CCHAP Survey to Support Practices without Behavioral Health Providers

CCHAP is proud to be partnering with the Rose Community Foundation on an exciting new project to assist primary care pediatric practices in enhancing the behavioral health services your practice offers. However, we need to hear from you to understand what barriers and challenges you are facing so we can be sure we are offering the support you need. This survey is not anonymous but answers will be kept confidential.

This survey is intended for practices that DO NOT offer behavioral health services. If your practice does, please contact jodi.carpinello@cchap.org.

Question Title

* 1. Please indicate your role in the practice?

Practice Manager

Medical Provider

Other (please specify)

Question Title

* 2. How would you best describe your practices comfort with managing behavioral health needs that arise with children during medical visits?

Very comfortable

Comfortable

Neutral

Somewhat uncomfortable

Very uncomfortable

Question Title

* 3. How would you best describe your practices comfort with managing behavioral health needs that arise with caregivers/parents during medical visits?

Very comfortable

Comfortable

Neutral

Somehat uncomfortable

Very uncomfrotable

Question Title

* 4. Are you interested in having a behavioral health provider in your clinic?

Yes, and would like to do this in the next year

Yes, but don't have a timeline

No, but we would like to explore if this is the right fit for our office

No, are we are not interested at this time

Other (please specify)

Question Title

* 5. What barriers do you face in having a behavioral health provider in your office? Please rank in order of Most Challenging (1) to Least Challenging (5)

Billing and Coding

N/A

Reimbursement

N/A

Credentialing

N/A

Finding qualified behavioral health provider to hire

N/A

Understanding how to utilize a behavioral health provider

N/A

Question Title

* 6. In what areas would you be interested in receiving support, training or assistance from CCHAP?

General overview of behavioral health in primary care

Training to enhance current medical or behavioral health staff's ability to meet some of the behaviroal health needs of your patients/families

Integrating a behavioral health provider into your team

Billing and Coding

We do not need additional supports in this area

Other (please specify)

Question Title

* 7. Do you provide teen depression screening?

Yes

Question Title

* 8. Do you have any of the following concerns with this screening?

Have concerns related to billing and coding

Have concerns related to documentation

Have concerns related to risk management

Have concerns about referral resources and tracking outcomes

No concerns

Question Title

* 9. Do you provide pregnancy related depression screening in your practice?

Yes

Question Title

* 10. Do you have any of the following concerns with this screening?

Have concerns related to billing and coding

Have concerns related to documentation

Have concerns related to risk management

Have concerns about referral resources and tracking outcomes

No concerns

Question Title

* 11. Do you or have you in the past, participated in the State Innovation Model (SIM)?

Yes

Question Title

* 12. We will contact practices that have indicated interest in receiving support, training or assistance from CCHAP. Feel free to contact either Bridget Burnett (bridget.burnett@cchap.org) or Mindy Craig (mindy.craig@cchap.org) with any questions or concerns.

Name

Company

Email Address

Phone Number