Form SHIPP Questionnair SHIPP Questionnair SHIPP Questionnaire (CATI Specifications)

Survey of Health Insurance and Program Participation (SHIPP)

omb qnnaire

Survey of Health Insurance and Program Participation

OMB: 0607-0959

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Survey of Health Insurance and Program Participation (SHIPP)

CATI Questionnaire Specifications

February 19, 2010





1. FRONT/BACK (display and check items only)


Section Overview:

The purpose of this section is to:

  • screen the phone number for a household residence

  • screen the person who answers the phone to identify an eligible household respondent (HHR)

  • inform the HHR on the survey (topic, duration, OMB approval and confidentiality, etc) and request their participation.

  • in the case of a callback, identify an eligible respondent and continue the interview

See front/back specs for more details on universe statements, output specifications, etc.


I.A CALLBACK-ONLY SCREENS

Note: these four screens are only used for callbacks B that is, where an initial contact was made but the interview was not completed. The break-off point may have occurred before even reaching the demographics section, or it may have occurred at some later point in the interview. The fills in these four screens account for these various conditions.


HELLOTWO

May I please speak to <fill RESNAME> ?

This is correct person => ID_SPVR

Correct person called to phone => ID_SPVR

Person not home or not available now => HELLORS

Other outcome or problem interviewing respondent, including immediate hangup

  • PROBCALL

RESNAME FILL instructions:

  • If the end of the household roster was reached, use NAME (that is, FIRSTNAME LASTNAME) of respondent from previous interview

  • else if CBNAME is not blank, use CBNAME

  • else use Aa resident who is 18 years old or older. Would that be you?@


HELLO_RS

Perhaps you can help me. I’d like to speak with a member of this household who is 18 years old or older.

Respondent is resident 18+ => CK-NEWRESP

Resident 18+ called to phone => CK-NEWRESP

Eligible person not home now or not available now => TYCLBCK

No one living in household is 18+ => FINDOTH

Other outcome/problem interviewing respondent, including immediate hangup and teenage phone line)

  • PROBCALL


CK-NEWRESP

  • if a new household member (different from the person originally listed as Person 1) is now completing the survey => NEWRESP

  • else => IDSPVR


NEWRESP

(FILL instructions: display ROSTER)

To whom am I speaking?

Select appropriate person from displayed household roster. => IDSPVR

NOTE: the original hh respondent is always listed as Person 1. If there is a change in hh respondent part-way thru the interview, the hh respondent and all household members remain listed in the same line numbers where they were originally listed, but questions for the new hh respondent should fill Ayou@ (versus NAME) and questions for the original Person 1 should fill NAME.


I.B INITIAL CONTACT and ADDITIONAL CALLBACK SCREENS


RESNUM

Is this the number for a business, a private residence, a cell phone, or is this college housing, or some other type of place?

Business => THANKRES

Private residence => HELLONEW

College housing => THANKRES

Other type of place => THANKRES

Cell or mobile phone => THANKRES

Other outcome or problem interviewing respondent, including immediate hangup => PROBCALL

DK => TYCLBK

Ref => EXITTHNK


HELLO NEW

I=d like to speak with a resident who is 18 years old or older.

  • If appropriate: Would that be you?

Respondent is resident 18+ => CK-LETTER

Resident 18+ called to phone, => CK-LETTER

Eligible person not home now or not available now => IDOTHER

No one living in household is 18+, => FINDOTH

Other outcome/problem interviewing respondent, including immediate hangup and teenage phone line)

  • PROBCALL


FIND_OTH

Perhaps you can help me. You indicated that no one living in this household is 18 years old or older. May I speak to a person who lives here, is at least 16 or 17 years old, and is knowledgeable about this household?

Would you or someone else there qualify?

Yes, respondent qualifies => CK-LETTER

Yes, someone else called to phone => CK-LETTER

Yes, but person not home now or not available now => IDOTHER

No, no qualified person lives here => THANKRES

Don=t know => IDOTHER

Refused => EXITTHNK


CK-LETTER

  • if an advance letter was sent (ADLTR_FL=4) => INTRO_LTR

  • else => INTRO_1ST


INTRO_LTR

We=re conducting an important survey on health insurance coverage. Not long ago we mailed a letter to your household telling you about this survey. Did you receive our letter?

Yes => ID_SPVR

No => INTRO_1ST

DK => INTRO_1ST

Ref => INTRO_1ST


INTRO_1ST

(If necessary: Hello. This is ... from the U.S. Census Bureau.)

We=re conducting an important survey on health insurance coverage and we=d like your participation to make the survey as accurate as possible. The survey will take about 12 minutes and is voluntary. We are conducting this survey under the authority of Title 13, and the Office of Management and Budget has approved this survey under project 0607-XXXX, which legally certifies the survey. The Privacy Act of 1974 requires us to keep your information confidential and use it for statistical purposes only.

  • ID_SPVR


PROBCALL

Person Not Available

Temporarily absent or away; Nobody available through closeout => EXITTHNK

Ill, hospitalized; Nobody available through closeout => EXITTHNK

Temporarily Ill, hospitalized => IDOTHER

Vacant => EXITTHNK

Physically or mentally unable => EXITTHNK

Other Problems

Answering machine/service reached => TYLAST

Language problem – Refer to Supervisor => TYLAST

Hearing problem => TYLAST

Bad connection => TYLAST

Refused interview => EXITTHNK

Immediate hangup => TYLAST

No one living in household is 18 or older => FINDOTH

No one uses this place as usual residence (for example: vacation home, recreational vehicle, car phone)

  • EXITTHNK

Teenager=s phone line => THANKRES


ID_SPVR

[If HELLOTWO=1 or 2 (correct person is on phone) or HELLO_RS=1 or 2 (resident 18+ is on phone) fill: We recently contacted your household as part of a survey on health insurance coverage that the Census Bureau is conducting.]

[If fill in HELLOTWO was Aa resident who is...@ then fill: This survey will take about 12 minutes and is voluntary, but its accuracy depends on your participation. We are conducting this survey under the authority of Title 13, and the Office of Management and Budget has approved this survey under project 0607‑XXXX, which legally certifies the survey. The Privacy Act of 1974 requires us to keep your information confidential and use it for statistical purposes only.]

My supervisor is working with me today and may listen in to evaluate my performance.

PERSUADE RESPONDENT TO COMPLETE INTERVIEW NOW IF POSSIBLE.

Continue with interview => FINDQUEST

Inconvenient time, callback needed => IDOTHER

Refused to participate => EXITTHNK

Language problem => EXITTHNK

Refer to supervisor => EXITTHNK


FIND QUEST

  • Press the <END> key for the next unanswered question.


ID_OTHER

Ok that=s fine. I’ll call back later. Whom should I ask for when I call back?

PROBE: If respondent prefers NOT to give their name, use YOUR best judgment and key LADY OF HOUSE or MAN of HOUSE.

[open-text name] => store in CBNAME => TYCLBCK

the Lady of the House => TYCLBCK

the Man of the House => TYCLBCK

[Do not allow DK or Refused]


THANKRES

Thank you for your time. Your phone number is not eligible for this survey. => TYLAST


EXITTHNK

Thank you for your time and cooperation. If you’d like to send us any comments about this survey I’d be glad to give you an address. The expiration date for this survey is September 30, 2010. => TYLAST


READ IF NECESSARY

Paperwork Project 0607-XXXX

U.S. Census Bureau

4600 Silver Hill Road, Room 3K138

Washington, DC 20233.

e-mail: Paperwork@census.gov (use "Paperwork Project 0607-XXXX" as the subject).


TYCLBCK

We will try again at another time. What are the best days and times to call? [record days/times] Thank you for your help.

  • TYLAST


F10EXIT

Thank you for your time. I would like to set an appointment to call back at a better time to complete the interview. What are the best days and times to call? [record days/times] Thank you for your help.

  • TYLAST


TYLAST

End Call


2. DEMOGRAPHICS


Section Overview:

The purpose of this section is to collect a list of the names of all household members, and to collect basic demographic information for each member.

  • We ask the HHR to list the names of all household members, including middle name (since we may need this for matching to administrative records). We then conduct the entire interview with this HHR, who answers questions about him/herself and about all other household members.

  • Demographic questions are asked in a Atopic-based@ format, where the full question is read for the first person asked about (eg: AHow is NAME related to you?@) and for all subsequent people for whom the same question is administered, a simpler AHow about NAME?@ is asked, and the full question is displayed in parentheses in case the interviewer and/or respondent needs a reminder.

  • The first eight items (RELATE thru RACE) are asked about all household members, regardless of age; the next three items (EDUCA, AFEVER, MARITL) are asked only of those age 15+.

  • The final item (HHINC) is a household-level question.


FNAME/MNAME/LNAME

What are the names of all persons living or staying here? Let=s start with you. (What is your name?)

PROBE: And what is [your/NAME=s] middle name?

Fill 1: Is anyone else living or staying here now?

Fill 2: What is the name of the next person living or staying here?

=> HHCHECK


HHCHECK

So I have listed [one person/# people] living or staying here now: [READ NAMES]. Is there anyone else living or staying here now -- any babies, small children, non-relatives or anyone else?

Yes

No

INTERVIEWER: Please verify that the information on this screen is correct. You will not be able to alter the list of household members after this screen.

=> SEX


SEX

ASK ONLY IF NECESSARY:

Person 1: What is your sex?

Persons 2+: And how about NAME? (What is NAME=s sex?)

Male

Female

=> CK-RELATE


CK-RELATE

if single-person household => DOB

else => RELATE


RELATE

Person 1: How is NAME related to you/Person 1?

Persons 2+: And how about NAME? (How is NAME related to you/Person 1?)

<0> Self

<1> Spouse

<2 >Unmarried partner

<3> Child

<4> Grandchild

<5> Parent (mother/father)

<6> Brother/Sister

<7> Other relative (Aunt, Cousin, Nephew, Mother-in-Law, etc.)

<8> Foster child

<9> Housemate/Roommate

<10> Other non-relative

<99> DK/Ref

=> DOB

NOTE: Once the roster is collected, household members maintain their original line number throughout the entire survey. APerson 1" will always start off as the household respondent, but if there=s a break-off/callback and the interviewer cannot reach the original household respondent, a different household member may serve as the new household respondent. In these cases the wording above would fill the name of the original household respondent as APerson 1" rather than Ayou.@


DOB

Person 1: What is your date of birth?

Persons 2+: And how about NAME? (What is NAME=s date of birth?)

<MONTH>

<DAY>

<YEAR>

<DK>

<REF>

if day/month combination is are not possible (e.g.: February 30) => MONTH_CHECK

else if MONTH=Ref => AGE2

else if DAY=DK => AGEGSS

else => VERIFY_AGE

Note: complete series from DOB thru to AGE2 about each person before moving on to the next person on the roster


VERIFY_AGE

As of last week, that would make [you/NAME] [if YEAR=DK fill: approximately] [agefill] years old. Is that correct?

Yes => HSPNON

No => AGEGSS

DK => AGEGSS

Ref => AGE2


AGEGSS

Even though you don=t know [NAME=s] exact birth date, what is your best guess as to how old [he/she] was on [his/her] last birthday?

<number> => HSPNON

DK => AGE2

Ref => AGE2


AGE2

Is he/she under 15, 15 to 64, or 65 or older?

under 15 years old

15-64 years old

65 years old or older

DK

Ref

=> HSPNON


THSPNON

Person 1: Are you Spanish, Hispanic, or Latino?

Persons 2+: And how about NAME? (Is NAME Spanish, Hispanic, or Latino?)

Yes

No

DK

Ref

=> RACE


RACE

Person 1: I am going to read you a list of five race categories. Please choose one or more races that you consider yourself to be: White; Black or African American; American Indian or Alaska Native; Asian; OR Native Hawaiian or Other Pacific Islander.

Persons 2+: And how about NAME? (Please choose one or more races that NAME considers himself/herself to be: White; Black or African American; American Indian or Alaska Native; Asian; OR Native Hawaiian or Other Pacific Islander).

Do not probe unless response is Hispanic or a Hispanic origin.

Enter all that apply.

White

Black or African American

American Indian or Alaska Native

Asian

Native Hawaiian or Other Pacific Islander

Other [DO NOT READ] => RACEOT: What is his/her/your race? [open text]

DK/Ref

=> EDUCA


EDUCA

ASK ONLY FOR PEOPLE AGE 15+

Person 1: What is the highest level of school you have completed or the highest degree you have received?

Persons 2+: And how about NAME? (What is the highest level of school NAME has completed or the highest degree NAME has received?)

