0915-0338_MCHB_HSMED_Implementation Guide ParentChild Form_Redline_03052025

Healthy Start Monitoring and
Evaluation Data System (HSMED)- II

Data Dictionary and XML Schema
Implementation Guide
Parent/Child Form

Feb 27, 2025

Health Resources and Services Administration

Maternal and Child Health Bureau

5600 Fishers Lane

Contents

Element name: PPUID 1

Element name: ChildUID 1

Element name: OtherLinkedPP 2

Element name: NoOtherPP 2

Element name: ChildEnrollmentDate 3

Element name: FormVersion 4

Element name: CompletionDate 5

Element name: UpdateType 6

Element name: 6MonthDate 7

Element name: 12MonthDate 7

Element name: ChildExitDate 8

Element name: OtherUpdateDate 8

Element name: Correction 9

Element name: ChildEnrollmentDateRangeWarningComment 9

Element name: CompletionDateWarningComment 10

Element name: ChildEnrolledWhen 10

Element name: AgeAtEnrollment 11

Element name: ChildBirthYear 12

Element name: ChildBirthYearWarningComment 13

Element name: ChildSex 13

Element name: ChildEthnicity 14

Element name: ChildRace 15

Element name: WeeksGestation 16

Element name: GestationDD 16

Element name: BirthWeightLb 17

Element name: BirthWeightOz 17

Element name: BirthWeightGrams 18

Element name: BirthWeightDD 18

Element name: Singleton 19

Element name: HadInfantHospitalStay 19

Element name: ChildAgeRange 20

Element name: ChildAgeMonths 20

Element name: ChildHadHealthcare 21

Element name: ChildInsuranceType 22

Element name: ChildMedicaidNameSpecification 23

Element name: ChildOtherInsuranceSpecification 23

Element name: AgeWellVisit 24

Element name: AgeWellVisitMonths 24

Element name: HadRecommendedWellVisit 25

Element name: BreastfedEver 25

Element name: BreastfedCurrently 26

Element name: HowLongBreastfed 26

Element name: BreastfedMonths 27

Element name: BreastfedFor6Months 27

Element name: BabySleepPosition 28

Element name: BabySleepsAlone 28

Element name: SafeSleepBedding 29

Element name: ReceivedPostpartumCare 30

Element name: ScheduledPostpartumCareDate 31

Element name: NoPostpartumCareSpecification 31

Element name: Last3MonthsTobaccoFrequency 32

Element name: ScheduledPostpartumCareDateWarningComment 32

Element name: NoPostpartumCareSpecificationWarningComment 33

Element name: ChildMortality 33

Element name: ChildMortalityWarningComment 34

Element name: ChildDeathYear 35

Element name: PPUID

Field	Description
Question Number	Cover Page 1 (G1)
Section & Sub-section	CoverPage
Definition	Primary Participant Unique ID
Required field	Yes
Allowed values	Alphanumeric text string that allows a minimum of 9 character and a maximum of 50 characters. PPUIDs should be in the format: 3 digit grantee org code + PP + a unique ID (at least 4 digits long). NOTE: With the exception of the initial ‘PP’ format requirement, PPUIDs are NOT case-sensitive (for example, 123PPUID0001 and 123PPuid0001 would be considered the same client).
Allow multiple values	No
Occurrence	1 per client
XML example	<PPUID>100PP12345</PPUID>
Data Validation Type	Error
Data Validation Rule	[If there are two or more of the same PPUID’s] – The PPUID '({PPUID)' is duplicate.

Element name: ChildUID

Field	Description
Question Number	Cover Page 2 (G2)
Section & Sub-section	CoverPage
Definition	Enrolled Child Unique ID
Required field	Yes (May not have duplicates of EC Unique IDs in one file (during upload checking).
Allowed values	Alphanumeric text string that allows a minimum of 9 character and a maximum of 50 characters. ChildUIDs should be in the format: 3 digit grantee org code + EC + a unique ID (at least 4 digits long). NOTE: With the exception of the initial ‘EC’ format requirement, ChildUIDs are NOT case-sensitive (for example, 123ECUID0001 and 123ECuid0001 would be considered the same client).
Allow multiple values	No
Occurrence	1 per client
XML example	<ChildUID>100EC12345</ChildUID>
Data Validation Type	None
Data Validation Rule	None

Element name: OtherLinkedPP

Field	Description
Question Number	Cover Page 3 (G3)
Section & Sub-section	CoverPage
Definition	Other linked primary participants unique IDs
Required field	No
Allowed values	Alphanumeric text string that allows a minimum of 9 character and a maximum of 50 characters. PPUIDs should be in the format: 3 digit grantee org code + PP + a unique ID (at least 4 digits long). NOTE: PPUIDs are NOT case-sensitive (for example, 123PPUID0001 and 123ppuid0001 would be considered the same client).
Allow multiple values	Yes
Occurrence	0-3 per client
XML example	<OtherLinkedPPList> <OtherLinkedPP>100String123345</OtherLinkedPP> <OtherLinkedPP>100String78900</OtherLinkedPP> </OtherLinkedPPList>
Data Validation Type	Error
Data Validation Rule	[If both “Other Linked Participant/Adult ID” and “No other participants/adults” are empty] – Input ‘OtherLinkedPP’ or ‘NoOtherPP’.

