37. E-mail Certifying Representative 38. Name (last, 39. Title 40. Phone 41. E-mail Screen 2: Change in Lead Agency or Implementing Entity 1. Describe the mechanisms established to ensure coordination of activities and collaboration between the Implementing Entity and the state. [Text box - required if 16 is checked yes] Instructions: According to section 4(c)(1)(B) of the AT Act of 1998, as amended, the Implementing Entity must carry out its responsibilities through a subcontract or other administrative agreement with the Lead Agency. The description should identify the mechanism used and how the Lead Agency provides oversight and holds the Implementing Entity accountable for appropriate implementation of the Statewide AT Program. 2. Is the Lead Agency in this State Plan a new or different Lead Agency from the one designated by the Governor in your previous State Plan? [Drop-down menu - required] Instructions: The drop-down menu allows you to select “yes” or “no.” The “previous plan” was the plan under which the Statewide AT Program operated from October 1, 2015 until the submission of this State Plan. If a change in Lead Agency already has been approved by ACL under the previous State Plan, the state can select “no.” If you select “no,” and you use an Implementing Entity, move on to Question 46 about changing Implementing Entities. If you answered no to this question, and you do not use an Implementing Entity, you may skip ahead to the next section. Otherwise, you must answer the following questions. 3. Explain why the Lead Agency previously designated by the Governor should not serve as the Lead Agency. [Text box-required if Question 2 above is yes] Instructions: Describe all factors that led the state to consider changing from the previous Lead Agency or Implementing Entity, such as concerns about performance, state policies that require periodic competition for contracts, or restructuring of state government. 4. Explain why the Lead Agency newly designated by the Governor should serve as the Lead Agency. [Text box-required if Question 2 above is yes] Instructions: Describe how and why the new Lead Agency was chosen to implement the Statewide AT Program and justify the appropriateness of the choice. 5. Is the Implementing Entity in this State Plan a new or different Implementing Entity from the one designated by the Governor in the previous State Plan? [Drop-down menu-required if Screen1: Line16 is yes]
Provide financial support to this entity- Select this category “yes” if the Statewide AT Program provides dollars directly to an entity to conduct all or part of a state level or state leadership activity. This entity will be providing the State AT Program with data to submit for the activity in the Annual Progress Report. In-kind support is NOT included here. Receive financial support from this entity- Select this category “yes” if the Statewide AT Program receives dollars directly from an entity to conduct all or part of a level or state leadership activity. Details of this financial support will be reported in the Leveraged Funding section of the Annual Progress Report. In-kind support is NOT included here. Select all organization types that apply for each column. Banks/financial institution – Self-explanatory, typically only used with financial loan programs. Independent Living Center – Entity identified in the state as a recognized Independent Living Centers funded with federal and/or state independent living funding. Easter Seals – Entity recognized as an affiliate of the Easter Seals organization. Disability/AT Organizations – Any entity that primarily serves individuals with disabilities or provides AT services that is not more definitively identified in another category. Federal Entities/Agencies – Any public federal entity (usually reported as an agency providing funding) such as Department of Education, Rehabilitation Services Administration or Administration on Community Living, National Institute on Disability, Independent Living, and Rehabilitation Research, etc. State Entities/Agencies – Any public state entity such as Vocational Rehabilitation, State Medicaid Agencies, Special Education, State Colleges and Universities, etc. Local/Community Entities – Any public local or community entities, such as local school districts, city government, county election offices, etc. Private Entities – Private entities of any type, non-profits, foundations, etc. at any level, national, state, or local. Other – This category should only be used when the entity cannot reasonably be categorized in any of the previous categories provided. (Should be used rarely and a description must be provided.)