Consumer Satisfaction

Report of Survey Findings

October 2009 through September 2010

Prepared by Denetta Dowler, Ed. D.
January, 2011

The WV Statewide Independent Living Council conducted a survey of consumer satisfaction with Independent Living services in West Virginia. The Council continued to use the instrument they developed several years ago. In the survey, consumers were asked to rate their level of agreement with statements about the independent living services they received. Consumers were also asked about specific services and their rights as a consumer. A final section included open-ended items designed to determine the consumers’ opinion about program changes or improvements that could be made.

(You may download the current survey here.)

The surveys were distributed periodically to consumers during the October 2009 to September 2010 time period. The Council staff received address labels for each closed case and a sample of open cases from each CIL and sent out the surveys. Seventy-one completed surveys were returned. This report summarizes those responses and details the findings of the survey for the 2009-2010 program year.

Demographic Information

Coverage by County

Of the 55 counties in WV, 27 are served by the CILs through Part B and Part C programs (see bold entries in table at right). The counties served through Part B are Berkeley, Calhoun, Hampshire, Jackson, Jefferson, Morgan, and Roane. The Part C counties are Barbour, Boone, Braxton, Cabell, Clay, Doddridge, Gilmer, Harrison, Kanawha, Lewis, Marion, Monongalia, Preston, Putnam, Raleigh, Randolph, Taylor, Tucker, Upshur, and Wayne. Each of the 71 responses contained county information. The respondents represent 22 counties. Eight of the responses were from outside the CIL service areas.

In terms of coverage of the state, the people who responded to this survey were concentrated in DRS Districts 2, 1 and 4 (see district map). District 2 represented 44% of the returned surveys, District 1 was about 30%, and District 4 represented 16% of the responses.  Less than 5% of the responses were from Districts 3 and 6.

District 1: Boone (0 response), Jackson (2), Kanawha (15), Mason (0), Putnam (2), Roane (1) (20 responses = 29% of total)

District 2: Barbour (4 responses), Calhoun (0), Doddridge (1), Gilmer (0), Harrison (4), Lewis (0), Marion (1), Monongalia (1), Pendleton (0), Preston (0), Randolph (12), Taylor (0), Tucker (2), Upshur (6) (31 responses = 44%)

District 3: Brooke (0 responses), Hancock (0), Marshall (1), Ohio (0), Pleasants (0), Ritchie (0), Tyler (0), Wetzel (1), Wirt (0), Wood (1) (2 responses = 3%)

District 4: Braxton (0 responses), Fayette (4), Greenbrier (0), Mercer (0), Monroe (1), Nicholas (0), Pocahontas (0), Raleigh (6), Summers (1), Webster (0) (11 responses = 16%)

District 5: Cabell (2 responses), Lincoln (1), Logan (0), McDowell (0), Mingo (1), Wayne (0), Wyoming (0) (6responses = 9%)

District 6: Berkeley (0 response), Grant (0), Hampshire (0), Hardy (0), Jefferson (0), Mineral (0), Morgan (1) (1 response = 1%)

Type of Program

Each of the 71 surveys contained codes for the programs in which consumers participated. There were 45 people in the Community Living Services Program, 10 Navigator transition program participants, 7 people in the Title I-Part C program, 6 Family Support participants, and 2 in the DOE program.

Type of Disability

The consumers were asked to indicate their disability. There were 52 people who listed a disabling condition (e.g., Multiple Sclerosis) or a description of their disability (e.g., have trouble walking). Twenty-two respondents to this survey indicated that they have a motor-related disability (42%).  The Motor category included spinal cord injuries, MS, arthritis, and other movement limitations. The Sensory category included vision and hearing, impairments. People reported Cognitive impairments including Learning Disability, and memory problems. The Cardiac/Respiratory category included COPD and heart problems. The "other" category includes diabetes, cancer, and seizures. There were no responders who indicated that they had a Mental Health disability (e.g., depression, bipolar disorder).

