Overall Satisfaction

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Overall Satisfaction 1. GIVEN ALL THE CONSIDERATIONS, HOW SATISFIED ARE YOU WITH YOUR CONSUMER DIRECTED SUPPORT PROGRAM? 2. HOW LIKELY WOULD YOU BE TO RECOMMEND A CONSUMER DIRECTED SUPPORT PROGRAM IN YOUR COUNTY TO A FRIEND IN A SIMILAR SITUATION? VERY SATISFIED 3. HAS THE CONSUMER DIRECTED SUPPORT PROGRAM MET THE EXPECTATIONS Exceeded THAT WERE SET FOR YOU BY YOUR CASE MANAGER AND COUNTY SOCIAL VERY LIKELY NEITHER SATISFIED NOR DISSATISFIED NEITHER LIKELY NOR UNLIKELV VERY DISSATISFIED VERY UNLIKELV M • • • • • • L X P < C T A T I O N S I SERVICES DEPARTMENT? • Q£J Q Q Q • Q MET KXPECTATIONS FAILED KXPECTATIONS 4. WHAT IS THE ONE THING THAT WOULD HAVE THE GREATEST IMPACT ON YOUR SATISFACTION WITH CONSUMER DIRECTED SUPPORTS? _ _ _ _ _ _ _ TOE ci. THINKING BEYOND CONSUMER DIRECTED SUPPORTS TO YOUR overall quality of life, ON THE FOLLOWING PAGES PLEASE INDICATE HOW MUCH YOU AGREE OR DISAGREE WITH EACH STATEMENT. PLEASE COMPLETE THESE SECTIONS FROM THE perspective of the person with a developmental disability. THE PERSON WHO HAS THE DEVELOPMENTAL DISABILITY SHOULD BE DIRECTLY INVOLVED IN COMPLETING THIS SURVEY AS MUCH AS POSSIBLE. Independence j Mobility / Control / Privacy Agree Disagree ^B^^BHHHBHHBHBFHI^HHFL STRONGLY SOMEWHAT NEITHER SOMEWHAT STRONGLY 1. I CAN (EVEN IF SOMEONE HELPS M E BECAUSE OF MY DISABILITY) GET TO WHERE I WANT TO GO 2. I HAVE CONTROL OVER MY DAILY SCHEDULE. . CO E F • • • • ® • • • • I HAVE PRIVACY TO BE ALONE OR WITH PEOPLE I CHOOSE B • • • • 4. ONLY PEOPLE WHO ARE SUPPOSED TO KNOW MY PERSONAL INFORMATION HAVE ACCESS TO IT • • • • 5. I CAN SET DESIRED OUTCOMES (GOALS) FOR MYSELF. . . . . . . • • • • • 6. I CAN DECIDE ABOUT HOW I SPEND MY MONEY • • • • 7. I CAN MAKE DECISIONS THAT WILL AFFECT MY FUTURE • • • • 8. I AM SATISFIED WITH MY CURRENT LEVEL OF INDEPENDENCE • • • •
Overall Satisfaction 1. Given all the considerations, how satisfied are you with your consumer directed support program? 2. How likely would you be to recommend a consumer directed support program in your county to a friend in a similar situation? Very satisfii Very likely 3. Has the consumer directed support program met the expectations Exceeded that were set for you by your case manager and county social services department? cpecîi Expectations Neither satisfied nor dissatisfied Very dissatisfied 1 • ••••• Neither likely Very nor unlikely unlikel • •••••• Met Expectations Failed Expectations • ••••• 4. What is the one thing that would have the greatest impaction youp-satisfaction with consumer directed supports? V NR\^ SRRV> RLWX)
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CONSUMER DIRECTED COMMUNITY SUPPORT
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