ADD

A National Independent Study Of The State/Territorial Developmental=20 Disabilities Programs

OMB Control # 0584-NEW
Expiration = Date:=20 xx/xx/20xx

Public=20 reporting burden for this collection of information is estimated to = average 60=20 minutes per response, including the time for reviewing instructions, = searching=20 existing data sources, gathering and maintaining the data needed, and = completing=20 and reviewing the collection of information. Completion of this = questionnaire is=20 voluntary. An agency may not conduct or sponsor, and a person is not = required to=20 respond to, a collection of information unless it displays a currently = valid OMB=20 control number. Send comments regarding this burden estimate or any = other aspect=20 of this collection of information, including suggestions for reducing = this=20 burden, to: Administration on Developmental Disabilities, Administration = for=20 Children and Families, US Department of Health and Human Services, 370 = L=E2=80=99Enfant=20 Promenade, S.W., MAIL STOP: Humphrey Building, 405D, Washington, D.C. = 20447=20 ATTN: PRA (0584-xxxx*). Do not return the completed form to this = address.

As an Executive Director of a state or territorial Developmental = Disabilities=20 (DD) program, you are an important source of information and advice for = the=20 Administration on Developmental Disabilities (ADD). We are asking for = your=20 opinions on ADD's roles, ADD activities, and interaction between your = program=20 and ADD. Questions on the Projects of National Significance are not = included.=20

Please remember that completion of this questionnaire is voluntary = and all=20 your responses will remain confidential to the extent provided by law.=20

Definitions:
State level=20

State/territorial program: a single DD Council, or P&A, or UCEDD program.=20
State/territorial network: the DD Council, P&A, and UCEDD(s) collectively = in a=20 single state/territory.

National Level*=20

National DD Program: there are 3 National DD programs: 1) = all DD=20 Councils, 2) all P&A=E2=80=99s, and 3) all UCEDDs,=20
National DD Network: all programs in all states and = territories=20 collectively.

* The Projects of National Significance and the national associations = (NDRN,=20 NACDD, AUCD) are NOT included in these definitions.

Please be sure to answer all questions.

A. Section A: = ADD=E2=80=99s Roles=20

This first set of questions deals with ADD roles. Please tell us = (a)=20 whether each item below has been one of ADD=E2=80=99s roles in the past = 3 years and (b)=20 how important you think that role is now and into the future. =

Role	(a) Has this been ADD=E2=80=99s role in the past 3 = years?	(b) How important do you think this role = is?
1.	Ensure state/territorial = programs=E2=80=99 compliance=20 with the DD Act.
2.	Impose enforcement measures when a=20 state/territorial program is out of compliance with the DD = Act.
3.	Assess the impact of the National DD = Network on=20 people with developmental disabilities and their families.

Role	(a) Has this been ADD=E2=80=99s role in the past 3 = years?	(b) How important do you think this role = is?
4.	Assess the impact of each = state/territorial=20 program on the state/territory in which the program is = located.
5.	Assess the collective impact of the=20 state/territorial network on the state/territory in which the = network is=20 located.
6.	Articulate a vision for implementing = the=20 principles in the DD Act.

Role	(a) Has this been ADD=E2=80=99s role in the past 3 = years?	(b) How important do you think this role = is?
7.	Set performance goals for the three = National DD=20 programs.
8.	Assess the performance of each=20 state/territorial program.
9.	Assess the performance of each of the = National=20 DD Programs.
10.	Advocate for the National DD = Network.

Role	(a) Has this been ADD=E2=80=99s role in the past 3 = years?	(b) How important do you think this role = is?
11.	Participate with federal partners in = national=20 policy making on behalf of people with developmental disabilities = and=20 their families.
12.	Assist and/or intervene on behalf of = a=20 state/territorial program when needed.
13.	Represent the interests of = state/territorial=20 programs at national forums (e.g., federal task forces, = interagency work=20 groups, national meetings).
14.	Enter into collegial relationships = with a=20 state/territorial program to work toward state, regional, and = national=20 improvements to services for people with developmental = disabilities.

Role	(a) Has this been ADD=E2=80=99s role in the past 3 = years?	(b) How important do you think this role = is?
15a.	Conduct on-site technical assistance = visits.
15b.	Provide training on reporting = requirements.
15c.	Identify best practices.
15d.	Monitor contracts with technical = assistance=20 providers.

Role	(a) Has this been ADD=E2=80=99s role in the past 3 = years?	(b) How important do you think this role = is?
15e.	Generate opportunities for knowledge = sharing=20 among state/territorial programs.
15f.	Fund the national organizations = (NACDD, NDRN,=20 AUCD) to provide technical assistance to state/territorial = programs.

	Role	(a) Has this been ADD=E2=80=99s role in the past 3 = years?	(b) How important do you think this role = is?
15g.	Other, please specify in the = textbox
15h.	Other, please specify in the = textbox

16.	Please provide any additional comments you have on = ADD=E2=80=99s=20 role in the box below.

B. Section B: ADD=20 Activities

You have given your opinion on ADD=E2=80=99s = roles. Now we would=20 like you to consider ADD activities related to some of those roles. = Please tell=20 us:

(a) What is your impression of how important ADD = considers=20 each activity?

(b) How important do you consider each = activity?=20

Activities	(a) Importance to ADD (your impression)	(b) Importance to You
17.	Establishes and implements reporting = processes=20 to monitor compliance with the DD Act.
18.	Develops goals and expected outcomes = for each=20 National DD Program.
19.	Assesses state/territorial program=20 performance.
20.	Assesses performance of each National = DD=20 program.

B. Section B: = ADD=20 Activities

You have given your opinion on ADD=E2=80=99s = roles. Now we would=20 like you to consider ADD activities related to some of those roles. = Please tell=20 us:

(a) What is your impression of how important ADD = considers=20 each activity?

(b) How important do you consider each = activity?=20

Activities	(a) Importance to ADD (your impression)	(b) Importance to You
21.	Develops technical assistance plans = to improve=20 compliance with the DD Act.
22.	Develops technical assistance plans = to improve=20 state/territorial program performance on achieving goals.
23.	Learns about the details of your = program
24.	Organizes regional and national = meetings to=20 share knowledge and experience on specific issues (e.g., best=20 practices).

25.	Please provide any additional comments you have on = ADD=20 activities in the box below.

C. Section C: = Interaction=20 Between ADD and State/Territorial Programs

Please consider = the=20 interactions of the ADD with YOUR program. For each type of = interaction,=20 please tell us:

(a) Whether each interaction = has=20 occurred between YOUR program and ADD at least once in the past 3 = years=20 (yes or no);

(b) How valuable this interaction = is (or=20 would be) to your program;

If you have comments, please provide = them in=20 the comment box (c).

Type of interaction	(a) Has occurred in past three years	(b) How valuable is or would this interaction be to = your=20 program =E2=80=A6
26.	ADD provided feedback on your = program=E2=80=99s annual=20 report.
27.	ADD provided technical assistance = directly to=20 your program.
28.	At least 1 of your staff, per year,=20 participated in a technical assistance activity provided or = supported by=20 ADD.

Type of interaction	(a) Has occurred in past three years	(b) How valuable is or would this interaction be to = your=20 program =E2=80=A6
29.	At least 1 person per year from your = DD=20 Council, Board, or Consumer Advisory Committee participated in a = technical=20 assistance meeting provided or supported by ADD.
30.	ADD participated in an MTARS visit to = your=20 program. (For this item only, consider the last 10 years.)
31.	Your program contacted ADD for advice = or=20 information on a technical issue.

Type of interaction	(a) Has occurred in past three years	(b) How valuable is or would this interaction be to = your=20 program =E2=80=A6
32.	ADD sent at least one email bulletin = on a=20 national issue to your program.
33.	ADD provided feedback on the = performance of=20 your program.
34.	ADD solicited and obtained input from = your=20 program on a developmental disabilities issue.

35.	Please provide any additional comments you have on = your=20 program=E2=80=99s interaction with ADD in the box = below.

D. Additional comments

36.	What else would you like to see ADD do, or do=20 more?

37.	What would you like to see ADD do less, or not at=20 all?

38.	Which DD Network program do you=20 represent?

	State Developmental Disabilities=20 Council
	Protection and Advocacy = System
	National Network of University Centers = for=20 Excellence in Developmental Disabilities Education, = Research, and=20 Service (UCEDD)

39.	Was your program part of the sample of 19 states = and 1=20 territory for the National Independent Study of the State = Developmental=20 Disabilities Programs (formerly known as the Developmental = Disabilities=20 Program Independent Evaluation or = DDPIE)?

	Yes
	No