Element name: NoOtherPP

Field	Description
Question Number	Cover Page 3 (G3)
Section & Sub-section	CoverPage
Definition	No other linked pp
Required field	No
Allowed values	Boolean with value 1
Allow multiple values	No
Occurrence	0-1 per client
XML example	<NoOtherPP>1</NoOtherPP>
Data Validation Type	Error Error
Data Validation Rule	[If both “Other Linked Participant/Adult ID” and “No other participants/adults” are empty] – Input ‘OtherLinkedPP’ or ‘NoOtherPP’. [If ‘OtherLinkedPP’ is provided and ‘NoOtherPP’ is “Yes”] – Element 'NoOtherPP' cannot have a value since 'OtherLinkedPP' value is provided.

Element name: ChildEnrollmentDate

Field	Description
Question Number	Cover Page 4 (G4)
Section & Sub-section	CoverPage
Definition	Child enrollment date
Required field	Yes
Allowed values	Date with a format of mm/dd/yyyy The dates can only be provided between 20 months prior to the completion date and the date of upload into the HSMED system.
Allow multiple values	No
Occurrence	1 per client
XML example	<ChildEnrollmentDate>9/10/2024</ChildEnrollmentDate>
Data Validation Type	Error Warning
Data Validation Rule	[If different from previous submission] – The 'ChildEnrollmentDate' is different than previously reported and correction checkbox is not checked. Please confirm the child's enrollment date. Note: If enrollment date is different than the previously submitted value in the system and correction checkbox is checked, then validation will not appear. [If date falls outside of valid range] – The 'ChildEnrollmentDate' is not in the valid range. Please refer to the HS Implementation Guide or explain why it is different.

Element name: FormVersion

Field	Description
Question Number	Cover page 5 (G5)
Section & Sub-section	CoverPage
Definition	Version (initial or update) of the form
Required field	Yes
Allowed values	1 – Initial form 2 – Updated form
Allow multiple values	No
Occurrence	1 per client
XML example	<FormVersion>1<FormVersion>
Data Validation Type	Error Error
Data Validation Rule	[An Initial Form for this PPUID already exists, FormVersion selected as “Initial Form” and correction checkbox not checked. If previous submission is prior to 05/01/2024, error will not appear.] – If this upload is an update to the Parent/Child form, FormVersion should be provided as 'Updated form'. If this is a correction, please check 'This form is a correction'. [If Initial Form does not exist and user is selecting "Updated form" in FormVersion] – If this is an initial upload to the Parent/Child Form, FormVersion should be provided as ‘Initial Form’.

Element name: CompletionDate

Field	Description
Question Number	Cover Page 5 (G5)
Section & Sub-section	CoverPage
Definition	Date of initial form completion
Required field	Yes
Allowed values	Date with a format of mm/dd/yyyy The dates can only be entered between 04/30/2024 and the date of upload into the HSMED system.
Allow multiple values	No
Occurrence	1 per client
XML example	<CompletionDate>9/10/2024</CompletionDate>
Data Validation Type	Warning Error
Data Validation Rule	[If different from previous submission and correction checkbox is not checked, if previous submission date of initial form completion is prior to 05/01/2024, do not show validation] – The ‘CompletionDate’ is different than previously reported and correction checkbox is not checked. Please confirm the date of initial completion or explain the reason for the change. Note: If CompletionDate is different than the previously submitted value in the system and correction checkbox is checked, then validation will not appear. Note: If previous submission date of initial form completion is prior to 5/01/2024, then validation will not appear. [If date falls outside of valid range] – The 'CompletionDate' is not in the valid range. Please refer to the HS Implementation Guide.

Element name: UpdateType

Field	Description
Question Number	Cover Page 5 (G5)
Section & Sub-section	CoverPage
Definition	Form updates
Required field	No
Allowed values	1 - Enrolled child turns 6 months 2 - Enrolled child turns 12 months 3 - Enrolled participant is exiting Healthy Start 4 - Other update
Allow multiple values	No
Occurrence	0-1 per client
XML example	<UpdateType>1</UpdateType>
Data Validation Type	Error Error Error
Data Validation Rule	[If ‘FormVersion’ is “Updated form”, and ‘UpdateType’ is missing] – If this upload is an update to the Parent/Child form, 'UpdateType' should be provided. [If ‘FormVersion’ is “Updated form”, and correction checkbox is checked and ‘UpdateType’ does not exist in previous uploads] – 'UpdateType' does not currently exist, form cannot be corrected. [If ‘FormVersion’ is “Initial Form” and ‘UpdateType’ is NOT blank] – ‘UpdateType’ cannot have a value since ‘FormVersion’ is selected as ‘Initial Form’.

