Student and Program Evaluation Tools

THINK COLLEGE COORDINATING CENTER

Transition and Postsecondary Programs for Students with Intellectual Disabilities (TPSID) TPSID Evaluation System

PROGRAM EVALUATION TOOL

Public Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. Public reporting burden for this collection of information is estimated at 2 hours 30 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is required to obtain or retain benefit from the Higher Education Opportunities Act (HEOA) Amendments of 2008 (20 USC 1140f-1140i). Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Education, 400 Maryland Ave., SW, Washington, DC 20202-4536 or email [email protected] and reference the OMB Control Number 1840-NEW. Note: Please do not return the completed TPSID Program Evaluation Tool to this address.

PROGRAM DEMOGRAPHICS

S1. How many students attended your TPSID program this year? ____

S1a. How many of the students in S1 entered your TPSID program this year? ____

S1b. How many of the students in S1 are returning TPSID students? ____

SC1. What was the average age of the students in your program as of 10/1/2012: ___

What is the age range of the students in your program as of 10/1/2012: from ____ years to ____ years

SC2. How many students enrolled in your program this year are: Male: ____ Female: ____

SC3. How many students enrolled in your program this year are Hispanic or Latino? ____

SC4. How many students enrolled in your program this year are:

Asian: ____

American Indian or Alaska Native: ____

Black or African American: ____

Native Hawaiian or Other Pacific Islander: ____

White: ____

SC5. How many students enrolled in your program this year have each of the following disabilities?

Intellectual disability: ____

Autism: ____

Deaf-blindness: ____

Deafness: ____

Developmental delay: ____

Emotional disturbance: ____

Hearing impairment: ____

Multiple disabilities: ____

Orthopedic impairment: ____

Other health impairment: ____

Specific learning disability: ____

Speech or language impairment: ____

Traumatic brain injury: ____

Visual impairment, including blindness: ____

SC5a. What documentation do you use to confirm your students have an intellectual disability? Check all that apply

• ID is not confirmed through documentation

• Neuropsychological or psychological examination report

• Physician’s documentation of disability

• Individualized Education Plan

• SSA Disability Determination

• Other (please specify:________________)

SC6. How many students enrolled in your program this year received each type of benefit:

SSI (Supplemental Security Income) ___

SSDI (Social Security Disability Insurance) ___

Other (please specify:________________) ___

Don’t Know ___

SC7. How many students enrolled in your program this year received each type of health care:

Medicaid ___

Medicare___

Private health insurance ___

Student health insurance

Other (please specify:_______)

Don’t know___

SC8. How many students enrolled in your program this year experienced each of the following curriculum and educational settings in their high schools prior to entry into the TPSID program?

Fully included in general education curriculum in general education classes: ____

Student spent half of their time in general education and half of their time in special education: ____

Not included in general education curriculum or classes/only in special education classes (e.g., life skills): ____

SC10. How many students enrolled in your program this year received had ever been employed for pay prior to their entry into your TPSID Program? ____

STUDENT STATUS

AS1. How many students enrolled in your program this year received special education services via public school system under IDEA this year? ____

AS2. Among students who exited high school, how many of the students in your program had the following high school exit statuses?

Certificate of completion or attendance: ____

Standard diploma: ____

Modified or special diploma: ____

GED/high school equivalency certificate: ____

Dropped out: ____

AS2a. Among students who exited high school, how many of the students enrolled in your program this year participated in the following types of statewide assessments?

Regular with or without accommodations ___

Alternate ___

Waived___

None___

Don’t know___

AS3. This year, in addition to being a TPSID student, how many of the students enrolled in your program were:

Enrolled as a special student: ____

Enrolled in a IHE recognized certificate program: ____

Enrolled as a degree-seeking student: ____

Enrolled as non-degree student: ____

AS3A. For the purposes of tuition and fees, how many of students enrolled in your program this year are:

In-state students: ____

Out-of-state students: ____

AS4. How many of students enrolled in your program this year are in their:

1st year: ____

2nd year: ____

3rd year: ____

4th year: ____

Beyond 4^th year: ____

AS5. How many students enrolled in your program this year are in their final year in the TPSID program? ____

AS6. How many students enrolled in your program this year are seeking the meaningful credential offered by your TPSID program? ____

