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Community Medicine Demographic Survey
1.
What type of organization do you represent?
Private EMS
Fire-Based EMS
Third City Service
Utility Model
Other
2.
Does your organization have a Community Medicine Program?
Yes
No
In the process of starting one
3.
How long has your Community Medicine Program been active?
0-3 years
3-6 years
6 years or greater
Program is no longer active
Program is still in planning stage
4.
What demographic is your Community Medicine Program targeting?
Hospital readmission reduction (i.e.CHF or COPD patients)
High frequency 911 users
Pediatric asthma
Hospice Revocation Avoidance
Mental Health
Nurse Triage
Other
If you answered other please explain.
5.
What is the mission of your organizations Community Medicine Program?
Our Community Medicine Program does not currently have a mission statement.
Please provide mission statement if possible.
6.
How many full-time personnel are currently assigned to your Community Medicine Program?
0
1-5
5-10
Greater than 10
7.
How is your Community Medicine Program funded?
City/County
State
Federal
Hospitals
Private Insurance
Community Grants
Other Funding Source
8.
Who outside your organization has partnered with you in community medicine?
We have no external partners at this time.
Other Governmental Entities
Community Organizations
Charitable Organizations
Faith Based Organizations
Healthcare Organizations
Other Type of Organization
9.
Who evaluates your Community Medicine Program to determine if it has achieved its mission?
Chief or Director
External Partners
City or County Administrators
Steering Committee
No oversight at this time
10.
Who would be affected the most if your Community Medicine Program was discontinued?
Program is currently in the planning stage
Most affected group