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The NC Public Benefits Collective is a coordinated, values-driven effort to strengthen and protect public benefit systems in North Carolina by aligning stakeholders, community voices, data, and advocacy. Read more about the concept here.


This short survey is designed to gather input from partners and stakeholders to help shape priorities, identify opportunities for collaboration, surface questions or concerns, and ensure shared values are centered from the start. Your responses will help guide the focus and structure of this work and inform opportunities for ongoing engagement and leadership. We encourage you to also share the survey with others in this space!

About You
* 1. Name
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* 2. Are you completing this form on behalf on an organization or as an individual?
* 3. Organization/Affiliation
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4. Role/Title
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* 5. E-mail
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6. Phone
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7. Language(s) Spoken (other than English):
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8. Which best describes your work? (Select all that apply)
 
9. What perspectives or communities do you represent or work closely with?
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10. What languages (other than English) should be considered to support communication and engagement in your community?
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Your Connection to Public Benefits
11. Which public benefit areas are most relevant to you and your work? (Select up to 3)
12. How long have you been working in the public benefits space?
13. In 1–2 sentences, please describe your current involvement in public benefits work.
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Current Opportunities + Challenges
* 14. What NC-based public benefit initiatives are working well right now that should be protected or strengthened?
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15. Where do you see fragmentation, duplication, or missed opportunities for coordination related to public benefits in NC?
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Priorities + Measures of Success
16. What should be the top priorities of the NC Public Benefits Collective over the next 6–12 months? (Select up to 3).
17. What would success look like for this effort 1-2 years from now?
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18. What would make this initiative most useful to you or your organization?
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Values & Trust
19. Which values should guide this work? (Select up to 5)
20. Are there any concerns or past harms this effort should be mindful of?
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21. What questions or uncertainties do you have about the Public Benefits Collective?
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* 22. How would you like to engage? Note: This is NOT a commitment, just a place to indicate interest. (Select all that apply)
23. If you indicated interest in an issue-specific workgroup, please tell us more. For example: What type of workgroup are you interested in? Does this already exist or is a new table needed? What frequency of meetings would be helpful? What would be needed to make this workgroup successful?
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* 24. Are you interested in leadership or advisory roles as this effort develops?
25. Anything else you’d like to share as we build this together?
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26. Would you like to join the NC Benefits Collective Listserv?

Thank you for taking the time to complete this survey! We encourage you to share with other partners in the NC public benefits space! 

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Care Share Health Alliance | 1631 Midtown Pl., Suite 104 | Raleigh, NC 27609 US

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