1 

## INSTRUCTIONS OMB Control Number: 1820
- 0606 Expiration Date: xx/xx/201X
**UNITED STATES DEPART MENT OF EDUCATION**  **OFFICE OF SPECIAL ED UCATION AND REHABILI**  **TATIVE SERVICES**

**REHABILITATION SERVI CES ADMINISTRATION** 



# SECTION 704 **ANNUAL PERFORMANCE R EPORT**  **F or**  

# STATE INDEPENDENT LIVING SERVICES

**PROGRAM (Title VII, Chapter 1, Part B of the Rehabilitation Act of 1973, as amended)** 



# Part I **INSTRUCTIONS (To be completed by Designated State Units**  **And Statewide Independent Living Councils)**

According to the P aperwork 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 to average 35 hours per re sponse, 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 (P.L. 105
- 220 Section 410 Workforce I

nvestment Act). Send comments regarding the burden estimate or any other aspect of this collection of informat ion, including suggestions for reducing this burden, to Rehabilitation Services Administration, LBJ Basement, Attention: Timothy Beatty, PCP Room 5057, U.S. Department of Education, 400 Maryland Ave, SW, Washington, DC 20202
- 2800 or email timothy.beatty@ed.gov and reference the OMB Control Number 1820
- 0 606. Chapter 1, Title VII of the Rehabilitation Act.2 

## TABLE OF CONTENTS **Topic Page #**  **in the Instrument**  **Page #**

**in the Instructions**  Frequently

Asked Questions
-- 4 Glossary of Terms
-- 8 General Instructions
-- 1 1 **Subpart I**

**– Administrative Data**  2 1 1 Section A

– Sources and Amount of Funds and Resources 2 1 1 Section B

– Distribution of Title VII, Chapter 1, Part B Funds 4 1 2 Section C

– Grants or Contracts Used to Distribute Title VII, Chapter 1, Part B Funds 5 1 2 Section D

– Grants or Co ntracts for Purposes Other Than Providing IL Services or for the General Operation of CILs 6 1 2 Section E

– Monitoring Title VII, Chapter 1, Part B Funds 6 1 2 Section F

– Administrative Support Services and Staffing 6 1 3 Section G

– For Section 72 3 States ONLY 6 1 3 **Subpart II**

**– Number and Types of Individuals with**  **Significant Disabilities Receiving Services** 8 1 4 Section A

– Number of Consumers Served During the Reporting Year 8 14 Section B

– Number of CSRs Closed by September 30 of the R eporting Year 8 1 4 Section C

– Number of CSRs Active on September 30 of the Reporting Year 9 1 5 Section D

– IL Plans and Waivers 9 1 5 Section E

– Age 9 1 5 Section F

– Sex 10 1 53 **Topic Page #**  **in the Instrument**  **Page #**

**in the Instr**  **uctions** Section G
- Ethnicity 10 16 Section H
- Race 10 16 Section I
- Disability 11 16 **Subpart III**

**– Individual Services and Achievements**  **Funded Through Title VII, Chapter 1, Part B Funds** 12 17 Section A

– Individual Services and Achievements 12 19 Section B

– Increased Independence and Community Integration 13 2 1 Section C

– Additional Information Concerning Individual Services or Achievement 15 2 3 **Subpart IV**

**– Community Activities and Coordination**  16 2 4 Section A

– Community

Activi ties 16 2 4 Section B

– Working Relationships Among Various Entities 16 27 **Subpart V**

**– Statewide Independent Living Council**  **(SILC)** 17 27 Section A

– Composition and Appointment 17 27 Section B

– SIL C Membership Qualifications 18 27 Section C

– SI LC Staffing and Support 19 28 Section D

– SI LC Duties 19 28 Section E

– Training and Technical Assistance Needs 20 29 **Subpart VI**

**– SPIL Comparison and Updates, Other**  **Accomplishments And Challenges** 23 30 Section A

– Comparison of Reporting Y ear Activities with the SPIL 24 30 Section B

– Significant Activities and Accomplishments 24 3 0 Section C

– Substantial Challenges 24 3 0 Section D

– Additional Information 24 3 0 **Subpart VII**

**– Signatures**  25 3 04



## FREQUENTLY ASKED QUESTIONS **Question:** WHAT I S THE PURPOSE OF THE ANNUAL PERFORMANCE REPORT, OR 704 REPORT? **Answer:** The purpose of Part Iof the 704 Report is to: A) Serve as a performance activity measuring instrument of independent living (IL) programs, including both quantitative and qualitative information. B) Determine the training and technical assistance needs of Statewide Independent Living Councils (SIL Cs) as required by Section 721(b)(3) of the Rehabilitation Act of 1973, as amended (Act). C) Col lect information on the administration of the Part C program b y states who administer that program under section 723 of the Act. D) Collect information necessary for issuance of continuation awards for the State Independent Living Services (SILS) program. E) Collect the data required by Section 13, 706, and 721 of the Act for the SILS program. F) Serve as the basis for on
- site reviews of the SILS program. G) Obtain a report on SILC and designated state units (DSU) activities. H) Establish a uniform reporting s ys tem to compile an accurate national report on independent living. I) Serve as the state’s official request for continued funding under Part B or Part C of Chapter 1 of Title VII of the Act. J) Collect information on the distribution of title VII, chapter 1, Part B funds within the state and the monitoring of the use of those funds by grantees and contractors of the state. K) Enable each state to access information on all funds expended for independent living in the state, including individuals served, services provi ded and outcomes achieved, and to enable RSA to compare the performance among states. (Authority : Section 13, 704(m)(4)(D); 705 (c)(5); 706(d); 721; 723; of the Act; 34 CFR Parts 364, 365, and 366).5

**Question:** WHAT I S THE STRUCTURE OF THE 704 REPORT ? **Answer:** The 704 Report is composed of Part I and Part II Part Ireports on the SILC and DSU’s activities for the reporting y ear. It also contains data from consumer service records from the DSUs, DSU contractors and grantees and any center for indep endent living (CIL) receiving Part B funds from the DSU (not including CILs that also receive Part C funds and that file the 704 Report, Part II). Part II contains a CIL’s evidence of compliance with the requirements of Section 725 of the Act, a compariso n of the CIL’s activities during the reporting year with its work plan for that year, work plans for the next year, and data from consumer service records maintained by

the CIL. The structure of the 704 Report Part I is as follows: Subpart I

– Administr ative Data : This subpart contains information reflecting the duties of the DSU (including section 723 states) outlined in section 704(c) of the Act, including the sources and expenditures of funds during the reporting ye ar as well as the DSU’s administrat ive support services, staffing and monitoring activities involving grantees and contractors. Subpart II

