Trends in Residential Models & Options

Introduction to the Purpose of the Survey

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* 1. We want to get your sense of TRENDS in your state or province, to the best of your knowledge. Please mark what you perceive to be “going on” with each of the residential support models and options below. (Leave any line blank if you just don't know.)

	Major De-emphasis	Some De-emphasis	Steady	Some Emphasis	Major Emphasis
Assisted Living, Private Provider Operated	Assisted Living, Private Provider Operated Major De-emphasis	Assisted Living, Private Provider Operated Some De-emphasis	Assisted Living, Private Provider Operated Steady	Assisted Living, Private Provider Operated Some Emphasis	Assisted Living, Private Provider Operated Major Emphasis
Assisted Living, State or Local Government Operated	Assisted Living, State or Local Government Operated Major De-emphasis	Assisted Living, State or Local Government Operated Some De-emphasis	Assisted Living, State or Local Government Operated Steady	Assisted Living, State or Local Government Operated Some Emphasis	Assisted Living, State or Local Government Operated Major Emphasis
Group Residence (supporting 3 or fewer individuals), Private Provider Operated	Group Residence (supporting 3 or fewer individuals), Private Provider Operated Major De-emphasis	Group Residence (supporting 3 or fewer individuals), Private Provider Operated Some De-emphasis	Group Residence (supporting 3 or fewer individuals), Private Provider Operated Steady	Group Residence (supporting 3 or fewer individuals), Private Provider Operated Some Emphasis	Group Residence (supporting 3 or fewer individuals), Private Provider Operated Major Emphasis
Group Residence (supporting 3 or fewer individuals) State or Local Government Operated	Group Residence (supporting 3 or fewer individuals) State or Local Government Operated Major De-emphasis	Group Residence (supporting 3 or fewer individuals) State or Local Government Operated Some De-emphasis	Group Residence (supporting 3 or fewer individuals) State or Local Government Operated Steady	Group Residence (supporting 3 or fewer individuals) State or Local Government Operated Some Emphasis	Group Residence (supporting 3 or fewer individuals) State or Local Government Operated Major Emphasis
Group Residence (supporting more than 3 individuals), Private Provider Operated	Group Residence (supporting more than 3 individuals), Private Provider Operated Major De-emphasis	Group Residence (supporting more than 3 individuals), Private Provider Operated Some De-emphasis	Group Residence (supporting more than 3 individuals), Private Provider Operated Steady	Group Residence (supporting more than 3 individuals), Private Provider Operated Some Emphasis	Group Residence (supporting more than 3 individuals), Private Provider Operated Major Emphasis
Group Residence (supporting more than 3 individuals) State or Local Government Operated	Group Residence (supporting more than 3 individuals) State or Local Government Operated Major De-emphasis	Group Residence (supporting more than 3 individuals) State or Local Government Operated Some De-emphasis	Group Residence (supporting more than 3 individuals) State or Local Government Operated Steady	Group Residence (supporting more than 3 individuals) State or Local Government Operated Some Emphasis	Group Residence (supporting more than 3 individuals) State or Local Government Operated Major Emphasis
ICF (supporting more than 4 individuals), Private Provider Operated	ICF (supporting more than 4 individuals), Private Provider Operated Major De-emphasis	ICF (supporting more than 4 individuals), Private Provider Operated Some De-emphasis	ICF (supporting more than 4 individuals), Private Provider Operated Steady	ICF (supporting more than 4 individuals), Private Provider Operated Some Emphasis	ICF (supporting more than 4 individuals), Private Provider Operated Major Emphasis
ICF (supporting more than 4 individuals), State or Local Government Operated	ICF (supporting more than 4 individuals), State or Local Government Operated Major De-emphasis	ICF (supporting more than 4 individuals), State or Local Government Operated Some De-emphasis	ICF (supporting more than 4 individuals), State or Local Government Operated Steady	ICF (supporting more than 4 individuals), State or Local Government Operated Some Emphasis	ICF (supporting more than 4 individuals), State or Local Government Operated Major Emphasis
ICF (supporting fewer than 4 individuals), Private Provider Operated	ICF (supporting fewer than 4 individuals), Private Provider Operated Major De-emphasis	ICF (supporting fewer than 4 individuals), Private Provider Operated Some De-emphasis	ICF (supporting fewer than 4 individuals), Private Provider Operated Steady	ICF (supporting fewer than 4 individuals), Private Provider Operated Some Emphasis	ICF (supporting fewer than 4 individuals), Private Provider Operated Major Emphasis
ICF (supporting fewer than 4 individuals), State or Local Government Operated	ICF (supporting fewer than 4 individuals), State or Local Government Operated Major De-emphasis	ICF (supporting fewer than 4 individuals), State or Local Government Operated Some De-emphasis	ICF (supporting fewer than 4 individuals), State or Local Government Operated Steady	ICF (supporting fewer than 4 individuals), State or Local Government Operated Some Emphasis	ICF (supporting fewer than 4 individuals), State or Local Government Operated Major Emphasis
