Form 1 PADDSGP PPR

What to Count	Number
1. Individuals served as of October 1 (Carried over from previous FY).
2. Additional individuals served during the year.
3. Total individuals served during the year (Add lines A1 and A2).
4. Individuals with more than one (1) intervention opened/closed FY.
5. Individuals served as of September 30 (Carry over to next FY; ≤ A3).

B. Problem Areas/Complaints of Individuals Served

Problem Area/Complaint	Number
Complaint
1. Abuse (total)
1. Inappropriate Use of Restraint & Seclusion
2. Involuntary Treatment
3. Physical, Verbal, & Sexual Assault
4. Excessive Medication
5. Financial Exploitation
6. Other
2. Access to Administrative or Judicial Processes
3. Access to Records
4. Advance Directives
5. Architectural Accessibility
6. Assistive Technology (total)
1. Augmentative Communication Devices
2. Durable Medical Equipment
3. Vehicle Modification/Transportation
4. Other
7. Aversives (including ECT)
8. Civil Commitment
9. Criminal Justice
10. Custody/Parental Rights
11. Education (total)
1. FAPE: IEP/IFSP Planning/Development/Implementation
2. FAPE: Discipline/Procedural Safeguards
3. FAPE: Eligibility
4. FAPE: Least Restrictive Environment
5. FAPE: Multi-disciplinary Evaluation/Assessments
6. FAPE: Transition Services
7. Other
12. Employment Discrimination (total)
1. Benefits
2. Hiring/Termination
3. Reasonable Accommodations
4. Service Provider Issues
5. Supported Employment
6. Wage and Hour Issues
7. Other
13. Employment Preparation
14. Financial Benefits (total)
1. SSDI Work Incentives
2. SSI Eligibility
3. SSI Work Incentives
4. Social Security Benefits Cessation
5. Work Related Overpayments
6. Welfare Reform
7. Other Financial Entitlements
15. Forensic Commitment
16. Government Benefits/Services
17. Guardianship/Conservatorship/Substitute Decision Maker
18. Home & Community Based Services including Discharge Planning Transition Follow-up
19. Healthcare (total)
1. General Healthcare
2. Medicaid
3. Medicare
4. Private Medical Insurance
5. Other
20. Housing (total)
1. Accommodations
2. Architectural Barriers
3. Landlord/Tenant
4. Modifications
5. Rental Denial/Termination
6. Sales/Contracts/Ownership
7. Subsidized Housing/Section 8
8. Zoning/Restrictive Covenants
9. Other
21. Immigration
22. Juvenile Justice
23. Neglect (total)
1. Failure to Provide Necessary or Appropriate Medical Treatment
2. Failure to Provide Necessary or Appropriate Mental Health Treatment
3. Failure to Provide Necessary or Appropriate Personal Care & Safety
4. Other
24. Post-Secondary Education
25. Non-Medical Insurance
26. Privacy Rights
27. Public Accommodations
28. Rehabilitation Services (total)
1. Communications Problems (Individuals/Counselor)
2. Conflict About Services To Be Provided
3. Individual Request Information
4. Non-Rehabilitation Act
5. Private Providers
6. Related to Application/Eligibility Process
7. Related to IWRP Development/Implementation
8. Related to Title I of ADA
9. Other Rehabilitation Act-related problems
29. Suspicious Death
30. Transportation (total)
1. Air Carrier
2. Paratransit
3. Public Transportation
4. Other
31. Unnecessary Institutionalization including identification and assessment
32. Voting (total)
1. Accessible Polling Place/Equipment
2. Registration
3. Other
33. Other

C. Gender of Individuals Served

Gender	Number
1. Female
2. Male
TOTAL

D. Living Arrangements of Individuals Served

Living Arrangement	Number
1. Independent
2. Parental r Other Family Home
3. Community Residential Home for Children/Youth (0-18 Yrs.)
4. Community Residential Home for Adults
5. Non-Medical Community Base Residential Facility for Children and Youth
6. Foster Care
7. Nursing Homes, Including Skilled Nursing Facilities (SNF)
8. Intermediate Care Facilities (Icf)
9. Public And Private General Hospitals including Emergency Rooms
10. Public Institutional Living Arrangement
11. Private Institutional Living Arrangement
12. Psychiatric Wards (Public Or Private)
13. Jail
14. State Prison
15. Federal Detention Center
16. Federal Prison
17. Veterans Administration Hospital
18. Other Federal Facility
19. Homeless
20. Unknown
TOTAL

E. Reasons for Closing Individual Intervention Files

Reasons for Closing Individual Advocacy Case File	Number
1. Number of Closed Cases in which Client’s Objective Was Partially or Fully Met
3. Other Representation Found
4. Individual Withdrew Complaint
5. Services Were Not Needed Due To Client’s Death or Relocation
6. P&A Withdrew Because Individual or Client Would Not Cooperate
7. Individual’s Case Lacked Merit
8. Individual’s Issue Not Favorably Resolved
9. Appeal(s) Unsuccessful
TOTAL

Reason for Closing Individual Investigation File
Complaint was Withdrawn
Other Appropriate Entity Investigating
P&A withdrew because Individual or Client Would Not Cooperate
Investigation completed
TOTAL

F. Intervention Strategies Used in Serving Individuals

Individual Advocacy Service	Number
1. Self-Advocacy Assistance
2. Limited Advocacy
3. Administrative Remedies
4. Negotiation
5. Mediation/Alternative Dispute Resolution
6. Litigation
TOTAL (1-6)	Total (1-6)
Individual Investigation Service
7. Individual Investigation
TOTAL (1-7)

G. Age Range of Individuals Served

Range	Number
1. 0 – 2
2. 3 – 5
3. 5 – 10
4. 11 – 22
5. 23 – 64
6. 65 & Over
TOTAL

H. Primary Disability of Individuals Served

Primary Disability	Number
Disabling Condition
Absence of Extremities
Acquired Brain Injury
ADD/ADHD
AIDS/HIV Positive
All Other Disabilities
Autism
Auto-immune (non-AIDS/HIV)
Blindness (Both Eyes)
Cancer
Cerebral Palsy
Deafness
Deaf-Blind
Diabetes
Digestive Disorders
Epilepsy
Genitourinary Conditions
Hearing Impaired (Not Deaf)/Hard of Hearing
Heart & Other Circulatory Conditions
Intellectual Disability
20. Mental Illness
Multiple Sclerosis
Muscular Dystrophy
Muscular/Skeletal Impairment
Orthopedic Impairments
Other Emotional/Behavioral
Other Visual Impairments (not blind)
Neurological Disorders/Impairments
Respiratory Disorders/Impairments
Skin Conditions
Specific Learning Disabilities (SLD)
Speech Impairments
Spina Bifida
Substance Abuse (Alcohol or Drugs)
Tourette Syndrome
Traumatic Brain Injury (TBI)
TOTAL

Race and Ethnicity

I. Racial and Ethnic Diversity of Individuals Served

Race/Ethnicity

State %

Individual Advocacy #

Individual

Advocacy %

1. Hispanic/Latino (of any race)

Race/Ethnicity (NOT Hispanic/Latino)	State %	Individual Advocacy #	Individual Advocacy %
2. American Indian/Alaskan Native
3. Asian
4. Black/African American
5. Native Hawaiian/Other Pacific Islander
6. White
7. Two or more races
8. Race/Ethnicity Unknown

Intervention Benefitting Groups

J. Groups Served

Multiple counts not permitted for lines J1 –J3 and J6.

