Form 1 PADD PPR

Developmental Disabilities Protection and Advocacy Program Performance Report

PAPPR08-C-Inst-v1.rtf

Developmental Disabilities Protection and Advocacy Program Performance Report

OMB: 0980-0160

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Protection and Advocacy for Developmental Disabilities (PADD)

Annual Program Performance Report (PPR)




Section I. Identification



Reporting Period: October l, ____ Through Se ptember 30, ____


State:




P&A Agency Name:






Name and Phone Number of Contact Person (regarding questions):















Section II. Individual Clients Served


This section is for reporting of persons with developmental disabilities who received individual advocacy addressing at least one disability-related problem. Do not report the same individual more than once even if they received multiple services, and do not include individuals who were only represented as part of a group or class action.


A. Number of Individual Clients (Persons with Developmental Disabilities Receiving Individual Advocacy)


1. Number of clients receiving advocacy at start of fiscal year: _____


2. Number of new/renewed clients represented during fiscal year: _____

Total _____


B. Number of Case Problems* of Individual Clients _____


*This number may be more than the total number of clients served since each client may have more than one presenting problem to be addressed.


C. Age of Individual Clients


0-2 _____

3-4 _____

5-22 _____

23-59 _____

60 and over _____

Total _____


D. Sex of Individual Clients


Male _____

Female _____

Total _____


E. Racial/ Ethnic Background of Individual Clients

Data is self-reported. Select only one category for each client.


Asian _____

Black, not of Hispanic/Latino origin _____

Hispanic/Latino _____

North American Indian or Alaskan Native _____

Pacific Islander _____

White, not of Hispanic/Latino origin _____

Multi cultural (identified with more than one of above) _____

Other than above _____

Information Not Provided _____

Total Clients _____




F. Individual Clients' Geographic Location


Number of clients living out of state _____

List states include number of clients living in each state:


Data by County (see instructions; use additional space as needed). Please provide the following:


Number of

County Name Total Population Is County Mostly Rural Individual Clients

(fewer than 100 persons

per square mile on average)



Total number of clients living in and out of state _____



G. Clients' Living Arrangements


Independent _____

Parental or other Family Home _____

Community Residential Home (e.g.,supervised apartment, _____

Semi-independent, halfway house, board & care, small group home 3 or less)

Foster Care _____

*Nursing Home(includes ICF, SNF, etc.) _____

*Public (State Operated) Institutional Living Arrangement

(e.g., hospital treatment center/school or large ICF/MR group home more than 3 beds) _____

*Private Institutional Living Arrangement _____

(e.g.., hospital or treatment center, school or large group home more than 3 beds)

*Legal Detention/Jail/Prison/Detention Center _____

Homeless _____

*Federal Facility (List) _____

Other _____

Total Client Cases by Living Arrangement _____


(*Is considered an institution for the purposes of completing Section III A-1)




H. Individual Clients' Disability

Identify the client’s primary disability. This is the disability which directly impacts or allows the individual to be considered developmental disabled and results in the need for advocacy.


Autism _____

Cerebral Palsy _____

AIDS/HIV _____

Epilepsy _____

Mental Illness _____

Mental Retardation _____

Muscular Dystrophy _____

Spina Bifida _____

Learning Disabilities _____

Traumatic Brain Injuries (TBI) and other head injuries _____

Tourette Syndrome _____

Visual Impairment/ Blind _____

Hard of Hearing/Deaf _____

Other Physical/Orthopedic* _____

Other Emotional/Behavioral* _____

Other Intellectual* _____



Total Disabilities _____


Breakout of Other Disability*





Section III. Case Problem Areas (Complaints) of Individual Clients Served

This is the total number of problems addressed by the PADD program and collected at case closure. This will allow the PADD program to better determine the outcome of its work. This can be more than the number of problems presented upon intake that is the total number reported in Section II B.




A. The outcome of problems addressed for Individual Clients


1. Number of persons with developmental disabilities living in institutions* served by the P&A whose complaint of abuse, neglect, discrimination of their rights was remedied by the P&A. ____


(*See living arrangements to determine definition of institution)






(GPRA Outcome)

2. Number of persons with developmental disabilities living in the community who were served by the P&A and whose complaint of abuse, neglect, discrimination of their rights was remedied by the P&A during the course of the plan year


________



This GPRA Outcome will be included in a national total reported to Congress, in compliance with the Government Performance and Results Act of 1993 (GPRA). This Outcome will be compared with the Target/Objective in the SGP previously submitted in the Plan Year.






  1. Types of problems addressed by areas of emphasis


1. Quality Assurance including abuse, neglect & other violations of rights ____

2. Education and early intervention ____

3. Child care ____

4. Health care ____

5. Employment ____

6. Housing ____

7. Transportation ____

8. Recreation ____

Total Case Problem Areas of Individual Clients Addressed upon closure ____


C. Reasons for Closing Individual's Case Files:


1.Issues resolved partially or completely in the individual's favor _____

2.Other representation found _____

3.Individual withdrew complaint _____

4.Appeals were unsuccessful _____

5.PADD services not needed due to individual's death, relocation, etc. _____

6.PADD withdrew because individual would not cooperate _____

7.PADD unable to take case because of lack of resources _____

8.Individual's case lacks legal merit _____

9.Other _____


D. Intervention Strategies Used in Serving Individuals:

(List the highest level of Intervention used by PADD prior to closing each case file.)


1. Technical assistance in self-advocacy _____

2. Short-term assistance _____

3. Investigation/monitoring _____

4. Negotiation _____

5. Mediation/alternative dispute resolution _____

6. Administrative hearings _____

7. Litigation _____




E. Satisfaction of Individuals Served:


1. Number of satisfaction surveys distributed _____

2. Number of satisfaction surveys returned during the year _____

(may not be the same number sent out)

3. Of the total number of surveys returned, indicate how many individuals rated their overall satisfaction with PADD in the following ways:

a .satisfied _____

b. not satisfied _____


4. Number of client grievances filed under the client grievance procedure _____




Section IV. Interventions on Behalf of Groups of Clients


A. Summary Information


Type of Intervention Number of Potential # Concluded Concluded Pending

Groups Individuals Successfully Unsuccessfully

Impacted


Group Advocacy


Investigations


Monitoring


Court-Ordered

Monitoring


Systemic or Class-

Action Litigation


Total




  1. Systems Change & Capacity Building (of service delivery system for persons with developmental disabilities) Activities


In general, for all systems change and/or capacity building (of service delivery system for persons with developmental disabilities) activities, respond to the following:


1) What are the major areas of systems change and/or capacity building activities?

2) Which groups are likely to be affected?

3) What have been the major outcomes during the fiscal year?







Section V. Non_Case Directed Services


A. Information and Referral Services (See glossary for definition)


(Individual Non_Case I&R) Total I&R _____


B. Public Education and Training Activities (see glossary for definition)


Number of persons with disabilities (or their family members) who received education or training about their rights, enabling them to be more effective self advocates. _____


C. Information Dissemination Activities Number of Items


1. radio/TV appearances _____

2. newspaper articles (attach select articles) _____

3. PSAs/videos/films/etc. aired _____

4. reports disseminated _____

5. publications disseminated _____

6. Information about P&A disseminated _____

(include general training /outreach or presentations not included in training activities)

7. Number of hits on Website _____

8. Describe other media activities: _____


D. Consumer Involvement in P&A Organization

Please provide the following information on the number of individuals who self identify.


Primary Secondary Other Out of

Number of consumers (DD) Consumers Consumers Disabilities Total

  • on governing board


  • on advisory board




E. Racial/Ethnic Involvement in P&A Organization

Number of persons in a minority group in the P&A system:


African Hispanic Asian Native Out of

American American American American Other Total


  • staff

  • governing-

board

  • advisory councils





Does the PADD program utilize volunteers? If so how?




Section VI. Outcomes of Priorities and Objectives

List reporting year priorities from the Statement of Objectives and Priorities in order by priority.


Copy this page for each priority in the SGP, and provide the following information:


1. Identify and describe the priority. Priority # P/ ___ / (provide # from the SGP)





2. Identify the need, issue or barrier addressed by this priority.



3. Identify and describe indicators PADD used to determine successful outcome of activities pursued under this priority.


Indicator # (___) (from the SOP) Indicator is: / /Met / /Partially Met/Continuing / /Not Met

If "Not Met" was checked, explain:



4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration.




5. If this was this addressed through individual advocacy, provide the number of cases handled under the priority.




6. If this priority addresses systemic advocacy or capacity building of the service delivery system for persons with developmental disabilities, please describe how including indicating if any were class actions.





  1. Was this priority targeted to under/unserved and minority populations? If so please describe whether or not services to the targeted population resulted in an increase in clients served.




8. Provide at least one case summary that demonstrates the impact of the priority.





  1. Rounding off to the nearest hundred dollars how much of this year’s grant or award or its program income was spent on this priority?




10. Will this priority be continued in the next fiscal year?




Section VII. Developmental Disabilities Network Collaboration





A. Provide information related to only those issues/barriers affecting individuals with developmental disabilities and their families in your State that the DDC, P&A, and UAP(s) (the DD network) have jointly identified as critical State issues/barriers.


Using short titles, list 5-10 areas that the DDC, P&A, and UAP(s) have identified as critical State issues/barriers. Then, by checking the circle(s) to the left of the short title(s), identify any issues/barriers selected by your State DD Network for joint collaboration.


  1. O

  2. O

  3. O

  4. O

  5. O

  6. O

  7. O

  8. O

  9. O

  10. O






B. Provide the following information for at least one of the issues/barriers selected for DD Network collaboration. Repeat this section for reporting each issue/barrier selected for DD Network collaboration.


1. Issue/Barrier # (from above):


2. Provide a brief description of the collaborative issue/barrier and expected outcome(s).


3. Reference applicable SGP Goals(s):


4. Describe the P&A's specific roles and responsibilities in this collaborative effort.


5. Briefly identify problems, if any, encountered as a result of this collaboration.


6. Describe unexpected benefits, if any, of this collaborative effort.


7. If your P&A can provide technical assistance expertise in this area to other States, please describe.


8. If any, describe the technical assistance needs the P&A/DD Network have in this area.




Section VIII. Coordination


Check if the following programs are housed in the same organization as the P&A program:



/ / Client Assistance Program (CAP)


/ / Long Term Care Ombudsman (Older Americans Act)


/ / Other: Please list:






If the Client Assistance Program (CAP) and the Long Term Care Ombudsman (Older Americans Act) are not part of the P&A System (PADD, PAIMI, PAIR and PAAT programs) describe coordination between the PADD program and the CAP and the Long Term Care Ombudsman (Older Americans Act.)




Describe your system's relations with agencies other than above and any inter-agency agreements or joint projects you may have, other than mentioned above.




Section IX. Services Provided Using Non-Part C Funding

Are services and activities benefiting persons with developmental disabilities and their families supported by funding other than that provided by Part C of the DD Act or its program income.


Yes / / No / /



Please describe the projects funded with non-part C funding or its program income.

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