NATIONAL CHIPS PIU - CURRENT STATUS OF UTILISATION OF THE 5% CHIPS BHCPF IN STATES
State
*
Name of respondent
*
First Name
Last Name
Respondent's Phone Number
*
-
Area Code
Phone Number
Has your State commenced utilization of the 5% CHIPS BHCPF?
*
Yes
No
What are the challenges with accessing/utilization of the 5% CHIPS BHCPF in your State?
*
What is the total no. of CHIPS Agents trained in your State?
*
What is the total no. of CEFPs trained in your State?
*
What is the total no. of Supervising CHEWs trained in your State?
*
What source of funding did you utilize for the selection & training of CHIPS Personnel in your State?
*
5% CHIPS BHCPF only
Partner or Other Source only
5% CHIPS BHCPF & Partner or other sources
What is the Source of Funding for Payment of Stipends?
*
5% CHIPS BHCPF
Partner or Other Source
5% CHIPS BHCPF & Partner or other source
No funds for payment of Stipends
What is the total number of CHIPS Agents and CEFPs being paid stipends from the 5% BHCPF CHIPS fund?
*
If no CHIPS Agent or CEFP is being paid stipend with BHCPF, please enter 0
What is the total number of CHIPS Agents and CEFPs being paid stipends by partners or other sources?
*
If no CHIPS Agent or CEFP is being paid stipend by partner or other source, please enter 0
Has your State paid 5% BHCPF CHIPS Stipends for the month of November 2022?
*
Yes
No
Has your State paid the 5% BHCPF CHIPS Stipends for the month of December 2022?
*
Yes
No
Do CHEWs conduct monthly supervision of CHIPS Agents in your State?
*
Yes
No
Does your State pay the Supervising CHEWs a monthly transport allowance for the Supervision of CHIPS Agents
*
Yes
No
What is the Source of Funding for Payment monthly transport allowance for Supervising CHEWs?
*
5% CHIPS BHCPF
Partner or Other Source
5% CHIPS BHCPF & Partner or other source
No funds to pay for this monthly activity
The state does not specifically pay CHEWs to supervise CHIPS Agents
Do you have any challenge(s) with utilization of the 5% CHIPS BHCPF in your State?
*
Any additional comment
Submit
Should be Empty: