Form 817 2017 817 NHSC Site Satisfaction Survey - Updated_2017071

American Customer Satisfaction Index "Customer Satisfaction Surveys"

2017 817 NHSC Site Satisfaction Survey - Updated_20170718-CLEAN.DOCX

2017 817 NHSC Site Satisfaction Survey - Updated_20170718-CLEAN

OMB: 1090-0007

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NHSC Satisfaction Questionnaire

Health Resources and Services Administration
Bureau of Health Workforce

National Health Service Corps

Site Satisfaction Survey


Survey to be administered via the Web. Instructions and headings in BOLD and question numbers will not be seen by the respondents.


Survey Introduction



The National Health Service Corps (NHSC) is committed to continuous performance improvement. As part of this effort, we are requesting feedback on your experiences with the NHSC.


The survey is hosted via a secure server and your responses will remain strictly confidential and anonymous. This survey is authorized by Office of Management and Budget Control No. 1090-0007, which expires May 31, 2018.


The survey will take approximately 15 minutes to complete. Thank you in advance for completing the survey.


Please click on the “Next” button below to begin.


Introduction Questions


Throughout the following survey, we will frequently refer to the term “NHSC Site”. An "NHSC Site" is an NHSC-approved health care facility that provides comprehensive outpatient, ambulatory, primary health care services to populations residing in Health Professional Shortage Areas.


  1. Are you an NHSC Site Point of Contact?

  1. Yes

  2. No (Terminate survey)


CFI: For respondents who answer INTRO2=1 (Yes), can we add a reminder that for the purposes of this survey, they’re answering regarding their experience with NHSC?


  1. Are you also a NURSE Corps Point of Contact?

  1. Yes (I work with, manage or support one or more of the following types of NURSE Corps eligible employees: nurse faculty, registered nurses, and advanced practice registered nurses (nurse practitioners, certified registered nurse anesthetists, certified nurse midwives, and clinical nurse specialists)).

  2. No


IF INTRO2=YES: Please think about your experiences with NHSC for the entirety of this survey and base your answers and ratings upon this NHSC experience alone.


  1. What is your role at your NHSC-approved site? (Select all that apply)

    1. Recruiter (I hire and/or recruit new employees)

    2. Personnel Verifier (I can officially confirm employment status, work schedules, and/or absences of employees at my site)

    3. Administrator (I own, oversee, or manage my site(s) or a significant portion of my site(s) and/or I understand and can answer questions about site policies and operating procedures)


  1. How long has your site been NHSC approved?

    1. Less than 1 year

    2. 1-2 years

    3. 2-5 years

    4. More than 5 years

    5. Don’t know


  1. How long have you been an NHSC Point of Contact at your site?

    1. 1-3 months

    2. 3-6 months

    3. 6 months to 1 year

    4. 1-2 years

    5. 2-5 years

    6. More than 5 years

    7. Don’t know


CFI – For respondents who answer INTRO6=1 (Yes), can we include a header at top of each survey question or a reminder to answer based on overall experience with NHSC (as oppose to single site experience). Example of header: “Please answer the following question based on your whole network of sites.”


PROGRAMMING NOTE - IF INTRO6=YES, add the following header for remainder of survey (in normal black font at the first page, then gray for the remaining pages): Please consider your entire network of sites, rather than any one specific site when providing answers and ratings throughout the survey.


  1. Do you oversee multiple NHSC-approved sites?

    1. Yes [GROUP=2 (Network)]

    2. No [GROUP=1 (Single Site)]


  1. [If GROUP=1 (Single Site)] From the list below, please select the option that best describes the type of NHSC site you are located at:

    1. Federally Qualified Health Center (FQHC)

    2. FQHC Look-Alike

    3. Rural Health Clinic

    4. Hospital Affiliated Primary Care Outpatient Clinic

    5. Indian Health Service

    6. Tribal Clinic

    7. Urban Indian Health Clinic

    8. Correctional Facility

    9. Private Practice (Solo/Group)

    10. Community Mental Health Facility

    11. Community Outpatient Facility

    12. Critical Access Hospital

    13. Free Clinic

    14. Immigration and Customs Enforcement (ICE) Health Service Corps

    15. Mobile Unit

    16. School-based Health Program

    17. State or County Department of Health Clinic


  1. [If GROUP=2 (Network)] From the list below, please select all the options that best describe the type(s) of NHSC sites within your network:

    1. Federally Qualified Health Center (FQHC)

    2. FQHC Look-Alike

    3. Rural Health Clinic

    4. Hospital Affiliated Primary Care Outpatient Clinic

    5. Indian Health Service

    6. Tribal Clinic

    7. Urban Indian Health Clinic

    8. Correctional Facility

    9. Private Practice (Solo/Group)

    10. Community Mental Health Facility

    11. Community Outpatient Facility

    12. Critical Access Hospital

    13. Free Clinic

    14. Immigration and Customs Enforcement (ICE) Health Service Corps

    15. Mobile Unit

    16. School-based Health Program

    17. State or County Department of Health Clinic


  1. Have you promoted the NHSC to any students or clinicians in the past 12 months?

    1. Yes

    2. No

  1. [If INTRO9=Yes] Aside from the NHSC requirements (e.g., complete and update an online NHSC Site Profile in the Customer Service Portal) how has your organization promoted the NHSC in the past 12 months? (Select all that apply)

    1. Verbally provided recommendation

    2. Provided NHSC website link

    3. Provided NHSC materials

    4. Other (CAPTURE RESPONSE)



  1. [If GROUP=1 (Single Site)] Does your site currently employ an NHSC clinician?