What to Count	Number
1. Group cases/projects still open at October 1. (Carried over from prior FY(s))
2. New group cases/projects opened during the year.
3. Total group cases/projects worked on during the year. (Add lines I1 and I2)
4. Total group cases/projects as of September 30. (Carry over to next FY)
5. Group cases/projects targeted at serving racial/ethnic minority(ies).
6. Total # of individuals potentially impacted by the line I.J.3 projects/cases.

K. Problem Areas/Complaints of Groups Served

Indicate the number of group cases/projects addressing each of the problem areas/complaints below.

Problem Area/Complaint	Number
1. Abuse
2. Access to Administrative or Judicial Processes
3. Access to Records
4. Advance Directives
5. Architectural Accessibility
6. Assistive Technology
7. Aversives (including ECT)
8. Civil Commitment
9. Custody/Parental Rights
10. Education
11. Employment Discrimination
12. Employment Preparation
13. Financial Benefits
14. Forensic Commitment
15. Government Benefits/Services
16. Guardianship/Conservatorship/Substitute Decision Maker
17. Home & Community Based Services including Discharge Planning Transition Follow-up
18. Healthcare
19. Housing
20. Immigration
21. Neglect
22. Post-Secondary Education
23. Non-Medical Insurance
24. Privacy Rights
25. Rehabilitation Services
26. Suspicious Death
27. Transportation
28. Unnecessary Institutionalization including Identification and Assessment
29. Voting

L. Living Arrangements Targeted by Groups Interventions

Indicate number of group advocacy cases/projects targeted at people in each of the living arrangements listed below. Cases/projects not targeting by living arrangement should be counted under “Not Applicable”.

Living Arrangement	Number
1. Independent
2. Parental or Other Family Home
3. Community Residential Home for Children/youth (0-18 yrs.)
4. Community Residential Home for Adults
5. Non-medical Community Base Residential Facility for Children andY
6. Foster care
7. Nursing Homes, including Skilled Nursing Facilities (SNF)
8. Intermediate Care Facilities (ICF)
9. Public and Private General Hospitals including Emergency Rooms
10. Public Institutional Living Arrangement
11. Private Institutional Living Arrangement
12. Psychiatric Wards (Public Or Private)
13. Jail
14. State Prison
15. Federal Detention Center
16. Federal Prison
17. Veterans Administration Hospital
18. Other Federal Facility
19. Homeless
20. Not Applicable – Intervention not Focused on a Particular Living Arrangement
TOTAL

M. Reasons for Closing Group Cases/Projects

Reason	Number
1. Concluded Successfully
2. Concluded Unsuccessfully
3. Other
TOTAL

N. Intervention Strategies Used in Group Cases/Projects

Intervention Strategy	Number
1. Abuse and Neglect Investigation
2. Systemic Litigation
3. Educating Policymakers
4. Other Systemic Advocacy
TOTAL

O. Age Ranges Targeted by Interventions for Groups

Indicate number of cases/projects focused on people in each of the age ranges listed below. If a cases/project is not focused on age range, count it on the line 5 (not applicable).

Focus	Number
1. Group Cases/Projects Focused on Children Approximately 0-2 yrs. old
2. Group Cases/Projects Focused on Children Approximately 3-5 yrs. old
3. Group Cases/Projects Focused on Young People Approximately 5-10 yrs. old
4. Group Cases/Projects Focused on Young People Approximately 11-23 yrs. old
3. Group Cases/Projects Focused on Adults Approximately 23—64 yrs. old
4. Group Cases/Projects Focused on Seniors Approximately 65 yrs. & older
5. Not Applicable – Intervention Not Focused on Any Particular Age Range Grouping
TOTAL

P. Race/Ethnicity of Groups Served

Cases/projects where the number of people in the group served for any of the categories listed below is

disproportionately high in comparison to a state or territory’s census data. More than one category per

project/case may be counted.

Race/Ethnicity	Number
1. Hispanic/Latino (of any race)
2. American Indian/ Alaskan Native
3. Asian
4. Black/African American
5. Native Hawaiian/Other Pacific Islander
6. White
7. Two or more races
8. Unknown

Part II: Statement of Goals and Priorities

A. Report on FY 2014 Statement of Goals and Priorities (SGP)

Goal Number:

Goal Statement:

2. Priorities (Add rows below if needed)
#	Priority





3. Strategies Used to Implement Goal and Address Priorities (Check all that apply below)
□ Collaboration				□ Systemic Litigation
□ Rights-Based Individual Advocacy Services				□ Educating Policy Makers
□ Investigations of Abuse and Neglect				□ Other Systemic Advocacy
□ Monitoring				□ Training/Outreach
4. Extent to Which Goal was Achieved (Check one below)
□ Not Achieved		□ Partially Achieved	□ Achieved		□ No Results This Year

5. Stage of Implementation (Check one below)
□ Planning	□ Initiation	□ Implementation	□ Outcome/Fully Integrated

6. Results Narratives of P&A Activities and Accomplishments Related to Above Goal

List goal and priority #(s) addressed in the activity described in the narrative below.

Goal #(s): 1	Priority #(s):
Collaborator(s):
Underserved/Unserved/Minorities Targeted? ☐ Yes ☐ No (If yes, describe in narrative).
<Narrative Headline> <Story/Narrative> Choose performance measures from Part III here for activity described above in this Results Narrative
Performance measurement		Number

6. Results Narratives (cont.)

List goal and priority #(s) addressed in the activity described in the narrative below.

Goal #(s): 1	Priority #(s):
Collaborator(s):
Underserved/Unserved/Minorities Targeted? ☐ Yes ☐ No (If yes, describe in narrative).
<Narrative Headline> <Story/Narrative> Choose performance measures from Part III here for activity described above in this Results Narrative
Performance measurement		Number

6. Results Narratives (cont.)

List goal and priority #(s) addressed in the activity described in the narrative below.

Goal #(s): 1	Priority #(s):
Collaborator(s):
Underserved/Unserved/Minorities Targeted? ☐ Yes ☐ No (If yes, describe in narrative).
<Narrative Headline> <Story/Narrative> Choose performance measures from Part III here for activity described above in this Results Narrative
Performance measurement		Number

Other Qualitative Narrative Related to the Above Goal

Significant activity for which there were no quantifiable results goes here.