• We do not offer a meaningful credential at this time Skip to question AS8 and then answer AS9

AS7. How many students seeking your program’s meaningful credential this year are making satisfactory progress toward this credential? ____

AS8. How many students enrolled in your program this year are seeking a degree or certificate offered by the IHE other than the meaningful credential offered by the TPSID? ___ (if 0 skip AS9)

AS9. How many students enrolled in your program this year are making satisfactory progress toward this degree or certificate? ____

STUDENT CHARGES AND FINANCING

In this section we collect information on charges to TPSID students who attend your program, including tuition, fees, and room and board. For the purpose of this collection:

• Tuition refers to the amount of money charged to students for instructional services.

• Required fees include all fixed sum charges that are REQUIRED of a majority of TPSID students.

• Room refers to charges for an academic year for rooming accommodations for a typical TPSID student.

• Board refers to charges assessed to TPSID students for an academic year for meals.

PD5a. What is your institution’s ‘in-state’ cost for non-TPSID students? $____

PD5b: What is your institution’s ‘out-of-state’ cost for non-TPSID students? $____

PD5. Qualifier. Do the charges to students who attend your program differ depending on whether or not students are IN-STATE or OUT-OF-STATE residents?

• Yes  Go to question PD5_in and then PD5 _out.

• No Skip to question PD5_both

PD5_IN. What are the average total charges (including tuition, required fees, room and board) for an IN-STATE TPSID student to attend your program? $_______

PD5A_in. Please specify your institution’s ‘in-state’ cost for TPSID students for each category selected:

• Student charges are not broken out into individual categories, we charge a comprehensive fee that is all inclusive

(Skip to next question if this is selected)

Tuition (if selected, specify the average charge to a TPSID student: $_______)

Required Fees (if selected, specify the average charge to a TPSID student: $_______)

Room (if selected, specify the average charge to a TPSID student: $_______)

Board (if selected, specify the average charge to a TPSID student: $_______)

PD5_out. What are the average total charges (including tuition, required fees, room and board) for an OUT-OF-STATE TPSID student to attend your program? $_______

PD5A_out. Please specify your institution’s ‘out-of-state’ cost for TPSID students for each category selected:

• Student charges are not broken out into individual categories, we charge a comprehensive fee that is all inclusive

(Skip to next question if this is selected)

Tuition (if selected, specify the average charge to a TPSID student: $_______)

Required Fees (if selected, specify the average charge to a TPSID student: $_______)

Room (if selected, specify the average charge to a TPSID student: $_______)

Board (if selected, specify the average charge to a TPSID student: $_______)

PD5_both. What are the average total charges (including tuition, required fees, room and board) for a TPSID student to attend your program? $_______

PD5A_both. Please indicate the categories for which you charge TPSID students and specify the average total charges for an OUT-OF-STATE TPSID student for each category selected?

• Student charges are not broken out into individual categories, we charge a comprehensive fee that is all inclusive

(Skip to next question if this is selected)

Tuition (if selected, specify the average charge to a TPSID student: $_______)

Required Fees (if selected, specify the average charge to a TPSID student: $_______)

Room (if selected, specify the average charge to a TPSID student: $_______)

Board (if selected, specify the average charge to a TPSID student: $_______)

FSA1. Is your institution of higher education an approved Comprehensive Transition Program (CTP)?

• Yes (Skip to FSA2)

• No (Go to FSA1a)

FSA1a: Please indicate the current status of your institution in regards to becoming a CTP:

• Our IHE is in the process of developing an application

• Our IHE does not plan on applying to become a CTP

• Our IHE has completed and submitted an application and are awaiting approval

FSA2. How many students enrolled in your program this year received the following types of federal student aid this year?

Pell grant ___

Supplemental Education Opportunity Grants___

Work study ___

F1. Which of the following funding sources are used to pay tuition for your TPSID students?

Check all that apply.

