1 Grantee Baseline Survey

Attachment 2: RPHWTNP Grantee Baseline Survey
Question
No.

Question

Skip Logic

Response Options

Required Valid Response
Restriction

This survey is designed to collect baseline data from grantees that have been awarded funds for the Rural Public Health Workforce Training Network Program
(RPHWTNP) through the Health Resources and Services Administration (HRSA). The following questions will ask information about program plans and
activities. Information collected from this survey will be utilized by the Federal Office of Rural Health Policy (FORHP) to understand the existing landscape of
rural health training networks, prior to award funding on August 1, 2022. Should you have any questions regarding this survey, please direct your questions
to your HRSA Project Officer.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control
number. The OMB control number for this information collection is 0915/0906-XXXX and it is valid until XX/XX/202X. This information collection is required
to obtain or retain a benefit (42 U.S.C. § 254c(f) (§ 330A(f) of the Public Health Service Act); Section 2501 of the American Rescue Plan Act of 2021 (P.L. 117-2)
via the following funding opportunity: HRSA-22-117). Public reporting burden for this collection of information is estimated to average 0.25 hours per
response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA
Reports Clearance Officer, 5600 Fishers Lane, Room 14N136B, Rockville, Maryland, 20857 or paperwork@hrsa.gov.
General
1
Please select the name of your lead grantee
Drop-down (32 grantees)
*
organization.
2
Which workforce training track(s) has/have
Matrix response, 5 tracks (Track 1:
*
been selected for this program?
Community Health Support, Track 2: Health IT
and/or Technical Support, Track 3:
Community Paramedicine, Track 4a: Case
Management, Track 4b: Respiratory
Therapists) x 3 columns (Formally selected in
application, Informally selected, Not
applicable/Not selected)
Consortium (Training Network)
General
The following questions will ask about information relating to the training network, or consortium, that your organization has created/ is creating
Text
for the RPHWTNP.
Internal consortium members are organizations that have signed a memorandum of understanding, or MOU, with the lead grantee organization
for the purposes of the RPHWTNP.
External consortium members are organizations that have not signed a MOU, but will work with the lead grantee organization in some capacity
for the purposes of the RPHWTNP.

3

4
5

6

7

How many total (both internal and
external) entities, or consortium members, will
be involved in this organization's training
network throughout the duration of this
program? Please enter a numeric value.
Will any of the above entities, or consortium
members, be responsible for the delivery of
training content?
Please provide the names of organizations
outside of your consortium (external
organizations/ entities) that will be responsible
for the delivery of training content?

Which types of organizations (both internal
and external) will be involved in this
consortium throughout the duration of this
program? Please select all that apply.

Are there any types of organizations that will
be involved with this consortium not listed in
the previous question? Please specify.

Free-text

*

Skip to Q5

Yes

*

Skip to Q6

No
N/A - there will be no organizations outside of
our consortium that will be responsible for
the delivery of training content.

*

The following external organizations will be
responsible for the delivery of training
content (please include 1 organization per
line): [Free-text required]
Area Health Education Center (AHEC)
community-based organization (CBO)
health center or FQHC
health department
hospital/health system (including critical
access)
nonprofit or not-for-profit organization
other health care provider
state office of rural health (SORH)
university/academic institution
No
Yes, the following types of organizations were
not listed in the previous question: [Free-text]

numeric, 1-100

max 500 characters

*

*

Training

Attachment 2: RPHWTNP Grantee Baseline Survey

General
Text

Current
Training
Offerings
8

9

10

The following questions will ask about information relating to the trainings that are provided through the Rural Public Health Workforce Training
Network program. Training is defined as competency-based high-quality education, training, and other services, that:
a.) aligns with the skill needs of the workforce training tracks identified in the Rural Public Health Workforce Training Network Program
(RPHWTNP);
b.) prepares an individual (trainee) to be successful in any of a full range of secondary or postsecondary education options, including
apprenticeships;
c.) includes, as appropriate, education offered concurrently with and in the same context as workforce preparation activities and training for a
specific occupation or occupational cluster;
d.) organizes education, training, and other services that are culturally and linguistically competent to meet the particular needs of an individual
(trainee) in a manner that accelerates the educational and career advancement of the individual (trainee) to the extent practicable;
e.) helps an individual (trainee) enter or advance within a specific occupation or occupational cluster as listed in the
RPHWTNP.
For the purposes of
this survey, a “training” refers to a type of content-based training, and not a unit of training or modality of training. For example, if a consortium
is providing a motivational interviewing training on Monday’s, Wednesday’s, and Thursday’s, this is considered as one training. If a consortium is
providing a motivational interviewing training in person on Monday, virtually on Wednesday, and in person on Friday, this is still considered as
one training.
Current training offerings are trainings that already exist within the framework of the consortium and were offered prior to August 1, 2022. The
following questions will ask about the trainings that are already being offered by the consortium.
Does your training network or consortium,
currently offer, or have access to an
organization that offers, training programs for
the tracks that were selected in question 2?

