Please answer these nine short questions if you are a provider of Medicaid intellectual/developmental disability supports who 1) also provides Medicare supports and 2) received funds from the April general distribution from Department of Health and Human Services' (HHS) Public Health and Social Services Emergency fund. 

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* 1. Please enter the state(s) your organization operate(s) in - if in multiple states, please list them.

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* 2. Please enter your contact information (name, organization, phone/email) here. We will only use this to follow up with you if we need more information to strengthen our advocacy with detailed examples.

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* 3. Did you apply to receive funding through the April 10 general distribution by entering your revenues into the HHS portal?

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* 4. If you answered yes to question 3, how much did you receive through that application?

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* 5. Did you apply to receive funding through the April 24 Medicare distribution by entering your revenues into the HHS portal?

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* 6. If you answered yes to question 5, how much did you receive through that application?

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* 7. Did you re-apply to the Medicare portal when it re-opened on June 3?

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* 8. If you answered yes to question 7, what is the status of that application?

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* 9. If you answered yes to question 3 and/or 5, how would the sum(s) you received from those applications compare to what you would have received in the current June 9 Medicaid distribution? 

To provide the estimate, please align to the methodology used by HHS for the Medicaid distribution:
The Medicaid Targeted Distribution methodology will be based upon 2% of (gross revenues * percent of gross revenues from patient care) for CY 2017, or 2018 or 2019, as selected by the applicant.

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* 10. In a few sentences, could you let us know how you found out that you had received funding from HHS? For example, did your financial team receive an email, did you notice an unusual entry in your bank statements, etc.?

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