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AHWGMA 2024
Please fill out accordingly. (One submission per organization)
START
1
Let's get started - what is your
name
?
*
This field is required.
Please provide your full name.
First Name
Last Name
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2
Thank you, what is your
email
address?
*
This field is required.
Please provide your email address below.
example@example.com
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3
What
organization
do you represent/work for?
*
This field is required.
Please provide your full organization name.
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4
Organization Leadership Information:
*
This field is required.
Please provide first and last name as well as email address below.
First Name
Last Name
Email
CEO
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
COO
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
CEO
COO
First Name
Row 0, Column 0
Last Name
Row 0, Column 1
Email
Row 0, Column 2
First Name
Row 1, Column 0
Last Name
Row 1, Column 1
Email
Row 1, Column 2
1
of 2
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5
What
Counties
does your organization provide services in?
*
This field is required.
Please scroll through the list below and select all that apply:
Apache
Cochise
Coconino
Gila
Graham
Greenlee
La Paz
Maricopa
Mohave
Navajo
Pima
Pinal
Santa Cruz
Yavapai
Yuma
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6
Select all Managed Care Organizations (
MCO's)
your organization contracts with:
*
This field is required.
Please scroll through the list below and select all that apply:
American Indian Health Plan
Arizona Complete Health
Banner University Health Plans
Care1st Health Plan Arizona
Department of Child Safety / Comprehensive Health Plan (DCS/CHP)
Department of Economic Security / Division of Developmental Disabilities (DES/DDD)
Health Choice Arizona (Blue Cross® Blue Shield® of Arizona)
Mercy Care
Molina Healthcare
UnitedHealthcare Community Plan
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7
Which
line(s) of business
do you have contract(s) for?
*
This field is required.
Please scroll through the list below and select all that apply:
ALTCS EPD: Arizona Long-Term Care System Elderly and Physically Disabled
ACC: AHCCCS Complete Care
ACC-RBHA: AHCCCS Complete Care - Regional Behavioral Health Authority
DCS/CHP: Department of Child Safety/Comprehensive Health Plan
ALTCS DES/DDD: Department of Economic Security / Division of Developmental Disabilities
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8
Under your
ALTCS DES/DDD
Contract which of the following does your organization provide service(s) for?
*
This field is required.
DDD Qualified Vendor
ACC Intergrated Health Organization (Contracted with UnitedHealthcare Community Plan and/or Mercy Care)
Both
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9
Under
ALTCS EPD
contract, what service(s) does your organization provide?
*
This field is required.
Please scroll through the list below and select all that apply:
A2 Level III Behavioral HTH Residential
A3 Community Service Agency
A4 LIC Independent Substance Abuse Counselor (Lisac)
A5 Behavioral Health Therapeutic Home
A6 Rural Substance Abuse Transitional Agency
A7 Respite
B1 Residential Treatment Center-Secure (17+Beds) (IMD)
B3 Residential Treatment Center-Non-Secure (17+Beds) (IMD)
B5 Subacute Facility (1-16 Beds)
B6 Subacute Facility (17+ Beds) (IMD)
B7 Crisis Services Provider
B8 Behavioral Health Residential Facility
C1 Acupuncturist
C2 Federally Qualified Health Center (FQHC)
C3 Family Planning Services
DG Doc General Provider
DN Doc Non-Pay Provider
D1 Dentist-Endodontist
D2 Dentist-Pedodontist
D3 Dentist-Oral Surgeon
D4 Clinic - Dental Services
E1 Independent Testing Facilities
F1 Fiscal Intermediaries
G1 Exercise Physiologists
H1 DD/MR
IC Integrated Clinics
S1 Specialized Services
01 Group-Payment ID
02 Hospital
03 Pharmacy
04 Laboratory
05 Clinic
06 Emergency Transportation
07 Dentist
08 MD-Physician
09 Certified Nurse-Midwife
10 Podiatrist
11 Psychologist
12 Certified Registered Nurse Anesthetist
13 Occupational Therapist
14 Physical Therapist
15 Speech/Hearing Therapist
16 Chiropractor
17 Naturopath
18 Physicians Assistant
19 Registered Nurse Practitioner
20 Respiratory Therapist
22 Nursing Home
23 Home Health Agency
24 Personal Care Attendant
25 Group Home (DD)
26 MIPS Speech Therapist/Audiologists
27 Adult Day Health
28 Non-Emergency Transp. Providers
29 Community/Rural Health Center
30 DME Supplier
31 DO-Physician Osteopath
32 Medical Foods
33 Rehabilitation Center
34 Case Management Services
35 Hospice
36 Assisted Living Home
37 Homemaker
38 DD Day Care
39 Habilitation Provider
40 Attendant Care
41 Dialysis Clinic
43 Ambulatory Surgical Center
44 Environmental (LTC)
45 County Phase-In
46 Nurse-RN/LPN (Private)
47 Registered Dietitian
48 Nutritionist
49 Assisted Living Center
50 Adult Foster Care
53 Supervisory Care Home
54 Dental Hygienist
55 Hotels
56 Boarding Home
57 Residential Treatment Center (RTC)
58 State School for Deaf and Blind
59 Dental Lab
60 Blood Bank
61 Eye Bank
62 Audiologist
63 Drug & Alcohol Rehabilitation
64 DETOX Center
66 Organ Bank
67 Perfusionist
68 Homeopathic
69 Optometrist
70 Home Delivered Meals
71 Psychiatric Hospital
72 Regional Administrative Entity
73 Out-of-State ENC or 1 Time FFS Prov.
74 Alternative Residential Care Facility
77 BH Outpatient Clinic
78 Mental Health RTC
79 Vision Center
80 DHS MHS Provider
81 EPD HCBS
82 Surgical First Assistant
83 Free Standing Birthing Center
84 Licensed Midwife
85 Certified Independent Social Worker
86 Certified Marriage/Family Therapist
87 Certified Professional Counselor
88 School Based Guidance Counselor
89 School Based Certified School
Psychologist
90 QMB Only Provider
91 QMB Only Recipient
92 School Based Bus Transportation
93 School Based Attendant Care
94 School Based Nurse (RN/LPN)
95 Non-Medicare Certified Home Health Agencies
96 Non-Emergency Transportation (Recip)
97 Air Transportation
98 Case Manager
99 EVS/Non-Service Provider
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10
Under
ACC
contract, what service(s) does your organization provide?