Element name: 6MonthDate

Field	Description
Question Number	Cover Page 5 (G5)
Section & Sub-section	CoverPage
Definition	Date updated when child turns 6 months
Required field	No
Allowed values	Date with a format of mm/dd/yyyy The dates can only be entered between 04/30/2024 and the date of upload into the HSMED system.
Allow multiple values	No
Occurrence	0-1 per client
XML example	<SixMonthDate>9/10/2024</SixMonthDate>
Data Validation Type	Error Error
Data Validation Rule	[If date falls outside of valid range] – The ‘6MonthDate’ is not in the valid range. Please refer to the HS Implementation Guide. [If enrolled infant turns 6 months (1) is selected in UpdateType but 6MonthDate is blank] – Element '6MonthDate' is required when “Enrolled infant turns 6 months” is selected as the Update Type.

Element name: 12MonthDate

Field	Description
Question Number	Cover Page 5 (G5)
Section & Sub-section	CoverPage
Definition	Date updated when child turns 12 months
Required field	No
Allowed values	Date with a format of mm/dd/yyyy The dates can only be entered between 04/30/2024 and the date of upload into the HSMED system.
Allow multiple values	No
Occurrence	0-1 per client
XML example	<TwelveMonthDate>9/10/2024</TwelveMonthDate>
Data Validation Type	Error Error
Data Validation Rule	[If date falls outside of valid range] – The '12MonthDate' is not in the valid range. Please refer to the HS Implementation Guide. [If “Enrolled child turns 12 months” (2) is selected in ‘UpdateType’ but ‘12MonthDate’ is blank] – Element '12MonthDate' is required when “Enrolled child turns 12 months” is selected as the Update Type.

Element name: ChildExitDate

Field	Description
Question Number	Cover Page 5
Section & Sub-section	CoverPage
Definition	Date of child exit update
Required field	No
Allowed values	Date with a format of mm/dd/yyyy The dates can only be entered between 04/30/2024 and the date of upload into the HSMED system.
Allow multiple values	No
Occurrence	0-1 per client
XML example	<ChildExitDate>9/10/2024</ChildExitDate>
Data Validation Type	Error Error
Data Validation Rule	[If date falls outside of valid range] – The 'ChildExitDate' is not in the valid range. Please refer to the HS Implementation Guide. [If “Enrolled participant is exiting Healthy Start” (3) is selected in ‘UpdateType’ but ‘ChildExitDate’ is blank] – Element 'ChildExitDate' is required when “Enrolled participant/child is exiting Healthy Start” is selected as the Update Type.

Element name: OtherUpdateDate

Field	Description
Question Number	Cover Page 5 (G5)
Section & Sub-section	CoverPage
Definition	Date other update is completed
Required field	No
Allowed values	Date with a format of mm/dd/yyyy The dates can only be entered between 04/30/2024 and the date of upload into the HSMED system.
Allow multiple values	No
Occurrence	0-1 per client
XML example	<OtherUpdateDate>9/10/2024</OtherUpdateDate>
Data Validation Type	Error Error
Data Validation Rule	[If date falls outside of valid range] – The 'OtherUpdateDate' is not in the valid range. Please refer to the HS Implementation Guide” [If Other Update (4) is selected in UpdateType but OtherUpdateDate is blank] – Element 'OtherUpdateDate' is required when Other Update is selected as the Update Type.

Element name: Correction

Field	Description
Question Number	Cover page 6
Section & Sub-section	CoverPage
Definition	Correction box
Required field	No
Allowed values	0 - No 1 - Yes
Allow multiple values	No
Occurrence	0-1 per client
XML example	<Correction>1</Correction>
Data Validation Type	None
Data Validation Rule	None

Element name: ChildEnrollmentDateRangeWarningComment

Field	Description
Question Number	NA
Section & Sub-section	CoverPage
Definition	Warning justification if ChildEnrollmentDate is not in the valid date range.
Required field	No
Allowed values	Text string that allows a maximum of 250 characters
Allow multiple values	No
Occurrence	0-1 per client
XML example	< ChildEnrollmentDateRangeWarningComment>String</ ChildEnrollmentDateRangeWarningComment>
Data Validation Type	Warning
Data Validation Rule	See element ChildEnrollmentDate

Element name: CompletionDateWarningComment

Field	Description
Question Number	NA
Section & Sub-section	CoverPage
Definition	Warning justification if CompletionDate value is different than previously reported
Required field	No
Allowed values	Text string that allows a maximum of 250 characters
Allow multiple values	No
Occurrence	0-1 per client
XML example	< CompletionDateWarningComment>String</ CompletionDate WarningComment>
Data Validation Type	Warning
Data Validation Rule	See element CompletionDate

Element name: ChildEnrolledWhen

Field	Description
Question Number	1
Section & Sub-section	ClientInfo SettingStage
Definition	Child enrollment relative to pregnancy
Required field	Yes
Allowed values	1 - Part of a family enrolled for HS services before the child’s birth 2 - Part of a family enrolled for services within 30 days following child’s birth 3 - Part of a family enrolled for services more than 30 days following child’s birth
Allow multiple values	No
Occurrence	1 per client
XML example	<ChildEnrolledWhen>1</ChildEnrolledWhen>
Data Validation Type	None
Data Validation Rule	None

