FLORIDA HIV/AIDS MINORITY NETWORK CAPACITY BUILDING NEEDS SURVEY

Transcription

1 FLORIDA HIV/AIDS MINORITY NETWORK CAPACITY BUILDING NEEDS SURVEY 1. Agency/Organization Name: 2. Mailing Address: 3. County: 4. Name of Person completing survey: Phone number: Fax number: Position of person completing survey: 5. Please indicate the type of agency/organization. (Check all that apply) A. B. C. D. E F. G. H. I. J. K. L. M. N. O. P. Q. R. S. T. [ ] Community-based organization [ ] AIDS service organization [ ] Sexually Transmitted Disease (STD) clinic [ ] Counseling and testing site [ ] Family planning clinic [ ] Other primary care provider [ ] Educational institution [ ] Hospital [ ] Lesbian/Gay organization [ ] Religious organization [ ] Women's organization [ ] Youth services provider [ ] Persons With AIDS (PWA) coalition [ ] Mental health center [ ] Substance abuse treatment center [ ] Criminal justice system/prison [ ] Local/county health department [ ] Community Planning Partnership [ ] City/County [ ] Other (Please specify) 6. Is your agency considered a minority CBO (a governing board composed of at least 51 % racial or ethnic minority members, 51% of minority individuals in key positions including management, administrative and service provision who reflect the racial and ethnic demographics and other characteristics of the population to be served, has an established record of service to racial or ethnic minority community or communities). Yes No 7. How many years has your agency/organization been in operation? If less than one year, please indicate the number of months: A. Years/Months: / 1

2 8. How many years has your agency/organization been providing HIV prevention and/or AIDSrelated services? If less than one year, please indicate the number of months. A. Years/Months: / 9. If your agency does not provide HIV/AIDS prevention or patient care, how has it been involved in HIV/AIDS? 10. Please indicate the TOTAL NUMBER of full-time and part-time employees on your staff. Number (#) Employees A. Full-time B. Part-time 11. Please indicate the number of full-time and part-time employees on your staff WHO WORK IN HIV PREVENTION AND/OR AIDS-RELATED SERVICE PROVISION ONLY. Number (#) Employees A. Full-time B. Part-time We are interested in knowing more about the type(s) of capacity building that might be helpful to you. 12. Using the scale below, please indicate how important the various types of capacity building training that your agency/organization need. For those areas identified as extremely important, please provide a brief explanation. IMPORTANCE Does Not Not At All A Little Somewhat Very Extremely Don t Apply Important Important Know A Grant writing/proposal development B Board development C. Fiscal/grant management D Administrative management* * Includes the following areas: accounting records & ledgers, agency bylaws, personnel records, operating policies & procedures, appropriate allocation and expenditure of funds, payroll records, disbursements & documentation. 2

3 E Program planning/development F Program evaluation G Staff recruitment/training H Volunteer recruitment/training I Information dissemination/communications J Media/public relations/social marketing K Community needs assessment Comments : L Sources of funding M Motivational training for staff N Motivational training for clients/empowerment O Computer training P Internet training Q Community planning R HlV/AIDS general training S STD general training T Other(s) (Please specify);

4 13. For those types of capacity building training identified as very and extremely important in question #12, please rank the top three, with A being most important. A. B. C. 14. If you have previously received capacity building training, please list topics, dates of training and check which staff member attended. Executive Director Program Coordinator Outreach Worker Fiscal Manager Other 15. Were the previous training sessions helpful? Yes No If you answered no, please list areas you would like emphasizes to better meet your particular needs. 16. In your opinion, would individual follow-up sessions after training courses be helpful for your agency/organization? Yes No Other 17. If your agency found previous capacity building training helpful and were able to translate what you learned into practice, in which area is your agency able to provide follow-up mentoring? 18. Capacity building training courses vary in length. In your opinion, what length of training best suits your agency's needs? Please check the one best answer. A. [ ] 1/2 day training 8am-12pm 1pm-5pm 5pm-9pm B. [ ] 1 day training C. [ ] 11/2 day training D. [ ] 2 days of training E. [ ] 3 days of training F. [ ] 4 days or more of training G. [ ] Don't know/not sure H. [ ] Other (Please specify) 19. Does your agency/have access to the Internet?* Yes No Don't know/not sure If yes, please list address: * (local libraries may allow free internet service use and accounts) 4

5 20. Please list any pertinent information about your agency that will assist us in providing useful capacity building services 21. Other comments: If there are things you would like assistance in, but do not feel comfortable writing, please feel free to call Vanessa Crowther at (850) Thank you for taking the time to complete this survey! Please return to: Prevention Section Florida Department of Health Bureau of HIV/AIDS, Prevention Section 4052 Bald Cypress Way, Bin A09 Tallahassee, FL