FOI 24/25-1267
DOCUMENT 7
National Disability Insurance Scheme
Outcomes Framework
Short Form Questionnaires
Participant aged 25 and over
v3.0
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Participants aged 25 and over
In this first section, I will ask you some background questions.
Participant information
| Question | Answer |
|---|---|
| 1. NDIS Participant ID number | Pre-populated NDIS participant number |
| 2. What level of school have you completed? | ☐ None ☐ Year 7 or below ☐ Year 8 ☐ Year 9 ☐ Year 10 ☐ Year 11 ☐ Year 12 or above |
| 3. What is the highest level of post-school qualification you have completed? | ☐ None ☐ TAFE Certificate I-IV ☐ Diploma or Advanced Diploma ☐ Graduate Certificate or Graduate Diploma ☐ Bachelor degree ☐ Postgraduate degree (e.g. Masters, PhD) ☐ Other (please specify): |
| 4. Who do you currently live with? | ☐ Alone ☐ Parents ☐ Spouse/partner ☐ Spouse/partner and child(ren) ☐ Child(ren) ☐ Other family members ☐ People not related to me ☐ Other, please specify: |
| 5. What are your current housing arrangements? | ☐ Private home: owned by self/family ☐ Private home: rented from private landlord ☐ Private home: rented from public authority ☐ Large residential (20+ people) ☐ Small residential (<20 people) ☐ Hostel ☐ Aboriginal or Torres Strait Islander community residence ☐ Supported accommodation ☐ Boarding house/private hotel ☐ Short-term crisis ☐ Temporary shelter (homeless) ☐ Nursing home/aged care facility ☐ Other, please specify: |
| 6. What type of employment activities do you currently attend/participate in? | ☐ Do not participate (not working and not looking for work) ☐ Job seeking (on your own or with an employment service) |
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| Question | Answer |
|---|---|
| ☐ Employment in the open employment market with full award wages ☐ Employment in the open employment market at less than minimum wage, i.e. Supported Wage System ☐ Employment with an Australian Disability Enterprise ☐ Pre-vocational training ☐ Australian Apprenticeship ☐ Work experience ☐ Self-employed ☐ Other (please specify) |
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| 7a. 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) |
| 7b. What is your job or role title? | Text field |
| 8. What is the typical number of hours you work per week (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 ☐ 30 or more hours |
| 9. What is your annual income, before tax and other deductions? Include all sources, such as 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 |
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| Question | Answer |
|---|---|
| 10. What is the annual income of your household, before tax and other deductions? Include income from all sources, such as wages, investments and Government pensions and benefits. (Don’t include the income of people you only share accommodation with, e.g. in a group home) | ☐ $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 |
| 11. What educational activities are you currently participating in? | ☐ Not studying ☐ Secondary (high) school – mainstream class ☐ Secondary (high) school - special class in mainstream school ☐ Special school ☐ Pre-apprenticeship vocational training ☐ Australian Apprenticeship ☐ TAFE college or other post-secondary training college ☐ University course ☐ Other (please specify): |
| 12. Are you currently studying full time or part time? | ☐ Full time ☐ Part time |
| 13. Are you seeking or have you previously sought compensation related to your injury/disability? | ☐ Yes ☐ No |
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These next question are about the level of independence, control and choice you have in your life.
Domain 1: Choice and Control
| # | Question | Answer |
|---|---|---|
| 1 | Do you choose who supports you? | a) Yes I choose b) Sometimes I have a say c) No, someone else chooses |
| 2 | Do you choose what you do each day? | a) Yes I choose b) Sometimes I have a say c) No, someone else chooses |
| 3 | Who makes most decisions in your life? | a) I do b) My family c) My friends d) My service providers e) Others (please specify): |
| 4 | Do you feel able to advocate (stand up) for yourself? That is, do you feel able to speak up if you have issues or problems with accessing supports? | a) Yes b) No |
| 5 | Have you ever participated in a self-advocacy group meeting, conference, or event? | a) Yes b) No, I had the opportunity but chose not to participate c) No, I have not had the opportunity to participate |
| 6 | Do you want more choice and control in your life? | a) Yes b) No |
| 11 | Has the NDIS helped you have more choices and more control over your life? | ☐ Yes, a lot ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area) |
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We will now move onto some questions about your daily activities – including activities you need support with and thinking about any support that you do receive. We will cover eight (8) activity areas.