– Numbers and Ty pes of Individuals with Significant Disabilities Receiving Services : This subpart asks for information from CSRs on the numbers and ty p es of consumers receiving IL services. Subpart III

– Individual Services and Achievements : This subpart asks for information on the individual IL services provided and received, goals set and met, and outcomes achieved. Subpart IV

– Community Activities and Coordination : This subpart asks for a report on the community

activities involving the DSU, SIL C and DSU contractors and grantees and the outcomes of such activities. Subpart V

– Statewide Independent Living Council : This subpart asks for a report on the composition, qualifications and activities of the Statewide Independent Living Council (including technical assistance and training needs for next fiscal year). Subpart VI

– SPI L Comparison and Updates, Other Accomplishments and Challenges : This subp art asks for program accomplishments and goal achievements, updates to the SPI L, substantial problems or difficulties and an y additional information. Subpart VII

– Signatures : Signatures, printed names, titles and phone numbers of DSU director(s) and SIL C chair.6

**Question:** WHO MUST COMPLETE PA RT I OF THE 704 REPO RT? **Answer:** Each DSU and SILC will jointly complete Part I. The SILC and the DSU must be given the freedom to independently prepare the portions of the report for which they are responsibl e. Subpart VI is designed to be a cooperative venture of both the DSU and SI LC. In this manner, a complete report of activities that is jointly developed and shared within the state is assured. Only a single Part I report, with data aggregated from the state’s reporting entities, will be accepted b y RSA. Subparts II and III report information obtained from CSRs maintained by the DSU and grantees/contractors receiving Part B funds (other than CILs who receive Part C funds and who complete Part II of the 704 Report). This is also true for section 723 states. **Question:** WHERE MUST THE 704 REPORT BE SUBMITTED? **Answer:** Section 722 states **:** The DSU and SILC will jointly submit the 704 Report both electronically and in an original, signed hard copy. F or the FY 2008 reporting year, states may submit the 704 Report via email to RSA and the Independent Living Research Utilization Project (ILRU) or they may choose to complete and submit the 704 Report directl y through the RSA Management Information Sy stem (MIS). The signed hard cop y of the 704 Report is to be mailed to RSA only
. Detailed instructions for the electronic and hard copy submittals will be provided when RSA officially

transmits the 704 Report. Section 723 states : The 723 states forward th eir Part I 704 Report, along with the Part II reports of the Part C funded CILs, to RSA both electronically and in an original, signed hard copy . For the FY 2008 reporting year, states may submit the 704 Report via email to RSA and the Independent Living Research Utilization Project (ILRU) or they may choose to complete and submit the 704 Report directl y through the RSA Management Information System (MI S). The signed hard copy of the 704 Report is to be mailed to RSA only
. The 723 states are no longer re sponsible for aggregating Part II report data into their Part I report. (They still may want to summarize applicable Part II information in their Part I report, as appropriate). Detailed instructions for the electronic and hard copy submittals will be provided to DSUs and SILCs when RSA officially transmits the 704 Report.7

**Question:** WHEN MUST THE DSU AN D SILC SUBMIT THE 70 4 PART IREPORT TO RSA? **Answer:** The date will vary depending on whether the state is a section 722 or section 723 state. Sectio n 722 states must submit the 704 Report, Part Ito RSA postmarked by December 31, 2006, for the preceding federal fiscal ye ar (10/1/2005

– 9/30/2006). Section 723 states must submit the 704 Report, Part Ito RSA postmarked by January 31, 2007, for the pr eceding federal fiscal ye ar (10/1/2005

– 9/30/2006). **Question:** HOW L ONG MUST RECORD S BE RETAINED? **Answer:** Three Years. Information provided in this report by federal grantees is subject to confirmation at an on
- site review; therefore, financial re cords, statistical records, and all supporting documents and other records pertinent to the grant award, adequate to document the accuracy

of the information and statements in the 704 Annual Performance Report, must be kept for three ye ars. (Authority : 34 CFR 74.53)8 

## GLOSSARY OF TERMS
Act The Rehabilitation Act of 1973, as amended. CI L A Center for Independent L iving meeting the definition in Section

702 of the Act, the standards in Section 725 of the Act, and included in the state’s network of centers. CI L Program The Centers for Independent L iving Program funded under Part C,

Chapter 1 of title VII of the Act. Community
- based These living arrangements include apartments, Living privately owned housing, self

- directed assisted living, or s elf
directed living with family or friends. Consumer Any individual with a significant disability who is eligible for IL services under 34 CFR 364.40(a) and is currently receiving or has been provided with any

I L service(s) under the program, other than i nformation and referral. Core Services IL services defined in Section 7(17) of the Act means: information

and referral services; IL skills training; peer counseling (including cross - disability

peer counseling); and, individual and sy stems advocacy
. CSR A Consumer Service Record maintained for an eligible consumer

receiving IL services and meeting the requirements of 34 CFR 364.53. In cases where IL services are provided to the parent or guardian of a consumer, the CSR is established for the consumer and the services provided are reflected in that CSR. DSU The designated state unit, or units, identified under section

101(a)(2)(B) of the Act, authorized to jointly develop and sign, with the Statewide Independent L iving Council (SILC), the State Plan for Independent Living (SPIL) under section 704 of the Act. The term includes a state agency solel y designated under state law to provide IL services to individuals who are blind. In such states, the state agency

for the blind may

administer the provisions in the state plan related to services for individuals who are blind. In a 723 state, the DSU receiving, accounting for, and disbursing the funds for the CIL program is alway s the general agency
. Earmarked Funds Funds appropriated b y the state and expressl y or clearl y identified

as state expenditures in the relevant fiscal ye ar for the sole purpose of funding the general operation of CILs meeting the requirements of Sections 702 and 725 of the Act.9

FTE The equivalent of one person working full
- time for one year. IL Independent Living ILP An Independent L iving Plan for the provision of IL services

mutually agreed upon b y an appropriate staff member of a service provider and an individual with significant disabilities. Minority Alaskan Natives, American In dians, Asian Americans, Blacks

(African Americans), Hispanic Americans, Native Hawaiians, and Pacific Islanders. Pass Through Funds that a provider receives on behalf of a consumer that are

subsequently

issued by

the provider directl y to the consumer (e. g., representative payee funds, Medicaid or state PAS funds). Reporting Year The most recentl y completed federal fiscal project year starting

October 1 and ending September 30. RSA The Rehabilitation Services Administration at the United States

Department of Education, Office of Special Education and Rehabilitative Services.
Section 722 State A state in which RSA issues grants under Part C directly to eligible agencies for the planning, establishment, and operation of CILs. Section 723 State A state wh ere the DSU issues grants or assistance contracts under

