Below are the questions for the Admin provider survey for Alaska Medicaid for state plan Community Behavioral Health and Mental Health Physician Clinic services.

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* 1. What is the name and contact information of the individual completing the survey? This will be utilized if more than one survey is completed by an organization to reach out to the organization to see which one to utilize.

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* 2. How many days of sick and/or paid time off does your organization offer full-time equivalent (FTE) employees in a year on an FTE basis?

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* 3. Does your organization offer paid time off at different amounts based on position title? For example, does your organization provide PhD level psychologists different paid time off than Bachelor’s level staff?

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* 4. How many paid holidays does your organization offer full-time equivalent (FTE) employees in a year? Please ensure this value is separate from the Paid Leave in Question #2.

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* 5. What is the monthly premium your organization pays for the employer portion of family health insurance for one employee?

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* 6. What is the monthly premium your organizations pays as the employer portion of individual health insurance for one employee?

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* 7. What percent of your organization’s full-time employees opt into your organization’s health insurance coverage?

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* 8. Of the individuals who opt into health insurance coverage, what percentage is for individual health insurance coverage and what percentage is for family health insurance coverage?

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* 9. What is the percentage value of fringe benefits (fringe benefits / wages) for your organization? Please include items like: paid time off, health insurance, retirement, Social Security, Medicare, federal and state unemployment insurance, worker's compensation, long and short-term disability, and life insurance.

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* 10. What is the average hourly wage paid by your organization for the following position types?

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* 11. Please explain any change in wages, in a percentage, over each of the last two years.

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* 12. Please explain any difficulty in recruiting of service providers, such as your organization's vacancy factor, average length of time to fill a position, number of recruitments during the last year that did not result in placement, etc.

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* 13. Please provide any additional information you feel would be beneficial for rate setting purposes.

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