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<br />. Targeted population defined <br />. Samples of outreach materials used <br />. Number of clients who called. the type of assisLlIlce requested by mutually defined <br />categories and geographic location <br />. Number of murually defmed cype of written materials mailed to providers and <br />clients (e.g.. Provider lists, THSteps fact shee:s, etc.) <br />. Provider access problems referred to RECENING AGENCY contract staff and <br />corrective action initiated <br />. Number of clients with abnormalities <br />. Number of clients contacted for follow-up <br />. Number of clients scheduled for follow-up appointment <br />. Number of clients w.ho kept appointments <br />. Number and type of provider contacts <br />. Plans for outreach evaluation <br />. Plans for corrective action <br /> <br />The report format will be provided to PERFORMING AGENCY by RECENING AGENCY. <br /> <br />Automated Record Keepincr and Documentation <br /> <br />RECEIVING AGENCY has developed an automated reporting system that has the capacity to <br />capture and disseminate data elements required for reporting on activities related to Client Support <br />Services and Targeted Outreach. It will include the ability to determine the following: <br /> <br />. number of written offers of outreach mailed to recipients <br />. number of requests for outreach by health care providers <br />. number of recipients who did not respond to the initial written offer of outreach <br />within 45 days <br />. number of recipients who did noc receive oral outreach within 45 days of receipt <br />of outreach lists <br />. number of recipients who responded to the initial written offer of outreach and the <br />number who requested each method of outreach <br />. number of recipients who received each method of outreach <br />. number and status of recipients identified on earlier outreach lists who did not <br />receive oral outreach in prior months who requested services <br /> <br />RECEIVING AGEJ.'fCY Client Activity Reporting of EPSDT Services (CARES) data entry <br />forms. provided to PERFORMING AGENCY by RECEIVING AGENCY, will be submitted to <br />Public Health Region 4/5 contract staff weekly. CARES data entry forms will be completed by <br />outre:lCh staff tq document each client contact as follows: <br /> <br />. Outreach and informing activities <br />. Client support services <br />. Client follow-up <br /> <br />,. <br />