Part C to eligible entities for the planning, establishment, and operation of CILs. Service Provider Can mean: 1) A DSU that directly provides IL services to consumers; 2) A CIL; or 3) An entity that provides IL services under a grant or contract from the DSU. SI LC The Statewide Independent L iving Council established in each

state as required b y Section 705 of the Act. SI LS A State Independent L iving Services program funded under Part B,

Chapter 1 o f Title VII of the Act. SPI L A State Plan of Independent L iving jointly developed and signed by the director of the designated state unit(s) and the chairperson of the Statewide Independent L iving Council, acting on behalf of and at the direction of the C ouncil. The plan addresses the provision of state IL services, the development and support of a statewide network of centers for independent living and the10 working relationships among programs providing IL services, CI Ls, the state VR program, and other p rograms providing services for individuals with disabilities. State The term state includes, in addition to each of the several states of

the United States, the District of Columbia, the Commonwealth of Puerto Rico, the United States Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Is lands, except where otherwise noted. Unserved and In clude, but are not limited to, groups or Underserved populations of individuals with significant Populations disabilities who: (1) have cognitive and sensory impairments; (2) are members of racial and ethnic minority groups; (3) live in rural areas; or (4) have been identified b y the eligible agency as unserved or underserved with a center’s project area.11 

## Instructions: 704 Report, Part I

**General I nstructions:**  Please respond to each subpart of this preprint. 1) When a question/section requests a description, list or other non
- data information but does not apply to your state, a “NOT APPLICABLE” response is appropriate. 2) When a subpart requests d ata or a numerical response but does not apply to your state, enter zero, “0”. 

### Specific Instructions: Please carefull y read the instructions below and provide the requested details and/or data. 

### SUBPART I

**– ADMINISTRATIVE DATA**  **Section A**

**– Sources and Am**  **ounts of Funds and Resources** Sections 704(m)(3) and (4) of the Act; 34 CFR 364.35 and 364.36 List the amounts of all resources received by the state from items 1 through 3 during the federal fiscal reporting ye ar. In item 2 include “pass through” funds re ceived from state or local governments. “Pass through” funds are funds, received b y the DSU on behalf of consumers, that are subsequently

passed on to consumers, e.g., personal assistance services, representative pay ee funds, or Medicaid funds. In item 3 (H), “other resources” may include, for example, foundations, corporations or trust grants, donations from individuals or investment or endowment income. Note: If the State receives funding dedicated or restricted to a particular purpose, that funding s hould be included in the appropriate source category . For example, if the DSU receives funding from another Federal agency for specified transportation services for people with significant disabilities under the IL program, that funding should be included in the “Other Federal Funds” category
. Round off to the nearest dollar amount an y funds ending with cents. Example: $4,240,010.87  $4,240,011) (1) Add lines 1(A) through 3(H) to get the amount of Total Income received by the state. Record this amount in Item 4. (2) Enter the total amount of “pass through” funds received in Item 5. (3) Subtract the amount in Item 5 from the amount in Item 4 to get the total of Net Operating Resources for the state. Enter this amount in Item 6.12



### Section B

**– Distri**  **bution of Title VII, Chapter 1, Part B Funds** Section 713 of the Act; 34 CFR 364.22, 365.1, 365.20, and 365.21 Complete the table by

providing in items (1) through (8) the amount of Part B funds expended by the state directl y or through grant or contract i n each category in the appropriate column. If funds were not used for a purpose listed, please indicate b y placing $0 in the appropriate column. 

### Section C

**– Grants or Contracts Used to Distribute Title VII, Chapter 1, Part**  **B Funds** Sections 704(f) and 7 13 of the Act; 34 CFR 364.43, and 34 CFR 365 Subpart C Review your answers to Section B and enter the requested information for all grants or contracts funded at least in part by

Part B funds, in the table. Include Part C funded centers if they also rec eived Part B funds. Add more rows as necessary . A contractor or grantee that receives Part B funds for more than one activity (e.g., to provide IL services, as well as to conduct IL philosophy training), must be listed for as man y different activities it performs. If a column is not applicable to a particular grant or contract, such as the consumer eligibility or CSR columns intended only for service providers, enter “N/A.” If there were no non
- Part B funds (e.g. title VII, Chapter 2 funds, other feder al funds or state funds) provided to this grantee or contractor for the purpose listed, enter “$0” in that column. 

### Section D

**– Grants or Contracts for Purposes Other Than Providing IL**  **Services or For the General Operation of Centers** Section 713 of the Act ; 34 CFR 365.1 and 34 CFR 365.20 For Part B funds awarded as grants or contracts **for purposes other than to provide IL services or for the general operation of centers**  , provide a brief narrative description of the objectives for each agreement, what activ ities were conducted during the ye ar, and what results were achieved (e.g. funding for data collection, outreach programs to minorities, survey s). 

### Section E

**– Monitoring Part B Funds**  34 CFR 80.40(a) Provide a summary

of the program or fiscal review, evalu ation, and monitoring activities conducted b y the state during the reporting ye ar for an y of the grantees/contractors receiving Part B funds. Examples of review, evaluation and monitoring activities include review of 704 Reports or other program reports, on - site reviews by DSU and/or SIL C, fiscal audits of expenditures of Part B funds, summaries of corrective action plans, etc.13



### Section F

**– Administrative Support Services and Staffing**  Section 704(m)(2) and (4) of the Act; 34 CFR 364.31 **Item 1**

**– Administr**  **ative Support Services** Section 704(c)(2); 34 CFR 364.22(a)(2) Describe an y administrative support services, including staffing, provided by the DSU to the Part B program. **Item 2**

**– Staffing**  Report the total number Full Time Equivalents (FTEs) employed in the SILS program administered b y the DSU(s) and b y service providers other than CILs reporting in 704 Report, Part II. Report the total decision making and other staff and the number of FTEs filled b y individuals with disabilities.

 To compute FTEs, dete rmine the number of hours (excluding overtime) for which all employees were actuall y paid during the last six months of the reporting ye ar. Multiply the hours worked b y 2 (two), divide b y 2080 (approximate number of hours worked b y an FTE), the subsequent total is the equivalent fraction of the FTEs. 

