AZSILC Needs Assessment Survey 2024

AZSILC NEEDS ASSESSMENT SURVEY 2024
The Arizona Statewide Independent Living Council (AZSILC) is conducting a survey to gather information about programs and services that provide support and opportunities for people who have disabilities in Arizona to live full lives in the community.

Arizona Statewide Independent Living Council seeks responses directly from people who have disabilities, their family members, friends, caregivers, and other stakeholders.

Your response is anonymous. Thank you again for taking the time to share your thoughts and ideas.

This survey is available in alternative formats upon request. Please email operations@azsilc.org or call 602-262-2900 for further information.
GENERAL INFORMATION
Please type the Arizona County that you live in.*
Please check all that apply.*

I am a person who has a disabilityI am a parent or guardian of a person who has a disabilityI am a family member, spouse or partner of a person who has a disabilityI am a friend or personal assistant of a person who has a disabilityI am a community advocate or service provider
Check here if you are familiar with the Arizona Statewide Independent Living Council (AZSILC).*

Familiar with AZSILCNot Familiar with AZSILC

4. Below is a list of statements related to your general feeling about yourself as a person who has a disability, or on behalf of the person who has a disability to whom you are connected. Please check the box related to each statement that best describes how you feel. *

	Strongly Agree	Agree	Disagree	Strongly Disagree
a. In general I am satisfied with my life.
b. In general my physical health is good.
c. I am able to live independently.
d. I am able to maintain and stay within my budget.
e. I can get the medical attention I need.
f. I am happy in my current living situation.
g. I receive the social and emotional support that I need.
h. I participate in and feel connected to my community.
i. I am able to access the services I need.
j. I have adequate opportunity to be involved in the community.
k. I feel people have a good understanding of disability.
l. I feel discriminated against because of my disability.

	Strongly Agree	Agree	Disagree	Stongly Disagree
a. In general I am satisfied with my life.
b. In general my physical health is good.
c. I am able to live independently.
d. I am able to maintain and stay within my budget.
e. I can get the medical attention I need.
f. I am happy in my current living situation.
g. I receive the social and emotional support that I need.
h. I participate in and feel connected to my community.
i. I am able to access the services I need.
j. I have adequate opportunity to be involved in the community.
k. I feel people have a good understanding of disability.
l. I feel discriminated against because of my disability.
m. None of these describe how I feel.

5. Have you contacted a Center for Independent Living for information, assistance, or services during the past 12 months? *

YesNo
6. If yes, please check the box next to the Center for Independent Living you contacted for services.

Ability360Assist! to IndependenceDirect Advocacy & Resource Center (formerly Direct Center for Independence)New Horizons Disability Empowerment CenterServices Maximizing Independent Living and Empowerment – SMILE

7. Did you NEED any of the following services in the last 12 months? (Please check all that apply)*

	Yes	No
Advocacy/Self-Advocacy (how to ask for help and speak to others about your needs)
Assistive Technology
Mental Health Services
Work Incentives Counseling (Help with SSI, SSDI, AHCCCS, Etc.)
Emergency Preparedness/Safety
Employment/Vocational Services (Training, resources, and supports to get and keep a job)
Healthcare (Help with AHCCCS, Medicare, getting help with medical issues)
Home Modifications (Ramp, wider doorways, grab bars, Etc.)
Housing Assistance (Help finding affordable and/or accessible housing)
Independent Living Skills Training
Information and Referral (access to disability-related information and resources)
ASL Interpreter Services and/or CART
Long Term Care Transition (Help moving back into the community)
Long Term Care Diversion (Help to continue living in the community rather than in a facility)
Peer Support
Personal Assistance Services/Home Care
Training for managing Personal Care Services
Temporary Emergency Shelter
Transportation (access to public transportation and training)
Disability Rights/Law Services (Help understanding your rights, or with legal issues related to disability)
Computer Training
Durable Medical Equipment (Help in obtaining or repairing DME)
Social/Recreation
Youth Transition Services
*Other

8. Did you RECEIVE any of the following services in the last 12 months? (Please check all that apply).*

	Yes	No
Advocacy/Self-Advocacy (how to ask for help and speak to others about your needs)
Assistive Technology
Mental Health Services
Work Incentives Counseling (Help with SSI, SSDI, AHCCCS, Etc.)
Emergency Preparedness/Safety
Employment/Vocational Services (Training, resources, and supports to get and keep a job)
Healthcare (Help with AHCCCS, Medicare, getting help with medical issues)
Home Modifications (Ramp, wider doorways, grab bars, Etc.)
Housing Assistance (Help finding affordable and/or accessible housing)
Independent Living Skills Training
Information and Referral (access to disability-related information and resources)
ASL Interpreter Services and/or CART
Long Term Care Transition (Help moving back into the community)
Long Term Care Diversion (Help to continue living in the community rather than in a facility)
Peer Support
Personal Assistance Services/Home Care
Training for managing Personal Care Services
Temporary Emergency Shelter
Transportation (access to public transportation and training)
Disability Rights/Law Services (Help understanding your rights, or with legal issues related to disability)
Computer Training
Durable Medical Equipment (Help in obtaining or repairing DME)
Social/Recreation
Youth Transition Services
*Other

9. Please respond to the following questions regarding COVID-19.
I received the health services I needed during the pandemic*

YesNo
I want to get the COVID-19 vaccination*

YesNo
I received the COVID-19 vaccination*

YesNo
I need help getting the COVID-19 vaccination*

YesNo
I chose not to, or have been advised not to get the COVID-19 vaccination *

YesNo
10. What makes it hard for you to get the services you need? (Check all that apply)*

The services I need are not available where I liveI do not have access to reliable transportationI do not have money to pay for gas or transportationServices are not provided in my primary languageI cannot leave my home because of access issuesWhere I need to get services is not accessibleOther
11. What keeps you from living more independently and participating in your community? (Please check all that apply)*

Lack of housing optionsThe places I want to go are not accessibleLack of communication access (Need ASL Interpreter, Braille, Large Print, CART)Attitudes/DiscriminationLack of Assistive Technology/Adaptive equipmentPersonal finances/resourcesLack of transportation optionsNo barriers to participating in the community
12. Did you vote in the last election?*

YesNot registered to voteNot eligible to voteNo

13. How important are the following for people who have disabilities? *

	Not Important	Important	Very Important
Advocacy/Self-Advocacy (how to ask for help and speak to others about your needs)
Assistive Technology
Mental Health Services
Work Incentives Counseling (help with SSI, SSDI, AHCCCS, etc.)
Emergency Preparedness/Safety
Employment/Vocational Services (training, resources, and supports to get and keep a job)
Healthcare (help with AHCCCS, Medicare, medical issues)
Home Modifications (ramp, wider doorways, grab bars, etc.)
Housing Assistance (help finding housing options)
Independent Living Skills Training (budgeting, cooking, etc.)
Information and Referral (access to disability-related information and resources)
ASL Interpreter Services and/or CART
Long Term Care Transition (help moving back into the community)
Long Term Care Diversion (help to continue living in the community rather than in a facility)
Peer Support (from others who have disabilities)
Personal Assistance Services/Home Care
Training/managing Home Care providers
Emergency Shelter
Transportation (public transportation/transportation options)
Disability Rights/Law (help understanding your rights, or with legal issues related to disability)
Computer Training
Durable Medical Equipment (wheelchair, walker, shower chair, ventilator, pressure mattresses, etc.)
Social/Recreation
Youth Transition Services (moving into adulthood)
*Other

AZSILC NEEDS ASSESSMENT SURVEY 2024

GENERAL INFORMATION

DEMOGRAPHIC INFORMATION