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Survey of Community Health Centers in AK, BC, ID, OR, WA

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This survey is being rolled out to assist in identifying possible opportunities for knowledge-exchange, collaboration and partnership among Community Health Centers throughout Alaska, British Columbia, Idaho, Oregon and Washington State (collectively known as "Cascadia"). A similar survey is also being conducted simultaneously for CHCs in the central/east region of North America. These surveys are an initial support tool to inform discussion and networking. They are not for evaluation or any reporting purposes.

The information gathered from the surveys will help inform discussions at the 2018 Canada - U.S. Community Health Centres Summit in Victoria, BC from September 26-28, 2018 http://www.ifchc.org/victoriasummit2018 and ongoing engagement related to collaboration between CHCs and associations across borders in Cascadia.

The survey takes approximately 15 minutes to complete. We ask for only one response per Community Health Centre.
Deadline for response is September 10, 2018.
THANK YOU FOR YOUR TIME AND PARTICIPATION!
Please first tell us a little bit about who is completing the survey (i.e. you). This information is being collected in order to make sure we are able to follow up in case any survey responses require clarification, and also to share aggregate survey findings with all participants.
1.Name of person completing the survey(Required.)
2.Title(Required.)
3.Email(Required.)
4.Full name of your Community Health Centre(Required.)
5.City/Town (in event of multiple sites please list your administrative location)(Required.)
6.Province/State(Required.)
7.Which of the following describes the location(s) in which your CHC delivers services and program? Please select all that apply.(Required.)
8.How many sites / points of service are operated by your CHC (across all services and programs)?(Required.)
9.Does your Community Health Centre provide services to clients/patients within a defined geographical service area? Please select the answer that BEST reflects your CHC's circumstances.(Required.)
10.For which of the population groups listed below do you have targeted/focused services and programs? We recognize that there is overlap among many groups below. Please check off all that you feel apply. In the next question (#11) you may tell us more about any specific population groups for whom you have particular interest in sharing experiences and collaborating with other CHCs.

(Required.)
11.Are there specific population groups you serve for whom you have particular interests in exchanging experiences and collaborating with other CHCs in order to better serve those populations (eg, migrant farm workers from Central America, people in rural communities who inject drugs, et al).
12.Does your CHC provide services and programs in languages other than English? If so, please list the top five other languages in which these services and programs are provided. Answer to the best of your ability.
13.In which of the following areas does your CHC provide direct services and/or programs? Please check all that apply. You may indicate up to five (5) “other” responses in the following question.(Required.)
14.If you offer other types of services and programs not reflected above or if you feel options provided do not adequately reflect some of your key services/programs, you may enter them here. You may list up to five (5).
15.The opioid crisis has been identified by the governments of BC, CA, OR and WA as a priority for joint Can-Am collaboration within the "Pacific Coast Collaborative" political agreement. We would like to get a brief sense of how the opioid crisis is affecting communities served by CHCs throughout "Cascadia". Please select all of the options below that reflect observations and experiences at your CHC. You may also add additional observations using the "Other" option.(Required.)
16.Which of the following are currently provided/operated by your Community Health Centre as part of your effort to address the opioid crisis. An "Other" option is also provided.(Required.)
17.Does your Community Health Centre have particular services or programs that you believe demonstrate innovation or excellence, and that other CHCs might want to learn more about?
18.What areas of service/programming has your CHC identified as important for future development or expansion? If other CHCs are already operating in these areas and have experiences to share, what kind of things would you want to learn about?
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