National Disability Insurance Scheme
Outcomes Framework
Short Form Questionnaires
Family Questions for participants aged 15 to 24
1 Page 47 of 58 DOCUMENT 6
Family Questions for participants aged 15 to 24
Introduction
Thank you for participating in our survey. The purpose of these questions is to find out how NDIS participants and their families and carers are going in different areas of their lives. The questions are an important part of pre-planning, and will help us to develop a plan that provides the right supports. Because we ask the questions again at plan review, we will also be able to see what progress has been made, and whether any adjustments to plans are needed. Information from the questions will also be important for tracking the progress of the NDIS, and will help to improve the Scheme.
Family member/carer information
| 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 Spouse/partner Other family member Carer Other (please specify): |
- Are you currently working in a paid job?
- Yes
- No (go to 7) - Is it permanent or casual?
- Permanent
- Casual - What is the industry of employment? | Free text |
- 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
- 30 or more hours - 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+ |
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Source Page 49
CONFIDENTIAL AND NOT FOR FURTHER DISTRIBUTION
LC Not disclosed
before tax and other deductions? Include all sources (e.g. wages, investments and Government pensions and benefits)
- What is the annual income of your household,
LX) $0-$9,999
- $10,000-$19,999 LJ $20,000-$29,999 LJ $30,000-$39,999 LJ $40,000-$59,999 LJ $60,000-$79,999
- $80,000-$99,999 LJ $100,000-$149,999
- $150,000-$199,999 OC $200,000+ CL] Not disclosed
- Please specify whether you currently receive any government benefits:
Yes No Carer payment O 0 Carer allowance O O Other (please specify): Free text 10. Are you currently studying? UI Yes, full time LI Yes, part time CL) No
Please answer the following questions about the family member/ carer 3
Domain 1: Families know their rights and advocate effectively for their family member with disability
| Question Number | 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? | c) It’s our first plan a) Yes b) No |
Domain 2: Families have the support they need to care
| Question Number | Statement/Question | 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? | a) It’s our first plan b) Yes c) No |
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Domain 3: Families are able to gain access to desired services, programs, and activities in their community
| Question Number | 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? | a) It’s our first plan b) Yes c) No |
Domain 4: Families help their young person become independent
| Question Number | Statement/Question | Response options |
|---|---|---|
| 1 | I know what my family can do to enable my family member with disability to become as independent as possible | a) Yes b) I have some difficulty c) I have a great deal of difficulty |
| 2 | I enable/support my family member with disability to make more decisions in his/her life | a) Yes b) I have some difficulty c) I have a great deal of difficulty |
| 3 | I enable/support my family member with disability to interact and develop strong relationships with non-family members | a) Yes b) I have some difficulty c) I have a great deal of difficulty |
| 4 | Has the NDIS helped you to help your family member with disability to be more independent? | a) It’s our first plan b) Yes c) No |
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Domain 5 Families enjoy health and wellbeing
| Question number | Question/Statement | Answer options |
|---|---|---|
| 1 | In general, my health is | a) Excellent b) Very good c) Good d) Fair e) Poor |
| 2 | Family who provide informal care to my family member with disability are able to work as much as they want | a) Yes (go to 4) b) No, they would like to work more |
| 3 | The barriers to working more are | Choose one or more of: 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) |
| 4 | Has the NDIS improved your health and wellbeing? | a) It’s my first plan b) Yes c) No |
Thank you for completing the family member/carer questions. If you have any further comments, please enter them below.
Any comments?