### Section G

**– For Section 723 States ONLY**  Section 723 of the Act, 34 CFR Part 366, Subpart D **Item 1**

**– Distribution of Part C Funds to Centers**  In the table provided, please respond with the following informat ion: A) the name of each center within your state that received Part C funding during the reporting year; B) the amount of Part C funding each center received; C) whether the Part C funding included a cost
- of
- living increase, with a yes or no response; D) whether the Part C funding included any excess funds remaining after cost
- of
- living increases were provided, with a yes or no response; E) whether an y of the centers received its Part C funding pursuant to a competition for a new center in the state, with a yes or no response; and F) whether the center was the subject of an on
- site compliance review conducted by the DSU during the reporting ye ar, with a ye s or no response. Add additional rows as necessary
. **Item 2**

**– Administrative Support Services**  Section 704(c)(2 ); 34 CFR 364.22(a)(2) Describe the administrative support services used by the DSU to administer the Part C program.14

**Item 3**

**– Monitoring and On**  **- site Compliance Reviews**  Section 723(g), (h), and (i); 34 CFR 366.38, 366.40
- 46 Provide a summary

of the monit oring activities involving Part C centers conducted b y the state during the current reporting ye ar, including the on
- site reviews of at least 15% of centers receiving Part C funds under section 723. The summary should include, at least, the following: A) th e center’s level of compliance with the standards and assurances in section 725 of the Act; B) any adverse actions taken against centers; C) any corrective action plans entered into with centers; and D) exemplary , replicable or model practices of centers. **Item 4**

**– Updates or Issues**  Provide an y updates to the administration of the Part C program b y the DSU, including an y significant changes in the amount of earmarked funds or an y changes in the order of priorities in the distribution of Part C funds. Provide a des cription of any issues of concern addressed by the DSU in its administration of the Part C program. 

### SUBPART II

**– NUMBER AND TYPES OF INDIVIDUALS WITH**  **SIGNIFICANT DISABILITIES RECEIVING SERVICES**  Section 704(m)(4) of the Act; 34 CFR 364.53 In this section, provide data from all service providers (DSU, grantees, contractors) who received Part B funds and who were listed in subpart I, section C of this report, except centers for independent living that receive Part C funds . (Part C centers will provide this data themselves on their annual 704 Reports, Part II.) 

### Section A

**– Number of Consumers Served During the Reporting Year**  In clude Consumer Service Records (CSRs) for ALL cons umers served during the reporting y ear. (1) Enter the number of active CSRs carried over from September 30 of the y ear preceding the reporting year. Active CSRs are those corresponding to consumers who were actuall y served during the reporting ye ar. (2) Enter the number of new CSRs opened since October 1 of the reporting year. (3) To get the number of consumers served during the reporting ye ar, add the number of active CSRs carried over from the preceding ye ar to the number of new CSRs opened for the reporting year. Enter this number in line A(3). A(1) + A(2) = A(3). 

### Section B

**– Number of CSRs Closed by September 30 of the Reporting Year**  In the appropriate category , enter the number of CSRs that have been closed out of the active CSR files during the reporting ye ar because the consumer has:15

(1) Moved
- The consumer has moved out of the service provider’s service area and/or has moved and left no forwarding address (e.g. unable to locate consumer). (2) Withdrawn
- The consumer has stated he or she is no longer interested in receiving services at this time. (3) Died. (4) Completed all goals set
- The consumer has completed all goals and objectives, whether or not listed in the Independent Living Plan (ILP), and does not need/is not interested in rec eiving additional services at this time. (5) Other
- The CSR has been closed for an y other reason than those listed above. Total the number of CSRs for each category to get the number of CRSs closed for the reporting ye ar. Example: line B(1) + B(2) + B(3) + B(4) + B(5) = B(6). 

### Section C

**– Number of CSRs Active on September 30 of the Reporting Year**  To get the number of CSRs active on September 30 of the Reporting Year subtract the total number of CSRs closed by September 30 (line B(6)) from the total number of consumers served during the reporting ye ar (line A(3)). Enter this number in the table in Section C. 

### Section D

**– IL Plans and Waivers**  (1) Enter the total number of consumers with active CSRs during the reporting ye ar who have knowingl y and voluntarily signed a waiver stating an IL plan was unnecessary
. (2) Enter the total number consumers with active CSRs during the reporting ye ar with whom an ILP was developed. (3) Add the total number of consumers who signed a waiver to the total number of consumers who developed ILPs. Enter this figure in line D(3). D(1) + D(2) = D(3). This is the total number of consumers served during the reporting year and **MUST** equal the “number of consumers served” in Section A, line 3 above. 

### Section E

**– Age**  (1 ) through (6)
- Enter the number of consumers served during the reporting year in each age category as self reported by

each consumer. 

### Section F

**– Sex**  (1) and (2)

– Enter the number of male and female consumers served during the reporting year as self reported by

each consumer.16



### Section G

**– Race and Ethnicity**  (1) through (8)
- Enter the number of consumers served during the reporting year in each category , as self

- reported by

each consumer. **Each consumer may be counted under ONLY ONE of the following ca**  **tegories in the 704 Report, even if the consumer reported more than one race and/or Hispanic/Latino ethnicity.**  (1) American Indian or Alaska Native. American Indian or Alaska Native means a person having origins in an y of the original peoples of North and S outh America (including Central America), and who maintains tribal affiliation or community attachment. (2) Asian means a person having origins in an y of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malay sia, Pakistan, the Philippine I slands, Thailand, and Vietnam. (3) Black or African American means a person having origins in an y of the black racial groups of Africa. Terms such as “Haitian” may be used. (4) Native Hawaiian or Other Pacific Islander means a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. (5) White means a person having origins in an y of the original peoples of Europe, the Middle East or North Africa. (6) Hispanic or Latino of any race or Hispanic/ Latino only . Hispanic or Latino means a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. **Any consumer who reports Hispanic/Latino ethni city can only**  **be counted as “Hispanic/Latino,” even if the consumer also reported one or more race categories.**  (7) Two or more races. If a consumer self
- reports more than one race, that consumer must counted once in the 704 Report, that is, as “Two or More Races.” (8) “Race and ethnicit y unknown”

– A consumer is counted as Race/Ethnicit y Unknown if the consumer does not reports any race or ethnicit y. Note: The total of G1 through G8 must agree with subpart II, A3. 

### Section H

**– Disability**  (1) through (7)

– Enter the total number of consumers served in each category during the current reporting year as self reported by each consumer. These categories are meant to describe the functional limitations involved with a consumer’s disability rather than a grouping o f specific diagnoses of disabilities.17



### SUBPART III

**– INDIVIDUAL SERVICES**  **AND ACHIEVEMENTS FUNDED THROUGH TITLE**  **VII, CHAPTER 1, PART B FUNDS**  Sections 13, 704(m)(4) of the Act; 34 CFR 364.53; Government Performance Results Act (GPRA) Performance Measures S ubpart III features three related tables designed to measure how IL core services and other IL services help maximize the leadership, empowerment, independence, and productivity of individuals with disabilities, and the integration and full inclusion of in dividuals with disabilities into the mainstream of American society . Each table is described below. Section A

– Individual Services
- Quantifies the IL services requested b y, and provided to, consumers during the reporting ye ar. These services can be con sidered as the independent living program’s outputs contributing to the consumers’ expected outcomes , that is, greater independence and community integration. Section B
- Independence And Community Integration
- Quantifies the independent living program’ s outcomes , expressed in terms of the diverse goals that consumers have achieved through the provision of IL services ( outputs ), including the four core services. Section B consists of two related tables: Item 1 (Goals Related to Increased Independence i n a Significant Life Area). This table tracks the number of consumers who achieved independence in at least one significant life area. The term significant life area (SLA) is a way to classify

the multiplicity

of possible consumer goals into a few catego ries representing the range of life achievements made possible through IL services. SLAs represent the varying way s in which diverse consumers with disabilities can realize their particular potential

– ranging from competence in self

- care to relocation from a nursing home/institution to fulfillment of educational and vocational aspirations. Item 2 (Improved Access to Transportation, Health Care and Assistive Technology). The lack of access to essential opportunities such as transportation, appropriate he alth care services, or assistive technology may prevent an individual from achieving independence in one or more significant life areas. This table measures how the independent living program enables consumers to overcome barriers to their independence b y helping them to access previously

unavailable transportation, health care services, and assistive technology . These are certainly not the onl y barriers faced b y individuals with disabilities. However, data provided in these areas will enhance RSA’s abili ty to document the impact of the independent living program on individuals in these areas. Individuals with disabilities can overcome barriers to accessing transportation, health care services, or assistive technology through a combination of the IL servi ces listed in the table under section A, including the four core services
-- information and referral services, independent living skills training, peer counseling, and individual advocacy
. [Sy stems advocacy

is addressed in subpart IV.] For example, a service provider may facilitate a consumer’s access to previousl y unavailable transportation through mobility training, assistive devices, prosthesis or personal attendant care assistance; or independent living skills training to help consumers avail themselv es of existing community

transportation services. Access to appropriate health care services may be18

enhanced through information and referral services, such as the provision of directories of local medical facilities with available interpreters or TDD pho ne numbers; individual advocacy efforts resulting in accessible ramps or examining tables at doctors’ offices; peer counseling services to improve consumers’ self
- advocacy

abilities; or the arrangement of assistive technology services for consumers to bett er communicate with their doctors. Access to assistive technology may be expanded through information and referral to public and private sector sources of funding or equipment, independent living skills training on the use of assistive technology , and pee r counseling and individual advocacy to help consumers advocate for the services and equipment for which they are eligible. Note: T he term “assistive technology” (as defined in subpart III, section A) encompasses a broad range of independent living resour ces such as daily living, mobility , cognitive and communications aids as well as information technology
. The subpart III tables (section A, section B, item 1 and section B, item 2) are closely related. Transportation and assistive technology , for examp le, appear in each table. There are important differences, however, as the following examples illustrate:

 A consumer whose goal is Mobility/Transportation (section B, item 1) may receive Transportation Services such as information and referral to the community’s para
- transit sy stem (section A). Yet it may be that the consumer cannot achieve the Mobility/Transportation goal until he or she gains the necessary confidence to utilize the para - transit sy stem through IL skills training and peer counseling serv ices. In this example, the Mobility/Transportation goal (section B, item 1) involves more than just Transportation Services ( section A)

.  A consumer whose goal is Community

-Based Living (section B, item 1) may be impeded from reaching that goal because he/she lacks Access To Transportation (section B, item 2). Access to transportation is not the consumer’s goal, but simply the means to the consumer’s goal, community
- based living. Consumers may

appear in more than one of the subpart III tables:

 In the fi rst example, the successful consumer would appear in section A (under Transportation Services , Peer Counseling and IL Skills Training); in section B, item 1 (under the Mobility/Transportation goal); and in section B, item 2 (under Access to Transportation )
.  In the second example, the consumer would also appear in the three tables, except that he/she would appear under the Community

-Based Living goal instead of the Mobility/Transportation goal in section B, item 1.19

Detailed instructions for completing s ubpart III follow below : 

### Section A

**– Individual Services**  List the number of consumers requesting and the number of consumers receiving each of the following services during the reporting ye ar, including the IL core services. Include all consumers who we re provided services during the reporting year through Part B funds, either directly by DSU staff or via grants or contracts with other providers. Do not include consumers who were served b y an y centers that received Part C funds during the reporting year . Note: The total number of individual services provided is not expected to equal the number of active CSRs during the reporting ye ar, because one consumer may receive multiple services during the reporting ye ar. Also, individuals who receive informati on and referral (I&R) services would not necessarily

have an CSRs. A) Advocacy

/L egal Services

– Assistance and /or representation in obtaining access to benefits, services, and programs to which a consumer may be entitled. B) Assistive Technology

– Any assis tive technology device, that is, an y item, piece of equipment or product s ys tem that is used to increase, maintain or improve functional capabilities of individuals with disabilities and any assistive technology service that assists an individual with a di sability in the selection, acquisition or use of an assistive technology

device. C) Children’s Services

– The provision of specific IL services designed to serve individuals with significant disabilities under the age of 14. D) Communication Services

– Servi ces directed to enable consumers to better communicate, such as interpreter services, training in communication equipment use, Braille instruction, and reading services. E) Counseling and Related Services

– These include information sharing, psychological se rvices of a non
- ps ychi atric, non
- therapeutic nature, parent
- to - parent services, and related services. F) Family

Services

– Services provided to the famil y members of an individual with a significant disability

when necessary

for improving the individual’s ab ility to live and function more independently , or ability to engage or continue in employ ment. Such services may

include respite care. Record the service in the consumer’s CSR on behalf of whom services were provided to the family
. G) Housing, Home Modific ations, and Shelter Services

– These services are related to securing housing or shelter, adaptive housing services (including appropriate accommodations to and modifications of an y space used to serve, or occupied by individuals with significant disabilit ies).

 Note : A CIL may

not provide housing or shelter as an IL service on either a temporary

or long term basis unless the housing or shelter is incidental to the20 overall operation of the CIL and is provided to any individual for a period not to exceed eight weeks during an y six
- month period. H) IL Skills Training and Life Skill Training Services

– These may include instruction to develop independent living skills in areas such as personal care, coping, financial management, social skills, and household ma nagement. This may

also include education and training necessary

for living in the community and participating in community activities. I) In formation and Referral Services

– Id entify all individuals who requested this ty pe of assistance. This is the onl y service (other then services to family members) that may be provided to all individuals, whether or not the individual has a disability . Some entities record this service using strokes on an answering pad without opening a CSR, others create a CSR or other such file for future contact and outreach. J) Mental Restoration Services

– Psychiatric restoration services including maintenance on psychotropic medication, psychological services, and treatment management for substance abuse. K) Mobility

Training Serv ices

– A variet y of services involving assisting consumers to get around their homes and communities. L) Peer Counseling Services

– Counseling, teaching, information sharing, and similar kinds of contact provided to consumers by other people with disabilitie s. M) Personal Assistance Services

– These include, but are not limited to, assistance with personal bodily

functions; communicative, household, mobility , work, emotional, cognitive, personal, and financial affairs; community participation; parenting; leisure; and other related needs. N) Phy sical Restoration Services

– Restoration services including medical services, health maintenance, eyeglasses, and visual services. O) Preventive Services

– Services intended to prevent additional disabilities, or to prevent an increase in the severity

of an existing disability
. P) Prostheses, Orthotics, and Other Appliances

– Provision of, or assistance in obtaining through other sources, an adaptive device or appliance to substitute for one or more parts of the human body. Q) Recr eational Services

– Provision or identification of opportunities for the involvement of consumers in meaningful leisure time activities. These may include such things as participation in community affairs and other recreation activities that may be compet itive, active, or quiet. R) Rehabilitation Technology Services

– An y service that assists an individual with a disability in the selection, acquisition or use of applied technologies, engineering methodologies or scientific principles to meet the needs of th e individual and address the21

barriers confronted b y individuals with significant disabilities with respect to education, rehabilitation, employ

ment, transportation, IL and/or recreation. Note: Rehabilitation technology services may

include assistive tec hnology devices and services. However, for the purpose of this report, include the provision of assistive technology devices and services under item B, above. S) Therapeutic Treatment

– Services provided b y registered occupational, ph ysical, recreational, hearing, language, or speech therapists. T) Transportation Services

– Provision of, or arrangements for, transportation. U) Youth/Transition Services

– Any service that develops skills specifically designed for yo uth with significant disabilities between the a ges 14 and 24 to promote self
- awareness and esteem, develop advocacy and self
- empowerment skills and career exploration, including the transition from school to post school activities such as postsecondary education, vocational training, emplo ym ent, continuing and adult education, adult services, independent living or community participation. V) Vocational Services

– Any services designed to achieve or maintain employ ment. W) Other Services

– An y IL services not listed above in A
- V. 

### Section B

**– Increased**  **Indep endence And Community Integration**  **Item 1**

**– Goals Related to Increased Independence in a Significant Life Area**  For each of the significant life areas below, indicate the number of consumers who set goals, the number who achieved their goals, and the numb er whose goals were in progress at the end of the reporting year. Goal achievement is to be determined through self
- reporting b y the consumer and recorded in the individual’s CSR. (A) Self
- Advocacy

/Self
- Empowerment

– Goals involving improvement in a consumer ’s ability to represent himself/herself with public and/or private entities, the ability to make key decisions involving himself/herself, or the ability to organize and manage his/her own activities to achieve desired objectives. (B) Communication

– Goals inv olving either improvement in a consumer’s ability to understand communication by others (receptive skills), and/or improvement in a consumer’s abilit y to share communication with others (expressive skills). (C) Mobility

/Transportation

– Goals to improve a con sumer’s access to her/his life space, environment, and community . This may occur b y improving the consumer’s ability to move, travel, transport himself/herself, or use public transportation. (D) Community
- Based L iving

– Goals that provide for a change in liv ing situations with increased autonom y for the consumer. This may involve a consumer’s goals related to obtaining/modifying an apartment or house. Community
- based living22 arrangements may

include apartments, privatel y owned housing, self
- directed assisted living, or self

- directed living with family /friends. (E) Educational

– Academic or training goals that are expected to improve the consumer’s knowledge or ability to perform certain skills that would expand his/her independence, productivity or income
- generating potential. (F) Vocational

– Goals related to obtaining, maintaining, or advancing in employ ment. (G) Self
- Care

– Goals to improve/maintain a consumer’s autonom y with respect to activities of daily

living such as personal grooming and hygiene, meal preparat ion and nutrition, shopping, eating, and other aspects of personal health and safety
. (H) In formation Access/Technolog y
– Goals related to a consumer obtaining and/or using information necessary for the consumer’s independence and community integration. Thes e may

include use of a computer or other assistive technology , devices, or equipment, as well as developing information technology skills, such as using computer screen
- reading software. (I) Personal Resource Management

– Goals related to a consumer learning to establish and maintain a personal/family budget, managing a checkbook, and/or obtaining knowledge of available direct and indirect resources related to income, housing, food, medical, and/or other benefits. (J) Relocation from a Nursing Home or Institution

– Goals related to relocation from nursing homes or other institutions to community
- based living arrangements. This significant life area specifically pertains to consumers who live in a nursing home or institution, unlike the Community

-Based Living life area, above, which includes an y consumer regardless of his/her living situation prior to receiving IL services. (K) Community

/Social Participation

– Goals related to full participation in the mainstream of American society , including the ability to participat e in community events such as community fairs and government functions, attend worship services and access recreational activities and facilities. (L) Other

– IL goals not included in the above categories. **Item 2**

**– Im**  **proved Access To Transportation, Health C are Services and Assistive**  **Technology (A) Table:**  Please complete the columns in the Access Table found at (A) as follows: Column 1 (Consumers Requiring Access)

– Indicate the number of consumers

– whether or not they

originally

requested the assistance

– who required access to previously unavailable transportation, assistive technology or health care services in order to reach one or more of their IL goals listed in Item 1.23  The lack of transportation, health care services or assistive technology as bar riers to independence may

be identified by

the consumer and/or by

the service provider’s staff (as the consumer’s advisor). Column 2 (Consumers Achieving Access)

– Of the consumers counted in column 1, indicate the number who gained access to previously unavailable transportation, assistive technology

or health care services as a result of the provision of IL services. Include all consumers whose access in these areas was facilitated through the IL services provided

– whether or not such access had been the consumers’ originall y stated goal. Column 3 (Consumers Whose Access Is In Progress)

– Indicate the number of consumers who, at the end of the reporting ye ar, were in the process of attaining access to previously unavailable transportation, assistive te chnology or health care services through the provision of IL services.