<1> Less than 1st grade

<2> 1st, 2nd, 3rd or 4th grade

<3> 5th or 6th grade

<4> 7th or 8th grade

<5> 9th grade

<6> 10th grade

<7> 11th grade

<8> 12th grade, NO DIPLOMA

<9> HIGH SCHOOL GRADUATE B High school DIPLOMA or the equivalent (For example: GED)

<10> Some college but no degree

<11> Associate degree in college B Occupational/vocational program

<12> Associate degree in college B Academic program

<13> Bachelor=s degree (For example: BA, AB, BS)

<14> Master=s degree (For example: MA, MS, MEng, Med, MSW, MBA)

<15> Professional School Degree (For example: MD, DDS, DVM, LLB, JD)

<16> Doctorate degree (For example: PhD, EdD)

<99> DK/Ref

=> AFEVER


AFEVER

ASK ONLY FOR PEOPLE AGE 15+

Person 1: Did you ever serve on active duty in the U.S. Armed Forces?

Persons 2+: And how about NAME? (Did NAME ever serve on active duty in the U.S. Armed Forces?)

Yes

No

DK

Ref

=> MARITL


MARITL

READ IF NECESSARY; ASK ONLY FOR PEOPLE AGE 15+

[NOTE: If reference person reports being married to any other household member in RELATE, store >married= in MARITL for both the reference person and his/her spouse and do not ask this question for either of them.]

Person 1: Are you now married, widowed, divorced, separated, or never married?

Persons 2+: And how about NAME? (Is NAME now married, widowed, divorced, separated, or never married?)

Married

Widowed

Divorced

Separated

Never married

DK/Ref


STATE

What state do you live in?

[menu with hard-coded state codes for all 50 states plus District of Columbia]


HHINC

This next question is about income. We know that people aren=t used to talking about their income but we ask this question to get an OVERALL statistical picture of your community and the nation, NOT to find out about you personally. Is [your/the combined] total annual income [of everyone living in this household] above or below $[xx]?

(1) Above ($xx)

(2) Below ($xx)


Specifications for dollar amount:

If there is no one under 18 living in the household then fill these amounts, based on the number of household members:

1 person: 20000

2 people: 25000

3 people: 30000

4 people: 40000

5 people: 45000

6 people: 50000

7 people: 60000

8 people: 65000

9 people: 75000

10+: 75000 + (# people - 9)*5000


If there is at least one child age 0-17 living in the household then fill these amounts, based on the number of household members :

1 person: 30000

2 people: 40000

3 people: 45000

4 people: 55000

5 people: 65000

6 people: 75000

7 people: 85000

8 people: 95000

9 people: 115000

10+: 115000 + (# people - 9)

=> HEARING


3. DISABILITY


Section Overview: The purpose of this section is to identify any disabilities of all household members.


HEARING

We want to learn about people who have physical, mental, or emotional conditions that cause serious difficulty with their daily activities. [Are you/Is anyone in this household] deaf or [do you/does anyone] have serious difficulty hearing?

Yes => if single-person household store (1) and => SEEING; else => HEARWHO

No => SEEING

DK/Ref => SEEING


HEARWHO

Who is that?

PROBE: Anyone else?

=> SEEING


SEEING

[Are you/Is anyone in this household] blind or [do you/does anyone] have serious difficulty seeing, even when wearing glasses?

Yes => if single-person household store (1) and => CONCEN; else => SEEWHO

No => CONCEN

DK/Ref => CONCEN


SEEWHO

Who is that?

PROBE: Anyone else?

=> CONCEN


CONCEN

Because of a physical, mental, or emotional condition, [do you/does anyone in this household] have serious difficulty concentrating, remembering, or making decisions?

Yes => if single-person household store (1) and => WALK; else => CONCENWHO

No => WALK

DK/Ref => WALK


CONCENWHO

Who is that?

PROBE: Anyone else?

=> WALK


WALK

[Do you/Does anyone in this household] have serious difficulty walking or climbing stairs?

Yes => if single-person household store (1) and => DRESS; else => WALKWHO

No => DRESS

DK/Ref => DRESS


WALKWHO

Who is that?

PROBE: Anyone else?

=> DRESS


DRESS

[Do you/Does anyone in this household] have difficulty dressing or bathing?

Yes => if single-person household store (1) and => ERRANDS; else => ERNDSWHO

No => ERRANDS

DK/Ref => ERRANDS


DRESSWHO

Who is that?

PROBE: Anyone else?

=> ERRANDS


ERRANDS

Because of a physical, mental, or emotional condition [do you/does anyone in this household] have difficulty doing errands alone such as visiting a doctor's office or shopping?

Yes => if single-person household store (1) and => JOBS; else => ERNDSWHO

No => JOBS

DK/Ref => JOBS


ERNDSWHO

Who is that?

PROBE: Anyone else?

=> JOBS


4. LABOR FORCE


Section Overview:

The purpose of this section is to collect information on work activities and earnings of all household members age 15+. The items are asked in a Aperson-based@ format, in which the entire series (JOBS thru TIPSEARN) is asked about one person, and then the series is asked for the next person on the roster, and so on, until there are no more people age 15+.


JOBS

(Next I have some questions about work experience.) (First/Next I=d like to ask you about yourself/NAME). Did [you/NAME] work at a job or business at any time during 2009?

Yes => WKSWORK

No => PART

DK/Ref => PART


PART

Did [you/NAME] do any temporary, part-time, or seasonal work even for a few days during 2009?

Yes => WKSWORK

No => NOWRK

DK/Ref => CK-JOBS


NOWRK

What was the main reason [you/NAME] did not work in 2009?

Ill, or disabled and unable to work

Taking care of home or family

Going to school

Retired

No work available

Other/specify => NOWRKSP (open-text specify)

=> CK-JOBS


WKSWORK

During 2009 in how many weeks did [you/NAME] work even for a few hours? Include paid vacation and sick leave as work.

PROBE: If respondent can only answer in months, multiply the number of months by four to derive number of weeks and ask if that number sounds about right.

[number of weeks (1-52)] => HRSWEEK

DK => EARN

Ref => CK-JOBS


HRSWEEK (Q41)

In the weeks that [you/NAME] worked, how may hours did [you/NAME] usually work per week?

[number of hours, 1-168]

DK/Ref

=> EARN


EARN (Q48aa)

How much did [you/NAME] earn from this work before taxes and other deductions during 2009?

PROBE: Your best estimate is fine.

READ IF NECESSARY: You can give me a weekly, monthly, yearly amount or whatever is easiest for you.

[dollar amount] => UNIT

DK/Ref => CK-JOBS


UNIT (Q48aap)

ASK OR VERIFY

Is this a weekly, every other week, twice a month, monthly, or yearly amount?

Weekly

Every other week

Twice a month

Monthly

Yearly

DK/Ref

=> TIPSYN


TIPSYN (Q48a3)

Does this amount include all tips, bonuses, overtime pay, or commissions [you/NAME] may have received from this work in 2009?

Yes => CK-JOBS

No => TIPSEARN

DK/Ref => CK-JOBS


TIPSEARN (Q48aad)

How much did [you/NAME] earn in tips, bonuses, overtime pay, or commissions from that work in 2009?

=> CK-JOBS


CK-JOBS

  • if there are more people age 15+ => back to JOBS

  • else => CK-UNEMP


5. UNEARNED INCOME


Section Overview:

The purpose of this section is to collect information on receipt of the following benefits:

  • unemployment compensation

  • social security

  • supplemental security income (SSI)

  • TANF cash assistance

  • food stamps

  • WIC

  • pension and retirement income

The question on unemployment compensation is asked at the person-level, and it is asked only of those people who worked less than 35 weeks during 2009 (including people who did not work at all during 2009). All remaining topics (Social Security thru pensions/retirement) are asked at the household level (ie: ADid anyone in the household receive X@). If yes, followup questions determine who in the household received the benefit and, for certain benefits (all but SSI and WIC), the amount received from that benefit.


V.1. UNEMPLOYMENT COMPENSATION


CK-UNEMP:

  • if SUBJECT did not work all year (PART=no) or worked less than 35 weeks (WKSWORK<35) or is retired => UNEMP

  • else => SSYN


UNEMP

(Now I have some questions about benefits.) (First/Next I=d like to ask you about yourself/NAME). At any time during 2009 did [you/NAME] receive any State or Federal unemployment compensation?

Yes => UNEMPAMT

No => CK-SSYN

DK/Ref => CK-SSYN


UNEMPAMT

How much did [you/NAME] receive from State or Federal unemployment compensation during 2009?

PROBE: Your best estimate is fine.

[dollar amount]

DK/Ref

=> CK-SSYN


CK-SSYN

  • if there are more people age 15+ => back to CK-UNEMP for next person on the roster

  • else => SSYN


V.2. SOCIAL SECURITY


SSYN (56a)

(Now I have some questions about benefits.) During 2009 did (you/anyone in this household) receive any Social Security payments from the U.S. Government?

Yes => if single-person household => SSEASY; else => SSWHO

No => SSIYN

DK/Ref => SSIYN


SSWHO (56b)

Who received Social Security payments either for themselves or as combined payments with other family members?

PROBE: Anyone else?

[display hh roster] => SSEASY

DK/Ref => SSIYN


SSEASY (56dp)

(If multiple people selected in SSWHO fill: First/Now I=d like to ask you about yourself/NAME). What is the easiest way for you to tell us (name's/your) Social Security payment: monthly, quarterly, or yearly?

(4) Monthly => SSAMT

(5) Quarterly => SSAMT

(7) Yearly => SSAMT

DK => SSAMT

Ref => CK-SSRSN


SSAMT (56d)

How much did (you/name) receive per [if SSEASY=monthly or quarterly fill: (month/quarter)] in Social Security payments in 2009?

[dollar amount]

DK/Ref

[Blank] If already included in amount reported for another household member, press enter => AMT_ALR

=> CK-SSPMTS


CK-SSPMTS

  • if SSEASY=monthly or quarterly or DK => SSMPTS

  • else => CK-SSRSN


SSPMTS (56d2)

For how many (months/quarters) did (name/you) receive Social Security in 2009?

[number of months/quarters]

DK/Ref

=> CK-SSRSN


CK-SSRSN

  • If SUBJECT is 65+ (AGERNG=3) store (1) in SSRSN and => CK-SSIYN

  • else => SSRSN


SSRSN

What were the reasons (name/you) (was/were) getting Social Security in 2009?

Enter all that apply

Probe: Any Other Reason?

Retired

Disabled

Widowed

Spouse

Surviving child

Dependent child

On behalf of surviving, dependent, or disabled children

Other/Specify => SSRs

DK/Ref


CK-SSIYN

  • if there are more people checked in SSWHO => SSEASY for next person on the roster

  • else if HHINC=below => SSIYN

  • else => PENSYN


V.3: SSI (SUPPLEMENTAL SECURITY INCOME)


SSIYN (57a)

During 2009 did (you/anyone in this household) receive any SSI payments, that is, Supplemental Security Income?

Note: SSI are assistance payments to low-income aged, blind and disabled persons, and come from state or local welfare offices, the Federal government, or both.

Yes => SSIWHO

No => TANFYN

DK/Ref => TANFYN


SSIWHO (57b)

Who received SSI?

PROBE: Anyone else?

=> TANFYN


V.4. TANF CASH ASSISTANCE


TANFYN (59a88)

At any time during 2009, even for one month, did (you/anyone in this household) receive any CASH assistance from a state or county welfare program [if STATE ne Arizona fill: such as [fill state-specific name]]?

PROBE: Include cash payments from:

welfare or welfare‑to‑work programs,

Temporary Assistance for Needy Families program (TANF),

Aid to Families with Dependent Children (AFDC),

General Assistance/Emergency Assistance program,

Diversion Payments,

Refugee Cash and Medical Assistance program,

General Assistance from Bureau of Indian Affairs, or

Tribal Administered General Assistance.

PROBE: Do not include food stamps/Supplemental Nutrition Assistance Program (SNAP) benefits, SSI, energy assistance, WIC, school meals or transportation, childcare, rental, or educational assistance.

Yes => TANFWHO

No => FSYN

DK/Ref => FSYN


TANFWHO (59b_88)

Who received this cash assistance?

PROBE: Anyone else?

[display hh roster] => TANFEASY

[no one selected] => CK-FSYN

DK/Ref => CK-FSYN


TANFEASY (59ep)

(If multiple people selected in TANFWHO fill: First/Next I=d like to ask you about yourself/NAME). What is the easiest way for you to tell us (name's/your) CASH assistance payments: weekly, every other week, twice a month, monthly, or yearly?

Weekly => TANFAMT

Every other week (bi-weekly) => TANFAMT

Twice a month => TANFAMT

Monthly => TANFAMT

Yearly => TANFAMT

DK => TANFAMT

Ref => CK-FSYN


TANFAMT (59e)

During 2009 how much CASH assistance did (you/name) receive [if TANFEASY=weekly/every other week/twice a month/monthly fill: per week/every other week/twice a month/per month]?

[dollar amount]

DK/Ref

=> CK-TANFPMTS


CK-TANFPMTS

  • if TANFEASY=weekly, every other week, twice a month, monthly or DK => TANFPMTS

  • else => CK-FSYN


TANFPMTS (59e2)

How many (weekly/every other week/twice a month/monthly) cash assistance payments did (name/you) receive in 2009?

