THE QSI AND YOU What you need to know about APD’s Questionnaire for Situational Information (APD logo) Agency for Persons with Disabilities State of Florida - - - APD’s Assessment Tool The Questionnaire for Situational Information (QSI) is an assessment tool used by the Agency for Persons with Disabilities (APD) that gathers key information about your life and your need for services and supports. The QSI is divided into four main life areas: • The Life Changes and Community Inclusion section asks questions about your work and living plans for the next year, and how you are adjusting to any major changes in your life. • The Functional Status section asks about things you do every day, such as eating, bathing, brushing your teeth, and getting dressed in the morning. It also asks questions about your vision, hearing, communication, and how you move around. • The Behavioral Status section asks questions about behavioral issues that might require assistance or intervention. • The Physical Status section asks about your health and physical concerns, including your medical condition and medications Your answers to the questionnaire will help you set goals and plan for things that are important to you. They also will help APD identify the supports you need now and in the future. How the Process Works The assessment is done by APD employees who are qualified, trained, and certified to complete the questionnaire. It is always done in a face-to-face interview with you and your family or guardian and anyone else you would like to include. Your support coordinator does not have to be present for the assessment. In addition, interviews with your caregivers, health care personnel, and support coordinator will help make sure nothing is overlooked. All the information gathered about you will be kept private and will be shared with your providers only with your consent. The QSI is reviewed every year before your support plan is developed and can be updated any time there is a major change in your life, such as a change of caregiver, major change in your health, or if you move to a new home. The QSI is given to all individuals who are on the Medicaid waiver and may be given to individuals on the waiting list for waiver services. The QSI is one of several methods that APD uses to determine the type of support you may need and to help you decide what is important to you. The services identified in your plan may be provided through the Medicaid waiver, Medicaid State Plan, or other agencies, as well as family and community sources. Do You Have Questions for Us? If you have questions about the QSI, please visit APD’s Web site, contact your local APD area office, or call the agency’s headquarters in Tallahassee at the numbers below. (map) 1-866-APD-CARES (1-866-273-2273) (850) 488-4257 apdcares.org MAY 2010