NLAAN Survey
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1. Default Section
1
. Name (optional)
Name (optional)
2
. Are you...? (select all that apply)
Are you...? (select all that apply)
a consumer of HIV/AIDS Services
an HIV/AIDS service provider
working in HIV prevention
a combination of the above
doesn't apply
3
. City, State
City, State
4
. Race/Ethnicity
Race/Ethnicity
Latino/Hispanic
African American/Black
Caucasian/White
Asian/Pacific Islander
Native American
Mixed Latino with other race/ethnicity
5
. Gender
Gender
Male
Female
Transgender MtF
Transgender FtM
6
. Are you a member of the National Latino AIDS Action Network (NLAAN)?
Are you a member of the National Latino AIDS Action Network (NLAAN)?
Yes
No
7
. Would you like to become a member of NLAAN? If you answered yes, please provide your email address.
Would you like to become a member of NLAAN? If you answered yes, please provide your email address.
Yes
No
Already a member
Email Address:
8
. Please select YOUR TOP 3 CHOICES regarding additional information you would be interested in receiving about NLAAN.
Please select YOUR TOP 3 CHOICES regarding additional information you would be interested in receiving about NLAAN.
how to mobilize Latinos locally
how to mobilize Latinos at the state level
how to mobilize Latinos at the national level
how to join an NLAAN committee
how to become a member of the NLAAN leadership committee
9
. How familiar are you with the Affordable Care Act, also known as the Health Care Reform Law?
How familiar are you with the Affordable Care Act, also known as the Health Care Reform Law?
Extremely familiar
Very familiar
Familiar
Somewhat familiar
Not familiar at all
10
. How would you best describe the Affordable Care Act's impact on the Latinos in your community?
How would you best describe the Affordable Care Act's impact on the Latinos in your community?
Extremely positive
Somewhat positive
No impact
Somewhat negative
Extremely Negative
11
. How has the economic recession affected your organization and its ability to target outreach and prevention to Latinos?
How has the economic recession affected your organization and its ability to target outreach and prevention to Latinos?
Extreme negative effect
Negative effect
No effect at all
Positive effect
Extreme positive effect
Not applicable
12
. How has the recession impacted your agency's or organization's ability to serve the Latino population?
How has the recession impacted your agency's or organization's ability to serve the Latino population?
Drastically decreased services
Decreased services
No effect at all
Increased services
Extreme increase in services
Not applicable
13
. Thinking back one year, how many Latino clients are you able to serve now compared to a year ago?
Thinking back one year, how many Latino clients are you able to serve now compared to a year ago?
Over 50% less
Between 25% and 49% less
About the same
Between 25% to 49% more
Over 50% more
Not applicable
14
. From whom do you receive funding? (please select all that apply)
From whom do you receive funding? (please select all that apply)
HRSA
SAMHSA
CDC
OAR
NIH
Other federal funding
State funding
County funding
City funding
Private foundation funding
Not applicable
15
. Under each of these categories please check how the funding amounts have reacted to the present economic climate.
Less
More
Same
Not applicable
HRSA
*
Under each of these categories please check how the funding amounts have reacted to the present economic climate. HRSA Less
HRSA More
HRSA Same
HRSA Not applicable
SAMHSA
SAMHSA Less
SAMHSA More
SAMHSA Same
SAMHSA Not applicable
CDC
CDC Less
CDC More
CDC Same
CDC Not applicable
OAR
OAR Less
OAR More
OAR Same
OAR Not applicable
NIH
NIH Less
NIH More
NIH Same
NIH Not applicable
State Funding
State Funding Less
State Funding More
State Funding Same
State Funding Not applicable
County Funding
County Funding Less
County Funding More
County Funding Same
County Funding Not applicable
Private Foundation funding
Private Foundation funding Less
Private Foundation funding More
Private Foundation funding Same
Private Foundation funding Not applicable
16
. Please select your TOP 3 CONCERNS about how the Affordable Care Act will directly impact Latinos in your community?
Please select your TOP 3 CONCERNS about how the Affordable Care Act will directly impact Latinos in your community?
Does not provide health coverage for undocumented immigrants
Latino communities are not familiar with the coverage soon available to them
Most of the information about the Affordable Care Act is primarily available in English
Latinos living with HIV/AIDS need information about how the Affordable Care Act will benefit them
Recent documented immigrants must wait 5 years to access Medicare/Medicaid
No concerns at all
Other (please specify, limit 100 characters)
17
. How familiar are you with the National HIV/AIDS Strategy?
How familiar are you with the National HIV/AIDS Strategy?
Extremely familiar
Very familiar
Familiar
Somewhat familiar
Not familiar at all
18
. How would you best describe the National HIV/AIDS Strategy's potential impact on Latinos in your community?
How would you best describe the National HIV/AIDS Strategy's potential impact on Latinos in your community?
Extremely positive
Somewhat positive
No impact
Somewhat negative
Extremely negative
19
. Please select your TOP 3 CONCERNS about how the National HIV/AIDS Strategy will impact Latinos in your community?
Please select your TOP 3 CONCERNS about how the National HIV/AIDS Strategy will impact Latinos in your community?
It does not sufficiently address health care for undocumented immigrants living with HIV
It does not address housing for undocumented immigrants living with HIV
It does not address the need for Latino specific home-grown interventions
It does not specify the need for bilingual education for the at risk Latino population
Other
Other (please specify, limit 100 characters)
20
. In your opinion, what should THE TOP 3 priorities be for the development of the 2011 Latino/Hispanic HIV/AIDS Federal Policy Recommendations?
In your opinion, what should THE TOP 3 priorities be for the development of the 2011 Latino/Hispanic HIV/AIDS Federal Policy Recommendations?
Increase Latino-specific prevention interventions
Gather more data about Latino communities at risk
Increase HIV testing with underserved Latino communities
Increase funding for Latinos to receive care and services
Increase funding for Latino-specific outreach, education, and prevention
Increase Funding for Latino specific HIV testing services
Better coordination of programs and services through proper oversight
Improved inclusion of Latino community members in planning, implementation, and evaluation
I don’t think Latinos are a priority in the Federal HIV/AIDS Policies
Other
Other (please specify, limit 100 characters)
21
. How many Latinos received services from your organization in the last year?
How many Latinos received services from your organization in the last year?
0 - 500
501 -1,000
1,001 - 5,000
5,001 - 10,000
10,001 - 20,000
More than 20,000
22
. Does your organization provide services to undocumented immigrants?
Does your organization provide services to undocumented immigrants?
Yes
No
23
. If you answered NO; is it because of restrictions with State and/or local laws?
If you answered NO; is it because of restrictions with State and/or local laws?
Yes
No
Not applicable
24
. What is the percentage that most accurately resembles the proportion of Latinos served by your organization in comparison to the total population served?
What is the percentage that most accurately resembles the proportion of Latinos served by your organization in comparison to the total population served?
10% - 20%
30% - 40%
50% - 60%
70% - 80%
90% - 100%
25
. How many undocumented immigrants did your organization serve last year? (estimate)
How many undocumented immigrants did your organization serve last year? (estimate)
1 – 100
101 – 200
201 – 300
301 – 400
401 or more
Not applicable
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