Please Complete the Following Survey AB 650 Survey for Healthcare Districts Name* District* Have you provided any of the following to support your staff? (Please select all that apply) Hazard pay for a specified time Incentive pay per shift Meals, deserts, coffee Food/grocery pantry If you have supported your staff in additional ways, please explain: What have you done to support your community during the COVID-19 pandemic?Please select all the ways the extra expenditures required by AB 650 would impact your district: Reduced services Inability to increase wage scale Reduced employee programs/benefits If there are additional impacts, or specific examples of the above, please explain: Please provide individual and personal stories, including quotes, of how your efforts have impacted individuals, departments and community members:Please upload any relevant and supporting pictures of the district engaging with the community and staff support services. Drop files here or Select files Max. file size: 256 MB. Please upload your district logo. Drop files here or Select files Max. file size: 256 MB. Consent* I give ACHD permission to use our district name and logo on coalition materials, including letters, fact sheets, webpages, social media, etc. I do NOT give ACHD permission to use our district name and logo on coalition materials, including letters, fact sheets, webpages, social media, etc.