Change Request Chart FEMA Form 519-0-1NT

CHANGE REQUEST CHART

PUBLIC ASSISTANCE CUSTOMER SATISFACTION SURVEY

FEMA Form 519-0-1INT (Internet)

CURRENT LOCATION	CURRENT TEXT	REVISED TEXT
	FEMA FORM 519-0-1INT (Internet)	FEMA FORM 519-0-1INT (Internet)
	PUBLIC ASSISTANCE CUSTOMER SATISFATION SURVEY	PUBLIC ASSISTANCE CUSTOMER SATISFATION SURVEY
	Please answer the following questions about your experience with the Federal Emergency Management Agency (FEMA) Public Assistance Program. Please select the appropriate response to the following questions. Your answers will help to improve FEMA’s response in future disasters.	Same
	General Questions The following questions ask for general information about your background.	Same
	What was the disaster type, declaration date, State involved, and disaster number of your most recent disaster where FEMA provided assistance? Type (flood, tornado, etc.)_______ Date declared (month, year)______ State involved_________________ Disaster number, if known_______
	The following questions may not pertain to all respondents. Please follow instructions associated with the response chosen. What is your organization type and your position? State Grantee: State Director Governor’s Authorized Representative - GAR Alternate GAR Public Assistance Officer – PAO Deputy PAO State Coordinating Officer - SCO Assistance SCO Other (Skip to Q4) Tribal Tribal Subgrantee: Local government State subgrantee Special district Private non-profit Indian tribe/tribal organization / native village Other	Same
	For what type(s) of project(s) did you apply? Not applicable, state grantee (skip to question 5) All large projects (over $xx,xxx in FY xxxx)(after responding, skip to Question 5) All small projects ($xx,xxx and under) More small than large projects Equal number of large and small projects	Same
	If you applied for all large projects, please mark “not applicable” and go to Question 5. Applicants have the option of writing their own Project Worksheet(s) for small projects. For the small projects for which you applied, did you chose to write your own Project Worksheet(s): All of the time Most of the time Half of the time Some of the time Never Not applicable, did not apply for small projects	Same
	Program Results Please select the response that best describes your satisfaction level: Overall, how satisfied are you with the Public Assistance Program? Very Satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied	Same
New Response Option		(If a negative response, go to 4a. Else, go to 6.) 5a. What specifically were you dissatisfied with? (Text)
	Overall, how satisfied are you with the Public Assistance Process? Very Satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied	Same
New Response Option		(If a negative response, go to 4a. Else, go to 6.) 4a. What specifically were you dissatisfied with? (Text)
	Information The following questions pertain to your initial contact with FEMA. How satisfied were you with the published information FEMA provided on the Public Assistance Program (e.g. documents on FEMA’s website, documents received at the Kickoff Meeting, etc.)? Very Satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied	Same
	How satisfied were you with staff’s communication of information? Very Satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied Never dealt with staff	Same
	How satisfied were you with the information FEMA provided you concerning the availability of Public Assistance mitigation funding? Very Satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied Did not receive any information on mitigation	Same
	Personal Interaction and Customer Service The following questions concern your interactions with staff. The field staff understood the eligibility requirements: All of the time Most of the time More than half of the time Some of the time Never Do not know	Same
	The field staff that conducted the site visit(s) were competent and understood the types of damage they were assessing: All of the time Most of the time More than half of the time Some of the time Never Not applicable-No site visit(s) necessary because always wrote own Project Worksheet(s) Not applicable-Site visit(s) not yet conducted	Same
	The field staff that conducted the site visit(s) understood the local conditions that influence the rebuilding process. Strongly agree Agree Slightly agree Slightly disagree Disagree Strongly disagree Not applicable-No site visit(s) necessary because always wrote own Project Worksheet(s) Not applicable-Site visit(s) not yet conducted	Same
	How reliable were the decisions and information you received from staff? Very reliable Reliable Slightly reliable Slightly unreliable Unreliable Very unreliable Do not know	Same
	Was staff turnover a problem? Yes No Do not know	Same
	Please select the response that best describes your satisfaction level: Overall, how satisfied were you with the Customer Services provided by staff? Very satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied	Same
	Overall, how satisfied are you with the responsiveness provided by staff? Very satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied	Same
	Project Worksheet Process The following questions related to the Project Worksheet Process. Note: Not all questions may apply to you. Some questions ask about very specific Project Worksheet activities.( Please select “not applicable,” where appropriate.) Overall, how satisfied were you with the Project Worksheet process? Very satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied	Same
	18a. Did you receive Public Assistance mitigation funding? Yes, received funding (please go to 18b) No – applied for but did not receive funding (After responding, please skip to Question 19.) Do not know (After responding, please skip to Question 19.) Not applicable-Did not apply for funding (After responding, please skip to Question 19.)	Same
	18b. If you answered “yes” to Question 18a, how satisfied were you with the amount of Public Assistance mitigation funding you received? Very satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied Do not know	Same
