Version 2.78

98896-4 Has your Household income changed significantly since February 2020? (please EXCLUDE a stimulus payment from the federal government if you have received one)

Observation ID in Form

1

Fully-Specified Name

Component
Household income changed significantly since the beginning of the pandemic
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6063-3

Answer Code Score Answer ID
Yes, my household income is more 1 LA32676-1
Yes, my household income is less 2 LA32677-9
No, my household income is about the same 3 LA32678-7

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98895-6 How worried are you that your household income has been or will be negative impacted the coronavirus (COVID-19) and its effects?

Observation ID in Form

2

Fully-Specified Name

Component
Level of worry that household income has been or will be negatively impacted by COVID-19
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6064-1

Answer Code Score Answer ID
Very worried 1 LA32679-5
Somewhat worried 2 LA27030-8
Not very worried 3 LA32680-3
Not at all worried 4 LA32681-1

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98894-9 How worried are you that the value of your assets (including housing, savings, and other financial assets) has been or will be negatively impacted by the coronavirus (COVID-19) and its effects?

Observation ID in Form

3

Fully-Specified Name

Component
Level of worry that asset value has been or will be negatively impacted by COVID-19
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6064-1

Answer Code Score Answer ID
Very worried 1 LA32679-5
Somewhat worried 2 LA27030-8
Not very worried 3 LA32680-3
Not at all worried 4 LA32681-1

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98893-1 In the past month, how difficult has it been for you to cover your expenses and pay all your bills?

Observation ID in Form

4

Fully-Specified Name

Component
Difficulty level of paying expenses in past Mo
Property
Find
Time
1Mo
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6065-8

Answer Code Score Answer ID
Very difficult 1 LA6575-0
Somewhat difficult 2 LA6573-5
Not at all difficult 3 LA14957-7
Don't know Copyright http://snomed.info/sct ID:456791000124100 Do not know (qualifier value) 4 LA12688-0

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98892-3 Suppose now you have an emergency expense that costs $400. Based on your current financial situation, how would you pay this expense?

Observation ID in Form

5a

Fully-Specified Name

Component
Emergency expense payment method
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6061-7

Answer Code Score Answer ID
By putting it on my credit card and paying it off in full at the next statement 1 LA32664-7
By putting it on my credit card and paying it off over time 1 LA32665-4
With the money currently in my checking/savings account or with cash 1 LA32666-2
Using a bank loan or line of credit 1 LA32667-0
By borrowing from a friend or family member 1 LA32668-8
Using a payday loan, deposit advance, or overdraft 1 LA32669-6
By selling something 1 LA32670-4
By using my stimulus payment 1 LA32671-2
By asking my landlord or mortgage provider for an extension 1 LA32672-0
I wouldn't be able to pay for the expense right now 1 LA32673-8
Other, Please specify other method: 1 LA46-8

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98891-5 What methods are you using or do you plan to use to cover your expense?

Observation ID in Form

5b

Fully-Specified Name

Component
Methods using or plan to use to cover expenses
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6061-7

Answer Code Score Answer ID
By putting it on my credit card and paying it off in full at the next statement 1 LA32664-7
By putting it on my credit card and paying it off over time 1 LA32665-4
With the money currently in my checking/savings account or with cash 1 LA32666-2
Using a bank loan or line of credit 1 LA32667-0
By borrowing from a friend or family member 1 LA32668-8
Using a payday loan, deposit advance, or overdraft 1 LA32669-6
By selling something 1 LA32670-4
By using my stimulus payment 1 LA32671-2
By asking my landlord or mortgage provider for an extension 1 LA32672-0
I wouldn't be able to pay for the expense right now 1 LA32673-8
Other, Please specify other method: 1 LA46-8

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98890-7 Unemployment Insurance

Observation ID in Form

6

Form Context

Since February 2020, have you either received, applied for, or tried to apply for any of the following forms of income or assistance?

Source: RTI International

Fully-Specified Name

Component
Received or applied for unemployment insurance since the beginning of the pandemic
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6060-9

Answer Code Score Answer ID
Received 1 LA32660-5
Applied and waiting to receive 2 LA32661-3
Tried but was not able to apply for, or was not eligible 3 LA32662-1
Did not apply for 4 LA32663-9

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98888-1 SNAP (Supplemental Nutrition Assistance Program) or Food Stamps

Observation ID in Form

6

Form Context

Since February 2020, have you either received, applied for, or tried to apply for any of the following forms of income or assistance?

Source: RTI International

Fully-Specified Name

Component
Received or applied for nutrition assistance since the beginning of the pandemic
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6060-9

Answer Code Score Answer ID
Received 1 LA32660-5
Applied and waiting to receive 2 LA32661-3
Tried but was not able to apply for, or was not eligible 3 LA32662-1
Did not apply for 4 LA32663-9

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98901-2 TANF (Temporary Assistance for Needy Families)

Observation ID in Form

6

Form Context

Since February 2020, have you either received, applied for, or tried to apply for any of the following forms of income or assistance?

Source: RTI International

Fully-Specified Name

Component
Received or applied for temporary assistance since the beginning of the pandemic
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6060-9

Answer Code Score Answer ID
Received 1 LA32660-5
Applied and waiting to receive 2 LA32661-3
Tried but was not able to apply for, or was not eligible 3 LA32662-1
Did not apply for 4 LA32663-9

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98887-3 Social Security

Observation ID in Form

6

Form Context

Since February 2020, have you either received, applied for, or tried to apply for any of the following forms of income or assistance?

Source: RTI International

Fully-Specified Name

Component
Received or applied for social security since the beginning of the pandemic
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6060-9

Answer Code Score Answer ID
Received 1 LA32660-5
Applied and waiting to receive 2 LA32661-3
Tried but was not able to apply for, or was not eligible 3 LA32662-1
Did not apply for 4 LA32663-9

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98886-5 Supplemental Social Security

Observation ID in Form

6

Form Context

Since February 2020, have you either received, applied for, or tried to apply for any of the following forms of income or assistance?

Source: RTI International

Fully-Specified Name

Component
Received or applied for supplemental social security since the beginning of the pandemic
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6060-9

Answer Code Score Answer ID
Received 1 LA32660-5
Applied and waiting to receive 2 LA32661-3
Tried but was not able to apply for, or was not eligible 3 LA32662-1
Did not apply for 4 LA32663-9

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98885-7 Any kind of government health insurance or health coverage plan including Medicaid, Medical Assistance or Medicare

Observation ID in Form

6

Form Context

Since February 2020, have you either received, applied for, or tried to apply for any of the following forms of income or assistance?

Source: RTI International

Fully-Specified Name

Component
Received or applied for government health insurance since the beginning of the pandemic
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6060-9

Answer Code Score Answer ID
Received 1 LA32660-5
Applied and waiting to receive 2 LA32661-3
Tried but was not able to apply for, or was not eligible 3 LA32662-1
Did not apply for 4 LA32663-9

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98884-0 Paycheck Protection Program

Observation ID in Form

6

Form Context

Since February 2020, have you either received, applied for, or tried to apply for any of the following forms of income or assistance?

Source: RTI International

Fully-Specified Name

Component
Received or applied for paycheck protection since the beginning of the pandemic
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6060-9

Answer Code Score Answer ID
Received 1 LA32660-5
Applied and waiting to receive 2 LA32661-3
Tried but was not able to apply for, or was not eligible 3 LA32662-1
Did not apply for 4 LA32663-9

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98883-2 Other aid from the government

Observation ID in Form

6

Form Context

Since February 2020, have you either received, applied for, or tried to apply for any of the following forms of income or assistance?

Source: RTI International

Fully-Specified Name

Component
Received or applied for other government aid since the beginning of the pandemic
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6060-9

Answer Code Score Answer ID
Received 1 LA32660-5
Applied and waiting to receive 2 LA32661-3
Tried but was not able to apply for, or was not eligible 3 LA32662-1
Did not apply for 4 LA32663-9

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98882-4 Assistance from a union or other association

Observation ID in Form

6

Form Context

Since February 2020, have you either received, applied for, or tried to apply for any of the following forms of income or assistance?

Source: RTI International

Fully-Specified Name

Component
Received or applied for assistance from a union since the beginning of the pandemic
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6060-9

Answer Code Score Answer ID
Received 1 LA32660-5
Applied and waiting to receive 2 LA32661-3
Tried but was not able to apply for, or was not eligible 3 LA32662-1
Did not apply for 4 LA32663-9

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98881-6 Assistance from a church or religious organization

Observation ID in Form

6

Form Context

Since February 2020, have you either received, applied for, or tried to apply for any of the following forms of income or assistance?

Source: RTI International

Fully-Specified Name

Component
Received or applied for assistance from a religious organization since the beginning of the pandemic
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6060-9

Answer Code Score Answer ID
Received 1 LA32660-5
Applied and waiting to receive 2 LA32661-3
Tried but was not able to apply for, or was not eligible 3 LA32662-1
Did not apply for 4 LA32663-9

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98880-8 Assistance from another community organization

Observation ID in Form

6

Form Context

Since February 2020, have you either received, applied for, or tried to apply for any of the following forms of income or assistance?

Source: RTI International

Fully-Specified Name

Component
Received or applied for assistance from community organization since the beginning of the pandemic
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6060-9

Answer Code Score Answer ID
Received 1 LA32660-5
Applied and waiting to receive 2 LA32661-3
Tried but was not able to apply for, or was not eligible 3 LA32662-1
Did not apply for 4 LA32663-9

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98879-0 A food pantry

Observation ID in Form

6

Form Context

Since February 2020, have you either received, applied for, or tried to apply for any of the following forms of income or assistance?

Source: RTI International

Fully-Specified Name

Component
Received or applied for assistance from a food pantry since the beginning of the pandemic
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6060-9

Answer Code Score Answer ID
Received 1 LA32660-5
Applied and waiting to receive 2 LA32661-3
Tried but was not able to apply for, or was not eligible 3 LA32662-1
Did not apply for 4 LA32663-9

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances

98878-2 Other assistance

Observation ID in Form

6

Form Context

Since February 2020, have you either received, applied for, or tried to apply for any of the following forms of income or assistance?

Source: RTI International

Fully-Specified Name

Component
Received or applied for other assistance since the beginning of the pandemic
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL6060-9

Answer Code Score Answer ID
Received 1 LA32660-5
Applied and waiting to receive 2 LA32661-3
Tried but was not able to apply for, or was not eligible 3 LA32662-1
Did not apply for 4 LA32663-9

Member of these Panels

LOINC Long Common Name
98889-9 COVID-19 related household finances