NYTD Survey- 19 year olds
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- Kathleen Bridges
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1 1 The fllwing survey is being dne t recrd yur experience in the West Virginia Fster Care System. Yur respnses are imprtant and we really d want yur input as we try t find ways t imprve Fster Care and create mre pprtunities fr yuth exiting Fster Care t achieve their persnal gals. Please mark ne answer fr each questin. Yu may decline individual questins n the survey. Answer the questins hnestly and frm yur wn experience. If smene helps yu cmplete the survey they are suppsed t mark yur answers and shuld nt influence yur answers. Smene might help yu by explaining a questin but they shuld nt tell yu an answer because that wuld nt reflect yur experience, which is the gal f the survey. Shuld yu have any questins, please cntact us at Will yu participate in the survey and answer the questins? Parent r guardian declined n behalf f a child in their care State Date f Birth Sex Date Survey Cmpleted mm/dd/yyyy Male Female mm/dd/yyyy Survey administered by: Telephne Facebk In Persn Web Mail Other ( ) Please prvide the fllwing infrmatin s we can stay in tuch with yu: Update yur name fr us if it has changed: What is yur current mailing address? What is yur address? What is yur hme phne number? What is yur cell phne number? What is yur Facebk ID? What is yur MySpace ID?
2 2 Currently, are yu emplyed full-time? Full time means ttal number f hurs wrked is at least 35 hurs per week. Currently are yu emplyed part-time? Part-time means ttal number f hurs wrked is between 1-34 hurs per week. In the past year did yu cmplete an apprenticeship, internship r ther n-the-jb training, either paid r unpaid? This means apprenticeships, internships, r ther nthe-jb trainings, either paid r unpaid that helped yu acquire emplyment related skills (which can include specific trade skills such as carpentry r aut mechanics, r ffice skills such as wrd prcessing r use f ffice equipment). Apprenticeship means yu wrk fr smene but yu may r may nt get paid. Currently are yu receiving Scial Security payments (Supplemental Security Incme (SSI), Scial Security Disability Insurance (SSDI) r dependents payments)? These are payments frm the gvernment t meet basic needs fr fd, clthing, and shelter f a persn with a disability. Yu culd be receiving these payments because f a parent r guardian s disability r yur wn. Currently are yu using a schlarship, grant, stipend, student lan, vucher, r ther type f educatinal financial aid t cver any educatinal expenses? Currently are yu receiving any peridic and/r significant financial resurces r supprt frm anther surce nt previusly indicated and excluding paid emplyment? Currently are yu receiving public fd assistance (als knwn as Fd Stamps, EBT, SNAP, WIC, USDA Vuchers)? Currently are yu receiving any srt f husing assistance frm the gvernment, such as living in public husing r receiving a husing vucher (HUD)? Public husing is rental husing prvided by the gvernment t keep rents affrdable fr eligible individuals and families, and a t Applicable t Applicable t Applicable
3 3 husing vucher allws participants t chse their wn husing while the gvernment pays part f the husing csts. This des nt include yur Independent Living Subsidy. Currently are yu receiving any peridic and/r significant financial resurces r supprt frm anther surce nt previusly indicated and excluding paid emplyment? Fr example, are yu regularly receiving mney frm ne r mre f the fllwing: A spuse/partner A family member (bilgical, fster, adptive) Child supprt Legal settlements This des nt include special ccasin gifts r mney fr small items such as fd r persnal items. What is the highest level f educatinal degree r certificatin that yu have received? Vcatinal certificate means a dcument stating a persn has received educatin r training that qualifies him r her fr a particular jb, like aut mechanics. Vcatinal license means a dcument that indicates the State r lcal gvernment recgnizes an individual as a qualified prfessinal in a particular trade r business. An Assciate s degree is generally a tw year degree frm a cmmunity cllege and a Bachelr s degree is a fur year degree frm a cllege r university. ne f the abve means yu have nt received any f the abve educatinal certificatins. High schl diplma/ged Vcatinal certificate (dcument received stating yu qualify fr a particular jb based n yur educatin and training) Vcatinal license (dcument received in which the State r lcal gvernment recgnizes yu as qualified prfessinal in a particular trade r business) Assciate s degree (fr example A.A. generally tw years frm a cmmunity cllege) Bachelr s degree (fr example B.A. r B.S. generally fur years frm cllege r university) Higher degree (fr example M.A., M.S., PhD., r J.D.) ne f the abve (yu have nt received any f the educatinal certificates listed)
