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t <br />Kittitas County <br />Public Health <br />Depailtmenl <br />507 N. Nanum Sheet, Suite 102 Ellensburg, WA 9g926 <br />T: 509.962.7 515 F: 509.962.7581 <br />www.co.kittitas.wa. us/health/ <br />lnstructions for Completing Report: <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 />1. Column <br />A: <br />2. Columns <br />B-F: <br />Estimate for each population category the proportion with Title XlX, Title xxl, <br />Private/Other, No or Unknown health coverage. <br />HP Version: I Supersedes: 0 Date Adopted:9129/21 Modified/Created By: Chelsev Loeffers Approval By: T Lamb