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<br /> <br /> <br /> <br />507 N. Nanum Street, Suite 102 Ellensburg, WA 98926 <br /> T: 509.962.7515 F: 509.962.7581 <br />www.co.kittitas.wa.us/health/ <br />HP Version: 1 Supersedes: 0 Date Adopted: 9/29/21 Modified/Created By: Chelsey Loeffers Approval By: T Lamb <br /> <br /> <br /> <br />Instructions for Completing Report: <br /> <br />1. Column <br />A: <br />Enter the unduplicated number of individuals in each population category who received a <br />direct or enabling service (in person, by phone) that was fully or partially supported with <br />Title V (MCH Block Grant) funds. These services would generally be included in direct and <br />enabling services, and would not include those individuals encountered in Public Health <br />Services and Systems work. NOTE: There will be overlap between the figures listed for <br />Column (A) and the remaining columns. <br /> <br />2. Columns <br />B - F: <br />Estimate for each population category the proportion with Title XIX, Title XXI, <br />Private/Other, No or Unknown health coverage. <br />