1. Default Section

The Virginia Department of Social Services has asked for assistance from FACES in gathering information about the health care experiences of foster families on behalf of the youth in their care. Information gathered from this survey will be used to improve health care services for children and youth in foster care. All information gathered will be kept confidential and reported out only in summary form from all responses. We estimate that the survey should take about 10-15 minutes of your time. Thank you for taking the time to complete this important survey!

Please answer the questions based on the most recent child/youth placed in your home as a foster care placement.

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* 1. How old is the child, currently?

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* 2. What is the child's race or ethnicity?

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* 3. How long has this child been in your home?

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* 4. For this child, please indicate your current relationship with the child.

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* 5. Please indicate which of the following services the child in your home has received in the past year. Mark all that apply.

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* 6. Does the child have a regular doctor you use for routine appts. or call for information on medical issues?

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* 7. Where have you taken this child for routine medical services? Mark all that apply.

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* 8. How have you arranged for routine medical services for this child?

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* 9. How have you arranged for specialized medical care?

The next several questions ask about your overall experiences with medical care for this child in your care.

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* 10. Getting medical information or medical history for this child is/was...

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* 11. Getting an active Medicaid card for this child is/was...

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* 12. Finding a doctor for routine medical care during the past year who accepts Medicaid...

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* 13. Finding a dentist who accepts Medicaid during the past year is/was...

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* 14. Finding a specialty medical provider who accepts Medicaid during the past year is/was...

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* 15. Are there any medical services that the child needs that you had trouble getting during the past year for this child?

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* 16. If you answered "yes" to the question above, please identify all reasons for the difficulty is securing needed services.

The next questions ask specifically about your experiences with behavioral, mental health, and/or substance abuse services for this child.

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* 17. Please identify which of the following services needs were experienced by this child in the past year.

If you did not identify any services in the above question, please go directly to question 22.

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* 18. Where did the child receive the identified behavioral, mental health, and substance abuse services identified in question 15? Mark all that apply.

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* 19. How have you arranged for behavioral, mental health, or substance abuse services for this child?

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* 20. Getting behavioral, mental health or substance abuse history for this child is/was...

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* 21. Finding a behavioral, mental health, or substance abuse provider who accepts Medicaid during the past year is/was...

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* 22. Are there any behavioral, mental health or substance abuse services that this child needs and you had difficulty securing in the past year?

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* 23. If you answered "yes" to the above question, please identify all reasons for the difficulty in securing the services.

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* 24. Please share any comments about your experiences securing medical or other health services for this child.

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* 25. Please provide us with an indication of your locality and a method for contacting you, if we make contact you for follow-up.

Thank you for your time in completing this survey. You will be able to check the FACES website (www.facesofvirginia.org) to learn about the survey results and the state's plans for improving access to health care for children in foster care.

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