*
This field is required.
Please scroll through the list below and select all that apply:
A2 Level III Behavioral HTH Residential
A3 Community Service Agency
A4 LIC Independent Substance Abuse Counselor. (Lisac)
A5 Behavioral Health Therapeutic Home
A6 Rural Substance Abuse Transitional Agency
A7 Respite
B1 Residential Treatment Center-Secure (17+Beds) (IMD)
B2 Residential Treatment Center-Non-Secure (1-16) Beds
B3 Residential Treatment Center-Non-Secure (17+Beds) (IMD)
B5 Subacute Facility (1-16 Beds)
B6 Subacute Facility (17+ Beds) (IMD)
B7 Crisis Services Provider
B8 Behavioral Health Residential Facility
C1 Acupuncturist
C2 Federally Qualified Health Center (FQHC)
C3 Family Planning Services
DG Doc General Provider
DN Doc Non-Pay Provider
D1 Dentist-Endodontist
D2 Dentist-Pedodontist
D3 Dentist-Oral Surgeon
D4 Clinic - Dental Services
E1 Independent Testing Facilities
F1 Fiscal Intermediaries
G1 Exercise Physiologists
H1 DD/MR
S1 Specialized Services
01 Group-Payment ID
02 Hospital
03 Pharmacy
04 Laboratory
05 Clinic
06 Emergency Transportation
07 Dentist
08 MD-Physician
09 Certified Nurse-Midwife
10 Podiatrist
11 Psychologist
12 Certified Registered Nurse Anesthetist
13 Occupational Therapist
14 Physical Therapist
15 Speech/Hearing Therapist
16 Chiropractor
17 Naturopath
18 Physicians Assistant
19 Registered Nurse Practitioner
20 Respiratory Therapist
22 Nursing Home
23 Home Health Agency
24 Personal Care Attendant
25 Group Home (DD)
26 MIPS Speech Therapist/Audiologists
27 Adult Day Health
28 Non-Emergency Transp. Providers
29 Community/Rural Health Center
30 DME Supplier
31 DO-Physician Osteopath
32 Medical Foods
33 Rehabilitation Center
34 Case Management Services
35 Hospice
36 Assisted Living Home
37 Homemaker
38 DD Day Care
39 Habilitation Provider
40 Attendant Care
41 Dialysis Clinic
43 Ambulatory Surgical Center
44 Environmental (LTC)
45 County Phase-In
46 Nurse-RN/LPN (Private)
47 Registered Dietitian
48 Nutritionist
49 Assisted Living Center
50 Adult Foster Care
53 Supervisory Care Home
54 Dental Hygienist
55 Hotels
56 Boarding Home
57 Residential Treatment Center (RTC)
58 State School for Deaf and Blind
59 Dental Lab
60 Blood Bank
61 Eye Bank
62 Audiologist
63 Drug & Alcohol Rehabilitation
64 DETOX Center
66 Organ Bank
67 Perfusionist
68 Homeopathic
69 Optometrist
70 Home Delivered Meals
71 Psychiatric Hospital
72 Regional Administrative Entity
73 Out-of-State ENC or 1 Time FFS Prov.
74 Alternative Residential Care Facility
77 BH Outpatient Clinic
78 Mental Health RTC
79 Vision Center
80 DHS MHS Provider
81 EPD HCBS
82 Surgical First Assistant
83 Free Standing Birthing Center
84 Licensed Midwife
85 Certified Independent Social Worker
86 Certified Marriage/Family Therapist
87 Certified Professional Counselor
88 School Based Guidance Counselor
89 School Based Certified School
90 QMB Only Provider
91 QMB Only Recipient
92 School Based Bus Transportation
93 School Based Attendant Care
94 School Based Nurse (RN/LPN)
95 Non-Medicare Certified Home Health Agencies
96 Non-Emergency Transportation (Recip)
97 Air Transportation
98 Case Manager
99 EVS/Non-Service Provider
(IC) Integrated Clinic
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11
Under
DCS CHP
contract, what service(s) does your organization provide?
*
This field is required.
Please scroll through the list below and select all that apply:
A2 Level III Behavioral HTH Residential
A3 Community Service Agency
A4 LIC Independent Substance Abuse Counselor (Lisac)
A5 Behavioral Health Therapeutic Home
A6 Rural Substance Abuse Transitional Agency
A7 Respite
B1 Residential Treatment Center-Secure (17+Beds) (IMD)
B2 Residential Treatment Center-Non-Secure (1-16) Beds
B3 Residential Treatment Center-Non-Secure (17+Beds) (IMD)
B5 Subacute Facility (1-16 Beds)
B6 Subacute Facility (17+ Beds) (IMD)
B7 Crisis Services Provider
C1 Acupuncturist
C2 Federally Qualified Health Center (FQHC)