Element name: AgeAtEnrollment

Field	Description
Question Number	1
Section & Sub-section	ClientInfo SettingStage
Definition	Child age at enrollment
Required field	No
Allowed values	An integer value between 1-24
Allow multiple values	No
Occurrence	0-1 per client
XML example	<AgeAtEnrollment>1</AgeAtEnrollment>
Data Validation Type	Error
Data Validation Rule	[If "ChildEnrolledWhen" = "3"(Part of a family enrolled for services more than 30 days following child’s birth), this field cannot be blank] – Element 'AgeAtEnrollment' cannot be blank since client indicated 'ChildEnrolledWhen' as Part of a family enrolled for services more than 30 days following child’s birth.

Element name: ChildBirthYear

Field	Description
Question Number	1a
Section & Sub-section	ClientInfo SettingStage
Definition	Year of Birth
Required field	Yes
Allowed values	Year will be a 4 digit value of YYYY Boundaries: Past: The year can't be earlier than 2 years before Initial Completion date. Future: The “latest” year is the year of upload into HSMED
Allow multiple values	No
Occurrence	1 per client
XML example	<ChildBirthYear>2019</ChildBirthYear>
Data Validation Type	Error Error Error Warning
Data Validation Rule	[If the Year falls outside of valid range], The 'ChildBirthYear' is not in the valid range. Please refer to the HS Implementation Guide” [if different from previous submission, show validation, if correction box is checked, validation shouldn't fire] The 'ChildBirthYear' is different than the previously reported. [If ECUID on Prenatal form, year must match] ELement 'ChildBirthYear' value should match the element 'BirthYear' value in prenatal form. [If ECUID on Prenatal form, Birthyear on PN is not matching with PC Birthyear and CB is yes] Element 'ChildBirthYear' value should match the element 'BirthYear' value in prenatal form.Please confirm the 'ChildBirthYear' or explain the reason for the change.

Element name: ChildBirthYearWarningComment

Field	Description
Question Number	NA
Section & Sub-section	ClientInfo SettingStage
Definition	Warning justification if ChildBirthYear not matching with ECUID on Prenatal form, Birthyear on Prenatal form and Correction Box is yes
Required field	No
Allowed values	Text string that allows a maximum of 250 characters
Allow multiple values	No
Occurrence	0-1 per client
XML example	< ChildBirthYearWarningComment>String</ ChildBirthYearWarningComment>
Data Validation Type	Warning
Data Validation Rule	See element ChildBirthYear

**Element name: ChildSex

Field	Description
Question Number	2
Section & Sub-section	ClientInfo SettingStage
Definition	Child sex
Required field	Yes
Allowed values	1 - Female 2 – Male 88 - Declined to answer
Allow multiple values	No
Occurrence	1 per client
XML example	<ChildSex>1</ChildSex>
Data Validation Type	None
Data Validation Rule	None

Element name: ChildEthnicity

Field	Description
Question Number	3
Section & Sub-section	ClientInfo SettingStage
Definition	Child ethnicity
Required field	Yes
Allowed values	0 - No, not Hispanic or Latino/a or Spanish 1 - Yes, Mexican, Mexican American or Chicano/a 2 - Yes, Puerto Rican 3 - Yes, Cuban 4 - Yes, Another Hispanic, Latino/a or Spanish origin 88 - Declined to answer
Allow multiple values	Yes
Occurrence	1-5 per client
XML example	<ChildEthnicityList> <ChildEthnicity>0</ChildEthnicity> <ChildEthnicity>1</ChildEthnicity> </ChildEthnicityList>
Data Validation Type	-Error
Data Validation Rule	[If "88 - Declined to answer", no other selection can be made] - If 'Declined to answer' is selected, de-select any other 'ChildEthnicity' selected.

Element name: ChildRace

Field	Description
Question Number	4
Section & Sub-section	ClientInfo SettingStage
Definition	Child race
Required field	Yes
Allowed values	1 - White 2 - Black or African American 3 - American Indian or Alaska Native 4 - Asian Indian 5 - Chinese 6 - Filipino 7 - Japanese 8 - Korean 9 - Vietnamese 10 - Other Asian 11 - Native Hawaiian 12 - Guamanian or Chamorro 13 - Samoan 14 - Other Pacific Islander 88 - Declined to answer
Allow multiple values	Yes
Occurrence	1-14 per client
XML example	<ChildRaceList> <ChildRace>1</ChildRace> <ChildRace>2</ChildRace> </ChildRaceList>
Data Validation Type	Error
Data Validation Rule	[If "88 - Declined to answer", no other selection can be made] – If 'Declined to answer' is selected, de-select any other 'ChildRace' selected.

Element name: WeeksGestation

Field	Description
Question Number	5
Section & Sub-section	ClientInfo InfantHealth
Definition	Weeks gestation
Required field	No
Allowed values	An integer value between 1-45
Allow multiple values	No
Occurrence	0-1 per client
XML example	<WeeksGestation>1</WeeksGestation>
Data Validation Type	Error
Data Validation Rule	[If both WeeksGestation and GestationDD are empty] – A value is required in ‘WeeksGestation’ or ‘GestationDD’.

Element name: GestationDD

Field	Description
Question Number	5
Section & Sub-section	ClientInfo InfantHealth
Definition	Gestation don't know declined
Required field	No
Allowed values	88 - Declined to answer 99 - Don't know
Allow multiple values	No
Occurrence	0-1 per client
XML example	<GestationDD>1</GestationDD>
Data Validation Type	None
Data Validation Rule	None

Element name: BirthWeightLb

Field	Description
Question Number	6
Section & Sub-section	ClientInfo InfantHealth
Definition	Birth weight lb
Required field	No
Allowed values	An integer value between 1-15
Allow multiple values	No
Occurrence	0-1 per client
XML example	<BirthWeightLb>1</BirthWeightLb>
Data Validation Type	Error
Data Validation Rule	[If “birth weight lb,” “birth weight oz,” “birth weight grams,” and “birth weight dont know declined” are empty] – A value is required in ‘BirthWeightLb’, ‘BirthWeightOz’, ‘BirthWeightGrams’, or ‘BirthWeightDD’.

Element name: BirthWeightOz

Field	Description
Question Number	6
Section & Sub-section	ClientInfo InfantHealth
Definition	Birth weight oz
Required field	No
Allowed values	An integer value between 1-15
Allow multiple values	No
Occurrence	0-1 per client
XML example	<BirthWeightOz>1</BirthWeightOz>
Data Validation Type	None
Data Validation Rule	None

Element name: BirthWeightGrams

Field	Description
Question Number	6
Section & Sub-section	ClientInfo InfantHealth
Definition	Birth weight grams
Required field	No
Allowed values	A decimal between 0 – 6900.00
Allow multiple values	No
Occurrence	0-1 per client
XML example	<BirthWeightGrams>30.5</BirthWeightGrams>
Data Validation Type	None
Data Validation Rule	None

Element name: BirthWeightDD

Field	Description
Question Number	6
Section & Sub-section	ClientInfo InfantHealth
Definition	Birth weight don't know declined
Required field	No
Allowed values	88 - Declined to answer 99 - Don't know
Allow multiple values	No
Occurrence	0-1 per client
XML example	<BirthWeightDD>1</BirthWeightDD>
Data Validation Type	None
Data Validation Rule	None

Element name: Singleton

Field	Description
Question Number	7
Section & Sub-section	ClientInfo InfantHealth
Definition	Singleton or multiple
Required field	Yes
Allowed values	1 - Singleton (from a pregnancy involving just one baby) 2 - Twins 3 - Triplets or more 99 - Don’t know 88 - Declined to answer
Allow multiple values	No
Occurrence	1 per client
XML example	<Singleton>1</Singleton>
Data Validation Type	None
Data Validation Rule	None

Element name: HadInfantHospitalStay

Field	Description
Question Number	8
Section & Sub-section	ClientInfo InfantHealth
Definition	Infant hospital stay
Required field	Yes
Allowed values	0 - No 1 - Yes 88 - Declined to answer 99 - Don't know
Allow multiple values	No
Occurrence	1 per client
XML example	<HadInfantHospitalStay>0</HadInfantHospitalStay>
Data Validation Type	None
Data Validation Rule	None

Element name: ChildAgeRange

Field	Description
Question Number	9
Section & Sub-section	ClientInfo InfantHealthCare
Definition	Current child age range
Required field	Yes
Allowed values	1 - More than 1 month 2 - Less than 1 month
Allow multiple values	No
Occurrence	1 per client
XML example	<ChildAgeRange>1</ChildAgeRange>
Data Validation Type	None
Data Validation Rule	None

Element name: ChildAgeMonths

Field	Description
Question Number	6
Section & Sub-section	ClientInfo InfantHealthCare
Definition	Current child age range
Required field	No
Allowed values	An integer value between 1-30
Allow multiple values	No
Occurrence	1 per client
XML example	<ChildAgeMonths>1</ChildAgeMonths>
Data Validation Type	Error
Data Validation Rule	[If ChildAgeRange is selected as More than 1 month and ChildAgeMonths is empty] – Element 'ChildAgeMonths' cannot be blank since client indicated 'ChildAgeRange' as More than 1 month.

