LORHN USAC Provider Survey

COMPLETE BY NOVEMBER 30, 2019 TO ENTER RAFFLE FOR A $50 GIFT CARD!

Lake Okeechobee Rural Health Network, Inc. (LORHN) is a non-profit organization that serves Okeechobee, Glades, Hendry, Western Palm Beach and Western Martin Counties. Our mission is to improve access to quality health care for rural residents of our region and stimulate the financial viability of providers and communities within the Network through planning and coordinated utilization of limited health care.

To fulfill that mission, we are collecting information from providers serving rural areas around Lake Okeechobee to glean interest in joining a Consortium to apply a national program that provides a large discount on eligible expenses related to broadband connectivity to rural health care providers. These savings can help providers of various sizes and allow for growth via workforce or new services and programs. We are committed to helping stimulate viability and sustainability for health providers and access to quality care for residents.

Below is insight shared by R.D. Williams,

CEO of Hendry Regional Medical Center and Treasurer for LORHN Board of Directors:

“Hendry Regional Medical Center has participated in the USAC Rural Health Care Program for over 6 years. The significant savings generated by this program has allowed HRMC to expand the bandwidth entering our facilities in support of the ever-increasing movement towards interconnectedness in healthcare. Our network now allows each of our 7 facilities to be interconnected for the rapid exchange of patient care data among our care sites.”

We appreciate you taking 3-4 minutes to complete this survey if you are interested in joining the consortia to apply for a discount on eligible broadband services (and are located in Okeechobee, Glades, Hendry, Martin, or Western Palm Beach counties).

If you have any questions please do not hesitate to contact us at info@lorhn.org or 561-844-4220 x1500.

COMPLETE BY NOVEMBER 30, 2019 TO ENTER RAFFLE FOR A $50 GIFT CARD!

Question Title

* 1. Are you interested in joining LORHN's consortia to apply for discounts on eligible broadband services?

Yes

Not sure - I have questions

Question Title

* 2. Please check which type of entity your organization is (the Rural Health Care program is only available for the entities listed below, if you’re organization is not then we regret to inform you are not eligible to join the consortia)

Post-secondary educational institutions offering health care instruction, teaching hospitals, and medical schools

Community health center or health care centers providing care to migrants

Local health departments or agencies

Community mental health centers

Not-for-profit hospitals

Rural health clinics, including mobile clinics

Skilled nursing facility (SNF)

A dedicated emergency room of a rural for-profit hospital

Question Title

* 3. Organization Name (how it's listed on EIN)

Question Title

* 4. Point of Contact for the organization (name - first & last)

Question Title

* 5. Point of Contact for the organization (phone)

Question Title

* 6. Point of Contact for the organization (e-mail)

Question Title

* 7. Organization Address (street, city, zip)

Question Title

* 8. Does your organization have multiple locations?

Yes

If yes, please list all additional addresses below. If there is not enough space, email info@lorhn.org

Question Title

* 9. How would you like to receive information about this opportunity?

Phone call/webinar

In-person meeting

Other (please specify)

Question Title

* 10. What questions or comments about the consortium do you have at this time?

None

Other (please specify)

Question Title

* 11. Are you interested in collaborating with LORHN and our current programs/services?
(please check all that interest you)

Refer clients for health insurance enrollment assistance (Marketplace, Medicaid, KidCare)

Refer clients for help with Prescription Assistance Program applications

Refer clients for care coordination services (linkage to health and social supports, scheduling appointments, etc.)

"Your Health Matters" a health literacy workshop (provide space to host, refer participants)

Chronic Disease Self-Management Workshop (provide space to host, refer participants)

Diabetes Self-Management Workshop (provide space to host, refer participants)

Other (please specify)

LORHN USAC Provider Survey

COMPLETE BY NOVEMBER 30, 2019 TO ENTER RAFFLE FOR A $50 GIFT CARD!

Question Title

* 1. Are you interested in joining LORHN's consortia to apply for discounts on eligible broadband services?

Question Title

* 2. Please check which type of entity your organization is (the Rural Health Care program is only available for the entities listed below, if you’re organization is not then we regret to inform you are not eligible to join the consortia)

Question Title

* 3. Organization Name (how it's listed on EIN)

Question Title

* 4. Point of Contact for the organization (name - first & last)

Question Title

* 5. Point of Contact for the organization (phone)

Question Title

* 6. Point of Contact for the organization (e-mail)

Question Title

* 7. Organization Address (street, city, zip)

Question Title

* 8. Does your organization have multiple locations?

Question Title

* 9. How would you like to receive information about this opportunity?

Question Title

* 10. What questions or comments about the consortium do you have at this time?

Question Title

* 11. Are you interested in collaborating with LORHN and our current programs/services? (please check all that interest you)

* 11. Are you interested in collaborating with LORHN and our current programs/services?
(please check all that interest you)