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HomeGrown StL Black Men's Health Campaign Survey

Returning?

A A A

HomeGrown StL is collecting information about Medicaid enrollment initiatives in the St. Louis region as part of our Black Men's Health Campaign - a coordinated regional effort to ensure that 100% of eligible Black males in St. Louis are able to benefit from Missouri's recent Medicaid expansion. Please complete this brief survey to share information about any Medicaid enrollment initiatives that your organization is currently involved in.

Name:

* must provide value

Email address:

* must provide value

Phone number:

* must provide value

Job title:

* must provide value

Organization:

* must provide value

Is your organization currently advertising Medicaid eligibility and/or other information about Missouri's recent adoption of Medicaid expansion? This can include advertisements in client waiting areas, contacting clients who may be eligible for Medicaid, etc.

* must provide value

Yes

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What materials and/or resources is your organization sharing regarding Missouri Medicaid? Select all that apply:

* must provide value

HGStL Black Men's Health Campaign flyer

Other flyers/resources

Please specify other the materials/resources that your organization is sharing, including links for any that are accessible online so that we may share them with our network.

* must provide value

Expand

How is your organization sharing the HGStL Black Men's Health Campaign flyer? Select all that apply:

* must provide value

Bulletin board in client waiting areas

Digital bulletin board in client waiting areas (e.g. slide show on tv monitor)

Direct, digital outreach to all clients (e.g. email, client portal, etc.)

Direct, in-person outreach to all clients (e.g. paper flyers/handouts)

Direct, digital outreach to eligible clients ONLY (e.g. email, client portal, etc.)

Direct, in-person outreach to eligible clients ONLY (e.g. email, client portal, etc.)

Sharing with partner organizations /network

Sharing on social media

Sharing on website

Other

Please specify:

* must provide value

Expand

How is your organization sharing other materials/resources to advertise Missouri Medicaid? Select all that apply:

* must provide value

Bulletin board in client waiting areas

Digital bulletin board in client waiting areas (e.g. slide show on tv monitor)

Direct, digital outreach to all clients (e.g. email, client portal, etc.)

Direct, in-person outreach to all clients (e.g. paper flyers/handouts)

Direct, digital outreach to eligible clients ONLY (e.g. email, client portal, etc.)

Direct, in-person outreach to eligible clients ONLY (e.g. email, client portal, etc.)

Sharing with partner organizations /network

Sharing on social media

Sharing on website

Other

Please specify:

* must provide value

Expand

Is your organization currently leading or supporting any initiatives to assist St. Louis residents with MO Healthnet applications OR any other Medicaid-related efforts?

* must provide value

Yes

reset

Name of initiative (if applicable):

Please provide a brief description of initiative (e.g. target population, initiative activities, additional organizations/groups participating in initiative, etc.) as well as links to any online materials for the initiative (e.g. website, Facebook page, PDF flyers, etc.):

Expand

Primary staff contact for initiative (first and last name):

Staff contact email address:

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.