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Managing Programs Through COVID-19 Work Group, Preparing for a Remote Open Enrollment Subcommittee

IMPORTANT: This toolkit for ACL grantees is intended to supplement state and local decision-making processes. State and local policies regarding COVID-19 vary nationally. Therefore, all final programmatic and policy decisions for providing services during the COVID-19 pandemic must be made at the state and local levels.

This survey is anonymous with an option to leave your contact information, if desired. Responses will be shared periodically for consideration by the Preparing for a Remote Open Enrollment Subcommittee of the Administration for Community Living (ACL) COVID-19 Work Group.

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* 1. What is your ACL grant program (check all that apply)?

State Health Insurance Assistance Program (SHIP)

Senior Medicare Patrol (SMP)

Medicare Improvements for Patients and Providers Act (MIPPA)

Other (please specify)

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* 2. Provide the name of the resource for which you are providing feedback (if applicable).

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* 3. What is your feedback for this resource?

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* 4. Do you have a recommendation for a new resource or resources? If so, please describe:

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* 5. Your state or territory

State/Province

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* 6. Please rate this toolkit (with 5 stars being the highest rating).

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* 7. Your contact information (Complete this only if you want us to contact you.)

Name

Agency

Email Address