    1. Yes, at least one NHSC clinician is currently employed at my site

    2. No, there are no NHSC clinicians currently employed at my site

    3. I don’t know

  2. [IF INTRO11=1] How many NHSC clinicians are currently employed at your site? [ACCEPT A WHOLE NUMBER VALUE]



  1. [If GROUP=1 (Single Site) AND INTRO11=Yes] Through which program(s) did the clinician(s) currently employed at your site enter the NHSC? (Select all that apply)

    1. Loan Repayment Program

    2. Scholarship Program

    3. Students to Service Loan Repayment Program

    4. I don’t know


  1. [If GROUP=1 (Single Site) AND INTRO11=No] Has your site ever employed an NHSC clinician?

    1. Yes

    2. No

    3. I don’t know


  1. [If GROUP=2 (Network)] Does at least one of the sites in your network currently employ an NHSC clinician?

    1. Yes, at least one NHSC clinician is currently employed at a site in my network

    2. No, there are no NHSC clinicians currently employed at any of the sites in my network

    3. I don’t know


  1. [If GROUP=2 (Network) AND INTRO15=Yes] Through which program(s) did the clinician(s) currently employed at your network enter the NHSC? (Select all that apply)

    1. Loan Repayment Program

    2. Scholarship Program

    3. Students to Service Loan Repayment Program

    4. I don’t know


  1. [If GROUP=2 (Network) AND INTRO15=No] Have sites in your network ever employed an NHSC clinician?

    1. Yes

    2. No

    3. I don’t know


NHSC Site Assistance


  1. Have you received any technical assistance from the NHSC pertaining to your site in the last 12 months?

    1. Yes

    2. No [SKIP TO NEXT SECTION]


  1. In the past 12 months, which of the following types of support did you receive from the NHSC to aid you in your role as an NHSC site POC? Select all that apply:

    1. Recruitment

    2. Retention

    3. NHSC program compliance

    4. NHSC member management

    5. Becoming a new site

    6. Site recertification

    7. Health Professional Shortage Area (HPSA) score

    8. Other [CAPTURE RESPONSE]


  1. In the past 12 months, where have you received this type of support? Select all that apply:

    1. NHSC Website (online materials)

    2. On-site technical assistance (site visit)

    3. Call Center

    4. NHSC Program Representative (Regional/program analyst)

    5. Health Workforce Connector (formerly NHSC Jobs Center) Customer Service Portal

    6. Webinar/webcast

    7. Other [CAPTURE RESPONSE]


  1. Using a scale from 1 to 10, where 1 means Poor and 10 means Excellent, please rate the level of support provided to you by the NHSC in the past 12 months to aid you in your role. [CAPTURE RESPONSE]


  1. Do you know how to contact NHSC with any questions or concerns you may have?

    1. Yes

    2. No

Customer Service


  1. Have you contacted the NHSC during the past 12 months regarding your site?

    1. Yes

    2. No [SKIP TO NEXT SECTION]


  1. In the past 12 months, through what means have you contacted the NHSC regarding your site? (Select all that apply)

    1. Telephone

    2. E-mail

    3. Fax

    4. Customer Service Portal

    5. Facebook

    6. Twitter

    7. LinkedIn

    8. Other [CAPTURE RESPONSE]




  1. Please select all the reasons that you contacted the NHSC regarding your site in the past 12 months.

    1. General information

    2. Program requirements

    3. Posting job opportunities

    4. Employee applying to NHSC Loan Repayment Program/Scholar fulfilling service commitment

    5. Maternity/paternity/adoption leave

    6. Medical or non-medical suspension

    7. NHSC participant converting to half-time service

    8. Participant resignation/termination

    9. Six-month verification

    10. Site visit

    11. Leave of absence request (personal/family/medical reasons)

    12. Update contact information

    13. Recertification

    14. New site application

    15. Health Professional Shortage Area (HPSA) score

    16. Other [CAPTURE RESPONSE]


  1. Of all the reasons you selected for contacting the NHSC in the past 12 months, what was the reason for your most recent contact? [Only show selections made in Q2.3][CAPTURE RESPONSE][IF ONLY ONE SELECTION MADE @ Q2.3, AUTOCODE AND DO NOT DISPLAY]


  1. For your most recent contact, approximately how long did it take for the NHSC to first respond to, or acknowledge, your initial contact?

