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Pennsylvania Statewide Needs Assessment - Advocate Survey

1. How are you connected to the disability community? (Check any that apply)

2. How often do you advocate for a person or groups with disabilities?

3. What is the ZIP code of the person/group you advocate for?

4. Describe your work experience in working with people who have cognitive, emotional, sensory, or physical barriers.

5. What are the most common barriers faced by the people for whom you advocate? (Check all that apply)

Communication (e.g., needing an ASL interpreter, understanding/comprehension)
Education/Training
Employment
Knowledge of available services
Knowledge of available technology (e.g., screen readers, scanners)
Mobility/Transportation
Other people's impression of one's ability
Receiving necessary medical treatment
Other Please enter an 'other' value for this selection.

6. What kind of services are you most commonly advocating for in your role?

Assistive technology
Counseling
Education
Evaluations (vocational, mobility, etc.)
Support services (room, board, tools, licenses, home modification, transportation modification, job accomodations, personal care assistance)
Training
Vocational placement
Vocational planning
Other Please enter an 'other' value for this selection.

7. In applying for services, people with disabilities face the following barriers:

Application process (forms, documentation, deadlines)
Lack of awareness of requirements
Lack of knowledge of available services
Long waitlists for services
Meeting eligibility requirements
Response time to receive services and other red tape
Other Please enter an 'other' value for this selection.

8. Was the application process accomodating (alternative formats offered, assistive technology used) to the identified disability, if necessary?

9. If you could make one change to the system in serving people with disabilities, what would it be?

10. Are you aware of any groups of people with disabilities who, because of their membership in the group (e.g., race, age, nature of disability, geographic location), have a harder time receiving services?

Please identify and list the group(s) you referred to in Question 10.

Age
Multiple disabilities
Nature of disability
Race
Rural area
Urban area
Other

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