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Executive Office of Health and Human Services

Survey Review



 
 
Survey Name: NYTD MA Survey - Cohort 2 - Eng
Note: Questions marked with * are mandatory
NATIONAL YOUTH IN TRANSITION SURVEY
Welcome to the National Youth in Transition Survey! Let your voice count. By answering the questions, you'll let us know how you are doing and what services work well. Foster youth turning age 17 from across the country will also be taking part in this survey. It will take you about 15 minutes to complete. Thank you for participating!
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* 1. First Name:
* 2. Last Name:
* 3. Date of Birth (please use mm/dd/yyyy format):
* 4. Person ID# (please enter exactly as found on DCF birthday card):
* 5. Today's Date (please use mm/dd/yyyy format):
* 6. I hereby give my consent to participate in the NYTD Survey:
NOTE: If you have declined to participate, please proceed to the end of the survey and click on the "SUBMIT" button.
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7. Currently are you employed full-time?
ITEM 7 HELP: As of today, do you work 35 hours or more per week at one or more jobs?
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8. Currently are you employed part-time?
ITEM 8 HELP: As of today, do you work at least 1 hour but no more than 34 hours per week at one or more jobs?
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9. In the past year, did you complete an apprenticeship, internship, or other on-the-job training, either paid or unpaid?
ITEM 9 HELP: In the past year, did you complete an apprenticeship, internship, or other on-the-job training for which you were paid or unpaid, that helped you acquire employment related skills? Some examples: specific trade skills such as carpentry or auto mechanics, or office skills such as word processing or use of office equipment.
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10. Currently are you receiving social security payments (Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), or dependents’ payments)?
ITEM 10 HELP: As of today, are you receiving payments from SSI or SSDI, either directly, or as a beneficiary?
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11. Currently are you using a scholarship, grant, stipend, student loan, voucher, or other type of educational financial aid to cover any educational expenses?
ITEM 11 HELP: As of today, are you receiving any of the following payments to aid your education: a scholarship, ETV voucher, grant, stipend, student loan, tuition or fee waiver, or other type of educational financial aid?
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12. Currently are you receiving ongoing welfare payments (TANF) from the government to support your basic needs?
ITEM 12 HELP: As of today, are you receiving TANF (Temporary Assistance for Needy Families)?
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13. Currently are you receiving public food assistance?
ITEM 13 HELP: As of today, are you receiving food assistance from the government such as SNAP/food stamps, EBT, or WIC? This does not include assistance such as a food pantry.
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14. Currently are you receiving any sort of housing assistance from the government, such as living in public housing or receiving a housing voucher?
ITEM 14 HELP: As of today, are you living in public housing or receiving an FUP or Section 8 voucher?
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15. Currently are you receiving any periodic and/or significant financial resources or support from another source not previously indicated and excluding paid employment?
ITEM 15 HELP: As of today, are you receiving any other support not listed above, including payments from a spouse or family member (biological, foster or adoptive), child support that you receive for yourself, or funds from a legal settlement. NOTE: This does NOT include occasional gifts, such as birthday or graduation checks or small donations of food or personal incidentals, child care subsidies, child support for your own child or other financial help that does not benefit you directly in supporting yourself.
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16. What is the highest educational degree or certification that you have received?


ITEM 16 HELP: Vocational certificate: a document stating that you have received education or training that qualifies you for a particular job, e.g., auto mechanics or cosmetology.
---Vocational license: a document that indicates that the State or local government recognizes you as a qualified professional in a particular trade or business.
---An Associate’s degree is generally a two-year degree from a community college, and a Bachelor’s degree is a four-year degree from a college or university.
---Higher degree: indicates a graduate degree, such as a Masters or Doctorate degree.
---None of the above: means that the you have not received any of the above educational certifications.
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17. Currently are you enrolled in and attending high school, GED classes, post-high school vocational training, or college?
ITEM 17 HELP: As of today, are you enrolled and attending classes, even if school is out of session (e.g., spring break, summer vacation, etc.)? This includes: high school, GED classes, or postsecondary vocational training or college.
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18. Currently is there at least one adult in your life, other than your caseworker, to whom you can go for advice or emotional support?
ITEM 18 HELP: As of today, do you have an adult connection? This is someone that you can easily access either by telephone or in person for advice or guidance when you have a decision to make or a problem to solve, or for companionship to share personal achievements. This can include, but is not limited to, adult relatives, parents or foster parents. Do NOT include: spouses, partners, boyfriends or girlfriends and current caseworkers.
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19. Have you ever been homeless?
ITEM 19 HELP: Have you ever experienced homelessness? “Homelessness” is considered as not having a regular or adequate place to live and includes: living in a car, living on the street, living in a homeless shelter, or another temporary living situation like “couch surfing.”
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20. Have you ever referred yourself or has someone else referred you for an alcohol or drug abuse assessment or counseling?
ITEM 20 HELP: Alcohol or drug abuse assessment is a process designed to determine if someone has a problem with alcohol or drug use.
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21. Have you ever been confined in a jail, prison, correctional facility, or juvenile or community detention facility, in connection with allegedly committing a crime?
ITEM 21 HELP: Have you ever been confined in a jail, prison, correctional facility, or juvenile or community detention facility because you committed, or were accused of committing a crime?
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22. Have you ever given birth or fathered any children that were born?
ITEM 22 HELP: If you are a male completing this survey, and you do not know if you have fathered a child that was born, answer “No.”
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23. If you responded yes to the previous question, were you married to the child’s other parent at the time each child was born?
ITEM 23 HELP: An answer of “Yes” on this question indicates that at the time that each of your children was born, you were married to the other parent of the child.
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24. Currently are you on MassHealth?
ITEM 24 HELP: As of today, are you receiving MassHealth coverage (or your State’s medical assistance coverage if you currently are living outside of Massachusetts)?
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25. Currently do you have health insurance, other than MassHealth?
ITEM 25 HELP: ‘‘Health insurance’’ other than MassHealth or Medicaid means having a third party pay for all or part of health care. You might have health insurance such as group coverage offered by your employer or your school, or an individual policy that covers medical and/or mental health care and/or prescription drugs, or you might be covered under your parents’ insurance. This also could include access to free health care through a college, Indian Tribe, or other source.
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26. Does your health insurance include coverage for medical services?
ITEM 26 HELP: If you answered “Yes” to having MassHealth or other health insurance (item 24 or 25), is all or part of the cost of medical health care services included in your health insurance coverage? Answer “Yes” if you have MassHealth through DCF.
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27. Does your health insurance include coverage for mental health services?
ITEM 27 HELP: If you answered “Yes” to having health insurance with medical coverage (item 26), is all or part of the cost for mental health care services, such as counseling or therapy included in your health insurance coverage? Answer “Yes” if you have MassHealth through DCF.
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28. Does your health insurance include coverage for prescription drugs?
ITEM 28 HELP: If you answered “Yes” to having health insurance with medical coverage (item 26), is all or part of the cost for some prescription drugs included in your health insurance coverage? Answer “Yes” if you have MassHealth through DCF.
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Thank you for completing the NYTD Survey! --- Please call 877.624.3440 and verify your mailing address so that we can be sure to get the INCENTIVE to you as quickly as possible. --- Be sure to click on the "SUBMIT" button.