C3 Family Planning Services
DG Doc General Provider
DN Doc Non-Pay Provider
D1 Dentist-Endodontist
D2 Dentist-Pedodontist
D3 Dentist-Oral Surgeon
D4 Clinic - Dental Services
E1 Independent Testing Facilities
F1 Fiscal Intermediaries
G1 Exercise Physiologists
H1 DD/MR
S1 Specialized Services
01 Group-Payment ID
02 Hospital
03 Pharmacy
04 Laboratory
05 Clinic
06 Emergency Transportation
07 Dentist
08 MD-Physician
09 Certified Nurse-Midwife
10 Podiatrist
11 Psychologist
12 Certified Registered Nurse Anesthetist
13 Occupational Therapist
14 Physical Therapist
15 Speech/Hearing Therapist
16 Chiropractor
17 Naturopath
18 Physicians Assistant
19 Registered Nurse Practitioner
20 Respiratory Therapist
22 Nursing Home
23 Home Health Agency
24 Personal Care Attendant
25 Group Home (DD)
26 MIPS Speech Therapist/Audiologists
27 Adult Day Health
28 Non-Emergency Transp. Providers
29 Community/Rural Health Center
30 DME Supplier
31 DO-Physician Osteopath
32 Medical Foods
33 Rehabilitation Center
34 Case Management Services
35 Hospice
36 Assisted Living Home
37 Homemaker
38 DD Day Care
39 Habilitation Provider
40 Attendant Care
41 Dialysis Clinic
43 Ambulatory Surgical Center
44 Environmental (LTC)
45 County Phase-In
46 Nurse-RN/LPN (Private)
47 Registered Dietitian
48 Nutritionist
49 Assisted Living Center
50 Adult Foster Care
53 Supervisory Care Home
54 Dental Hygienist
55 Hotels
56 Boarding Home
57 Residential Treatment Center (RTC)
58 State School for Deaf and Blind
59 Dental Lab
60 Blood Bank
61 Eye Bank
62 Audiologist
63 Drug & Alcohol Rehabilitation
64 DETOX Center
66 Organ Bank
67 Perfusionist
68 Homeopathic
69 Optometrist
70 Home Delivered Meals
71 Psychiatric Hospital
72 Regional Administrative Entity
73 Out-of-State ENC or 1 Time FFS Prov.
74 Alternative Residential Care Facility
77 BH Outpatient Clinic
78 Mental Health RTC
79 Vision Center
80 DHS MHS Provider
81 EPD HCBS
82 Surgical First Assistant
83 Free Standing Birthing Center
84 Licensed Midwife
85 Certified Independent Social Worker
86 Certified Marriage/Family Therapist
87 Certified Professional Counselor
88 School Based Guidance Counselor
89 School Based Certified School
11 Psychologist
90 QMB Only Provider
91 QMB Only Recipient
92 School Based Bus Transportation
93 School Based Attendant Care
94 School Based Nurse (RN/LPN)
95 Non-Medicare Certified Home Health Agencies
96 Non-Emergency Transportation (Recip)
97 Air Transportation
98 Case Manager
99 EVS/Non-Service Provider
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12
Under the
ALTCS DES/DDD
and/or
DDD Qualified Vendor
contract, what service(s) does your organization provide?
*
This field is required.
Please scroll through the list below and select all that apply:
ATC Attendant Care
DTA Day Treatment & Training - Adults
DTS Day Treatment & Training - Children Summer
DTT Day Treatment & Training - Children After-School
HBA/HBC Habilitation - Development Homes (Adult & Child)
HAB/HPD Habilitation - Group Home - with Room & Board
HAN Habilitation - Medical Group Home - with Room & Board
HAH Habilitation - Hourly
HID/HAI Habilitation - Individually Designed Living Arrangement - Daily and Hourly
HHA/HN1/HNR Nursing - Home Health Aide, Nursing Continues, Nursing Respite
HSK Housekeeping/Homemaker
HAM Habilitation - Music Therapy
RSP Respite
OTA/OEA Occupational Therapy & Evaluation
STA/SEA Speech Therapy & Evaluation
PTA/PEA Physical Therapy & Evaluation
GSE Group Supported Employment
ISE Individual Supported Employment
CBE Center Based Employment
ESA Employment Support Aid
CPR Career Preparation Readiness
TTE Transition to Employment
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13
Under the
RBHA
contract, what service(s) does your organization provide?
*
This field is required.
Please scroll through the list below and select all that apply:
A2 Level III Behavioral HTH Residential
A3 Community Service Agency
A4 LIC Independent Substance Abuse Counselor (Lisac)
A5 Behavioral Health Therapeutic Home
A6 Rural Substance Abuse Transitional Agency
A7 Respite
B1 Residential Treatment Center-Secure (17+Beds) (IMD)
B2 Residential Treatment Center-Non-Secure (1-16) Beds
B3 Residential Treatment Center-Non-Secure (17+Beds) (IMD)
B5 Subacute Facility (1-16 Beds)
B6 Subacute Facility (17+ Beds) (IMD)
B7 Crisis Services Provider
B8 Behavioral Health Residential Facility
C1 Acupuncturist
C2 Federally Qualified Health Center (FQHC)
C3 Family Planning Services
DG Doc General Provider
DN Doc Non-Pay Provider
D1 Dentist-Endodontist
D2 Dentist-Pedodontist
D3 Dentist-Oral Surgeon
D4 Clinic - Dental Services
E1 Independent Testing Facilities
F1 Fiscal Intermediaries
G1 Exercise Physiologists
H1 DD/MR
IC Integrated Clinics
S1 Specialized Services
01 Group-Payment ID
02 Hospital
03 Pharmacy
04 Laboratory
05 Clinic
06 Emergency Transportation
07 Dentist
08 MD-Physician
09 Certified Nurse-Midwife
10 Podiatrist
11 Psychologist
12 Certified Registered Nurse Anesthetist
13 Occupational Therapist
14 Physical Therapist
15 Speech/Hearing Therapist
16 Chiropractor
17 Naturopath
18 Physicians Assistant
19 Registered Nurse Practitioner
20 Respiratory Therapist
22 Nursing Home
23 Home Health Agency
24 Personal Care Attendant
25 Group Home (DD)
26 MIPS Speech Therapist/Audiologists
27 Adult Day Health
28 Non-Emergency Transp. Providers
29 Community/Rural Health Center
30 DME Supplier
31 DO-Physician Osteopath
32 Medical Foods
33 Rehabilitation Center
34 Case Management Services
35 Hospice
36 Assisted Living Home
37 Homemaker
38 DD Day Care
39 Habilitation Provider
40 Attendant Care
41 Dialysis Clinic
43 Ambulatory Surgical Center
44 Environmental (LTC)
45 County Phase-In
46 Nurse-RN/LPN (Private)
47 Registered Dietitian
48 Nutritionist
49 Assisted Living Center
50 Adult Foster Care
53 Supervisory Care Home
54 Dental Hygienist
55 Hotels
56 Boarding Home
57 Residential Treatment Center (RTC)
58 State School for Deaf and Blind
59 Dental Lab
60 Blood Bank
61 Eye Bank
62 Audiologist
63 Drug & Alcohol Rehabilitation
64 DETOX Center
66 Organ Bank
67 Perfusionist
68 Homeopathic
69 Optometrist
70 Home Delivered Meals
71 Psychiatric Hospital
72 Regional Administrative Entity
73 Out-of-State ENC or 1 Time FFS Prov.
74 Alternative Residential Care Facility
77 BH Outpatient Clinic
78 Mental Health RTC
79 Vision Center
80 DHS MHS Provider
81 EPD HCBS
82 Surgical First Assistant
83 Free Standing Birthing Center
84 Licensed Midwife
85 Certified Independent Social Worker
86 Certified Marriage/Family Therapist
87 Certified Professional Counselor
88 School Based Guidance Counselor
89 School Based Certified School
11 Psychologist
90 QMB Only Provider
91 QMB Only Recipient
92 School Based Bus Transportation
93 School Based Attendant Care
94 School Based Nurse (RN/LPN)
95 Non-Medicare Certified Home Health Agencies
96 Non-Emergency Transportation (Recip)
97 Air Transportation
98 Case Manager
99 EVS/Non-Service Provider
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14
How many total
paid
employees does your organization employ?
