A2.
1.
2.
3.
4.
5.
6.
7.
8.
Community-Based Clinical Services
Circle
Yes or No
Behavioral health screenings.
Blood pressure and/or lipid profile/
cholesterol screening clinics.
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Blood pressure screening.
Cardiology risk factor screening clinics
(take care not to include if screening if
really marketing or case-finding).
Clinics for low-income persons.
Clinics for which a fee is charged and a
profit is realized (do report if there is a
negative margin).
Colon cancer screening clinics.
Costs for staff time, equipment, and
overhead costs.
Why?
A2.
9.
10.
11.
12.
13.
14.
15.
16.
Community-Based Clinical Services
Circle
Yes or No
Dental care clinics.
Y
N
Y
N
Y
N
Free school team physicals provided for
public relations purposes.
Y
N
Free school team physicals, where there is
a demonstrated need for this service.
Y
N
Y
N
Y
N
Y
N
Eye examinations.
Flu shots or physical exams for employees.
General screening programs.
Grants to an unrelated free clinic.
Health education regarding diabetes.
Why?
A2.
17.
18.
19.
20.
21.
22.
23.
24.
Community-Based Clinical Services
Circle
Yes or No
Health screening program in low-income
community.
Y
N
Health screening program in upscale mall
for marketing purposes.
Y
N
Health screenings associated with
conducting of a health fair.
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Health-risk appraisals.
Immunization clinics.
Immunizations for low-income children.
Lab and medication costs.
Lipid profile and/or cholesterol screening.
Why?
A2.
25.
26.
27.
28.
29.
30.
31.
Community-Based Clinical Services
Circle
Yes or No
Mammography screenings.
Y
N
Y
N
Y
N
Y
N
School and sport physical examinations
(only of there is a demonstrated need).
Y
N
School physical clinics to increase access
to health care.
Y
N
Screenings for which a fee is charged,
unless there is a negative margin.
Y
N
Mobile units that deliver primary care to
underserved populations on an
occasional or one-time basis.
One-time or occasionally held primary
care clinics.
Osteoporosis screenings.
Why?
A2.
Community-Based Clinical Services
32.
Screenings provided primarily for public
relations or marketing purposes.
33.
34.
35.
36.
37.
Screenings where referrals are made only
to the health care organization or its
physicians.
Circle
Yes or No
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Skin cancer screenings.
Stroke risk screenings.
Stroke screening clinics.
Subsidized, mobile specialty care services
that are an extension of the organization’s
outpatient department, such as
mammography, radiology, and lithotripsy.
Why?
A2.
38.
39.
40.
Community-Based Clinical Services
Circle
Yes or No
Subsidized, permanent, ongoing
programs and outpatient services.
Y
N
Vans and other vehicles used to deliver
primary care services.
Y
N
Volunteers’ time and contributions by
other community partners.
Y
N
Why?