Independent Living Needs Assessment

The following survey is intended to collect information about the needs and priorities of Texans living with disabilities. The information collected will be considered during the drafting of the State Plan for Independent Living, a three-year plan that sets the parameters and goals for the provision of Independent Living Services in Texas.

Directions: Please answer the following questions by choosing the best answer(s) that applies to you. Should you need assistance or clarification with the questions, the Texas SILC staff and volunteers are happy to assist any way we can. Thank you in advance for your time and helpful feedback.

**If you are a FAMILY MEMBER of a person with a disability, please answer questions with information for your family member**

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* 1. What county do you live in?

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* 2. What is your race/ethnicity?

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* 3. What is your age?

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* 4. Are you living with a disability (e.g. brain injury, depression, paralysis, etc.)?

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* 5. If you answered yes to the question above, please select which disability type(s) best describe you.

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* 6. What are the most important services for you to continue living independently? Please select no more than 5

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* 7. From the list of services in Question 6, which services are NOT meeting your needs? If possible, please explain why these services are not meeting your needs. (example: Issue: Transportation, Reason: Lack of paratransit services in my area)

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* 8. Do you believe you can easily access a provider for Independent Living Services (i.e. a Center for Independent Living, Community Center, Government agency, etc.) in your area?

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* 9. If you answered No to Question 8, can you explain which providers you have trouble accessing and why?

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* 10. If you cannot find a provider or access to the services you need, where do you go for help? (e.g., family members, friends, etc.)

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* 11. The next State Plan for Independent Living will focus on improving services and supports for people with disabilities in Texas. Do you have any suggestions for how we can improve Independent Living services in Texas?

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