Open versus Closed Cases

About 60% of the surveys were returned by consumers whose cases were still open and about 40% of the responses were from consumers who case had been closed (44 versus 27 responses).

Service Provider

The surveys were color coded to indicate which of the Centers provided services for each consumer. There were 32 surveys from the offices of Northern West Virginia Center for Independent Living (45%), 20 from the Appalachian Center for Independent Living (28%), and 19 from consumers at the Mountain State Centers for Independent Living offices (27% of total).

Living Situation

The respondents were asked whether they were "living where I want to live." Of the 61 consumers who responded, all but 2 answered affirmatively. This percentage is a little higher than in previous surveys.

Survey Completed By ...

Of the 58 responses, 38 consumers (66%) completed the survey themselves, 7 had a parent or guardian complete the form, and 13 indicated that someone "other" (e.g., spouse, Caretaker) completed the survey. It is typical for about 60% of respondents to report that they completed the survey themselves.

Satisfaction Items

The consumers were asked to rate their agreement with a series of 13 statements about their interactions with independent living services. They used a Likert-type scale that ranged from Strongly Agree to Strongly Disagree with options to indicate that they were neutral or that the item was not applicable.

All Consumers

The current survey was initially distributed in 2003-2004. Therefore, we have data for these items for the past 5 program years. Table 1 lists the percent of responders who agreed or strongly agreed with each of the survey items for the previous 2 years and for this year. The first column of the Table is the survey item. The second column indicates the percent of responders who "agreed" or "strongly agreed" with the statement during the 2007-08 year, the third column represents the 2008-09 year. The last 2 columns of the table display the current (2009-2010) percent of responders who "agreed" or "strongly agreed" with the item and the number of responders for each item.

As may be seen in Table 1, there is some fluctuation in levels of satisfaction across the 3 years that are displayed. If, however, you take an average of satisfaction level for the 3 years, the current level is within + or – 4% of that average for 11 of the 13 items. This may mean that although the absolute numbers change, the relative satisfaction level is fairly stable (within 4 percentage points). There were 2 times (“I chose my own independent living goals” and “The CIL office was accessible” there were 5 percentage points below the 3 year average rating. Caution must be exercised in interpreting these data, however, due to the small sample sizes.

Table 1

Table 1 indicates that 90% or more of the consumers who responded indicated that they Agree or Strongly Agree that CIL staff members answered their questions clearly and understood their needs. They also exceeded 90% agreement that the CIL staff were excellent and that the services received were excellent. Each of the other items was rated between 83% agreement and 89%. No item had less than 83% agreement.

The lowest response rates (fewest people responding) were for the items concerning (1) the accessibility of the CIL office (22 responses) and (2) receiving information about job opportunities or other IL resources (29 responses). This is consistent with the previous years and seems reasonable since (1) many consumers receive services in their homes rather than a CIL office and (2) several consumers indicated that they did not want or need information about jobs or other IL resources.

Reported Satisfaction Levels by Year

Respondents with Open versus Closed Cases

There were 27 individuals whose cases were closed when they completed the survey and 44 who were still receiving services (open case). It is difficult to make meaningful comparisons between those groups since the number of people in each group is so different. A comparison of the satisfaction ratings of the two groups was made to determine whether patterns of difference existed. The percent of consumer responses by open versus closed cases are displayed in the following graph and in Table 2.

The mean responses for the Open case group ranged from 87% to 97% agreement with each statement. The mean responses for the Closed case group ranged from 71% to 84% agreement. The "mean of means" was only 79% for the Closed group and was 94% for the Open Case group.

The pattern of responses (as displayed in the graph) is similar for the two groups, but the overall ratings were dramatically lower for the Closed case group. As may be seen in the graph, the highest rating by the Closed group was lower than the lowest rating by the Open group.

Consumers of Different CILS

Of the 71 completed surveys, 20 responses were received from consumers of the Appalachian CIL, 32 responses from the Northern WV CIL, and 19 responses from the Mountain State CIL.  Unfortunately, the proportions of Open versus Closed cases varied widely across the 3 Centers. There were 10 Open and 10 Closed in the ACIL group, 12 Closed and 7 Open cases in the NWVCIL group, but there were only 5 Open cases versus 26 Closed in the MtState group. It is clear that those with open cases answer very differently from those with closed cases. The disparity in the number of responses from people whose cases were open versus closed makes direct comparisons across the Centers impossible.

Rights Information

The consumers were asked to indicate which rights information had been explained to them.  For each rights item in this survey, the consumers were asked to indicate whether the right had been explained, had not been explained, or that they did not remember being told about that right. There were 46 individuals who responded that at least one right had been explained (68% of the sample).   

Most individuals indicated that they had received several rights explanations. Therefore, the total number of rights explained was 291. If each of these individuals had been given information about each of the rights listed, the total would have been 414 (46 individuals X 9 issues).

In Table 2, Column 1 lists the type of rights information. Column 2 reports the number of individuals who indicated they were told about that right.  Column 3 lists the percent of responders who report that they were not told about it. Column 4 lists those who did not remember being told about that right.

Consumers indicated that they were most often made aware of their rights to know about all the services that are available (43).   They were least often made aware of their right to request another staff person (23).   They indicated that they were not told about their right to request another staff person (12). They most often reported that they did not remember whether they had been told about their right to help develop their IL plan (11). This is the first year in which clients were asked to indicate that they had not been told information or don’t remember being told rights information. It would be premature to make assumptions based on this limited sample, but this information should be tracked to help assess the process of providing rights information to consumers.

Impact of Services

The consumers were asked, "Did the CIL services help to make your life different?"  Of the 61 people who responded to this item, 42 (69%) reported that the services did make a difference, 20% said the services had not made a difference, and 11% were unsure about whether services had made a difference.

Respondents were asked to describe how the services had made a difference in their lives. There were 18 comments detailing receipt of assistive technology, lifestyle improvements, home assistance, and appreciation for staff members. Five people indicated that services had not been helpful. These comments are listed below.

• I appreciate the hearing aid I received.
• I needed a lift chair and it is being delivered. But my manual wheelchair is falling apart waiting for it.
• I received financial support for a new bed, now my back doesn't hurt anymore, thank God.
• They have given me the tools I needed to better myself and try to live life to the fullest. They have given me hope and a second chance at life after my injury.
• They will help very much when I get them.
• Come in help me things I can't do and did everything I need help with.
• I don't have to sweep or mop or clean bathtub and do laundry on my own which was so hard on me. I'm not quite as exhausted as I was without the extra help. Getting my hair washed is a great help when my hands and wrist are painful and stiff at times.
• My children both have allergies and it is much easier for them to breathe without the carpet fibers in our home. Also my son's life saver bracelet is paid for one year.
• I am really glad I went to the conference. I met many interesting people and I learned something important.
• Day to day living by making decisions to improve my lifestyle.
• Everyday living easier
• I'd be in a nursing home without them.
• Made me more independent.
• Showed easier ways to work with mobility
• I am more comfortable and my pain has lessened.
• All reasons above. CIL staff very friendly also, not afraid to talk to them.
• Knowing the workers and developing a friendship.
• Staff (Name) saw to it that patient (Name) received a (unreadable) and a talking clock, etc. after she lost her sight and after knee surgery. This has been extremely helpful.

There were five comments indicating that services had no impact or a negative impact. These comments are listed below.

• I am not a good candidate for filling out this survey. My contact with CIL was minimal. I requested information regarding alarm clocks for deaf individuals. Was given several options. Clock promptly ordered and delivered. I am independent and did not require goal planning/counseling, etc.
• I don't think I've gotten help from CIL.
• I have not received any services at all.
• Seen and evaluated in regard to computer skills and appliance, but never followed up by main case worker. Never meet with her or develop any formal plan of care. Very much would like to have any help your facility could provide for me.
• They sure did for the worse.

Services Received

The survey recipients were asked to indicate which IL services they had received. There were 48 people who indicated that they had received at least one service. The following table lists the types of services they said they received.

Respondents reported receiving a variety of services. They most often reported receiving referrals to other agencies or services, advocacy, assistive technology, help with home accessibility, health care information, and modifications to their home or vehicle.  Some services are used less often than others, but low-incidence services (e.g., helped me find a place to live) may be life-changing for the person who needs that service.  It may be more important to examine the breadth of services provided than the absolute incidence of a particular service.  There were 4 individuals who reported that they received each of the 11 services listed. There were 7 people who received 7 or more services, 13 people who received between 4 and 6 services, and 23 people who reported that they received 1 to 3 services. This variety in the number and type of services received may be seen as an indicator that services are individualized to meet client needs.

Service Needs

The consumers were asked, "What other services would you like the CIL to offer?" There were 22 individuals who responded to this item. They listed needs that include Home Modification/Housing, Medical Services/ Personal Care, Social Activity, and Transportation. Comments included:

• A ramp or chair to get up and down stairs. A shower that I can get in and out of. Something to help get groceries up the stairs.
• Any available help with memory loss, financial needs, keeping checkbook. Computer skills to maintain work abilities.
• Bowling leagues.
• Doctor visits - a way that I can go without trying to climb steps on bus (I'm 84 yrs old).
• Fix the bathroom
• Get people to go in the home and do their job in helping the handicapped.
• Have thing for the bathroom lift chair.
• Help me get a wheelchair ramp.
• Help with information.
• Helping me get a new wheelchair.
• I didn't know about transportation services and I like to receive them.
• I don’t know right now, to help get my aid ramp and lifts and vans.
• I love have a home.
• I would like to see doctors make home visits and services for doctor appointments.
• More communication
• More handicap signs
• More sign language, passable lip reading.
• Provide care and services I need to support myself with my disability.
• To help put a better heating system in the older homes and help put insulation in older homes.
• Upper false teeth are broken

What could we do better?

There were 28 consumers who responded to this item. Four people were satisfied with services and did not suggest any changes or improvements. Other comments included praise and appreciation for services, suggestions for improvements, and complaints/other. These comments follow.

Suggestions:

• Be able to get more funds to help the disabled people.
• Communication
• Contact me to set up an evaluation to assess my needs and how your facility could assist me in independent living.
• Educate nurses in Case Management offices about services that homemakers are provided. Do not exagerate!
• Have nurse make more home visits.
• Hire better qualified people and fire those in there. Get Get county and government aid to provide me disabilty care and medical treatment.
• Hire people that want work and that care about other needs.
• I need more hours and wheel chair ramp bad.
• Inform people about what services they can receive
• More staff that know sign language
• Try to work on getting things done a little faster. I've been waiting 3-10 till now.

Praise

• I am satisfied. Thank you.
• I don't know, I appreciate the help that I have received.
• Keep doing what your doing it’s a great service to help others and also  I feel strongly [counselor] need to be at least acknowledged from CIL for her outstanding commitment and skills to better CIL!!!
• Patient (Allen) appreciate your help in getting the insert for his shoes. Thank you.
• Thank you so much for helping get a walk in shower for me. It has helped me so much. Thanks again.
• Thanks for everything
• The staff and services are excellent.
• They do a great job.

Complaints

• Currently received no help from CIL. Don't know what is offered.
• Everything
• Install the hand rails and pulls that have provised me for over 1 year.
• Never heard from again after initial visit or help for home modifications.
• The contractor they hired destroyed our bathroom. We cannot even use this bathroom now.

Summary

Demographics

The respondents represent each of the six districts of West Virginia, and 22 of the 55 counties in the state are represented in this sample of consumers. That does not mean that consumers from the other counties were not served during this reporting period, but there were no survey responses received from consumers in those counties.

