Access to Independence Community Needs Assessment FY22-23

We want to identify some of the challenges that people with disabilities face in the community. In particular, we would like to identify barriers in accessing disability-related services.This survey is anonymous, but we will be using the summarized information we collect to improve services, secure necessary funding for service and improve the overall quality of life for people with disabilities in your community. The survey contains questions about who you are, the services you use, and how you feel living in your city. We are asking lots of questions to get a detailed picture that looks at lots of different aspects of life for people with disabilities.

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* 1. What County do you reside in?

Imperial County

Honolulu County

San Diego County

North County San Diego

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* 2. What is your age?

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* 3. What describes you best as a member of our community?

Current consumer of a Center for Independent Living

Person with a disability

Service provider

Caregiver for a person with a disability

Family member/friend of a person with a disability

Other (please specify)

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* 4. How would you describe your disability?

Developmental disability

Learning disability

Mental health or emotional disability

Unseen disability

Physical disability

Sensory disability

Vision disability

Multiple or more than 1 disability

Other (please specify)

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* 5. What is your current employment situation

Full time employed

Part time employed

Full time education or training

Self employed

Looking after home/family

Volunteering

Not working due to health or disability

Retired

Unemployed

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* 6. Please rate the column that you believe best describes the need for the following services in your community.

	High Priority	Priority	Neutral	Low Priority	Not a Priority
Systems advocacy	Systems advocacy High Priority	Systems advocacy Priority	Systems advocacy Neutral	Systems advocacy Low Priority	Systems advocacy Not a Priority
Individual advocacy	Individual advocacy High Priority	Individual advocacy Priority	Individual advocacy Neutral	Individual advocacy Low Priority	Individual advocacy Not a Priority
Accessible Transportation	Accessible Transportation High Priority	Accessible Transportation Priority	Accessible Transportation Neutral	Accessible Transportation Low Priority	Accessible Transportation Not a Priority
Accessible Housing	Accessible Housing High Priority	Accessible Housing Priority	Accessible Housing Neutral	Accessible Housing Low Priority	Accessible Housing Not a Priority
Nursing home Transition	Nursing home Transition High Priority	Nursing home Transition Priority	Nursing home Transition Neutral	Nursing home Transition Low Priority	Nursing home Transition Not a Priority
Preventing institutionalization (Diversion)	Preventing institutionalization (Diversion) High Priority	Preventing institutionalization (Diversion) Priority	Preventing institutionalization (Diversion) Neutral	Preventing institutionalization (Diversion) Low Priority	Preventing institutionalization (Diversion) Not a Priority
Employment services for adults	Employment services for adults High Priority	Employment services for adults Priority	Employment services for adults Neutral	Employment services for adults Low Priority	Employment services for adults Not a Priority
Employment services for youth	Employment services for youth High Priority	Employment services for youth Priority	Employment services for youth Neutral	Employment services for youth Low Priority	Employment services for youth Not a Priority
Individual (one-on-one) Peer Support	Individual (one-on-one) Peer Support High Priority	Individual (one-on-one) Peer Support Priority	Individual (one-on-one) Peer Support Neutral	Individual (one-on-one) Peer Support Low Priority	Individual (one-on-one) Peer Support Not a Priority
Peer support groups	Peer support groups High Priority	Peer support groups Priority	Peer support groups Neutral	Peer support groups Low Priority	Peer support groups Not a Priority
Information regarding services, disability issues, etc.	Information regarding services, disability issues, etc. High Priority	Information regarding services, disability issues, etc. Priority	Information regarding services, disability issues, etc. Neutral	Information regarding services, disability issues, etc. Low Priority	Information regarding services, disability issues, etc. Not a Priority
Referral to needed programs and services	Referral to needed programs and services High Priority	Referral to needed programs and services Priority	Referral to needed programs and services Neutral	Referral to needed programs and services Low Priority	Referral to needed programs and services Not a Priority
Independent Living Skills Training	Independent Living Skills Training High Priority	Independent Living Skills Training Priority	Independent Living Skills Training Neutral	Independent Living Skills Training Low Priority	Independent Living Skills Training Not a Priority
Emergency financial assistance	Emergency financial assistance High Priority	Emergency financial assistance Priority	Emergency financial assistance Neutral	Emergency financial assistance Low Priority	Emergency financial assistance Not a Priority
Voting accessibility	Voting accessibility High Priority	Voting accessibility Priority	Voting accessibility Neutral	Voting accessibility Low Priority	Voting accessibility Not a Priority
Technical Assistance around the Americans with Disabilities Act	Technical Assistance around the Americans with Disabilities Act High Priority	Technical Assistance around the Americans with Disabilities Act Priority	Technical Assistance around the Americans with Disabilities Act Neutral	Technical Assistance around the Americans with Disabilities Act Low Priority	Technical Assistance around the Americans with Disabilities Act Not a Priority
Benefits Planning Counseling	Benefits Planning Counseling High Priority	Benefits Planning Counseling Priority	Benefits Planning Counseling Neutral	Benefits Planning Counseling Low Priority	Benefits Planning Counseling Not a Priority
Assistive Technology	Assistive Technology High Priority	Assistive Technology Priority	Assistive Technology Neutral	Assistive Technology Low Priority	Assistive Technology Not a Priority
Durable medical equipment	Durable medical equipment High Priority	Durable medical equipment Priority	Durable medical equipment Neutral	Durable medical equipment Low Priority	Durable medical equipment Not a Priority
Communication services (interpreters, Braille, and alternative formats)	Communication services (interpreters, Braille, and alternative formats) High Priority	Communication services (interpreters, Braille, and alternative formats) Priority	Communication services (interpreters, Braille, and alternative formats) Neutral	Communication services (interpreters, Braille, and alternative formats) Low Priority	Communication services (interpreters, Braille, and alternative formats) Not a Priority
Personal Care Attendant Services	Personal Care Attendant Services High Priority	Personal Care Attendant Services Priority	Personal Care Attendant Services Neutral	Personal Care Attendant Services Low Priority	Personal Care Attendant Services Not a Priority
Youth Services	Youth Services High Priority	Youth Services Priority	Youth Services Neutral	Youth Services Low Priority	Youth Services Not a Priority
Recreational Opportunities	Recreational Opportunities High Priority	Recreational Opportunities Priority	Recreational Opportunities Neutral	Recreational Opportunities Low Priority	Recreational Opportunities Not a Priority
Disaster Preparedness	Disaster Preparedness High Priority	Disaster Preparedness Priority	Disaster Preparedness Neutral	Disaster Preparedness Low Priority	Disaster Preparedness Not a Priority
Mental Health Services	Mental Health Services High Priority	Mental Health Services Priority	Mental Health Services Neutral	Mental Health Services Low Priority	Mental Health Services Not a Priority