    1. Within 24 hours

    2. Between 24 and 48 hours

    3. Between 2 and 4 days

    4. More than 4 days but less than 1 week

    5. More than 1 week but less than 1 month

    6. More than 1 month

    7. They have never responded to my initial contact


  1. For your most recent contact, ideally, how long should the NHSC have taken to first respond to, or acknowledge, your initial contact?

    1. No more than 24 hours

    2. No more than 48 hours

    3. No more than 3-4 days

    4. No more than 1 week

    5. No more than 1 month


  1. Was the NHSC representative able to resolve your issue/situation?

    1. Yes

    2. No [SKIP to Q2.9]


  1. How long did it take for the NHSC to resolve your issue/situation?

    1. Within 24 hours

    2. Between 24 and 48 hours

    3. Between 2 and 4 days

    4. More than 4 days but less than 1 week

    5. More than 1 week but less than 1 month

    6. More than 1 month


  1. Ideally, what is your expectation for how long it should have taken the NHSC to resolve your issue/situation?

    1. No more than 24 hours

    2. No more than 48 hours

    3. No more than 3-4 days

    4. No more than 1 week

    5. No more than 1 month


  1. [If Q2.7=No] You indicated the NHSC representative was not able to resolve your issue. Did he/she refer you elsewhere for further assistance?

    1. Yes

    2. No


  1. [If Q2.10=Yes] Where did the NHSC representative refer you?

    1. Customer Service Portal

    2. NHSC Website

    3. Another department/representative

    4. Other [CAPTURE RESPONSE]



CFI: Question numbers below have been updated to follow sequence above


Thinking about your most recent contact with the NHSC, and using a scale from 1 to 10, where 1 means Poor and 10 means Excellent, please rate:

  1. Ease of reaching an NHSC representative

  2. Courteousness of the NHSC representative

  3. Knowledge of the NHSC representative

  4. Timeliness of the representative’s response to your inquiry or concern

  5. Relevance of the information provided by the NHSC representative

  6. Level of service provided by the NHSC representative

  7. Please use this space for any additional information you would like to provide the NHSC regarding ways we can improve the program. [CAPTURE RESPONSE]


Customer Service Portal


  1. Have you used the Customer Service Portal in the last 12 months? The Customer Service Portal is a secured online account where NHSC Sites can post and update job positions, view clinicians currently under obligation, update site contact information, and ask the NHSC questions.

    1. Yes

    2. No [SKIP TO NEXT SECTION]

    3. Don’t know [SKIP TO NEXT SECTION]


  1. How have you used the Customer Service Portal in the last 12 months? (Select all that apply)

    1. Complete in-service verification

    2. Employment verification

    3. Update contact information

    4. Apply for site recertification

    5. Update or complete an NHSC Site Profile

    6. Manage current job openings

    7. Alert the NHSC to any changes at your site (e.g., POC, location, etc.)

    8. Other [CAPTURE RESPONSE]


  1. What additional feature, if any, would you like to see added to the Customer Service Portal? [CAPTURE RESPONSE]


Please think about your overall experience using the Customer Service Portal in the last 12 months. Using a scale from 1 to 10, where 1 means Poor and 10 means Excellent, please rate:

  1. Ease of navigation

  2. Ability to find the information needed

  3. Your ease of understanding the information communicated

  4. Organization of the information provided

  5. Usefulness of conducting business through the Customer Service Portal

  6. Timeliness of NHSC responses

Information/Communication


  1. Which of the following NHSC communications have you accessed in the last 12 months? (Select all that apply)

    1. Customer Service Portal

    2. Emails or e-blasts from the NHSC

    3. NHSC Facebook page

    4. NHSC Twitter account

    5. Other [CAPTURE RESPONSE]


  1. Which do you access most often? (Select one) [Filter responses based on selections in QInfo_1]

    1. Customer Service Portal

    2. Emails or e-blasts from the NHSC

    3. NHSC Facebook page

    4. NHSC Twitter account

    5. Other [CAPTURED RESPONSE]


HRSA: QInfo_3 previously read “For the method you use most often, which device did you use?” The revision below would pipe in the actual response option selected at QInfo_2 to provide a bit more clarity


QInfo_3. With which device do you typically access [INSERT RESPONSE FROM QInfo_2]? (Select one)

    1. Desktop computer/laptop

    2. Tablet/iPad

    3. Smart phone

    4. Other [CAPTURE RESPONSE]


CFI – Original set of questions (below) were:

Please think about the communications you last received from the NHSC. Using a scale from 1 to 10, where 1 means Poor and 10 means Excellent, please rate…

Q5_1 The timeliness of the communications

Q5_2 The relevance of the information provided to your inquiry

Q5_3 The sufficiency of detail to meet your needs

Q5_4 Your ease of understanding the information communicated

Q5_5 The organization of the information provided

Q5_6 The format in which the information was provided

Q5_7 The helpfulness of information in guiding your decision-making


Thinking about the [INSERT RESPONSE FROM QInfo_2], and using a scale from 1 to 10, where 1 means Poor and 10 means Excellent, please rate:

