KY DEVELOPMENTAL DISABILITIES COUNCIL ~ HUMAN DEVELOPMENT INSTITUTE ~ KY PROTECTION & ADVOCACY

Joint Needs Assessment Survey 2009-2010

The Kentucky Council on Developmental Disabilities, the University of Kentucky Human Development Institute (HDI), and KY Protection and Advocacy (P&A) work together to improve the lives of people with developmental disabilities and their families. We want to know your ideas about the most important things affecting people with developmental disabilities in Kentucky. Please take 5-15 minutes to complete this survey and tell us those things you want us to consider in making services better. Your responses are anonymous and no information about you will be shared. Your response is voluntary and will only be used to help improve our services. If you need assistance in completing this form, please call the KY Council on Developmental Disabilities at 1-877-367-5332 or 502-564-7841. Alternative formats are available, including a Spanish version and a printed version.       Feel free to tell others about this survey! Thank you. 1 . Please check the consumer category that applies to you: [Check all that apply] Individual with a developmental disability     Service provider     Family member of an individual with a developmental disability     Others: Please Specify   2. Your Ethnic Background White, Non-Hispanic Black/ African American Latino/ Hispanic Asian/ Pacific Islander Native American Other   3. Your age group     0-17 18-39 40-59 60-79 80+ 4. Your Gender Female Male 5. County in Kentucky where you live:    6. Please check any of the areas below that you believe should be priorities for services and assistance to individuals with developmental disabilities in Kentucky.    Evaluating the Quality of Services in Our State    Self-Advocacy and Choice    Education and Early Intervention    Child Care    Health care and Wellness    Employement    Housing    Transportation    Recreation    Other (eg. transition, life planning, emergency planning). Please Identify :        7. Of all the areas above that you checked, which should be the TOP 3 priorities? Please explain what specific issue under that priority is the most important.          Ranking [1=Highest] Priority Area Most Important Issue Example Education and Early Intervention Involvement in extracurricular activities 1st 2nd 3rd 8. Of the 9 areas listed above in question 6, what area has improved the most in our state in the past 5 years? (CHECK ONLY ONE)   Evaluating the Quality of Services in our state Self Advocacy and Choice Education and Early Intervention Child Care Health Care and Wellness Employement Housing Transportation Recreation 9. Of the 9 areas listed above in question 6, what area has improved the least in our state in the past 5 years? (CHECK ONLY ONE) Evaluating the Quality of Services in our state Self Advocacy and Choice Education and Early Intervention Child Care Health Care and Wellness Employement Housing Transportation Recreation 10. Are there any services or assistance that you or your family members need that you are not currently receiving? If yes, please explain.      11. Why did you pick your highest priority area (Question 7) ?