Version 2.80

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

Long Common Name

Household income changed significantly since the beginning of the pandemic

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Level of worry that household income has been or will be negatively impacted by COVID-19

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Level of worry that asset value has been or will be negatively impacted by COVID-19

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Difficulty level of paying expenses in past month

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Emergency expense payment method

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Methods using or plan to use to cover expenses

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Received or applied for unemployment insurance since the beginning of the pandemic

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Received or applied for nutrition assistance since the beginning of the pandemic

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Received or applied for temporary assistance since the beginning of the pandemic

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Received or applied for social security since the beginning of the pandemic

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Received or applied for supplemental social security since the beginning of the pandemic

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Received or applied for government health insurance since the beginning of the pandemic

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Received or applied for paycheck protection since the beginning of the pandemic

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Received or applied for other government aid since the beginning of the pandemic

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Received or applied for assistance from a union since the beginning of the pandemic

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Received or applied for assistance from a religious organization since the beginning of the pandemic

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Received or applied for assistance from community organization since the beginning of the pandemic

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Received or applied for assistance from a food pantry since the beginning of the pandemic

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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

Long Common Name

Received or applied for other assistance since the beginning of the pandemic

Basic Attributes

Class
SURVEY.COVID
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72 (ADD)
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