Other (please specify)

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* 7. Are you able to meet your daily needs in the following areas? Please answer Yes/No

	Yes	No
Medical Device Repair	Medical Device Repair Yes menu	Medical Device Repair No menu
Medical Supplies	Medical Supplies Yes menu	Medical Supplies No menu
Having enough food	Having enough food Yes menu	Having enough food No menu
Transportation	Transportation Yes menu	Transportation No menu
Having enough medicine	Having enough medicine Yes menu	Having enough medicine No menu
Keeping doctors and/or therapy appointments	Keeping doctors and/or therapy appointments Yes menu	Keeping doctors and/or therapy appointments No menu
Home Modification	Home Modification Yes menu	Home Modification No menu
Recreational activities	Recreational activities Yes menu	Recreational activities No menu
Safety concerns in the home	Safety concerns in the home Yes menu	Safety concerns in the home No menu

Other (please specify)

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* 8. Do you find the following useful? Please choose all that apply

Monthly Newsletters about disability-related topic

Access to Independence Facebook Page

Access to Independence Website

Access to Independence Instagram

Virtual appointments or programs with your local Center for Independent Living

In-person appointments at your local Center for Independent Living

Other (please specify)

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* 9. What type of workshops or trainings would interest you? Choose all that apply

Disability Awareness

How to self advocate

Emergency Preparedness

Legislative Education Programs

Money management/Life Skills training

Nutrition

Community Involvement

College Preparedness

Employment Readiness

Other (please specify)

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* 10. What types of community activities would you like to see your local Center for Independent Living office host?

Community Forums

Educational Trainings around systemic advocacy

Arts

Walk/Run

Trivia night

Other (please specify)

Access to Independence Community Needs Assessment FY22-23

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* 1. What County do you reside in?

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* 2. What is your age?

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* 3. What describes you best as a member of our community?

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* 4. How would you describe your disability?

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* 5. What is your current employment situation

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* 6. Please rate the column that you believe best describes the need for the following services in your community.

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* 7. Are you able to meet your daily needs in the following areas? Please answer Yes/No

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* 8. Do you find the following useful? Please choose all that apply

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* 9. What type of workshops or trainings would interest you? Choose all that apply

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* 10. What types of community activities would you like to see your local Center for Independent Living office host?

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* 11. Legislative Priorities: Please rate the following legislative priorities , 1 being the most important and 6 being the least important

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* 12. What legislative issues would you like to see us advocating on?

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* 13. Please provide any information not asked in this survey that you think we should know.