Skip to
Q13

No

*

Yes

How many trainings does your organization
currently offer relating to, or supporting
professionals working in:

*

1. Community Health Support (such as
Community Health Workers)

Free-text + numeric

numeric only

2. Health IT/Telehealth Technical Support
3. Community Paramedicine
4a. Case management
4b. Respiratory Therapists
For which topics are trainings currently offered
through your consortium?

Free-text + numeric
Free-text + numeric
Free-text + numeric
Free-text + numeric
Multi-select (20 options from training list)

numeric only
numeric only
numeric only
numeric only
*

Attachment 2: RPHWTNP Grantee Baseline Survey

11

Are there additional trainings offered by your
consortium not listed in the previous options?

No

*

Yes, our consortium already offers trainings
on additional topics such as (please enter 1
training per line):
12

What types of credentials or certificates are
currently offered for these training programs?
Please select all that apply.

Associate Degree (please specify): [free-text

*

Billing and Coding Specialist
Certified Doula: Birth Doula, Antepartum
Doula, Postpartum Doula, End of Life Doula
Certified Health Care Interpreter
Certified Nurse Assistant
Certified Respiratory Therapist (CRT) /
Registered Respiratory Therapist
Clincal Medical Assistant/ Certified Medical
Assistant
Community Health Worker certification
Electronic Health Records (EHR) Specialist
EMT: Basic, Intermediate, Advanced, General
(no specific level)
Paramedic/ Mobile Integrated Health
Patient Navigator and/or Peer Support
Specialist certification

Future
Offerings

13

Pulmonary Rehabilitation Certificate
Something else: Please specify [free-text]
Future training offerings are trainings that did not already exist within the framework of the training network, or consortium as of August 1,
2022. The following questions will ask about the future trainings that the consortium will offer to trainees throughout the duration of the
RPHWTN.
How many new trainings does your training
network, or consortium, plan to offer relating
to, or supporting professionals working in the
tracks selected: (If this organization does not
anticipate offering additional trainings, please
indicate this by entering "0")

*

Attachment 2: RPHWTNP Grantee Baseline Survey

14
15

16

1. Community Health Support (such as
Community Health Workers)

Free-text + numeric

numeric only

2. Health IT/Telehealth Technical Support
3. Community Paramedicine
4a. Case management
4b. Respiratory Therapists
What trainings does your consortium plan to
offer?
Are there trainings that your consortium plans
to offer which are not listed in the previous
options?

Free-text + numeric
Free-text + numeric
Free-text + numeric
Free-text + numeric
Multi-select (20 options from training list)

numeric only
numeric only
numeric only
numeric only

No
Yes, our consortium plans to offer trainings
on additional topics such as (please enter 1
training per line): [free-text]

*

What credentials or certificates does this
training network, or consortium, plan to offer
for completion of these training programs?
Please select all that apply.

Associate Degree (please specify): [free-text
Billing and Coding Specialist
Certified Doula: Birth Doula, Antepartum
Doula, Postpartum Doula, End of Life Doula

*

*

Certified Health Care Interpreter
Certified Nurse Assistant
Certified Respiratory Therapist (CRT) /
Registered Respiratory Therapist
Clincal Medical Assistant/ Certified Medical
Assistant
Community Health Worker certification
Electronic Health Records (EHR) Specialist
EMT: Basic, Intermediate, Advanced, General
(no specific level)
Paramedic/ Mobile Integrated Health
Patient Navigator and/or Peer Support
Specialist certification

17

Throughout this program, will any efforts be
made to equip trainees with the skills
necessary to support delivery of care for
patients with long COVID-19?

Pulmonary Rehabilitation Certificate
Something else: Please specify [free-text]
Yes
Skip to 20

No

*
Attachment 2: RPHWTNP Grantee Baseline Survey

18

19

What efforts will your program make in
equipping trainees with the skills necessary to
support delivery of care for patients with long
COVID-19?
Throughout this program, will any efforts be
made to equip trainees with the skills
necessary to support patients in need of
behavioral health care services?

20

What efforts will your program make in
equipping trainees will the skills necessary to
support patients in need of behavioral health
care services?
Access & Equity
22
In what languages will trainings be offered?
Select all that apply.

