| Instructions for performance reporting for ACL/CDC supplemental funding to Expand COVID-19 Vaccine Access for People with Disabilities |
| Complete the tables of quantitative and qualitative data for service activities conducted between April 1, 2021 and September 30, 2022. |
| • Enter data for the full project period 4/1/21 through 9/30/22. |
| • Ensure that the information you enter is complete and correct. |
| • Enter the information in the column as specified in both Quantitative and Qualitative worksheets. |
| • If a list of valid values is provided, select only from these values. Do not add or change any values. |
| • Do not add or delete any columns in the worksheets. |
| •Do not change the sequence of the columns. |
| • Do not delete worksheets. |
| • In the Quantitative worksheet, enter digits only (no letters, punctuation, or symbols). |
| • In the Qualitative worksheet, enter up to 2,500 characters to describe your narrative, successes, and challenges for the service activities |
| completed. Completion of all service activities was not required. For service activities not completed, enter N/A. |
| • In the Qualitative worksheet, enter up to 2,500 characters to describe collaborations with ACL partners, collaborations with other |
| community-based organizations, lessons learned, and recommendations for future activities. These fields are not optional. |
| • Direct any questions related to the completion of this spreadsheet to Sheryl Matney (smatney@nacdd.org) or Cherie Moon (cmoon@nacdd.org) |
| • Upload completed data sheets as an attachment in the annual PPR due January 1, 2023. |
| Project Title | Expand COVID-19 Vaccine Access for People with Disabilities | |
| Council Name | ||
| Project Timeline | April 1, 2021 - September 30, 2022 | |
| Service Activity | Number of people Served | |
| Education about the importance of receiving a vaccine | Number of people with disabilities reached by your education activities. | |
| Number of all other people (including family members, direct support providers, personal care attendants, and other support providers) reached by your education. | ||
| Identifying people unable to independently travel to a vaccination | Number of people unable to independently travel to a site. | |
| Providing technical assistance (TA) to local health departments or other entities on vaccine accessibility | Number of local health departments or other entities assisted with TA on vaccine appointments. | |
| Helping with scheduling a vaccine appointment | Number of people helped in scheduling vaccine appointments. | |
| Arranging or providing accessible transportation | Number of people assisted with accessible transportation to a vaccination site. | |
| Providing companion/personal support | Number of people assisted with companion/personal support to receive vaccines. | |
| Reminding people of their second vaccination appointment if needed | Number of people who needed and received a reminder of their second vaccination appointment | |
| Overall outcome: Number of people vaccinated as a result of implementing one or more of the service activities | ||
| Number of people with disabilities vaccinated as a result of implementing one or more of the service activities | ||
| Total number of all other people vaccinaated as a result of implementing one or more of the service activities. | ||
| Project Title | Expand COVID-19 Vaccine Access for People with Disabilities | |||
| Council Name | ||||
| Project Timeline | April 1, 2021 - September 30, 2022 | |||
| Service Activity | Narrative | Successes | Challenges | |
| Education about the importance of receiving a vaccine. | Describe the type of education activities conducted (e.g., one-on-one assistance, brochures/pamplets/fliers, social media postings, social stories). | Describe the most successful/effective education activities implemented | Describe challenges that limited your ability to educate others about the importance of the vaccine. | |
| Character Count | 0 | 0 | 0 | |
| Service Activity | Narrative | Successes | Challenges | |
| Identifying people unable to independently travel to a vaccination site. | Describe the strategy to identify people unable to independently travel to a vaccination site. | Describe the most commonly cited reasons for why they could not travel to the site. | Describe successes achieved as a result of identifying people to independently travel to a site (i.e., were people able to vaccinated at an alternative site?) | Describe challenges that limited your ability to identify people unable to independently travel to a site. |
| Character count | 0 | 0 | 0 | 0 |
| Service Activity | Narrative | Successes | Challenges | |
| Providing TA to local health departments or other entities on vaccine accessibility | Describe the types of strategies/TA activities to assist local health departments or other entities on vaccine accessibility. | Describe successes achieved as a result of TA activities provided to local health departments. | Describe challenges that limited your ability to provide TA to local health departments or other entities on vaccine accessibility. | |
| Character count | 0 | 0 | 0 | |
| Service Activity | Narrative | Successes | Challenges | |