Element name: ChildHadHealthcare

Field	Description
Question Number	10
Section & Sub-section	ClientInfo InfantHealthCare
Definition	Child health insurance coverage past year
Required field	Yes
Allowed values	0 - No 1 - Yes, covered all 12 months 2 - Yes, but this child had a gap in coverage 88 - Declined to answer 99 - Don't know
Allow multiple values	No
Occurrence	1 per client
XML example	<ChildHadHealthcare>1</ChildHadHealthcare>
Data Validation Type	None
Data Validation Rule	None

Element name: ChildInsuranceType

Field	Description
Question Number	11
Section & Sub-section	ClientInfo InfantHealthCare
Definition	Child health insurance type
Required field	Yes
Allowed values	1 - Private health insurance from job 2 - Private health insurance from parents 3 - Private health insurance from the State Health Insurance Marketplace, State website, or HealthCare.gov 4 - Medicaid 5 - Medicare 6. CHIP 7 - Subsidized ACA plan 8 - TRICARE 9 - Indian Health Service or tribal 10 - Other health insurance 0 - No health insurance 88 - Declined to answer 99 - Don't know
Allow multiple values	Yes
Occurrence	1-10 per client
XML example	<ChildInsuranceTypeList> <ChildInsuranceType>1</ChildInsuranceType> <ChildInsuranceType>3</ChildInsuranceType> </ChildInsuranceTypeList>
Data Validation Type	Error Error Error
Data Validation Rule	[If " No health insurance" = Yes, no other selections allowed] – If 'No health insurance' is selected, de-select any other health insurance types selected. [If "Don't know" = Yes, no other selections allowed] – If 'Don't know' is selected, de-select any other health insurance types selected. If "Declined to answer" = Yes, no other selections allowed] – If 'Declined to answer' is selected, de-select any other health insurance types selected.

Element name: ChildMedicaidNameSpecification

Field	Description
Question Number	11
Section & Sub-section	ClientInfo InfantHealthCare
Definition	Medicaid name
Required field	No
Allowed values	Text string that allows a maximum of 250 characters
Allow multiple values	No
Occurrence	0-1 per client
XML example	<ChildMedicaidNameSpecification>String</ChildMedicaidNameSpecification>
Data Validation Type	Error
Data Validation Rule	[If health insurance type = medicaid or medicaid name has a value, then both fields should have a value] – If the client has Medicaid, the Medicaid option should be checked and the state Medicaid name should be provided.

Element name: ChildOtherInsuranceSpecification

Field	Description
Question Number	11
Section & Sub-section	ClientInfo InfantHealthCare
Definition	Other health insurance name
Required field	No
Allowed values	Text string that allows a maximum of 250 characters
Allow multiple values	No
Occurrence	0-1 per client
XML example	<ChildOtherInsuranceSpecification>String</ChildOtherInsuranceSpecification>
Data Validation Type	Error
Data Validation Rule	[If health insurance type =other insurance type or other insurance name has a value, then both fields should have a value] – If the client has other insurance type, the option should be checked and other insurance name should be provided.

Element name: AgeWellVisit

Field	Description
Question Number	12
Section & Sub-section	ClientInfo InfantHealthCare
Definition	Child age at last well visit
Required field	Yes
Allowed values	1 - More than 1 month 2 - Less than 1 month 88 - Declined to answer
Allow multiple values	No
Occurrence	1 per client
XML example	<AgeWellVisit>1</AgeWellVisit>
Data Validation Type	None
Data Validation Rule	None

Element name: AgeWellVisitMonths

Field	Description
Question Number	12
Section & Sub-section	ClientInfo InfantHealthCare
Definition	Child age at last well visit
Required field	No
Allowed values	An integer value between 1-30
Allow multiple values	No
Occurrence	0-1 per client
XML example	<AgeWellVisit>1</AgeWellVisit>
Data Validation Type	Error
Data Validation Rule	[If AgeWellVisit is selected as More than 1 month (1) and AgeWellVisitMonths is missing] – Element 'AgeWellVisitMonths' cannot be blank since client indicated 'AgeWellVisit' as “More than 1 month.”

Element name: HadRecommendedWellVisit

Field	Description
Question Number	12a
Section & Sub-section	ClientInfo InfantHealthCare
Definition	Child most recent age appropriate recommended well visit
Required field	Yes
Allowed values	0 - No 1 - Yes 99 - Unable to determine
Allow multiple values	No
Occurrence	1 per client
XML example	<HadRecommendedWellVisit>1</HadRecommendedWellVisit>
Data Validation Type	None
Data Validation Rule	None

Element name: BreastfedEver

Field	Description
Question Number	13
Section & Sub-section	ClientInfo InfantFeeding
Definition	Child ever breastfed
Required field	Yes
Allowed values	0 - No 1 - Yes 88 - Declined to answer 99 - Don't know
Allow multiple values	No
Occurrence	1 per client
XML example	<BreastfedEver>1</BreastfedEver>
Data Validation Type	None
Data Validation Rule	None

Element name: BreastfedCurrently

Field	Description
Question Number	14
Section & Sub-section	ClientInfo InfantFeeding
Definition	Breastfeed currently
Required field	Yes
Allowed values	0 - No 1 - Yes 88 - Declined to answer 99 - Don't know
Allow multiple values	No
Occurrence	1 per client
XML example	<BreastfedCurrently>1</BreastfedCurrently>
Data Validation Type	None
Data Validation Rule	None

