Page 276 - QAP Manual 2020
P. 276
Background Information
Q# Q Indicator/Intent Other Notes Field Appropriate (Y/N)
BI-4 What is this person’s race Person’s race and Check all that apply. N
and ethnicity? Check ONE ethnicity Race and ethnicity are now captured in
or MORE races to indicate one question.
what this person
considers themselves to
be
BI-5 Does this person have a Whether the person is Question continues to capture full or N
legal appointed legally under limited guardianship, but now also
guardian/conservator (a guardianship. provides a category for those unable to
person who is legally distinguish between categories.
granted authority to
make decisions on behalf
of the individual)?
BI-6 If this person has a Relationship of If ‘other’, please explain. N
legal/court-appointed guardian/conservator
guardian, what is the
guardian’s relationship to
the individual?
BI-7 Marital status Marital status Y
BI-8 Is this person a parent? Whether the person has a Check all that apply. N
(This includes adult child (of any age)
children.)
8
