These are the most direct signals that a SNAP reduction or loss is already changing what the household can eat or afford.

Offer current food and basic-needs options; record whether the person wants help and whether the connection reaches contact, enrollment, and food received.

The twelve-month lookback may capture need that predates HR1. Pair the response with timing and benefit-status context rather than attributing the need automatically.

Lost food or medical support can force tradeoffs with rent, utilities, and safe shelter. Unstable housing also makes notices and proof harder to receive and retain.

Offer housing-stability or shelter navigation and establish a reliable way to receive time-sensitive notices when the client wants assistance.

A housing response needs separate urgency and safety triage; the screen alone does not rank imminent eviction, homelessness, or unsafe conditions.

Transportation can determine whether a client reaches a renewal appointment, provider, workforce activity, food source, or referred service.

Connect the transportation need to the specific next step and confirm whether the client can reach it before the deadline.

A general transportation referral is weak unless it fits the route, hours, mobility needs, and date that prompted the question.

A benefit loss can shift scarce income toward food or health costs and expose an existing shutoff risk.

Offer utility and emergency-assistance pathways and distinguish an active shutoff from a past threat.

The item uses a twelve-month period. Capture current urgency separately so staff know whether same-day action is needed.

The complete CMS core includes these questions, and financial or housing disruption can increase danger or constrain a person's options.

Use the existing confidential safety protocol and let the client's immediate safety and choice determine the response.

Do not treat safety disclosure as an HR1 data point or ordinary referral. Privacy, safe contact, and trained response take precedence.

A positive needs screen does not mean the person wants DCHS to act. This proposed local item separates identified need from requested assistance.

Ask permission for each next step and record declined, information only, referral accepted, and follow-up requested as distinct outcomes.

This is a proposed local addition, not part of the CMS AHC-HRSN instrument. Declining help must not affect benefits or other services.

This question can reveal the broader tradeoffs created or intensified by lost food or health coverage, including rent, care, heating, and other basics.

Offer benefits assistance and basic-needs navigation based on the expense the client identifies; avoid assuming one generic financial referral fits.

The source defines no positive threshold. Use the response to begin a conversation, not to assign a risk category automatically.

Coverage uncertainty, interrupted treatment, food insecurity, and administrative burden can worsen distress. These questions help identify continuity and clinical follow-up needs.

Use established behavioral-health and crisis pathways, protect existing treatment where possible, and track whether care continued through the benefit transition.

PHQ-2 is a brief signal, not a diagnosis, and does not ask about suicidal ideation. A defined escalation pathway must exist before fielding it.

Difficulty concentrating, remembering, deciding, or completing errands can make notices, portals, proof gathering, and appointments harder to manage.

Offer accessible communication, completion assistance, a designated representative when appropriate, and navigation to formal eligibility or medical review.

These answers do not establish a Medicaid exemption or medical status. They indicate where accommodation and qualified review may be useful.

A person managing a renewal or service transition alone may need practical help with meals, shopping, finances, communications, or follow-through.

Ask what kind of support is missing and connect to a concrete service or consented helper rather than treating social isolation as a referral category by itself.

Household composition for benefits and the people who provide practical support are different concepts; do not infer one from the other.

A notice, proof request, or referral that cannot be understood is unlikely to produce a timely response.

Record and honor the person's preferred language and provide interpretation or translated materials across the benefits and referral journey.

This item asks only whether another language is spoken at home; it does not identify the preferred language. Offer language access before screening rather than waiting for this question.

For clients who want it, employment help may support income stability or connect them with an approved activity pathway.

Offer Workforce Development, SNAP E&T, or another suitable pathway only after confirming the client's goal and the program's current fit.

This question asks whether help is wanted. Do not turn a voluntary needs screen into work-requirement monitoring or assume employment is the right response for every client.

Training or education may be a client-chosen route toward employment, income, or an approved activity, depending on current program rules.

Connect interested clients to a verified program and clarify the enrollment, documentation, schedule, and support needed to participate.

Interest is not enrollment, and enrollment is not necessarily qualifying participation. Keep those outcomes separate.

Child care can determine whether a parent can work, train, attend appointments, or complete a benefits process.

Offer child-care navigation when the household and custody context make it relevant, then track whether care was found and usable.

These are proposed local additions, not CMS AHC-HRSN items. Ask only of applicable households and do not infer benefit-household status from the response.

Loss of health coverage can interrupt treatment or increase the urgency of connecting someone to care.

Field these questions only with a confidential, clinically appropriate pathway and clear consent, storage, and access rules.

Responses may create specially protected substance-use records depending on who asks and where they are stored. Resolve governance before implementation.

These questions add useful health context but are less directly connected to stabilizing a SNAP or Medicaid transition than the earlier groups.

Use them when a meaningful clinical or community-health response exists and the result will change the support offered.

Age-specific interpretation is required. Do not let this lower-priority module delay the direct benefit-loss response.