[number of payments]

DK/Ref

=> CK-FSYN


CK-FSYN

  • if there are more people checked in TANFWHO => TANFEASY

  • else => FSYN


V.5. FOOD STAMPS


FSYN (Q87)

Did (you/ anyone in this household) get food stamps or a food stamp benefit card at any time during 2009?

Yes => FSWHO

No => CK-WIC

DK/Ref => CK-WIC

FSWHO (Q88)

Which of the people now living here were covered by food stamps during 2009?

PROBE: Anyone else?

[display hh roster] => FSEASY

[no one selected] => CK-WIC

DK/Ref => CK-WIC


FSEASY (Q90p)

(If multiple people selected in FSWHO fill: First/Next I=d like to ask you about yourself/NAME). What is the easiest way for you to tell us the value of the food assistance [you/he/she] received: monthly or yearly?

Monthly => FSAMT

Yearly => FSAMT

DK => FSAMT

Ref => CK-CK-WIC


FSAMT (Q90)

What is the (monthly) value of the food assistance [you/NAME] received in 2009?

[dollar amount]

DK/Ref

=> CK-FSPMTS


CK-FSPMTS

  • if FSEASY=monthly => FSPMTS

  • else => CK-CK-WIC


FSPMTS (Q902)

How many months was food assistance received in 2009?

[number of months]

DK/Ref

=> CK-CK-WIC


CK-CK-WIC

  • if there are more people checked in FSWHO => FSEASY

  • else => CK-WIC


CK-WIC

  • if there is at least one female age 15-64 in the household => WICYN

  • else => PENSYN


V.6. WIC


WICYN

At any time during 2009, (was/were) (you/ anyone in this household) on WIC, the Women, Infants, and Children Nutrition Program?

Yes => WICWHO

No => PENSYN

DK/Ref => PENSYN


WICWHO

Who received WIC for themselves or on behalf of a child?

PROBE: Anyone else?

=> PENSYN


V.7. PENSION INCOME [ASK ONLY FOR PEOPLE AGE 15+]


PENSYN (Q62A)

During 2009 did (you/ anyone in this household) receive any pension or retirement income from a previous employer or union, or any other type of retirement income (other than Social Security)?

Yes => PENSWHO

No => Health section

DK/Ref => Health section


PENSWHO (Q62b)

Who received pension or retirement income?

PROBE: Anyone else?

[display hh roster] => PENSEASY

[DK/REF/no one selected] => CK-HEALTH

PENSEASY (Q62E1p)

(If multiple people selected in PENSWHO fill: First/Now I=d like to ask you about yourself/NAME). What is the easiest way for you to tell us (name=s/your) pension or retirement income: weekly, every other week, twice a month, monthly or yearly?

Weekly => PENSAMT

Every other week => PENSAMT

Twice a month => PENSAMT

Monthly => PENSAMT

Yearly => PENSAMT

DK => PENSAMT

Ref => CK-HEALTH


PENSAMT (Q62E1)

How much did (name/you) receive (per week, every other week, twice a month, per month) in pension or retirement income in 2009?

[dollar amount]

DK/Ref

=> CK-PENSPMTS


CK-PENSPMTS

  • if PENSEASY=weekly, every other week, twice a month, monthly => PENSPMTS

  • else => CK-HEALTH


PENSPMTS (Q62E12)

How many (weekly/every other week/twice a month/monthly)payments did (name/you) receive in pension and retirement income in 2009?

[number of payments]

DK/Ref

=> CK-HEALTH


CK-HEALTH

  • if there are more people checked in PENSWHO => PENSEASY

  • else => Health Section (CPS, ACS or EXP, depending on case ID)


6. HEALTH INSURANCE: CPS


Section Overview:

The purpose of this section is to capture health coverage status (covered or not) and type of plan covered by AT ANY TIME during the past calendar year, for all household members regardless of age. The series asks a set of eight household-level questions, one on each plan type (eg: AAt any time during 2009 was anyone in this household covered by Medicare?@). If the answer to the household-level screener is Ayes@ then a followup question is asked to determine who had the coverage.


SHI1

These next questions are about health insurance coverage during the calendar year 2009. The questions apply to ALL persons of ALL ages.

=> SHI2


SHI2

At any time in 2009, (was/were) (you/ anyone in this household) covered by a health insurance plan provided through (their/your) current or former employer or union?

PROBE: Military health insurance will be covered later in another question.

Yes => if single-person hh Store (1) in O_JOBPOL, column 17 and => SHI5; else => SHI3

No => SHI7

DK/REF => SHI7


SHI3

Who in this household were policyholders?

Enter all that apply, separate using the space bar or a comma.

PROBE: Anyone Else?

[line numbers] => Store (1) in O_JOBPOL, column 17 for each person selected => SHI4

DK/Ref => SHI7


SHI4

In addition to (name/you) who else in this household was covered by (name=s/your) plan?

Enter all that apply, separate using the space bar or a comma.

Probe: Anyone else?

[line numbers] => Store (1) in O_JOBDEP, column 17 for each person selected

DK/Ref =>

=> SHI5


SHI5

Did (name=s/your) plan cover anyone living outside this household?

Yes => Who? [?] PROBE: Anyone else?

No =>

DK/REF =>

=> SHI6


SHI6

Did (name=s/your) former or current employer or union pay for all, part, or none of the health insurance premium?

NOTE: Report here employer's contribution to employee's health insurance premiums, not the employee's medical bills.

All

Part

None

=> SHI7

NOTE: Repeat SHI4 thru SHI6 for each policyholder selected in SHI3 then => SHI7


SHI7

At any time during 2009, (was/were) (you/ anyone in this household) covered by a health insurance plan that (you/they) PURCHASED DIRECTLY FROM AN INSURANCE COMPANY, that is, not related to current or past employment?

Yes => SHI8 => if single-person hh Store (1) in O_DIRPOL, column 17 and => SHI10; else => SHI8

No => SHI11

DK/REF => SHI11


SHI8

Who in this household were policyholders?

Enter all that apply, separate using the space bar or a comma.

PROBE: Anyone Else?

[line numbers] => Store (1) in O_DIRPOL, column 17 for each person selected => SHI9

DK/Ref => SHI11


SHI9

In addition to (name/you) who else in this household was covered by (name=s/your) plan?

Enter all that apply, separate using the space bar or a comma.

Probe: Anyone else?

[line numbers] => Store (1) in O_DIRDEP, column 17 for each person selected

DK/Ref =>

=> SHI10


SHI10

Did (name=s/your) plan cover anyone living outside this household?

Yes =>

No =>

DK/REF =>

=> SHI11

NOTE: Repeat SHI9 thru SHI10 for each policyholder selected in SHI8 then => SHI11


SHI11

At any time in 2009, (was/were) (you/ anyone in this household) covered by the health insurance plan of someone who does not live in this household?

Yes => SHI12 => if single-person hh Store (1) in O_OUT, column 17 => SHI13; else => SHI12

No => SHI13

DK/REF => SHI13


SHI12

Who was that?

Enter all that apply, separate using the space bar or a comma.

PROBE: Anyone Else?

[line numbers] => Store (1) in O_OUT, column 17 for each person selected

DK/Ref =>

=> SHI13


SHI13

At any time in 2009, (was/were) (you/ anyone in this household) covered by Medicare?

Read if necessary: Medicare is the health insurance for persons 65 years old and over OR persons with disabilities.

Yes => if single-person hh Store (1) in O_MCARE, column 17 => SHI15; else => SHI14

No => SHI15

DK/REF => SHI15


SHI14

Who was that?

Enter all that apply, separate using the space bar or a comma.

PROBE: Anyone Else?

[line numbers] => Store (1) in O_MCARE, column 17 for each person selected

DK/Ref =>

=> SHI15


SHI15

At any time in 2009, (was/were) (you/ anyone in this household) covered by Medicaid / (fill state name)?

Read if necessary: Medicaid / (fill state name) is the Government Assistance Program that pays for health care.

Yes => if single-person hh Store (1) in O_MCAID, column 17 => SHI17; else => SHI16

No => SHI21

DK/REF => CK-SHI21


SHI16

Who was that?

Enter all that apply, separate using the space bar or a comma.

PROBE: Anyone Else?

[line numbers] => Store (1) in O_MCAID, column 17 for each person selected => SHI17

DK/Ref => CK-SHI21


SHI17

How many months during 2009, (was/were) (name/you) covered by Medicaid/(fill State name)?

Enter number of months (1-12)

NOTE: Repeat SHI7 for each person selected in SHI16 => CK-SHI21


CK-SHI21

  • If anyone in the household is under 19 years old => SHI21

  • else => SHI18


SHI21

In [fill STATE], the [fill state SCHIP program name(s)] helps families get health insurance for CHILDREN. [in certain states fill: Just to be sure, were/else fill: Were) any of the children in this household covered by that program?

Read if necessary: (fill state CHIP program name) is the name of your state's CHIP program. It is the same as the Children's Health Insurance Program, which helps pay for children's health care.

Yes => if single-person hh Store (1) in O_OTHGOVT, column 17 => SHI18; else => SHI22

No => SHI18

DK/REF => SHI18


SHI22

Who was that?

Enter all that apply, separate using the space bar or a comma.

PROBE: Anyone Else?

[line numbers] => Store (1) in O_OTHGOVT, column 17 for each person selected

DK/Ref =>

=> SHI18


SHI18

At any time in, 2009 (was/were) (you/ anyone in this household) covered by TRICARE, CHAMPUS, CHAMPVA, VA, military health care, or Indian Health Service?

NOTE: CHAMPVA is the Civilian Health And Medical Program of the Department of Veteran's Affairs.

Yes => if single-person hh Store (1) in O_MIL, column 17 => SHI20; else => SHI19

No => SHICI

DK/REF => SHICI


SHI19

Who was that?

Enter all that apply, separate using the space bar or a comma.

PROBE: Anyone Else?

[line numbers] => Store (1) in O_MIL, column 17 for each person selected => SHI20

DK/Ref => SHIC1


SHI20

What plan (was/were) (name/you) covered by?

Enter all that apply, separate using the space bar or a comma.

Probe: Any Other Plan?

TRICARE, CHAMPUS or military health care

CHAMPVA

VA

Indian Health Service

Other => SHI20s [other/specify open text; allow 65 characters]

=> SCHC1

NOTE: Repeat SHI20 for each person selected in SHI19 => SHIC1


SHIC1

Other than the plans I have already talked about, during 2009, was anyone in this household covered by a health insurance plan [in certain states fill: such as the [state-specific plan name(s)] or any other type of plan/else fill: of any other type]?

Yes => if single-person hh => SHIC3; else => SHIC2

No => CK-SHIC4

DK/REF => CK-SHIC4


SHIC2

Who has insurance?

Enter all that apply, separate using the space bar or a comma.

PROBE: Anyone Else?

[line numbers] => SHIC3

DK/Ref => CK-SHIC4


SHIC3

What type of health insurance (was/were) (name/you) covered by in 2009?

Up to six entries allowed

Probe: Any Other Type Of Plan?

Medicare => Store (1) in O_MCARE, column 17 for each person selected in SHIC1/2

Medicaid => Store (1) in O_MCAID, column 17 for each person selected in SHIC1/2

TRICARE or CHAMPUS => Store (1) in O_MIL, column 17 for each person selected in SHIC1/2

CHAMPVA (CHAMPVA IS THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERAN\'S AFFAIRS) => Store (1) in O_MIL, column 17 for each person selected in SHIC1/2

VA => Store (1) in O_MIL, column 17 for each person selected in SHIC1/2

Military Health Care => Store (1) in O_MIL, column 17 for each person selected in SHIC1/2

Children's Health Insurance Program (CHIP) => Store (1) in O_OTHGOVT, column 17 for each person selected in SHIC1/2

Indian Health Service

Other government health care => Store (1) in O_OTHGOVT, column 17 for each person selected in SHIC1/2

Employer/union provided (policyholder) => Store (1) in O_JOBPOL, column 17 for each person selected in SHIC1/2

Employer/union provided (as dependent) => Store (1) in O_JOBDEP, column 17 for each person selected in SHIC1/2

Privately purchased (policyholder) => Store (1) in O_DIRPOL, column 17 for each person selected in SHIC1/2

Privately purchased (as dependent) => Store (1) in O_DIRDEP, column 17 for each person selected in SHIC1/2

Plan of someone outside the household => Store (1) in O_OUT, column 17 for each person selected in SHIC1/2

Other => Store (1) in O_OTHER, column 17 for each person selected in SHIC1/2 => SHIC3s [other/specify open text; allow 65 characters]

NOTE: We=ll need to decide what to do if respondents report a plan type here that was already reported in the earlier questions (this is not that uncommon in the real CPS). Should we just overwrite (with another A1") or store a different value? For example, we could set up logic whereby if a plan type gets reported here, the instrument first checks to see if a A1" was already filled and if so, fills a A2" instead.