	If FEMA conducted a site visit, FEMA conducted the Project Worksheet site visit(s) Too soon after the disaster At the right time Too Late to be helpful Do not know Site visit(s) not yet conducted Not applicable-No site visit(s) necessary because always wrote own Project Worksheet(s)	Same
	If FEMA developed the scope(s) of work, how satisfied were you with their development? Very satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied Do not know Not applicable – Always wrote own Project Worksheet(s)	Same
	If FEMA identified damage repair cost estimates, how satisfied were you with these estimates? Very satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied Do not know Cost estimates not yet completed Not applicable – Always wrote own Project Worksheet(s)	Same
	If you wrote your own Project Worksheet(s), how satisfied were you with completing your Project Worksheet(s) in terms of its complexity, your time invested, and the availability of necessary information? Very satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied Not applicable - Did not write any Project Worksheets	Same
	If you had any small projects, and you chose not to write your own Project Worksheet(s), please briefly explain why you asked FEMA to write your Project Worksheet(s). (Text)	Same
	Program Results The following questions pertain to the overall results of the Public Assistance Program. How satisfied were you with FEMA’s timeliness 24a. Overall: Very satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied 24b. In relation to providing information: Very satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied 24c. In relation to making eligibility decisions: Very satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied 24d. In relation to providing funds: Very satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied	Same
	How reasonable were administrative requirements for the following? 25a. Overall program? Very reasonable Reasonable Slightly reasonable Slightly unreasonable Unreasonable Very unreasonable 25b. Pre-disaster documentation? Very reasonable Reasonable Slightly reasonable Slightly unreasonable Unreasonable Very unreasonable 25c. Project Worksheet review? Very reasonable Reasonable Slightly reasonable Slightly unreasonable Unreasonable Very unreasonable 25d. Payment of claims? Very reasonable Reasonable Slightly reasonable Slightly unreasonable Unreasonable Very unreasonable	Same
New Question		Alternative Procedures The next questions relate to the Public Assistance Alternative Procedures which you may have elected to use for permanent work and debris removal projects. Were you offered the opportunity to participate in the Alternative Procedures? Yes No Don’t know/Don’t remember (If response = No or Don’t Know/Don’t Remember, go to 32. If response = Yes, go to 25a)
New Question		25a. Did you decide to participate? Would you say: Yes No Started to but then opted out No Don’t know/Don’t remember (If response = Started to but then opted out or No, go to Q25b. If response = Yes, go to Q26.)
New Question		25b. What were your response for not participating in the Public Assistance Alternative Procedures? (Text)
New Question		Thinking about the program elements that influenced your decision to participate, would you say: 26a. The incentives were Very important Important Not very important Not at all important
New Question		26b. Was the flexibility of the program Very important Important Not very important Not at all important
New Question		26c. What other factors influenced your decision to participate? (Text)
New Question		The next questions relate to the impact of the Alternative Procedures on your current level of recovery. How would you rate the Alternative Procedures on improving the speed of your recovery? Would you say Excellent Good Satisfactory Below Average Poor No opinion Too early to determine (If response = Below Average or Poor, go to Q27a, else go to Q28.)
New Question		27a. What changes could FEMA make to this program to improve your speed of recovery? (Text)
New Question		How effective have the Alternative Procedures been in improving your recovery? Excellent Good Satisfactory Below Average Poor No opinion Too early to determine (If response = Below Average or Poor, go to Q28a, else go to Q29.)
New Question		28a. What changes could be made to improve the effectiveness? (Text)
New Question		How satisfied are you with the estimates used for your pilot program projects? Very Satisfied Satisfied Slightly Satisfied Slightly Dissatisfied Dissatisfied Very Dissatisfied No Opinion Too early to determine (If response = Slightly Dissatisfied, Dissatisfied or Very Dissatisfied, go to Q29a, else go to Q30.)
New Question		29a. What changes are needed to improve your satisfaction with the estimates?
New Question		If the independent expert panel was used on your projects, how satisfied are you with the panel process? Very Satisfied Satisfied Slightly Satisfied Slightly Dissatisfied Dissatisfied Very Dissatisfied No Opinion Too early to determine (If response = Slightly Dissatisfied, Dissatisfied or Very Dissatisfied, go to Q30a, else go to Q31.)
New Question		30a. What changes are needed to the panel process? (Text)
New Question		In the future, should you need to apply for a Public Assistance grant, how likely are you to use the Alternative Procedures option? Definitely use Probably use Might or Might Not use Probably would Not use Definitely would Not use Don’t know/No Opinion
New Question		What additional recommendations do you have for improving the Alternative Procedures? (Text)
Old Q#26	Is there anything you would have liked FEMA to have done differently during this disaster recovery? (Text)	Same
Old Q#27	Please provide any additional comments or suggestions regarding the Public Assistance Program. (Text)	Same
	The Federal Emergency Management Agency (FEMA) Public Assistance Program appreciates your feedback! Please click the “Submit” button to confirm your responses.