*
This field is required.
Please include all departments, part-time, temp agencies, and full-time employees.
Definition
of Full-time employee is, for a calendar month, an employee employed on average at least
30 hours of service per week, or 130 hours of service per month.
1099 Independent Contractor
W-2 Employee
Temp Agency Staff
Total amount
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Total amount
1099 Independent Contractor
Row 0, Column 0
W-2 Employee
Row 0, Column 1
Temp Agency Staff
Row 0, Column 2
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15
What
population
does your organization serve?
*
This field is required.
Please scroll through the list below and select all that apply:
Adult System of Care (ASOC)
Autism Spectrum Disorder (ASD) / neurodivergent-ASD
Children's System of Care (CSOC)
Division of Developmental Disabilities (DDD)
Elderly & Physically Disabled (E/PD)
Foster Care (FC)
General Mental Health (GMH)
Homeless/Unsheltered
Intellectually Developmentally Disabled (I/DD)
Maternal & Child Health (MCH)
Medication Assisted Treatment (MAT) Services
Seriously Mentally Ill (SMI)
Substance Use Disorder (SUD)
Tribal and Native Services
Veterans
Population Served is Not Listed
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16
Does your organization utilize a
Relias Learning Management System
(LMS) Account?
*
This field is required.
YES
NO
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17
Which
Relias LMS
do you currently use?
*
This field is required.
Check all that apply
Arizona Association of Health Plans (AzAHP) Enterprise - incuding Small Provider Portal (SPP)
Independently purchased
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18
What
Learning Management System (LMS
) do you currently use?
*
This field is required.
Type your full name without abbreviation.
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19
To the best of your knowledge, how many of your employees at your organization fall into the age ranges listed below? Please include full-time, part time, temp agency, W-2 employees, and 1099 independent contractors.
*
This field is required.
*REMINDER*
The total number of employees from the question "How many total paid employees does your organization employ?" Need to equal the sum of the boxes below. Please scroll through the list below and input the total number of employees per age group.
Employees
Under 18 years old
Row 0, Column 0
18-24 years old
Row 1, Column 0
25-34 years old
Row 2, Column 0
35-44 years old
Row 3, Column 0
45-54 years old
Row 4, Column 0
55-64 years old
Row 5, Column 0
65+ years old
Row 6, Column 0
Under 18 years old
18-24 years old
25-34 years old
35-44 years old
45-54 years old
55-64 years old
65+ years old
Employees
Row 0, Column 0
Employees
Row 1, Column 0
Employees
Row 2, Column 0
Employees
Row 3, Column 0
Employees
Row 4, Column 0
Employees
Row 5, Column 0
Employees
Row 6, Column 0
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of 7
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20
Does your organization participate in the collection of The
Equal Employment Opportunity Commission
(EEOC)
data
? Please provide data from 2023.
*
This field is required.
The
Equal Employment Opportunity Commission (EEOC
) requires all private employers with 100 or more employees as well as federal contractors and first-tier subcontractors with 50 or more employees AND contracts of at least $50,000 complete an EEO-1 report each year.
YES
NO
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21
Gender
: How many of your employees fall within the below categories?
*
This field is required.
Please input the total number of employees per category, if you don't have an employee that falls within the category then type 0:
Employees
Male
Row 0, Column 0
Female
Row 1, Column 0
Nonbinary
Row 2, Column 0
Male
Female
Nonbinary
Employees
Row 0, Column 0
Employees
Row 1, Column 0
Employees
Row 2, Column 0
1
of 3
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22
RACE/ETHNICITY:
*
This field is required.
Please scroll through the list below and input the total number of employees corresponding to the ethnic group in which they identify. If you don't have an employee that falls within the category, then type 0:
Employees
Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
Row 0, Column 0
White (Not Hispanic or Latino): A person having origins in any of the original peoples of Europe, the Middle East or North Africa.
Row 1, Column 0
Black or African American (Not Hispanic or Latino): A person having origins in any of the black racial groups of Africa.
Row 2, Column 0
Native Hawaiian or Pacific Islander (Not Hispanic or Latino): A person having origins in any of the peoples of Hawaii, Guam, Samoa or other Pacific Islands.
Row 3, Column 0
Asian (Not Hispanic or Latino): A person having origins in any of the original peoples of the Far East, Southeast Asia or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.
Row 4, Column 0
Native American or Alaska Native (Not Hispanic or Latino): A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment.
Row 5, Column 0
Two or more races (Not Hispanic or Latino): All persons who identify with more than one of the above five races.
Row 6, Column 0
Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
White (Not Hispanic or Latino): A person having origins in any of the original peoples of Europe, the Middle East or North Africa.
Black or African American (Not Hispanic or Latino): A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Pacific Islander (Not Hispanic or Latino): A person having origins in any of the peoples of Hawaii, Guam, Samoa or other Pacific Islands.
Asian (Not Hispanic or Latino): A person having origins in any of the original peoples of the Far East, Southeast Asia or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.
Native American or Alaska Native (Not Hispanic or Latino): A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment.
Two or more races (Not Hispanic or Latino): All persons who identify with more than one of the above five races.
Employees
Row 0, Column 0
Employees
Row 1, Column 0
Employees
Row 2, Column 0
Employees
Row 3, Column 0
Employees
Row 4, Column 0
Employees
Row 5, Column 0
Employees
Row 6, Column 0
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23
Which
recruitment platforms/strategies
are your organization currently using for recruitment and talent acquisition?