  1. Timeliness of the communications

  2. Relevance of the information provided to your inquiry

  3. Received enough detail to meet your needs

  4. Ease of understanding the information communicated

  5. Organization of the information provided

  6. Helpfulness of information in guiding your decision-making

  7. Frequency of receiving information


  1. How would you prefer to receive future communications from the NHSC? (Select all that apply)

    1. Customer Service Portal

    2. Emails or e-blasts from the NHSC

    3. NHSC Facebook page

    4. NHSC Twitter account

    5. Other [CAPTURE RESPONSE]


  1. How would you prefer to receive time-sensitive communications from the NHSC? (Select one)

    1. Customer Service Portal

    2. Emails or e-blasts from the NHSC

    3. NHSC Facebook page

    4. NHSC Twitter account

    5. NHSC LinkedIn

    6. Other [CAPTURE RESPONSE]





  1. In the past 12 months, how often did you receive communications from the NHSC regarding your site (including communications in reference to your NHSC clinicians)?

    1. Weekly

    2. Monthly

    3. Quarterly

    4. Twice per year

    5. Yearly


  1. In the past 12 months, how would you rate the frequency of communications received from the NHSC?

    1. Too frequent

    2. Just right

    3. Not frequent enough


  1. How often would you like to receive communications from the NHSC?

    1. More often than once per month

    2. Monthly

    3. Quarterly

    4. Twice per year

    5. Yearly or less often


  1. In the past 12 months, which resource and/or event do you consider to be the most beneficial in keeping you up to date on NHSC activities/events? (Select one)

    1. NHSC website

    2. NHSC online newsletters

    3. Fact sheets related to NHSC programs and services

    4. NHSC Facebook page

    5. NHSC Twitter account

    6. Customer Service Portal

    7. Other [CAPTURE RESPONSE]


  1. In the past 12 months, which resource and/or event do you consider to be the most beneficial in keeping you up to date on programmatic requirements? Examples of programmatic requirements include completing in-service and employment verifications. (Select one)

    1. NHSC website

    2. NHSC online newsletters

    3. NHSC Site Reference Guide

    4. NHSC Facebook page

    5. NHSC Twitter account

    6. Customer Service Portal

    7. NHSC educational videos

    8. Educational webinars hosted by the NHSC

    9. Technical assistance conference calls hosted by the NHSC

    10. Fact sheets related to NHSC programs and services

    11. E-mails from the Customer Service Portal

    12. Other [CAPTURE RESPONSE]


  1. Was there any other information to support transition to the NHSC program that the NHSC could have provided to your site when it received NHSC approval?

    1. Yes [CAPTURE RESPONSE]

    2. No

    3. I did not work at my site when it received NHSC-approval.


Regional Offices


  1. The NHSC Regional Offices are responsible for offering sites NHSC program-specific assistance; supporting sites with clinician recruitment and retention; and promoting the development of networks, partnerships and collaborations. Are you aware there are NHSC Regional Offices available to provide support to NHSC-approved sites?

    1. Yes

    2. No


  1. Are you aware the NHSC conducts site visits to NHSC-approved sites?

    1. Yes

    2. No


  1. [QRegions_2=Yes] Has your site ever received a site visit from the NHSC Regional Office?

    1. Yes

    2. No

    3. Don’t know


  1. [QRegions_1=Yes OR QRegions_2=Yes] Have you interacted with the NHSC Regional Offices in the past 12 months?

    1. Yes

    2. No


  1. [QRegions_4=Yes] Using a scale from 1 to 10, where 1 means Poor and 10 means Excellent, please rate the level of support provided by the NHSC Regional Offices.

    1. General information

    2. Program requirements

    3. Update contact information

    4. Site visit


  1. [QRegions_1=Yes OR QRegions_2=Yes] What other types of support would you like the NHSC Regional Offices to provide? [CAPTURE RESPONSE]


ACSI Benchmark Questions


  1. Please consider all of the experiences you have had with the NHSC program as an approved site. Using a 10-point scale on which 1 means Very Dissatisfied and 10 means Very Satisfied, how satisfied are you with the NHSC program? [CAPTURE RESPONSE]


  1. Using a 10-point scale on which 1 means Falls Short of Your Expectations and 10 means Exceeds Your Expectations, to what extent has the NHSC program fallen short of or exceeded your expectations? [CAPTURE RESPONSE]


  1. Imagine an ideal scholarship and loan repayment program. How well do you think the NHSC compares with that ideal program? Please use a 10-point scale on which 1 means Not Very Close to Ideal, and 10 means Very Close to Ideal. [CAPTURE RESPONSE]

Outcome Measures


  1. On a scale from 1 to 10 where 1 means Completely Disagree and 10 means Completely Agree, to what extent do you agree that the National Health Service Corps is delivering a meaningful experience to its members? [CAPTURE RESPONSE]


