Our Homes

A Community Integration Survey

ADAPT/Personal Attendant Coalition of Texas (PACT) needs your help in advocating for increased wages and benefits for your Community Attendants.

We need information from you: people with disabilities, seniors, family members, Community Attendants and advocates, about how the difficulty in recruiting and retaining Community Attendants has affected your ability to participate in community activities as well as causing health problems.

All information provided will be private unless you give us permission to release it. Thank you for participating in this Community Integration Survey.

Question Title

* 1. Please provide the following

Name

Association

Address

Apt

City

State

Zip Code

Age

Phone

Question Title

* 2. Do you receive Home and Community Based Services (HCBS)? This is sometimes called Attendant Services.

Yes

Question Title

* 3. Do you use Consumer Directed Services (CDS)?

Yes

Question Title

* 4. What HCBS program are you receiving services through?

Star Plus

Star Kids

Community Attendant Services (CAS)

Family Care

CLASS

Client Managed Personal Attendant Services (CMPAS)

Home and Community Service (HCS)

Texas Home Living (TxHL)

Medically Dependent Children's Program (MDCP)

Deaf Blind Multiple Disabilities (DBMD)

Medicare

Medicare Advantage

VA Benefits

Private Insurance

Private Pay

Other (please specify)

Question Title

* 5. Hour many HCBS hours of attendant service are you assessed for (receiving) or are supposed to receive?

5-14

15-28

29-42

43-56

57-70

71-98

+ 99

Question Title

* 6. Are you satisfied with the number of HCBS Attendant Service hours you receive?

Yes

Question Title

* 7. What do you do when your Community Attendant does not show up?

Call the agency

I have a back-up Community Attendant

Call on family members or friends

Go without services

Other (please specify)

Question Title

* 8. Have you had any negative health problems or outcomes because of a lack of HCBS Service?

Yes

Describe:

Question Title

* 9. Are you worried or concerned about going into a nursing facility or other institutional setting?

Yes

Question Title

* 10. Do you know of anyone who has gone into a facility because of a lack of attendant services available in their home?

Yes

Other (please specify)

Question Title

* 11. How do you recruit and /or retain your Community Attendant(s)?

Rely on the agency

Rely on the fiscal Intermediary

Rely on family and friends

Advertise

Other (please specify)

Question Title

* 12. What, in your experience, have been/are the barrier(s) when trying to find a Community Attendant?

Low wages

No Health Benefits

No paid sick leave or vacation time off

Other (please specify)

Question Title

* 13. Have you had a specific event/situation when attempting to recruit, hire and train a Community Attendant? Please share your story.

Question Title

* 14. Do you have suggestions on how to Recruit and Retain Community Attendants?

Question Title

* 15. Do you have any memorable situations that have taken place with you and your Community Attendant that you would like to share?

We are gathering stories to show how important Community Attendants are to keeping persons with disabilities in their homes and communities.

Question Title

* 16. How long is the longest time you have had the same attendant?

Question Title

* 17. Can we share your information?

Yes

Other (please specify)

Our Homes

A Community Integration Survey

Question Title

* 1. Please provide the following

Question Title

* 2. Do you receive Home and Community Based Services (HCBS)? This is sometimes called Attendant Services.

Question Title

* 3. Do you use Consumer Directed Services (CDS)?

Question Title

* 4. What HCBS program are you receiving services through?

Question Title

* 5. Hour many HCBS hours of attendant service are you assessed for (receiving) or are supposed to receive?

Question Title

* 6. Are you satisfied with the number of HCBS Attendant Service hours you receive?

Question Title

* 7. What do you do when your Community Attendant does not show up?

Question Title

* 8. Have you had any negative health problems or outcomes because of a lack of HCBS Service?

Question Title

* 9. Are you worried or concerned about going into a nursing facility or other institutional setting?

Question Title

* 10. Do you know of anyone who has gone into a facility because of a lack of attendant services available in their home?

Question Title

* 11. How do you recruit and /or retain your Community Attendant(s)?

Question Title

* 12. What, in your experience, have been/are the barrier(s) when trying to find a Community Attendant?

Question Title

* 13. Have you had a specific event/situation when attempting to recruit, hire and train a Community Attendant? Please share your story.

Question Title

* 14. Do you have suggestions on how to Recruit and Retain Community Attendants?

Question Title

* 15. Do you have any memorable situations that have taken place with you and your Community Attendant that you would like to share? We are gathering stories to show how important Community Attendants are to keeping persons with disabilities in their homes and communities.

Question Title

* 16. How long is the longest time you have had the same attendant?

Question Title

* 17. Can we share your information?

* 15. Do you have any memorable situations that have taken place with you and your Community Attendant that you would like to share?

We are gathering stories to show how important Community Attendants are to keeping persons with disabilities in their homes and communities.