manage your child’s care or 8 = (GO DON’T KNOW treatment from different TO 17 INTRO) doctors or care providers? 9 = REFUSED (GO TO 17 INTRO) 3C. Another provider ALL GO TO 5A Who was it that helped from a different you? If more than one office/clinic person helped you, A care coordinator we want to know the who of isn’t part person who helped you [FILL office 1A’s] most often in the last 12 staff months. A social worker who of isn’t part office staff [1A’s] A care or case manager who isn’t part of [1A’s] office staff Someone else who of isn’t part [1A’s] office staff 4. 1. Your main Who in the main child’s provider’s provider office helped you? If more 2. Another doctor or nurse than one person helped you, in the main we want to know the person provider’s office who helped you most often 3. A clerk or receptionist in in the last 12 months. the main office provider’s 4. A care coordinator in the main office provider’s 5. A social worker in the main office provider’s 6. A care manager or case manager in the main office provider’s 7. Someone else in the main office provider’s 8 = DON’T KNOW 9 = REFUSED 5a. 1 = Yes, definitely In the last 12 months, did 2 = Yes, somewhat the person who helped you 3 = No child’s with managing your care know the important 8 = information about your DON’T KNOW 9 = REFUSED health and care child’s needs? Would you say: 5b. 1 = Yes, definitely In the last 12 months, did 2 = Yes, somewhat the person who helped you 3 = No with managing your care seem informed child’s 8 = and up-to-date about the DON’T KNOW
8 = DON’T KNOW (GO TO 17 INTRO) 9 = REFUSED (GO TO 17 INTRO) manage your child’s care or treatment from different doctors or care providers? 3C. Another provider from a different office/clinic A care coordinator who isn’t part of [FILL 1A’s] office staff A social worker who isn’t part of [1A’s] office staff A care or case manager who isn’t part of [1A’s] office staff Someone else who isn’t part of [1A’s] office staff Who was it that helped you? If more than one person helped you, we want to know the person who helped you most often in the last 12 months. ALL GO TO 5A 4. 1. Your child’s main provider 2. Another doctor or nurse in the main provider’s office 3. A clerk or receptionist in the main provider’s office 4. A care coordinator in the main provider’s office 5. A social worker in the main provider’s office 6. A care manager or case manager in the main provider’s office 7. Someone else in the main provider’s office 8 = DON’T KNOW 9 = REFUSED Who in the main provider’s office helped you? If more than one person helped you, we want to know the person who helped you most often in the last 12 months. 5a. 1 = Yes, definitely 2 = Yes, somewhat 3 = No 8 = DON’T KNOW 9 = REFUSED In the last 12 months, did the person who helped you with managing your child’s care know the important information about your child’s health and care needs? Would you say: 5b. 1 = Yes, definitely 2 = Yes, somewhat 3 = No 8 = DON’T KNOW In the last 12 months, did the person who helped you with managing your child’s care seem informed and up-to-date about the
fecc_nqf_telephone-interview-survey.docx