Element name: HowLongBreastfed

Field	Description
Question Number	15
Section & Sub-section	ClientInfo InfantFeeding
Definition	How long was the child breastfed
Required field	Yes
Allowed values	1 - Not at all 2 - Less than 1 month 3 - More than 1 month 88 - Declined to answer 99 - Don't know
Allow multiple values	No
Occurrence	1 per client
XML example	<HowLongBreastfed>1</HowLongBreastfed>
Data Validation Type	None
Data Validation Rule	None

Element name: BreastfedMonths

Field	Description
Question Number	15
Section & Sub-section	ClientInfo InfantFeeding
Definition	Breastfed months
Required field	No
Allowed values	An integer value between 1-30
Allow multiple values	No
Occurrence	0-1 per client
XML example	<BreastfedMonths>15.5</BreastfedMonths>
Data Validation Type	Error
Data Validation Rule	[If HowLongBreastfed is 3, then BreastfedMonths can't be empty] – Element 'BreastfedMonths' cannot be blank since client indicated 'HowLongBreastfed' as “More than 1 month.”

Element name: BreastfedFor6Months

Field	Description
Question Number	16
Section & Sub-section	ClientInfo InfantFeeding
Definition	Breastfed at 6 months
Required field	Yes
Allowed values	1 - Yes 2 - Not yet 3 - No 99 - Unable to determine/Don’t know (Note: Unable to determine and don’t know should both be coded the same)
Allow multiple values	No
Occurrence	1 per client
XML example	<BreastfedFor6Months>1</BreastfedFor6Months>
Data Validation Type	None
Data Validation Rule	None

Element name: BabySleepPosition

Field	Description
Question Number	17
Section & Sub-section	ClientInfo InfantSleep
Definition	Infant sleep position
Required field	Yes
Allowed values	1 - On side 2 - On back 3 - On stomach 77 - Not applicable 88 - Declined to answer
Allow multiple values	No
Occurrence	1 per client
XML example	<BabySleepPosition>1</BabySleepPosition>
Data Validation Type	None
Data Validation Rule	None

Element name: BabySleepsAlone

Field	Description
Question Number	18
Section & Sub-section	ClientInfo InfantSleep
Definition	Sleep in bed by self
Required field	Yes
Allowed values	1 - Always 2 - Often 3 - Sometimes 4 - Rarely 5 - Never 77 - Not applicable 88 - Declined to answer
Allow multiple values	No
Occurrence	1 per client
XML example	<BabySleepsAlone>1</BabySleepsAlone>
Data Validation Type	None
Data Validation Rule	None

Element name: SafeSleepBedding

Field	Description
Question Number	19
Section & Sub-section	ClientInfo InfantSleep
Definition	Safe sleep bedding
Required field	Yes
Allowed values	0 - No 1 - Yes 77 - Not applicable 88 - Declined to answer 99 - Don’t know
Allow multiple values	No
Occurrence	1 per client
XML example	<SafeSleepBedding>1</SafeSleepBedding>
Data Validation Type	None
Data Validation Rule	None

Element name: ReceivedPostpartumCare

Field	Description
Question Number	20
Section & Sub-section	ClientInfo WomanPregnancyHealth
Definition	When was postpartum visits during first 12 weeks
Required field	No
Allowed values	1 - Yes, within first 3 weeks 2 - Yes, between 4-6 weeks 3 - Yes, between 7-8 weeks 4 - Yes, between 9-12 weeks 5 - Not yet, but scheduled 6 - Not yet 7 - No, did not have postpartum visit 88 - Declined to answer 99 - Don't know
Allow multiple values	Yes
Occurrence	0-5 per client
XML example	<ReceivedPostpartumCareList> <ReceivedPostpartumCare>1</ReceivedPostpartumCare> <ReceivedPostpartumCare>3</ReceivedPostpartumCare> </ReceivedPostpartumCareList>
Data Validation Type	Error Error
Data Validation Rule	[If Participant type in demographic form = CM/CC particpant and Sex in Demographic form is 'Female' and ReceivedPostpartumCare is missing] – Element ‘ReceivedPostpartumCare’ is required since ‘ParticipantType’ is a “CM/CC particpant” and ‘Sex’ is “Female”. [Prevent conflicting selections between Yes and No, and declined/Don't know for anyone who answers this question] – If "Not yet " or "No, did not have postpartum visit" or "Don't know" or "Declined to answer" is selected, de-select any other postpartum care options selected.

Element name: ScheduledPostpartumCareDate

Field	Description
Question Number	20
Section & Sub-section	ClientInfo WomanPregnancyHealth
Definition	Scheduled postpartum visit date
Required field	No
Allowed values	Date with a format of mm/dd/yyyy The dates can only be entered between the Completion Date and 6 months from the Completion Date.
Allow multiple values	No
Occurrence	0-1 per client
XML example	<ScheduledPostpartumCareDate>9/10/2020</ScheduledPostpartumCareDate>
Data Validation Type	Warning
Data Validation Rule	[If date falls outside of valid range] – The 'ScheduledPostpartumCareDate' is not in the valid range. Please refer to the HS Implementation Guide” or explain why it is different.

Element name: NoPostpartumCareSpecification

Field	Description
Question Number	20
Section & Sub-section	ClientInfo WomanPregnancyHealth
Definition	Reason no postpartum visit scheduled
Required field	No
Allowed values	Text string that allows a maximum of 250 characters
Allow multiple values	No
Occurrence	1 per client
XML example	<NoPostpartumCareSpecification>String</NoPostpartumCareSpecification>
Data Validation Type	Warning
Data Validation Rule	[If "Not yet, Specify reason" is selected but NoPostpartumCareSpecification is missing] – Provide the reason 'NoPostpartumCareSpecification' or an explanation why it is missing.

Element name: Last3MonthsTobaccoFrequency

Field	Description
Question Number	21
Section & Sub-section	ClientInfo WomanPregnancyHealth
Definition	Tobacco or nicotine products frequency
Required field	No
Allowed values	1 - Never 2 - Daily or almost daily 3 - Weekly 4 - Monthly 5 - Less than monthly 88 - Declined to answer
Allow multiple values	No
Occurrence	0-1 per client
XML example	<Last3MonthsChewingTobaccoFrequency>1</Last3MonthsChewingTobaccoFrequency>
Data Validation Type	Error
Data Validation Rule	[If participant type in demographic form = CM/CC particpant and Sex in Demographic form is 'Female' and Last3MonthsTobaccofrequency is missing] – Element 'Last3MonthsTobaccoFrequency' is required since ‘ParticipantType’ is a “CM/CC particpant” and ‘Sex’ is “Female”.

Element name: ScheduledPostpartumCareDateWarningComment

Field	Description
Question Number	NA
Section & Sub-section	ClientInfo WomanPregnancyHealth
Definition	Warning justification if ScheduledPostpartumCareDate is not in the valid date range.
Required field	No
Allowed values	Text string that allows a maximum of 250 characters
Allow multiple values	No
Occurrence	0-1 per client
XML example	<ScheduledPostpartumCareDateWarningComment >String</ ScheduledPostpartumCareDateWarningComment>
Data Validation Type	Warning
Data Validation Rule	See element ScheduledPostpartumCareDate.

Element name: NoPostpartumCareSpecificationWarningComment

Field	Description
Question Number	NA
Section & Sub-section	ClientInfo WomanPregnancyHealth
Definition	Warning justification if NoPostpartumCareSpecification cannot be provided.
Required field	No
Allowed values	Text string that allows a maximum of 250 characters
Allow multiple values	No
Occurrence	0-1 per client
XML example	<NoPostpartumCareSpecificationWarningComment>String</NoPostpartumCareSpecificationWarningComment>
Data Validation Type	Warning
Data Validation Rule	See element NoPostpartumCareSpecification.

Element name: ChildMortality

Field	Description
Question Number	22
Section & Sub-section	ClientInfo FollowUp
Definition	Child mortality
Required field	No
Allowed values	1 - Within 0 to 27 days of life (neonatal) 2 - 28 to 364 days after birth (infant) 3 - 12 months or older (post-infancy)
Allow multiple values	No
Occurrence	1 per client
XML example	<ChildMortality>1</ChildMortality>
Data Validation Type	Warning
Data Validation Rule	[If the value 1,2 or 3 is entered in ChildMortality, the given warning validation should fire.] – You have indicated this child has passed away. If this is correct, please provide a comment confirming the child has passed away. If the child is alive, ChildMortality must be blank.

Element name: ChildMortalityWarningComment

Field	Description
Question Number	NA
Section & Sub-section	ClientInfo FollowUp
Definition	Warning confirming the child has passed away
Required field	No
Allowed values	Text string that allows a maximum of 250 characters
Allow multiple values	No
Occurrence	0-1 per client
XML example	<ChildMortalityWarningComment >String</ ChildMortalityWarningComment>
Data Validation Type	Warning
Data Validation Rule	See element ChildMortality.

Element name: ChildDeathYear

Field	Description
Question Number	23
Section & Sub-section	ClientInfo FollowUp
Definition	Year of Death
Required field	No
Allowed values	Year will be a 4 digit value of YYYY Boundaries: Past: The year can't be earlier than 2 years before Initial Completion date. Future: The “latest” year is the year of upload into HSMED
Allow multiple values	No
Occurrence	0-1 per client
XML example	< ChildDeathYear>2019</ ChildDeathYear>
Data Validation Type	Error Error Error Error Error
Data Validation Rule	[If the Year falls outside of valid range], The 'ChildDeathYear' is not in the valid range. Please refer to the HS Implementation Guide” [if different from previous submission, show validation, validation shouldn't fire if correction box checked] The 'ChildDeathYear' is different than previously reported. [If ChildMortality has value, but ChildDeathYear is blank] Element 'ChildDeathYear' is required since participant indicated Child Mortality. [Year of death has to be equal to or greater than year of birth] 'ChildDeathYear' cannot be less than the 'ChildBirthYear'. [If ChildMortality is blank, but ChildDeathYear has value] Element 'ChildDeathYear' cannot have a value since 'ChildMortality' is blank.