children’s psychiatric drugs in delaware medicaid: delaware’s own three numbers
delaware told cms three things about its children in the 2025 reporting year: 60.2 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, 24th of the 50 states that reported it; 52.5 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, 6th of the 49 states that reported it; 35.3 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, 46th of the 51 states that reported it.[1]
across the whole age range, delaware sits in the top quarter of the country on the two metabolic blood tests and in the bottom quarter of the country on the 30-day adhd follow-up. same state, same year, same children.
every row delaware sent to cms
| measure | delaware | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 60.2 | withheld | 24 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 50.6 | withheld | 49 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 53.3 | withheld | 46 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 52.5 | withheld | 6 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 50.9 | withheld | 6 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 51.3 | 818 | 6 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 62.3 | 818 | 8 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 53.1 | 818 | 5 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 35.3 | 1,199 | 46 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 49.7 | 330 | 35 of 49 | 55.5 |
rank 1 is the highest rate. how the ranks and the withheld cells work.[1]
talking treatment before the antipsychotic
for the youngest children, aged 1 to 11, delaware reported 60.2 percent — 1.0 points above the national median of 59.2, and 24th of the 50 states that reported it. put the other way round, 39.8 percent of the youngest children in delaware who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 50.6 percent. across ages 1 to 17, 53.3 percent, 46th of the 51 states that reported it. it reported 58.3 the year before on the same method, so this one moved 5.0 points down — the only one of the three where that comparison holds. either side of delaware on that row: south dakota at 53.6 and west virginia at 51.5.
the two blood tests
delaware reported that 52.5 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 6th of the 49 states that reported it, 23.4 points above the national median of 29.1. split into halves across ages 1 to 17, glucose ran 62.3 percent and cholesterol 53.1 percent, both on 818 children — 8th of the 51 states that reported it on glucose, the fifth-highest of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 51.3 percent. either side of delaware on the both-tests row for ages 1 to 17: montana at 51.9 and wyoming at 51.2.
the 30-day visit after a new adhd prescription
35.3 percent, on 1,199 children aged 6 to 12 who were newly prescribed an adhd medicine in delaware — 46th of the 51 states that reported it, 12.3 points below the national median of 47.6. that leaves 64.7 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 49.7 percent had at least two more visits on 330 children, against a national median of 55.5 — 35th of the 49 states that reported it. either side of delaware on the 30-day row: massachusetts at 38.4 and illinois at 35.2.
what medicaid paid for in delaware in 2024
in 2024 medicaid in delaware paid for 28,046 hydroxyzine prescriptions, $297,098 worth, and 44,047 benzodiazepine prescriptions, $487,451 worth — 63.7 hydroxyzine prescriptions for every 100 benzodiazepine ones. 168 of the 338 hydroxyzine rows and 542 of the 979 benzodiazepine rows for delaware were suppressed, so both are floors.[2] our own sums of the federal file, which has no ages, so neither is a children’s number, and no rank.
four things to ask, with delaware’s own numbers behind them
ask which drug it is, not which class
delaware, 2024: 28,046 hydroxyzine prescriptions and 44,047 benzodiazepine prescriptions
hydroxyzine is an antihistamine; a benzodiazepine brings dependence and withdrawal. read the name on the bottle. why they get merged.
if an antipsychotic is being started, ask what came first
delaware: 60.2 percent of children aged 1 to 11, 24th of the 50 states that reported it
in 39.8 percent of these cases the answer is “none yet”. ask what was tried first, and ask for it in the notes.
if your child is on an antipsychotic, get the date of the bloodwork
delaware: 52.5 percent of children aged 1 to 11 had both tests, 6th of the 49 states that reported it
missed 47.5 percent of the time in delaware. ask when the glucose and cholesterol test is booked, and leave with a date.
if an adhd medicine has just been started, book the 30-day visit now
delaware: 35.3 percent, 46th of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and delaware misses it 64.7 percent of the time. book it before you leave the room.
how to read any of this
self-reported, on methods that differ by state, and process not outcome.[1] method and suppression rules; the national picture.
questions people ask
In Delaware, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Delaware reported 60.2 percent for children aged 1 to 11, against a national median of 59.2 percent — 24th of the 50 states that reported it. For ages 12 to 17 it was 50.6 percent, and across ages 1 to 17 53.3 percent.
In Delaware, do children on antipsychotics get the blood tests?
52.5 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 6th of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 62.3 percent, cholesterol 53.1 percent, on 818 children.
In Delaware, how often does the 30-day ADHD follow-up visit happen?
35.3 percent of the time, on 1,199 children aged 6 to 12 newly prescribed an ADHD medicine — 46th of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 49.7 percent in Delaware against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Delaware rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 60.2 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 50.6 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 53.3 (denominator not publicly reported); APM-CH both blood tests, 1 to 11: 52.5 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 50.9 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 51.3 on a denominator of 818; APM-CH glucose alone, 1 to 17: 62.3 on a denominator of 818; APM-CH cholesterol alone, 1 to 17: 53.1 on a denominator of 818; ADD-CH 30-day adhd follow-up, 6 to 12: 35.3 on a denominator of 1,199; ADD-CH nine-month adhd follow-up, 6 to 12: 49.7 on a denominator of 330. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Delaware rows, summed by product name, read 2026-09-28: hydroxyzine 28,046 prescriptions, $297,098, 168 of 338 rows suppressed; benzodiazepines 44,047 prescriptions, $487,451, 542 of 979 rows suppressed. Our sum, not a CMS statistic. https://data.medicaid.gov/dataset/61729e5a-7aa8-448c-8903-ba3e0cd0ea3c
all 51 states ranked · what the national numbers say
nothing here is a reason to start, stop or change a child’s medication. it is a set of questions to bring to the person who prescribes it.
adam