*
This field is required.
Please scroll through the list below and select all that apply:
AZ Connects
AZ Healthcare Careers/Healthcare Hub (PipeLine AZ)
Apprenticeships
CareerBuilder
Community Centers
Community Posting (ex., Starbucks bulletin board)
Community Vendor Events
Craigslist
Farmers Markets
Flex Jobs
Getwork
Glassdoor
Google for Jobs
Government Job Board (i.e. USAjobs.gov)
Indeed
Internships
Job.com
Job Fairs-Live Events
Job Fair -Virtual
LinkedIn
Monster
Newspaper/Newsletter
Radio Advertising
Referral
School Job Board (i.e. Handshake)
Simply Hired
Social Media (TikTok, Facebook, Twitter X, Instagram, etc.)
Television Advertising
ZipRecruiter
Recruitment Platform Not Listed
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24
Does your organization provide
Veterans services
?
*
This field is required.
YES
NO
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25
Which
Veteran services
does your organization provide?
*
This field is required.
Case Management
Department of Corrections (DOC)
Employment Assistance
Help with filling out paperwork for disability services (PTSD)
Housing Assistance
Mental Health
Navigators (navigating benefits, assisting with VA benefits, receive specialized benefits through VA)
Peer Support
Primary Care
Substance Use (i.e. Medication Assisted Treatment (MAT) etc.)
Suicide Prevention
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26
Does your organization employ
unlicensed
direct service employees (DCW, DSP, BHT, etc.)?
*
This field is required.
YES
NO
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27
Does your organization employ board-recognized
licensed
direct service employees (therapist, BCBA, etc.)?
*
This field is required.
YES
NO
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28
What is the
average length of employment
for
unlicensed
direct service employee (DCW, DSP, BHT, etc.) at your organization?
*
This field is required.
Less than a year (0-11 months)
1-2 years (12-35 months)
3-4 years (36-59 months)
5-6 years (60-83 months)
7-8 years (84-107 months)
9-10 years (108 - 131 months)
More than 10 years (132+ months)
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29
What is the
average length of employment
for board-recognized
licensed
direct service employee (therapist, BCBA, etc.) at your organization?
*
This field is required.
Less than a year (0-11 months)
1-2 years (12-35 months)
3-4 years (36-59 months)
5-6 years (60-83 months)
7-8 years (84-107 months)
9-10 years (108 - 131 months)
More than 10 years (132+ months)
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30
What is the
average length of time
associated with
unlicensed
direct service employee (DCW, DSP, BHT, etc.)
onboarding/new employee orientation
?
*
This field is required.
**For the purposes of this assessment,
ONBOARDING
is defined as the time frame of the first day on the job, to the day they are able to provide and bill for a service.
1-5 days
6-10 days
11-15 days
16-21 days
22+ days
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31
What is the
average length of time
associated with
licensed
direct service employee (therapist, BCBA, etc.)
onboarding/new employee orientation
?
*
This field is required.
**For the purposes of this assessment,
ONBOARDING
is defined as the time frame of the first day on the job, to the day they are able to provide and bill for a service.
1-5 days
6-10 days
11-15 days
16-21 days
22+ days
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32
Does your organization have a
tool that assesses and documents an employee's competency
for their role?
*
This field is required.
Competency
= key behaviors that are essential for strong job performance and the ability to successfully and efficiently do their job.
YES
NO
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33
What
workplace conditions
add to your organizations
desired
workforce performance?
*
This field is required.
Please scroll through the list below and select all that apply:
Analyze performance metrics
Stay goal-oriented
Make accountability a priority
Train and develop your team
Encourage feedback
Embrace flexibility
Build a culture of well-being and support
Create opportunities for collaboration
Celebrate wins
Find technology solutions
Workplace condition not listed
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34
What additional workplace conditions add to your organizations
desired
workforce performance?
*
This field is required.
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35
What
barriers
or workplace conditions
detract
from your organizations desired workforce performance?
*
This field is required.
Please scroll through the list below and select all that apply:
Absence of measurable performance goals
Conflict among team members
Few opportunities to collaborate across teams
Inadequate job or skills training
Insufficient opportunities for development
Lack of resources or support
Misunderstanding of organizational vision
Barrier not listed
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36
What additional
barriers
or workplace conditions
detract
from your organizations desired workforce performance?
*
This field is required.
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37
Would your organization like
additional training
on any of the following topics?
*
This field is required.
Please scroll through the list below and select all that apply:
Abuse, Neglect, and Exploitation
Adolescent and Adult Services
ASAM
Billing & Coding
Client/Member Rights, Ethics, and Confidentiality
Communication, Relationship Building, and Resolving Conflicts
Cross-training
Emergency Preparedness
Guardianship
Honoring Client/Member Choices and Individuality
Housing
Infection Prevention and Control
Injury Prevention
Nutrition and Food Preparation
Observing, Reporting, and Documenting
Organizing work tasks so that everything gets done on time.
Patient Transportation (Wheelchairs, Vehicles, etc.)
Personal care skills such as helping with eating, bathing, dressing, and walking.
Professional Boundaries
Relating to client/members of different cultures or ethnicities, or with different values or beliefs.
Self-Care and Stress Management
System Navigation
Training in Specific Client/member Conditions
Treating Co-occurring DX
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38
Was your organization in operation prior to 9/1/2022?
*
This field is required.
YES
NO
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39
What is your organization's
retention
rate?
*
This field is required.
Retention Period: 9/1/2022 - 8/31/2023 (Please exclude any recent acquisitions)
- Retention = # of FTE's on 9/1/22 2 divided by# of FTE's on 08/31/23. - Multiply the answer by 100 to get the percentage and round to the nearest whole number. - Please adjust the slider below to that number.
For a spreadsheet to help calculate this rate, please visit this
link
.
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40
Reason for
Retention
Rate
at or above 90%
*
This field is required.
