FQHC Look-Alike Administrators:Help us out by taking a brief survey. The data we collect will be made public and it will aid in our advocacy efforts. Name * First Name Last Name Title * Email * Health Center * How many patients did you serve in 2019? * How much did your health center pay for malpractice insurance coverage in 2019? * COVID-19 PANDEMIC QUESTIONS Percentage drop in visits since Stay-Home orders issued * Loss in program revenue since Stay-Home orders issued * Since COVID-19 hit your area, how many FTEs have you laid off? * Since COVID-19 hit your area, how many FTEs have you furloughed? * How many staff members are unable to report for work due to exhibiting symptoms or high risk of contracting COVID-19? * Have you cut back on hours of operation at any of your clinics? * Yes No Have you shut down any of your clinics following the outbreak of this pandemic? * Yes No If no, are you planning to shut down any of your clinics in the next two months? * Yes No NA Are you using telehealth to conduct services? * Yes No Do you need additional funding for telehealth equipment? * Yes No Is your state's Medicaid program reimbursing you for telehealth encounters? * Yes No Is your state's Medicaid program reimbursing you for telephone-only encounters? * Yes No Do you need additional funding for PPE? * Yes No How many patients have you tested for COVID-19? * How many patients have tested positive for COVID-19? * How many COVID-19 test kits do you have on hand? * Do you have enough COVID-19 test kits to meet demand for your existing patients? * Yes No Do you need additional funding for COVID-19 testing supplies? * Yes No Do you currently maintain capability and capacity to advertise yourself as a public testing site? * Yes No Thank you! Your information will help us greatly in our advocacy efforts. Check back on our Data page as we begin to compile these responses and generate some statistics that will be helpful to us all in securing emergency response funding.
