Page 232 - QAP Manual 2020

NCI™ ADULT IN-PERSON SURVEY (IPS) 2020-21

86. Do you choose what you buy with your spending money? Do not include things like
rent or groceries.

Other respondent: Does this person choose how to spend his/her money?
Respondent: ( ) 1-individual ( ) 2-family/friend ( ) 3-staff ( ) 4-other

□ 98. Not applicable – person does not have spending money
□ 2. Person chooses
□ 3. Person has help choosing what to buy, or has set limits (such as can buy small items,
but not big items)
□ 1. Someone else chooses
□ 99. Don’t know, no response, unclear response

PS-2 87. Can you change your case manager/service coordinator if you want to?
 (Can you change__________________________________ if you want to?)

Other respondent: Can this person change their case manager/service coordinator if desired?

Respondent: ( ) 1-individual ( ) 2-family/friend ( ) 3-staff ( ) 4-other

□ 98. Not applicable – no case manager/service coordinator
□ 2. Yes
□ 1. No
□ 99. Don’t know, no response, unclear response

88. Do you choose (or pick) your staff?
(Do you get to interview them? Did you get to meet different people or was someone
assigned to you? Could you ask to change to someone different?)
PS-6 (Did you choose______________________________________ to work with you?)

Other respondent: Does this person choose their staff?

Respondent: ( ) 1-individual ( ) 2-family/friend ( ) 3-staff ( ) 4-other

□ 98. Not applicable – no staff
□ 2. Person chose staff

□ 3. Staff are assigned but can be changed if requested by person
□ 1. Someone else chose
□ 99. Don’t know, no response, unclear response

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