  1. On a scale from 1 to 10 where 1 means Completely Disagree and 10 means Completely Agree, to what extent do you agree that you have made a difference in connecting dedicated primary care providers with communities in need by promoting the NHSC? [CAPTURE RESPONSE]


  1. On a scale from 1 to 10 where 1 means Not at All Likely and 10 means Very Likely, how likely are you to continue promoting NHSC as a partner? [CAPTURE RESPONSE]


  1. On a scale from 1 to 10 where 1 means Not at All Likely and 10 means Very Likely, how likely are you to recommend the National Health Service Corps to someone else? [CAPTURE RESPONSE]


NHSC Recruitment Tools


  1. The Health Workforce Connector (formerly NHSC Jobs Center) is an interactive online resource, launched in 2012, that allows sites to list job opportunities and promote their organization to clinicians seeking employment. Have you heard of the Health Workforce Connector (formerly NHSC Jobs Center) ?

    1. Yes

    2. No [SKIP TO QJobs_20 – VJF SECTION]


  1. Has your site used the Health Workforce Connector (formerly NHSC Jobs Center) in the past 12 months to create or update your site profile?

    1. Yes

    2. No

    3. Don’t know


  1. [IF QProfile_2=NO] Why has your site not used the Health Workforce Connector (formerly NHSC Jobs Center) to create or update your site profile? [CAPTURE RESPONSE]


  1. Has your site used the Health Workforce Connector (formerly NHSC Jobs Center) in the past 12 months to post job vacancies at your site?

    1. Yes

    2. No

    3. Don’t know


  1. [IF QJobs_4=NO] Why has your site not used the Health Workforce Connector (formerly NHSC Jobs Center) to recruit? [CAPTURE RESPONSE]


  1. Have you been contacted by providers based on your job vacancies listed in Health Workforce Connector (formerly NHSC Jobs Center) ?

    1. Yes

    2. No


  1. [IF QJobs_6=YES] Of the providers who contacted you, how many did you interview?

    1. 1

    2. 2-3

    3. 4-6

    4. More than 6

    5. None

    6. I don’t know


  1. [IF QJobs_7=1, 2, 3 or 4] Of the providers whom you interviewed, how many did you successfully recruit based on your NHSC Site Profile?

    1. 1

    2. 2-3

    3. 4-6

    4. More than 6

    5. None

    6. I don’t know


  1. Has your site used other online recruitment sites in the past 12 months?

    1. Yes

    2. No [SKIP to QJobs_13]

    3. Don’t know [SKIP to QJobs_13]


  1. What other online sites has your site used in the past 12 months to recruit clinicians for your site? [CAPTURE NO MORE THAN 5 RESPONSES]


CFI: For EACH response provided to QJobs_10, ask QJobs_11 and QJobs_12:


  1. Did your site pay a fee for using [ENTER RESPONSE FROM QJobs_10]?

    1. Yes

    2. No

    3. Don’t know


  1. Were you able to recruit a clinician for your site using [ENTER RESPONSE FROM QJobs_10]?

1. Yes

2. No


  1. [ONLY IF QJob_1=Yes] How could the Health Workforce Connector (formerly NHSC Jobs Center) be more useful in helping your site recruit and post employment opportunities? [CAPTURE RESPONSE]


[ONLY IF QJob_2=Yes] Please think about your overall experience while visiting the Health Workforce Connector (formerly NHSC Jobs Center) in the past 12 months. Using a scale from 1 to 10, where 1 means Poor and 10 means Excellent, please rate:

  1. Ease of navigation

  2. Ease of creating and updating site profile

  3. Ease of posting job vacancies

  4. Accuracy of site information

  5. Quantity of applicants/responses for posted positions

  6. Ease of onboarding selected candidates


  1. NHSC Virtual Job Fairs are on-line versions of traditional job fairs that connect qualified job-seekers with NHSC-approved sites with open job opportunities. Has your site participated in an NHSC Virtual Jobs Fair within the last 12 months? (Select all that apply)


    1. July 19, 2016

    2. October 18, 2016

    3. November 17, 2016

    4. March 21, 2017

    5. May 9, 2017

    6. July 18, 2017

    7. August 1, 2017

    8. No [SKIP TO QJobs_24]

    9. Don’t know [SKIP TO NEXT SECTION]


CFI: For EACH response to QJobs_20 (1-4) ask QJobs_21 and QJobs_22:


  1. Were you contacted by any providers regarding your job vacancy following your site’s participation in the [QJobs_20 DATE RESPONSE] Virtual Job Fair?

    1. Yes

    2. No


  1. Of the providers who contacted you following your participation in the Virtual Job Fair, how many did you interview?

    1. 1

    2. 2-3

    3. 4-6

    4. More than 6

    5. None

    6. Not sure


  1. [IF QJobs_22= 1-4] Of the providers whom you interviewed, how many did you successfully recruit based on participation in the [QJobs_20 DATE RESPONSE] Virtual Job Fair?