Please scroll through the list below and select all that apply:
Celebration of milestones
Comprehensive onboarding/orientation process
Culture of Inclusion
Culture of Respect
Communication and feedback
Competency evaluations/assessments
Employee engagement surveys
Employee compensation (wages)
Employee benefits program
Employee bonus program
Encouragement of employee creativity/involvement
Flexible work environments (i.e. Remote, Hybrid, In-office)
Mentorship programs
Mileage reimbursement
Paid time off
Performance reviews
Positive environment
Pre-hire selection process
Rewards/Recognition program
Referral bonus
Support from supervisor
Support from upper management
Work-Life Balance
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41
Reason for
Retention
Rate
below 90%
.
*
This field is required.
Please scroll through the list below and select all that apply:
Burnout
COVID-19 related reasons (temp position, could not perform job duties etc.)
Employee moved/relocated
Flexible work environments (i.e. Remote, Hybrid, In-office)
High caseload/workload
High-stress environment
Inadequate access to resources
Left for higher paying position
Left position to go back to school
Little room for growth within position/company
Loss of funding
Low engagement/motivation
Misalignment with company culture
Negative relationship with supervisor
Negative relationship with coworkers
Non-regrettable (an employee that you did want to see go)
Personal issues/life challenges
Program closure
Regrettable (an employee that you did not want to see go)
Retirement
Safety concerns
Termination
Voluntary termination
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42
What is your organization doing to
strive
to meet a
Retention
Rate
at or above 90%?
*
This field is required.
Please scroll through the list below and select all that apply:
Celebration of milestones
Comprehensive onboarding/orientation process
Culture of Inclusion
Culture of Respect
Communication and feedback
Competency evaluations/assessments
Employee engagement surveys
Employee compensation (wages)
Employee benefits program
Employee bonus program
Encouragement of employee creativity/involvement
Flexible work environments (i.e. Remote, Hybrid, In-office)
Mentorship programs
Mileage reimbursement
Paid time off
Performance reviews
Positive environment
Pre-hire selection process
Rewards/Recognition program
Referral bonus
Support from supervisor
Support from upper management
Work-Life Balance
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43
What is your organization's
turnover
rate?
*
This field is required.
-
Turnover period: 9/1/2022 - 8/31/2023 (Please exclude any recent acquisition)
- Turnover = Step 1: #FTE ON 9/1/22 + #FTE ON 8/31/23 divided by 2 = Average #FTE during period. Step 2: #FTE Separated during period divided by Average #FTE during period. - Multiply the answer by 100 to get the percentage and round to the nearest whole number. - Round up the nearest whole number and please adjust the slider below to that number.
For a resource to help calculate this rate, please visit this
link
.
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44
Reason for
Turnover
Rate of
less than 10%.
*
This field is required.
Please scroll through the list below and select all that apply:
Celebration of milestones
Comprehensive Onboarding/orientation process
Culture of Inclusion
Culture of Respect
Communication and feedback
Competency evaluations/assessments
Employee engagement surveys
Employee compensation (wages)
Employee benefits program
Employee bonus program
Encouragement of employee creativity/involvement
Flexible work environments (i.e. Remote, Hybrid, In-office)
Mentorship programs
Mileage reimbursement
Paid time off
Performance reviews
Positive environment
Pre-hire selection process
Rewards/Recognition program
Referral bonus
Support from supervisor
Support from upper management
Work-Life Balance
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45
Reason for
Turnover
Rate
at or above 10%
.
*
This field is required.
Please scroll through the list below and select all that apply:
Burnout
COVID-19 related reasons (temp position, could not perform job duties etc.)
Employee moved/relocated
Flexible work environments (i.e. Remote, Hybrid, In-office)
High caseload/workload
High-stress environment
Inadequate access to resources
Left for higher paying position
Left position to go back to school
Little room for growth within position/company
Loss of funding
Low engagement/motivation
Misalignment with company culture
Negative relationship with supervisor
Negative relationship with coworkers
Non-regrettable (an employee that you did want to see go)
Personal issues/life challenges
Program closure
Regrettable (an employee that you did not want to see go)
Retirement
Safety concerns
Termination
Voluntary termination
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46
What is your organization doing to
strive
to meet a
Turnover
Rate of
less than 10%?
*
This field is required.
Please scroll through the list below and select all that apply:
Celebration of milestones
Comprehensive onboarding/orientation process
Culture of Inclusion
Culture of Respect
Communication and feedback
Competency evaluations/assessments
Employee engagement surveys
Employee compensation (wages)
Employee benefits program
Employee bonus program
Encouragement of employee creativity/involvement
Flexible work environments (i.e. Remote, Hybrid, In-office)
Mentorship programs
Mileage reimbursement
Paid time off
Performance reviews
Positive environment
Pre-hire selection process
Rewards/Recognition program
Referral bonus
Support from supervisor
Support from upper management
Work-Life Balance
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47
For your organization as a whole, what are some of the
difficult to fill positions
?
*
This field is required.
Please scroll through the list below and select all that apply:
Administrative (i.e., Human Resources)
BH Direct Care Professional / Direct Care Worker
Clinical – Licensed (i.e., Therapist)
Clinical – Non-Licensed (i.e., Case Manager)
Direct Caregiver / Line Staff / Direct Care Worker
Executive (i.e., Chief Medical Officer)
Licensed (i.e., PT, OT, ST Therapist)
Management (i.e., Supervisor, Team Lead, etc.)
Medical – Licensed (i.e., Medical Doctor)
Medical – Non-Licensed (i.e., Nursing Assistant)
Operations (i.e., Facilities)
Difficult to fill position not listed
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48
What additional
difficult to fill position
does your organization have that was not listed?
*
This field is required.
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49
Does your organization
offer higher education benefits
?
*
This field is required.
i.e. tuition reimbursement or loan repayment assistance.
YES
NO
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50
Higher Education Benefits:
*
This field is required.
After reviewing each row, select the box(es) that apply to your organization. If your organization only offers either tuition reimbursement
or
loan repayment, complete row(s) 1 or 2 based on what is offered. *If your organization offers both tuition reimbursement
and
loan repayment, complete row 3 based on what is offered.
Part-Time Only
Full-Time Only
Both Part and Full Time
1. Does your organization offer tuition reimbursement for employees?
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
2. Does your organization offer school loan repayment assistance for employees?
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
3. *Both tuition reimbursement and loan repayment.
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
1. Does your organization offer tuition reimbursement for employees?
2. Does your organization offer school loan repayment assistance for employees?
3. *Both tuition reimbursement and loan repayment.
Part-Time Only
Row 0, Column 0
Full-Time Only
Row 0, Column 1
Both Part and Full Time
Row 0, Column 2
Part-Time Only
Row 1, Column 0
Full-Time Only
Row 1, Column 1
Both Part and Full Time
Row 1, Column 2
Part-Time Only
Row 2, Column 0
Full-Time Only
Row 2, Column 1
Both Part and Full Time
Row 2, Column 2
1
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51
Is your organization currently offering
language differential incentives
?
Employees who receive a pay differential that is granted to a certified bilingual employee who is in a certified bilingual position.
YES
NO
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52
Which
language(s)
does your organization offer differential incentives for?
*
This field is required.
Employees who receive a pay differential that is granted to a certified bilingual employee who is in a certified bilingual position.
American Sign Language (ASL)
Apache
Arabic
Chinese
Farsi
French
Haitian
German
Hindi
Hopi
Japanese
Korean
Navajo
O'odham
Persian
Russian
Serbo-Croatian
Spanish
Tagalog
Thai
Vietnamese
Other Native American Languages
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53
For your organization as a whole, please rank the categories from 1-7, with
1 being the most challenging.
*
This field is required.
For a list of definitions please reference this
document
.
Most Critical Challenges
Advancement
Row 0, Column 0
Compensation
Row 1, Column 0
Deployment
Row 2, Column 0
Recruitment
Row 3, Column 0
Retention
Row 4, Column 0
Selection
Row 5, Column 0
Training
Row 6, Column 0
Advancement
Compensation
Deployment
Recruitment
Retention
Selection
Training
Most Critical Challenges
Row 0, Column 0
Most Critical Challenges
Row 1, Column 0
Most Critical Challenges
Row 2, Column 0
Most Critical Challenges
Row 3, Column 0
Most Critical Challenges
Row 4, Column 0
Most Critical Challenges
Row 5, Column 0
Most Critical Challenges
Row 6, Column 0
1
of 7
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54
What type of
career pathways
and
advancement opportunities
does your organization currently provide?
*
This field is required.
Please scroll through the list below and select all that apply:
Apprenticeship
Cross-training
Internal certifications
Formal succession planning
Leadership training
Mentoring
Specialized training
Tuition reimbursement
Additional opportunity not listed
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55
What
additional
types of
career pathways and advancement opportunities
does your organization currently provide?
*
This field is required.
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56
License Type by Discipline -
Social Work
Please skip the licensure type if it does not apply to your
organization
.
How many do you currently have employed?
How many positions for this role do you intend to add/fill in the next year?
How many additional positions are required in the next year to meet members' needs?
Baccalaureate Social Worker (LBSW)
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Master Social Worker (LMSW)
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Clinical Social Worker (LCSW)
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Baccalaureate Social Worker (LBSW)
Master Social Worker (LMSW)
Clinical Social Worker (LCSW)
How many do you currently have employed?
Row 0, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 0, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 0, Column 2
How many do you currently have employed?
Row 1, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 1, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 1, Column 2
How many do you currently have employed?
Row 2, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 2, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 2, Column 2
1
of 3
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57
License Type by Discipline -
Counseling
Please skip the licensure type if it does not apply to your
organization.
How many do you currently have employed?
How many positions for this role do you intend to add/fill in the next year?
How many additional positions are required in the next year to meet members' needs?
Associate Counselor (LAC)
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
LAC training to be an LPC
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Professional Counselor (LPC)
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Associate Counselor (LAC)
LAC training to be an LPC
Professional Counselor (LPC)
How many do you currently have employed?
Row 0, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 0, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 0, Column 2
How many do you currently have employed?
Row 1, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 1, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 1, Column 2
How many do you currently have employed?
Row 2, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 2, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 2, Column 2
1
of 3
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58
License Type by Discipline -
Marriage and Family Therapy
Please skip the licensure type if it does not apply to your organization.
How many do you currently have employed?
How many positions for this role do you intend to add/fill in the next year?
How many additional positions are required in the next year to meet members' needs?
Associate Marriage and Family Therapist (LAMFT)
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
LAMFT training to be an LMFT
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Marriage and Family Therapist (LMFT)
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Associate Marriage and Family Therapist (LAMFT)
LAMFT training to be an LMFT
Marriage and Family Therapist (LMFT)
How many do you currently have employed?
Row 0, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 0, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 0, Column 2
How many do you currently have employed?
Row 1, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 1, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 1, Column 2
How many do you currently have employed?
Row 2, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 2, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 2, Column 2
1
of 3
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59
License Type by Discipline -
Substance Use Counseling
Please skip the licensure type if it does not apply to your organization.
How many do you currently have employed?
How many positions for this role do you intend to add/fill in the next year?
How many additional positions are required in the next year to meet members' needs?
Substance Abuse Technician (LSAT)
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
LSAT training to be an LASAC
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Associate Substance Abuse Counselor (LASAC)
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
LASAC training to be an LISAC
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Independent Substance Abuse Counselor (LISAC)
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Substance Abuse Technician (LSAT)
LSAT training to be an LASAC
Associate Substance Abuse Counselor (LASAC)
LASAC training to be an LISAC
Independent Substance Abuse Counselor (LISAC)
How many do you currently have employed?
Row 0, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 0, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 0, Column 2
How many do you currently have employed?
Row 1, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 1, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 1, Column 2
How many do you currently have employed?
Row 2, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 2, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 2, Column 2
How many do you currently have employed?
Row 3, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 3, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 3, Column 2
How many do you currently have employed?
Row 4, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 4, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 4, Column 2
1
of 5
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60
License Type by Discipline -
Physical Health
Please skip the licensure type if it does not apply to your organization.
How many do you currently have employed?
How many positions for this role do you intend to add/fill in the next year?
How many additional positions are required in the next year to meet members' needs?
Certified Nurse Assistant (CNA)
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
DO Physician Osteopath - Cardiologist
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
MD Physician
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Dentist
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
OBGYN
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Physician Assistant
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Pediatrician
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Registered Nurse (RN)
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Certified Nurse Assistant (CNA)
DO Physician Osteopath - Cardiologist
MD Physician
Dentist
OBGYN
Physician Assistant
Pediatrician
Registered Nurse (RN)
How many do you currently have employed?
