CD20 Minority Status - At or Below Count of Consumers at or below Yes All registered services - unduplicated • Poverty poverty by minority status that Registered services with ADL/IADL - • Minority received service. CDC Source: unduplicated • Not Minority Racial and ethnic minority Each registered service separately • • Minority Status Missing populations are defined as: Confidential service: Legal Assistance • • Asian American, Black or African American, Hispanic or Latino, Native Hawaiian and Pacific Islander, American Indian and Alaska Native. CD21 Medicaid Status - At or Below Total Count of Consumers at or Yes All registered services - unduplicated • Poverty below poverty by Medicaid Registered services with ADL/IADL - • Medicaid beneficiary beneficiary status that received unduplicated • Not Medicaid beneficiary service. Each registered service separately • • Medicaid beneficiary Status Confidential service: Legal Assistance • • Missing CD22 ADL Score - At or Below Poverty Count of Consumers at or below Yes Registered services with ADL/IADL - • 0 poverty by ADL score that unduplicated • 1-2 received service. Each registered service separately for • • 3+ this is required (Personal Care, • ADL Missing Homemaker, Chore, Home-delivered • Nutrition, Adult Day Care, Case Mgmt) CD23 IADL - At or Below Poverty Count of minority Consumers by Yes Registered services with ADL/IADL - • 0 poverty status that received unduplicated • 1-2 service. Each registered service separately for • 3+ this is required (Personal Care, • IADL Missing Homemaker, Chore, Home-delivered • Nutrition, Adult Day Care, Case Mgmt)
CD20 Minority Status - At or Below Poverty • Minority • Not Minority • Minority Status Missing Count of Consumers at or below poverty by minority status that received service. CDC Source: Racial and ethnic minority populations are defined as: Asian American, Black or African American, Hispanic or Latino, Native Hawaiian and Pacific Islander, American Indian and Alaska Native. Yes • All registered services - unduplicated • Registered services with ADL/IADL - unduplicated • Each registered service separately • Confidential service: Legal Assistance CD21 Medicaid Status - At or Below Poverty • Medicaid beneficiary • Not Medicaid beneficiary • Medicaid beneficiary Status Missing Total Count of Consumers at or below poverty by Medicaid beneficiary status that received service. Yes • All registered services - unduplicated • Registered services with ADL/IADL - unduplicated • Each registered service separately • Confidential service: Legal Assistance CD22 ADL Score - At or Below Poverty • 0 • 1-2 • 3+ • ADL Missing Count of Consumers at or below poverty by ADL score that received service. Yes • Registered services with ADL/IADL - unduplicated • Each registered service separately for this is required (Personal Care, Homemaker, Chore, Home-delivered Nutrition, Adult Day Care, Case Mgmt) CD23 IADL - At or Below Poverty • 0 • 1-2 • 3+ • IADL Missing Count of minority Consumers by poverty status that received service. Yes • Registered services with ADL/IADL - unduplicated Each registered service separately for this is required (Personal Care, Homemaker, Chore, Home-delivered Nutrition, Adult Day Care, Case Mgmt)
State_Program_Performance_Report_Requirements_Draft.docx