Providers

Survey for Providers

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 promotion of specific incentives, experiences with using an incentive if you have worked with someone who has used it, barriers to using / reasons for the person not choosing to use it and what may assist the person to decide to take advantage of an incentive you recommend. 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 an individual with a disability chooses to use to gain employment.

1. Survey Completion Information

* Indicates required field

Name *

First

Last

Title *

Phone Number *

Email *

Agency Name *

Agency Address *

Line 1

Line 2

City

State

Zip Code

Country

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 the process of referring individuals for enrollment.”

Programs:

Medicaid Waiver *

Ticket to Work (NYESS/WIN) *

ACCES-VR/Commission for the Blind *

Property Essential to Self-Support (PESS) *

Expedited Reinstatement of Benefits *

Labor for America *

Income Averaging (SSDI) *

NYS Apprenticeship Program *

Supportive Employment/Job Coaching *

1619(a)/11619(b) *

Earned Income Tax Credits *

Trial Work Period (TWP) *

Medicaid Buy-In *

Plan for Achieving Self-Support (PASS) *

NY ABLE *

Comment *

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 referring individuals to 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 frequently refer individuals in need to these services.”

Programs:

Medicaid Waiver *

Ticket to Work (NYESS/WIN) *

ACCES-VR/Commission for the Blind *

Property Essential to Self-Support (PESS) *

Expedited Reinstatement of Benefits *

Labor for America *

Income Averaging (SSDI) *

NYS Apprenticeship Program *

Supportive Employment/Job Coaching *

1619(a)/11619(b) *

Earned Income Tax Credits *

Trial Work Period (TWP) *

Medicaid Buy-In *

Plan for Achieving Self-Support (PASS) *

NY ABLE *

Comment *

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 individuals that have been referred to each program or resource 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 referred individuals to this work incentive program or resource and they have clearly benefitted from the services provided.”

Programs:

Medicaid Waiver *

Ticket to Work (NYESS/WIN) *

ACCES-VR/Commission for the Blind *

Property Essential to Self-Support (PESS) *

Expedited Reinstatement of Benefits *

Labor for America *

Income Averaging (SSDI) *

NYS Apprenticeship Program *

Supportive Employment/Job Coaching *

1619(a)/11619(b) *

Earned Income Tax Credits *

Trial Work Period (TWP) *

Medicaid Buy-In *

Plan for Achieving Self-Support (PASS) *

NY ABLE *

Comment *

5. Internal catalyst for use of work incentive programs

We are interested in learning more about the specific agency staff members that act as catalysts to increase the use of work incentive programs for your agency. For the staff positions listed, please rate the level of involvement of these individuals 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.

“The agency staff members in these positions are expected to link individuals receiving employment support to work incentive programs and act as catalysts to promote employment.”

Staff Position:

Care/Case Coordinators *

Program Supervisors *

VR Staff- ACCES or Commission for Blind *

Employment Specialists *

Peer Specialists *

Residential Staff *

Job Coaches *

Human Resource Professionals *

Other (Be Specific) *

Comment *

6. Barriers to using work incentive programs

We are interested in learning more about potential barriers you have encountered when referring to or working with various work incentive programs. For the work incentive programs listed, please list the letter associated with the barrier or reason(s) this service is not more fully utilized. 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.

A. Not aware of this program
B. Complicated or difficult referral process
C. Wait lists are too long
D. Lack of clear and understandable guidance in using program/Not sure of program’s purpose
E. Lack of adequate support/responsiveness when problems arise
F. Individuals previously referred have not benefitted from program

“I have not utilized this work incentive program or resource due to the barriers I have listed.”

Programs:

Medicaid Waiver *

Ticket to Work (NYESS/WIN) *

ACCES-VR/Commission for the Blind *

Property Essential to Self-Support (PESS) *

Expedited Reinstatement of Benefits *

Labor for America *

Income Averaging (SSDI) *

NYS Apprenticeship Program *

Supported Employment/Job Coaching *

1619(a)/11619(b) *

Earned Income Tax Credits *

Trial Work Period (TWP) *

Medicaid Buy-In *

Plan for Achieving Self-Support (PASS) *

NY ABLE *

Comment *

What would you need to help you take advantage of using work incentives? (check all that apply) *

Clear understandable guidance Access to technical assistance for “how to apply” for benefit Advice about how employment and having a disability can work together Specific training for agency staff to learn about work incentives Easy to use website Online tutorials Other (list in "Comments" area)

Comment *

All done? Click the submit button below to send us your survey.

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Surveys

Survey for Providers

1. Survey Completion Information

2. Awareness of Work Incentive Programs

“I am familiar with this work incentive program or resource and understand the process of referring individuals for enrollment.”

3. Utilization of Work Incentive Programs

“I am aware of this work incentive program or resource, understand the admission criteria, and frequently refer individuals in need to these services.”

4. Effectiveness of Work Incentive Programs

“I have referred individuals to this work incentive program or resource and they have clearly benefitted from the services provided.”

5. Internal catalyst for use of work incentive programs

“The agency staff members in these positions are expected to link individuals receiving employment support to work incentive programs and act as catalysts to promote employment.”

6. Barriers to using work incentive programs

“I have not utilized this work incentive program or resource due to the barriers I have listed.”