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Adaptive Wage Survey Form – Online
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Adaptive Wage Survey Form – Online
Adaptive Wage Survey Form – Online
Stephanie Schrage
2026-06-28T17:31:54-04:00
2026 Adaptive Wage Case Study
Adaptive wages reported by a 14c Employee
Employee Profile
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My name is:
Employment provider of choice:
Provider Logo
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About me:
Benefits & Support Services
SSI
SSDI
Medicare
Medicaid
SNAP
Rent Assistance / Section HUD
Residential Support
Transportation
Waiver Services
Other:
Community Membership / Wrap Around Services
To be completed by the 14c Provider
AVG DSP Wage ($ / hour):
AVG Admin Wage ($ / hour):
By the Numbers: Employment Scenario Comparison
By the Numbers
CIE
Not Working
State Min. Wage
Current 14c Wage
Hourly Wage
Employer
Hours Per Week
Monthly Income
SSI / SSDI
SSI $
SSDI $
SSI $
SSDI $
SSI $
SSDI $
SSI $
SSDI $
Total Monthly Income
Total Hourly Wage
DSP Support Level
N/A
High
Moderate
Low
N/A
High
Moderate
Low
N/A
High
Moderate
Low
N/A
High
Moderate
Low
Admin Support Level
N/A
High
Moderate
Low
N/A
High
Moderate
Low
N/A
High
Moderate
Low
N/A
High
Moderate
Low
Monthly DSP Value
(Ave Wage Γ hours Γ level ratio)
Monthly Admin Value
(Ave Wage Γ hours Γ level ratio)
Monthly Transportation Value
(rides Γ days Γ cost/ride)
# Rides/day
# Days/month
Cost/Ride $
Total $
# Rides/day
# Days/month
Cost/Ride $
Total $
# Rides/day
# Days/month
Cost/Ride $
Total $
# Rides/day
# Days/month
Cost/Ride $
Total $
Total Monthly Value
Total Program Hourly Value
Adaptive Wage *
* Adaptive wage is their actual wages and SSDI/SSI, transportation costs plus their census share of the hourly DSP and administrative support
(not including payroll taxes and benefit expenses in the program).
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