Community Health Needs Assessment 2018

Redwood Coast Medical Services (RCMS) and Mendonoma Health Alliance (MHA), a partnership with RCMS, Coast Life Support District (CLSD), and Santa Rosa Memorial Hospital are conducting this Community Health Needs Assessment (CHNA) to better understand the health concerns and needs in our community. Your participation in this survey will help RCMS, MHA, and other health organizations create action plans to improve the delivery of healthcare in our community.

This survey should take 5-10 minutes to complete.

Results of the survey will be available on www.rcms-healthcare.org and www.mendonomahealth.org February 2019.

GENERAL INFORMATION

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* 1. Where do you receive your routine healthcare? (check all that apply)

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* 2. Where do you receive your dental care?

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* 3. In the past year, which of the following local services have you or your dependents used? (check all that apply)

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* 4. In the past year, which of the following transportation services have you or your dependents used? (check all that apply)

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* 5. Please check any of the free local health classes that you use or have used:

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* 6. In the past year, how often have you or your dependents used Urgent Care services at RCMS?

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* 7. Where do you go for hospital/emergency care?

ACCESS TO HEALTHCARE

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* 8. Do any of the following prevent you from accessing local healthcare? (check all that apply)

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* 9. What local medical services would improve the health of you or your dependents? (check all that apply)

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* 10. Please indicate your top three health interests:

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* 11. If available locally, which of the following specialty dental options would you and/or your dependents use? (check all that apply)

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* 12. If you would not use dental specialty care, even if offered locally, please indicate why.

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* 13. If available locally at RCMS, which of the following specialty healthcare options would you and/or your dependents use? (check all that apply)

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* 14. If you would not use specialty care, even if offered locally, please indicate why.

DIABETES

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* 15. Do you or someone in your household have diabetes?

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* 16. Do you regularly monitor your blood sugar with a home screening device?

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* 17. Do you have regular check-ups with your provider?

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* 18. Do you receive treatment from RCMS for your diabetes?

HIGH CHOLESTEROL

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* 19. Do you or someone in your household have high cholesterol?

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* 20. Do you regularly monitor you high cholesterol with a home screening device?

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* 21. Do you have regular check-ups with your provider?

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* 22. Do you receive treatment from RCMS for your high cholesterol?

HYPERTENSION

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* 23. Do you, or someone in your household have hypertension?

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* 24. Do you regularly monitor you hypertension with a home screening device?

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* 25. Do you receive treatment from RCMS for your hypertension?

HEART DISEASE

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* 26. Do you, or someone in your household have heart disease?

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* 27. Do you regularly monitor your heart disease with a home screening device?

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* 28. Do you have regular check-ups with your provider?

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* 29. Do you receive treatment from RCMS for your Heart disease?

BEHAVIORAL HEALTH

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* 30. Are you aware that RCMS has a Behavioral Health program including a psychologist and a psychiatrist?

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* 31. Did you know that RCMS’ Behavioral Health program provides psychotherapy, psychiatric medication therapy, psychological testing, community education classes, a grief group, and a caregiver support group?

ABOUT YOU

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* 32. What is your age?

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* 33. What is your gender?

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* 34. What is the highest grade or level of education that you have completed?

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* 35. What is your primary language?

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* 36. What is your ethnicity?

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* 37. I live in this community…

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* 38. I reside in:

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* 39. What is your housing status?

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* 40. What is your family size (include all household Members supported by earners)?

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* 41. What is your household yearly income?

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* 42. What type of insurance do you have? (check all that apply)

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* 43. In what format would you like to learn about health?

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* 44. Please select the health challenges you face. (check all that apply)

Thank you for completing this survey!

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