Disability Vote Coalition Survey

Thank you for your partnership with the Wisconsin Disability Vote Coalition this year.

It’s been a year of many elections and steep challenges for many voters who have a disability as well as many older adults. We are reaching out to the disability community and the aging network to ask for your feedback by completing this survey. Your comments will help us plan for 2021.

The purpose of the survey includes the following:
- Get feedback on Disability Vote Coalition trainings and resource materials.
- Learn about what you did to help support voters
- Learn about any barriers for voters with disabilities and older adults - based on your experience.
- Get your input for our planning.

Question Title

* 1. What is your organization’s role? Check all that apply:

ADRC

Medicaid HMO

IRIS Agency

Family Care MCO

Behavioral health provider

County Health and Human Services provider

Residential provider

Nursing Home

Independent Living Center

Advocacy Organization

Day Program

Educator

Transportation Provider

Other (please specify)

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* 2. What is the name of your agency?

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* 3. What community is your office in?

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* 4. Providing your name and email address is optional but helpful if we have follow up questions:

Name

Email Address

Question Title

* 5. What regions of the state do you serve? (check all that apply)

Northeastern

Northern

Southeastern

Southern

Western

Question Title

* 6. These are the 10 largest cities in Wisconsin. Do you serve people in any of these communities?

Milwaukee

Madison

Green Bay

Kenosha

Racine

Appleton

Waukesha

Eau Claire

Oshkosh

Janesville

Yes

Question Title

* 7. What did you and/or your organization do to support people to participate in the 2020 elections? Did you provide information or assistance with any of the following? Check all that apply:

Voter registration

Requesting an absentee ballot

Assistance completing an absentee ballot

Witnessing an absentee ballot

Photo ID

Early voting

Polling place questions

Transportation

Questions about Indefinitely Confined

Voter rights and accommodations

Accessible voting machine

Guardianship and voting questions

Comments

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* 8. Estimate how many people you assisted:

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* 9. What challenges did the voters you assisted experience? Check all that apply:

Do not have photo id

Difficulty getting documentation for proof of residency

Not registered to vote

Access to Transportation

Guardianship concerns

Unsure of right to vote

Lack of accommodations such as curbside voting

Accessible voting machine issues

Accessibility at the polls

No accessible absentee ballot

Do not have access to internet to submit or check voting information

Had difficulty using technology for voting support such as registering to vote

COVID 19 restrictions

Other

Additional Comments

Question Title

* 10. What settings did the voters you assisted live in? (check all that apply)

Independent

Independent Living

Assisted Living

Adult family Home

CBRF/ group home

Nursing home

Mental Health facility

Hospital

State Centers

Other (please specify)

Question Title

* 11. Do you work at a facility that has used Special Voting Deputies in previous elections?

Yes

Disability Vote Coalition Survey

Question Title

* 1. What is your organization’s role? Check all that apply:

Question Title

* 2. What is the name of your agency?

Question Title

* 3. What community is your office in?

Question Title

* 4. Providing your name and email address is optional but helpful if we have follow up questions:

Question Title

* 5. What regions of the state do you serve? (check all that apply)

Question Title

* 6. These are the 10 largest cities in Wisconsin. Do you serve people in any of these communities? Milwaukee Madison Green Bay Kenosha Racine Appleton Waukesha Eau Claire Oshkosh Janesville

Question Title

* 7. What did you and/or your organization do to support people to participate in the 2020 elections? Did you provide information or assistance with any of the following? Check all that apply:

Question Title

* 8. Estimate how many people you assisted:

Question Title

* 9. What challenges did the voters you assisted experience? Check all that apply:

Question Title

* 10. What settings did the voters you assisted live in? (check all that apply)

Question Title

* 11. Do you work at a facility that has used Special Voting Deputies in previous elections?

Question Title

* 12. If yes, what was the impact of not having Special Voting Deputies for the 2020 elections?

* 6. These are the 10 largest cities in Wisconsin. Do you serve people in any of these communities?

Milwaukee

Madison

Green Bay

Kenosha

Racine

Appleton

Waukesha

Eau Claire

Oshkosh

Janesville