    1. 1

    2. 2-3

    3. 4-6

    4. 6 or more

    5. None

    6. Not sure


  1. How could the NHSC Virtual Job Fairs improve and assist with your site’s recruitment efforts? [CAPTURE RESPONSE]


  1. [If QJobs_20=NO] Why have you not participated in an NHSC Virtual Job Fair in the last 12 months?

    1. Wasn’t aware of NHSC Virtual Job Fairs

    2. Scheduling conflicts

    3. No available job opportunities to promote

    4. Using other recruitment sites/tools

    5. Did not qualify to participate

    6. Other [CAPTURE RESPONSE]


Recruitment and Retention


The following questions are intended to help us assess the needs of NHSC approved sites so that we can better serve you in your recruitment and retention efforts.


CFI: RecRet_1 is the only question where the scale is 1-5; all others are 1-10. Is there a preference to use one scale over the other in survey design? We would prefer 1-5 for this question.


  1. On a scale of 1-10 where 1 means don’t use and 10 means critically important, how important are the NHSC-supported disciplines in meeting the needs of your site? [Ask question for each discipline listed below]

    1. Physician (MD, DO) (family medicine, obstetrics/gynecology, general internal medicine, geriatrics, general pediatrics, general psychiatry)

    2. Physician Assistant (adult, family, pediatrics, psychiatric/mental health, geriatrics and women’s health)

    3. Nurse Practitioner (adult, family, pediatric, psychiatric/mental health, geriatrics and women’s health)

    4. Certified Nurse Midwife

    5. Psychiatric Nurse Specialist

    6. Dentist (DDS, DMD)

    7. Dental Hygienist

    8. Health Service Clinical Psychologist

    9. Licensed Clinical Social Worker

    10. Licensed Professional Counselor

    11. Marriage and Family Therapist


  1. Of the following NHSC-supported disciplines, which are the hardest to fill? Choose and rank up to three, with 1 being the most difficult.

    1. Physician (MD, DO)

    2. Physician Assistant

    3. Nurse Practitioner

    4. Certified Nurse Midwife

    5. Psychiatric Nurse Specialist

    6. Dentist (DDS, DMD)

    7. Dental Hygienist

    8. Health Service Clinical Psychologist

    9. Licensed Clinical Social Worker

    10. Licensed Professional Counselor

    11. Marriage and Family Therapist



  1. [For EACH discipline selected in RecRet_2] On average, how long does it take your site to recruit for a [RecRet_2 DISCIPLINE RESPONSE]?

    1. 1-3 months

    2. 3-6 months

    3. 6 months to 1 year

    4. 1-2 years

    5. More than 2 years


  1. Does your site have a recruitment plan?

    1. Yes

    2. No

    3. I don’t know


  1. [If RecRet_4=No] What resources does your site need in order to create a recruitment plan? [CAPTURE RESPONSE]


  1. [If RecRet_4=Yes] Does your site use its recruitment plan?

    1. Yes

    2. No

    3. I don’t know


  1. [If RecRet_6=No] What resources does your site need in order to use its recruitment plan? [CAPTURE RESPONSE]


  1. [For EACH discipline selected in RecRet_1] Does your site offer clinical training opportunities for [RecRet_1 DISCIPLINE RESPONSE] students?

    1. Yes

    2. No

    3. I don’t know


  1. [If RecRet_8=No] What has prevented you from offering training: Check all that apply ?


  1. Financing/return on investment

  2. Administration and coordination of the program

  3. Training preceptors and faculty

  4. Partnerships with academic institutions

  5. Logistics – space, clinic schedules, time, etc.

  6. Other (please specify)


  1. [For EACH discipline selected in RecRet_1] Does your site offer clinical training opportunities for recent [RecRet_1 DISCIPLINE RESPONSE] graduates (e.g., residents)?

    1. Yes

    2. No

    3. I don’t know


  1. [If RecRet_6=No] What resources does your site need to be able to accommodate for [RecRet_1 DISCIPLINE RESPONSE] graduate trainees?

[CAPTURE RESPONSE]


  1. Does your site have a retention plan?

    1. Yes

    2. No

    3. I don’t know


  1. [If RecRet_8=No] What resources does your site need in order to create a retention plan? [CAPTURE RESPONSE]


  1. [If RecRet_8=Yes] Does your site use its retention plan?

    1. Yes

    2. No

    3. I don’t know


  1. [If RecRet_10=No] What resources does your site need in order to use its retention plan? [CAPTURE RESPONSE]




  1. How long do you expect clinicians to remain working at your service site after they have completed their NHSC service obligation?

    1. I do not expect them to remain after their obligation is complete

    2. 1-3 months

    3. 3-6 months

    4. 6 months to 1 year

    5. 1-2 years

    6. 2-5 years

    7. More than 5 years


  1. What do you think the challenges are in retaining NHSC clinicians at your site past the completion of their service obligation? Please rank responses from 1 being most challenging to 10 being least challenging.

