NCADV Public Policy Survey

The NCADV Public Policy Office is developing our federal policy and funding priorities for 2012. We have created this online legislative survey designed to gather data and identify the emerging issues in your area.  Your feedback is important to us and will ensure that we are conveying the message of our Congressional members based on your input.  

We recommend that you print out the survey first and gather statistical data requested, then complete the survey online. Once your information is gathered, this online survey should only take roughly 10 minutes to complete. (Click here to print the form).

We ask that only one person from your organization fill out this survey to avoid duplication of information and preserve the quality of the responses we receive.

If you have any questions, please contact publicpolicy@ncadv.org.

Thank you very much for your time and attention!! Your imput is so very important to this process.

Sincerely,

NCADV

Your Name (first and last)*
Email Address Confirm Email Address*
Organization Name *
Organization's Address *
City

State
Zip
* In effort to preserve the quality of information we receive, we ask that only one person from each agency complete this survey.

General Questions:

 
1) Please select the listing that best categorizes your organization/agency:
 Shelter 
 Multi-Service, Faith-Based Community Program 
 Multi-Service, Community Program (Non-Religious) 
 State or Local Government Agency 
 Local Coalition or Program 
 State Coalition 
 Dual DV/SA Program 
 National Organization 
 Hotline 
 Family Justice Center 
 Other 
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2) What geographic regions and/or counties do you serve in your state/area?
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3) Please choose the option that best categorizes the region you serve:
 Urban 
 Suburban 
 Rural 
 Other 
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4) What is your program's annual budget?
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5) Please choose the type of services provided by your program. Please check all that apply. *
 Emergency Shelter 
 Transitional housing 
 Civil/legal assistance/advocacy 
 Family counseling 
 Substance abuse counseling 
 Child welfare/protective services advocacy 
 Financial counseling, early intervention/prevention 
 Crisis hotline 
 Training and technical assistance to judges and/or court personnel 
 Training and technical assistance to schools and/or colleges 
 Training and technical assistance to health professionals 
 Workplace training 
 Outreach to rural victims 
 Specialized services for communities of color 
 Specialized services for older or disabled victims 
 Specialized services to GLBT communities 
 Specialized services to immigrant communities 
 Other 
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6) Please indicate your five (5) most frequently used funding sources. Please do not check more than five options.
 STOP Grants 
 Civil Legal Assistance Grants 
 Grants to encourage arrests 
 Family Violence and Prevention Services Act 
 Victims of Crime Act Assistance Grants 
 Community Development Block Grants 
 Sexual Assault Services and Prevention Grants 
 Rape Prevention Education Grants 
 Transitional Housing Grants 
 McKinney Vento Homelessness Grants 
 Emergency Shelter Grants 
 Domestic Violence Prevention Enhancement and Leadership Through Grants (DELTA) 
 State funding 
 Local Government Funding 
 Private grants (foundations, donors) 
 Other 
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7) What is the breakdown by percentage of your revenue streams? (Such as private donors, foundation, corporate, government grants, etc.)
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8) On average, how many victims does one service provider job within your program serve in a year?

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9) Please identify what wrap-around services victims use in your area (such as TANF, Food Stamps, Section 8, etc.):
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10) Please describe how instrumental government grant funding has been to your program:
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11) Please share a success story where "systems" worked:
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12) Please share a story where "systems" did not work:
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13) Which policymakers do you meet with each year?
 local  
 state 
 federal 
 none 
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14) How frequently do you meet with policymakers each year?
 0  times a year
 1-2  times a year
 3-5  times a year
 >5  times a year
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15) What form of "take action" alerts do you respond to?
 letters 
 phone calls 
 media outreach 
 organized meetings 
 email alerts 
 other 
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16) Which age range do you fall into?
 Under 23 
 24-49 
 50+ 
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Questions Specific to 2008

17) How many jobs were created by your organization in 2008? (Please specify by what services or programs and for whom those services were provided.)
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18) In 2008, to your knowledge, how many domestic violence incidents were reported to the police within your region?
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19) How many domestic violence homicides happened within your region in 2008?
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20) How many domestic violence homicides involved the use of firearms within your region in 2008?
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21) Was your program/organization directly affected by the economic downturn in 2008? *
 Yes 
 No 
If you answered "No" above, please click here to skip to question 23.
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22) As a result, how was your program/organization impacted (08)?
Impact How Many/By How Much Which?
 We had to lay off staff  N/A
 We had to cut general programs and services 
 We had to cut specialized services to marginalized populations 
 We had to reduce beds/shelter/hotel space  N/A
 We could not respond to all requests for services  N/A
 Other   
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23) Do you know of DV or SA agencies or organizations in your area/state/region that closed as a result of the economic downturn in 2008?
 Yes 
 No 
If you answered "Yes" above, please list the names of any organizations you know of that may have closed in your region in 2008:
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Questions Specific to 2009

24) How many jobs were created by your organization in 2009? (Please specify by what services or programs and for whom those services were provided.)
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25) In 2009, to your knowledge, how many domestic violence incidents were reported to the police within your region?
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26) How many domestic violence homicides happened within your region in 2009?
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27) How many domestic violence homicides involved the use of firearms within your region in 2009?
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28) Was your program/organization directly affected by the bad economy in 2009? *
 Yes 
 No 
If you answered "No," please click here to skip to question 30.
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29) As a result, how was your program/organization impacted ('09)?
Impact How Many/By How Much Which?
 We had to lay off staff  N/A
 We had to cut general programs and services 
 We had to cut specialized services to marginalized populations 
 We had to reduce shelter/hotel space  N/A
 We could not respond to all requests for services  N/A
 Other   
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30) Do you know of other agencies or organizations in your area/state/region that closed as a result of the economic downturn in 2009?
 Yes 
 No 
If you answered "Yes" above, please list the organizations' names (09):
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Questions Specific to 2010

31) How many jobs were created by your organization in 2010? (Please specify by what services or programs and for whom those services were provided.
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32) In 2010, to your knowledge, how many domestic violence incidents were reported to the police within your region?
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33) How many domestic violence homicides happened within your region in 2010?
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34) How many domestic violence homicides involved the use of firearms within your region in 2010?
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35) Was your program/organization directly affected by the bad economy in 2010?
 Yes 
 No 
If you answered "No," please click here to skip to question 37.
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36) As a result, how was your program/organization impacted (10)?
Impact How Many/By How Much Which?
 We had to lay off staff  N/A
 We had to cut general programs and services 
 We had to cut specialized services to marginalized populations 
 We had to reduce beds/shelter/hotel space  N/A
 We could not respond to all requests for services  N/A
 Other   
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37) Do you know of other agencies or organizations in your area/state/region that closed as a result of the economic downturn in 2010?
 Yes 
 No 
If you answered "Yes" above, please list the organizations' names (10):
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