For more on Performance Measurement, visit here.
For more sample measurement tools, visit here.
Data Elements
South Carolina
Data Elements for Lifespan Respite Reporting
Outcomes
Alabama
HEARTS Pre and Retrospective Post Test Form
Colorado
2018 Lifespan Respite Care Survey - for family caregivers post receipt of respite Grants/Vouchers
Delaware
Financial Assistance Evaluation Form
Respite Care I&R Evaluation Form
DE RespiteOnline Referral Service Evaluation Form
DE Financial Assistance Survey Results
Montana
Montana Post Respite Voucher Satisfaction Survey with caregiver outcomes
NebraskaFamily Caregiver Depression Screening
Nebraska Lifespan Respite Network: Producing Positive Outcomes for Families 2015-2017 Evaluation Final Report, UNMC-MMI and DHHS. The evaluation demonstrated respite services resulted in a range of family caregiver outcomes, including fewer health symptoms reported by family caregivers and less relationship strain with the care recipient. Read the Executive Summary.
2017 NE Lifespan Respite Family Caregiver Survey for caregivers receiving NE Lifespan Respite Subsidy families, with supplemental questions.
The supplemental questions are used by the local Respite Network Coordinators for all initial and renewal clients at the time of eligibility determination notification. Calling the family caregiver is done by the Respite Coordinator when receiving notice from the Lifespan Respite Subsidy Social Services Worker (SSW) that eligibility has been completed. This interaction provides an opportunity to begin building (or enhance an existing) relationship with the family caregiver. Goal is to enable families to have confidence in contacting the local respite network if there are concerns or questions.
Nebraska Lifespan Respite Subsidy 2015 Evaluation Report, September 2015
Nevada
Final Report 2021 - Caregiver Respite Self-Directed Pilot
NV Pre and Post Respite Caregiver Surveys (Rx - 2019)
NV Pre and Post Respite Caregiver Surveys (Expansion Grant 2011)
LifeCourse Tool
Nevada Lifespan Respite Care Program Data on Caregivers 2012, Final Report
Nevada Helping Hands of Vegas Valley
Respite Care Voucher Program Application (includes Pre-Survey)
Caregiver Respite Satisfaction Survey
Caregiver Results
HHOVV Caregiver Retrospective Survey Caregiver Letter
NV Respite Pre Respite Survey
NV Respite Rx POST Respite Survey
Post Survey Results
Pre Survey Results
New Hampshire
NH LRC Coalition Logic Model
New York
NY Post-Respite Survey
New York’s Lifespan Respite Evaluation Plan for the 2014-2017 grant award
Lifespan Respite Care Program: Advancing State Lifespan Respite Systems - New York, Program Evaluation Report
North Carolina
NC Pre and Post Caregiver Respite Surveys
Mini-Grant Tools and Reports
Setting Goals to Maximize Your Respite Time Tool
Mini-grant Summary Tables
Mini-grant Summary Report, March 2012-May 2013
Caregiver Survey Results
Oklahoma
OK Voucher Program - Respite Pre and Post Respite Caregiver Outcome Surveys
Pennsylvania
CareBreak Retrospective Survey
CareBreak PreService Survey
CareBreak PostService Survey
Tennessee
Caregiver Survey
VirginiaSatisfaction Survey 2022
Respite Voucher Reimbursement Packet 2022 (includes surveys)
Organizational Success and Capacity
Massachusetts
Tools for evaluating MA state level strategic alliance:
Levels of Organizational Integration Rubric
LOIR Template
Utilizing Collaboration Theory
Evaluating Organizational Collaborations
Process/Outputs
Delaware
DE Choice of Respite Care Provider by 2010 Financial Assistance Recipients
DE Demographics of Respite Recipients
PPT of Yearly Summary of DE Demographic Descriptors
Nebraska
NE Annual Report of Activities, Outcomes and Individuals Served
North Carolina
NC Lifespan Respite Mini-Grantee Quarterly Reporting Form