Medically Intensive Community Living Supports Designed for Adults, Private Provider Operated	Medically Intensive Community Living Supports Designed for Adults, Private Provider Operated Major De-emphasis	Medically Intensive Community Living Supports Designed for Adults, Private Provider Operated Some De-emphasis	Medically Intensive Community Living Supports Designed for Adults, Private Provider Operated Steady	Medically Intensive Community Living Supports Designed for Adults, Private Provider Operated Some Emphasis	Medically Intensive Community Living Supports Designed for Adults, Private Provider Operated Major Emphasis
Medically Intensive Community Living Supports Designed for Adults, State or Local Government Operated	Medically Intensive Community Living Supports Designed for Adults, State or Local Government Operated Major De-emphasis	Medically Intensive Community Living Supports Designed for Adults, State or Local Government Operated Some De-emphasis	Medically Intensive Community Living Supports Designed for Adults, State or Local Government Operated Steady	Medically Intensive Community Living Supports Designed for Adults, State or Local Government Operated Some Emphasis	Medically Intensive Community Living Supports Designed for Adults, State or Local Government Operated Major Emphasis
Medically Intensive Community Living Supports Designed for Children, Private Provider Operated	Medically Intensive Community Living Supports Designed for Children, Private Provider Operated Major De-emphasis	Medically Intensive Community Living Supports Designed for Children, Private Provider Operated Some De-emphasis	Medically Intensive Community Living Supports Designed for Children, Private Provider Operated Steady	Medically Intensive Community Living Supports Designed for Children, Private Provider Operated Some Emphasis	Medically Intensive Community Living Supports Designed for Children, Private Provider Operated Major Emphasis
Medically Intensive Community Living Supports Designed for Children, State or Local Government Operated	Medically Intensive Community Living Supports Designed for Children, State or Local Government Operated Major De-emphasis	Medically Intensive Community Living Supports Designed for Children, State or Local Government Operated Some De-emphasis	Medically Intensive Community Living Supports Designed for Children, State or Local Government Operated Steady	Medically Intensive Community Living Supports Designed for Children, State or Local Government Operated Some Emphasis	Medically Intensive Community Living Supports Designed for Children, State or Local Government Operated Major Emphasis
Medically Intensive Community Living Supports Designed for People Living in Nursing Homes, Private Provider Operated	Medically Intensive Community Living Supports Designed for People Living in Nursing Homes, Private Provider Operated Major De-emphasis	Medically Intensive Community Living Supports Designed for People Living in Nursing Homes, Private Provider Operated Some De-emphasis	Medically Intensive Community Living Supports Designed for People Living in Nursing Homes, Private Provider Operated Steady	Medically Intensive Community Living Supports Designed for People Living in Nursing Homes, Private Provider Operated Some Emphasis	Medically Intensive Community Living Supports Designed for People Living in Nursing Homes, Private Provider Operated Major Emphasis
Medically Intensive Community Living Supports Designed for People Living in Nursing Homes, State or Local Government Operated	Medically Intensive Community Living Supports Designed for People Living in Nursing Homes, State or Local Government Operated Major De-emphasis	Medically Intensive Community Living Supports Designed for People Living in Nursing Homes, State or Local Government Operated Some De-emphasis	Medically Intensive Community Living Supports Designed for People Living in Nursing Homes, State or Local Government Operated Steady	Medically Intensive Community Living Supports Designed for People Living in Nursing Homes, State or Local Government Operated Some Emphasis	Medically Intensive Community Living Supports Designed for People Living in Nursing Homes, State or Local Government Operated Major Emphasis
Congregate Apartment Living	Congregate Apartment Living Major De-emphasis	Congregate Apartment Living Some De-emphasis	Congregate Apartment Living Steady	Congregate Apartment Living Some Emphasis	Congregate Apartment Living Major Emphasis
Government Subsidized Housing e.g. HUD	Government Subsidized Housing e.g. HUD Major De-emphasis	Government Subsidized Housing e.g. HUD Some De-emphasis	Government Subsidized Housing e.g. HUD Steady	Government Subsidized Housing e.g. HUD Some Emphasis	Government Subsidized Housing e.g. HUD Major Emphasis
Residential Agrarian Living Options	Residential Agrarian Living Options Major De-emphasis	Residential Agrarian Living Options Some De-emphasis	Residential Agrarian Living Options Steady	Residential Agrarian Living Options Some Emphasis	Residential Agrarian Living Options Major Emphasis
In Home Supports	In Home Supports Major De-emphasis	In Home Supports Some De-emphasis	In Home Supports Steady	In Home Supports Some Emphasis	In Home Supports Major Emphasis
Host Home	Host Home Major De-emphasis	Host Home Some De-emphasis	Host Home Steady	Host Home Some Emphasis	Host Home Major Emphasis
Shared Living	Shared Living Major De-emphasis	Shared Living Some De-emphasis	Shared Living Steady	Shared Living Some Emphasis	Shared Living Major Emphasis