Domain 2: Daily living activities
| # | Question | Answer | Logic, rules & validation |
|---|---|---|---|
| Activity area 1: Domestic tasks | |||
| 1 | Do you need support to do domestic tasks (e.g. shopping, cooking, cleaning, meal preparation)? | a) Yes b) No |
Yes (go to 2) No (go to 5) |
| 2 | Do you get support for domestic tasks? | a) Yes b) No |
Yes (go to 3) No (go to 5) |
| 3 | Does the support you receive meet your needs? | a) Yes b) No |
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| 4 | Does the support you currently receive enable you to perform the tasks yourself as much as possible? | a) Yes b) No |
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| Activity area 2: Personal care | |||
| 5 | Do you need support with personal care (e.g. washing yourself, dressing)? | a) Yes b) No |
Yes (go to 6) No (go to 9) |
| 6 | Do you get support with personal care (e.g. washing yourself, dressing)? | a) Yes b) No |
Yes (go to 7) No (go to 9) |
| 7 | Does the support you receive meet your needs? | a) Yes b) No |
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| 8 | Does the support you currently receive enable you to care for yourself as much as possible? | a) Yes b) No |
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| Activity area 3: Travel & transport | |||
| 9 | Do you need support for travel & transport? | a) Yes b) No |
Yes (go to 10) No (go to 13) |
| 10 | Do you get support for travel & transport? | a) Yes b) No |
Yes (go to 11) No (go to 13) |
| 11 | Does the support you receive meet your needs? | a) Yes b) No |
|
| 12 | Does the support you currently receive allow you to travel by yourself as much as possible? | a) Yes b) No |
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| Activity area 4: Communication | |||
| 13 | Do you need support to communicate with other people? | a) Yes b) No |
Yes (go to 14) No (go to 17) |
| 14 | Do you get support for communicating with others? | a) Yes b) No |
Yes (go to 15) No (go to 17) |
| 15 | Does the support you receive meet your needs? | a) Yes b) No |
|
| 16 | Does the support you currently receive enable you to communicate as independently as possible? | a) Yes b) No |
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| # | Question | Answer | Logic, rules & validation |
|---|---|---|---|
| Activity area 5: Getting out of the house | |||
| 17 | Do you need support for getting out of the house? | a) Yes b) No |
Yes (go to 18) No (go to 21) |
| 18 | Do you get support for getting out of the house? | a) Yes b) No |
Yes (go to 19) No (go to 21) |
| 19 | Does the support you receive meet your needs? | a) Yes b) No |
|
| 20 | Does the support you currently receive enable you to get out of the house with as little assistance as possible? | a) Yes b) No |
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| Activity area 6: Dealing with finances/money | |||
| 21 | Do you need support with dealing with your finances/money? | a) Yes b) No |
Yes (go to 22) No (go to 25) |
| 22 | Do you get support with dealing with your finances/money? | a) Yes b) No |
Yes (go to 23) No (go to 25) |
| 23 | Does the support you receive meet your needs? | a) Yes b) No |
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| 24 | Does the support you currently receive enable you to manage finances/money by yourself where possible? | a) Yes b) No |
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| Activity area 7: Reading and/or writing | |||
| 25 | Do you need support with reading and/or writing? | a) Yes b) No |
Yes (go to 26) No (go to 29) |
| 26 | Do you get support with reading and/or writing? | a) Yes b) No |
Yes (go to 27) No (go to 29) |
| 27 | Does the support you receive meet your needs? | a) Yes b) No |
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| 28 | Does the support you currently receive enable you to read and/or write by yourself where possible? | a) Yes b) No |
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| Activity area 8: Technology | |||
| 29 | Do you need support with using technology? | a) Yes b) No |
Yes (go to 30) No (go to 33) |
| 30 | Do you get support with using technology? | a) Yes b) No |
Yes (go to 31) No (go to 33) |
| 31 | Does the support you receive meet your needs? | a) Yes b) No |
|
| 32 | Does the support you currently receive enable you to use technology by yourself where possible? | a) Yes b) No |
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| Overall | |||
| 33 | Have you ever undertaken training to do more of these daily activities by yourself? | a) Yes b) No |
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| 34 | Has the NDIS helped you with daily living activities? | ☐ Yes, a lot |
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| # | Question | Answer | Logic, rules & validation |
|---|---|---|---|
| ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area) |
These next questions and statements centre on relationships, including friendships and any caring responsibilities you may have.
Domain 3: Relationships
| # | Question | Answer |
|---|---|---|
| 1 | Do you have someone outside your home to call when you need help? (choose all that apply) | a) Yes, paid staff b) Yes, family c) Yes, friends d) No |
| 2 | Are you happy with how often you see your family? | a) Yes b) No, I would like to see them more c) No, I would like to see them less |
| 3 | Do you provide care for others? | a) Yes b) No |
| 4 | Do you need help to continue caring for someone else? | a) Yes, and I receive enough assistance b) Yes but I don’t receive enough assistance c) Yes, but I don’t receive any assistance d) No |
| 5 | Do you have friends other than family or paid staff? | a) Yes, people with disability b) Yes, people without disability c) No |
| 6 | Are you happy with how often you see friends? | a) Yes b) No, I would like to see them more c) No, I would like to see them less |
| 7 | Has the NDIS helped you to meet more people? | ☐ Yes, a lot ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area) |
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I would like to ask you a few questions now about your home environment.
