The same ten questions, every time

Small Set of Standard Questions Working prototype Open full screen ↗ All questions on one page ↗

The CMS Accountable Health Communities Health-Related Social Needs tool, built as a working screener: ten core questions across five domains asked of everyone, sixteen supplemental items offered as optional areas, and three local additions. Every question is verbatim, and every question shows where it came from.

What it is

Ten core questions — housing, food, transportation, utilities and safety, asked identically of everyone.

Sixteen supplemental items — eight further domains, offered as optional areas rather than required ones.

Three local additions — child care (absent from AHC entirely) and a closing “would you like help?” item.

A screening result — which domains flagged, using the instrument's own thresholds. Not an eligibility decision.

Why the wording never changes

The point of a small, standard question set is that everyone answers the same questions the same way — so results support population analysis, hot-spotting and automated referral triggers. Every question here is transcribed verbatim from the CMS instrument; a test asserts that against the source on every build.

What it deliberately does not do

No diagnosis and no eligibility determination — a positive screen says a problem may exist, not what is causing it.

No invented thresholds — thirteen supplemental items have no positivity rule in the source, and the results screen says so plainly.

No demographic intake — age and household questions are asked only where the instrument's own “applies to” lines require them.

AHC-HRSN screener

A few questions about your everyday needs

The same short set of questions we ask everyone — about housing, food, getting around, utilities and safety. Answer what you want to; skip anything you'd rather not.

Nothing is saved. Your answers stay on this device and disappear when you close it.

10 core questions · about 3 minutes

Every question cites its source

AHC is an assembly of separately-owned items — Hunger Vital Sign, HITS, PHQ-2, PRAPARE and others — and CMS requires the citation to travel with each question. Rather than crowd the screen, each question carries an i that opens its source, scoring rule and any implementation flag.

Two flags worth settling first

The substance-use items may create 42 CFR Part 2 protected records depending on who administers them and where responses are stored. And PHQ-2 is the first two items of PHQ-9 — it does not include the suicidal-ideation item, so an escalation pathway has to exist before it is fielded. Both surface in the app rather than sitting in a footnote.

Known gaps

AHC has no childcare domain at all — none of the comparable instruments do — so the two child-care items here are drawn from federal survey wording and marked as local additions. It also omits income, legal needs, digital access and justice involvement.

The whole instrument on one page

The app asks one question at a time. To review the instrument itself — all 30 items, their exact response options and which answers count as positive — there is a print-style sheet.

Open the full sheet →