    1. Noncompetitive salary

    2. Opportunities for advancement

    3. Opportunities for distance learning

    4. Site operation/employer

    5. Academic opportunities

    6. Community and/or lifestyle

    7. Work/life balance

    8. Family considerations

    9. Retirement

    10. Flexibility

    11. Benefits

    12. Other [CAPTURE RESPONSE]


  1. How are you working to retain NHSC clinicians at your site? Select all that apply

    1. Offering salary above the local average salary for similar positions

    2. Offering additional fringe benefits

    3. Providing a flexible work environment

    4. Paying for continuing education

    5. Providing malpractice coverage

    6. Providing a pension plan

    7. Including NHSC clinician in key practice decisions

    8. Offering NHSC clinician leadership roles at the site

    9. Including NHSC clinician in the development of site policies and procedures Offering performance based compensation

    10. Implementing new care delivery and payment models, such as the Patient Centered Medical Home

    11. Streamlining workflows and processes to make practice more efficient

    12. Offering academic linkages that include teaching and/or research responsibilities

    13. Improving site leadership skills

    14. Providing career guidance and skill development

    15. Other [CAPTURE RESPONSE]


  1. What resources does your site have to support the development of your workforce? [CAPTURE RESPONSE]


  1. What workforce development resources do you need from the NHSC program that you are not currently receiving? [CAPTURE RESPONSE]


  1. In order to help retain NHSC clinicians at your site past the completion of their service obligation, what types of support do you need from the NHSC program that you are not currently receiving? [CAPTURE RESPONSE]


  1. Telemedicine is the exchange of clinical information from one location to another through electronic audiovisual media to improve patients' health status. The exchange may either be between providers or between provider and patient. Does your site provide or participate in any of the following clinical telemedicine services? (Check all that apply)

    1. My site does not provide/participate in clinical telemedicine services (SKIP to RecRet_21]

    2. Health care services to patients at other locations

    3. Consults with offsite providers with patients present

    4. Consults with offsite providers without patients present

    5. Receiving information from home monitoring equipment

    6. Mobile health communication via mobile devices such as cell phones and PDAs

    7. Not sure

    8. Other [Capture response]

  2. [If RecRet_22=2] On average, what percentage of clinical service time do clinicians at your site spend providing health care services to patients at other locations?

    1. 10%

    2. 20%

    3. 25%

    4. 50%

    5. 75%

    6. 100%

    7. Don’t know


  1. For which type of clinical consultation service(s) does your site use telemedicine? (Check all that apply)

    1. Behavioral health (mental health or substance abuse)

    2. Dental

    3. Dermatology

    4. Diabetic retinopathy

    5. Endocrinology

    6. High risk obstetrics

    7. HIV or AIDS related

    8. Viral hepatitis

    9. Pain management

    10. Neurology

    11. Primary care backup to School-based Health Clinic(s)

    12. Primary care backup to HIV/AIDS Clinic(s)

    13. Primary care backup to Homeless Clinic(s)

    14. Primary care backup to Public Housing Clinic(s)

    15. Primary care backup to remote or rural health clinic(s)

    16. Primary care backup to Free Clinic(s)

    17. Primary care backup to Family Planning Clinic(s)

    18. Primary care backup to Home Health Care program(s)

    19. Psychiatry

    20. Radiology

    21. Trauma/Emergency services

    22. Not sure

    23. Other [Capture response]


  1. Telehealth is the delivery of health-related services and information via telecommunications technologies, and is often used to encompass a broader range of health care beyond direct clinical services. Does your site provide or participate in any of the following telehealth services? (Check all that apply)

    1. My site does not provide/participate in telehealth services

    2. Chronic disease management

    3. Nursing call center

    4. Continuing professional education

    5. Grand rounds

    6. Other distance learning

    7. Clinical or administrative staff meetings

    8. In-service training sessions for staff

    9. Not sure

    10. Other [CAPTURE RESPONSE]


  1. [If RecRet_19=1 OR RecRet_21=1] Does your site foresee integrating telemedicine and/or telehealth services into your care delivery model in the near future (1-2 years)?

    1. Yes

    2. No

    3. Don’t know


  1. [If RecRet_19=1 OR RecRet_21=1] What does your site see as barriers to implementing telemedicine and/or telehealth services? (Check all that apply)

    1. Availability of certified specialists

    2. Reimbursement of for telemedicine services

    3. Equipment costs

    4. Training staff

    5. Low demand or utilization

    6. Connectivity / bandwidth availability

    7. Connectivity/ bandwidth costs

    8. Workflow

    9. EHR barriers

    10. Licensure/certification barriers

    11. Not sure

    12. Other [CAPTURE RESPONSE]


  1. Outside of the NHSC-approved disciplines that are already offered, which of the following clinicians would your site like to recruit using the NHSC Loan Repayment Program as a tool? Select 5 in rank order.