NOTE: Repeat SHIC3 for each person selected in SHIC2 then => CK-SHIC4


CK-SHIC4

  • if anyone in the household is uninsured => SHIC4

  • else => HEALTHSTAT


SHIC4

I have recorded that [you/NAME(s)] [were/was] not covered by a health plan at any time during 2009. Is that correct?

Yes => HEALTHSTAT

No => if single-person hh => SHIC6; else => SHIC4A

DK/REF => HEALTHSTAT


SHIC4A

Who should be marked as covered?

Enter all that apply, separate using the space bar or a comma.

PROBE: Anyone Else?

[line numbers] => SHIC6

DK/Ref => HEALTHSTAT


SHIC6

What type of health insurance (was/were) (name/you) covered by in 2009?

Up to six entries allowed

Probe: Any other type of plan?

Medicare => Store (1) in O_MCARE, column 17 for each person selected in SHIC4/4A

Medicaid => Store (1) in O_MCAID, column 17 for each person selected in SHIC4/4A

TRICARE or CHAMPUS => Store (1) in O_MIL, column 17 for each person selected in SHIC4/4A

CHAMPVA (CHAMPVA IS THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERAN\'S AFFAIRS) => Store (1) in O_MIL, column 17 for each person selected in SHIC4/4A

VA => Store (1) in O_MIL, column 17 for each person selected in SHIC4/4A

Military Health Care => Store (1) in O_MIL, column 17 for each person selected in SHIC4/4A

Children's Health Insurance Program (CHIP) => Store (1) in O_OTHGOVT, column 17 for each person selected in SHIC4/4A

Indian Health Service

Other government health care => Store (1) in O_OTHGOVT, column 17 for each person selected in SHIC4/4A

Employer/union provided (policyholder) => Store (1) in O_JOBPOL, column 17 for each person selected In SHIC4/4A

Employer/union provided (as dependent) => Store (1) in O_JOBDEP, column 17 for each person selected in SHIC4/4A

Privately purchased (policyholder) => Store (1) in O_DIRPOL, column 17 for each person selected in SHIC4/4A

Privately purchased (as dependent) => Store (1) in O_DIRDEP, column 17 for each person selected in SHIC4/4A

Plan of someone outside the household => Store (1) in O_OUT, column 17 for each person selected in SHIC4/4A

Other => Store (1) in O_OTHER, column 17 for each person selected in SHIC4/4A SHIC6s [other/specify open text; allow 65 characters]

NOTE: Similar to SHIC3 above, we=ll need to decide what to do if respondents report a plan type here that was already reported in the earlier series.

NOTE: Repeat SHIC6 for each person selected in SHIC4A => HEALTHSTAT


7. HEALTH INSURANCE: ACS


Section Overview:

The purpose of this section is to capture CURRENT health coverage status (covered or not) and type of plan for all household members. The series is asked at the Aperson-level@ about ALL household members (regardless of age). This means that the entire series (ACSJOB thru ACSOTHER) is asked about one person in the household, and then the series is repeated for the next person, and so on, until all household members have been asked about.


ACSJOB

I am now going to ask you some questions about [your/NAME=s] health insurance and health coverage. [Are you/Is NAME] currently covered by health insurance through a current or former employer or union of [yours/yours or another family member/<him/her> or another family member]?

Yes => Store (1) in O_JOBDK, column of interview month, for NAME

No =>

DK/Ref =>

=> ACSDIR


ACSDIR

[Are you/Is NAME] currently covered by insurance purchased directly from an insurance company by [you/you or another family member/<him/her> or another family member]?

Yes => Store (1) in O_DIRDK, column of interview month, for NAME

No =>

DK/Ref =>

=> ACSMCARE


ACSMCARE

[Are you/Is NAME] currently covered by Medicare, for people 65 and older or people with certain disabilities?

Yes => Store (1) in O_MCARE, column of interview month, for NAME

No =>

DK/Ref =>

=> ACSMCAID


ACSMCAID

[Are you/Is NAME] currently covered by Medicaid, Medical Assistance, or any kind of government-assistance plan for those with low incomes or a disability?

Yes => Store (1) in O_MCAID, column of interview month, for NAME

No =>

DK/Ref =>

=> ACSMIL


ACSMIL

[Are you/Is NAME] currently covered by TRICARE or other military health care?

Yes => Store (1) in O_MIL, column of interview month, for NAME

No =>

DK/Ref =>

=> ACSVA


ACSVA

[Are you/Is NAME] currently covered through the Veteran=s Administration or [have you/has NAME] ever used or enrolled for Veteran=s Administration health care)?

Yes => Store (1) in O_MIL, column of interview month, for NAME

No =>

DK/Ref =>

=> ACSIHS

ACSIHS

[Are you/Is NAME] currently covered through Indian Health Service?

Yes =>

No =>

DK/Ref =>

=> ACSOTHER


ACSOTHER

[Are you/Is NAME] currently covered by any other type of health insurance or health coverage plan?

Yes => Store (1) in O_OTHER, column of interview month, for NAME

=> ACSOTHERS

No => HEALTHSTAT

DK/Ref => HEALTHSTAT


ACSOTHERS

What is the name of the health care plan?

[open text; allow 30 characters]

=> HEALTHSTAT


Note: repeat ACSJOB thru ACSOTHERS for each person on the roster

=> HEALTHSTAT


HELP SCREENS


For ACSMCAID:

Medicaid, medical assistance, or government assistance plans for those with low incomes or a disability may be known by different names in different states. Below is a list of program names by state. This list is not comprehensive, but provides guidance for those not familiar with the term Medicaid and may only know their specific state program name.

[fill state-specific program name(s) based on the attachment]


For all items except ACSMCAID:

DATA USES

  • Used to allocate funds to states and local areas for government‑provided health care.

  • Used by federal agencies, such as the Department of Health and Human Services, to evaluate the effectiveness of government health care programs.

  • Used by federal and local agencies to examine the adequacy of existing health care facilities in meeting current and future health care needs.


WHY WE ASK IT THIS WAY

  • These questions ask about each type of insurance a respondent may have.

  • Insurance can include both private coverage (provided by an employer or purchased) as well as public coverage (from government programs such as Medicare, Medicaid, and VA).

  • The reason the question specifies Ahealth insurance or health coverage plans@ is because many types of public (government) coverage are not technically health insurance plans. The goal of the item is to obtain information on whether an individual has health insurance coverage and if so, what kind of coverage he/she has.


8. HEALTH INSURANCE: EXP


Section Overview:

The purpose of this section is to capture health coverage status (covered or not), type of plan, and months of coverage (from January 1, 2009 until the date of interview in March/April/May, 2010) for all household members.


Household Respondent: The series begins by asking whether the household respondent has coverage now and, if so, the type of coverage. We then ask whether that coverage started before or after January 1, 2009 and, if after, we ask for the start month. In either case, we ask whether the coverage was continuous from the reported start date, and if so we infer that the coverage lasted from that start date through to the date of the interview. If the coverage was not continuous we determine the start month of the current spell of coverage, and what other months between January 1, 2009 and the start date the respondent also had coverage from that same plan or plan type. We then determine whether any other household members are also covered by that same plan and, if so, whether they were covered during the same months as the household respondent.


We then check for any gaps in coverage for the household respondent between January 1, 2009 and the interview month. If there were gaps we ask about coverage from any other plan during those gaps, and go through the same routine described above to capture details (plan type, months of coverage, other household members also covered, etc.). For all respondents (those with and without gaps) we ask if they currently have, or had at any time during 2009, any coverage in addition to that already reported. If so, again the same routine on plan type, months, etc. is followed.

Other Household Members: Once the entire series is administered for the household respondent, we move on to Person 2. If this person was mentioned as having any coverage during the course of the household respondent=s interview, we simply ask the two questions on additional plans B that is, whether Person 2 has or had any coverage in addition to any plans already reported by the household respondent. If so the same routine is followed to determine plan type, months of coverage, and whether any other household members are also covered under that plan. If Person 2 was not mentioned during the household respondent=s interview as being covered, the series for Person 2 begins from the first basic question on any type of coverage, plan type, months of coverage, etc. The series then repeats in this fashion for Persons 3+, until all household members (regardless of age) have been asked about explicitly.


Plan Name Fills


The following specifications should be used to fill APLANTYPE" and APLANOR" throughout the instrument, and to fill the labels in the FR grid on health insurance status of all household members.


PLANTYPE

  • if plan is job-related (SRCEGEN=job OR JOBCOV=yes OR SRCEMISC=former employer or union/business assn) and NAME was selected in POLHOLDER fill:

  • Aby a plan through your job@ in questionnaire items

  • ANAME=s job@ in FR grid label

  • if plan is job-related (SRCEGEN=job OR JOBCOV=yes OR SRCEMISC=former employer or union/business assn) and a name was selected in POLHOLDER but it was NOT NAME fill:

  • Aby a plan through [policyholder]=s job@ in questionnaire items

  • ANAME=s job@ in FR grid label

  • if plan is job-related (SRCEGEN=job OR JOBCOV=yes OR SRCEMISC=former employer or union/business assn) and POLHOLDER=DK or REF fill:

  • Aby a plan through someone=s job@ in questionnaire items

  • AJob@ in FR grid label

  • if plan is directly-purchased (SRCEDEPDIR=direct purchase) and NAME was selected in POLHOLDER fill:

  • Aby a plan you purchased directly@ in questionnaire items

  • ANAME=s direct@ in FR grid label

  • if plan is directly-purchased (SRCEDEPDIR=direct purchase and a name was selected in POLHOLDER but it was NOT NAME fill:

  • Aby a plan that [policyholder] purchased directly@ in questionnaire items

  • ANAME=s direct@ in FR grid label

  • if plan is directly-purchased (SRCEDEPDIR=direct purchase and POLHOLDER=DK or REF fill:

  • Aby a plan that someone purchased directly@ in questionnaire items

  • ADirect@ in FR grid label

  • if POLHOLDER=@Outside HH@ fill:

  • Aby a plan of someone outside the household@ in questionnaire items

  • AOutside HH@ in FR grid label

  • if (MCARE1 or MCARE2 = yes) OR GOVTYPE=Medicare fill:

  • Aby Medicare@ in questionnaire items

  • AMedicare@ in FR grid label

  • fills for government plans (ie: if OTHGOVT=yes or if GOVTYPE=Medicaid/Medical Assistance/SCHIP):

  • if GOVPLAN=1 thru 11 fill Aby [response category selected in GOVPLAN]@

  • else if GOVPLAN=12 (other government plan) fill:

  • Aby a government plan@ in questionnaire items

  • AGovt plan@ in FR grid label

  • else if GOVPLAN=13 (other/specify) fill:

  • Aby [open-text write-in from GOVSPEC]@ in questionnaire items

  • A[Write-in from GOVSPEC]@ in FR grid label

  • fills for military plans:

  • if MILTYPE =1 thru 5 fill:

  • Aby [plan type selected in MILTYPE]@ in questionnaire items

  • AMilitary@ in FR grid label

  • else if MILTYPE=6, DK or REF fill:

  • Aby a military plan@ in questionnaire items

  • AMilitary@ in FR grid label

  • if SRCEMISC=school fill:

  • Aby a school plan@ in questionnaire items

  • ASchool@ in FR grid label

  • if SRCEMISC=other fill:

  • Aby [open-text write-in from MISCSPEC]@ in questionnaire items

  • A[open-text write-in from MISCSPEC@ in FR grid label

  • if SRCEMISC=DK/Ref fill:

  • A@ in questionnaire items

  • APlan@ in FR grid label


PLANOR:

  • if GOVPLAN=1 thru 11 fill: Aor any other type of government assistance plan@

  • if MILTYPE=1 thru 5 fill: Aor any other plan related to military service@


A. COVERAGE STATUS


Section Overview:

The purpose of this section is to identify whether household members have any type of coverage at all. For those aged 65+ or disabled, the series begins with a question on Medicare. For all others the series begins with a basic question on whether the person is covered or not. If they are covered, they immediately skip to the next section (Section B: Plan Type) in order to identify the particular type of coverage. If they say Ano@ to this initial question on coverage, there is a series of follow up questions which explicitly prompt the respondent with certain plan types that are often underreported (e.g.: Medicare and Medicaid). So if these explicit followup questions prompt a report of coverage, then the particular plan type is identified. However, it is in Section B that plan type is identified for most people.


HINTRO

[First time read fill: These next questions are about health insurance. I'll be asking you about coverage from January, 2009 up until now.] [First time read fill: First I=d like to ask you about yourself/Second time read fill: Now I=d like to ask you about NAME.]

=> CK-MCARE1


CK-MCARE1

  • if NAME is 65+ or at least one of the six questions on disability is yes => MCARE1

  • else go to ANYCOV


MCARE1

Medicare is the health insurance for persons 65 years old and over or persons with disabilities. [Are you/Is NAME] NOW covered by Medicare?

< Yes > => Store (1) in O_MCARE, column of interview month => BEFORAFT

< No > => ANYCOV

< DK/Ref > => ANYCOV


ANYCOV

[Do you/Does NAME] NOW have any type of health plan or health coverage?

< Yes > => SRCEGEN

< No > => MCAID

< DK/Ref > => MCAID


MCAID

[Are you/Is NAME] NOW covered by Medicaid, Medical Assistance, S-CHIP, or any other kind of government assistance program that helps pay for health care?

READ IF NECESSARY: [Some examples of government programs/An example of a government program] in [STATE] is/are: [fill names in STATE from attachment "state-specific plan names"]. [STATE] also offers AS-CHIP@ (now called CHIP), which is the State Children's Health Insurance Program.

< Yes > => GOVPLAN

< No > => CK-MCARE2

< DK/Ref > => CK-MCARE2


CK-MCARE2:

  • If MCARE1 was already asked => OTHGOVT

  • else => MCARE2


MCARE2

Medicare is the health insurance for persons 65 years old and over or persons with disabilities. [Are you/Is NAME] NOW covered by Medicare?

< Yes > => Store (1) in O_MCARE, column of interview month => BEFORAFT

< No > => OTHGOVT

< DK/Ref > => OTHGOVT

OTHGOVT

[Are you/Is NAME] NOW covered by any kind of plan, such as [fill state-specific PLAN NAME 1 thru PLAN NAME n, separated by commas, and Aor@ before the final plan name]?

READ IF NECESSARY: [Some examples of government programs/An example of a government program] in [STATE] is/are: [fill names in STATE from attachment "state-specific plan names"]. [STATE] also offers AS-CHIP@ (now called CHIP), which is the State Children's Health Insurance Program.

< Yes > => GOVPLAN

< No > => VERIFY

< DK/Ref > => VERIFY


VERIFY

OK, I have recorded that [you are/NAME is] not covered by any kind of health plan or health coverage. Is that correct?

< Yes, not covered > => Store (1) in O_UNINSURED, column of interview month => ADDLASTP

< No, NAME is covered > => SRCEGEN

< DK/Ref > => ADDLASTP


BLOCK EXPR.GETCOVA


B. PLAN TYPE: LEADERS


Section Overview:

The purpose of this section is to identify the plan type (e.g.: Medicare, military, job-based policyholder, etc.) for all Aleaders@ B that is, the first person for whom a given plan was identified. Note this is not necessarily the policyholder; it is defined simply based on the somewhat arbitrary order in which household members were listed on the roster. For example, if a husband and wife are both covered by the husband=s plan through his job, but the wife is the household respondent (and thus listed first on the roster) the husband=s policy will first reported in her interview, and she will be identified as a dependent. However, for purposes of data collection, she will be defined as a ALeader@ since it was during her interview that the plan was first reported. Other household members (the husband and any other dependents) would be considered AFollowers@ on this plan.


Answers in this section will be used to create variables for the 14 plan types described in the AOutput Overview@ appendix. The specifications below refer to these variables specifically whenever possible, but when an instruction applies to any of the 14 plan types the generic O_PLANTYPE is used.


SRCEGEN

ASK OR VERIFY

(In order to better understand the health care needs of Americans, we=d like to learn more about how [you get/NAME gets] that coverage). Is it provided through a job, the government, or some other way?

PROBE: "Job" includes coverage from someone=s own job as well as coverage from a spouse=s or parent=s job.

PROBE: Include coverage through former employers and unions, and COBRA plans.

PROBE: If this coverage is provided through a job with the government or the military, consider that coverage through a job.

< Job (current or former) > => MILPLAN

< Government > => JOBCOV

< Other way > => SRCEDEPDIR

< DK/Ref > => GOVASST


GOVASST

Is it a government assistance-type plan?

READ IF NECESSARY: [Some examples of government programs/An example of a government program] in [STATE] is/are: [fill names in STATE from attachment "state-specific plan names"]. [STATE] also offers AS-CHIP@ (now called CHIP), which is the State Children's Health Insurance Program.

< Yes > => GOVTYPE

< No/DK/Ref > => SRCEDEPDIR

JOBCOV

Is or was that coverage related to a JOB with the government?

PROBE: Include coverage through FORMER employers and unions, and COBRA plans.

< Yes > => MILPLAN

< No > => GOVTYPE

< DK/Ref > => GOVTYPE


GOVTYPE

ASK OR VERIFY

What type of government plan is it B Medicare, Medicaid, Medical Assistance or S-CHIP, military or Veterans Administration coverage, or something else?

READ IF NECESSARY: [Some examples of government programs/An example of a government program] in [STATE] is/are: [fill names in STATE from attachment "state-specific plan names"]. [STATE] also offers AS-CHIP@ (now called CHIP), which is the State Children's Health Insurance Program.

READ IF NECESSARY: Medicare is for people 65 years old and older or people with certain disabilities; Medicaid is for low-income families, disabled and elderly people who require nursing home care; and S-CHIP is for low-income families and children.

< Medicare > => Store (1) in O_MCARE, column of interview month => BEFORAFT

< Medicaid, Medical Assistance, SCHIP> => GOVPLAN

< Military or Veterans Administration care> => Store (1) in O_MIL, column of interview month => MILTYPE

< Other > => GOVPLAN

< DK/Ref > => GOVPLAN


GOVPLAN

ASK IF NECESSARY

What do you call the program?

(1) < Medicaid >

(2) < Medical Assistance >

(3) < S-CHIP or CHIP (the State Children=s Health Insurance Program) >

(4) < PLAN NAME 1>

(5) < PLAN NAME 2>

(6) < PLAN NAME 3>

(7) < PLAN NAME 4>

(8) < PLAN NAME 5>

(9) < PLAN NAME 6>

(10) < PLAN NAME 7>

(11) < PLAN NAME 8>

(12) < other government plan >

(13) < other/specify > GOVSPEC [allow 65 characters]

< DK, REF>

=> If AMedicaid@ or AMedical Assistance@ store (1) in O_MCAID, column of interview month; else Store (1) in O_OTHGOVT, column of interview month => BEFORAFT


MILPLAN

READ IF NECESSARY

Is that plan related to military service in any way?

< Yes > => Store (1) in O_MIL, column of interview month => MILTYPE

< No/DK/Ref > => POLHOLDER


MILTYPE

ASK OR VERIFY

Which plan [Are you/Is NAME] covered by? Is it TRICARE, TRICARE for Life, CHAMPVA, Veterans Administration care, military health care, or something else?

<1> TRICARE

<2> TRICARE for Life

<3> CHAMPVA

<4> Veterans Administration

<5> Military health care

<6> Other

<99> DK/Ref

=> POLHOLDER


SRCEDEPDIR

ASK OR VERIFY

How is that coverage provided? Is it through a parent or spouse, direct purchase from the insurance company, or some other way?

PROBE: If a parent/spouse purchases the coverage directly (both 1 and 2), then code <2> for direct purchase.

<1> Parent or spouse => POLHOLDER

<2> Direct purchase from the insurance company => POLHOLDER

<3> Some other way => SRCEMISC

<99> DK/Ref => SRCEMISC


SRCEMISC

ASK OR VERIFY

Is it provided through a former employer, a union or business association, a school, or some other way?

<1> Former employer => POLHOLDER

<2> Union or business association => POLHOLDER

<3> School =>Store (1) in O_SCHOOL, column of interview month => BEFORAFT

<4> Some other way (specify) => MISCSPEC

<99> DK/Ref => Store (1) in O_OTHER, column of interview month => BEFORAFT


MISCSPEC [allow 65 characters] => Store (1) in O_OTHER, column of interview month => BEFORAFT


POLHOLDER

ASK OR VERIFY

Who is the policyholder?

< display household roster > => CK-SRCEPTSP

<> Someone living outside the household => CK-SRCEPTSP

< DK/Ref > => CK-SRCEPTSP

Output specs:

<> if plan is job-related (SRCEGEN=job OR JOBCOV=yes OR SRCEMISC=former employer or union/business assn) and the name selected as policyholder is NAME:

=> If O_MIL ne 1 store (1) in O_JOBPOL, column of interview month

<> if plan is job-related and the name selected as policyholder is within the hh but NOT NAME:

=> If O_MIL ne 1 store (1) in O_JOBDEP, column of interview month

<> if plan is job-related and policyholder=DK/Ref:

=> If O_MIL ne 1 store (1) in O_JOBDK, column of interview month

<> if plan is directly-purchased (SRCEDEPDIR=direct purchase) and the name selected as policyholder is NAME:

=> If O_MIL ne 1 store (1) in O_DIRPOL, column of interview month

<> if plan is directly-purchased and the name selected as policyholder is within the household but NOT the same person as NAME:

=> If O_MIL ne 1 store (1) in O_DIRDEP, column of interview month

<> if plan is directly-purchased and policyholder=DK/Ref:

=> If O_MIL ne 1 store (1) in O_DIRDK, column of interview month

< > if name selected as policyholder is outside the household:

=> If O_MIL ne 1 store (1) in O_OUT, column of interview month


CK-SRCEPTSP

  • if SRCEDEPDIR=parent/spouse => SRCEPTSP

  • else =>BEFORAFT


SRCEPTSP

ASK OR VERIFY

And is that coverage provided through their job, direct purchase from the insurance company, or some other way?

< Job (current or former) > => If O_MIL ne 1 and if POLHOLDER ne 17 then store (1) in O_JOBDEP, column of interview month

< Direct purchase from the insurance company > => If O_MIL ne 1 if POLHOLDER ne 17 then store (1) in O_DIRDEP, column of interview month

< Some other way > => If O_MIL ne 1 if POLHOLDER ne 17 then store (1) in O_OTHER, column of interview month

< DK/Ref > => If O_MIL ne 1 if POLHOLDER ne 17 then store (1) in O_OTHER, column of interview month

ALL ABOVE => BEFORAFT


C. MONTHS OF COVERAGE: LEADERS


Section Overview:

The purpose of this section is to identify the months of coverage (from January, 2009 up thru the interview month) for all leaders.


BEFORAFT

Did that coverage start before or after January 1, 2009?

PROBE: Your best estimate is fine.

If PLANTYPE for NAME=jobpol or jobdep or jobdk display: PROBE: When we say Athat coverage@ we mean any coverage through [your/policyholder=s] employer. So if [you/policyholder] switched plans offered by the employer, or even switched employers, we still consider this all the same coverage.

If PLANTYPE for NAME=dirpol or dirdep or dirdk display: PROBE: When we say Athat coverage@ we mean any coverage [you/policyholder] purchased directly. So if [you/policyholder] switched plans but they were all directly-purchased, we still consider this all the same coverage.

< Before January 1, 2009 > => CNTCOV

< On or after January 1, 2009 > => MNTHBEG1

< DK/REF > => ANYTHIS


MNTHBEG1

In what month did that coverage start?

PROBE: Your best estimate is fine.

If PLANTYPE for NAME=jobpol or jobdep display: PROBE: When we say Athat coverage@ we mean any coverage through [your/policyholder=s] employer. So if [you/policyholder] switched plans offered by the employer, or even switched employers, we still consider this all the same coverage.

If PLANTYPE for NAME=dirpol or dirdep display: PROBE: When we say Athat coverage@ we mean any coverage [you/policyholder] purchased directly. So if [you/policyholder] switched plans but they were all directly-purchased, we still consider this all the same coverage.

< MONTH 1-12 > => CK-YEARBEG1

< DK/Ref > => ANYTHIS


CK-YEARBEG1

  • if MNTHBEG1 is January, February, March (or month of interview) => YEARBEG1

  • else store 2009 in YEARBEG1 and =>CNTCOV


YEARBEG1

ASK IF NECESSARY: And what year was that?

< 2009 > => CNTCOV

< 2010 > => CNTCOV

< DK/Ref > => ANYTHIS


ANYTHIS

Did [you/NAME] have the coverage at any time THIS YEAR (2010)?

If PLANTYPE for NAME=jobpol or jobdep display: PROBE: When we say Athat coverage@ we mean any coverage through [your/policyholder=s] employer. So if [you/policyholder] switched plans offered by the employer, or even switched employers, we still consider this all the same coverage.

If PLANTYPE for NAME=dirpol or dirdep display: PROBE: When we say Athat coverage@ we mean any coverage [you/policyholder] purchased directly. So if [you/policyholder] switched plans but they were all directly-purchased, we still consider this all the same coverage.

< Yes > => WHATMNTHS1

< No > => ANYLAST

< DK > => ANYLAST

< Ref > => ANYLAST


ANYLAST

Did [you/NAME] have the coverage at any time LAST YEAR (2009)?

If PLANTYPE for NAME=jobpol or jobdep display: PROBE: When we say Athat coverage@ we mean any coverage through [your/policyholder=s] employer. So if [you/policyholder] switched plans offered by the employer, or even switched employers, we still consider this all the same coverage.

If PLANTYPE for NAME=dirpol or dirdep display: PROBE: When we say Athat coverage@ we mean any coverage [you/policyholder] purchased directly. So if [you/policyholder] switched plans but they were all directly-purchased, we still consider this all the same coverage.

< Yes > => WHATMNTHS2

< No > => CK-OTHMEMB

< DK> => CK-OTHMEMB

<Ref > => CK-OTHMEMB


CNTCOV

And has it been continuous since then?

If PLANTYPE for NAME=jobpol or jobdep display: PROBE: When we say Athat coverage@ we mean any coverage through [your/policyholder=s] employer. So if [you/policyholder] switched plans offered by the employer, or even switched employers, we still consider this all the same coverage.

If PLANTYPE for NAME=dirpol or dirdep display: PROBE: When we say Athat coverage@ we mean any coverage [you/policyholder] purchased directly. So if [you/policyholder] switched plans but they were all directly-purchased, we still consider this all the same coverage.

< Yes > => If BEFORAFT=before store (1) in O_PLANTYPE, column 1 up through the column of interview month; else store (1) in O_PLANTYPE columns starting with month and year reported in MNTHBEG1 and YEARBEG1 and ending with interview month => CK-OTHMEMB

< No > => MNTHBEG2

< DK > => MNTHBEG2

< REF > => WHATMNTHS1


MNTHBEG2

In what month did this most recent spell of coverage start?

PROBE: Your best estimate is fine.

If PLANTYPE for NAME=jobpol or jobdep display: PROBE: When we say Athat coverage@ we mean any coverage through [policyholder=s] employer. So if [policyholder] switched plans offered by the employer, or even switched employers, we still consider this all the same coverage.

If PLANTYPE for NAME=dirpol or dirdep display: PROBE: When we say Athat coverage@ we mean any coverage directly purchased by you or another policyholder. So if you/NAME switched plans but they were all directly-purchased, we still consider this all the same coverage.

< MONTH 1-12 > => CK-YEARBEG2

< DK/Ref > => WHATMNTHS1


CK-YEARBEG2

  • if MNTHBEG2 is January, February, March (or month of interview) => YEARBEG2

  • else store 2009 in YEARBEG2=> Store (1) in O_PLANTYPE columns, starting with the column for the month/year reported in MNTHBEG2/YEARBEG2 and ending with column of interview month then => SPELLADD


YEARBEG2

ASK IF NECESSARY: And what year was that?

< 2009 > => SPELLADD

< 2010 > => SPELLADD

=> Store (1) in O_PLANTYPE columns, starting with the column for the month/year reported in MNTHBEG2/YEARBEG2 and ending with column of interview month

< DK/Ref > => WHATMNTHS1


SPELLADD

A little earlier you mentioned you were covered [PLANTYPE] [if BEFORAFT=before fill: Aat some point before January 2009"; else fill Ain [month/year selected in MNTHBEG1/YEARBEG1]], and I=ve just recorded that you were also covered from [fill month/year reported in MNTHBEG2/YEARBEG2] until now. Were there any other months between January 2009 and [fill month/year reported in MNTHBEG2/YEARBEG2] that you were also covered [if GOVPLAN=1 thru 11 or if MILTYPE=1 thru 5 fill PLANOR; else fill PLANTYPE]?

< Yes > => WHATMNTHS1

< No > => CK-OTHMEMB

< DK> => CK-OTHMEMB

<Ref > => CK-OTHMEMB


Example 1: Job-based policyholder who said coverage started before January 1, 2009 (in BEFORAFT) but then said it was not continuous (in CNTCOV), and said that the most recent spell started in June, 2009 (in MNTHBEG2/YEARBEG2):

A little earlier you mentioned you were covered by a plan through your job at some point before January 2009, and I=ve just recorded that you were also covered from June, 2009 until now. Were there any other months between January 2009 and June, 2009 that you were also covered by a plan through your job?


Example 2: Direct-purchase dependent who said coverage started after January 1, 2009 (in BEFORAFT) and said it started in February, 2009 (in MNTHBEG1/YEARBEG1), but then said it was not continuous (in CNTCOV), and said that the most recent spell started in June, 2009 (in MNTHBEG2/YEARBEG2):

A little earlier you mentioned you were covered by a plan that John Doe purchased directly in February, and I=ve just recorded that you were also covered from June, 2009 until now. Were there any other months between January 2009 and June, 2009 that you were also covered by a plan that John Doe purchased directly?


Example 3: Respondent covered by HAWK-I (Iowa=s SCHIP plan) who said coverage started before January 2009 (in BEFORAFT), but then said it was not continuous (in CNTCOV), and said that the most recent spell started in June, 2009 (in MNTHBEG2/YEARBEG2):

A little earlier you mentioned you were covered by HAWK-I at some point before January 2009, and I=ve just recorded that you were also covered from June, 2009 until now. Were there any other months between January 2009 and June, 2009 that you were also covered by HAWK-I or any other type of government assistance plan?


Example 4: Respondent covered by TRICARE who said coverage started after January 1, 2009 (in BEFORAFT) and said it started in February, 2009 (in MNTHBEG1/YEARBEG1), but then said it was not continuous (in CNTCOV), and said that the most recent spell started in June, 2009 (in MNTHBEG2/YEARBEG2):

A little earlier you mentioned you were covered by TRICARE in February, and I=ve just recorded that you were also covered from June, 2009 until now. Were there any other months between January 2009 and June, 2009 that you were also covered by TRICARE or any other plan related to military service?


WHATMNTHS1

What [if SPELLADD asked fill: other] months [if ANYTHIS=1 fill: between January 2010 and now; else fill: between January 2009 and now] [were you/was NAME] covered [PLANTYPE]?

< MONTHS 0-16 > => Store (1) in O_PLANTYPE columns for months/years selected then

=> if ANYTHIS =1 => WHATMNTHS2; else CK-OTHMEMB

< DK/Ref > => CK-OTHMEMB


WHATMNTHS2

What months during 2009 [were you/was NAME] [if ANYTHIS=1 fill: also] covered [PLANTYPE]?

< MONTHS 1-12 > => Store (1) in O_PLANTYPE columns for months/year selected => CK-OTHMEMB

< DK/Ref > => CK-OTHMEMB


CK-OTHMEMB

  • if single-person household => CK-ADDGAP1

  • else goto OTHMEMB


D. FOLLOWERS COVERED BY LEADER=S PLAN


Section Overview:

The purpose of this section is to determine whether anyone in addition to the leader also has that same type of coverage and, if so, what months they had the coverage. As noted in Section B, household members other than the leader who were also covered on the same plan are called Afollowers.@


OTHMEMB

And is anyone else in this household also covered by [PLANTYPE] [or any other type of government assistance plan/or any other plan related to military service]?

< Yes > => COVWHO

< No > => CK-ADDGAP1

< DK/Ref > => CK-ADDGAP1


COVWHO

Who? (Who else is covered by [PLANTYPE] [or any other type of government assistance plan/or any other plan related to military service])?

PROBE: Anyone else?

< display household roster > => Store (1) in O_PLANTYPE, column of interview month for each person selected => CK-SAMEMNTHS

< DK/Ref > => CK-ADDGAP1


CK-SAMEMNTHS

  • if leader was covered from January 2009 up to the interview date (BEFORAFT=before and CNTCOV=yes) => SAMEMNTHS1

  • else if leader=s coverage started after January, 2009 and was continuous (BEFORAFT=on/after and CNTCOV=yes) => SAMEMNTHS2

  • else => WHATMNTHS3


SAMEMNTHS1

And [was NAME also/were NAME(s) selected in COVWHO all] covered the same months as you/NAME, or [was he/she/you//were they] covered for more or fewer months?

< All covered same months > => Store (1) in O_PLANTYPE, column 1 thru column of interview date for each person selected in COVWHO => CK-ADDGAP1

< At least one person covered more or fewer months > => WHATMNTHS3

< DK/Ref > => WHATMNTHS3


SAMEMNTHS2

And [was NAME also/were NAME(s) selected in COVWHO all] covered the same months as you/NAME, or [was he/she/you//were they] covered for more or fewer months?

< All covered same months > => Store (1) in O_PLANTYPE, starting with MNTHBEG1/YEARBEG1 and ending with column of interview date for each person selected in COVWHO

=> ADDGAP1

< At least one person covered more or fewer months > => WHATMNTHS3

< DK/Ref > => WHATMNTHS3


WHATMNTHS3

Person 1: What months between January 2009 and now was [NAME from COVWHO] covered?

Persons 2+: How about NAME? (What months between January 2009 and now was [NAME from COVWHO] covered?)

< MONTHS 0-16 > => Store (1) in O_PLANTYPE columns for months/years selected for each person asked about => CK-ADDGAP1

< DK/Ref > => CK-ADDGAP1

[REPEAT FOR EACH PERSON SELECTED IN COVWHO]


E. LEADER: Additional current and past plans


E.1 Gaps in Coverage


Item Overview: If the leader had no gaps in coverage, from January, 2009 up until the interview month, they skip to Section G on any additional past coverage. For any leader who had a gap in coverage, the purpose of this section is to determine whether they had any other coverage during those gaps (ADDGAP1). If coverage during a gap is reported, we ask APAST LOOP.@ This is basically a repeat of Sections B thru D, but with minor modifications. All questions are asked in the past tense, and this is the only change to Section B (on plan type). In Section C (on months covered), rather than asking the full series (before/after January 1, 2009, etc.), we ask just one question on months of coverage. In Section D (on followers) the only modification is that there is one version of SAMEMNTHS (rather than two). See PAST LOOP for full specifications.


CK-ADDGAP1

  • if no gaps in coverage => CK-ADDTHISP

  • else => ADDGAP1


ADDGAP1

[if covered by only one PLANTYPE fill: Ok so far I have recorded that [you were/NAME was] covered by PLANTYPE in recent months.]

[if covered by 2+ PLANTYPEs fill: Earlier I recorded [you were/NAME was] covered by different sources of health coverage in recent months.]

What about [months not covered]? [Were you/Was NAME] covered by any type of health plan or health coverage in [that/those] month[s]?

< Yes > => SRCEGEN-PST [PAST LOOP then => CK-ADDGAP2]

< No > => CK-ADDTHISP

< DK/Ref > => CK-ADDTHISP


Past Loop [for ADDGAP1=yes] BLOCK EXPR.GETPAST


Section B: Plan Type


SRCEGEN-PST

ASK OR VERIFY

Was that coverage provided through a job, the government, or some other way?

PROBE: "Job" includes coverage from someone=s own job as well as coverage from a spouse=s or parent=s job.

PROBE: Include coverage through former employers and unions, and COBRA plans.

PROBE: If this coverage is provided through a job with the government or the military, consider that coverage through a job.

< Job (current or former) >=> MILPLAN-PST

< Government > => JOBCOV-PST

< Other way > => SRCEDEPDIR-PST

< DK/Ref > => GOVASST-PST


GOVASST-PST

Was it a government assistance-type plan?

< Yes > => GOVTYPE-PST

< No/DK/Ref > => SRCEDEPDIR-PST


JOBCOV-PST

Was that coverage related to a JOB with the government?

PROBE: Include coverage through FORMER employers and unions, and COBRA plans.

< Yes > => MILPLAN-PST

< No > => GOVTYPE-PST

< DK/Ref > => GOVTYPE-PST


GOVTYPE-PST

ASK OR VERIFY

What type of government plan was it B Medicare, Medicaid, Medical Assistance or S-CHIP, military or Veterans Administration coverage, or something else?

READ IF NECESSARY: [Some examples of government programs/An example of a government program] in [STATE] is/are: [fill names in STATE from attachment].

READ IF NECESSARY: Medicare is for people 65 years old and older or people with certain disabilities; Medicaid is for low-income families, disabled and elderly people who require nursing home care; and S-CHIP is for low-income families and children.

< Medicare > => Store (1) in O_MCARE (months selected in WHATMNTHS-PST) => WHATMNTHS-PST

< Medicaid, Medical Assistance, SCHIP> => GOVPLAN-PST

< Military or Veterans Administration care> => Store (1) in O_MIL, (months selected in WHATMNTHS-PST)

=> MILTYPE-PST

< Other > => Store (1) in O_OTHGOVT, (months selected in WHATMNTHS-PST) => GOVPLAN-PST

< DK/Ref > => Store (1) in O_OTHGOVT (months selected in WHATMNTHS-PST) => GOVPLAN-PST


GOVPLAN-PST

ASK IF NECESSARY

What did you call the program?

(1) < Medicaid >

(2) < Medical Assistance >

(3) < SCHIP >

(4) < PLAN NAME 1>

(5) < PLAN NAME 2>

(6) < PLAN NAME 3>

(7) < PLAN NAME 4>

(8) < PLAN NAME 5>

(9) < PLAN NAME 6>

(10) < PLAN NAME 7>

(11) < PLAN NAME 8>

(12) < other government plan > => GOVSPEC-PST

(13) < other/specify >

< DK, REF>

=> If AMedicaid@ or AMedical Assistance@ store (1) in O_MCAID; else Store (1) in O_OTHGOVT, (months selected in WHATMNTHS-PST) => WHATMNTHS-PST


GOVSPEC-PST [allow 65 characters] => WHATMNTHS-PST


MILPLAN-PST

READ IF NECESSARY

Was that plan related to military service in any way?

< Yes > => Store (1) in O_MIL, (months selected in WHATMNTHS-PST) => MILTYPE-PST

< No/DK/Ref > => POLHOLDER-PST


MILTYPE-PST

ASK OR VERIFY

Which plan [were you/was NAME] covered by? Was it TRICARE, TRICARE for Life, CHAMPVA, Veterans Administration care, military health care, or something else?

<1> TRICARE

<2> TRICARE for Life

<3> CHAMPVA

<4> Veterans Administration

<5> Military health care

<6> Other

<99> DK/Ref

=> POLHOLDER-PST


SRCEDEPDIR-PST

ASK OR VERIFY

How was that coverage provided? Was it through a parent or spouse, direct purchase from the insurance company, or some other way?

PROBE: If a parent/spouse purchases the coverage directly (both 1 and 2), then code <2> for direct purchase.

<1> Parent or spouse => POLHOLDER-PST

<2> Direct purchase from the insurance company => POLHOLDER-PST

<3> Some other way => SRCEMISC-PST

<99> DK/Ref => SRCEMISC-PST


SRCEMISC-PST

ASK OR VERIFY

Was it provided through a former employer, a union or business association, a school, or some other way?

<1> Former employer => POLHOLDER-PST

<2> Union or business association => POLHOLDER-PST

<3> School =>Store (1) in O_SCHOOL, (months selected in WHATMNTHS-PST) => WHATMNTHS-PST

<4> Some other way (specify) => MISCSPEC-PST

<99> DK/Ref => Store (1) in O_OTHER, (months selected in WHATMNTHS-PST) => WHATMNTHS-PST


MISCSPEC-PST [allow 65 characters] => Store (1) in O_OTHER, (months selected in WHATMNTHS-PST)

=> WHATMNTHS-PST


POLHOLDER-PST

ASK OR VERIFY

Who was the policyholder?

< display household roster > => CK-SRCEPTSP-PST

<> Someone living outside the household => CK-SRCEPTSP-PST

< DK/Ref > => CK-SRCEPTSP-PST

Output specs:

<> if plan is job-related (SRCEGEN=job OR JOBCOV=yes OR SRCEMISC=former employer or union/business assn) and the name selected as policyholder is NAME:

=> if O_MIL ne 1 then store (1) in O_JOBPOL, (months selected in WHATMNTHS-PST)

<> if plan is job-related and the name selected as policyholder is within the hh but NOT NAME:

=> if O_MIL ne 1 then Store (1) in O_JOBDEP, (months selected in WHATMNTHS-PST)

<> if plan is job-related and policyholder=DK/Ref:

=> if O_MIL ne 1 then Store (1) in O_JOBDK, (months selected in WHATMNTHS-PST)

<> if plan is directly-purchased (SRCEDEPDIR=direct purchase) and the name selected as policyholder is NAME:

=> if O_MIL ne 1 then Store (1) in O_DIRPOL, (months selected in WHATMNTHS-PST)

<> if plan is directly-purchased and the name selected as policyholder is within the household but NOT the same person as NAME:

=> if O_MIL ne 1 then Store (1) in O_DIRDEP, (months selected in WHATMNTHS-PST)

<> if plan is directly-purchased and policyholder=DK/Ref:

=> if O_MIL ne 1 then Store (1) in O_DIRDK, (months selected in WHATMNTHS-PST)

< > if name selected as policyholder is outside the household:

=> if O_MIL ne 1 then Store (1) in O_OUT, (months selected in WHATMNTHS-PST)


CK-SRCEPTSP-PST

  • if SRCEDEPDIR=parent/spouse => SRCEPTSP-PST

  • else => WHATMNTHS-PST


SRCEPTSP-PST

ASK OR VERIFY

And was that coverage provided through their job, direct purchase from the insurance company, or some other way?

< Job (current or former) > => If O_MIL ne 1 and if POLHOLDER ne 17 then Store (1) in O_JOBDEP, (months selected in WHATMNTHS-PST)

< Direct purchase from the insurance company > => If O_MIL ne 1 and if POLHOLDER ne 17 then Store (1) in O_DIRDEP, (months selected in WHATMNTHS-PST)

< Some other way > => If O_MIL ne 1 and if POLHOLDER ne 17 then Store (1) in O_OTHER, (months selected in WHATMNTHS-PST)

< DK/Ref > => If O_MIL ne 1 and if POLHOLDER ne 17 then Store (1) in O_OTHER, (months selected in WHATMNTHS-PST)

ALL ABOVE => WHATMNTHS-PST


Section C: Months of Coverage (Leader)


WHATMNTHS-PST

What months between January 2009 and now were you covered by [PLAN-PST]?

< MONTHS 0-16 > => Store (1) in O_PLANTYPE columns for months/years selected

< DK/Ref >

<all responses>

=> if single-person hh => [pick up where you left off; see flow chart]

else => OTHMEMB-PST


Section D: Followers


OTHMEMB-PST

And was anyone else in this household also covered by [PLANTYPE]?

< Yes > => COVWHO-PST

< No > => [pick up where you left off; see flow chart]

< DK/Ref > => [pick up where you left off; see flow chart]


COVWHO-PST

Who? (Who else was covered by [PLANTYPE])?

PROBE: Anyone else?

< display household roster > => CK-SAMEMNTHS-PST

< DK/Ref > => [pick up where you left off; see flow chart]


SAMEMNTHS-PST

And [was NAME also/were NAME(s) selected in COVWHO all] covered the same months as you/NAME, or [was he/she/you//were they] covered for more or fewer months?

< All covered same months > => Store (1) in O_PLANTYPE, column 1 thru column of interview date for each person selected in COVWHO-PST => [pick up where you left off; see flow chart]

< At least one person covered more or fewer months > => WHATMNTHS3-PST

< DK/Ref > => WHATMNTHS3-PST


WHATMNTHS3-PST

Person 1: What months between January 2009 and now was [NAME from COVWHO-PST] covered?

Persons 2+: How about NAME? (What months between January 2009 and now was [NAME from COVWHO-PST] covered?)

< MONTHS 0-16 > => Store (1) in O_PLANTYPE columns for months/years selected for each person asked about

< DK/Ref >

[REPEAT FOR EACH PERSON SELECTED IN COVWHO-PST]

<all responses> => [pick up where you left off; see flow chart]


CK-ADDGAP2

  • if NAME had any gap in coverage => ADDGAP2

  • else => CK-ADDTHISP


ADDGAP2

[if covered by only one PLANTYPE fill: Ok so far I have recorded that [you were/NAME was] covered by PLANTYPE in recent months.]

[if covered by 2+ PLANTYPEs fill: Earlier I recorded [you were/NAME was] covered by different sources of health coverage in recent months.]

What about [months not covered]? [Were you/Was NAME] covered by any type of health plan or health coverage in [that/those] month[s]?

< Yes > => GAPMNTHSP

< No > => CK-ADDTHISP

< DK/Ref > => CK-ADDTHISP


GAPMNTHSP

What months between January 2009 and now was/were you/NAME covered?

< MONTHS 0-16 > => Store (1) in O_OTHER in columns for months/years selected

=> CK-ADDTHISP

< DK/Ref > => CK-ADDTHISP


E.2 Additional Current Plans


Item Overview: The purpose of this section is to determine, for those currently covered, whether they have an additional, concurrent plan (ADDTHISP). We allow for data collection of only two concurrent plans for the interview month. Hence, respondents for whom we already have recorded at least two concurrent plans are skipped out. (Note that those without any current coverage would have skipped over this section entirely, from VERIFY to ADDLASTP). If the leader does have a second concurrent plan, we repeat Sections B thru D above and collect data on plan type, months of coverage, other household members covered, and months they were covered.


CK-ADDTHISP

  • if currently covered by 2+ plans (that is, if O_PLANTYPE=1 for two or more different plan types in interview month) => CK-ADDLASTP

  • else => ADDTHISP


ADDTHISP

Ok other than [if only one PLANTYPE reported for NAME so far for any month(s) fill: PLANTYPE; else if 2+ PLANTYPEs reported for NAME fill: the coverage we’ve already talked about] do you/does NAME NOW have any other type of health plan or health coverage?

PROBE: Do not include plans that cover only one type of care, such as dental or vision plans.

< Yes > => SRCEGEN [repeat Sections B thru D then => CK-ADDLASTP]

< No > => CK-ADDLASTP

< DK/Ref > => CK-ADDLASTP


Sections B thru D [for ADDTHISP=yes] BLOCK EXPR.GETCOVB


E.3 Additional Past Plans


Item Overview: The purpose of this section is to determine whether leaders had any additional plans at any time in 2009. All leaders get this question. If past coverage was reported during the course of questioning on current plans we fill AOther than those plans...@


CK-ADDLASTP

  • If ADDGAP1=(No, DK or REF) or ADDGAP2=(No, DK or REF) => CK-NEXTMEMB

  • else => ADDLASTP


ADDLASTP

And how about [if O_MASTER=Y for any month of 2009 fill: any other plans] during 2009? [If only one PLANTYPE for any month of 2009 fill: Other than PLANTYPE; else if 2+ PLANTYPEs for any months of 2009 fill: Other than the coverage we’ve already talked about] [WERE you/was NAME] covered by any [if 1+ PLANTYPEs fill: other] type of health plan or health coverage AT ANY TIME between January 2009 and now?

PROBE: Do not include plans that cover only one type of care, such as dental or vision plans.

< Yes > => SRCEGEN-PST [PAST LOOP then => CK-NEXTMEMB]

< No > => CK-NEXTMEMB

< DK/Ref > => CK-NEXTMEMB


Past Loop [for ADDLASTP=yes] BLOCK EXPR.GETPASTB


ROUTING INSTRUCTIONS FOR ADDITIONAL HOUSEHOLD MEMBERS


CK-NEXTMEMB

  • If all household members have been asked about explicitly (that is, at least one of the following questions was asked for each household member: MCARE1, ANYCOV, MCARE3, ANYGOVT2, ADDTHISS, ANYGOVT3, ADDLASTS) => HEALTHSTAT

  • else go to next person on roster

  • if O_PLANTYPE=blank for all plan types and all months => HINTRO for that person

  • else if O_PLANTYPE=1 for at least one plan type (ie: this person is a follower) then:

  • if NAME is 65+ and Medicare was not reported for him/her for any period of time => MCARE3

  • if Medicaid/Other govt plan was NOT yet reported for NAME for any period of time but there is a likelihood that NAME could be covered by these plan types (either because another hh member has been covered by Medicaid/other govt plan, or it is a low-income household) then => ANYGOVT2 [in terms of code, this means both O_MCAID and O_OTHGOVT are blank for all months for NAME and either: (O_MCAID=1 or O_OTHGOVT=1 for at least one other hh member for at least one month) or (HHINC=2) => ANYGOVT2]

  • else if NAME is currently covered by 2+ plans => CK-ANYGOVT3

  • else => CK-ADDTHISS


F. FOLLOWER: Additional current and past plans


F.1 Additional Current Plans


Item Overview: The purpose of this section is to explicitly ask about any additional plans covering Afollowers@ B household members who have already been reported as covered during the course of another person=s interview. In most cases these followers will skip to a simple question on any other coverage now (ADDTHISS), and then go on to a question on any additional past coverage (ADDLASTS). However, in some cases we first explicitly prompt respondents about certain types of public coverage, and then move on to the more general questions on any additional plans.


For both Medicare and Medicaid, there is ample evidence that respondents confuse the plans, and that Medicaid is substantially underreported. To reduce the chance of underreporting and improve on accuracy of plan type reporting, we exploit certain correlates of coverage. For Medicare, if a household member is 65+ or disabled but Medicare was not yet reported for that person, we explicitly ask about Medicare. For Medicaid and other government plans, often if one household member is covered by Medicaid, others are as well. Furthermore, respondents in low income households are more likely to be covered by Medicaid. So if a Follower has not yet been reported to have Medicaid, but Medicaid has been reported for one or more other household members, and/or if the Follower lives in a low-income household, we explicitly ask about Medicaid.


Under-reported Plans (for certain subgroups)


CK-MCARE3

  • if conditions for MCARE3 are met (see CK-NEXTMEMB above) => MCARE3

  • else if conditions for ANYGOVT2 are met (see CK-NEXTMEMB above) => ANYGOVT2

  • else => CK-ADDTHISS


MCARE3

Ok now I=d like to ask you about NAME. Medicare is the health insurance for persons 65 years old and over or persons with disabilities. Is NAME NOW covered by Medicare?