Describe any other significant activity related to this goal

1. Goal Number: 2 Goal Statement:

2. Priorities (Add rows below if needed)
#	Priority





3. Strategies Used to Implement Goal and Address Priorities (Check all that apply below)
□ Collaboration				□ Systemic Litigation
□ Rights-Based Individual Advocacy Services				□ Educating Policy Makers
□ Investigations of Abuse and Neglect				□ Other Systemic Advocacy
□ Monitoring				□ Training/Outreach
4. Extent to Which Goal was Achieved (Check one below)
□ Not Achieved		□ Partially Achieved	□ Achieved		□ No Results This Year

5. Stage of Implementation (Check one below)
□ Planning	□ Initiation	□ Implementation	□ Outcome/Fully Integrated

6. Results Narratives (cont.)

List goal and priority #(s) addressed in the activity described in the narrative below.

Goal #(s): 2	Priority #(s):
Collaborator(s):
Underserved/Unserved/Minorities Targeted? ☐ Yes ☐ No (If yes, describe in narrative).
<Narrative Headline> <Story/Narrative> Choose performance measures from Part III here for activity described above in this Results Narrative
Performance measurement		Number

6. Results Narratives (cont.)

List goal and priority #(s) addressed in the activity described in the narrative below.

Goal #(s): 2	Priority #(s):
Collaborator(s):
Underserved/Unserved/Minorities Targeted? ☐ Yes ☐ No (If yes, describe in narrative).
<Narrative Headline> <Story/Narrative> Choose performance measures from Part III here for activity described above in this Results Narrative
Performance measurement		Number

6. Results Narratives (cont.)

List goal and priority #(s) addressed in the activity described in the narrative below.

Goal #(s): 2	Priority #(s):
Collaborator(s):
Underserved/Unserved/Minorities Targeted? ☐ Yes ☐ No (If yes, describe in narrative).
<Narrative Headline> <Story/Narrative> Choose performance measures from Part III here for activity described above in this Results Narrative
Performance measurement		Number

Other Qualitative Narrative Related to the Above Goal

Significant activity for which there were no quantifiable results goes here.

Describe any other significant activity related to this goal

1. Goal Number: 3 Goal Statement:

2. Priorities (Add rows below if needed)
#	Priority





3. Strategies Used to Implement Goal and Address Priorities (Check all that apply below)
□ Collaboration				□ Systemic Litigation
□ Rights-Based Individual Advocacy Services				□ Educating Policy Makers
□ Investigations of Abuse and Neglect				□ Other Systemic Advocacy
□ Monitoring				□ Training/Outreach
4. Extent to Which Goal was Achieved (Check one below)
□ Not Achieved		□ Partially Achieved	□ Achieved		□ No Results This Year

5. Stage of Implementation (Check one below)
□ Planning	□ Initiation	□ Implementation	□ Outcome/Fully Integrated

6. Results Narratives (cont.)

List goal and priority #(s) addressed in the activity described in the narrative below.

Goal #(s): 3	Priority #(s):
Collaborator(s):
Underserved/Unserved/Minorities Targeted? ☐ Yes ☐ No (If yes, describe in narrative).
<Narrative Headline> <Story/Narrative> Choose performance measures from Part III here for activity described above in this Results Narrative
Performance measurement		Number

6. Results Narratives (cont.)

List goal and priority #(s) addressed in the activity described in the narrative below.

Goal #(s): 3	Priority #(s):
Collaborator(s):
Underserved/Unserved/Minorities Targeted? ☐ Yes ☐ No (If yes, describe in narrative).
<Narrative Headline> <Story/Narrative> Choose performance measures from Part III here for activity described above in this Results Narrative
Performance measurement		Number

6. Results Narratives (cont.)

List goal and priority #(s) addressed in the activity described in the narrative below.

Goal #(s): 3	Priority #(s):
Collaborator(s):
Underserved/Unserved/Minorities Targeted? ☐ Yes ☐ No (If yes, describe in narrative).
<Narrative Headline> <Story/Narrative> Choose performance measures from Part III here for activity described above in this Results Narrative
Performance measurement		Number

Other Qualitative Narrative Related to the Above Goal

Significant activity for which there were no quantifiable results goes here.

Describe any other significant activity related to this goal

B. Priority Setting Process¹

Complete this section by providing a thorough description of how the P&A conducts priority setting process (e.g., methods) used to develop the goals and priorities for the fiscal years covered in your multiyear plan. Revise based on public input on an annual basis with the idea that major changes will be made when it is time for a new multiyear plan.

1. Means by which the P&A conducted data-driven strategic planning, including formal public input (Check all that apply below)

Public Hearing

☐

Public Comment

☐

Experience

☐

Focus

Groups

☐

Advisory Council(s)

☐

Monitoring

Visits

☐

Research/Data

☐

Narrative (describe how the P&A conducted data driven strategic planning):

2. Number of days for public comment:

3. A copy of the proposed SGP for comment was provided to the:

State Council on Developmental Disabilities: Yes/No

The University Centers for Excellence in Developmental Disabilities Education, Research and Service: Yes/No

Describe efforts to assure diversity (disability, geographic, racial, etc.) in the data-driven strategic planning process

3. Summary of Findings

4. Summary of How Data was used to Develop P&A Goals and Priorities (include how priority input used, including input from the DDC and UCEDD)

5. List of topic areas of additional priorities that would be listed but are not due to lack of resources.

C. FY _ _ _ _ Statement of Goals and Priorities (SGP)

☐ There are no changes to the SGP from prior year. ☐ There are changes to the SGP (see below below).

1. Goal Number: 1 Goal Statement:

2. Priorities (Add rows below if needed)
#	Priority




3. Strategies to Be Used to Implement Goal and Address Priorities (Check all that apply below)
□ Collaboration		□ Systemic Litigation
□ Rights-Based Individual Advocacy Services		□ Educating Policy Makers
□ Investigations of abuse and neglect		□ Other Systemic Advocacy
□ Monitoring		□ Training/Outreach

4. Rationale for Adding/Changing Goal

5. Rationale for Adding/Changing Priorities

1. Goal Number: 2 Goal Statement:

2. Priorities (Add rows below if needed)
#	Priority




3. Strategies to Be Used to Implement Goal and Address Priorities (Check all that apply below)
□ Collaboration		□ Systemic Litigation
□ Rights-Based Individual Advocacy Services		□ Educating Policy Makers
□ Investigations of abuse and neglect		□ Other Systemic Advocacy
□ Monitoring		□ Training/Outreach

4. Rationale for Adding/Changing Goal

5. Rationale for Adding/Changing Priorities

1. Goal Number: 3 Goal Statement:

2. Priorities (Add rows below if needed)
#	Priority




3. Strategies to Be Used to Implement Goal and Address Priorities (Check all that apply below)
□ Collaboration		□ Systemic Litigation
□ Rights-Based Individual Advocacy Services		□ Educating Policy Makers
□ Investigations of abuse and neglect		□ Other Systemic Advocacy
□ Monitoring		□ Training/Outreach

4. Rationale for Adding/Changing Goal

5. Rationale Adding/Changing Priorities

1. Goal Number: 4 Goal Statement:

2. Priorities (Add rows below if needed)
#	Priority




3. Strategies to Be Used to Implement Goal and Address Priorities (Check all that apply below)
□ Collaboration		□ Systemic Litigation
□ Rights-Based Individual Advocacy Services		□ Educating Policy Makers
□ Investigations of abuse and neglect		□ Other Systemic Advocacy
□ Monitoring		□ Training/Outreach

4. Rationale for Adding/Changing Goal

5. Rationale for Adding/Changing Priorities

D. Description of P&A Operations

Provide a description of how the P&A operates. Include information on how the P&A coordinates the PADD program with other Protection and Advocacy programs administered by the State Protection and Advocacy System. This description must include the System’s processes for intake, internal and external referrals, and streamlining of advocacy services.

Will the System will be requesting or requiring fees or donations from clients as part of the intake process?
1. Yes
2. No

Collaboration and Coordination:
1. Describe how the P&A is collaborating with others in the State, including the DDC and UCEDD.

Describe how the P&A is reducing duplication and overlap of services and sharing of information on service needs.

Part III: Results of P&A Activity²

Overarching Outcome Statement:

People with disabilities exercise their civil, human and legal rights.

A. End Outcomes of P&A Activity

By End Outcome

Performance Measurement	Number
People with disabilities who are provided with appropriate community based services resulting in community integration and independence.
People with disabilities who accessed benefits.
People with disabilities who live in a healthier, safer or otherwise improved environment.
People with disabilities who were able to stay in their own home.
People with disabilities who work in safer and more humane conditions.
People with disabilities who go to school in safer and more humane conditions.
Students with disabilities who stayed in school.
Children with disabilities receiving appropriate services in most integrated settings.
People with disabilities who had their other rights enforced, retained, restored and/or expanded.
Public and private places/services made more accessible.

By Intervention Type

End Outcome	Technical Assistance	Individual Advocacy³	Abuse & Neglect Investigations	Systemic Litigation	Educating Policy Makers	Other Systemic Advocacy
On row below insert # from line to right	Line III.I.2	Line I.A.3	Line I.N.1	Line 1.N.2	Line 1.N.3	Line 1.N.4
T.A.’s/Cases/Projects
1			N/A
2			N/A
3
4			N/A
5
6
7			N/A
8			N/A
9			N/A
Total
10⁴			N/A

B. Overview of How Many People with Disabilities Served

Performance Measurement	Number
1. People with disabilities receiving individual advocacy services to exercise their civil, human and legal rights.
2. Abuse and neglect investigations to protect people with disabilities from abuse and neglect.
3. People with disabilities receiving information, technical assistance and referral services.
4. People with disabilities trained to become active participants in making decisions that affect their lives.
5. People whose rights were advanced through class and/or systemic impact litigation.
6. People with disabilities whose rights were enforced, protected or restored as a result of non-litigation group advocacy.
7. People with disabilities who received a lower level of services due to lack of P&A resources.
8. People with disabilities impacted by one or more provision(s) in law modified or prevented.

C. Rights-Based Individual Advocacy Services

Outcome Statements

People with disabilities exercised their rights because of access to rights-based and/or legal advocacy services.
The P&A protected rights of individuals with disabilities through legal and rights-based advocacy in accordance with the retainer agreement or similar agreement between the client and the P&A.⁵
The P&A took action to protect the rights of people with disabilities to be free from abuse, neglect or discrimination.

Performance Measurement	Number
People with disabilities who had their rights enforced and/or restored.
People with disabilities who were assisted in obtaining access to administrative or judicial processes.
Closed cases in which client objective was met or partially met.

D. Investigations of Abuse and Neglect

Outcome Statement

The P&A takes action to protect the rights of people with disabilities to be free from abuse and neglect.

Performance Measurement	Number
Investigations (not death related).
Investigations of abuse and neglect completed with a finding or determination (not including death investigations).
Death investigations.
Death investigations completed with a finding or determination.
People with disabilities who benefitted from the findings of investigations of abuse and neglect.
Provisions in policy added or prevented.

Other Qualitative Narrative

Report additional information related to investigations not already reported in Part II.

E. Monitoring

Outcome Statements

People with disabilities live, work and go to school in safe and humane conditions.
People with disabilities are provided with appropriate community-based services so that they can live as independently as possible.

Facilities/Programs Monitored

Unique Facility	Facility Type	Facility Capacity	Location (By County)	# of Visits	Court Ordered Monitoring? Yes/No

Total Number of Unique Facilities:

Performance Measurement	Number
People with disabilities whose living, working and/or other circumstances were monitored by P&A.
Cases opened for health and safety issue investigation.
Health and/or safety violations validated by the P&A.
Rights violations (not health or safety and including quality of life) identified and addressed as a result of P&A monitoring.
Complaints referred to regulatory agencies or investigative organizations.
Times P&A access was denied during a monitoring/access attempt.
Times denial of P&A access was successfully resolved.

Other Qualitative Narrative

Describe P&A’s overall approach and strategy for monitoring activities

F. Systemic Litigation

Outcome Statements

Rights of individuals with disabilities are advanced through class and/or systemic and/or systemic impact litigation.

Through systemic or class litigation, obtain changes in policy, regulations and law that will benefit individuals with disabilities and/or prevent creation or implementation of policy, regulations or law that would harm individuals with disabilities.
Settlements or judgments resulting from P&A systemic litigation positively impact the rights and interests of people with disabilities.

Performance Measurement	Number
Systemic or class action lawsuits handled for the benefit of people with disabilities.
Provisions in policy modified or prevented.
Provisions in regulation modified or prevented.
Provisions in law modified or prevented.
Lawsuits addressing systemic issues resolved by settlement.
Lawsuits addressing systemic issues resolved by judgment.
Amicus briefs signed onto or filed.
People with disabilities whose rights were advanced as a result of amicus participation.

G. Educating Policymakers⁶

Outcome Statement

Statutes, ordinances and regulations will benefit individuals with disabilities.

Performance Measurement	Number
Communications to people with disabilities explaining a policy initiative.
People with disabilities supported in expressing their own viewpoint on a policy related matter.
Times written comments were submitted regarding proposed legislation or regulations.
Times testimony was provided at a legislative hearing.
Provisions in regulation modified or prevented.
People with disabilities impacted by the regulation provision(s) modified or prevented.
Provisions in law modified or prevented.
People with disabilities impacted by one or more provision(s) in law modified or prevented.
Provisions in ordinances modified or prevented.

H. Other Systemic Advocacy

Outcome Statement

The rights of individuals with disabilities are advanced through non-litigation group advocacy.

Performance Measurement	Number
Changes in practices made or prevented.
Provisions in policy modified or prevented.

I. Information, Technical Assistance and Referrals

Outcome Statement

People with disabilities, family members and others will receive basic disability related information and referral services.

Performance Measurement	Number
People receiving information and referral services.
People receiving technical assistance.
Self-advocacy materials published or revised.
Self-advocacy materials distributed.

