Housing Opportunities for Persons with HIV/AIDS Program (HOPWA) Survey

  • Housing Opportunities for Persons with HIV/AIDS Program (HOPWA) Provider & Grantee Survey

  • This survey is designed to gather information about service providers and grantees of the federal Housing Opportunities for Persons with HIV/AIDS (HOPWA) program.

    A similar survey is being circulated to gather information from HOPWA program clients and patient populations who may be eligible to receive supportive services from HOPWA providers and grantees.

  • Screening Questions

  • Is your organization/entity a recipient of either Formula or Competitive grant funds from the federal Housing Opportunities for Persons with HIV/AIDS (HOPWA) program?*

  • Organizational Information

  • This section includes basic questions about your organization/entity, including contact information for internal use by the Appalachian Learning Initiative and for public/patient inquiries, and which HOPWA-eligible activities/services your organization provides, and in which state(s)/territory and counties your organization provides services.

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  • Does the Appalachian Learning Initiative have permission to use your organization/entity's logo on The HOPWA Directory's website? (Note: Permission to use this logo does not constitute the establishment of any formal relationship between APPLI, The HOPWA Directory, and your organization/entity, nor does use of your organization's logo imply any partnerships or endorsements by either party of the other.)*
  • Format: (000) 000-0000.
  • Is your organization a state or local government or an organization that oversees one or more HOPWA sub-grantees, service providers, or contracted organizations that provide services to eligible HOPWA beneficiaries?*
  • Does your organization/entity provide services directly to HOPWA beneficiaries (e.g., case management, rental assistance, housing placement, or any other services that require direct engagement with HOPWA beneficiaries outside of governmental- or regional-level program management?)*
  • Please indicate which HOPWA-eligible services/activities your organization provides: (Select all that apply)*
  • Please select the state(s)/territory in which your organization provides HOPWA services: (Select all that apply)*
  • Please indicate in which Alabama counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Alaska counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Arizona counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Arkansas counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which California counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Colorado counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Connecticut counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Delaware counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Florida counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Georgia counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Hawaii counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Idaho counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Illinois counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Indiana counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Iowa counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Kansas counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Kentucky counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Louisiana counties/parishes the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Maine counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Maryland counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Massachusetts counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Michigan counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Minnesota counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Mississippi counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Missouri counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Montana counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Nebraska counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Nevada counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which New Hampshire counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which New Jersey counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which New Mexico counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which New York counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which North Carolina counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which North Dakota counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Ohio counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Oklahoma counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Oregon counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Pennsylvania counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Rhode Island counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which South Carolina counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which South Dakota counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Tennessee counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Texas counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Utah counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Vermont counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Virginia counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Washington counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which West Virginia counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Wisconsin counties the organization/entity provides HOPWA services: (Select all that apply)*
  • Please indicate in which Wyoming counties the organization/entity provides HOPWA services: (Select all that apply)*

  • Public-Facing Contact Information

  • This section requests information about the public-facing contact information that will be used to provide former, potential, or existing HOPWA beneficiaries and caseworkers with contact information for your organization.

  • Format: (000) 000-0000.
  • Does your organization have a physical location that serves HOPWA recipients that is separate from the primary physical address you entered?*

  • Program Information

  • This section requests information about your organization/entity's operations, including questions about the availability of public-facing information that will be visible to end-users of The HOPWA Directory. Information provided in this section should not include information that would breach any confidentiality agreements your organization has entered.

  • General HOPWA Program Information

  • Please indicate where users can find information about the HOPWA-eligible services and activities you provide: (Please select all that apply)*
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  • HOPWA Eligibility Information

  • Please indicate where users can find information about the eligibility requirements/criteria for potential/existing HOPWA beneficiaries: (Please select all that apply)*
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  • HOPWA Application Process Information

  • Please indicate where users can find information about the application process for potential/existing HOPWA beneficiaries: (Please select all that apply)*
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  • HOPWA Document Requirements Information

  • Please indicate where where users can information about the documents that potential/existing HOPWA beneficiaries will have to provide: (Please select all that apply)*
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  • HOPWA State-Level Contact Information

  • Do you know the contact information for the state-level contact who oversees your program?*

  • Please provide the contact information for the state-level contact who oversees your program

  • Format: (000) 000-0000.

  • HOPWA Regional Contact Information

  • Do you know the contact information for the regional contact who oversees your state's HOPWA programs?*

  • Please provide the contact information for the regional-level contact who oversees your program

  • Format: (000) 000-0000.

  • HOPWA Client Grievance Process Information

  • Does your state or organization have in place a formal process by which former, potential, and current HOPWA beneficiaries may file grievances against their HOPWA services provider?*
  • Please indicate where and how your organization provides public-facing information about how former, potential, and current HOPWA beneficiaries may file formal grievances against the HOPWA grantee and about the grievance process: (Please select all that apply)*
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  • HOPWA Waitlist Information

  • Does your organization/entity's HOPWA program currently have a waitlist that prevents HOPWA-eligible patients from accessing HOPWA services?*
  • If your HOPWA program has a waitlist period, how often does your state/organization/entity require eligible recipients who are on that waitlist to reapply or seek recertification to remain on that waitlist?*

  • Additional Information (Optional)

  • Is there any additional information your organization/entity would like to provide that is not covered by the question in this survey?*
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  • Thank you for taking the time to complete the HOPWA Provider & Grantee survey. We truly appreciate your dedication to providing these vital services to Persons Living with HIV/AIDS, and we are excited to feature your organization in The HOPWA Directory.

    You can learn more about the Appalachian Learning Initiative and The HOPWA Directory by visiting our website:

    https://www.appli.org

  • Would you like to register to receive monthly newsletters from the Appalachian Learning Initiative?*
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  • Thank you for your interest in the Housing Opportunities for Persons with HIV/AIDS (HOPWA) Provider & Grantee Survey.

    Unfortunately, your responses to our screening questions indicate that your organization/entity does not qualify for participation in this survey.

    If you believe that you have received this message in error, please click on the 'Back' button, below, to submit a different answer.

    Otherwise, please click the submit button to complete the survey.

  • Would you like to register to receive monthly newsletters from the Appalachian Learning Initiative?*
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