| Helping with scheduling a vaccine appointment | Describe the types activities used to assist people in scheduling vaccines. | Describe successes achieved as a result of assistance provided to help schedule vaccine appointments. | Describe challenges that limited your ability to help with scheduling a vaccine appointment. | |
| Character count | 0 | 0 | 0 | |
| Service Activity | Narrative | Successes | Challenges | |
| Providing companion or personal support | Describe the types activities to provide companion/personal support services for people to receive vaccines. | Describe successes achieved as a result of providing companion/personal support services for people to receive vaccines. | Describe challenges that limited your ability to provide companion/personal support services. | |
| Character count | 0 | 0 | 0 | |
| Service Activity | Narrative | Successes | Challenges | |
| Reminding people of their second vaccination appointment if needed. | Describe the types activities to provide people with reminders on their second vaccination appointment. | Describe successes achieved as a result of providing reminders to people on their second vaccination appointment. | Describe challenges that limited your ability to provide people reminders on their second vaccination appointment. | |
| Character count | 0 | 0 | 0 | |
| Collaboration with ACL partners (ADRC's, AAA, CIL, P&A, UCEDD) | ||||
| Describe the nature of collaboration and join activities with ACL partners, including successes and challenges in your collaboration efforts. | ||||
| Character count | 0 | |||
| Collaboration with other community-based organizations. | ||||
| Describe the collaboration and joint activities with other community-based organizations, including successes and challenges in your collaboration efforts. | ||||
| Character count | 0 | |||
| Overall Lessons Learned | ||||
| Describe the leading key lessons learned as a result of your overall implementation activities. | ||||
| Character Count | 0 | |||
| Recommendations for future activities. | ||||
| Provide recommendations for ACL to consider that will maximize the impact of future responses to disasters or pandemics. | ||||
| Character count | 0 | |||
| SCDD |
| AL - Alabama Council on Developmental Disabilities |
| AK - Governor's Council on Disabilities and Special Education |
| AR - Governor's Developmental Disabilities Council |
| AS - American Samoa Developmental Disabilities Council |
| AZ - Arizona Developmental Disabilities Planning Council |
| CA - California State Council on Developmental Disabilities |
| CNMI - CNMI Council on Developmental Disabilities |
| CO - Colorado Developmental Disabilities Council |
| CT - Connecticut Council on Developmental Disabilities |
| DC - D.C. Developmental Disabiilties Council |
| DE - Delaware Developmental Disabilities Council |
| FL - Florida Developmental Disabilities Council |
| GA - Georgia Council on Developmental Disabilities |
| GU - Guam Developmental Disabiilties Council |
| HI - Hawaii State Council on Developmental Disabilities |
| IA - Iowa Developmental Disabilities Council |
| ID - Idaho State Council on Developmental Disabilities |
| IL - Illinois Council on Developmental Disabilities |
| IN - Governor's Council for People with Disabilities |
| KS - Kansas Council on Developmental Disabilities |
| KY - Commonwealth Council on Developmental Disabilities |
| LA - Louisiana Developmental Disabilities Council |
| MA - Massachusetts Developmental Disabilities Council |
| MD - Maryland Developmental Disabilities council |
| ME - Maine Developmental Disabilities Council |
| MI - Michigan Developmental Disabilities council |
| MN - Governor's Council on Developmental Disabilities |
| MS - Mississippi Developmental Disabilities Council |
| MO - Missouri Developmental Disabilities Council |
| MT - Montana Council on Developmental Disabilities |
| NC - North Carolina Council on Developmental Disabilities |
| ND - North Dakota State Council on Developmental Disabilities |
| NE - Nebraska Council on Developmental Disabilities |
| NH - New Hampshire Developmental Disabilities Council |
| NJ - New Jersey Council on Developmental Disabilities |
| NM - New Mexico Developmental Disabilities Planning Council |
| NV - Nevada Governor's Council on Developmental Disabilities |
| NY - New York State Developmental Disabilities Council |
| OH - Ohio Developmental Disabilities Council |
| OK - Developmental Disabilities Council of Oklahoma |
| OR - Oregon Council on Developmental Disabilities |
| PA - Pennsylvania Developmental Disabilities Council |
| PR - Puerto Rico Council on Developmental Disabilities (CEDD) |
| RI - Rhode Island Developmental Disabilities Council |
| SC - South Carolina Developmental Disabilities Council |
| SD - South Dakota Council on Developmental Disabilities |
| TN - Tennessee Council on Developmental Disabilities |
| TX - Texas Council on Developmental Disabilities |
| UT - Utah Developmental Disabilities Council |
| VA - Virginia Board for People with Disabilities |
| VI - Virgin Islands Developmental Disabilities Council |
| VT - Vermont Developmental Disabilities Council |
| WA - Washington State Developmental Disabilities Council |
| WV - West Virginia Developmental Disabilities Council |
| WI - Wisconsin Board for People with Developmental Disabilities |
| WY - Wyoming Governor's Council on Developmental Disabiilties |
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |