Continuum of Care Survey

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Continuum of Care Survey

Organization name, contact person, and contact information?

Type of role in your organization? (Check all that apply)

Which of the following applies to your organization? (Check all that apply)

Which sector best describes your work? (Check all that apply)

What are the services your organization provides?

Of the services listed above, how many individuals can be served for each service you provide?

If your organization provides education and awareness services, what is your reach?

What describes your organization’s level of care? (Check all that apply)

What ages does your organization serve? (Check all that apply)

Do you serve beyond Orleans Parish?

If you do serve beyond Orleans Parish, which areas do you serve?

If you only serve Orleans Parish, what are the boundaries of your geographical service coverage?

Does your organization accept private insurance?

Does your organization accept Medicaid?

Does your organization accept LaCHIP?

Does your organization offer a sliding fee scale for uninsured clients?

Can uninsured clients still access your organization's services?

Do you offer services for languages other than English? If yes, which languages? (Including ASL)

Are you currently accepting new clients?

If not, do you operate with a waitlist? If so, how long is your waitlist and how do you prioritize new clients?

Are there any criteria and/or restrictions to services?

Is your organization easily accessible using public transportation?

Do you have one location or multiple services location?

Please list your service locations.

During COVID-19, are your services being done in-person, via telehealth, or both?

What is your expectation for telehealth practices going forward? (Including beyond COVID-19)

Beyond funding, what other resources would help your organization better serve the community?

Please tell us about any additional information pertaining to your organization you’d like to share.

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