Pennsylvania’s new Community HealthChoices (CHC) program is designed to help older adults and people with disabilities stay healthier and more independent. Advocates want to understand your experience in this new program, so it can be improved.

Please share your honest answers in this survey. Your answers are very important and will help improve CHC for everyone. Your information will be kept private and confidential.

Please contact Erin Ninehouser of the Pennsylvania Health Access Network at 1-844-474-2643 or erin@pahealthaccess.org if you have questions about this survey. Thank you! 

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* 1.
Who is filling out this survey?

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* 2. Tell us a little bit about yourself, or the person you are filling this out for. (Please check all that apply):

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* 3. Which Community HealthChoices plan do you have today?

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* 4. Did you choose your plan yourself, or did the state choose it for you?

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* 5. How has your Community HealthChoices plan helped you? Please answer the questions below by checking “Yes” or “No” based on your experience.

  Yes No
Has your CHC plan given you clear information by mail or telephone that explains your benefits and what they can do to help you?
Do you know what your CHC plan is supposed to be doing for you?
Are you able to reach someone quickly at your CHC plan’s participant or member services number when you call for help?
Has your CHC plan made it easier for you to access medical and behavioral health treatment, or helped in other ways to coordinate your care?

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* 6. On a scale of 1 to 5, with 1 being the least satisfied and 5 being the most satisfied, how would you rate your experience with your Community HealthChoices plan?

Long-Term Services and Supports (LTSS) are covered through Community HealthChoices (CHC) waiver by CHC plans for people who qualify, based on medical need. A Service Coordinator helps arrange for these services, which can include: a personal care aide, non-medical transportation; job training (if you want to work); equipment or changes to make your home accessible, and much more.

The next questions are about your experience getting home and community-based LTSS services through your CHC plan. Please select whether you agree or disagree with the statement.

If you do not currently receive these services, you can skip to question #16.

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* 7. It is easy for me to contact my Service Coordinator, without having to wait a long time on the phone, or go through other people to get a hold them.

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* 8. When we put together my person-centered service plan, my Coordinator asked me about what's important to me and what I need to live the life I want.

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* 9. I was given information by my Coordinator about what benefits and services I can get through my CHC plan. 

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* 10. I am getting the right amount of services to help me live independently.

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* 11. My direct care workers (attendants) do what I ask and treat me with respect.

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* 12. My CHC plan responds quickly if I ask for changes in my services or the agencies that provide them.

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* 13. My CHC plan makes it easy for me to schedule transportation for both medical trips to the doctor, and non-medical trips like to the grocery store, church, or to visit family.

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* 14. I have someone to call who can help me if a ride is late.

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* 15. I know what my rights are and who to contact if I need help filing a complaint about how I’ve been treated, or a grievance about my benefits.

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* 16. Would it help you to have more support in any of the areas below? (Please check all that apply):

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* 17. Would you like to learn more about advocacy to improve Community HealthChoices and care for older adults and people with disabilities? (If yes, please check all that apply):

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* 18. OPTIONAL: If you would like an advocate to follow up with you about your experiences, or to get involved in advocacy, please list your contact information below.

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100% of survey complete.

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