Greetings:
Please excuse any cross postings.
Thank you,
Greg
R. Greg Carlson ! "Much virtue in waitresses;
pinellas talking book library ! little in men."
[log in to unmask] ! --zonefive
---------- Forwarded message ----------
Date: Tue, 09 Mar 1999 13:48:35 -0600
From: Cathleen Bourdon <[log in to unmask]>
To: Association of Specialized and Cooperative Library Agencies List
<[log in to unmask]>
Subject: Need your input on public libraries and Medicare survey
MEDICARE PROGRAM LIBRARY SURVEY
The Association of Specialized and Cooperative Library Agencies
(ASCLA) and the Reference and User Services Association (RUSA)have
received a grant from the Health Care Financing Administration (HCFA).
The grant project will assist public libraries by providing
information on changes in Medicare.
The committee members are: Betty Ann Funk, State Library of
Pennsylvania,chair; Greg Carlson, Talking Book Library, Largo, Fla.;
Lise Dickman, St. Mary's Medical Center, San Francisco, Calif.; Allan
Kleinman, Cranbury Public Library N.J.; Ina Pimpau, Newark Public
Library,N.J.; Harriet Schwanke, Miami-Dade Public Library, Fla.; Alan
Stewart, Memphis/Shelby County Public Library & Information
Center,Tenn.
If you have any questions concerning this survey, please contact
Allan Kleinman,
at 609-655-0555 or e-mail: [log in to unmask]
We appreciate your cooperation in completing this survey. Please
return by
March 22, 1999 to:
Lillian Lewis
e-mail:[log in to unmask]
fax: 312-944-8085
Library Name_______________________________________________________
Address____________________________________________________
____________________________________________________
Contact person_____________________________________________
Phone____________ fax_____________ e-mail___________
1. How familiar are you with the Medicare program (health insurance
for seniors and the disabled)?
1 2 3 4 5
Not at all
Very familiar
familiar
2. How many times a month does a senior (age 65 and over) asks for
help locating information relating to Medicare?
0 ___ 1 -10 ____10 -20 ____ 20 -50 ___ 50+ ____
3. How many times a month do you help a senior (age 65 and over) with
an Internet search for Medicare information?
0____ 1 -10____ 10 -20____ 20 -50____ 50+____
4. How many times a month does a caregiver of seniors ask for help
locating information relating to Medicare?
0____ 1 -10____ 10 -20____ 20 -50____ 50+____
5. How many times a month does a disabled person under age 65 ask for
help locating information relating to Medicare?
0____ 1 -10____ 10 - 20____ 20 -50____50+____
6. When you try to answer a question related to Medicare, do you use
the Internet?
Yes____ No____
7. Did you know that the agency that administers Medicare has a
website address with important consumer information
(www.medicare.gov)?
Yes____ No____
If yes, how were you made aware of the website?
8. Does your library's website have an active link to Medicare
related materials?
Yes____ No____
9. Do seniors (age 65 and over) take Internet training courses
offered through your library?
Yes ____
No ____
We do not offer training _____
10. How many seniors participated in training last year?
11. What types of Medicare information do you have? (Check all that
apply.)
____ Audio cassettes ____ Medicare Handbook
____ Bookmarks ____ Newspaper articles
____ Braille ____ Pamphlet
____ Brochures/Pamphlets ____ Posters
____ Large type print ____ Train the Trainer video
presentations
____ List of local contacts ____ Videos
____ Other (please specify)
12. What types of information would be most useful in your library
for disseminating Medicare information? (Check all that apply.)
____ Audio cassettes ____ Medicare Handbook
____ Bookmarks ____ Newspaper articles
____ Braille ____ Pamphlet
____ Brochures/Pamphlets ____ Posters
____ Large type print ____ Train the Trainer video
presentations
____ List of local contacts ____ Videos
____ Other (please specify)
13. Would your library find a "resource kit" with these kinds of
information on Medicare a useful tool?
____ Yes ____ No (If not, why?)
14. Do you need materials in languages other than English?
_____Yes, which languages?
____ No
15. Does your library have a relationship with a senior center?
____ Yes ____No
16. Do you have space available to display Medicare information
brochures?
____ Yes ____ No
17. How many people use your library on average, per day?
18. Place a percentage in each category ranging from 0 - 100% so that
the total of the categories equals 100% for your service area
population:
____ African American
____ Asian
____ Caucasian
____ Hispanic/Latino
____ Native American
____ Other
100% TOTAL
18. Does your library system have branches?
_____Yes, how many?
_____ No
Thank you for completing this survey. Please return by March 22, 1999
to:
Lillian Lewis
e-mail:[log in to unmask]
fax: 312-944-8085
50 East Huron Street
Chicago, Illinois 60611
|