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* 2. Are any other community living options being emphasized? Please describe if so.

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* 3. If a US-based entity, does your state government, under the Olmstead Settlement, participate in a DOJ Settlement?

Unsure

Yes

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* 4. Do you see any trends toward expanding church-based organizations role in providing community living supports?

Minor trend

Major trend

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* 5. Is your government currently contracting with or considering contracting with a medical managed care company?

Definitely Not

Probably Not

Possibly

Probably Yes

Definitely Yes

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* 6. If yes to the question above, how do you think this will affect the future of community living supports?

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* 7. If there is a Managed Care Organization (MCO), will participants be able to exercise personal choice in selecting community living support options?

Definitely Not

Probably Not

Possibly

Probably Yes

Definitely Yes

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* 8. Does your state/province actively support the following:

	Not At All	A Little	Some	A Lot	Very Much
Self-Determination	Self-Determination Not At All	Self-Determination A Little	Self-Determination Some	Self-Determination A Lot	Self-Determination Very Much
Person-Centered Planning	Person-Centered Planning Not At All	Person-Centered Planning A Little	Person-Centered Planning Some	Person-Centered Planning A Lot	Person-Centered Planning Very Much
Micro Boards	Micro Boards Not At All	Micro Boards A Little	Micro Boards Some	Micro Boards A Lot	Micro Boards Very Much
Micro Enterprises	Micro Enterprises Not At All	Micro Enterprises A Little	Micro Enterprises Some	Micro Enterprises A Lot	Micro Enterprises Very Much

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* 9. Now some questions about you, all voluntary, and all to be kept completely confidential. Your name & contact information:

Name:

Company:

City/Town:

State:

ZIP:

Country:

Email Address:

Phone Number:

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* 10. How do you describe your work?

Government - Federal

Government - State

Government - Local

Service Provider organization

Education - including academia

Advocate - including family and self-advocate

Other (please specify)