_provided
missing information?

New

1.36

Estab enrollee/recent disenrollee_ why did
not provide missing information

New

1.37

Estab enrollee/recent disenrollee_ease of
renewal experience

2001 CHIP 2.44 modified

Section 2. Child’s Health Care Coverage
2.1

Start date of current/last uninterrupted
coverage

2001 CHIP 3.7

2.2

Length of current/last coverage

2001 CHIP 3.8

2.3

Confirm last/current start date

2001 CHIP 3.9

2.4

Estimate coverage start date

2001 CHIP 3.9.1.A and 3.91B modified

2.5

Disenrollee who reenrolled_previous end date

2001 CHIP 3.11

2.6

Disenrollee who reenrolled_months btn
current start and previous end date

2001 CHIP 3.12

2.7

Disenrollee who reenrolled_confirm previous
end date

2001 CHIP 3.13

2.8

Disenrollee who reenrolled_estimate previous
end date

2001 CHIP 3.13.1A and 3.13.1B modified

2.9

Disenrollee who reenrolled_previous start
date

2001 CHIP 3.14

2.10

Disenrollee who reenrolled_estimate length
of previous enrollment

2001 CHIP 3.15

2.11

Disenrollee who reenrolled_confirm previous
start date

2001 CHIP 3.16

2.12

Disenrollee who reenrolled_estimate previous
start date

3.16.1A AND 3.16.1B modified

2

QNum

Data Element

Source

2.13

Recent disenrollee who reenrolled_reasons
coverage ended

2001 CHIP 3.26 modified

2.13.1

Recent disenrollee who reenrolled_reasons
did not re-enroll

2001 CHIP 3.26 modified

2.14

New enrollee_covered before last/current
CHIP start date?

2001 CHIP 3.31 modified

2.14.1

New enrollee_confirm coverage before
last/current C/M start date

2001 CHIP 3.35.1 modified

2.15

New enrollee_months without coverage
before last/current C/M start date

2001 CHIP 3.32 modified

2.16

New enrollee_main reason no coverage
before last/current C/M start date

2001 CHIP 3.34 modified

2.17.1

New enrollee_covered by employer/union
insurance before last/current C/M start date

2001 CHIP 3.36.1A modified

2.17.2

New enrollees_covered by private insurance
prior to last/current C/M start date

2001 CHIP 3.36.1B modified

2.17.3

New enrollee_covered by CHIP prior to
last/current Medicaid start date

2001 CHIP 3.36.1G

2.17.4

New enrollee_covered by Medicaid prior to
last/current CHIP start date

2001 CHIP 3.36.1D

2.17.5

New enrollee_covered by other insurance
prior to last/current C/M start date

2001 CHIP 3.36.1H modified

2.18

New enrollee_length of other coverage prior
last/current C/M start date

2001 CHIP 3.36.1AM modified

2.18.1

New enrollee_amt of premium paid by
employer

3.38.2 modified

2.18.2

New enrollee_employer/union coverage
included dental

NHIS FHI.074_00.000 modified

2.18.3

New enrollee_insuree still working for the
same company

New

2.18.4

New enrollee_employer still offers to cover
children of employees

New

2.18.5

New enrollee_main reason child’s coverage
prior to last/current CHIP/Medicaid ended

New

2.19.1

New enrollee_covered before prior coverage?

2001 CHIP 3.31 modified

2.19.2

New enrollee_length of time without
coverage before prior coverage

2001 CHIP 3.36.1B modified

2.20.1

New enrollee_before uninsured/prior
coverage was Child insured by employer or
union

2001 CHIP 3.36.1A modified

3

QNum

Data Element

Source

2.20.2

New enrollee_before uninsured/prior
coverage was Child covered by private
insurance

2001 CHIP 3.36.1B modified

2.20.3

New enrollee_before uninsured/prior
coverage was Child covered by CHIP

2001 CHIP 3.36.1G modified

2.20.4

New enrollee_before uninsured/prior
coverage was Child covered by Medicaid/
Medicaid HMO

2001 CHIP 3.36.1D modified

2.20.5

New enrollee_before uninsured/prior
coverage was Child covered by other
insurance

2001 CHIP 3.36.1H modified

2.21

New enrollee_months covered by insurance
from Q2.20.1 – Q2.20.

