Interagency Councils Questionnaire


This instrument was developed for the National Board and Care Survey project. This project was conducted by the Bureau of the Census under contract for the Department of Health and Human Services (HHS) Office of Disability, Aging and Long-Term Care Policy. For additional information about this subject, you can visit the DALTCP home page at http://aspe.hhs.gov/_/office_specific/daltcp.cfm or contact the office at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, SW, Washington, DC 20201. The e-mail address is: webmaster.DALTCP@hhs.gov. The DALTCP Project Officer was Robert Clark.


NOTE: This is a recreation of this form. See the PDF version for a scanned version of the actual form.

 

QUESTIONNAIRE 6
Interagency Councils

(Complete one per state)

FIFTY STATE SURVEY OF AGENCIES INVOLVED
IN THE REGULATION OF BOARD AND CARE HOMES

 

STATE: _________________________
AGENCY: _________________________
CONTACT: _________________________  
POSITION: _________________________
DATE: _________________________
INTERVIEWER: _________________________  

 

START TIME: _________________________    

INTERAGENCY COUNCILS

1. Does the board and care program in your state have separate offices for activities relating to clients and facilities? (For example, licensure, enforcement, financing, client services.)

_____Yes Y = Yes
N = No
D = Don't Know  
_____No
_____Don't Know  

2. Is there a coordinating unit or interagency group for board and care within your state?

_____Yes Y = Yes
N = No
D = Don't Know  
_____No (IF NO, SKIP TO NEXT QUESTIONNAIRE.)  
_____Don't Know

3. What is the name of the coordinating unit? _________________________ Abbreviate as possible.

4. When was it begun? 19_____

5. What authority does this coordinating unit have over the other state agencies with responisibilities for board and care homes? _________________________

6. How is the coordinating unit funded? _________________________

7. Describe its accomplishments. (LIST EACH ACCOMPLISHMENTS SEPARATELY.)

A. _________________________  
B. _________________________  
C. _________________________  
D. _________________________  
E. _________________________  
F. _________________________  

8. Describe its major limitations. (LIST EACH LIMITATION SEPARATELY.)

A. _________________________  
B. _________________________  
C. _________________________  
D. _________________________  
E. _________________________  
F. _________________________  

 

ENDING TIME: _________________________    

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