Survey for Individuals and Families

The intent of this survey is to help us better understand your knowledge/awareness of work incentives for persons with disabilities, where you heard about the incentive, your use of specific incentives, experiences with using an incentive if you have used it, barriers to using / reasons for not using if you have not used and what may assist you to decide to take advantage of an incentive. This information will help to inform recommendations on how to improve the system of work incentives to maximize the use and benefits of incentives for all parties. 

​For the purposes of this survey, a work incentive is defined as something of value or of benefit that assists an individual  with a disability in getting employment.


    1. Survey Completion Information

    2. Awareness of Work Incentive Programs

    We are interested in understanding your level of awareness of various work incentive programs and resources. Please rate your level of agreement with the statement below based on your familiarity with each work incentive program using the following Likert Scale from 1-5. Include any related thoughts or concerns about your awareness of work incentives in the “Comment” box below.

    “I am familiar with this work incentive program or resource and understand how to be referred to participate or to assist my family member or friend to be enrolled.”

    Programs:

    3. Utilization of Work Incentive Programs

    We are interested in learning more about your experience with various work incentive programs. Please rate your level of agreement with the statement below based on your experience in using each program or resource using the following Likert Scale from 1-5. Include any related thoughts or concerns about the utilization of work incentives in the “Comment” box below.

    “I am aware of this work incentive program or resource, understand the admission criteria, and have used these services.”

    Programs:

    4. Effectiveness of Work Incentive Programs

    We are interested in learning more about your perception of the effectiveness of the various work incentive programs throughout the system. Please rate your level of agreement with the statement below based on your experience with each program or resource and your thoughts about the effectiveness of the work incentive for you or your family member using the following Likert Scale from 1-5. Include any related thoughts or concerns about the effectiveness of work incentives in the “Comment” box below.

    “I have used/family member has used this work incentive program or resource and they have clearly benefitted from the services provided.”

    Programs:

    5. Promoting the use of work incentive programs

    We are interested in learning more about the members of your family that understand the value of work incentive programs. For the people listed, please rate the level of knowledge these people have in work incentive programs using the following Likert Scale from 1-5. Include any related thoughts or concerns about the value of work incentives in the “Comment” box below.

    “The family members listed below are interested in the individual receiving supports using work incentive programs to find employment.”

    Family Position:

    6. Barriers to using work incentive programs

    We are interested in learning more about potential barriers you have encountered when referred to or working with various work incentive programs. For the work incentive programs listed, please identify the top three reason(s) that you (i.e., the family member receiving services) do not use the work incentive programs referenced above. You may identify multiple barriers as appropriate. Include any related thoughts or concerns about the barriers to utilizing work incentives in the “Comment” box below.

    7. Demographic Information

    Race:
    Gender:
    I Identify As:
    Geographic Location:

    All done?

    Click the submit button below to send us your survey.
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