AIDD PROPOSED VERSION 06.29.2018

**ONE PPR**

Annual Program Performance Report (PPR)

Annual Statement of Goals and Priorities (SGP)  

**PADD**

**PAAT**

**PATBI**

**PAVA**

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 to average 128 hours 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 (P.L. 105-220 Section 410 Workforce Investment Act). Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Administration for Community Living, U.S. Department of Health and Human Services, 330 C Street, SW, Washington, DC 20201-0008, Attention Ophelia McLain, or email ophelia.mclain@acl.hhs.gov and reference the OMB Control Numbers for the four annual reports, i.e., (1) Developmental Disabilities Protection and Advocacy Systems Program Performance Report (0985-0027), (2) Protection and Advocacy for Assistive Technology (PAAT) Program Performance Report (0985-0046); (3) Protection and Advocacy Voting Access Annual Report (Help America Vote Act (HAVA) (0985-0028); Protection and Advocacy Systems (P&A) Annual Narrative Report (0970-0326) and (4) Protection and Advocacy for Traumatic Brain Injury (PATBI) Program Performance Report (0985-0058). Note: Please do not return the completed Program Performance Report to this address.

Part 1:  Demographics

## Interventions on behalf of Individuals 

### *The following subsections include demographic information for the seven intervention strategy types listed in Part I.F.*

# 

# 

# Part 2:  Statement of Goals and Priorities

### A.  Report on FY 20__  (Previous Year) Statement of Goals and Priorities (SGP)

**6.  Results Narratives of P&A Activities and Accomplishments Related to Above Goal[footnoteRef:2]** [2:  A results narrative is a story which presents relevant information pertinent to each goal and its priorities about an individual or group case/project which is being pursued or was pursued with the intent of achieving a result/outcome.  A grantee may submit multiple narratives.] 

***List goal and priority #(s) addressed in the activity described in the narrative below.***

**Other Qualitative Narrative Related to the Above Goal**

*Significant activity for which there were no quantifiable results goes here.*

### B.  Priority Setting Process[footnoteRef:3]  [3:  The P&A will submit periodically a thorough description of the methods used for the priority setting process, and then annually indicate whether they have changed the methods used for the priority setting process. If it has changed, they would need to include a full description of the changes.] 

*Complete this section by providing a thorough description of how the P&A conducts priority setting process (e.g., methods) used to develop the goals and priorities for the fiscal years covered in your multiyear plan. Revise based on public input on an annual basis with the idea that major changes will be made when it is time for a new multiyear plan.*

**1.  Means by which the P&A conducted data-driven strategic planning, including formal public input***(Check all that apply below)*

**2.  Number of days for public comment:**

**3.  A copy of the proposed SGP for comment was provided to the:[footnoteRef:4]** [4:  This question is only required for PADD. ] 

**State Council on Developmental Disabilities:**Yes/No

**The University Centers for Excellence in Developmental Disabilities Education, Research and Service:**Yes/No

4. **Describe efforts to assure diversity**(disability, geographic, racial, etc.)**in the data-driven strategic planning process**

**5.  Summary of Findings**

**6.  Summary of How Data was used to Develop P&A Goals and Priorities (include how priority input used, including input from the DDC and UCEDD)[footnoteRef:5]** [5:  This question is only required for PADD. ] 

### 

**5.  List of topic areas of additional priorities that would be listed but are not due to lack of resources.**

### 

### C.  FY _ _ _ _ (Current Year) Statement of Goals and Priorities (SGP)

*This section allows you to edit your goals and priorities for the next fiscal year. Check the box to indicate if there are changes or no changes to the SGP from prior year. If there are changes from the prior year, the system will give you the prompts below. There may be multiple goals for each grantee.*

☐ *There are no changes to the SGP from prior year.*☐ *There are changes to the SGP (see below below).*

### D.  Description of P&A Operations[footnoteRef:6] [6:  This section is only required for PADD. ] 

# Part III: Results of P&A Activity[footnoteRef:7] [7:  Only those measures and subsections with data will be displayed when the report is submitted.] 

### A.  End Outcomes of P&A Activity

By Intervention Type[footnoteRef:8]  [8:  There will be one table for each program. ] 

### B.  Overview of How Many People with Disabilities Served 

## 

### C.  Rights-Based Individual Advocacy Services 

### D.  Investigations of Abuse and Neglect

**Other Qualitative Narrative**

### E.  Monitoring [PADD/PATBI/PAAT]

## Facilities/Programs Monitored

Total Number of Unique Facilities: 

**Other Qualitative Narrative**

### 

### F.  Systemic Litigation

### G.  Educating Policymakers[footnoteRef:11] [11: ] 

### H.  Other Systemic Advocacy

**PROGRAM SPECIFIC MEASURES**

**PAAT PROGRAM**

**PAVA PROGRAM**

### Combined Report for ACL P&A Programs

### 

### *This is the place to report information common to the four P&A programs (PADD, PAVA, PAAT and PATBI) under the oversight of the Administration for Community Living (ACL).  Information is entered once here and applies to all programs.*

### 

### Part 1 - Public Relations and Outreach 

**Part 2 - Collaboration**

 The purpose for this section is to streamline the reporting of major collaborative efforts and avoid duplication in the reporting of activity.  Step 1 is to enter the name and description of all major collaborations.  Then when writing Results Narratives as a part of reporting on priority implementation in any of the ACL P&A PPRs, it will only be necessary to select name of the collaboration from a dropdown menu when work it contributed to is being described.  

  Required collaborations include the client assistance program (unless housed within the P&A), long term care ombudsman (unless housed within the P&A), developmental disabilities council, center(s) for excellence (university affiliated program) and any parent training centers. Listing other collaborations is optional but can be very useful in demonstrating the extent and effectiveness of collaborative efforts.

*Check one or more of the following boxes if the P&A houses any of these programs.*

*Multiple collaborations may be entered.*

### 

### Part 3 – Board, Staff, and Advisory Council Demographics

### A.   Advisory Council

**Does your P&A have a governing board?**

**□ Yes     □ No**

**Does your P&A have an advisory council(s) ?**

**□ General     □ PADD □ PATBI □ PAAT □ PAVA**

### B.  Board, staff and advisory council race and ethnicity

### 

### C.  Consumer involvement in P&A governance 

(Please report the total number of board members for your Board and/or Advisory Council. Then report how many members fall into each consumer group.  Members can be counted as more than one type of consumer)

### 

### Does the P&A Board meet the requirements of section 144 of the DD  Act? [footnoteRef:18]  [18:  42 U.S.C. 15044(B) a majority of the members of the board shall be— (i) individuals with disabilities, including individuals with developmental disabilities, who are eligible for services, or have received or are receiving services through the system; or (ii) parents, family members, guardians, advocates, or authorized representatives of individuals referred to in clause (i); ] 

**□ Yes     □ No**

###   Part 4 – General Information

### 

###   A. P&A Identification

###   B.  Main Office (or Office of Record)

###   C.  Additional Offices (If any) (Add rows if needed)

###   D. CEO Contact Information

###   E.  PPR Preparer Contact Information

  PADD PPR Preparer

  PAVA PPR Preparer

  PATBI PPR Preparer

  PAAT PPR Preparer

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