2026 Survey of California's Hospice and Palliative Care Resources for Children

The goal of this survey is to gather information about California's current pediatric hospice and palliative care landscape, including all hospital- and community-based resources and services that are offered to patients and their families. The data gathered will be used to update our Environmental Map. The Map is an online resource that lists the providers of services, their locations, and the kinds of resources and services they offer. The map can be found at https://chpcc.org/resources. Only the organization's name, physical address, web address, and services will be included in any future online resources created from this survey. No other personal information, such as your name, email address, phone number, or other details, will be shared or made public. Additionally, the data acquired from this survey will help to inform the coalition's future activities.

Question Title

1. Personal Information

Question Title

2. What is your job title?

Question Title

3. Organization name

Question Title

4. Organization Phone Number

Question Title

5. Organization address

Question Title

6. Organization Website

Question Title

7. Organization tax status?

Question Title

8. Under what license or licenses does your organization operate? (select all that apply)

Question Title

9. Does the organization have a dedicated pediatric care team? If NO please skip to question #12

Question Title

10. The following clinicians make up the pediatric care team at the organization (select all that apply):

Question Title

11. How many of your team are certified in pediatric palliative or hospice care in the organization? (select all that apply)

Question Title

12. Which population(s) does your organization work with? (Select all that apply) - Children are defined as newborn through age 21 for the purpose of this survey.

Question Title

13. What services does the organization provide? (Select all that apply)

Question Title

14. What type of care is offered to pediatric patients and their families by the organization (please select all that apply):

Question Title

15. What specific services does the organization provide for pediatric patients? (select all that apply):

Question Title

16. What are the organization's source(s) of reimbursement for pediatric services: (select all that apply)

Question Title

17. How many prenatal pediatric patients does the organization treat on an annual basis?

Question Title

18. How many newborns and toddlers (ages 0 to 4) does the organization treat on an annual basis?

Question Title

19. How many school-aged children (ages 5 to 12) does the organization treat on an annual basis?

Question Title

20. How many young adults (ages 13 to 21) does the organization treat on an annual basis?

Question Title

21. Which counties—the entire county or just a portion of it—does the organization serve? (Select all that apply)

Question Title

22. .Please list the Zip Codes that you service, if you do not serve the full county

Question Title

23. Would you like to add anything more about the organization?

Question Title

24. Who should we get in touch with if we need more information about the organization, its services, or programs?

Question Title

25. Other information

T