IM4Q: New Questions supporting ODP’s ISAC Recommendations
ISAC Recommendation #1: Assure Effective Communication
Do you feel that your staff/caregivers understand you when you communicate with them?
–Not Applicable—person does not have support staff
–Yes
–Sometimes or some staff
–No
–Don’t know, no response, unclear response or person does not communicate using words
ISAC Recommendation #2: Promote Self-Direction, Choice, and Control
Did your supports coordinator ask you about directing your own services and supports? This may be referred to as person-directed services or self-directed services.
–Yes
–No
–No response or unclear response or person does not communicate using words
–Don’t know, no response, unclear response or person does not communicate using words
ISAC Recommendation #3: Increase Employment
Is community employment a goal in this person’s service plan (NCI)?
–Yes
–No
Did anyone talk to you about employment in your most recent planning meeting?
–Yes
–No
–Don’t know, no response, unclear response
If someone did talk to you about employment, who was it? (Check all that apply)
–Supports Coordinator
–Roommates
–Family
–Provider
ISAC Recommendation #4: Support Families throughout the Lifespan
Have you learned about the Life Course Framework and Tools?
–Yes
–No
–Don’t know or no answer
Is the information you get about your relative’s services and supports easy to understand?
–Yes
–No
–Don’t know or no answer
Do you have opportunities to connect and network with other families with family members at similar life stages?
–Yes
–No
–Don’t know or no answer
Are you aware of the PA Family Network?
–Yes
–No
–Don’t know or no answer
If you are aware of the PA Family Network, have you participated in a workshop or training led by the Network of Family Advisors?
–Not applicable-not aware of the PA Family Network
–Yes
–No
–Don’t know or no answer
If your family member transitioned from school services to adult services in the past year, were you happy with the transition process?
–Not applicable-did not transition from school services to adult services in the past year
–Yes
–No
–Don’t know or no answer
Do you have enough information about other public services for which your family is eligible? For example, public services such as food stamps, SSI, or housing subsidies.
–Yes
–No
–Don’t know or no answer
Does the Supports Coordinator ask you about your vision for an everyday life for your family member?
–Yes
–No
–Don’t know or no answer
ISAC Recommendation #5 Promote Health, Wellness, and Safety and ISAC Recommendation #6: Support People with Complex Needs
Did you have an opportunity to discuss your health concerns with your psychiatrist?
–Not applicable-does not have a psychiatrist
–Yes
–No
–Don’t know, no response, unclear response or person does not communicate using words
At the end of your doctor appointment, did you feel that you understood your doctor’s instructions?
–Yes
–No
–Don’t know, no response, unclear response or person does not communicate using words
If you needed help with communication or translation at your doctor appointment, was it available to you?
–Yes
–No
–Don’t know, no response, unclear response or person does not communicate using words
Have you ever tried to see a medical specialist but were not able to?
–Yes, I was able to
–No, I was not able to (explain: ______)
–Don’t know, no response, unclear response or person does not communicate using words
How hard is it for you to get healthcare services in your community?
–Very hard
–Hard
–In between
–Pretty easy-not that hard
–Very easy-not hard at all
–Don’t know, no response, unclear response or person does not communicate using words
Have you ever not received medical services that you need because of your disability?
–Yes
–No
–Don’t know, no response, unclear response or person does not communicate using words
Are you able to provide consent for medical treatment? That means that you can give your own approval to get care without anyone else helping you.
–Yes
–No
–Don’t know, no response, unclear response or person does not communicate using words
If you are able to provide consent for medical treatment, does your doctor accept your consent or do they also require someone else’s, like a family member or guardian?
–Not applicable-am not able to provide consent for medical treatment
–My consent is accepted by the doctor
–My consent is not accepted, consent from someone else is required
–Don’t know, no response, unclear response or person does not communicate using words
Does your doctor speak directly to you during appointments?
–Yes
–No
About how many times/month do you exercise at home? ______
ISAC Recommendation #8: Simplify the System
Does your supports coordinator ask you what your interests are?
–Yes
–No
–Don’t know, no response, unclear response or person does not communicate using words
Does your supports coordinator ask you what you want your life to look like?
–Yes
–No
–Don’t know, no response, unclear response or person does not communicate using words
Does your supports coordinator ask you about what you want in your future?
–Yes
–No
–Don’t know, no response, unclear response or person does not communicate using words
Do services and supports change when your family member’s needs change? (NCI)
–Yes
–No
–Don’t know or no answer
ISAC Recommendation #10: Expand Options for Community Living
Is your name on the lease, deed, or other legally enforceable rental agreement?
–Not applicable – person is under age 18, lives with family, or owns a home
–Yes
–No
–Don’t know, no response, unclear response or person does not communicate using words
Do you own your own home?
–Not applicable – person is under age 18
–Yes
–No
–Don’t know, no response, unclear response or person does not communicate using words
Were you given a choice to live where people without disabilities live?
–Not applicable –person lives with family or is under 18 years of age
–Yes
–No
–Don’t know, no response, unclear response or person does not communicate using words
ISAC Recommendation #11: Increase Community Participation
When choosing your work or other day activity, were you given a choice to go where people without disabilities go?
–Not applicable—no work or community activity or goes to school
–Yes
–No
–Don’t know, no response, unclear response or person does not communicate using words
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