Tables 3A and 3B provide demographic
data on patients of the program and
are included in both
the Universal Report and the Grant Reports.
For the Universal Report ,
include as patients all individuals
receiving at least one face-to-face
encounter for services as described
below which is within the scope of any
of the programs covered by UDS. Regardless
of the number or types of services received,
each patient is to be counted only once
on Table 3A, once in the race/ethnicity
section of Table 3B and a maximum of
once in the language section of Table
3B.
The Grant Reports
include only individuals who received
at least one face-to-face encounter
within the scope of the program in question.
As discussed above, patients are to
be reported only once in each report
filed, however if the same patient is
served in more than one program, they
will be reported on the grant report
for each program that served them.
An encounter is a face-to-face contact
between a patient and a provider who
exercises independent professional judgment
in the provision of services to the
individual, and the services rendered
must be documented to be counted as
an encounter. See the "General Instructions:
Definitions" section above, for complete
definitions of patients and encounters.
Table 3A: Patients by Age
and Gender
Report the number of total patients
by appropriate categories for age and
gender. For reporting purposes, use
the individual's age on June 30 of the
reporting period.
Table 3B: Patients by Race,
Latino Identity and Linguistic Preference
Effective with this version of the
UDS, all patients are categorized by
both race and by Latino/Hispanic identity.
Each patient will be reported once in
the top section of the table on Latino/Hispanic
identity and once in the middle section
on race. Centers which have not used
a system like this should review instructions
on how to report their patient population.
Race:
• Report the number of patients
in each racial category. The total on
Table 3B line 7 must equal the total
on Table 3A, line 39 Columns A + B.
• All patients must be classified
in one of the racial categories (including
"Unreported / refused to report"). This
includes individuals who also consider
themselves to be "Latino" or "Hispanic".
If your data system has not separately
classified Latino/Hispanic patients
by race, they will be reported on line
10 as “unreported”
• Asian patients are further
divided on the Race table into three
separate ethnic categories:
• 1a. Native Hawaiian -
individuals who trace their ancestry
to the native population of the Hawaiian
islands .
• 1b. Pacific Islanders
-- patients who trace their ancestry
to the islands considered to be part
of Melanesia , Micronesia and Polynesia
. (Do not include patients from Indonesia
, the Philippines , Japan , or any other
islands in the Pacific.)
• 1c. Asian - all other
Asian patients.
• Line 1. "Asian / Hawaiian
/ Pacific Islander", must equal lines
1a + 1b + 1c
• "American Indian" (line
3) should be considered to include patients
who consider themselves to be members
of Indian tribes from all of North,
South, and Central America, not just
those from the United States .
• Note the addition of Line
5a "More than one race." Use this line
only if your system captures
multiple races (but not a
race and an ethnicity!) and the patient
has chosen two or more races. This is
usually done with an intake form which
lists the races and tells the patient
to "check all that apply".
• Note that line 5, "Hispanic
or Latino", has been deleted. Take extra
care not to mistakenly report Latino
populations on line 5a.
Latino Identity (Ethnicity):
• Report the number of patients
in each category. The total on Table
3B line 4 must equal the total on Table
3A, line 39 Columns A + B.
• This table really only collects
information on whether or not patients
considers themselves to be of Latino
or Hispanic identity.
- Report on line 1 individuals from
the continents of South America and
North America and from the Caribbean
islands who consider themselves to be
“Latinos.”
Report all other patients on line 2
– “all other”.
The mix of race and ethnicity categories
can be confusing to reporting entities.
Some common examples may serve to clarify
their use:
• A center which has categories
of “Asian, Black, White, and Latino”
would report those patients who selected
“Latino” on line 10 (“unreported”)
in the “Race” portion of
the table and line 1 of the Latino /
Hispanic Identity portion of the table.
• In the same situation, a patient
who selected “White” would
be reported on line 8 (White) in the
“Race” portion of the table
and line 2 (All other) of the Latino/Hispanic
Identity portion of the table.
• A patient who reports themselves
to be “Black Latino” would
be counted on line 6 (Black) in the
“Race” portion of the table
and line 1 of the Latino Identity portion
of the table.
• A patient who reported themselves
to be “French Creole” would
be reported on line 10 (Unreported)
in the “Race” portion of
the table and line 2 (All other) of
the Latino Identity portion of the table.
The mix of race and ethnicity categories
can be confusing to reporting entities.
Some common examples may serve to clarify
their use:
• A center which has categories
of "Asian, Black, White, and Latino"
would report those patients who selected
"Latino" on line 6 in the "Race" portion
of the table and line 9 of the Latino
Identity portion of the table.
• In the same situation,
a patient who selected "White" would
be reported on line 4 in the "Race"
portion of the table and line 11 of
the Latino Identity portion of the table.
• A patient who reports
themselves to be "Black Latino" would
be counted on line 2 in the "Race" portion
of the table and line 9 of the Latino
Identity portion of the table.
• A patient who reported
themselves to be "French Creole" would
be reported on line 6 in the "Race"
portion of the table and line 11 of
the Latino Identity portion of the table.
Linguistic Preference:
• Report on line 8 the number
of patients who are best served in a
language other than English or with
sign language.
• Include those patients
who were served by a bilingual provider
and those who may have brought their
own interpreter.
NOTE : Data reported on line 8, Linguistic
preference, only may
be estimated if the health center does
not maintain actual data in its PMS.
Wherever possible, the estimate should
be based on a sample.
Questions and Answers for Tables
3A and 3B
• Are there any
changes to Tables 3A or 3B?
