Subject: ADD
From: <Saved by Windows Internet Explorer 7>
Date: Wed, 8 Jun 2011 12:22:37 -0400

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

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

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

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

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

Definitions:
State level

State/territorial program: a single DD Council, or P&A, or UCEDD program.

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

National Level*

National DD Program: there are 3 National DD programs: 1) all DD
Councils, 2) all P&A’s, and 3) all UCEDDs,

National DD Network: all programs in all states and territories
collectively.

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

Please be sure to answer all questions.

A.      Section A: ADD’s Roles

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

Role

(a) Has this been ADD’s role in the past 3 years?

(b) How important do you think this role is?

1.

Ensure state/territorial programs’ compliance
with the DD Act.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

2.

Impose enforcement measures when a
state/territorial program is out of compliance with the DD Act.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

3.

Assess the impact of the National DD Network on
people with developmental disabilities and their families.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

A.      Section A: ADD’s Roles

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

Role

(a) Has this been ADD’s role in the past 3 years?

(b) How important do you think this role is?

4.

Assess the impact of each state/territorial
program on the state/territory in which the program is located.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

5.

Assess the collective impact of the
state/territorial network on the state/territory in which the network is
located.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

6.

Articulate a vision for implementing the
principles in the DD Act.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

A.      Section A: ADD’s Roles

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

Role

(a) Has this been ADD’s role in the past 3 years?

(b) How important do you think this role is?

7.

Set performance goals for the three National DD
programs.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

8.

Assess the performance of each
state/territorial program.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

9.

Assess the performance of each of the National
DD Programs.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

10.

Advocate for the National DD Network.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

A.      Section A: ADD’s Roles

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

Role

(a) Has this been ADD’s role in the past 3 years?

(b) How important do you think this role is?

11.

Participate with federal partners in national
policy making on behalf of people with developmental disabilities and
their families.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

12.

Assist and/or intervene on behalf of a
state/territorial program when needed.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

13.

Represent the interests of state/territorial
programs at national forums (e.g., federal task forces, interagency work
groups, national meetings).

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

14.

Enter into collegial relationships with a
state/territorial program to work toward state, regional, and national
improvements to services for people with developmental disabilities.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

A.      Section A: ADD’s Roles

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

15.
Provide or support technical assistance to a state/territorial program. For
example:

Role

(a) Has this been ADD’s role in the past 3 years?

(b) How important do you think this role is?

15a.

Conduct on-site technical assistance visits.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

15b.

Provide training on reporting requirements.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

15c.

Identify best practices.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

15d.

Monitor contracts with technical assistance
providers.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

A.      Section A: ADD’s Roles

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

Role

(a) Has this been ADD’s role in the past 3 years?

(b) How important do you think this role is?

15e.

Generate opportunities for knowledge sharing
among state/territorial programs.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

15f.

Fund the national organizations (NACDD, NDRN,
AUCD) to provide technical assistance to state/territorial programs.

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

A.      Section A: ADD’s Roles

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

Role

(a) Has this been ADD’s role in the past 3 years?

(b) How important do you think this role is?

15g.

Other, please specify in the textbox

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

15h.

Other, please specify in the textbox

Yes No Don’t
Know

Extremely important Important
Somewhat important Not
important

16.

Please provide any additional comments you have on ADD’s
role in the box below.

B.      Section B: ADD
Activities

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

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

(b) How important do you consider each activity?

Activities

(a) Importance to ADD (your impression)

(b) Importance to You

17.

Establishes and implements reporting processes
to monitor compliance with the DD Act.

Extremely important Important
Somewhat important Not
important

Extremely important Important
Somewhat important Not
important

18.

Develops goals and expected outcomes for each
National DD Program.

Extremely important Important
Somewhat important Not
important

Extremely important Important
Somewhat important Not
important

19.

Assesses state/territorial program
performance.

Extremely important Important
Somewhat important Not
important

Extremely important Important
Somewhat important Not
important

20.

Assesses performance of each National DD
program.

Extremely important Important
Somewhat important Not
important

Extremely important Important
Somewhat important Not
important

B.      Section B: ADD
Activities

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

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

(b) How important do you consider each activity?

Activities

(a) Importance to ADD (your impression)

(b) Importance to You

21.

Develops technical assistance plans to improve
compliance with the DD Act.

Extremely important Important
Somewhat important Not
important

Extremely important Important
Somewhat important Not
important

22.

Develops technical assistance plans to improve
state/territorial program performance on achieving goals.

Extremely important Important
Somewhat important Not
important

Extremely important Important
Somewhat important Not
important

23.

Learns about the details of your program

Extremely important Important
Somewhat important Not
important

Extremely important Important
Somewhat important Not
important

24.

Organizes regional and national meetings to
share knowledge and experience on specific issues (e.g., best
practices).

Extremely important Important
Somewhat important Not
important

Extremely important Important
Somewhat important Not
important

25.

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

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

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

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

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

If you have comments, please provide them in
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
program …

26.

ADD provided feedback on your program’s annual
report.

Yes No

Extremely valuable Valuable
Somewhat valuable Not
valuable

27.

ADD provided technical assistance directly to
your program.

Yes No

Extremely valuable Valuable
Somewhat valuable Not
valuable

28.

At least 1 of your staff, per year,
participated in a technical assistance activity provided or supported by
ADD.

Yes No

Extremely valuable Valuable
Somewhat valuable Not
valuable

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

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

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

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

If you have comments, please provide them in
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
program …

29.

At least 1 person per year from your DD
Council, Board, or Consumer Advisory Committee participated in a technical
assistance meeting provided or supported by ADD.

Yes No

Extremely valuable Valuable
Somewhat valuable Not
valuable

30.

ADD participated in an MTARS visit to your
program. (For this item only, consider the last 10 years.)

Yes No

Extremely valuable Valuable
Somewhat valuable Not
valuable

31.

Your program contacted ADD for advice or
information on a technical issue.

Yes No

Extremely valuable Valuable
Somewhat valuable Not
valuable

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

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

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

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

If you have comments, please provide them in
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
program …

32.

ADD sent at least one email bulletin on a
national issue to your program.

Yes No

Extremely valuable Valuable
Somewhat valuable Not
valuable

33.

ADD provided feedback on the performance of
your program.

Yes No

Extremely valuable Valuable
Somewhat valuable Not
valuable

34.

ADD solicited and obtained input from your
program on a developmental disabilities issue.

Yes No

Extremely valuable Valuable
Somewhat valuable Not
valuable

35.

Please provide any additional comments you have on your
program’s interaction with ADD in the box below.

D.      Additional comments

36.

What else would you like to see ADD do, or do
more?

37.

What would you like to see ADD do less, or not at
all?

38.

Which DD Network program do you
represent?

State Developmental Disabilities
Council

Protection and Advocacy System

National Network of University Centers for
Excellence in Developmental Disabilities Education, Research, and
Service (UCEDD)

39.

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

Yes

No