Page 277 - QAP Manual 2020
P. 277

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.)







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