FOI 24/25-1267 DOCUMENT 3
National Disability Insurance Scheme
Outcomes Framework
Short Form Questionnaires
Family Questions for participants aged 25 and over
v2.0
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Page 14 of 58Family Questions for participants aged 25 and over In this first section, I will ask you some background questions.
Family member/carer information
| Question | Answer |
|---|---|
| 1. Please enter the participant’s NDIS ID number | Free text (check for valid number of characters?) |
| 2. What is your relationship to the participant? | ☐ Mother ☐ Father ☐ Grandmother ☐ Grandfather ☐ Sister ☐ Brother ☐ Other family member ☐ Carer ☐ Other (please specify): |
| 3. Are you currently working in a paid job? | ☐ Yes ☐ No |
| 4. Is it permanent or casual? | ☐ Permanent ☐ Casual |
| 5a. What is the industry of employment? | a) Accommodation and Food Services b) Administrative and Support Services c) Agriculture, Forestry and Fishing d) Arts and Recreation Services e) Construction f) Education and Training g) Electricity, Gas, Water and Waste Services h) Financial and Insurance Services i) Health Care and Social Assistance j) Information Media and Telecommunications k) Manufacturing l) Mining m) Professional, Scientific and Technical Services n) Public Administration and Safety o) Rental, Hiring and Real Estate Services p) Retail Trade q) Transport, Postal and Warehousing r) Wholesale Trade s) Other services (please specify) |
| 5b. What is your job or role title? | Text field |
| 6. What are the typical hours per week worked (range)? | ☐ 0 hours ☐ More than 0 but less than 8 hours ☐ 8 hours to less than 15 hours ☐ 15 hours to less than 30 hours |
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Page 15 of 58| Question | Answer |
|---|---|
| ☐ 30 or more hours | |
| 7. What is your annual income, before tax and other deductions? Include all sources (e.g. wages, investments and Government pensions and benefits) | ☐ $0-$9,999 ☐ $10,000-$19,999 ☐ $20,000-$29,999 ☐ $30,000-$39,999 ☐ $40,000-$59,999 ☐ $60,000-$79,999 ☐ $80,000-$99,999 ☐ $100,000-$149,999 ☐ $150,000-$199,999 ☐ $200,000+ ☐ Not disclosed |
| 8. What is the annual income of your household, before tax and other deductions? Include all sources (e.g. wages, investments and Government pensions and benefits) | ☐ $0-$9,999 ☐ $10,000-$19,999 ☐ $20,000-$29,999 ☐ $30,000-$39,999 ☐ $40,000-$59,999 ☐ $60,000-$79,999 ☐ $80,000-$99,999 ☐ $100,000-$149,999 ☐ $150,000-$199,999 ☐ $200,000+ ☐ Not disclosed |
| 9. Please specify whether you currently receive any government benefits. Please select Yes or No for each option. | |
| Carer payment | Yes/ No |
| Carer allowance | Yes/ No |
| Other (please specify): | Free text |
| 10. Are you currently studying? | ☐ Yes, full time ☐ Yes, part time ☐ No |
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Page 16 of 58Thank you for that. I would now like to cover some questions and statements about your confidence in advocating for the participant.
Domain 1: Families know their rights and advocate effectively for their family member with disability
| # | Statement/question | Response options |
|---|---|---|
| 1 | I am able to identify the needs of my family member with disability and my family and know how to access available services and supports to meet those needs | a) Yes b) I have some difficulty c) I have a great deal of difficulty |
| 2 | I am able to advocate (stand up) for my family member: I am able to speak up if we have issues or problems with accessing supports | a) Yes b) I have some difficulty c) I have a great deal of difficulty |
| 3 | Has the NDIS helped you to know your rights and advocate effectively? | ☐ Yes, a lot ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area) |
The next few questions/statements focus on your relationships and support networks.
Domain 2: Families have the support they need to care
| # | Question/statement | Response options |
|---|---|---|
| 1 | I have friends and family that I see as often as I like | a) Yes b) No |
| 2 | I have people who I can ask for practical help as often as I need | a) Yes b) No |
| 3 | I have people who I can ask to support my family member with disability as often as I need | a) Yes b) No |
| 4 | I have people who I can ask for emotional support as often as I need | a) Yes b) No |
| 5 | I get the services and supports I need to care for my family member with disability | a) Yes b) I would like more support c) I would like different support d) I would like support at different times |
| 6 | Has the NDIS improved the level of support for your family? | ☐ Yes, a lot ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area) |
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Page 17 of 58Let’s now consider your experiences with getting access to services, programs and activities. I will now read out three statements relating to your engagement with services and supports.
Domain 3: Families are able to gain access to desired services, programs, and activities in their community
| # | Statement/question | Response options |
|---|---|---|
| 1 | I feel that the services my family member with disability and my family use listen to me | a) Yes b) Not very much c) Not at all |
| 2 | I feel in control in selecting services and supports that meet the needs of my family member with disability and my family | a) Yes b) I have some difficulty c) I have a great deal of difficulty |
| 3 | The services my family member with disability and my family receive meet our needs | a) Yes b) No |
| 4 | Has the NDIS helped you to access services, programs and activities in the community? | ☐ Yes, a lot ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area) |
The next few questions are about planning for the future.
Domain 4: Families have succession plans
| # | Statement/question | Response options |
|---|---|---|
| 1 | Have you made plans for when you are no longer able to care for your family member with disability? | a) Yes b) I have begun c) No |
| 2 | Have you asked for assistance from any of the following? Please answer Yes or No for each option. | |
| Siblings of the person with disability | ☐ | ☐ |
| Your extended family | ☐ | ☐ |
| Your friends | ☐ | ☐ |
| The friends of your family member | ☐ | ☐ |
| Service providers | ☐ | ☐ |
| Professionals | ☐ | ☐ |
| Support workers | ☐ | ☐ |
| Other (please specify): | ||
| 3 | Has the NDIS helped you with preparing for the future support of your family member? | ☐ Yes, a lot ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area) |
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Page 18 of 58Finally, we want to know a bit about your health and wellbeing. There are both statements and questions.
Domain 5 Families enjoy health and wellbeing
| # | Statement/question | Response options |
|---|---|---|
| 1 | In general, my health is | a) Excellent b) Very good c) Good d) Fair e) Poor |
| 2 | I feel that my family member gets the support he/she needs | a) Strongly agree b) Agree c) Neutral d) Disagree e) Strongly disagree |
| 3 | Family who provide informal care to my family member with disability are able to work as much as they want | a) Yes b) No, they would like to work more |
| 4 | The barriers to working more are (choose one or more options): | a) Situation of family member with disability b) Availability of jobs c) Available jobs do not have sufficient flexibility (e.g. of hours) d) Other (please specify) |
| 5 | Has the NDIS improved your health and wellbeing? | ☐ Yes, a lot ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area) |
Thank you for answering these questions. If you have any further comments, I can record them now.
| Question | Answer |
|---|---|
| Any comments? | Text field |
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