• Private pay (student and family)

• Scholarships

• State intellectual/developmental disability (IDD) services agency: state or local funds

• Local Education Agency

• Private student loans

• Federal/State grant

• Foundation/Private grant

• State Vocational Rehabilitation agency funds

• State IDD Services Agency: Medicaid Home and Community-Based Services (HCBS) Waiver funds

• Tuition Waivers via VR or Social Security

• National Service grants

• Social Security funds e.g. PASS plan

• Other funding source (please specify: __________)

• None of these sources are used to fund the students tuition

F2. Which of the following funding sources are used to pay for non-tuition expenses for TPSID students? Check all that apply.

• Private pay (student and family)

• Scholarships

• State intellectual/developmental disability (IDD) services agency: state or local funds

• Local Education Agency

• Private student loans

• Federal/State grant

• Foundation/Private grant

• State Vocational Rehabilitation agency funds

• State IDD Services Agency: Medicaid HCBS Waiver funds

• Tuition Waivers via VR or Social Security

• National Service grants

• Social Security funds e.g. PASS plan

• Other funding source (please specify: __________)

• None of these sources are used to fund the student’s non-tuition expenses

PROGRAM COSTS

This next item asks about your program’s total operating expenses. Total operating expenses are the total amount spent for the activities that result in goods and services being distributed to students that fulfill the purposes or mission for which the program exists. This amount should include expenses for instruction (including faculty salaries and instructional supplies), student services, administrative support (institutional and academic support including administrative salaries and information technology), student stipends, operations and maintenance expenses, and any other expense incurred to provide program services for the year being reported.

PD6a_1. What is your TPSID program's total operating expenses? $____________

PD9. Did your IHE serve and/or support students with ID prior to receiving the TPSID grant?

• Yes Go to question PD10

• No

PD10. If YES, how is your program using TPSID grant funds? Check all that apply

• Increasing the number of students with ID served 

• Expanding access to courses for students with ID 

• Funding additional locations to serve and support SWID 

• Adding staff 

• Providing more academic supports for SWID 

• Providing more social supports for SWID 

• Providing more residential options or supports for SWID 

FS1. Other than the funding you received from the Office of Postsecondary Education, which of the following sources of funds are you using to support the development & implementation of your TPSID program (e.g. to pay TPSID staff & other expenses)? Check all that apply.

• IHE resources

• Medicaid

• Local school districts (LEDs)

• Other government-funded grants

• Private foundation grants

• Funding from state budget

• State intellectual/developmental disability (IDD) services agency funds

• State Vocational Rehabilitation agency funds

• Veteran’s Affairs funds

• Student/Family funds

• Individual and/or corporate donors

• Other funding sources (please specify: __________)

• We don't use any of the sources listed above

STAFFING

This information is reported for each TPSID staff person

Staff1. What type of employee best describes this staff member’s job?

• Full professor

• Associate, Assistant professor, or Adjunct professor

• Dean or other Administrator

• Research staff

• Administrative staff

• Graduate student

• Undergraduate students

Staff2. What percentage of full time does this person work for the TPSID?

• 0-25%

• 26-50%

• 51-75%

• 76-100%

ACADEMIC ACCESS

AA1. Are TPSID students required to take placement or ability to benefit tests during the admissions process?

• Yes

• No

AA2. What types of credentials are available to students who attend your TPSID? Check all that apply.

• Associate degree specifically for TPSID students granted and approved by the Institution of Higher Education and not available to other students  Go to question AA30

• Bachelor’s degree specifically for TPSID students granted and approved by the Institution of Higher Education and not available to other students  Go to question AA3

• Associate degree granted by the Institution of Higher Education available to both TPSID and non-TPSID students  Skip to question AA4

• Bachelor’s College degree granted by the Institution of Higher Education available to both TPSID and non-TPSID students  Skip to question AA4

• Certificate specifically for TPSID students granted and approved by the Institution of Higher Education and not available to other students  Go to question AA3

• Certificate granted by the Institution of Higher Education available to both TPSID and non-TPSID students  Skip to question AA4

• Specialized certificate or other exit document specifically for TPSID students granted and approved by the TPSID program (Not the hosting IHE) and not available to other students  Go to question AA3

• Specialized certificate designed for TPSID students issued from the local education agency not available to other students  Go to question AA3

• Another credential not listed (Please specify :__________).  Go to question AA3

AA3. What elements of a student’s course of study/program are required for the credential?

Check all that apply.

• Coursework

• Completion of required courses

• Internships

• Independent Study

• Employment

• Campus Activities

• Independent Living

• Credit hours

• Credit hour equivalents

• Other element - Please provide a description: ________________________________________

AA4. What measures does your program use to track satisfactory academic progress for students in the TPSID program? Check all that apply.

• None

• Completion of components/stages of meaningful credential in expected completion time

• Program completion rate (meeting benchmarks)

• Credits earned

• Grade point average

• Course completion rate

• Skill assessment

• Student self-rating measure

• Peer mentor evaluation

• Attendance

• Portfolio assessment

• IEP progress or goal achievement (for dually-enrolled students)

• Other (please specify: __________)

AS11. How many students enrolled in your program this year received services from the Disability Services Office (DSO) this year? ____

AS11a. How many students enrolled in your program this year received the following accommodations this year?

Information Technology: ____

Assistive Technology: ____

Academic Supports provided by individuals: ____

Academic Accommodations: ____

Enrollment Accommodations: ____

ENROLLMENT

CO1. Please list the titles of the courses taken by your students this year:

CO2a. How many of courses taken by students in your program this year were:

INCLUSIVE (attended by TPSID and Non-TPSID students):

For-credit : ____

Continuing Education: ____

SPECIALIZED (attended only by TPSID students):

For-credit : ____

Continuing Education: ____

CO3. What topics are covered in the specialized courses taken by your students? Check all that apply.

• Academic skills

• Career preparation instruction

• Independent Living Instruction

• Technology training/computer literacy

• Social skills training

• Travel training instruction

• Other (please specify:________________)

CO4. How many of courses taken by your students met:

In-person: ____

Online: ____

Hybrid (Both online and in-person) ___

AC1. How are students accessing courses? Indicate the number of students accessing courses via the following types of enrollment this year.

Enrolled for credit that can only be used towards the TPSID credential: ___

Enrolled for standard IHE credit: ____

Audit: ____

Unofficially attending the course/sitting in: ____

EMPLOYMENT AND CAREER DEVELOPMENT

EC1. Who provides the employment services or work-related direct supports for the students in your TPSID program? Check all that apply.

• We do not provide employment services or direct supports for the students in our TPSID program 

• TPSID program staff

• Career Services staff available to all students attending the IHE

• Peer mentors or supports

• LEA transition staff for dually-enrolled students

• State Vocational Rehabilitation Staff

• State Intellectual and Developmental Disability agency staff

• Separate/Contracted employment service provider

• Supervisors at the worksite

• Coworkers at the worksite

• Other (please specify: __________)

CDE1. How many students enrolled in your program this year participated in the following unpaid/volunteer experiences this year?

No participation in unpaid/volunteer experiences this year: ____

Service learning opportunities: ____

Unpaid internships (not for-credit) : ____

Unpaid internships (for-credit) : ____

Volunteering and/or Community service: ____

Unpaid individual work training sites: ____

Other unpaid/volunteer experience, please specify:________) : ____

Job. How many students in your program have paid jobs? ___

Please provide a list of employers at which your students had paid jobs this year:

JOB1. How many students enrolled in your program this year are working in each of the following types of paid jobs:

Individual paid job: ____

Federal work-study: ____

Paid internships (for-credit): ____

Paid internships (non-credit): ____

Group paid work (Enclave or mobile work crew): ____

Individual work training sites paid by stipend (below minimum wage): ____

Group work training sites paid by stipend (below minimum wage): ____

Sheltered workshop: ____

JOB4. How many hours per week on average do students work in their paid jobs: ______ hours per week

What is the rage of hours worked per week in paid jobs: from ___ hours per week to ___ hours per week

JOB6. How many students enrolled in your program this year that are working in paid jobs receive benefits? ____

JOB7. How many students in paid jobs receive the following employment supports at these jobs?

Personal Care Assistant: ____  If > 0 Skip to question JOB9

Natural supports: ____  If > 0 Skip to question JOB9

Off-site coaching/instruction: ____  If > 0 Skip to question JOB9

Assistive technology: ____  If > 0 Skip to question JOB9

Job coaching: ____  If > 0 Go to question JOB8

Other support (please specify:______________) : ____  If > 0 Skip to question JOB9

JOB9. Of the students who have paid jobs, how many use each of the following forms of transportation to get to and from these jobs?

Existing Transportation

Drive self /Walk/ride bike: ____

Friend or Family member : ____

Public transportation or Para Transit or Taxi: ____

IHE transportation (Campus bus) : ____

Transportation Provided by IDD Agency: ____

Program Specific Transportation

LEA provided transport: ____

TPSID staff: ____

Other (please specify:___________________) : ____

Job12. (Answered for all paid jobs the student held at point of exit) Among students who exited, how many planned to remain at their paid job after exit? ____

Job14. On average, how many hours each week were students working at their paid job at exit? ____

What the range of hours worked in paid jobs at exit? From____ hours per week to____ hours per week

Job15. On average, what was the hourly rate of pay for students at their paid job when they exited the TPSID? $____

What the range of hourly rates of pay in paid jobs at exit? From $____ per hour to $____ per hour

SOCIAL ACTIVITIES

SA1. What strategies are used to identify opportunities and support for student participation in social activities on campus? Check all that apply.

• We do not actively identify opportunities and support participation in social activities on campus

• TPSID staff facilitate participation in social opportunities that are desired by TPSID students

• Peer mentors plan attendance at and/or attend social events with TPSID students

• Non-TPSID Students (undergraduate, graduate, practicum, etc.) plan attendance at and/or attend campus social events with TPSID students

• TPSID staff and/or peer mentors organize social events for TPSID students and invite non-TPSID students

• TPSID students organize social events and invite non-TPSID students

• TPSID students independently seek out and participate in desired social activities

• Other (please specify: __________)

SA2. How do you measure participation in social activities for students with ID?

Check all that apply.

• We do not measure participation in social activities

• Student self report

• Peer mentor monitoring

• As a follow-up to person-centered planning process

• Check student organization membership lists

• Scheduling system

• Regular review of student’s program plan or course of study

• Staff monitored

• Use of activity planners

• Other (Please specify: ____________________)

PLANNING AND ADVISING

PA1. Does the TPSID use Person Centered Planning with participating students?

• Yes  Go to question PA2

• No-  Skip to question PA4

PA2. Please indicate the Person Centered Planning model or models you are using? Check all that apply.

• We are not using a specific Person Centered Planning model

• Planning for Inclusive Communities Together Using Reinforcement and Evaluation (PICTURE)

• Choosing Options and Accommodations for Children (COACH)

• Making Action Plans (MAPS)

• Planning Alternative Tomorrows with Hope (PATH)

• Essential lifestyle planning

• Personal futures planning

• Whole life planning

• We use a combination of various models

• Other (please specify: ________)

PA4. What is the TPSID using for an academic advising process? Check one.

• Existing academic advising office used by non-TPSID students

• Separate advising system specially designed only for TPSID students and administered by TPSID staff

• Both

• Other (please specify: __________)

RESIDENTIAL ACCESS

RA1. Does this IHE provide institutionally owned/affiliated/operated housing for students?

• Yes  Go to question RA2

• No  Skip to question RA3

RA2. Do TPSID students have the opportunity to access this housing?

• Yes  Go to Room and Board section (if PD5_screen indicates comprehensive fee, section will be hidden)

• No

LS1. How many students enrolled in your program this year live:

With Family: ____

In other residences not provided by or associated with the IHE or TPSID program:

Independent - on his/her own: ____

Supervised apartment or supported living situation : ____

Group home: ____

Host Family/Foster Care: ____

Other (please specify:___________) : ____

In residences provided by or associated with the IHE or TPSID program:

Residence hall or section of a residence hall primarily for TPSID students: ____

Residence hall or section of a residence hall where the majority of residents are non-TPSID: ____

On-campus apartments primarily for TPSID students: ____

On-campus apartments where the majority of residents are non-TPSID students: ____

Off-campus apartments primarily for TPSID students: ____

Off-campus apartments where the majority of residents are non-TPSID students: ____

Fraternity/sorority houses primarily for TPSID students: ____

Fraternity/sorority houses where the majority of residents are non-TPSID students: ____

Other (please specify:____________) : ____

LS4. Which of the following residential supports do students in your program receive? Check all that apply.

• Roommate/suitemate who receives compensation

• An uncompensated roommate/suitemate who provides supports

• Residential Assistant or Advisor who provides supports

• Continuous staff support

• Intermittent or on-call staff support

• Other support (please specify:__________)

LS5. How do students get to class and campus activities? Please report the number of students for each category

Existing Transportation

Drive self /Walk/ride bike: ____

Friend or Family member : ____

Public transportation or Para Transit or Taxi: ____

IHE transportation (Campus bus) : ____

Transportation Provided by IDD Agency: ____

Program Specific Transportation

LEA provided transport: ____

TPSID staff: ____

Other (please specify:___________________) : ____

PEER SUPPORTS

PS1. Does your TPSID use peer mentors?

• Yes Go to question PS2

• No  There are no additional questions to answer in this section

PS2. In which areas do peer mentors support TPSID students? Check all that apply.

• Social

• Academic

• Independent living

• Employment

• Transportation

• Other (please specify: __________)

PS3. How are peer mentors at your TPSID compensated? Check all that apply.

• Course Credit

• Practicum

• Paid for supports

• Non-cash compensation (e.g. room and board)

• No compensation (e.g. volunteer)

PS4. In which programs of study are peer mentors at your IHE enrolled? Check all that apply.

• Peer mentors are not enrolled

• Education/ Special Education/Rehabilitation counseling/Therapies (Physical, Occupational, Speech)

• Business/Engineering/Computer Science

• Liberal arts/Psychology/ Sociology/ Social work/Nursing

• Biological, cognitive, or physical sciences

• Other (please specify: ________)

OUTUTREACH TO FAMILIES AND STUDENTS

OFS1. What types of outreach does your TPSID conduct for potential students and their families?

Check all that apply.

• We do not do outreach to potential students and families 

• Participation in Transition Fairs

• Presentations to Local Schools-Public, Private, Charter

• Presentations at parent advocacy and support groups

• Participation in Adult services/CRP events

• Attendance at IEP meetings

• Open houses at TPSID

• Tours of TPSID

• Include information about TPSID in general IHE marketing materials e.g. brochures, website

• TPSID marketing materials, e.g. brochures, catalog, newsletters

• TPSID website

• Other (please specify: ________)

OFS2. What type of orientation experiences are provided to family members of students attending the TPSID? Check one.

• Attend typical orientation for families sponsored by IHE

• Attend special orientation for families sponsored by TPSID

• Both

• Neither

• Other (please specify: ________)

OFS3. What information is offered to family members of students attending the TPSID? Check all that apply.

Transition Issues

• None

• Benefits/SSI

• Guardianship

• Connections to agencies/service providers (i.e. Voc Rehab, Social Security, etc.)

• Employer/workplace expectations

• Person Centered Planning

• Other transition issue (please specify:__________)

IHE-related issues

• None

• Family Educational Rights and Privacy Act (FERPA)

• Review the IHEs code of conduct

• Financial aid

• Disability laws that pertain to higher education and how they differ from IDEA (ADA, Rehabilitation Act)

• Disability-related services available at the IHE

• Non disability-related services available at the IHE

• Social Activities at the IHE

• Other (IHE-related issue (please specify:____________)

Student-specific Issues

• None

• Social

• Behavioral

• Academic

• Independent living

• Career development/Employment

• Other student-specific issue (Please specify:____________)

INTEGRATION WITH INSTITUTION OF HIGHER EDUCATION

PD1. Does your college have a public statement related to diversity?

• Yes  Go to question PD2

• No  Skip to question PD3

PD2. IF YES, does it explicitly mention students with disabilities?

• Yes

• No

PD3. Is your TPSID affiliated with a particular school, college, or academic department within your IHE?

• Yes - What is the name of the school, college, or academic department? _______________

• No

PD4. On average, how many years will it take for a student to complete your TPSID program? ___

PD7. Does your TPSID operate during the summer months?

• Yes  Go to question PD8

• No Skip to question PD9

PD8. If YES, what services and supports does your program offer to TPSID students during the summer? Check all that apply.

• Access to courses

• Orientation for new students

• Employment Supports for TPSID students with jobs

• Employment Services for TPSID students seeking jobs

• On campus residential services

• Off campus residential services

• Social activities organized by the TPSID

• Support for TPSID students to participate in social activities not organized by the TPSID

• Student mentors

• Other

IIHE1. Do any TPSID staff participate in existing IHE professional development?

• Yes  Go to question IIHE2

• No  Skip to question IIHE3

IIHE2. What professional development topics offered by the IHE did staff participate in this academic year? Check all that apply.

• Universal Design for Learning

• Software/information technology training

• Career services

• Diversity training

• Academic advising

• Project management

• Leadership training

• Staff supervision training

• Other (Please specify:____________)

IIHE3. Do any TPSID staff participate in professional development that was not provided by the IHE (E.g. provided by local agencies, staff from your TPSID, staff from another TPSID, staff from the Coordinating Center)?

• Yes Go to question IIHE4

• No Skip to question IIHE5

IIHE4. Please describe the professional development topics offered by an entity other than the IHE this academic year?

_______________________________________________________

_______________________________________________________

IIHE5. Have TPSID staff provided or facilitated training and/or professional development for IHE staff?

• Yes  Go to question IIHE6

• No  Skip to questions IIHE7

IIHE6. Please describe the training topics TPSID staff provided to IHE staff in this academic year?

_______________________________________________________

_______________________________________________________

IIHE7. Do TPSID students follow the academic calendar used by non-TPSID students attending the IHE?

• Yes

• No

IIHE8. Is the IHE’s code of conduct applied to TPSID students?

• Yes

• No  Skip to question IIHE11

IIHE9. How is this code of conduct shared with/communicated to TPSID students? Check all that apply.

• Reviewed with student

• Student is given a copy of the code of conduct

• Code of conduct is available but is not reviewed with or given directly to students

• Other (Please specify:____________)

IIHE11. Do TPSID students receive a transcript? Select one.

• Yes, a regular transcript received by non-TPSID students

• Yes, a transcript specifically for TPSID students

• Yes, a regular transcript and a transcript specifically for TPSID students

• No, they do not receive a transcript

IIHE12. Are TPSID students issued college ID cards?

• Yes Go to question IIHE13

• No Skip to question IIHE15

IIHE15. Do TPSID students participate in orientation? Select one.

• Yes, the regular orientation for non-TPSID students

• Yes, an orientation specifically for TPSID students

• Yes, the regular orientation and an orientation specifically for TPSID students

• No, they do not participate in orientation

IIHE16. To the best of your knowledge, which of the following IHE resources have TPSID students accessed in the past year? Check all that apply.

• Health center/counseling services

• Career services

• Registrar, Bursar, or financial aid office

• Tutoring services

• Library

• Bookstores

• Computer lab/Student IT services

• Sports and recreational facilities or Arts/cultural center

• Student center or Dining hall

COLLABORATION WITH OTHER PARTNERS – Report this information for each partner

CP1. Select each partner that your TPSID has an active partnership with:

• Education Agencies (K-12, Local, and Regional)

• State Education Agency

• Vocational Rehabilitation

• Community Rehabilitation Provider(s)

• Chambers of Commerce/Business councils

• Business Leadership Network (BLN)

• State Department of Labor

• State intellectual/Developmental Disability (IDD) services agency

• Self-Advocacy Groups

• One-Stop Career Centers (Workforce centers)

• Employers

• University Centers for Excellence in Developmental Disabilities (UCEDDs)

• Developmental disability councils (DD Councils)

• Health and wellness organizations (e.g., Planned Parenthood, Wellness)

• State department of health

• Parent Training Information Centers

• Parent/family advocacy or support groups

• Private foundations

• Public transportation agency

• Other IHEs

• Other (please specify:_________)

For each organization you partner with answer questions CP2 – CP4:

CP2. How frequently does the TPSID interact with this organization? Check one.

• Annually

• Bi-annually

• Quarterly

• Monthly

• Weekly

• Daily

CP3: What functions does this partner serve? Check all that apply.

• They do not serve any particular function 

• Team/Consortia member (State or regional)

• Serves as a consultant

• Participates in project advisory committee

• Provides direct service to TPSID students

• Provides transportation for TPSID students

• Provides training to TPSID students

• Provides training to TPSID staff

• Participates in PCP

• Provides career development/employment opportunities for TPSID students

• Conducts recruitment/outreach

• Provides instructional opportunities for TPSID students

• Other (please specify:____________)

CP4. What resources does this partner contribute to the TPSID program? Check all that apply.

• None

• Staff time and expertise

• Volunteers

• Funds for student tuition

• Funds for other expenses

• Equipment

• Curricula

• Physical space

EVALUATION ACTIVITIES

EA4. Does your IHE and/or TPSID program collect follow-up data on students who exited the TPSID program (with or without a credential)? Select one.

• Yes Go to question EA5

• No There are no additional questions to answer in this section

• Not yet  There are no additional questions to answer in this section

• Don't Know  There are no additional questions to answer in this section

EA5. For how long after exiting the program does the IHE and/or TPSID program collect data on students? Select one.

• 1 year

• 2 years

• 3 years

• 4 years

• 5 or more years

EA6. Which follow-up data does the IHE and/or TPSID program collect? Check all that apply.

• Type of job

• Earnings

• Hours worked per week

• Length of employment

• Volunteer or community service activities

• Living situation

• High school graduation rate

• Postsecondary graduation rate

• Transfer to 2 or 4-year colleges and universities

• Social or community involvement measures

• Self-determination measures

• Independent living measures

• Quality of life measures

• Other (please specify:__________)

• We do not collect any of these measures 

exit INformation

EX1. How many students exited the program this year? ____

EX1a. Of those students, how many had a paid job when they exited? ____

EX2. Indicate the number of students that exited with each status below for this year. (You should account for all students in your answer for EX1)

Completed TPSID program and earned TPSID credential ___

Completed degree or certificate program available to TPSID and non-TPSID students ___

Transferred to another postsecondary education program ___

No longer wanted to attend TPSID program ___

Student was dismissed from TPSID program ___

Unknown ___

Other reason ___

EX2a. If you had one or more students indicate they had plans to transfer, please indicate the number that planned to transfer to each of the following types of settings.

A specialized postsecondary education program for students with ID:

A 2-year IHE: ____ A 4-year IHE: ____ A vocational or technical school___

A general postsecondary education program for students with and without ID:

A 2-year IHE: ____ A 4-year IHE: ____ A vocational or technical school___

EX3. For those who exited after receiving a credential, how many students earned:

Associate Degree specifically for TPSID students granted and approved by the Institution of Higher Education and not available to other students: ____

Bachelor’s Degree specifically for TPSID students granted and approved by the Institution of Higher Education and not available to other students: ____

Associate degree granted by the Institution of Higher Education available to both TPSID and non-TPSID students: ____

Bachelor’s degree granted by the Institution of Higher Education available to both TPSID and non-TPSID students: ____

Certificate specifically for TPSID students granted and approved by the Institution of Higher Education and not available to other students: ____

Certificate granted by the Institution of Higher Education available to both TPSID and non-TPSID students: ____

Specialized certificate or other exit document specifically for TPSID students granted and approved by the TPSID program (Not the hosting IHE) and not available to other students: ____

Specialized certificate designed for TPSID students issued from the local education agency not available to other students: ____

EX5. Among those who exited, how many students were participating in the following unpaid/volunteer experiences at program exit?

Service learning opportunities: ____

Unpaid internships (not for-credit) : ____

Unpaid internships (for-credit) : ____

Volunteering and/or Community service: ____

Unpaid individual work training sites: ____

Other unpaid/volunteer experience: ____

EX6. Please indicate the number of students in your program lived in the following residential settings at the time of exit?

With Family: ____

Independent - on his/her own: ____

Supervised apartment or supported living situation: ____

Group home: ____

Host Family/Foster Care: ____

Other (please specify:________________) : ____

EX7. Please indicate the number of TPSIDs students receiving each type of benefit at exit:

None ___

SSI (Supplemental Security Income) ___

SSDI (Social Security Disability Insurance) ___

Other (please specify:________________) ___

Don’t Know ___

EX8. Please indicate the number of TPSID students receiving the following types of health insurance at program exit?

Medicaid ___

Medicare___

Private health insurance ___

Student health insurance ___

Other (please specify:_______) ______

Don’t know___

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