4 4 Currently are yu enrlled in and attending high schl, GED classes, pst high schl vcatinal training, r cllege? This means bth enrlled and attending. Currently, is there at least ne adult in yur life, ther than yur casewrker, t whm yu can g fr advice r emtinal supprt? This refers t an adult yu can g t fr advice r guidance when there is a decisin t make r a prblem t slve, r t share persnal achievements. In the past tw years, were yu hmeless at any time? Hmeless is defined as nt having a regular r adequate place t live. Fr example, at any time in the last tw years yu have: lived in a car lived n the street stayed in a hmeless r temprary shelter In the past tw years, did yu refer yurself r has smene else referred yu fr an alchl r drug abuse assessment r cunseling? This includes either self-referring r being referred by a scial wrker, schl staff, physician, mental health wrker, fster parent, r ther adult fr an alchl r drug abuse assessment r cunseling. In the past tw years, have yu been cnfined in jail, prisn, crrectinal facility, r juvenile r cmmunity detentin facility, in cnnectin with allegedly cmmitting a crime? This means yu were cnfined in ne f these facilities in cnnectin with a crime (misdemeanr r felny) allegedly cmmitted by yu. In the past tw years, have yu given birth r fathered children that were brn? This means giving birth t r fathering at least ne child that was brn. If males d nt knw, answer. If yu checked r, skip the next questin. If yu respnded yes t the previus questin, were yu married t the child s ther parent at the time each child was brn? This means when every child was brn yu were married t the ther parent f the child. Currently, are yu n Medicaid? Medicaid prvides a medical card that yu receive frm the West Virginia
5 5 Department f Health and Human Resurces (DHHR). Currently, d yu have health insurance, ther than Medicaid? Health Insurance means having a third party pay fr all r part f health care. Yu might have health insurance such as grup cverage ffered by emplyers r schls, r individual plicies that cver medical and/r mental health care and/r prescriptin drugs r yu might be cvered under parent s insurance. This als culd include access t free health care thrugh a cllege r ther surce. If yu checked, Dn t Knw, r, yu are dne cmpleting the survey. If yu checked, please cntinue n t the next questins. Des yur health insurance include cverage fr medical services? This refers t health insurance that is NOT Medicaid and means yur health insurance cvers at least sme medical services r prcedures. This questin is fr nly fr yu wh respnded yes t having health insurance. Des yur health insurance include cverage fr mental health services? This refers t health insurance that is NOT Medicaid. This means yur health insurance cvers at least sme mental health services. This questin is nly fr yu wh respnded yes t having health insurance with medical cverage. They have mental prblems, like depressin, anger, schizphrenia, biplar disrder, anger prblems r autism. Des yur health insurance include cverage fr prescriptin drugs? This refers t health insurance that is NOT Medicaid. This means yur health insurance cvers at least sme prescriptin drugs. This questin is nly fr yu wh respnded yes t having health insurance cverage with medical cverage. I Dn t Knw Dn t Knw Dn t Knw Dn t Knw Dn t Knw Additinal Questins: 1. D yu have any cncerns abut yur experience in fster care at this time? 2. Current and frmer fster yuth are wrking n issues arund the system. If yu culd name ne thing yu wuld like t see them wrk n, what wuld it be and why?
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1 The following survey is being done to record your experience in the West Virginia Foster Care System. Your responses are important and we really do want your input as we try to find ways to improve Foster
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