Row 0, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 0, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 0, Column 2
How many do you currently have employed?
Row 1, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 1, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 1, Column 2
How many do you currently have employed?
Row 2, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 2, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 2, Column 2
How many do you currently have employed?
Row 3, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 3, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 3, Column 2
How many do you currently have employed?
Row 4, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 4, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 4, Column 2
How many do you currently have employed?
Row 5, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 5, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 5, Column 2
How many do you currently have employed?
Row 6, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 6, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 6, Column 2
How many do you currently have employed?
Row 7, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 7, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 7, Column 2
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61
License Type by Discipline -
Additional Licensing
Please skip the licensure type if it does not apply to your organization.
How many do you currently have employed?
How many positions for this role do you intend to add/fill in the next year?
How many additional positions are required in the next year to meet members' needs?
Assisted Living Manager
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Board Certified Behavior Analyst (BCBA)
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Psychiatric Registered Nurse (BH RN)
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Behavioral Health Nurse Practitioner (BH NP)
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Doctor of Nursing Practice (DNP)
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Nurse Practitioner (NP)
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Licensed Practical Nurse (LPN)
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Medical Assistant (MA)
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Psychiatric Nurse Practitioner (PNP)
Row 8, Column 0
Row 8, Column 1
Row 8, Column 2
Family Practice Nurse Practitioner (FNP)
Row 9, Column 0
Row 9, Column 1
Row 9, Column 2
Physical Therapist (PT)
Row 10, Column 0
Row 10, Column 1
Row 10, Column 2
Speech Therapist (ST)
Row 11, Column 0
Row 11, Column 1
Row 11, Column 2
Occupational Therapist (OT)
Row 12, Column 0
Row 12, Column 1
Row 12, Column 2
Licensed Dietitian
Row 13, Column 0
Row 13, Column 1
Row 13, Column 2
Skilled Nursing Home Administrator
Row 14, Column 0
Row 14, Column 1
Row 14, Column 2
Psychiatrist
Row 15, Column 0
Row 15, Column 1
Row 15, Column 2
Psychologist
Row 16, Column 0
Row 16, Column 1
Row 16, Column 2
Assisted Living Manager
Board Certified Behavior Analyst (BCBA)
Psychiatric Registered Nurse (BH RN)
Behavioral Health Nurse Practitioner (BH NP)
Doctor of Nursing Practice (DNP)
Nurse Practitioner (NP)
Licensed Practical Nurse (LPN)
Medical Assistant (MA)
Psychiatric Nurse Practitioner (PNP)
Family Practice Nurse Practitioner (FNP)
Physical Therapist (PT)
Speech Therapist (ST)
Occupational Therapist (OT)
Licensed Dietitian
Skilled Nursing Home Administrator
Psychiatrist
Psychologist
How many do you currently have employed?
Row 0, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 0, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 0, Column 2
How many do you currently have employed?
Row 1, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 1, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 1, Column 2
How many do you currently have employed?
Row 2, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 2, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 2, Column 2
How many do you currently have employed?
Row 3, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 3, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 3, Column 2
How many do you currently have employed?
Row 4, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 4, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 4, Column 2
How many do you currently have employed?
Row 5, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 5, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 5, Column 2
How many do you currently have employed?
Row 6, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 6, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 6, Column 2
How many do you currently have employed?
Row 7, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 7, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 7, Column 2
How many do you currently have employed?
Row 8, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 8, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 8, Column 2
How many do you currently have employed?
Row 9, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 9, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 9, Column 2
How many do you currently have employed?
Row 10, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 10, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 10, Column 2
How many do you currently have employed?
Row 11, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 11, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 11, Column 2
How many do you currently have employed?
Row 12, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 12, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 12, Column 2
How many do you currently have employed?
Row 13, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 13, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 13, Column 2
How many do you currently have employed?
Row 14, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 14, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 14, Column 2
How many do you currently have employed?
Row 15, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 15, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 15, Column 2
How many do you currently have employed?
Row 16, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 16, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 16, Column 2
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62
Position Type by Discipline -
Certifications
Please skip the certification type if it does not apply to your organization.
How many do you currently have employed?
How many positions for this role do you intend to add/fill in the next year?
How many additional positions are required in the next year to meet members' needs?
Certified Assisted Living Caregiver
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Credentialed Family Support Specialist
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Home Health Aid (HHA)
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Peer Recovery Support Specialist (PRSS)
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Recovery Support Specialist (RSS)
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Registered Behavior Tech (RBT)
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Direct Care Worker (DCW)
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Certified Assisted Living Caregiver
Credentialed Family Support Specialist
Home Health Aid (HHA)
Peer Recovery Support Specialist (PRSS)
Recovery Support Specialist (RSS)
Registered Behavior Tech (RBT)
Direct Care Worker (DCW)
How many do you currently have employed?
Row 0, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 0, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 0, Column 2
How many do you currently have employed?
Row 1, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 1, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 1, Column 2
How many do you currently have employed?
Row 2, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 2, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 2, Column 2
How many do you currently have employed?
Row 3, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 3, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 3, Column 2
How many do you currently have employed?
Row 4, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 4, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 4, Column 2
How many do you currently have employed?
Row 5, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 5, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 5, Column 2
How many do you currently have employed?
Row 6, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 6, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 6, Column 2
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63
Additional Positions
Please skip if it does not apply to your organization.
How many do you currently have employed?
How many positions for this role do you intend to add/fill in the next year?
How many additional positions are required in the next year to meet members' needs?
BH Case/Care Manager
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Behavioral Health Tech (BHT)
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Direct Support Professional (DSP)
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
BH Case/Care Manager
Behavioral Health Tech (BHT)
Direct Support Professional (DSP)
How many do you currently have employed?
Row 0, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 0, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 0, Column 2
How many do you currently have employed?
Row 1, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 1, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 1, Column 2
How many do you currently have employed?
Row 2, Column 0
How many positions for this role do you intend to add/fill in the next year?
Row 2, Column 1
How many additional positions are required in the next year to meet members' needs?
Row 2, Column 2
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2024- Arizona Healthcare Workforce Goals and Metrics Assesment (AHWGMA)
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