23

In what formats will trainings be offered?

24

How does your organization define "cultural
responsiveness and racial equity?"
(Note: This definition does not need to be
extensive. FORHP is using this information so
that we may better understand the context of
your responses.)
How likely is cultural responsiveness and racial
equity to be accounted for in the trainings that
will be offered through your training network,
or consortium?
Please provide some examples of strategies
your training network or consortium, is using
to incorporate cultural responsiveness and
racial equity in the trainings that will be
offered.

25

26

Trainees
General
Text

Free-text

500 character max

Yes

Skip to 22

No
Free-text

*

Multi-select. English, Spanish

*

500 character max

Not listed here. Please specify (1 language per
line):
Multi-select + Free-text; web-based (live),
web-based (self-paced), in-person, other

*

Free-text

*

Likert Scale (Extremely unlikely - Extremely
likely)

*

Free-text

*

500 character max

The following questions will ask about information relating to the types of individuals that trainings are available to within the RPHWTNP.
Attachment 2: RPHWTNP Grantee Baseline Survey

27

How many of the following individuals does
the training network, or consortium, plan on
making trainings available to in the tracks
selected? (Please enter a number in each box.)

*

a. currently employed

Matrix: Individual type (currently employed
individuals, non-employed individuals) x track
selected (within consortium, outside of
consortium).
Matrix: Individual type (currently employed
individuals, non-employed individuals) x track
selected (within consortium, outside of
consortium).

b. individuals

Costs
General
Text
28

29

30
31

Numeric only

Numeric only

The following questions will ask about information relating to costs associated for trainings administered through the training network, or
consortium, within the RPHWTNP.
Will trainees be required to pay any fees out of
pocket to attend any trainings that will be
offered through this program?

Please indicate the reason why your
organization is not sure whether trainees will
be required to pay out-of-pocket costs to
attend trainings offered through the
RPHWTNP.
Please indicate the range of fees associated
with attending trainings offered through this
program.
Are there any trainings offered at a reduced
cost as a result of HRSA's funding?

Skip to
Q30
Skip to
Q31
Skip to
Q33

Yes

*

No
Not sure
Additional funding has not yet been secured
Program contracts have not yet been finalized
Other - please specify: [free-text]
Cost per training min: free-text, cost per
training max: free-text

*

Numeric only

No
Unsure
Yes. Training costs will be reduced by the
following dollar ($) amount: [free-text]
Yes. Training costs will be reduced by the
following percentage (%): [free-text]

*

Attachment 2: RPHWTNP Grantee Baseline Survey

32

How many trainings will be offered at a
reduced cost as a result of HRSA's funding?

33

Out of the funding received from HRSA, does
your organization plan to provide any of the
following to individual(s) enrolled in this
training program: (Select all that apply).

34
Funding
General
Text

Jan-50

Scholarships for trainings

*

Transportation
Childcare
Food assistance
Internet/ Internet access
Equipment (computer, headphones, tablets,
etc.)
Other. Please spcify [ free-text]
None of the above.
Free-text

Numeric only

The following questions will ask about information relating to funding, and funding sources, for your activities within the RPHWTNP.
Is HRSA the primary funding source your
organization will utilize to implement this
program?

36

Does your organization anticipate receiving
additional, or supplementary, funding outside
of HRSA's funding to support your efforts in
this program?
What other funding sources are you using, or
anticipate to using, to support your efforts in
this program?

Skills

Skip to
Q34

What is the total amount of funding in
scholarships that your organization plans to
distribute?

35

37

Slider

Skip to
Q38

Yes
No

*

No

*

Yes
I prefer not to answer/ Free-text

Attachment 2: RPHWTNP Grantee Baseline Survey

38

In building a stronger workforce, how would
you rate the importance of the skills listed
below? Please rate on a scale of 1 (not at all
important) to 5 (very important).
Technical Skills
Benefits counseling
Billing and coding
Case management
Contract management
CPR/AED
Crisis intervention
Math and science
Physical strength
Programming
Service coordination
Soft Skills
Analytical
Coordination
Critical thinking
Decision making
Listening
Interpersonal

*

Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Attachment 2: RPHWTNP Grantee Baseline Survey

Problem-solving
Time management
Verbal communication
Written communication
39

Please list up to 5 additional skills not
previously mentioned that your consortium
prioritizes with respect to one more specific
training tracks.

Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Likert scale (not at all important - extremely
important)
Free-text, up to 5 options

*

Attachment 2: RPHWTNP Grantee Baseline Survey