Page 182 - QAP Manual 2020

NCI™ ADULT IN-PERSON SURVEY (IPS) 2020-21
Employment/Other Daily Activities

 See PS-7. Please provide data based on a typical two-week period.
If yes:
Type of Activity a) Does this
Definitions: person do this b) Number of c) Wage (not including d) Does this person e) Is the job or
hours worked
get publicly funded activity done
benefits and before
Community-based setting is a place where activity during or spent at this taxes or deductions) services or primarily by a
most people do not have disabilities. the typical
two-week activity during earned at this activity supports to group of
Facility-based setting is a place where most period? the typical two- during the typical participate in this people with
people do have disabilities. week period: two-week period: activity? disabilities?
□ 1. No Number of HOURLY WAGE □ 1. No N/A
BI-43 Paid individual job in a community-
based setting □ 2. Yes hours for which $ __ __ . __ __/hr □ 2. Yes
□ 99. Don’t person is paid □ 99. Don’t know
A person working at an individual job in a in typical two-
local business alongside peers who do not know week period:
have disabilities. Job is part of the typical __ __ __
labor market (e.g., competitive employment).
If the person does more than one activity of
this type, please refer to the activity at which
the person has spent the most time in the
past two weeks.

□ 1. No Number of HOURLY WAGE □ 1. No N/A
BI-44 Paid small-group job in a community-
based setting □ 2. Yes hours for which $ __ __ . __ __/hr □ 2. Yes
□ 99. Don’t person is paid □ 99. Don’t know
The activity is done in an integrated setting, in typical two-
as part of a group of not more than 8 people know week period:
with disabilities (e.g., enclave, work crew). __ __ __

If the person does more than one activity of
this type, please refer to the activity at which
the person has spent the most time in the
past two weeks.

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