J. Training

Outcome Statements

People with disabilities have the skills necessary to conduct effective self-advocacy.
People with disabilities have knowledge necessary to be an effective self-advocate.
Family members and additional groups are provided information about laws and policies affecting individuals with disabilities as the P&A determines useful.

Performance Measure	Number
People who report the training enhanced their knowledge and/or skill (was beneficial) at the completion of the training.
People with disabilities who received advocacy skills training.
People with disabilities who received rights training.

K. Public Relations and Outreach

Outcome Statements

The public will become more aware of the existence and mission of the P&A.
The public will become more aware of the content of disability rights laws and regulation and of disability rights issues.

Performance Measure	Number
Press releases issued.
Times a P&A representative was interviewed or featured on TV or radio.
Articles about the P&A or its work in external mass media such as newspapers, radio, podcasts, blogs or television.
Social media followers.
Absolute unique visitors to blogs/web pages where information about the P&A is posted.
Circulation of the P&A’s newsletter and/or listserv updates.
Articles by the P&A about disability rights issues published in newspapers, books, journals or magazines.
Links to other disability rights related information sources published on the P&A website.
Times the P&A exhibited at conferences, community fairs, etc.
Presentations made to community groups.

Other Qualitative Narrative

Describe any innovative or significant P&A activity related to public relations and/or outreach (to include unserved and underserved populations/communities, and outreach to self-advocates)

Part IV: Collaborations

Use the boxes below to report on collaborative and coordination efforts with the following client assistance program (unless housed within the P&A), long term care ombudsman (unless housed within the P&A), developmental disabilities council, center(s) for excellence (university affiliated program) and any parent training centers. This is another place to describe collaboration with unserved/underserved communities/groups/populations and discuss collaboration with self-advocates. Optional: Add boxes to report on other major collaborations.

Check one or more of the following boxes if the P&A houses any of these programs.

☐ Client Assistance Program

☐ Long Term Care Ombudsman

☐ Parent Training Center

Name of Collaboration

Description of collaboration

Role of P&A within the collaboration

Name of Collaboration

Description of collaboration

Role of P&A within the collaboration

Name of Collaboration

Description of collaboration

Role of P&A within the collaboration

Add boxes as needed

Part V: Governance and Compliance

A. Board, staff and advisory council race and ethnicity

Race/Ethnicity

Board

Employees

Advisory Council

1) Hispanic/Latino (of any race)

Race/Ethnicity (NOT Latino/Hispanic)
2) American Indian/ Alaskan Native
3) Asian
4) Black/African American
5) Native Hawaiian/ Other Pacific Islander
6) White
7) Two or more races
8) Race/Ethnicity Unknown
TOTAL

Describe advisory council if applicable

B. Consumer involvement in P&A governance

	Board	Advisory Council If Applicable
PADD Eligible Primary Consumers
PADD Eligible Secondary Consumers
Other Eligible Primary Consumers
Other Eligible Secondary Consumers
TOTAL Membership

Part VI: General Program Information

A. P&A Identification

Name of state, territory or jurisdiction
Name of P&A system

B. Main Office

Mailing Address & Phone Number of Main Office

C. Satellite Offices (If Any) (Add rows if needed)

Name, Mailing Address

D. CEO Contact Information

Name, phone number, and email address of P&A CEO

E. PPR Preparer Contact Information

Name, title, phone number, and email address of P&A Preparer

Part VII: Definitions

Absolute Unique Visitor (pertaining to websites, blogs, etc.)

The phrase “absolute unique visitor” is a term of art used in Google Analytics and similar applications. It represents the number of different people that visit a particular website or blog during a period of time specified by the user.

Abuse

The term “abuse” means any act or failure to act which was performed, or which was failed to be performed, knowingly, recklessly, or intentionally, and which caused, or may have caused, injury or death to an individual with developmental disabilities, and includes but is not limited to such acts as: verbal, nonverbal, mental and emotional harassment; rape or sexual assault; striking; the use of excessive force when placing such an individual in bodily restraints; the use of bodily or chemical restraints which is not in compliance with Federal and State laws and regulations, or any other practice which is likely to cause immediate physical or psychological harm or result in long term harm if such practices continue. In addition, the P&A may determine, in its discretion that a violation of an individual’s legal rights amounts to abuse, such as if an individual is subject to significant financial exploitation.

Administrative Hearing

An administrative hearing is a case level of intervention where an individual is represented by the P&A in requesting, preparing for, or participating in a formal proceeding to challenge a decision within an agency or facility, or between agencies, which does not involve adjudication by a court of law.

Administrative Remedy

An administrative remedy is where the P&A represents the client in any non-judicial complaint resolution process provided by government agencies, boards, commissions, or other designated adjudicators, exercising decision making authority delegated by statute. Administrative remedy processes are generally simpler, less formal, and less technical than the judicial process.

Advocacy Activities

The term “advocacy activities” means active support of policies and practices that promote systems change efforts and other activities that further advance self-determination and inclusion in all aspects of community living (including housing, education, employment, and other aspects) for individuals with developmental disabilities, and their families.

Alternative Dispute Resolution

Alternative Dispute Resolution (ADR) describes any process for settling a contested matter outside of the formal judicial process. ADR includes, but is not limited to negotiation, conciliation, mediation, and arbitration. ADR often includes the aid of a third, neutral party to guide the parties to a settlement.

Areas of Emphasis

The term “areas of emphasis” means the areas related to quality assurance activities, education activities and early intervention activities, child care-related activities, health-related activities, employment-related activities, housing-related activities, transportation-related activities, recreation-related activities, and other services available or offered to individuals in a community, including formal and informal community supports that affect their quality of life.

Case

A matter in which a significant service is provided that is intended to benefit one or more eligible individuals with developmental disabilities. A case file must be established and maintained by the P&A in each such matter. Each case must have a documented client goal.

Capacity Building Activities

The term “capacity building activities” means activities (e.g. training and technical assistance) that expand and/or improve the ability of individuals with developmental disabilities, families, supports, services and/or systems to promote, support and enhance self-determination, independence, productivity and inclusion in community life.

Client

For the purposes of the PPR (but not necessarily for determining a client-attorney relationship), a client is an individual or group of individuals who meets three criteria: 1) he/she is eligible for the PADD program; 2) a file/service record has been opened which includes at least the name, address, age, race, disability, signed release of information form (if appropriate), the concern or complaint and the goal of the action to be taken; and 3) he/she has been provided at least one significant service.

Client Objective

The result(s) a client(s) desires and the P&A has agreed to pursue as documented in a retainer agreement between the client(s) and the P&A.

Client Objective Met

The result(s) a client(s) desired and the P&A agreed to pursue as documented in a retainer agreement was achieved, at least in part.

Closed Case

The status of a case when the issue has been addressed through the provision of some level of service, the service is no longer needed, or the client is no longer available to address the issue(s) and the closed status is documented in the P&A case management system.

