My Support Link

Community Living Essex County is at the beginning stages of exploring the feasibility of ‘My Support Link,’ a user-friendly online platform for families to connect with one another around supports and services, sharing resources and accessing affordable and flexible supports.

As a family member your input is key to the development of this online resource. We ask that you take 10 minutes to complete this survey – your answers will help guide our decision-making. We thank you for your time and valuable input.

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* 1. Please provide us with your postal code to identify the area in which you live.

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* 2. How many people live in your home?

None

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* 3. How many members of your immediate family have an intellectual disability?

* 4. How old is/are your family members with an intellectual disability?

10 years or younger

11 to 18 years

19 to 21 years

21 to 30 years

31 to 40 years

41 to 50 years

51 to 64 years

65 and older

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* 5. Please indicate how likely it is that you would use ‘My Support Link’ to connect with other families:

	Very Likely	Likely	Unlikely
To explore sharing support or pooling resources	To explore sharing support or pooling resources Very Likely	To explore sharing support or pooling resources Likely	To explore sharing support or pooling resources Unlikely
For support, guidance and friendship	For support, guidance and friendship Very Likely	For support, guidance and friendship Likely	For support, guidance and friendship Unlikely

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* 6. Please indicate if you would use ‘My Support Link’ to gain access to:

	Very Likely	Likely	Unlikely
Locate and Hire Support Workers/Respite Workers	Locate and Hire Support Workers/Respite Workers Very Likely	Locate and Hire Support Workers/Respite Workers Likely	Locate and Hire Support Workers/Respite Workers Unlikely
Locate & access agency supports to assist your family member to explore volunteerism, find employment, participate in educational, recreation & leisure opportunities in the community.	Locate & access agency supports to assist your family member to explore volunteerism, find employment, participate in educational, recreation & leisure opportunities in the community. Very Likely	Locate & access agency supports to assist your family member to explore volunteerism, find employment, participate in educational, recreation & leisure opportunities in the community. Likely	Locate & access agency supports to assist your family member to explore volunteerism, find employment, participate in educational, recreation & leisure opportunities in the community. Unlikely

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* 7. Please indicate if you would use ‘My Support Link’ to find connections to:

	Very Likely	Likely	Unlikely
Shared transportation	Shared transportation Very Likely	Shared transportation Likely	Shared transportation Unlikely
Classified advertising for specialized equipment, vehicles, and other goods and services relevant to supporting people with a disability	Classified advertising for specialized equipment, vehicles, and other goods and services relevant to supporting people with a disability Very Likely	Classified advertising for specialized equipment, vehicles, and other goods and services relevant to supporting people with a disability Likely	Classified advertising for specialized equipment, vehicles, and other goods and services relevant to supporting people with a disability Unlikely

Other (what other service functions would you like to see offered that isn’t listed?):

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* 8. Please indicate if you would use ‘My Support Link’ to gather information on:

	Very Likely	Likely	Unlikely
Financial and estate planning services	Financial and estate planning services Very Likely	Financial and estate planning services Likely	Financial and estate planning services Unlikely
News & press releases relevant to supporting your family	News & press releases relevant to supporting your family Very Likely	News & press releases relevant to supporting your family Likely	News & press releases relevant to supporting your family Unlikely
Family support websites	Family support websites Very Likely	Family support websites Likely	Family support websites Unlikely
Community Living Essex County services and events	Community Living Essex County services and events Very Likely	Community Living Essex County services and events Likely	Community Living Essex County services and events Unlikely

Other (what other information would you like to see included that isn’t listed?):

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* 9. If you were looking for respite services, where would you prefer to have respite provided? Please rate your choices in order of preference.

	1st	2nd	3rd	4th
In your own home	In your own home 1st	In your own home 2nd	In your own home 3rd	In your own home 4th
In an Agency owned or operated home in the community	In an Agency owned or operated home in the community 1st	In an Agency owned or operated home in the community 2nd	In an Agency owned or operated home in the community 3rd	In an Agency owned or operated home in the community 4th
In a combination of the above	In a combination of the above 1st	In a combination of the above 2nd	In a combination of the above 3rd	In a combination of the above 4th
With another family, in an approved host family home	With another family, in an approved host family home 1st	With another family, in an approved host family home 2nd	With another family, in an approved host family home 3rd	With another family, in an approved host family home 4th

Other (please specify)

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* 10. If you are looking to purchase respite services for your family member, please identify which type(s) of respite support you are most interested in. Please check all that apply.

	1st	2nd	3rd	4th	5th	6th
Weekend respite (typically Friday night to Sunday evening)	Weekend respite (typically Friday night to Sunday evening) 1st	Weekend respite (typically Friday night to Sunday evening) 2nd	Weekend respite (typically Friday night to Sunday evening) 3rd	Weekend respite (typically Friday night to Sunday evening) 4th	Weekend respite (typically Friday night to Sunday evening) 5th	Weekend respite (typically Friday night to Sunday evening) 6th
3 or more consecutive days to accommodate a vacation, business trip or other need for a break	3 or more consecutive days to accommodate a vacation, business trip or other need for a break 1st	3 or more consecutive days to accommodate a vacation, business trip or other need for a break 2nd	3 or more consecutive days to accommodate a vacation, business trip or other need for a break 3rd	3 or more consecutive days to accommodate a vacation, business trip or other need for a break 4th	3 or more consecutive days to accommodate a vacation, business trip or other need for a break 5th	3 or more consecutive days to accommodate a vacation, business trip or other need for a break 6th
Only evenings	Only evenings 1st	Only evenings 2nd	Only evenings 3rd	Only evenings 4th	Only evenings 5th	Only evenings 6th
Only during the day	Only during the day 1st	Only during the day 2nd	Only during the day 3rd	Only during the day 4th	Only during the day 5th	Only during the day 6th
A few hours here and there during the week	A few hours here and there during the week 1st	A few hours here and there during the week 2nd	A few hours here and there during the week 3rd	A few hours here and there during the week 4th	A few hours here and there during the week 5th	A few hours here and there during the week 6th
A few hours here and there on weekends	A few hours here and there on weekends 1st	A few hours here and there on weekends 2nd	A few hours here and there on weekends 3rd	A few hours here and there on weekends 4th	A few hours here and there on weekends 5th	A few hours here and there on weekends 6th

Other (please specify)

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* 11. If you were to purchase services for your family member, would you be using:

“Passport” funds provided by the government

“Special Services At Home” funds provided by the government

Your own funds

A combination of both government funds and your own funds

Other government funds i.e. ODSP

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* 12. Would you consider linking online with other families who share similar support needs to combine your resources and purchase services together?

Yes

Unsure

If you answered "Unsure" or "No", please tell us why?

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* 13. In general, what level of interest do you have in visiting and using an online resource, such as My Support Link, to connect with other families, potentially share resources, and access information about services available to you and your family member with an intellectual disability?

Very Interested

Interested

Somewhat Interested

Not Interested

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* 14. To help us develop My Support Link we are holding focus group discussions with families on Monday, June 20th to learn more about what features you would like My Support Link to include. Please let us know if you are able to join us at one of the following times at Community Living Essex County’s office at 372 Talbot Street North, Essex, Ontario, N8M 2W4.

10:00 a.m. – 11:15 a.m.

1:00 p.m. – 2:15 p.m.

7:00 p.m. – 8:15 p.m.

I cannot attend.

Please provide your email address to receive a formal invitation to attend the focus group:

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* 15. How would you rate your current level of awareness of Community Living Essex County and the work that it does?

Extremely Aware

Very Aware

Moderately Aware

Slightly Aware

Not at all Aware

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* 16. Tell us in a sentence or two, when you think of Community Living Essex County, what comes to mind for you?

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* 17. Please feel free to leave any other comments or suggestions in the comment box provided below.

Thank you very much for completing our survey! Your opinions are very important to us and we hope to see you at our focus group on June 20. If you require assistance in completing this survey or have any questions, please feel free to contact Community Living Essex County at 519-776-6483 and we will be glad to help.