    1. Chiropractors

    2. Clinical Laboratory Technologists

    3. Diabetes Health Educators

    4. Dieticians/Nutritionists

    5. General Surgeons

    6. General Practitioner Physicians

    7. Occupational Therapists

    8. Optometrists

    9. Pharmacists

    10. Pharmacy Technicians

    11. Physical Therapists

    12. Podiatrists

    13. Preventive Medicine Physicians

    14. Radiologic Technologists and Technicians

    15. Registered Nurses

    16. Respiratory Therapists

    17. Speech Language Pathologists

    18. Substance Abuse Counselors


  1. Among the following disciplines (NHSC-approved and non-NHSC-approved), which five (5) disciplines does your site require to operate most effectively? Please rank the top 5 disciplines.

    1. Certified Nurse Midwife

    2. Chiropractors

    3. Clinical Laboratory Technologists

    4. Dental Hygienist

    5. Dentist (DDS, DMD)

    6. Diabetes Health Educators

    7. Dieticians/Nutritionists

    8. General Practitioner Physicians

    9. General Surgeons

    10. Health Service Clinical Psychologist

    11. Licensed Clinical Social Worker

    12. Licensed Professional Counselor

    13. Marriage and Family Therapist

    14. Nurse Practitioner

    15. Occupational Therapists

    16. Optometrists

    17. Pharmacists

    18. Pharmacy Technicians

    19. Physical Therapists

    20. Physician (MD, DO)

    21. Physician Assistant

    22. Podiatrists

    23. Preventive Medicine Physicians

    24. Psychiatric Nurse Specialist

    25. Radiologic Technologists and Technicians

    26. Registered Nurses

    27. Respiratory Therapists

    28. Speech Language Pathologists

    29. Substance Abuse Counselors

    30. Nurse Anesthetist

    31. School psychologist

    32. Nephrologists

    33. Naturopaths

    34. Advanced dental hygiene practitioners

    35. Emergency medicine



Demographics about Site’s Patient Population

  1. [If INTRO6=No (Single Site)] Please list the zip-code of your site.


  1. [If INTRO6=Yes (Network)] Please select the region where the majority of your sites are located from the list below.

    1. Region 1: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont

    2. Region 2: New Jersey, New York, Puerto Rico, and the Virgin Islands

    3. Region 3: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia

    4. Region 4: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee

    5. Region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin

    6. Region 6: Arkansas, Louisiana, New Mexico, Oklahoma, and Texas

    7. Region 7: Iowa, Kansas, Missouri, and Nebraska

    8. Region 8: Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming

    9. Region 9: Arizona, California, Hawaii, Nevada, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands, and Republic of Palau

    10. Region 10: Alaska, Idaho, Oregon, and Washington


  1. What language(s), other than English, does your patient population speak? Select all that apply.

    1. Spanish

    2. French

    3. German

    4. Chinese/Mandarin

    5. Hindi

    6. Arabic

    7. Portuguese

    8. Vietnamese

    9. Russian

    10. Other [CAPTURE RESPONSE]


  1. [If INTRO6=No (Single Site)] How many patients does your site see annually?

    1. 1-2,500 patients

    2. 2,501-5,000 patients

    3. 5,001-7,500 patients

    4. 7,501-10,000 patients

    5. Over 10,000 patients


  1. [If INTRO6=Yes (Network)] How many patients does your network see annually?

    1. Under 20,000 patients

    2. 20,001-50,000

    3. 50,001-100,000

    4. 100,001-150,000

    5. Over 150,000 patients


  1. From which of the following racial and ethnic groups is your patient population? Select all that apply.

    1. Asian

    2. Native Hawaiian and Other Pacific Islander

    3. Black/African American

    4. American Indian/Alaska Native

    5. White

    6. Hispanic/Latino

    7. Other [CAPTURE RESPONSE]

    8. I prefer not to say

    9. I don’t know


  1. Please rank up to five of the following insurance sources in terms of their frequency of use among your patient population, with 1 being the most frequent.

    1. None/Uninsured

    2. Medicaid

    3. CHIP Medicaid

    4. Medicare

    5. Private Insurance

    6. Other [CAPTURE RESPONSE]

    7. I prefer not to say

    8. I don’t know


  1. Which special populations does your site serve? Select all that apply.

    1. Migrant/seasonal

    2. Homeless (including shelter, transitional, doubling up, street)

    3. School-based

    4. Veterans

    5. LGBT

    6. Other [CAPTURE RESPONSE]

    7. I prefer not to say

    8. I don’t know



Thank you for your time. The National Health Service Corps greatly appreciates your input!

____________________________________________________________________________________________

1/22/21 Questionnaire – Page 44

Group 1 = Single Site ; Group 2 = Network

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleHRSA OPR
AuthorHeather Reed/Sheri Teodoru
File Modified0000-00-00
File Created2021-01-22

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