Please respond by August 12, 2015

This survey is developed by United Way of Pennsylvania in partnership with statewide organizations representing human service providers likely to be impacted by the impasse, including Arc of PA, County Commissioners Association of Pennsylvania, Drug and Alcohol Service Providers of PA, Housing Alliance of PA, Hunger Free PA, PA Advocacy and Resources for Autism and Intellectual Disability, PA Association of Nonprofit Organizations, PA Coalition Against Domestic Violence, the PA Council of Children, Youth and Family Services.and the Rehabilitation and Community Providers Association

The goal of this survey is to quantify the impacts of the impasse. The questions ask you to talk about cash flow impacts through the month of August, and to project impacts if the impasse if it extends into September. Each provider or county only needs to respond once. 

Question Title

* 1. Name of Organization: 

Question Title

* 2. How many individual Pennsylvanians does your organization serve annually?

Question Title

* 3. What types of services do you provide? (Choose all applicable services)

Question Title

* 4. How many employees does your organization have?

Question Title

* 5. How much (in dollars) of your accounts receivable for the month of July is delayed due to the budget impasse? 

Question Title

* 6. When will you begin to experience cash flow problems as a result of the current impasse?

Question Title

* 7. When will your contingency funds run out?

Question Title

* 8. What budget impasse contingency plans will you put into motion in the month of August? (Choose all that apply)

Question Title

* 9. Explain what services will be curtailed and describe the impacts. If you project that costs will  be shifted to other services or other systems as a result of services being curtailed, please explain in your answer.

Question Title

* 10. Estimate interest costs that will be incurred by your organization if you are accessing lines of credit. 

Question Title

* 11. Describe how the clients you serve will be impacted by an impasse that continues through the month of August.

Question Title

* 12. Project steps that your organization will need to take if the impasse continues into September.

T