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Overall Satisfaction

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<strong>Overall</strong> <strong>Satisfaction</strong><br />

1. Given all the considerations, how satisfied are you with your<br />

consumer directed support program?<br />

2. How likely would you be to recommend a consumer directed<br />

support program in your county to a friend in a similar situation? ..<br />

3. Has the consumer directed support program met the expectations<br />

that were set for you by your case manager and county social<br />

services department? :<br />

Very<br />

satisfied<br />

Neither satisfied<br />

nor dissatisfied<br />

i/ Very<br />

dissatisfied<br />

• • • • •<br />

Very Neither likely Very<br />

likely<br />

10 •<br />

nor unlikely<br />

• •<br />

unlikely<br />

• •<br />

T<br />

Exceeded<br />

Expectations<br />

Met<br />

Expectations<br />

Failed<br />

Expectations<br />

4. What is the one thing ^atwoiuW have the greatest impact on your satisfaction with consumer directed<br />

supports?<br />

A<br />

overal quality of life, Thinking beyond consumer direct^ supports toydur on the following<br />

perspective^ the agre person or with wflfeach a developmental disability. please indicate how much you disagree statement. PleasecompTeM<br />

Jrom the The pe<br />

"developmental disability should ledjredtly involved m completing this survey mmSSPuSap^^^<br />

Independence | Mobility/Control/Privacy Agree Disagree<br />

—<br />

~BH——i••——————_B___ Strongly Somewhat Neither Somewhat Strongly<br />

1. I can (even if someone helps me because of my disability) get<br />

to where I want to go • h • • a<br />

a 2. I have control over my daily schedule.. • a •<br />

3. I have privacy to be alone or with people I choose... • • • •<br />

4. Only people who are supposed to know my personal<br />

information have access to it...... • • • a<br />

5. I can set desired outcomes (goals) for myself... • • • •<br />

CD<br />

I can decide about how I spend my money . . • • • • •<br />

7. I can make decisions that will affect my future.. -El<br />

8.<br />

• • a a<br />

I am satisfied with my current level of independence • • a •

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