DDD Home & Community Based Services Settings Survey for People Receiving Services

Your Voice Matters!

Many people with intellectual and developmental disabilities pay for their services (day and residential) with money from the Medicaid waiver. There is a new rule in the United States about Medicaid waivers. It is called the Home and Community-Based Services Settings Rule. The rule says that services must be done in a way that helps people be part of their communities. Providers of Medicaid waiver services must follow this rule. You can learn more about the rule by watching the What the HCBS Settings Rule Means for You video.

The Illinois Department of Human Services (IDHS) Division of Developmental Disabilities (DDD) needs to make sure that Medicaid waiver providers are following the new rule by March 2023. DDD knows that your life, services, and voice matter. DDD needs to hear from you!

DDD asks you to take this survey about your life. It will help DDD make waiver services better for all people getting home and community-based services in Illinois. You can ask a trusted person to help you. It can be a support person, family member, guardian, or friend. You can take the survey online or you can print this form, complete it, and send it to Meg Cooch at 600 East Ash Street, Building 400, 1st Floor, Springfield, IL 62703.

If you have questions or need help, you can call Meg Cooch at 217-993-2716 or email her at meg.cooch@illinois.gov.

About You and Your Services





Person Centered Planning

1. Do you have a Person Centered Plan?

If No, skip to the next section.

2. Did you have a say what went in the Person Centered Plan?


3. Do you understand your Person Centered Plan?


4. Are the services you need listed in the person centered plan?


General Questions

1. Do you have choice in how you spend your free time?



2. Do you have a choice about who you spent your free time with?



3. Can you choose how you spend your money?



4. Can you choose to spend time alone?



5. Can you choose the provider(s) you want for your services/supports?



6. Can you choose the staff who help you do what you want in your free time?



7. Do the staff who support you respect you by listening to you and not yelling at you or bossing you around?



8. Can you choose the places you go like the bank, the grocery store, the mall, where to eat, where to go to church/temple/mosque or other?



9. Work/Job/Employment:



10. Do you have the help you need to look for a job and think about what kind of job you want?



11. If you have a job, do you need to look for a job and think about what kind of job you want?



12. Do you like your job?



Where I live/Home/CILA/Residence

Now we want to hear from you about your experience about where you live:

1. Did you choose where you live?



2. Do you like where you live?



3. Do you feel safe around the staff that work with you in your home?



4. Can you have visitors whenever you want including at night or for a long time?



5. Do you have a key, key fob, or code to your house?



6. Are you able to lock your bedroom door if you want privacy?



7. Do you have a rental lease agreement with your group home provider and/or landlord?



8. Do people knock and wait for you to answer before they come into your room?



9. Can you decorate your room the way you want?



10. Can you do things in the community even if it is not on the house activity schedule?



11. Can you choose when and what to eat for meals?



12. Can you move easily around your home?



Community Day Programs and Work

Now we want to hear from you about your community day programs.

If you do not attend a community day program, please answer no to the first question and you will skip the remaining questions. Please note, we understand this last year was very different because of COVID. We would ask you to think about your experience prior to the COVID pandemic, knowing that there are current limits to what we all can do because of the virus.

1. Do you attend activities during the day like community day program, at home day programs, or other activities during the day?



If No, Don't Know, or Doesn't Apply, skip to the next section.

2. Do you do things in the community as part of your day program?



3. Can you choose what to do during the day and who to hang out with even if they are not in your group?



4. Do you feel safe around the staff at your day program?



5. Is your privacy respected at the day program, especially in the bathroom?



6. Is it easy for you to get around the day program?



General Closing

1. Do you have any other thoughts about how you would like to see your waiver services help you to live the life you want to live?

2. Did someone help you fill out this survey?

If No, skip to the end.

3. The person who helped me fill out this survey is:



Thank you for taking the time to fill out this important survey. Your answers will help the Division of Developmental Disabilities to make sure that your waiver services are helping you live the life you want to live. What you say matters.