Collaboration

An activity or set of activities the P&A undertakes with a community partner(s) to pursue a shared advocacy goal. For purpose of this report it includes working with federally funded entities identified in the P&A mandates to assure coordination of the activities between the entities and to avoid inappropriate or wasteful duplication of services. These entities include a state’s or territory’s client assistance program, long term care ombudsman, developmental disabilities council, center(s) for excellence (university affiliated program) and mental health agency. Reporting on these collaborations is mandatory.

It also includes coalitions, task forces, councils, etc. in which a P&A participates for the purpose of advocating for systemic reform. These can be ongoing or time limited collaborations. Reporting on these collaborations is optional.

Community Residential Setting

A community residential setting optimizes autonomy, independence, and access to services and supports in the community in compliance with new Medicaid Home and Community Based Services regulations.

Complaint

The term “complaint” includes, but is not limited to, any report or communication, whether formal or informal, written or oral, received by the P&A system, including media accounts, newspaper articles, electronic communications, telephone calls (including anonymous calls) from any source alleging abuse or neglect of an individual with a developmental disability.

Culturally Competent

The term “culturally competent,” used with respect to services, supports, and other assistance means that services, supports, or other assistance that are conducted or provided in a manner that is responsive to the beliefs, interpersonal styles, attitudes, language, and behaviors of individuals who are receiving the services, supports or other assistance, and in a manner that has the greatest likelihood of ensuring their maximum participation in the program involved.

Direct Representation

Legally advocacy provided pursuant to a retainer agreement between a client and a P&A. The intervention types employed by the P&A in representing its client may include negotiation, administrative hearings and/or litigation.

Developmental Disability

The term “developmental disability” means a severe, chronic disability of an individual that:

(1) Is attributable to a mental or physical impairment or combination of mental and physical impairments;

(2) Is manifested before the individual attains age 22;

(3) Is likely to continue indefinitely;

(4) Results in substantial functional limitations in three or more of the following areas of major life activity:

(i) Self-care;

(ii) Receptive and expressive language;

(iii) Learning;

(iv) Mobility;

(vi) Self-direction;

(vii) Capacity for independent living; and

(viii) Economic self-sufficiency.

(5) Reflects the individual’s need for a combination and sequence of special, interdisciplinary or generic services, individualized supports, or other forms of assistance that are of lifelong or extended duration and are individually planned and coordinated.

(6) An individual from birth to age nine, inclusive, who has a substantial developmental

delay or specific congenital or acquired condition, may be considered to have a developmental disability without meeting three or more of the criteria described in paragraphs (1) through (5) of this definition, if the individual, without services and supports, has a high probability of meeting those criteria later in life.

Educating Policy Makers

An essential strategy used to achieve systems change. Policy Makers may include individuals in both the executive and legislative branches of government who make or interpret policies (legislation, regulations, rules or practices) that impact the lives of people with disabilities. Our advocacy efforts might be directed at the local, state, or federal level. Educating these individuals makes them aware of how their actions may impact people with disabilities. Information reported should only include work done in accordance with the limit on federal funding.

End Outcome

An end outcome is a quantitative performance measurement that expresses the ultimate benefit to the client.

Full Investigation (see also Investigation)

The term “full investigation” means access to service providers, individuals with developmental disabilities and records authorized under these regulations, that are necessary for a P&A system to make a determination about whether alleged or suspected instances of abuse and neglect are taking place or have taken place. Full investigations may be conducted independently or in cooperation with other agencies authorized to conduct similar investigations.

Goal Statement

A goal statement is a general but measurable declaration that describes a future state and gives the general direction, purpose or intent of what should be achieved. A goal statement explains the end result or specific desired outcome. A goal should include a description of the result and the entity/group for whom the result applies. Goals should ultimately be achievable.

Group Advocacy Services

Group advocacy services include work on behalf of groups of people with disabilities pursued through the interventions of systemic litigation, legislative and regulatory advocacy and systemic advocacy (non-litigious and non-legislative). It is concerted action to reform the policies or mode of operations of a system of services such as the disabilities service system or the policies and practices of private actors.

Group Number Impacted (And the “At Least” Method of calculating an estimate)

A specific unduplicated number of people impacted should be used with a “number impacted” performance measure when the number is known or a very close estimate is possible based on available data. For instance, you know all of the people on a particular ward of a hospital will benefit but the number of people on that ward varies slightly from day to day. Then a number close to the number usually present on that ward can be used.

If a close estimate is not possible based on available data but the range the number falls within can be determined and supported by available data, a number followed by a plus sign (+) from the following chart should be used in the “number impacted” performance measure. This method of estimation should also be used when a certain number of people could be impacted but it is not clear that they all will be impacted.

If the number is unknown and there is no available data to support the estimation, then a “number impacted” performance measure should not be used.

Estimate to Put in PPR	Range for what the estimate means
1+	1-9
10+	10-99
100+	100-999
1,000+	1,000-9,999
10,000+	> 10,000

Inclusion

The term ''inclusion'', used with respect to individuals with developmental disabilities, means the acceptance and encouragement of the presence and participation of individuals with developmental disabilities, by individuals without disabilities, in social, educational, work, and community activities, that enable individuals with developmental disabilities to have friendships and relationships with individuals and families of their own choice; live in homes close to community resources, with regular contact with individuals without disabilities in their communities; enjoy full access to and active participation in the same community activities and types of employment as individuals without disabilities; and take full advantage of their integration into the same community resources as individuals without disabilities, living, learning, working, and enjoying life in regular contact with individuals without disabilities.

Individual Advocacy Service

Legal work on behalf of a client using one or more of the following intervention types: Self-advocacy assistance, limited advocacy, administrative remedies, negotiation, mediation/alternative dispute resolution, and/or litigation.

Individualized Supports

The term “individualized supports” means supports that: enable an individual with a developmental disability to exercise self-determination, be independent, be productive, and be integrated and included in all facets of community life; designed to enable such individual to control such individual’s environment, permitting the most independent life possible; and prevent placement into a more restrictive living arrangement than is necessary and enable such individual to live, learn, work, and enjoy life in the community; and include early intervention services, respite care, personal assistance services, family support services, supported employment services support services for families headed by aging caregivers of individuals with developmental disabilities, and provision of rehabilitation technology and assistive technology, and assistive technology services.

Information and Referral Service

Information and referral includes responses to individuals at meetings, one-time telephone discussions, and follow-up mailings of letters, brochures and/or pamphlets per an individual’s request. I&R includes brief written or oral information, such as, generic information about the P&A, including information about additional programs and resources external to the P&A relating to the individual’s service needs and statutory or constitutional rights as a person with a disability. The agency generally would not have personal identifying information about the individuals who request and/or receive I&R services, except for possibly the name, address and telephone number.

Institutional Living Arrangement

In keeping with the Medicaid Home and Community Based Services regulations, any facilities that does not optimize autonomy, independence, and access to services and supports in the community.

