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 vaccinated 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/pamphlets/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 get 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 of 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 of 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 of 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