* Please indicate which County you live in
Please Select County Adair Andrew Atchison Audrain Barry Barton Bates Benton Bollinger Boone Buchanan Butler Caldwell Callaway Camden Cape Girardeau Carroll Carter Cass Cedar Chariton Christian Clark Clay Clinton Cole Cooper Crawford Dade Dallas Daviess DeKalb Dent Douglas Dunklin Franklin Gasconade Gentry Greene Grundy Harrison Henry Hickory Holt Howard Howell Iron Jackson Jasper Jefferson Johnson Knox Laclede Lafayette Lawrence Lewis Lincoln Linn Livingston McDonald Macon Madison Maries Marion Mercer Miller Mississippi Moniteau Monroe Montgomery Morgan New Madrid Newton Nodaway Oregon Osage Ozark Pemiscot Perry Pettis Phelps Pike Platte Polk Pulaski Putnum Ralls Randolph Ray Reynolds Ripley St. Charles St. Clair St. Genevieve St. Francois St. Louis City St. Louis County Saline Schuyler Scotland Scott Shannon Shelby Stoddard Stone Sullivan Taney Texas Vernon Warren Washington Wayne Webster Worth Wright

Please indicate your Zip Code

* Please indicate whether you are a :
Please Select Person with a disability Family member/Friend Government agency Service provider Educator/Employer Other

If Other, please describe

Please think about your specific community when answering the following questions.

Has your community engaged people with disabilities in emergency preparedness training in case of a blizzard, tornado, or extreme heat/cold?
__YES              __NO              __Don't Know

Has your community developed universal design housing? (The design accommodates a wide range of individual preferences and abilities.)
___YES       ___NO       ___Don't Know

On a scale of 1 to 5 rate how important is universal design housing to you?
1 = Definitely Not Important       3 = Neutral       5 = Definitely Important
1       2       3       4       5

Does your community have adequate medical providers (doctors, nurses, dentists, therapists, audiologists, psychologists, and counselors) who accept MO HealthNet (Medicaid)?
____YES       ____NO       ____Don't Know

Does your doctor's office or hospital have accessible services and equipment?
____YES       ____NO       ____Don't Know

The following questions are based on disability-related topics from the past legislative sessions. Please indicate whether each one is Definitely Important, Important, Neutral, Not Important, or Definitely Not Important.

1. Maintaining the Human Rights Act and employment discrimination protection
Definitely Important
Important
Neutral
Not Important
Definitely Not Important

2. Requiring a photo ID in order to vote
Definitely Important
Important
Neutral
Not Important
Definitely Not Important

3. Requiring a photo ID to obtain food stamps
Definitely Important
Important
Neutral
Not Important
Definitely Not Important

4. The Department of Mental Health developing a plan to transition individuals with developmental disabilities to the community
Definitely Important
Important
Neutral
Not Important
Definitely Not Important

5. People with psychiatric disorders (i.e.: Post Traumatic Stress Disorder) or the diagnosis of Autism should have their therapy dog reclassified as a "service animal" under state law and be allowed in appropriate public venues
Definitely Important
Important
Neutral
Not Important
Definitely Not Important

6. Accessible parking space law requirements being identical to the Americans with Disabilities Act requirements
Definitely Important
Important
Neutral
Not Important
Definitely Not Important

7. Additional accessible parking for vehicles which require more space for ramps and lifts (access aisles being 96 inches wide)
Definitely Important
Important
Neutral
Not Important
Definitely Not Important

8. Individuals with permanent disabilities who are renewing accessible license plates or placards not being required to obtain a physician's statement
Definitely Important
Important
Neutral
Not Important
Definitely Not Important

9. Maintaining the helmet law requirement for all riders and drivers of motorcycles
Definitely Important
Important
Neutral
Not Important
Definitely Not Important

10. Expanding MO HealthNet coverage to include dental, comprehensive day rehabilitation for brain injury, and hearing aids
Definitely Important
Important
Neutral
Not Important
Definitely Not Important

11. Prohibiting spanking of any public school student who is receiving special education services
Definitely Important
Important
Neutral
Not Important
Definitely Not Important

12. Increasing employment training and job placement for people with disabilities in community- based employment
Definitely Important
Important
Neutral
Not Important
Definitely Not Important

Please indicate which accommodations or services you, your family member, or client utilizes on a regular basis.

Interpreters
CART
Scent-free policies
Behavioral supports
Mental health services (counseling, support groups)
Prescription medication
Applied Behavioral Analysis
Physical, Occupational, Speech, or Massage therapy
Assistive Technology (hearing aids, cochlear implants, wheelchair, crutches, software)
Public transportation including paratransit services
Accessible parking spaces
Personal care attendant(s)
Relay Missouri
Braille
Service animal

Please add any comments regarding what you would like legislators to work on to improve services for people with disabilities:

Please rate the Governor's Council on Disability's weekly Legislative Update on the following scale:
1 = Excellent      2 = Above Average      3 = Average      4 = Below Average     5 = Unsatisfactory
___User Friendly       Select Rate 1 2 3 4 5
___Valuable tool       Select Rate 1 2 3 4 5
___Useful content     Select Rate 1 2 3 4 5

Do you share the Legislative Update with other organizations?
___YES       ___NO

If yes, which organizations do you share it with?

If you do not receive the GCD Legislative Update and would like to be added to the listserv, please provide your email address here:

Add your suggestions or comments:

If you have participated in the Legislative Education Project Training at the Capitol, please rate the various components in order of importance to you.
1 = least important, 5 = most important
    Select Rate 1 2 3 4 5 ___ Presentation on how a bill becomes a law
    Select Rate 1 2 3 4 5 ___ Presentation on advocacy strategies and legislator meeting tips
    Select Rate 1 2 3 4 5 ___ Tour of the Capitol
    Select Rate 1 2 3 4 5 ___ Meeting with Center for Independent Living advocates
    Select Rate 1 2 3 4 5 ___ Time to attend hearings and/or meet with legislators

We welcome feedback. If there is anything you would like to see improved with the Legislative Education Project please provide information in the space below.

If you are interested in learning more about the Legislative Education Project or being contacted when 2013 dates have been determined please provide an email address and/or phone number here.

Please use the space below to share any additional information.

* Answer the random question below (if you get it wrong, it will ask you a different question) :
What is four thousand and forty one as digits?