21 Million Children’s Health:
Our Shared Responsibility

The Medical Child Support Working Group’s Report

Guide to Format of this Report

Contents

Chapters at a Glance

The first page of each chapter contains a "chapter at a glance" box (see box for Chapter 1, page 1-1, as sample). This box lists the contents of the chapter, including page numbers, and presents the theme of the chapter. Although a detailed table of contents appears at the beginning of this Report, the list of contents at the beginning of each chapter will help readers locate sections in individual chapters quickly and easily.

""Quote Boxes

Throughout the chapters, various quotes appear in quote boxes, as shown in the sample here. These quotes comment on and add to the discussion at hand.

“Your task is, quite simply, to keep the kids in mind and to think broadly beyond the scope of the work you all individually do to what's a good and workable solution to the issues that face you.... It's not just about the coverage; it's about better health outcomes for the people — for these kids.”

~Kevin Thurm, Deputy Secretary, HHS

Cross-References

Cross-references to specific chapters, recommendations, and pages within this Report are highlighted in the margins as shown to the right. [N.B. Not shown in HTML version of report, instead, references are linked .]

Acronym Reminders

While all acronyms are spelled out and defined in the list of acronyms at the beginning of this Report (see below), they are also spelled out and defined upon first usage. In addition, upon first use of an acronym in each chapter, an acronym reminder is provided in the margin as shown here.

Recommendations

Recommendations are numbered in sequential order throughout the Report and are presented in boxes at the bottom of the sections in which they are discussed. The category/type of each recommendation appears in parentheses following the recommendation number. The body of the recommendation follows. A sample recommendation is shown at the bottom of this page.

Recommendation 1 (Federal Regulation)
The HHS should require each State to maximize the enrollment of children in appropriate health care coverage; the first recourse should be appropriate private coverage of either parent. ("Appropriate coverage" is defined in Recommendation 8.)

Background Boxes

Background information pertinent to the discussion at hand is presented in boxes, as shown in the sample to the right.

History of Federal Funding of the IV-D Program
In 1950, without providing funding, Congress required welfare agencies to inform appropriate law enforcement officials when AFDC was furnished to a child who had been abandoned by a parent. The rationale was to encourage law enforcement officials to take action, including the filing of non-support proceedings against those who had abandoned their children.

Definitions

As necessary, selected terms or phrases are defined in the text in definition boxes, as shown in the sample below ("child support-eligible children"). These and additional definitions may also be found in the Glossary at the end of this Report.

"Child Support-Eligible Children"

As used in this report, child support-eligible children are children under the age of 19 whose parents are divorced, separated, or never-married (and not living together). Not all child support-eligible children live in single parent households, about 17 percent live in married step-parent families. In this report, 21 million children living in single or stepparent households are considered to be eligible for child support. Additional child support-eligible children live with a related adult, a guardian or foster parent. Our data is not able to count these children. (See APPENDIX D: Health Care Coverage for Child Support-Eligible Children, page A-32).

Acronyms Used in this Report

The box below lists all of the acronyms used in this report.

AFDC
Aid to Families with Dependent Children
CCPA
Consumer Credit Protection Act
CSHN
Children with Special Health Needs
CSPIA
Child Support Performance and Incentive Act of 1998
COBRA
Consolidated Omnibus Budget Reconciliation Act of 1985
DOL
Department of Labor
HIPAA
Health Insurance Portability and Accountability Act of 1996
HHS
Department of Health and Human Services
ERISA
Employee Retirement Income Security Act of 1974
FFP
Federal Financial Participation
GAO
General Accounting Office
HCFA
Health Care Financing Administration
HMO
Health Maintenance Organization
IV-D Program
Federal/State Child Support Enforcement Program
NAIC
National Association of Insurance Commissioners
NMSN
National Medical Support Notice
NPRM
Notice of Proposed Rule Making
OBRA '93
Omnibus Budget Reconciliation Act of 1993
OCSE
Federal Office of Child Support Enforcement
OIG
Office of the Inspector General
PRWORA
Personal Responsibility and Work Opportunity Reconciliation Act of 1996
PLPW
Poverty Level Pregnant Women Program
PPO
Preferred Provider Organization
QDRO
Qualified Domestic Relations Order
QMCSO
Qualified Medical Child Support Order
SCHIP
State Children's Health Insurance Programs
SDU
State Disbursement Unit
TANF
Temporary Assistance for Needy Families
TPA
Third-party Contract Administrator
UIFSA
Uniform Interstate Family Support Act
URESA
Uniform Reciprocal Enforcement of Support Act
WIC
The Supplemental Feeding Program for Women, Infants, and Children

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Home Pages:
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U.S. Department of Health and Human Services (HHS)

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Last updated: 11/27/00