Most of the consumers (60%) in the sample had Open cases at the time they completed the survey. Nearly 65% of the consumers were served through the Community Living Services Program. The others were in Navigator program, DOE program, Title I- Part C, or Family Support.

Respondents were asked about their disabling condition. About 40% of those who responded listed a motor-related limitation as their disabling condition. Cognitive, Sensory, Cardiac/Respiratory, and Other disability categories were also represented in the sample. There were no responses from individuals who described their disability as a mental health condition.

Satisfaction Items

According to the responses to the Likert-type items, at least 90% of the consumers reported that they Agree or Strongly Agree that:

• their questions were answered clearly (91%),
• CIL staff understood their needs (91%),
• CIL staff members were excellent, overall (93%), and
• the services were excellent (90%).

Each of the other items was rated at well above 80% agreement. The ratings of satisfaction across the items revealed a pattern that was similar to the previous years, although the responses were somewhat lower overall. It is likely that this is due to the low response rate and the relatively large number of closed case responses.

Rights Information

About 68% of the consumers reported that they were given specific information about their rights (or at least 1 right) as a client. Consumers who reported that rights were explained most often were told about their rights to know about available services, appeal eligibility decisions, and to develop their IL plan. Consumers reported that they were least often told about their right to request another staff member. This year, they were asked to indicate whether they were told about each right, were not told about each right, or don’t remember being told. It will be interesting to monitor the responses to these choices to determine client perceptions of how rights information is or is not provided.

Impact of Services

Consumers were asked whether the services had an impact on their lives. Sixty-nine percent of the consumers who responded to this item agreed that they did see a difference. When asked to describe how the services had impacted their lives, consumers noted improvements in use of assistive technology (e.g., hearing aids, Life alert bracelet), modifications to the inside of their home (e.g., lift chair), and increased independence (e.g., hope, everyday living easier, I’d be in a nursing home without them).

Services Received

Consumers reported receiving a variety of services. There were 4 consumers who reported receiving each of the 11 types of services (e.g., advocacy, I&R, assistive technology, skills training).  Forty-eight consumers reported receiving 208 services for an average of about 4 services per person. Most consumers (79%) reported that they had received a variety of services.

Service Needs

When asked about additional service needs, consumers listed services related to home modification (e.g., walk-in shower, ramps installation, insulation) and medical/personal services (e.g., home health aides, medical appointments).

Improvements

When asked, "What things could we do better?" many respondents reported that the experience had been positive for them, that they were satisfied with services, and encouraged the CILs to continue doing their work. As in previous years, consumers offered suggestions related to improving communication between staff and consumers. The primary complaints revolved around timeliness of services.

Overall

The patterns of responses demonstrate the value of the IL program to the residents of West Virginia. Coverage across the state continues to be of concern, but for citizens with disabilities who do receive services, the reported levels of satisfaction remain high. Every satisfaction item is rated above 80%. Again this year, there was only one satisfaction item with which 85% or fewer of the respondents report that they agreed or strongly agreed (“The CIL staff told me about job opportunities for independent living resources” at 83%).

The levels of satisfaction that the consumers report continue to describe a program that is providing effective services to West Virginians with disabilities. The current sample has a higher-than-typical proportion of closed cases. This Open to Closed case balance is reflected in slightly lowered ratings for the satisfaction items. While the absolute percentage of individuals reporting satisfaction with services varies from year to year, the overall pattern is consistent and remains high. Caution must be taken in interpreting these results, however, due to the low response rate. Although the low response rate is typical for a survey of this type, it continues to be an issue of concern.

For more information about the SILC, please contact:

WVSILC
P.O. Box 625
Institute, WV 25112-0625
Telephone: 304-766-4624 (voice or TDD), 304-766-4721 (fax)
e-mail: wvsilc@wvsilc.org