 Any consumer counted in column 2 or 3 must also be counted in column 1. In the case of a consumer who achieves access as a result of I& R services, for example, that consumer should be counted under “Consumers Requiring Access” (column 1) as well as under “Consumers Achieving Access” (column 2). Note: For most IL services, a consumer’s access to previously unavailable transportation, health care and assistive technology is documented through his or her CSR. In some instances, consumers may

achieve an outcome solel y through information and referral services. In order to report these instances as successful outcomes, providers are not required to create CSRs for these consumers but mus t be able to document that follow
- up contacts with these consumers showed access to previously

unavailable transportation, health care and assistive technology
. **(B) Information and Referral Information:** To inform RSA how many service providers engaged i n I&R follow
- up contacts regarding access to transportation, health care services or assistive technology , please respond to the corresponding question in the instrument. 

### Section C

**– Additional Information Concerning Individual Services or**  **Achievements** Please provide an y additional description or explanation concerning individual services or achievements reported in subpart III, including outstanding success stories and/or major obstacles encountered.24



### SUBPART IV

**– COMMUNITY ACTIVITIES**  **AND COORDINATION** Section 704(i), (l), and (m)(4) of the Act; 34 CFR 364.26, 364.27, 364.32 

### Section A

**– Community Activities**  **Item 1**

**– Community Activities Table**  In the table provided, give a summary of the community

activities involving the DSU staff, SILC members/staf

f and CIL board members or staff during the reporting y ear. **Include in this count only CILs in the statewide network of centers that do not receive Part C funds.**  Add more rows as needed.

 In cluding information about the community activities of non
- Part C centers in the statewide network, in addition to DSU and SIL C community activities, will help provide a more complete picture of the independent living program’s impact on the lives of individuals with disabilities. For each activity , complete the fo llowing columns: Column 1 (I ssue Area)

– Indicate which of the following disability issue areas is most closely related to the purpose of the activity by placing it in column 1:

 In creasing accessibility to transportation  In creasing access to appropriate health care  In creasing the availability /access to assistive technology  In creasing opportunities for affordable, accessible housing units RSA has chosen to highlight the four issue areas listed above. However, respondents are expected to include all community activities in which they

participated during the reporting year. Therefore, respondents should identify an y other disability issue areas and include them in column 1. **A sample table is provided below.** Column 2 (Activity

Ty pe)

– Indicate which of the following activity t ypes best describes the activity

by placing it in column 2:

 Community

/Sy stems Advocacy

– In cludes efforts to implement local and state policy changes to make facilities, services, and opportunities available and accessible to indiv iduals with disabilities.

 Technical Assistance

– Assistance to the community on making services, programs, activities, resources, and facilities in society accessible to individuals with significant disabilities.

 Community

Education and Public Informatio n
– Activities and information programs to enhance the community ’s awareness of disabilities and disability issues, e.g., local TV, radio, or newspaper campaigns. This type of services may include the creation and distribution of publications (such as acce ssibility guides,25 disability awareness brochures, ADA information) and databases/directories for personal assistants, recreation opportunities, accessible transportation, accessible housing, and other available services.

 Outreach Efforts

– Entails the l ocation of, and encouragement to use services for unserved/underserved populations, including minority groups and urban and rural populations.

 Collaboration/Networking

– Activities related to building coalitions or collaborative partnerships designed to expand the participation of individuals with significant disabilities in services, programs, activities, resources and facilities. RSA has chosen to highlight the five activity t yp es listed above. However, respondents are expected to include all commun ity activities in which they participated during the reporting ye ar. Therefore, respondents should identify any additional ty

pes of activities related to the disability issue areas identified in column 1. **A sample table is provided below.** Column 3 (E ntity

)

– Specify

whether the DSU, the SILC and/or a center was the primary entity involved in the activity . More than one primary entity may be specified, if appropriate. (Entities with a secondary or supportive role may

be included in Subpart IV, Sectio n A, item 2) **A sample table is provided below.** Column 4 (Number of Hours )

– Report the number of hours spent b y DSU staff, SIL C members/staff or CIL board members or staff on each activity . Please round to nearest whole hour. **A sample table is provided below.** 

 The number of hours of community activities must be reported, not the number of hours times the number of participants. For example: If one CIL staff member gives a one
- hour presentation to an audience of 50 people, one hour of community service would be counted, not 50 hours. Conversely , if three CIL staff persons each gave a one
- hour presentation at the same event, three hours of community service would be counted. Column 5 (Objectives)

– Provide a brief narrative describing the primary objec tive(s) of the activity . Include, wherever possible, quantifiable data such as the number of people the activity

is expected to benefit. **A sample table is provided below.** Column 6 (Outcomes)

– Provide a brief narrative describing the primary outcome(s) of the DSU, SILC or CIL activity including, wherever possible, the number of people who actuall y benefited from the activity. **A sample table is provided below.**26 **SAMPLE TABLE Issue Area**  **Activity Type Primary**  **Entity Hours** 

**Spent Objective(s)**  **Outcome(s)** Heal th care Community

education / Outreach CI Ls 50 To develop an accessibility guide listing service area ph ys icians, specialists and facilities offering accessibility and reasonable accommodations. The guide will also identify

accessible medical providers of

fering services in Spanish. Distributed copies of the accessibility guide to 5,000 individuals with disabilities through partner organizations, including in underserved areas. Received feedback from 50 consumers reporting that the guides helped them to a chieve access to previously

unavailable health care. Transportation Advocacy CI Ls 30 To secure the count y council’s commitment to repairing and/or replacing aging and failing para
- transit wheelchair lifts. The count y council voted to conduct an assessment of the wheelchair lifts in its entire 50
- vehicle fleet of para
- transit buses, and to make the required repairs/replacements within two y ears. Assistive technology Collaboration DSU, SI LC, CI Ls 60 To establish a consortium of universities,

businesses, service providers, disability advocacy groups, mental health organizations and state/local government agencies to identify

way s to expand the availability

of assistive technology

for individuals with significant disabilities. Held the first monthly meeting of the consortium, with the participation of 6 partner organizations.

Housing Technical

assistance SI LC,

CI Ls 20 To provide information about applicable

laws related to housing accessibility and accommodations to approximately 20 apartment owners and management companies accounting for 20% of all rental housing units in the city
. Completed a legal resource guide and compiled a list of 20 initial target companies and owners.27

**Item 2**

**– Description of Community Activities**  For the community

activities mentioned above, provide an y additional details such as the role of the DSU, SILC, CIL, and/or consumers, names of any partner organizations and further descriptions of the specific activities and services performed and benefits conferred. **Section B**

**– Working**  **Relationships Among Various Entities** Describe DSU and SILC activities to maximize the cooperation, coordination, and working relationships among the independent living program, the SILC, and CILs; and the DSU, other state agencies represented on the SILC , other councils that address the needs of specific disability populations and issues, and other public and private entities. Describe the expected or actual outcomes of these activities. 

