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SOKS Healthcare Needs Survey
Hello athletes! Special Olympics Kansas has taken the initiative to make sure that our athletes have access to ongoing, quality healthcare. In our efforts, we need your help! Please fill out the following survey to help us determine where athletes may fall through the cracks. Your response will help athletes live a longer and healthier life!
PLEASE NOTE: There are no right or wrong answers. Every answer given is a step forward!
Please don't answer any of the questions that you do not feel comfortable answering. There are no required questions. Each answer that you have provided is done by your consent. This survey's results will not be made public but will be used by SOKS staff to provide a direction for our next steps to ensure quality healthcare for our athletes.
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General Demographic Information
Please fill out the following questions to the best of your ability.
What is your Age range?
10 - 17
18-25
26 - 40
41 - 50
51 - 60
61 - 70
71 - 80
81 - 90
Clear selection
Which SOKS Region are you from? (
https://ksso.org/ksregions
)
Metro Region
North Central Region
Southeast Region
South Central Region
West Region
Not Sure
Clear selection
Who is filling out this Survey?
I am, the athlete
My caregiver is helping me
My parent is helping me
My staff is helping me
Other:
General Information
Please answer these 4 general questions to the best of your ability.
What is your experience going through the healthcare system?
Your answer
What are some challenges that you and/or other athletes face in healthcare?
Your answer
Can healthcare providers do anything to make Kansas athletes feel more comfortable when they go to an appointment?
Your answer
What can a healthcare provider know about athletes to improve their treatment plans?
Your answer
Healthcare Access
Please answer the following questions based on which type of insurance or waiver that you have.
Please check any/all of the insurances or waivers that you have.
Commercial Insurance (Through Work or a Parent)
Medicaid or KanCare without a waiver
KanCare Home and Community Based Services (HCBS) Waiver
KanCare 1115 Waiver
CHIP
Medicare Part A
Medicare Part B
Medicare Part C
Medicare Part D
No Insurance (Uninsured)
Other:
Which service(s) do you use most frequently?
Dental
Vision
Audiology (Ear)
Mental Health
Primary Care
Physical Therapy
Preventative Care
Emergency Department
Other:
Preparing for a Healthcare Visit
In preparation for your healthcare visit, please answer the following questions to the best of your ability.
Do you have any chronic healthcare conditions? If so, please explain. (Anything that persists for more than 3 months. Example: Diabetes, High Blood Pressure, Asthma, High Cholesterol, etc.)
Your answer
How do you schedule an appointment with any healthcare provider?
Through my Caregiver
Through a Parent
Myself
Through my Organization
Through my Coach
Routine Appointments come to Me
Other:
How do you go to any appointment? (Please check all that apply)
I drive myself
My Parent drives me there
My Caregiver drives me there
A Healthcare Professional drives to me
Telehealth (I see my doctor or related on the computer)
Transportation is a barrier to me and I can't get there
Other:
Are you limited to a certain amount of appointments per year? (Example: I can only see my healthcare provider 20 times/year before insurance stops covering my visits.) If yes, please explain.
Your answer
At the Appointment
During your healthcare visit, please answer these questions to the best of your ability.
When you go to a physician's office for primary care, how often do you see a Nurse Practitioner (APRN) or a Physician Assistant (PA)?
Every Time
75% or Most of the time
About Half the Time
25% or Less of the time
Never
Clear selection
Is there a language barrier between you and any of your healthcare providers?
Yes
No
Other:
Clear selection
Does the healthcare provider use difficult words to understand or does the healthcare provider use easy words to understand?
Your answer
How often do you go to the Emergency Room or Emergency Department? If so, why?
Your answer
After the Appointment
After your healthcare visit, please answer these questions to the best of your ability.
Medications are expensive for me...
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
Other:
Clear selection
I take my medications as prescribed without ever missing a dose...
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Other:
Clear selection
The healthcare provider helped me understand how the medication works and why I should take it...
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Other:
Clear selection
Medicaid/KanCare
Please ONLY fill out this section if you are on KanCare or Medicaid.
What is one thing that you like about Medicaid and what is one thing that Medicaid could improve on?
Your answer
Which Medicaid Payor do you have?
UnitedHealthcare
Sunflower
Aetna
Clear selection
Does Medicaid cover your dental care?
Yes
No
Clear selection
If Medicaid covers your dental care, what services do they cover?
Your answer
Are you in a Medicaid Managed Care Program?
Yes
No
Clear selection
How often do you go to the Emergency Room or Emergency Department? If so, why?
Your answer
On a scale of 1-10 (1 being easy and 10 being hard), is it easy or hard to find a Primary Care Provider?
Easiest
1
2
3
4
5
6
7
8
9
10
Hardest
Clear selection
On a scale of 1-10 (1 being easy and 10 being hard), is it easy or hard to find a Specialist?
Easiest
1
2
3
4
5
6
7
8
9
10
Hardest
Clear selection
Last Question!!
Please share any other thoughts that you have about Healthcare in Kansas.
Please share any other thoughts, experiences, or improvements that you'd like to see in Kansas Healthcare. (Are you content with your services? Could some types of Healthcare Services be improved or made better for you? If you could have one thing today to make your health better, what would it be?)
Your answer
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