1. Default Section

* 1. Name (optional)

* 2. Are you...? (select all that apply)

* 3. City, State

* 4. Race/Ethnicity

* 5. Gender

* 6. Are you a member of the National Latino AIDS Action Network (NLAAN)?

* 7. Would you like to become a member of NLAAN? If you answered yes, please provide your email address.

* 8. Please select YOUR TOP 3 CHOICES regarding additional information you would be interested in receiving about NLAAN.

* 9. How familiar are you with the Affordable Care Act, also known as the Health Care Reform Law?

* 10. How would you best describe the Affordable Care Act's impact on the Latinos in your community?

* 11. How has the economic recession affected your organization and its ability to target outreach and prevention to Latinos?

* 12. How has the recession impacted your agency's or organization's ability to serve the Latino population?

* 13. Thinking back one year, how many Latino clients are you able to serve now compared to a year ago?

* 14. From whom do you receive funding? (please select all that apply)

* 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
SAMHSA
CDC
OAR
NIH
State Funding
County Funding
Private Foundation funding

* 16. Please select your TOP 3 CONCERNS about how the Affordable Care Act will directly impact Latinos in your community?

* 17. How familiar are you with the National HIV/AIDS Strategy?

* 18. How would you best describe the National HIV/AIDS Strategy's potential impact on Latinos in your community?

* 19. Please select your TOP 3 CONCERNS about how the National HIV/AIDS Strategy will impact Latinos in your community?

* 20. In your opinion, what should THE TOP 3 priorities be for the development of the 2011 Latino/Hispanic HIV/AIDS Federal Policy Recommendations?

* 21. How many Latinos received services from your organization in the last year?

* 22. Does your organization provide services to undocumented immigrants?

* 23. If you answered NO; is it because of restrictions with State and/or local laws?

* 24. What is the percentage that most accurately resembles the proportion of Latinos served by your organization in comparison to the total population served?

* 25. How many undocumented immigrants did your organization serve last year? (estimate)

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