Yes. In 2007 an additional
race category, “More than one
race”, and information about Latino
/ Hispanic identity were added. With
the addition of this informtion, the
UDS racial classifications are consistent
with those used by the Census Bureau
as per the October 30, 1997, Federal
Register Notice entitled, '' Revisions
to the Standards for the Classification
of Federal Data on Race and Ethnicity,
'' issued by the Office of Management
and Budget (OMB). These standards govern
the categories used to collect and present
federal data on race and ethnicity.
The OMB requires five minimum categories
(White, Black or African American, American
Indian or Alaska Native, Asian, and
Native Hawaiian or Other Pacific Islander)
for race. In addition to the five race
groups, the OMB also states that respondents
should be offered the option of selecting
more than one race. The addition of
Line 5a permits reporting of those people
who have chosen to report two or more
races.
• How do you report
Latino Patients now?
In 2007, we have divided table
3B into two sections. Patients who,
in the past, were reported on line 5
(Latino / Hispanic) will be reported
on line 9 and will be reported
on lines 1 through 6 as appropriate.
If "Latino" is the only identity recorded
in the center's files, these patients
will be reported on line 6 as having
an "Unreported" racial identification.
• How do we report
individuals who receive different types
of services or use more than one of
the grantee's service delivery sites?
For example, a person who receives both
medical and dental services or a woman
who receives primary care from one clinic,
but gets prenatal care at another.
UDS Tables 3A and 3B provide unduplicated
counts of patients. Grantees are required
to report each patient once and only
once on Table 3A and once in each section
of Table 3B, regardless of the type
or number of services they receive or
where they receive them. Each
person who has received at least one
encounter reported on Table 5 is to
be counted once and only once on Table
3A and in lines 1-7 of Table 3B. Encounters
are defined in detail in the General
Instructions. Note the following:
• Persons who only receive
WIC services and no other services at
the agency are not to be counted as
patients or reported on Table 3A.
• Persons who only receive
lab services or whose only service was
an immunization or screening test as
part of a community wide health promotion/disease
prevention effort are not to be counted
as patients or reported on Table 3A.
NOTE : The sum of Table 3A, Line 39,
Column A + B must equal Table 3B, Lines
7 and 12; Table 4, Line 6; and Table
4 Line 12, Column A + B. The sum of
Table 3A, Lines 1-20, Column A + B must
equal Table 4, Line 12, Column A.
3. Do we need to collect information
on and report on the race and
ethnicity of all of our patients?
Yes. According to the Office of Management
and Budget (OMB) this information must
be collected for all patients. Race/ethnicity
is best self-reported by patients and
patients may refuse to provide the information.
Patients for whom there is no racial
information are reported on Line 6 of
Table 3B. Patients for whom there is
no Latino identity information are reported
on line 2.
Reporting Period: January 1, 2007 through
December 31, 2007 OMB No. 0915-0193 Expiration
Date:______
TABLE 3A - PATIENTS BY AGE AND GENDER
Age
Groups |
Male
Patients
(a) |
Female
Patients
(b) |
Number
of Patients |
1
|
Under age 1 |
|
|
2
|
Age 1 |
|
|
3
|
Age 2 |
|
|
4
|
Age 3 |
|
|
5
|
Age 4 |
|
|
6
|
Age 5 |
|
|
7
|
Age 6 |
|
|
8
|
Age 7 |
|
|
9
|
Age 8 |
|
|
10
|
Age 9 |
|
|
11
|
Age 10 |
|
|
12
|
Age 11 |
|
|
13
|
Age 12 |
|
|
14
|
Age 13 |
|
|
15
|
Age 14 |
|
|
16
|
Age 15 |
|
|
17
|
Age 16 |
|
|
18
|
Age 17 |
|
|
19
|
Age 18 |
|
|
20
|
Age 19 |
|
|
21
|
Age 20 |
|
|
22
|
Age 21 |
|
|
23
|
Age 22 |
|
|
24
|
Age 23 |
|
|
25
|
Age 24 |
|
|
26
|
Ages
25 - 29 |
|
|
27
|
Ages
30 - 34 |
|
|
28
|
Ages
35 - 39 |
|
|
29
|
Ages
40 - 44 |
|
|
30
|
Ages
45 - 49 |
|
|
31
|
Ages
50 - 54 |
|
|
32
|
Ages
55 - 59 |
|
|
33
|
Ages
60 - 64 |
|
|
34
|
Ages
65 - 69 |
|
|
35
|
Ages
70 - 74 |
|
|
36
|
Ages
75 - 79 |
|
|
37
|
Ages
80 - 84 |
|
|
38
|
Age
85 and over |
|
|
39
|
Total
Patients
(Sum Lines
1-38) |
|
|
Reporting Period: January 1, 2007 through
December 31, 2007 OMB No. 0915-0193
Expiration Date:______
TABLE 3B - PATIENTS BY ETHNICITY/RACE/LANGUAGE
|
Users
by Hispanic
/ Latino Identity
|
Number
(a)
|
|
number of patients
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total Patients
(Sum
Lines 1-23
)must = line 11)
|
|
Note:
Line 4 must = Table 3a, Line 39 Column
a + b)
| Users
by race |
Number
(a) |
| number
of patients |
| |
|
|
| |
|
|
| |
|
|
| |
Total Asian/Hawaiian/Pacific
Islander
(Sum Lines 5a + 5b + 5c) |
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
Total Patients (Sum Lines 5 - 10)
must = line 4) |
|
|
Users by Language
|
Number
(a)
|
|
number of
patients
|
|
|
|
|
|
|
|
Note:
Line 4 must = Table 3a, Line 39 Column
a + b)