Investigation

An investigation is a methodological and thorough examination of information, records, evidence and circumstances surrounding an allegation of abuse and neglect. Investigations require a significant allocation of time and resources including such activities as interviewing witnesses, record review, gathering evidence and generating a written report, which may or may not be made public. An investigation is distinct from advocacy. A P&A may choose to pursue an individual advocacy service for direct representation (except when a death has occurred) arising from an investigation, i.e. consistent with the terms of a retainer agreement, and distinct from the investigation itself.

Law (see also regulation and policy)

For the purpose of completing this report, “law” refers to the body of federal or state common law, statutory law, regulations, and policy prescribing action or directing forbearance, usually attaching a legal consequence for failure to adhere.

Statutory law is created by enactments of legislative bodies declaring, commanding, or prohibiting something. Common law is developed from judicial decisions based on custom and precedent, unwritten in statute or code.

Legal Guardian, Conservator, and Legal Representative

The terms “legal guardian,” “conservator,” and “legal representative” all mean a parent of a minor, unless the State has appointed another legal guardian under applicable State law, or an individual appointed and regularly reviewed by a State court or agency empowered under State law to appoint and review such officers, and having authority to make all decisions on behalf of individuals with developmental disabilities. It does not include persons acting only as a representative payee, persons acting only to handle financial payments, executors and administrators of estates, attorneys or other persons acting on behalf of an individual with developmental disabilities only in individual legal matters, or officials or their designees responsible for the provision of services, supports, and other assistance to an individual with developmental disabilities.

Limited Advocacy

Limited advocacy is a level of intervention that includes the provision of a discrete task to a client or a discrete contact on behalf of a client with a third party. Such activities upon completion require no further or ongoing actions, either formal or informal. Limited advocacy can include communications by letter, telephone or other means to a third party, preparation of a simple legal document, or assisting a client in the preparation of documents that are submitted by the client pro se to a third party.

Litigation

Litigation is any lawsuit or other resort to the courts to determine a legal question or matter. Litigation involves many complex legal issues which require not only a knowledge of the law that governs the dispute, but also, the laws governing the procedures to be followed in order to properly litigate a claim. There are rules governing who may file a claim, where it must be filed, when it must be filed, and how to file it.

Mediation

Mediation is an alternative dispute resolution process using the services of an independent third party to help settle differences or disputes between two or more individuals.

Monitoring

Monitoring includes activities in which a P&A evaluates compliance issues and quality of service by providers of services, supports and other assistance. Monitoring may involve using the a P&A’s access authority to visit and in other ways seek information from institutional or community settings including public and private facilities where people with disabilities live, work and go to school by a) conducting face-to-face interviews with individuals with disabilities in those settings; b) conducting at least one face-to-face interview with a staff member in those settings; 3) observing and evaluating the physical conditions of the setting; and 4) accessing and reviewing records, when appropriate, in accordance with applicable federal and state law.

Neglect

The term “neglect” means a negligent act or omission by an individual responsible for providing services, supports or other assistance which caused or may have caused injury or death to an individual with a developmental disability(ies) or which placed an individual with developmental disability(ies) at risk of injury or death, and includes acts or omissions such as failure to: establish or carry out an appropriate individual program plan or treatment plan (including a discharge plan); provide adequate nutrition, clothing, or health care to an individual with developmental disabilities; or provide a safe environment which also includes failure to maintain adequate numbers of trained staff or failure to take appropriate steps to prevent self-abuse, harassment, or assault by a peer.

Negotiation

Negotiation is a problem-solving process in which two or more people voluntarily discuss their differences with a third party in an attempt to reach a joint decision on their common concerns.

Number Impacted Performance Measure

A number impacted performance measure is one that asks for the number of people with disabilities in a group that was the target of a P&A’s advocacy.

Other Systemic Advocacy

Other systemic advocacy refers to concerted action by the P&A agency to promote and effectuate changes in the policies, rules and laws that impact groups of people with disabilities, and to remove the barriers that prevent or impede them from leading full, productive lives in the community that does fit elsewhere in the form. Systems advocacy typically addresses the establishment, support, improvement, or expansion of (1) programs that provide services or benefits to persons with disabilities, and (2) the legal rights, protections, and entitlements of persons with disabilities; and may involve opposition to efforts to weaken, reduce or eliminate existing services or rights.

Outcome

An outcome is a quantifiable performance measure expressed in terms of any result achieved for a client or group of clients.

Output

An output is a performance measure that describes something quantifiable and concrete that is not descriptive of an end result desired by a client or group of clients but rather an incremental or interim step along the way. It can also be used to capture P&A engagement in an ongoing intervention.

Outreach

Outreach is an activity that provides targeted information to specific populations regarding the activities of the P&A or one of its programs.

Performance Measure Menu

Each advocacy intervention type has an associated list of outcome and output performance measures. It is not expected that a P&A would use every performance measure on every menu.

Policy (see regulation and law)

For the purposes of completing this report, a policy is a basic principle and associated guideline, formulated in writing and enforced by the governing body of an entity, to direct and limit its actions.

Priority

For purposes of this report, a priority is a subset of and related to a larger goal statement which the P&A plans to work on during the reporting period. Priorities are allocated resources so that a measurable result can be documented. Priorities as established through the SGP serve as the basis for the P&A to determine which cases are selected in a given fiscal year. P&As have the authority to turn down a request for assistance when it is outside the scope of the SGP, but they must inform individuals when this is the basis for turning them down.

Probable Cause

The term “probable cause” means a reasonable ground for belief that an individual with developmental disability(ies) has been, or may be, subject to abuse or neglect, or that the health or safety of the individual is in serious and immediate jeopardy. The individual making such determination may base the decision on reasonable inferences drawn from his or her experience or training regarding similar incidents, conditions or problems that are usually associated with abuse or neglect.

Provision

For the purpose of completing this report, a provision is a clause in statute, regulation or policy that explains a specific condition, effect, implication, qualification, or requirement that would result in benefit or detriment to people with disabilities.

Qualitative Results

The result of advocacy efforts expressed primarily through a narrative describing what was accomplished and includes the specifics of the outcomes and outputs reported in the quantitative results.

Quantitative Results

The result of advocacy efforts expressed using outcome or output performance measures.

Regulation (see policy, and law)

For the purpose of completing this report, a “regulation “ is a rule or order, usually promulgated by federal or state administrative agencies or governmental departments, designed to implement, interpret, or prescribe the procedures or practice requirements of an agency to carry out the intent of statutory enactments of the legislature.

Results Narrative

A qualitative results narrative describes the specifics of what the P&A achieved in response to a direct representation service request or in a group advocacy project in a way that illustrates and humanizes the associated quantitative performance measures. The narrative includes:

Headline capturing the gist of what follows (optional but helpful to the AIDD reviewer)
Priority addressed if applicable
The results narratives document (provide story of) how the advocacy elements worked together to achieve outcomes for our clients in a more efficient and coherent way than in the current program performance reports. The story/results narrative:
- Describe the problem presented, what the P&A did and what was accomplished
- Give specifics to general terms in performance measures
- Description of how targeted toward unserved/underserved minority population, if applicable
- Next steps, if applicable
- Mention collaborators and partners, if applicable, including a cross reference to where a collaboration is described elsewhere in the report (Collaborations Section)
Completed quantitative performance measures accomplished

Self-Advocacy Assistance

Self-advocacy assistance, formerly referred to as Short Term Assistance, is a level of intervention that can include advice and counseling, brief research, or letter writing to the client to summarize assistance given. Advice and counseling assistance includes informing a client of their rights; coaching the client in self advocacy; reviewing information; counseling a client on actions one may take; or assisting the client in preparing letters or documents and/or the dissemination of information and materials related to the disability rights issue raised by the client. It includes providing information sheets and other materials.

Self-determination Activities

The term “self-determination activities” means activities that result in individuals with developmental disabilities, with appropriate assistance, having the ability and opportunity to communicate and make personal decisions; the ability and opportunity to communicate choices and exercise control over the type and intensity of services, supports, and other assistance the individuals receive; the authority to control resources to obtain needed services, supports, and other assistance; opportunities to participate in, and contribute to, their communities; and support, including financial support, to advocate for themselves and others to develop leadership skills through training in self-advocacy to participate in coalitions, to educate policymakers, and to play a role in the development of public policies that affect individuals with developmental disabilities.

Significant Service

Includes self-advocacy assistance, limited advocacy, negotiation, administrative hearings/alternative dispute resolution, or litigation on behalf of P&A client.

Substantive Work

Work performed by a P&A that can reasonably be interpreted as having contributed to a result measurable using one or more of the End Outcomes performance measures listed in Part III.A.

Standardized Performance Measure

A standardized performance measure is one that is to be used when doing like activity and reporting like results. For the purpose of this report it refers to both the outcome and output performance measures included in the result sections.

Systemic change activities

The term “systemic change activities” means a sustainable, transferable and replicable change in some aspect of service or support availability, design or delivery that promotes positive or meaningful outcomes for individuals with developmental disabilities and their families.

Systemic Litigation

Systemic litigation is a concerted action to reform the policies or mode of operations of a system of services. It attempts to address a systemic issue raised by many individuals, through class action litigation, multi-plaintiff litigation, or in some cases individual litigation when the relief sought has the potential of affecting many people with disabilities.

Technical Assistance

Technical assistance is provided to family members, non-legal guardians, professionals or other advocates in consultation regarding an area of the law in which the P&A has expertise. It is considered a non-client directed activity.

Tier 1 Review Tool

The Tier I Review Tool is used by AIDD in the compliance and outcome review process of the SGP and PPR and will be used, in part, to determine whether a P&A needs a higher level of review (Tier II). It is used annually by AIDD staff to conduct high level program compliance and outcome reviews of the P&A PPR and SGP. The compliance review verifies through review of the PPRs and SGPs that the P&A is compliant with DD Act requirements. The outcome review uses narrative information and measures (data) to evaluate performance based on data analysis. The outcome review focuses on data and narrative results of outcomes/results achieved. The outcome and output data is reviewed for each P&A program and across all P&A programs to understand results.

Training

Training is an activity that builds skills and knowledge of target populations. Training may be provided to individuals with disabilities and others.

Unserved and Underserved

The term “unserved and underserved” includes populations such as individuals from racial and ethnic minority backgrounds, disadvantaged individuals, individuals with limited English proficiency, individuals from underserved geographic areas (rural or urban), and specific groups of individuals within the population of individuals with developmental disabilities, including individuals who require assistive technology in order to participate in community life.

1 We propose that the P&A submit periodically a thorough description of the methods used for the priority setting process, and then annually indicate whether they have changed the methods used for the priority setting process. If it has changed, they would need to include a full description of the changes.

2 Only those measures and subsections with data will be displayed when the report is submitted.

3 Individual advocacy includes self-advocacy assistance, limited advocacy, administrative remedies, negotiation, mediation/alternative dispute resolution and litigation.

4 End Outcome 10 is separated because it does not count people and therefore cannot be included in the total.

5 As developed in the P&A Standards, it is understood that all client representation is provided consistent with applicable rules of professional conduct including rules regarding ethics and requirements for continuing education.

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	markstroh
File Modified	0000-00-00
File Created	2021-01-23

Form 1 PADDSGP PPR

Developmental Disabilities Protection and Advocacy Program Performance Report

PADD-PPR-proposed

Developmental Disabilities Protection and Advocacy Statement of Goals and Priorities Program Performance Report

OMB: 0985-0027

Table of Contents

Part I: Demographics

Interventions on behalf of Individuals

The following subsections include demographic information for the seven intervention strategy types listed in Part I.F.

A. Individuals Served

B. Problem Areas/Complaints of Individuals Served

C. Gender of Individuals Served

D. Living Arrangements of Individuals Served

E. Reasons for Closing Individual Intervention Files

F. Intervention Strategies Used in Serving Individuals

G. Age Range of Individuals Served

H. Primary Disability of Individuals Served

Race and Ethnicity

I. Racial and Ethnic Diversity of Individuals Served

Intervention Benefitting Groups

J. Groups Served

K. Problem Areas/Complaints of Groups Served

L. Living Arrangements Targeted by Groups Interventions

M. Reasons for Closing Group Cases/Projects

N. Intervention Strategies Used in Group Cases/Projects

O. Age Ranges Targeted by Interventions for Groups

P. Race/Ethnicity of Groups Served

Part II: Statement of Goals and Priorities

A. Report on FY 2014 Statement of Goals and Priorities (SGP)

Describe any other significant activity related to this goal

Describe any other significant activity related to this goal

Describe any other significant activity related to this goal

B. Priority Setting Process1

C. FY _ _ _ _ Statement of Goals and Priorities (SGP)

D. Description of P&A Operations

Part III: Results of P&A Activity2

A. End Outcomes of P&A Activity

B. Overview of How Many People with Disabilities Served

C. Rights-Based Individual Advocacy Services

D. Investigations of Abuse and Neglect

E. Monitoring

Facilities/Programs Monitored

Describe P&A’s overall approach and strategy for monitoring activities

F. Systemic Litigation

G. Educating Policymakers6

H. Other Systemic Advocacy

I. Information, Technical Assistance and Referrals

J. Training

K. Public Relations and Outreach

Describe any innovative or significant P&A activity related to public relations and/or outreach (to include unserved and underserved populations/communities, and outreach to self-advocates)

Part IV: Collaborations

Part V: Governance and Compliance

A. Board, staff and advisory council race and ethnicity

B. Consumer involvement in P&A governance

Part VI: General Program Information

A. P&A Identification

B. Main Office

C. Satellite Offices (If Any) (Add rows if needed)

D. CEO Contact Information

E. PPR Preparer Contact Information

Part VII: Definitions

B. Priority Setting Process¹

Part III: Results of P&A Activity²

G. Educating Policymakers⁶