2001 CHIP 3.36.1AM modified

2.22

New enrollee_any period without coverage in
12 months prior to enrolling in C/M

2001 CHIP 3.31 modified

2.23

New enrollee_number of months without
coverage during 12 months prior to enrolling
in C/M

2001 CHIP 3.32 modified

2.24

New enrollee_Frequency that coverage in the
12 months prior to C/M met child’s needs

NSCH K3Q20 modified

2.25

New enrollee_Frequency that coverage in the
12 months prior to C/M allowed child to see
necessary doctors

NSCH K3Q22 modified

2.26

New enrollee_Paid any out-of-pocket
expenses for health care in 12 months prior to
C/M

NSCH K3Q21A

2.27

New enrollee_Frequency that out-of-pocket
expenses were reasonable during 12 months
prior to CHIP/Medicaid

NSCH K3Q21B

2.28

Disenrollee_any coverage after last/previous
C/M coverage ended YES NO

2001 CHIP 3.60 modified

2.29

Disenrollee_Months without coverage after
last/previous C/M coverage ended

2001 CHIP 3.63

2.30

Disenrollee_Any coverage after last/previous
C/M coverage ended

2001 CHIP 3.64

2.31

Disenrollee_Months covered since
last/previous C/M coverage ended

2001 CHIP 3.64.1

2.31.1

Disenrollee_since last/previous coverage
ended, covered by current/past
employer/union?

2001

4

CHIP 3.65.A

QNum

Data Element

Source

2.31.2

Disenrollee_since last/previous coverage
ended, covered by private insurance?

2001

CHIP 3.65.B modified

2.31.3

Disenrollee_since last/previous coverage
ended, covered by CHIP?

2001 CHIP 3.65.G

2.31.4

Disenrollee_since last/previous coverage
ended, covered by Medicaid/Medicaid HMO?

2001 CHIP 3.65.D

2.31.5

Disenrollee_since last/previous coverage
ended, covered by other insurance?

2001

2.32

Disenrollee_Of plans in 2.31 – 2.31.5 which
coverage did CHILD have after last/previous
coverage ended?

2001 CHIP 3.66.1-3.66.7

2.33

Disenrollee_ coverage through employer: did
employer pay all, some, none of premiums

2001

CHIP 3.66.2

2.34

Disenrollee_Is child covered by employer
insurance now?

2001

CHIP 3.66.3

CHIP 3.65.H

Section 3. Child’s Health
3.1

Child’s general health

2001 CHIP 4.1 modified; NSCH K2Q01
modified

3.2

Child’s general health compared to 12 months
ago

2001 CHIP 4.2

3.3

Child’s mental health

MEPS PE PE00B response categories

3.4

Child’s dental health

NSCH K2Q02

3.5

Current height of child

NSCH K2Q03

3.6

Current weight of child

NSCH K2Q03

3.7

Needs prescription medication?

NSCH K2Q10 modified

3.8

Needs prescription medication due to
medical, behavior or other health condition

NSCH K2Q11

3.9

Expected duration of condition requiring
prescription medication is more than 12
months

NSCH K2Q12 modified

3.10

Expected to need prescription medication for
more than 12 months

NSCH K2Q12A

3.11

Needs more medical care, mental health, or
educational services than is usual

NSCH K2Q13

3.12

Needs more services due to medical,
behavioral or other health condition

NSCH K2Q14

3.13

Expected duration of condition requiring
greater use of services is more than 12
months

NSCH K2Q15

5

QNum

Data Element

Source

3.14

Expected to need special services for more
than 12 months

NSCH K2Q15A

3.15

Limited in abilities

NSCH K2Q16

3.16

Limitation in abilities due to medical,
behavioral, or other health condition

NSCH K2Q17

3.17

Expected duration of ability-limiting condition
is more than 12 months

NSCH K2Q18

3.18

Expected to experience limitation in abilities
for more than 12 months

NSCH K2Q18A

3.19

Needs special therapy

NSCH K2Q19

3.20

Need for special therapy due to medical,
behavioral, or other health condition

NSCH K2Q20

3.21

Expected duration of condition requiring
special therapy is more than 12 months

NSCH K2Q21

3.22

Expected to need special therapy for more
than 12 months

NSCH K2Q21A

3.23

Presence of emotional, developmental, or
behavioral problem requiring counseling

NSCH K2Q22

3.24

Expected duration of emotional,
developmental, or behavioral problem is
more than 12 months

