DMH Division of Developmental Disabilities HCBS Participant Survey 2016

10% of survey complete.
We need your help.

The Center for Medicare and Medicaid Services, known as CMS, has published a rule changing the requirements that make up a Home and Community-based setting. The purpose of this survey is to find out if you are included in and have access to supports in the community. Your answers to these questions will help the Division of DD determine if your services are part of the community.

*This survey asks for your name.  However it is not necessary.

If there are questions you do not wish to answer, or questions that do not have to do with the services you receive you may skip those.

You will have an opportunity at the end of this survey to check a box to ask for someone from the Division to come talk with you.

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* 1. Who Am I?

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* 2. This survey asks for your name. However, it is not necessary.

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* 3. Please check the box(es) for the services you receive and then answer the questions for those services.