| 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 ([email protected]) or Cherie Moon ([email protected]) |
| • 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 |