Domain 4: Home
| # | Question | Answer |
|---|---|---|
| 1 | Thinking about where you currently live in relation to your disability support needs: Are you happy with the home you live in? |
a) Yes b) No, I want to choose my home c) No, because of factors related to my support needs (e.g. access, equipment, support) d) No, for another reason (please specify): |
| 2 | Will you want to live here in 5 years’ time? | a) Yes b) No, I want to choose my home c) No, because of factors related to my support needs (e.g. access, equipment, support) d) No, for another reason (please specify) |
| 3 | What stops you from living in a home that you would choose? | a) Lack of support b) Lack of affordable housing c) Lack of choice d) Other (please specify): |
| 4 | How safe or unsafe do you feel in your home? | a) Very safe b) Safe c) Neither safe nor unsafe d) Unsafe e) Very unsafe |
| 5 | Has your involvement with the NDIS helped you to choose a home that’s right for you? | ☐ Yes, a lot ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area) |
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Life domain five (5) relates to health and wellbeing.
Domain 5: Health and wellbeing
| # | Question | Answer |
|---|---|---|
| 1 | Overall, do you think that your health is excellent, very good, good, fair or poor? | a) Excellent b) Very good c) Good d) Fair e) Poor |
| 2 | Do you have a doctor that you see on a regular basis? | a) Yes b) No |
| 3 | Have you had difficulty in getting health services? | a) Yes, because of the attitudes and/or expertise of health professionals b) Yes, because of access issues c) Yes, because I don’t have support d) Yes, because I don’t have transport d) Yes, because I can’t afford it e) No |
| 4 | How many times have you been to the hospital in the last 12 months? | a) 0 b) 1 c) 2 d) 3-5 e) 6+ |
| 6 | Do you feel safe getting out and about in your community? | a) Yes b) No |
| 7 | Has your involvement with 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) |
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I would now like to understand a little bit about your learning and education experience.
Domain 6: Lifelong learning
| # | Question | Answer |
|---|---|---|
| 1 | Do you get opportunities to learn new things? | a) Yes b) No but I would like to learn new things c) No and that’s OK |
| 2 | Do you currently participate in education, training or skill development? | a) Yes b) No |
| 3 | Where do you do this? | a) Disability education facility b) TAFE c) Community college or school d) University e) Other (please specify): |
| 4 | Are you in a class for students with disability? | a) Yes b) No |
| 5 | Is it what you want? | a) Yes b) No |
| 6 | In the last 12 months, is there any course or training that you wanted to do but couldn’t? | a) Yes, I lacked support b) Yes, course requirements prevented me from participating c) Yes, travel prevented me from getting there d) Yes, the cost of courses prevented me from participating e) Yes, there was no suitable course f) Yes, other (please specify) g) No |
| 7 | Has your involvement with the NDIS helped you to learn things you want to learn or to take courses you want to take? | ☐ Yes, a lot ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area) |
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The following set of questions are work related.
Domain 7: Work
| # | Question | Answer |
|---|---|---|
| 1 | Are you currently working in an unpaid job | a) Yes b) No |
| 2 | Are you currently working in a paid job? | a) Yes b) No, but I would like one c) No and I don’t want one |
| 3 | What type of employment is it? | a) Open employment market with full award wages b) Open employment market at less than minimum wage, i.e. Supported Wage System c) Australian Disability Enterprise d) Australian Apprenticeship e) Self-employed f) Other (please specify) |
| 4 | Do you get the support you need to do your job? | a) Yes b) No |
| 5 | Are you being assisted to get a job? | a) Yes b) No |
| 6 | Has your involvement with the NDIS helped you find a job that’s right for you? | ☐ Yes, a lot ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area) |
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Finally, I would like to understand a little more about your social and community involvement.
Domain 8: Social, community and civic participation
| # | Question | Answer |
|---|---|---|
| 1 | Do you spend your free time doing activities that interest you? | a) Yes b) No |
| 2 | In the last 12 months, is there anything that you wanted to do but couldn’t? | a) Yes, b) No |
| 3 | Are you currently a volunteer? | a) Yes b) No, but I would like to c) No, it doesn’t interest me |
| 4 | Have you been actively involved in a community, cultural or religious group in the last 12 months? | a) Yes, a general community group b) Yes, a group for people with a disability c) No, but I would like to be d) No and I don’t want to be |
| 5 | Do you know people in your community? | a) Yes b) No |
| 6 | How often do you feel you are able to have a say with the services that provide support for you? | a) All of the time b) Most of the time c) Some of the time d) A little of the time e) None of the time |
| 7 | Has the NDIS helped you be more involved? | ☐ Yes, a lot ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area) |
Conclusion
Thank you for answering these questions. To close this out I just need to record (confirm) who completed the questionnaire. You may also provide some comments if you wish.
| Question | Answer options |
|---|---|
| 1. Are you a participant in the NDIS or are you taking this questionnaire on someone else’s behalf? | ☐ I am the participant ☐ I am taking the survey on someone else’s behalf |
| 2. What is your relationship to the participant? | ☐ Mother ☐ Father ☐ Spouse/partner ☐ Other family member ☐ Carer ☐ Friend ☐ Other (please specify): |
| 3. Any comments? |
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