RFCC Leaders Director/Program Coordinator Questionnaire

RURAL/FRONTIER WOMEN’S HEALTH COORDINATING CENTERS

Center Director/Program Coordinator Questionnaire

Please answer the following questions as completely as possible. Thank you for your time and assistance.

OBJECTIVE 1: CREATE AN RFCC WITH FIVE REQUIRED COMPONENTS

1. In your experience in establishing and operating your RFCC, what have you found to be the most important needs of women in the service/catchment area? Please include healthcare needs as well as related needs such as transportation and social services.

1. __________________________________________________

2. __________________________________________________

3. __________________________________________________

4. __________________________________________________

5. __________________________________________________

2. Please refer the list of services below and indicate whether the RFCC provides the service directly and/or provides referrals for the service. Then indicate the name of the providers/organizations where women are referred, the location (city/town) and whether the organization is an RFCC partner organization.

Service	Is the service Provided Directly? Referred? or Both?	If service is referred, please list the name of the referral organization	Please indicate the location of the referral organization (City/Town)	Is this referral organization an RFCC partner? (Yes/No)
Preventive services and routine care
Mammogram
Bone Density Scan
Pap smear
Colon cancer screening
Counseling and social services
Mental health and substance abuse treatment
Dental services
Imaging services
Laboratory/pathology services
Other subspecialty services
Transportation

3. Does the RFCC refer to and/or partner with any of the following entities?

Please check: (you may check both) Refers to Partners with

• Rural Health Clinic(s) □ □

• Community Health Center(s) □ □

• Hospital □ □

• Private practitioners □ □

• Health Department □ □

4. How does the RFCC facilitate financial access?

Check all that apply:

• Refer to providers that accept Medicaid □

• Assist with Medicaid enrollment □

• Refer to providers with sliding scale fee schedules, □

payment plans or free services for un/underinsured

• Assist with applications for other aid such as free/reduced □

cost prescription drugs

• Other (explain) _______________________________________________________________________

5. What is the annual budget for the RFCC? (including OWH and non-OWH funds)?_________________

6. Has the organization sought additional external funding (beyond OWH funding) in order to support RFCC program goals? Yes/No

If yes, please list these funding sources:

Funding Organization	Amount	Year	Purpose of Funds

7. Describe the day-to-day operations of the RFCC. How does a woman typically access the RFCC ? ____________________________________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________

OBJECTIVE 2: DEVELOP A REFERRAL AND TRACKING SYSTEM

1. Is the RFCC referral protocol/system fully operational? Yes/No (Circle) If no, please explain.

__________________________________________________________________________________________

2. Does the RFCC have an electronic database for tracking clients?

3. Describe how referral, tracking and follow-up works in your RFCC, e.g., staffing, data collection, software used, etc.

__________________________________________________________________________________________

__________________________________________________________________________________________

4. To what extent can women be tracked as they access services to which they are referred? ____________________________________________________________________________________________________________________________________________________________________________________

5. Describe how the referral and tracking system is integrated with other components of the RFCC program: ____________________________________________________________________________________________________________________________________________________________________________________

OBJECTIVE 3: UTILIZE ALLIED HEALTH PROFESSIONALS AND OTHER TYPES OF PROVIDERS

1. Describe any workforce shortages or other workforce issues in the RFCC service area.. ____________________________________________________________________________________________________________________________________________________________________________________

2. What types of allied health or lay health workers are utilized to improve access (either direct care or referrals) among RFCC referral/partner organizations?

Indicate gender Indicate racial/ethnic

composition if known composition if known

• Nurse Practitioners □ __________________ _____________________

• Midwives □ __________________ _____________________

• Doulas □ __________________ _____________________

• Promotores □ __________________ _____________________

• Parish Nurses □ __________________ _____________________

• Patient Navigators □ __________________ _____________________

• Other ­­­­­­________________________

3. Are there any types of special activities or initiatives (i.e., collaborations with partner organizations) have been implemented or are planned in order to encourage utilization of allied health professionals/lay health workers? Yes/No (Circle) If yes, please describe.

__________________________________________________________________________________________

__________________________________________________________________________________________

OBJECTIVE 4: UTILIZE INNOVATIVE APPROACHES

1. Describe innovative approaches that have been undertaken by the RFCC and their purpose in any or all of the following areas:

Area of Operations	Innovative Approach Undertaken? (Yes/No)	Description
Operational structure
Service delivery
Information Systems
Tele-medicine
Distance learning
Outreach
Educational materials/programs, including a resource center/kiosk, women’s health library, etc.
Transportation
Client Referral System
Client Tracking System
Performance Measurement
Quality of Care Initiatives
Disease Management Programs
Provider Training

Note: “Innovative” is defined as a service, process, etc. that was not in place prior to the RFCC or is new to the service area.

