Document
Mock Up - State Data Information System (SDIS) Tool
ICR 202610-0938-013 · OMB 0938-1148 · Object 174254000.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.presentationml.presentation |
|---|---|
| File Title | Mock Up - State Data Information System (SDIS) Tool |
| Author | Ewane, Mokube (CMS/CMCS) |
| Last Modified By | Impress |
| File Modified | 2026-05-12 |
| File Created | 2026-10-28 |
| Conversion State | complete |
Extracted Text
Data Collection Instrument Name: State Data Information System (SDIS) Name of Data Collected: Medicaid and CHIP Performance Indicators Current Performance Indicator (PI) Metrics Collected Added PI CE Metrics Mock-up for SDIS Tool. In red Added CE Metrics 9. Eligibility: By Community Engagement at Application • 9n: Number of individuals determined eligible who are determined to be a specified excluded individual • 9o: Number of individuals determined eligible who are applicable individuals and either demonstrated community engagement or were deemed to have demonstrated community engagement by meeting a mandatory exception. • 9p: Number of individuals determined eligible who are applicable individuals and were deemed to have demonstrated community engagement by meeting a shortterm hardship exception 10. Ineligibility: By Community Engagement at Application • 10m: Number of individuals determined ineligible due to not meeting the community engagement requirement • 10n: Number of individuals determined ineligible for procedural reasons • 10o: Number of individuals determined ineligible for all other reasons Current PI Metrics Current PI Metrics & Proposed Additional CE Metrics in red Additional eligibility CE metrics Additional ineligibility CE metrics PI Metric # 1: Call Volume PI Metric # 2: Call Center Wait Time PI Metric # 3: Call Center Abandonment Rate PI Metric # 4: Currently not collected PI Metric # 5: Number of Applications Received PI Metrics # 6: Number of Electronic Accounts Transferred Please note, this metric is only applicable to FFM states PI Metric # 7: Number of Renewals PI Metric # 8: Total Enrollment PI Metric # 9 including CE: Total Number of Individuals Determined Eligible # 9: Original PI Eligibility Metric without CE #9: PI Eligibility Metric with CE in red 9n: Number of individuals determined eligible who are determined to be a specified excluded individual 9o: Number of individuals determined eligible who are applicable individuals and either demonstrated community engagement or were deemed to have demonstrated community engagement by meeting a mandatory exception PI Metric # 10 including CE: Total Number of Individuals Determined Ineligible #10: Original Ineligibility PI Metric without CE #10: Ineligibility PI Metric with CE in red 10m: Number of individuals determined ineligible due to not meeting the community engagement requirement 10n: Number of individuals determined ineligible for procedural reasons 10o: Number of individuals determined ineligible for all other reasons PI Metric # 11: Total Number of Pending Applications/Redeterminations PI Metric # 12: Processing Time for Determinations