NSCH K2Q23

3.25

Doctor diagnosed child with mental health
condition or behavioral problem

2001 CHIP 4.13

3.26

Age when diagnosed with mental health
condition or behavioral problem

2001 CHIP 4.14 (not in public access file)

3.27

Doctor diagnosed child with ADD or ADHD

NSCH K2Q31A modified

3.28

Currently has ADD or ADHD

NSCH K2Q32B

3.29

Doctor diagnosed child with behavioral or
conduct problems

NSCH K2Q34A modified

3.30

Currently has behavioral or conduct problems

NSCH K2Q35B

3.31

Doctor diagnosed child with asthma

NSCH K2Q40A modified

3.32

Age of first asthma attack

2001 CHIP 4.10

3.33

Currently has asthma

NSCH K2Q41B

3.34

Severity of asthma over past 12 months

NSCH K2Q40C

3.35

Asthma attack during past 12 months

2009 NHIS Child CHS.090_00. 000

3.36

Number of school days missed due to illness
or injury

NHIS 2009, CHS.220_00.000 modified

3.37

Number of school days missed due to asthma

NHIS 2009, CHS.220_00.000, modified

6

QNum

Data Element

Source

Section 4. Access to and Satisfaction with Usual Place of Care and Health Service Utilization
4.1

Child has a usual place of care

NSCH K4Q01 modified

4.2

Usual place of care

NSCH K4Q02 modified

4.3

Kind of place child goes most often?

NSCH K4Q03 modified

4.4

Weekend hours at usual place of care

MEPS, 2009, AC24

4.5

Ease of scheduling appointments at usual
place of care over past 12 months

CAHPS Health Plan Survey
1158a_engchild survey_40.doc, Q2020,
modified

4.6

Ability to contact a doctor when usual place of
care is closed

2001 CHIP 5.23.2

4.7

Wait time for appointments at usual place of
care

2001 CHIP 5.27B modified

4.8

Estimate wait time for appointments at usual
place of care

2001 CHIP 5.27.1 modified

4.9

Child has personal doctor or nurse

NSCH K4Q04

4.10

Child has usual place of dental care

NSCH K4Q01 modified for dental

4.11

Night/ weekend hours at usual place of dental
care

MEPS 2009, AC24 modified

4.12

Ease of scheduling appointments at usual
place of dental care

CAHPS Health Plan Survey
1158a_engchild survey_40.doc, Q2020

4.13

Number of hospital stays in past 12 months

2001 CHIP 6.2

4.14

Total number of nights in the hospital during
the past 12 months

2001 CHIP 6.2.1

4.15

Number of ER visits in the past 12 months

NHIS 2009 CAU_280_00.000

4.16

Estimate number of ER visits in the past 12
months

2001 CHIP 6.7

4.17

Number of ER visits due to asthma

New

4.18

Number of doctor’s office visits in past 12
months

NHIS 2009 CAU.320_00.000 modified

4.19

Estimate number of doctor’s office visits in
past 12 months

2001 CHIP 6.9.1

4.20

Received mental health services

NSCH 2007 K4Q22 modified

4.21

Number of counseling visits in past 12 months

NSCH 2007 K4Q22 modified for N of visits

4.21.1

Number of counseling visits in past 12 months
with a mental health professional from child’s
school

New

4.22

Received services from a specialist

NSCH 2007 K4Q24

4.23

Number of specialist visits in past 12 months

NSCH 2007 K4Q24 modified for N visits

7

QNum

Data Element

Source

4.24

Received a well-child check-up

NHIS 2009 CAU.270_00.000 modified

4.25

Number of well-child check-ups in past 12
months

NHIS 2009 CAU.270_00.000 modified

4.26

Received flu shot in past 12 months

NHIS 2010 CFI.010_00.000 modified

4.27

Used prescription medication during past 12
months

LA Healthy Kids QD14 modified probe
and NSCH K2Q10 modified

4.28

Used asthma medication during past 12
months

New

4.29

Used medication for ADD/ADHD or difficulties
with emotion, concentration or behavior
during past 12 months

K2Q31D modified

4.30

Received dental check-up in past 12 months

2001 CHIP 6.20 and NSCH 2007 K4Q21
modified

4.30.1

Dentist recommended follow-up treatment

New

4.31

Received dental procedure during past 12
months

NSCH 20007 K4Q21

4.32

Received dental sealants

Maine Child Health Survey modified, Q35

4.32.1

Location where dental sealants were placed
on teeth

New

4.33

Received vision test in past 24 months

2011 NSCH “New 18”

4.34

Length of time since last vision test

New

4.35

Types of care that were postponed or not
received during past 12 months

2001 CHIP 6.23, 31, 36; NSHCN 20052006 modified C4Q05_X06

4.35a

Took less than recommended dosage of
prescription drug during past 12 months

2001 CHIP 6.58

4.36

Parent/ guardian completed questionnaire
about child’s development, communication,
or social behaviors during past 12 months

NSCH K6Q12 modified

4.37

Questionnaire addressed important issues

NCHS K6Q13A-D modified

4.38

Height and weight checked during past 12
months

2008 MEPS Child Preventive Health (CS)
CS22, CS23_01, CS23_02, CS24, CS25_01,
CS25_02 modified

4.39

Preventative health discussed during past 12
months

CAHPS Clinician and Group Survey
Q17HI1 (Q5.26.01-03), MEPS-Child
Preventative Health (5.27.04) modified

4.40

Confidence that child could get care if needed
during past 12 months

2001 CHIP 6.59

4.41

How often felt stress about meeting child’s
health care needs during past 12 months

2001 CHIP 6.62

8

QNum

Data Element

Source

4.42

How often did coverage and benefits met
child’s needs during past 12 months

NSCH K3Q20 modified

4.43

Dental coverage under CHIP/Medicaid

NSCH K3Q20 modified

4.44

Ease of seeing dental provider during past 12
months

MEPS 2009: CS21 modified

4.45

Ease of seeing specialist during past 12
months

MEPS 2009: CS21

4.46

Frequency of out of pocket payments for
child’s health care during past 12 months

NSCH K3Q21A modified

4.47

Degree of difficulty paying child’s medical bills
during past 12 months

Health Tracking Household Survey, C94
modified

4.48

Amount of money owed for health care child
received during past 12 months

Health Tracking Household Survey, C93
modified

4.49

Family paid premium during past 12 months

NEW based on Kaiser Health Tracking
Poll: March 2011 Q42 and MEPS-HC
HX45, modified

4.50

Degree of difficulty paying premium for child’s
enrollment during past 12 months

Health Tracking Household Survey, C94
modified

4.51

Willing to pay additional money to continue
coverage

LA Care “Health Kids Program Survey to
Assess Premium Contribution Capacity”
2009, modified

4.52

Willing to pay specific additional dollar
amount for coverage

LA Care “Health Kids Program Survey to
Assess Premium Contribution Capacity”
2009, modified

Section 5. Patient-Centeredness of Health Care
5.1

Need for referral during past 12 months

NSCH K5Q10

5.2

Difficulty of getting referrals

NSCH K5Q11

5.3

Help coordinating care

NSCH K5Q20

5.4

Need for extra help coordinating care

NSCH K5Q21

5.5

Frequency of receiving sufficient help
coordinating care

NSCH K5Q22

5.6

Overall satisfaction with communication
between providers

NSCH K5Q30

5.7

Health care providers communicate with child
care providers/ school

NSCH K5Q31

5.8

Satisfaction with communication between
health care providers and child care
providers/ school

NSCH K5Q32

9

QNum

Data Element

Source

5.9

How often providers spent enough time with
child during past 12 months

NSCH K5Q40

5.10

How often providers listened carefully during
past 12 months

NSCH K5Q41

5.11

How often providers were sensitive to family
values during past 12 months

NSCH K5Q42

5.12

How often providers gave information on how
to care and what to expect with the child

NSCH K5Q43

5.13

How often child’s doctors made respondent
feel like partner in care

NSCH K5Q44

5.14

Needed an interpreter to speak with care
providers

NSCH K5Q45

5.15

Ability to get help from interpreter

NSCH K5Q44

Section 6. Socio-demographics and Attitudes
6.1

Child is Hispanic or Latino

2001 CHIP 7.109

6.2

Child’s race

NSCH K11Q02EX modified

6.3

Respondent’s general health

2001 CHIP 7.3.21

6.4

Respondent’s mental and emotional health

NSCH K9Q23

6.5

Tobacco smoked inside child’s home

NSCH K9Q41 modified

6.6

Attitudes about health and health insurance

2001 CHIP 7.3.32, 7.3.38, 7.3.40, 7.3.41
modified

6.7

Important factors when choosing a health
plan

New

6.8

Important factors when choosing a health
plan

New

6.9

Number of people living in household

NSCH K9Q00 modified

6.10

Number of people 18 years or older in living in
household

2001 CHIP 7.4.1.1

6.11

Spouse or partner living in household

CHIP 6.14 modified

6.11.1

First name of spouse or partner

New

6.11.2

First names of other adults in household
besides respondent and respondent’s
spouse/partner

New

6.12

Relationship of adults in household to child

New

6.13

Respondent is a parent/guardian

2001 CHIP 6.15 modified

6.14

Parent/guardian current age

2001 CHIP 6.16 modified

6.15

Parent/guardian highest grade completed

2001 CHIP 6.17 modified

10

QNum

Data Element

Source

6.16

Parent/ guardian country of birth

2001 CHIP 6.18 modified

6.17

Parent/guardian is a U.S. citizen

2001 CHIP 6.19 modified

6.18.1

Main Parent/guardian covered by health
insurance now

2001 CHIP 7.63

6.18.2

Other parent/guardian covered by health
insurance now

2001 CHIP 7.63

6.19

Other parent/guardian, covered by same
insurance as main parent/guardian?