### PART V

**– STATEWIDE INDEPENDEN**  **T LIVING COUNCIL (SI LC**  **)** Section 705 o f the Act; 34 CFR 364.21 

### Section A **- Composition and Appointment**  **Item 1**

**– Current SILC Composition**  Provide the requested information for each SILC member in the table. Employ ment data is requested in order to ascertain whether the SIL C member is employe d by a center, a state agency , or neither. The category in which the member was appointed can be described, for example, as ex
- officio state agency representative, other state agency representative, center representative, person with a disability not empl oyed by

a center or state agency , section 121 funded project director, parent of person with a disability , community advocate, other service provider, etc.). Include current vacancies, along with the corresponding appointment category for each. Add more rows as necessary . **Item 2**

**– SILC Composition Requirements**  Provide the number of SILC members requested in each category . Include any current vacancies in a particular appointment category
. 

### Section B

**– SILC Membership Qualifications**  Section 705(b)(4) of the Act; 34 CFR 364.21(c) **Item 1**

**– Statewide Representation**  Describe how the SILC is composed of members who provide statewide representation. For example, you may

list the service areas currentl y represented in the SILC by center representatives or sect ion 121 representatives. You may also describe the policies and practices adopted b y the SILC to ensure continued statewide representation on the SILC.28

**Item 2**

**– Broad Range of Individuals with Disabilities from Diverse Backgrounds**  Describe how the SILC members represent a board range of individuals with disabilities from diverse backgrounds. For example, you may list the different disability groups and minority , urban and rural populations represented. You may also describe the policies and practices a dopted b y the SILC to ensure continued diversity on the SILC. **Item 3**

**– Knowledgeable about IL**  Describe how SIL C members are knowledgeable about centers for independent living and independent living services. For example, you may describe in general term s the SILC members’ IL background or expertise or efforts made to train members on IL philosoph y, laws, or best practices. You may also describe the policies and practices adopted by the SILC to ensure continued IL knowledge possessed b y members of the SI LC. 

### Section C

**– SILC Staffing and Support**  **Item 1**

**– SILC Staff**  Please provide the name and contact information for the SIL C executive director. Indicate the number and titles of an y other SILC staff, if applicable. Also indicate whether an y S ILC staff is also a state agency

employee. **Item 2**

**– SILC Support**  Describe the administrative support services for the SILC provided b y the DSU, if an y. 

### Section D

**– SILC Duties**  Section 705(c); 34 CFR 364.21(g) **Item 1**

**– SILC Duties**  Provide a summary

of SILC activi ties conducted during the reporting ye ar related to the SILC’s duties outlined in section 705(c) of the Act: **(A) State Plan Development** Describe an y activities related to the joint development of the state plan. Include any activities in preparation for developing the state plan, such as needs assessments, evaluations of consumer satisfaction, or hearings and forums. **(B) Monitor, Review and Evaluate the Implementation of the State Plan** Describe an y activities related to the monitoring, review and evaluation of the implementation of the state plan. Examples of discussion issues may include review of 704 Reports, SILC participation on site reviews conducted b y RSA, the DSU, and/or other relevant federal or state agencies, comments from persons with dis abilities, survey s conducted, etc.29

**(C) Coordination With Other Disability Councils** Describe the SIL C’s coordination of activities with the State Rehabilitation Council (SRC) established under section 105, if the state has such a Council, or the commissio n described in section 101(a)(21)(A), if the state has such a commission, and councils that address the needs of specific disability

populations and issues under other federal law. Please state whether the SILC has at least one representative serving as a member of the SRC and whether the SILC has any members serving on other councils, boards or commissions in the state. **(D) Public Meeting Requirements** Describe how the SILC has ensured that all regularly scheduled meetings and other public hearings and forums hosted by the SIL C are open to the public and sufficient advance notice is provided. This summary may include, for example, how meetings were publicized, methods used to ensure that individuals across the state had access to meetings, outreach to s pecial populations, state notification requirements, etc. **Item 2**

**– Other Activities**  Describe an y other SILC activities funded b y non - Part B funds. Please note that the SIL C may use Part B funds onl y to conduct the activities outlined in section 705 of the Act. An y activities that do not fall into the SILC’s federal duties may only be conducted with non
- federal funds. 

### Section E

**– Training and Technical Assistance Needs**  Section 721(b)(3) of the Act Please choose up to 10 priority needs that reflect th e technical assistance and training needs of the SILC. Using the column on the right, indicate the SILC’s top priorities rating items 1 through 10, with 1 being the top priority . Report any comments or clarifications using the blank space at the end of the subpart. The needs identified will be used to design CIL and SILC training opportunities offered through the training and technical assistance program. Please provide an y additional comments in the write
- in space provided.30



### SUBPART VI

**– SPIL COMPARISO**  **N AND UPDATES, OTHER ACCOMPLISHMENTS AND**  **CHALLENGES** Section 704(m)(4) of the Act; 34 CFR 76.140 

### Section A

**– Comparison of Reporting Year Activities with the SPIL**  **Item 1**

**– Comparison with SPIL goals and objectives**  Describe progress made in achieving the objectives and goals outlined in the most recentl y approved SPIL. Discuss goals achieved and/or in progress as well as barriers encountered. **Item 2**

**– Updates to SPIL Information**  Provide an y changes to the information contained in the currentl y approved SPI L. In particular, discuss any

changes that may

have occurred to the DSU administration of the SILS program, SI LC placement, legal status, membership or autonomy , SILC budget, or the statewide network of centers. Note: An amendment to the SPIL is re quired, in addition to this update, if there has been a significant and relevant change in the information or assurances in the plan, the administration or operation of the plan; or the organization, policies, or operations of the DSU (if the change materi ally affects the information or assurances in the plan). 

### Section B

**– Significant Activities and Accomplishments**  Describe an y significant activities and accomplishments achieved b y the DSU and SILC during the reporting ye ar and not included elsewhere in the report, e.g. brief summaries of innovative practices, improved service delivery to consumers, etc. 

### Section C

**– Substantial Challenges**  Describe an y substantial problems encountered b y the DSU and SIL C not included elsewhere in this report and discuss r esolutions/attempted resolutions. Examples include difficult y in outreach efforts, disagreements between the SILC and the DSU, complications recruiting SILC members, complications working with other State agencies or organizations within the State. 

### Secti **on D**

**– Additional Information**  Provide an y other information, comments or explanations of the reporting year activities and data that were not previously

included in other sections of the report. Please include any suggestions that may be helpful to other state agencies, SILCs, CILs and RSA. 

### SUBPART VII **- SIGNATURES**  Provide signatures, printed names, titles and phone numbers of DSU director(s) and SILC chair.