2. Describe how these innovative approaches have been integrated with other components of the RFCC program: _________________________________________________________________________________

__________________________________________________________________________________________

OBJECTIVE 5: ESTABLISH LINKS TO RESOURCES

1. Prior to the funding of the RFCC, were there existing links in the community, e.g., did providers and other organizations work together to provide services to women? Yes/No (Circle) If yes, please briefly describe these relationships. ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

2. Since the RFCC was formed, what activities have taken place or are planned in order to develop and strengthen community linkages and/or relationships? ____________________________________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________

2. What types of challenges has the RFCC faced in developing and strengthening these linkages? ____________________________________________________________________________________________________________________________________________________________________________________

2. What types of initiatives have been particularly effective? Why? ____________________________________________________________________________________________________________________________________________________________________________________

2. Has the RFCC established links to federal and state programs such as Area Health Education Centers (AHEC)? Yes/No (Circle) If yes, please describe these relationships. ____________________________________________________________________________________________________________________________________________________________________

2. Has the RFCC established relationships with the RWHC in the PHS region? Yes/No (Circle)

2. Has the RFCC established a relationship with the MWHPE, if there is a member in the service area? Yes/No (Circle)

8. What types of resources are now available to women because of these community linkages and relationships? (e.g., telehealth, patient education materials/programs). ____________________________________________________________________________________________________________________________________________________________________________________

8. Are there other ways that these linkages/relationships have had an impact on women’s health in the community (e.g., improved access to care, increased quality, etc.?) ____________________________________________________________________________________________________________________________________________________________________________________

OBJECTIVE 6: PROMOTE LEADERSHIP AND ADVOCACY OF WOMEN

1. List any programs or initiatives sponsored/administered by the RFCC (currently in place or planned) that are designed to promote leadership among women or otherwise advocate for women and women’s health.

Name of Program	Brief Description	Targeted to American Indian or Alaska Native Women? (Yes/No)	Targeted to elderly women? (Yes/No)	How is program funded?	The program short-term or long-term?

2. Describe how leadership promotion and advocacy for women have been integrated with other components of the RFCC program: __________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

OBJECTIVE 7: MAXIMIZE TRANSPORTATION AND INTAKE POINTS

1. Please describe the primary transportation problems or issues in the community that may prevent women from accessing healthcare services, e.g., lack of public transportation, long distances between providers, weather, etc. ____________________________________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________

2. What activities has the RFCC undertaken or planned in order to meet the transportation needs of women in the service area and improve access to healthcare services?

____________________________________________________________________________________________________________________________________________________________________________________

3. What activities has the RFCC undertaken or planned in order to increase the number of intake points in the service area? ____________________________________________________________________________________________________________________________________________________________________________________

4. Describe how transportation and intake activities are integrated with other components of the RFCC program: _________________________________________________________________________________

__________________________________________________________________________________________

OBJECTIVE 8: FACILITATE RESEARCH IN WOMEN’S HEALTH

1. List research projects on women’s health that RFCC partners are currently conducting, participating in or sponsoring. If applicable, indicate which projects include or are specifically aimed at American Indian, Alaska Native and/or elderly women?

Brief Description of Research Project	Project Purpose	Targeted to American Indian or Alaska Native Women? (Yes/No)	Targeted to elderly women? (Yes/No)	Sponsoring Organization	Funding Source

2. Describe how research in women’s health is integrated with other components of the RFCC program: ____________________________________________________________________________________________________________________________________________________________________________________

OBJECTIVE 9: PROMOTE CULTURAL AND GEOGRAPHIC COMPETENCE IN TRAINING AND EDUCATION

1. Briefly describe the geographic characteristics of the RFCC service area. ____________________________________________________________________________________________________________________________________________________________________________________

2. Briefly describe the cultural characteristics of the RFCC service area. Note: Cultural characteristics are RFCC-specific and define unique qualities of a population. For example, these characteristics may have an impact on the way women view and use the health care system. ____________________________________________________________________________________________________________________________________________________________________________________

3. Describe programs, initiatives, policies and/or procedures currently in place among RFCC referral organizations to ensure cultural competence for patients. (Examples: Translation services, Patient education materials published to meet the language and literacy levels of the clinic population, Bi-lingual clinicians)

Description of Program/Initiative/Policy/Procedure

Describe programs, initiatives, policies and/or procedures currently in place to ensure geographic competence for patients. (Examples: Outreach programs across the service area, Transportation services/intake points that are accessible from a variety of places within the service area)

Description of Program/Initiative/Policy/Procedure

3. Does the RFCC provide or sponsor training for providers or partner organizations to increase cultural competence? Yes/No (Circle) If yes, what type of training is provided? ­­­­­____________________________________________________________________________________________________________________________________________________________________

3. Describe how geographic and cultural competence is integrated with other components of the RFCC program: _________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

OBJECTIVE 10: ENCOURAGE LEADERSHIP DEVELOPMENT

1. Describe innovative programs, initiatives, policies and/or procedures currently in place to promote leadership development. ____________________________________________________________________________________________________________________________________________________________________

2. Please check either the Yes or No column for each question listed below:

Question	Yes	No
Do programs facilitate interaction with experts in women’s health (i.e., leaders of CoE and CCOE programs)?
Do individuals affiliated with the RFCC present at local, state and national conferences?
Do individuals affiliated with the RFCC have funding to attend leadership seminars and educational programs?
Are there incentives (financial or promotions) for individuals attaining leadership roles?

3. Describe how these leadership development activities are integrated with other components of the RFCC program: ___________________________________________________________________________

__________________________________________________________________________________________

Navigant Consulting Inc. Appendix D

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