2020 Self-Advocate and Family Member Survey

If you are a person with a disability or a family member who has been involved in a Wisconsin Board for People with Developmental Disabilities (WI-BPDD) activity during the last year, please take a moment to complete this brief survey. This survey provides WI-BPDD with important information about the impact we are having on the lives of people with disabilities and their family members.

If you have already completed the survey this year, please do not complete it again.

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* 1. During the past year which of the following WI-BPDD activities have you participated in? (Check all that apply)

People First

SPARKS Grants

Partners in Policy Making

Employment First Partner Grants

Take Your Legislator to Work

Living Well

Self-Determination Conference

Employment First Conference

Youth Leadership Forum

Voting Trainings

Disability Advocacy Day

Supported Decision Making

Building Full Lives

Family Led Project

Grassroots State or Federal Advocacy (i.e. took action on an issue brought to my attention by BPDD)

Social Media (i.e. follow BPDD on social media and share content with others in my network or follow Living Well Wednesdays or the Self-Determination YouTube Channel)

Other (please specify)

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* 2. Were you satisfied with the WI-BPDD activity that you participated in during the past year?

Yes

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* 3. Is your life better as a result of participating in a WI-BPDD activity during the past year?

Yes

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* 4. Please share a story about how participating in WI-BPDD activities has made your life better.

As a result of participating in a WI-BPDD activity...

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* 5. I have (check all that apply):

Voted or registered to vote.

Gotten a job in the community or increased my hours on the job.

Gotten more involved in my community.

Used Supported Decision-Making tools to avoid or minimize the limits resulting from guardianships.

Gotten connected to other people with disabilities or families to learn about resources and to network.

Increased my natural supports (the number of people, other than paid professionals, who help or support me).

Included transportation as part of my long-term care plan.

None of the above.

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* 6. I have increased (check all that apply):

My advocacy efforts at the state and/or federal levels.

My advocacy efforts around transportation.

My advocacy efforts to support people with disabilities to be safe and healthy.

The number of decisions I make about my life on my own or with support.

None of the above.

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* 7. I feel more confident that (check all that apply):

I can have a job in the community that pays minimum wage or higher.

I can make my own decisions.

I can live on my own with the support I need.

I have a plan for my future and my loved one's future.

I can stay safe and healthy.

I can be a leader in my community.

None of the above.

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* 8. I am better able to say what I want.

Yes

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* 9. I am now participating in advocacy activities.

Yes

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* 10. I am now on an advisory board, committee and/or serving in a leadership position (such as People First, a parent/teacher organization, a community board, etc.)

Yes

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* 11. Please tell us whether you are:

A person with a disability

Family member of a person with a disability

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* 12. Please tell us whether you are:

American Indian and Alaska Native

Asian

Black or African American

Hispanic/Latino

Native Hawaiian and other Pacific Islander

White or Caucasian

Two or more races

Race unknown

Prefer not to answer

Other (please specify)

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* 13. Do you identify as:

Female

Male

Non-binary

Prefer to self-describe

Prefer not to say

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* 14. Which of the following best describes the area that you live in?

Rural

Urban/Suburban

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* 15. COVID has created increased mental health challenges for everyone, including people with developmental disabilities. Are you or your loved one with developmental disabilities experiencing mental health concerns?

Yes

Unsure

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* 16. Please provide the following information (optional):

Name:

Address:

City/Town:

ZIP:

Email Address:

Phone Number: