California DMC-ODS Evaluation

Treatment Perceptions Survey (TPS)

TPS UPDATE (September 24, 2020)

  • The upcoming survey period of November 9-13, 2020 has been approved by DHCS.  Providers that are not open on Veterans Day (Wednesday, November 11) shall administer the survey for four rather than five days (e.g., outpatient clinics).
  • A new Information Notice and Instructions from DHCS is forthcoming.
  • An online Treatment Perceptions Survey (TPS) is currently under development. It will be available for the 2020 survey period.
  • A new telehealth survey item has been added to the TPS.
  • An option for completing the TPS over the phone using interactive voice response (IVR) technology is under consideration.
  • Please check back periodically for updated information and materials.

As part of the DMC-ODS waiver evaluation, counties are required to have their network of providers administer the client TPS. The information collected will be used to measure adult clients' perceptions of access to services and the quality of care.  The TPS is required to fulfill the county External Quality Review Organization (EQRO) requirement related to having a valid client survey.  The data may also be used by counties (and service providers) to evaluate and improve the quality of care and client experience.

If you have questions, please contact Cheryl Teruya, Ph.D., at cteruya@mednet.ucla.edu

TPS Information Notice and Instructions (A new IN/Instructions for the 2020 survey period is forthcoming.)

TPS 2020

In response to the increased provision of services to adult and youth clients via telehealth due to Coronavirus Disease 2019, counties will be given access to a secure online survey. If needed, paper forms (one-page and large print) will also be available, but counties that choose to use these will be responsible for scanning or data entering the data locally and submitting the electronic data files to UCLA, or entering the clients' responses using the data entry survey link that UCLA will provide to counties.

UCLA is also exploring use of automated telephone surveys for clients who do not have access to the internet or prefer to complete the survey over the phone.

If multiple data collection methods are used (online survey, phone/voice survey, paper survey forms), UCLA will merge the data collected into one dataset for each county.

Frequently Asked Questions (Coming soon!)

Online Survey

Clients receiving services from treatment providers whether in-person or by telephone or telehealth (e.g., video-conferencing) during the survey period should be given access to the online survey via a link. Each link is customized for a specific provider, meaning that the CalOMS Provider ID, Reporting Unit (if required by the county) and treatment setting have already been pre-filled in hidden fields. The list of unique provider links will be provided to county TPS coordinators prior to the survey period.

Both adults and youth can select among 13 languages (English, Spanish, Tagalog, Vietnamese, Russian, Chinese, Arabic, Korean, Eastern and Western Armenian, Cambodian, Hmong, and Farsi) after clicking on the link. Responses entered into the online survey are sent directly to UCLA.

Links will be distributed prior to the survey period, but will be active only as of midnight on November 9 through midnight on November 13, 2020.

The links below can be used for testing/demonstration purposes and to become familiar with how the online surveys work:

  • TPS online survey link - Adults:
  • TPS online survey link - Youth:

Phone/voice Survey (Information and instructions are forthcoming.)

Paper Survey Forms

Survey forms for both adults and youth are available in 13 languages, including English, Spanish, Tagalog, Vietnamese, Russian, Chinese, Arabic, Korean, Eastern and Western Armenian, Cambodian, Hmong, and Farsi. Forms are available in one-page and large print versions.

In the section at the top of each form, please pre-fill the following information by using either (1) the online "fillable" feature before printing the forms, or a pen (black or blue ink):

  • Six digit CalOMS Tx Provider ID
  • 10-digit (maximum) Program Reporting Unit ID (This field may be used for county-specific purposes and data analysis at the unit level. It is optional and may be left blank.)
  • Treatment setting/modality (If the same Provider ID is used for multiple treatment settings/modalities, prepare separate sets of forms. For example, if two different treatment settings/modalities use the same Provider ID, prepare one set of forms for the Residential clients and another set for the OP/IOP clients.)

Print the survey forms directly from the pdf files. Use both sides of the page (double-sided) when printing the two-page forms with the large print.

County-specific guidance should be communicated to providers in the county's network as data from the forms will need to be data entered or scanned locally. UCLA will send counties a data entry survey link that can be used.

All TPS Paper Survey Forms (zipped PDF files)

All Teleform Definition (TFT v.10.6, updated 08/06/18) Files

All TPS Forms (zipped PDF files)

Language Survey Forms (Adult)
English 1-page version Large-print version (2 pages)
Spanish 1-page version Large-print version (2 pages)
Chinese 1-page version Large-print version (2 pages)
Tagalog 1-page version Large-print version (2 pages)
Farsi 1-page version Large-print version (2 pages)
Arabic 1-page version Large-print version (2 pages)
Russian 1-page version Large-print version (2 pages)
Hmong 1-page version Large-print version (2 pages)
Korean 1-page version Large-print version (2 pages)
Armenian - Eastern 1-page version Large-print version (2 pages)
Armenian - Western 1-page version Large-print version (2 pages)
Vietnamese 1-page version Large-print version (2 pages)
Cambodian 1-page version Large-print version (2 pages)

 

Language Survey Forms (Youth)
English 1-page version Large-print version (2 pages)
Spanish 1-page version Large-print version (2 pages)
Chinese 1-page version Large-print version (2 pages)
Tagalog 1-page version Large-print version (2 pages)
Farsi 1-page version Large-print version (2 pages)
Arabic 1-page version Large-print version (2 pages)
Russian 1-page version Large-print version (2 pages)
Hmong 1-page version Large-print version (2 pages)
Korean 1-page version Large-print version (2 pages)
Armenian - Eastern 1-page version Large-print version (2 pages)
Armenian - Western 1-page version Large-print version (2 pages)
Vietnamese 1-page version Large-print version (2 pages)
Cambodian 1-page version Large-print version (2 pages)

 

TPS Summary Reports

  • Sample Reports
  • Statewide Results (2019 survey period)
    • Adults (30 counties) - revised 02/27/20
    • Youth (25 counties) - revised 02/27/20