< Yes > => Store (1) in O_MCARE, column of interview month => BEFORAFT [repeat Sections C-D] then

=> CK-ADDTHISS2

< No/DK/REF > => CK-ADDTHISS

ANYGOVT2

Ok now I=d like to ask you about NAME. Is NAME NOW covered by Medicaid, Medical Assistance, S-CHIP, or any other kind of government assistance program that helps pay for health care?

< Yes > => GOVTYPE [repeat Section B-D, starting at GOVTYPE, then => CK-ADDTHISS2]

< No > => CK-ADDTHISS

< DK > => CK-ADDTHISS

< Ref > => CK-ADDTHISS


Sections B thru D [for ANYGOVT2=yes or MCARE3=yes] BLOCK EXPR2.GETCOVA


CK-ADDTHISS

  • if MCARE3=yes or ANYGOVT2=yes => CK-ADDTHISS2

  • else if currently covered by 2+ plans => CK-ANYGOVT3

  • else => ADDTHISS


ADDTHISS

[Fill unless MCARE3 or ANYGOVT2 asked: Ok now I’d like to ask you about NAME.] Other than the coverage we’ve already talked about do you/does NAME NOW have any other type of health plan or health coverage?

PROBE: Do not include plans that cover only one type of care, such as dental or vision plans.

< Yes > => SRCEGEN [repeat Sections B thru D then => CK-ADDTHISS2

< No/DK/REF > => CK-ANYGOVT3


Sections B thru D [for ADDTHISS=yes] BLOCK EXPR2.GETCOVA2


CK-ADDTHISS2

  • if NAME is currently covered by 2+ plans => CK-ANYGOVT3

  • else => ADDTHISS2


ADDTHISS2

[Fill unless MCARE3 or ANYGOVT2 asked: Ok now Id like to ask you about NAME.] Other than the coverage we’ve already talked about do you/does NAME NOW have any other type of health plan or health coverage?

PROBE: Do not include plans that cover only one type of care, such as dental or vision plans.

< Yes > => SRCEGEN [repeat Sections B thru D then => CK-ANYGOVT3

< No/DK/REF > => CK-ANYGOVT3


Sections B thru D [for ADDTHISS2=yes] BLOCK EXPR2.GETCOVB


F.3 Additional Past Plans


CK-ANYGOVT3

  • if Medicaid/Other govt plan was NOT yet reported for NAME for any period of time but there is a likelihood that NAME could be covered by these plan types (either because another hh member has been covered by Medicaid/other govt plan, or it is a low-income household) then => ANYGOVT3 [in terms of code, this means both O_MCAID and O_OTHGOVT are blank for all months for NAME and either: (O_MCAID=1 or O_OTHGOVT=1 for at least one other hh member for at least one month) or (HHINC=2) => ANYGOVT3

  • else => ADDLASTS


ANYGOVT3

And how about at any time from January 2009 up until now? (Was NAME covered by any kind of government assistance program at any time from January 2009 up until now)?

< Yes > => SRCEGEN-PST [PASTLOOP, starting with GOVTYPE then => CK-ADDGAP3]

< No > => ADDLASTS

< DK/Ref > => ADDLASTS


ADDLASTS

And how about [if O_MASTER=1 for any month of 2009 fill: any other plans] during 2009? Other than the coverage we’ve already talked about,] [WERE you/was NAME] covered by any other type of health plan or health coverage AT ANY TIME between January 2009 and now?

PROBE: Do not include plans that cover only one type of care, such as dental or vision plans.

< Yes > => SRCEGEN-PST [PAST LOOP then => CK-ADDGAP3]

< No > => CK-NEXTMEMB

< DK/Ref > => CK-NEXTMEMB


Past Loop [for ANYGOVT3=yes or ADDLASTS=yes] BLOCK EXPR2.GETPASTB


CK-ADDGAP3

  • if ADDLASTS=(No, DK or REF) or no gaps in coverage => CK-NEXTMEMB

  • else => ADDGAP3


ADDGAP3

[if covered by only one PLANTYPE fill: Ok so far I have recorded that [you were/NAME was] covered by PLANTYPE in recent months.]

[if covered by 2+ PLANTYPEs fill: Earlier I recorded [you were/NAME was] covered by different sources of health coverage in recent months.]

What about [months not covered]? [Were you/Was NAME] covered by any type of health plan or health coverage in [that/those] month[s]?

< Yes > => PAST LOOP then => CK-ADDGAP4

< No/DK/REF > => CK-NEXTMEMB


Past Loop [for ADDGAP3=yes] BLOCK EXPR2.GETPASTC


CK-ADDGAP4

  • if no gaps in coverage => CK-NEXTMEMB

  • else => ADDGAP4


ADDGAP4

[if covered by only one PLANTYPE fill: Ok so far I have recorded that [you were/NAME was] covered by PLANTYPE in recent months.]

[if covered by 2+ PLANTYPEs fill: Earlier I recorded [you were/NAME was] covered by different sources of health coverage in recent months.]

What about [months not covered]? [Were you/Was NAME] covered by any type of health plan or health coverage in [that/those] month[s]?

< Yes > => GAPMNTHSS

< No > => CK-NEXTMEMB

< DK/Ref > => CK-NEXTMEMB


GAPMNTHSS

What months between January 2009 and now was/were you/NAME covered?

< MONTHS 0-16 > => Store (1) in O_OTHER in columns for months/years selected

< DK/Ref > => CK-NEXTMEMB


9. RESPONDENT DEBRIEFING


Section Overview:

This section asks about health status of all household members (in a topic-based format, as in the demographics items). It then asks household-level questions on the respondent=s confidence in their answers, and their impressions of the ease and efficiency of the questions on health insurance. And for households who did not receive an advance letter, we ask for consent to link their survey data to administrative records, and then we ask for zip code and address. (Note that for households that received a letter, informed consent on linking is included in the letter so we don=t repeat the request in the survey).


HEALTHSTAT

Person 1: An important factor in evaluating a person's or family's health insurance situation is their current health status. Would you say your health in general is excellent, very good, good, fair, or poor?

Person 2: How about NAME? (Would you say your health in general is excellent, very good, good, fair, or poor?)

< excellent >

< very good >

< good >

< fair >

< poor >

< DK/REF >

=> REPEAT FOR NEXT PERSON ON ROSTER then => GOAL


GOAL

Since this is a test, and we=re trying to learn how to improve our survey, now I=d like to ask you a few questions about the questionnaire we just completed. There are two main goals of the questionnaire:

  • first, to determine whether you/anyone in the household [CPS and EXP: had/ACS: has] health insurance coverage [CPS: at any time during 2009/EXP: at any time from January 2009 up to now] and

  • second, to determine the type of coverage (whether through a job, Medicaid, etc.).

[Summarize health coverage status of all household members (refer to grid on screen)]

Is that an accurate summary of [your health insurance coverage/the health insurance coverage for everyone in this household?

< Yes >

< No > => GOALSP: Probe reasons for inaccuracies (open text)

< DK/Ref >

=> CONFCOV1


CONFCOV1

[Now I have some questions about the answers you gave for yourself]. How confident are you about your answers on whether you had any health coverage, [if (1) stored in any month in any O_PLANTYPE for NAME fill: and how you got that coverage,] on a scale of 1 to 5, where 1 is very confident and 5 is not confident?

<1> Very confident => CK-CONFTIME1

<2> => CK-CONFTIME1

<3> => COVWHY1

<4> => COVWHY1

<5> Not confident => COVWHY1

< DK/REF > => CK-CONFTIME1


COVWHY1

Probe reasons for not being very confident (open text)

=> CK-CONFTIME1



CK-CONFTIME1

  • if O_UNINSURED=1 for all months => CK-CONFCOV2

  • else => CONFTIME1


CONFTIME1

What about your answers on when you had the coverage? (How confident are you about those answers, where 1 is very confident and 5 is not confident?)

CPS PROBE: The questions asked about coverage AAt any time during 2009.@

ACS PROBE: The questions asked about coverage now.

EXP PROBE: The questions asked about coverage at any time from January 2009 up to now.

<1> Very confident => CK-CONFCOV2

<2> => CK-CONFCOV2

<3> => TIMEWHY1

<4> => TIMEWHY1

<5> Not confident => TIMEWHY1

< DK/REF > => CK-CONFCOV2


TIMEWHY1

Probe reasons for not being very confident (open text)

=> CK-CONFCOV2


CK-CONFCOV2

  • if single-person household => DBEASY

  • else => CONFCOV2


CONFCOV2

And how about other people in the household? How confident are you about your answers on whether they had any coverage [if (1) stored in any month in any O_PLANTYPE for any hh member fill: and how they got their coverage] on a scale of 1 to 5, where 1 is very confident and 5 is not confident?

<1> Very confident => CK-CONFTIME2

<2> => CK-CONFTIME2

<3> => COVWHY2

<4> => COVWHY2

<5> Not confident => COVWHY2

< DK/REF > => CK-CONFTIME2


COVWHY2

Probe reasons for not being very confident (open text)

=> CK-CONFTIME2


CK-CONFTIME2

  • if O_UNINSURED=1 for all months for all other household members => DBEASY

  • else => CONFTIME2


CONFTIME2

What about your answers on when they had the coverage? (How confident are you about those answers, where 1 is very confident and 5 is not confident?)

CPS PROBE: The questions asked about coverage AAt any time during 2009.@

ACS PROBE: The questions asked about coverage now.

EXP PROBE: The questions asked about coverage at any time from January 2009 up to now.

<1> Very confident => DBEASY

<2> => DBEASY

<3> => TIMEWHY2

<4> => TIMEWHY2

<5> Not confident => TIMEWHY2

< DK/REF > => DBEASY


TIMEWHY2

Probe reasons for not being very confident (open text)

=> DBEASY


DBEASY

How easy or hard was it to understand the questions on health insurance coverage, on a scale of 1 to 5, where 1 is very easy and 5 is very hard?

<1> Very easy => EFFIC

<2> => EFFIC

<3> => EASYWHY

<4> => EASYWHY

<5> Very hard => EASYWHY

< DK/REF > => EFFIC


EASYWHY

Probe reasons questions were not easy to understand (open text)

=> EFFIC


EFFIC

And how efficient were the questions on health insurance coverage, on a scale of 1 to 5, where 1 is very efficient and 5 is very inefficient?

<1> Very efficient

<2>

<3>

<4>

<5> Very inefficient

< DK/REF >

=> CK-EXITTHNK


CK-EXITTHNK

  • if INTRO_LTR=1 (respondent received advance letter) => EXITTHNK

  • else => LINK


LINK

if 3rd digit of case ID=1 then fill:

We'd like to conduct additional research to improve on the accuracy of our results by combining

your survey answers with data from other government agencies. Do you have any objections?

if 3rd digit of case ID=2 then fill:

We'd like to produce additional statistical data, and to reduce costs we=d like to combine your survey answers with data from other government agencies. Do you have any objections?

if 3rd digit of case ID=3 then fill:

We'd like to produce additional statistical data, without taking up your time with more questions, by combining your survey answers with data from other government agencies. Do you have any objections?

Yes => LINKWHY (open-text)

No =>

DK/REF =>

=> ZIP


HELP SCREEN

What Other Government Agencies and Why?

Your consent allows the Census Bureau to combine your answers with data we obtain from other government agencies, such as Medicare and Medicaid enrollment records. This helps make sure the data are complete and accurate.

Confidentiality Protections

The Census Bureau serves as the leading source of quality data about the nation's people and economy. We honor privacy and protect confidentiality, and all our research is conducted for statistical purposes only. The same confidentiality laws that protect your survey answers B Title 13, US Code, Section 9 B also protect any additional information we collect. Providing your consent is voluntary.


ZIP

What is your zip code?

[5 digit boxes] => ADDRESS

DK => ADDRESS

REF => THANKS

PROBE: We ask this because this survey is a random sample of telephone numbers, and we need zip codes and addresses to establish your geographic location. Your location within the U.S. is an important part of analyzing this survey. It helps us understand differences across urban, rural and suburban areas B NOT to find out about you personally. You will NOT be placed on any type of mailing list.


ADDR1

And your address? (STREET NUMBER AND NAME)

ADDR2 (ADDITIONAL NUMBER/NAME)

PROBE: We ask this because this survey is a random sample of telephone numbers, and we need zip codes and addresses to establish your geographic location. Your location within the U.S. is an important part of analyzing this survey. It helps us understand differences across urban, rural and suburban areas B NOT to find out about you personally. You will NOT be placed on any type of mailing list.

=> EXITTHNK




9



File Typeapplication/msword
File TitleSHIPP 2010 Flow Document
AuthorBureau Of The Census
Last Modified Bysmith056
File Modified2010-02-19
File Created2010-02-19

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