DCOA - State Aging Plan Survey 2010

The DC Office on Aging (DCOA) wants to provide the District’s older residents, caregivers and persons who serve older residents with an opportunity to express their views on the needs and priorities of older residents (age 60 and over) and persons with disabilities.We would also like to obtain information that will be helpful to the agency in providing better customer service. The confidential information that you will provide will help DCOA plan its programs and services and in developing the State Plan on Aging for 2011 – 2013 which is required by the US Administration on Aging under The Older Americans Act.

Please complete the following short questionnaire so that we can include your valuable input in our planning process. The questionnaire will also be available in several different languages, available for persons via TYY, disseminated across the District at various meetings, can be mailed to you upon request, and will be provided at town meetings and special events for residents. However, residents should submit only one completed questionnaire.

If you have any questions or concerns, please feel free to call or email Mr. Courtney Williams, DCOA Community Planner, at (202) 727-8370 or courtney.williams@dc.gov or Ms. Anne Williams, DCOA Customer Service Program Specialist, at (202) 741-5887, anne.williams@dc.gov

Thank you for your time. We look forward to your response and comments.

1. On a scale of 1 to 5 with 5 being very aware and 1 being not aware at all, please indicate how aware you are of the DC Office on Aging.

2. Below, find a list of general services the office currently offers. On a scale of 1 to 5 with 5 being very important and 1 being not important at all, please indicate how important they are to you.

	1	2	3	4	5
Caregiver Support & Training
Congregate Meals and Nutrition Education Programs
Counseling & Case Management (Social Workers)
Disaster and Emergency Preparedness for Vulnerable Seniors
District of Columbia Caregivers' Institute
Elder Abuse and Neglect (Elder Rights Protection)
Employment Training & Placement
Health Promotion and Disease Prevention
Health Insurance Help (Medicare, Medicaid, Long Term Care)
Home Delivered Meals
Housing Renovations and Adaptation (Improvements)
In-Home Personal Care (Home Health Aide)
Independent Living Skills
Lead Agency (Service Providers) Support and Staffing
Legal Assistance
Light and Heavy House Cleaning
Nursing Home Services
Outreach and Advocacy
Senior Activities & Special Events (Ex. Elderfest, Holiday Celebration)
Senior Wellness Centers
Recreation and Socialization
Respite & Adult Day Care Programs
Transportation (medical, Leisure time & public benefits)
Volunteer Services

3. Below find a list of specific programs the office offers. On a scale of 1 to 5 with 5 being very aware and 1 being not aware at all, please circle how aware you are of he services.Question Text

	1 (Not Aware at all)	2	3	4	5 (Very Aware)
Counseling & Case Management
District of Columbia Caregivers' Institute
Employment
Elder Abuse & Neglect (Elder Rights Protection)
Health and Wellness
Health Insurance Help (Medicare, Medicaid, Long Term Care)
Home Delivered & Congregate Meals
Housing Assistance
Lead Agency Support (Service Providers)
Legal Assistance
Nutrition Education
Nursing Home Services
Outreach & Advocacy
Respite & Adult Day Care Programs
Senior Activities & Special Events
Senior Wellness Centers
Transportation (medical, Leisure time $ public benefits)
Volunteer Services
Intergenerational Activities
Long-Term Care
Information and Assistance
Literacy

4.The District government’s new Aging and Disability Resource Center (ADRC), a one-stop resource for public and private information and assistance related to long-term care services
for persons with disabilities , age 18 and older and seniors 60 years and older, is operated by the DC Office on Aging and the Department of Health Care Finance.On a scale of 1 to 5 with 5 being
very familiar and 1 being not familiar at all, please indicate how familiar you are with the ADRC.

5. If you have received one or more services from the Office on Aging in the past year, please indicate on a scale of 1 to 5 with 5 being very satisfied and 1 being not satisfied at all, how satisfied you are with the DC Office on Aging programs and services overall.

6. On a scale of 1 to 5 with 5 being very often and 1 being not at all, please rate the frequency you get information about DC Office on Aging information, news, and events from these sources.

	1	2	3	4	5
The Beacon Newspapers
Church, Civic Groups
Community Newsletter
DCOA Lead Agency (Service Providers)
DCOA Website
DC Government Website
Flyer/Mail
Other Newspapers
Phone
Radio Stations
Other Specify:

7. Baby Boomers, persons born between 1946 – 1964, are reaching the age of 60 and older at a rapid rate. Do you consider yourself a baby boomer?

Yes
No

8. If you are a baby boomer, what programs and services would you like the DC Office on Aging to provide? (List as many as you like), if not a Baby Boomer, please indicate at the bottom.
Not a Baby Boomer

9. Are there special programs or services you would like to see for older persons with disabilities? If yes, please describe or list, If No, Please Type None

10. Please provide any other comments you may have regarding the needs and priorities of the District’s older population.

11. Age

12. Sex

Male
Female

13. Sexual Orientation

Gay
Lesbian
Heterosexual
Other

14. Ethnicity

15. Ward in which you reside

16. Which Best Describes You? (more than one can be selected)

A senior citizen (age 60 and older)
A senior citizen with a disability
A non-senior citizen with a disability
A caregiver for a senior citizen
A relative of a senior that needs care
A neighbor of a senior that needs care
I work as a provider of services to older persons. Describe:
None of the Above Describe