2001 CHIP 7.66

6.20 col. 1

Main parent/guardian coverage type

2001 CHIP 7.70.1-7.70.5 modified

6.20 col. 2

Other parent/guardian coverage type

2001 CHIP 7.70.1-7.70.5 modified

6.21.1

Main parent/guardian has offer of insurance
through employer

MEPS-HC, EM114 modified

6.21.2

Other parent/guardian has offer of insurance
through employer

MEPS-HC, EM114 modified

6.22.1

Does Main Parent/Guardian’s employer
insurance offer insurance to children?

NEW

6.22.2

Does Other Parent/Guardian’s employer
insurance offer insurance to children?

NEW

6.23.1

Amount of premium paid by Main
parent/guardian’s employer

2001 CHIP 7.71 + 7.73

6.23.2

Amount of premium paid by Other
parent/guardian’s employer

2001 CHIP 7.71 + 7.73

6.24.1

Could child be covered by main
parent/guardian’s insurance

2001 CHIP 7.79 (LPER1) AND 7.80

6.24.2

Could child be covered by other
parent/guardian’s insurance

2001 CHIP 7.79 (LPER1) AND 7.80

6.25.1

Would main parent/guardian’s employer pay
all, some, none of premium to cover child

2001 CHIP 7.79.1.1 AND 7.79.1.2

6.25.2

Would other parent/guardian’s employer pay
all, some, none of premium to cover child

2001 CHIP 7.79.1.1 AND 7.79.1.2

6.26.col 1

Reason child is not covered by main
parent/guardian’s insurance

2001 CHIP 7.79.1 AND 7.79.2 modified

6.26.col 2

Reason child is not covered by other
parent/guardian’s insurance

2001 CHIP 7.79.1 AND 7.79.2 modified

6.27

Is child covered by Medicaid or private
insurance now

2001 CHIP 7.82 modified

6.28

Is child covered by same insurance as
respondent/main parent guardian is?

2001 CHIP 7.83 modified

11

QNum

Data Element

Source

6.29

Is child covered by any other kinds of
insurance

2001 CHIP 7.84.1 - 7.84.5 modified

6.30

If covered by employer, does employer pay
all, some, or none of premium?

2001 CHIP 7.85

6.31

Could child be covered by this insurance?

2001 CHIP 7.89.1

6.32

For insurance from employer, could child be
covered by it?

2001 CHIP 7.89.1.1

6.33

Main reason child not covered by this health
insurance?

2001 CHIP 7.89.2 modified

6.34

Confidentiality of parent income

2001 CHIP 7.90

6.35.1

Main Parent/ guardian employment over past
12 months

2001 CHIP 7.91 AND 7.92

6.35.2

Main Parent/ guardian employment over past
12 months

2001 CHIP 7.91 AND 7.92

6.36.col 1

Main parent/guardian current working status

NHIS ASD.060_00.000 modified

6.36.col 2

Other parent/guardian current working status

NHIS ASD.060_00.000 modified

6.37.1

Total number of employees at main
parent/guardian place of work greater or less
than 100

NSCH K12Q66

6.37.2

Total number of employees at other
parent/guardian place of work greater or less
than 100

NSCH K12Q66

6.38.1

Total number of employees at main
parent/guardian place of work greater or less
than 50

NSCH K12Q67 (based on 2011
NSCH/SLAITS)

6.38.2

Total number of employees at other
parent/guardian place of work greater or less
than 50

NSCH K12Q67 (based on 2011
NSCH/SLAITS)

6.39

Total household income greater or less than
$25,000

2001 CHIP 7.93

6.40

Specify total household income less than
$25,000

2001 CHIP 7.100

6.41

Total household income greater or less than
$60,000

2001 CHIP 7.101

6.42

Specify total household income less than
$60,000 and greater than $25,000

New

6.43

Total household income greater or less than
$100,000

New

6.44

Specify total household income greater than
$60,000

New

12

QNum

Data Element

Source

6.45

Total household out-of-pocket spending
during past 12 months

SCHIP 7.103

6.46

Difficulty of paying medical bills for entire
family

HSC Household Survey c96 modified

13


File Typeapplication/pdf
File TitleAppendix B2
AuthorKRuffin
File Modified2011-08-19
File Created2011-07-20

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