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ANNUAL PROTECTION & ADVOCACY FOR ASSISTIVE TECHNOLOGY - (PAAT)
PROGRAM PERFORMANCE REPORT

INSTRUCTION MANUAL

This document contains step-by-step instructions for completing the six parts of the PAAT annual progress reporting form.
If you want to see the Questions and Answers section click here.

A PREAMBLE TO THE INSTRUCTIONS

The obligation of Protection and Advocacy programs (P&As) to report to the U. S. Department of Education (ED) and ED's obligation to report to the President and Congress stems from the following language that is excerpted from section 5(f) of the Assistive Technology Act of 1998 as amended by the Assistive Technology Act of 2004 (AT Act) (P.L. 108-3 64). When completing this web-based reporting form, P&A staff should review this statutory language as a guide on how best to report annual Protection and Advocacy for Assistive Technology (PAAT) program activity.

P&As Annual Report to the Secretary of Education - 29 U.S.C. § 3012(c)

The following language creates the obligation of P&As receiving PAAT grants to annually report to the Rehabilitation Services Administration (RSA) within ED (emphasis added):

'An entity that receives a grant under this section shall annually prepare and submit to the Secretary a report that contains such information as the Secretary may require, including documentation of the progress of the entity in --

(1)   conducting consumer-responsive activities, including activities that will lead to increased access, for individuals with disabilities, to funding for assistive technology devices and assistive technology services;

(2)   engaging in informal advocacy to assist in securing assistive technology and assistive technology services for individuals with disabilities;

(3)   engaging in formal representation for individuals with disabilities to secure systems change, and in advocacy activities to secure assistive technology and assistive technology services for individuals with disabilities;

(4)   developing and implementing strategies to enhance the long-term abilities of individuals with disabilities and their family members, guardians, advocates, and authorized representatives to advocate the provision of assistive technology devices and assistive technology services to which the individuals with disabilities are entitled under law other than this chapter; and

(5)   coordinating activities with protection and advocacy services funded through sources other than this subchapter, and coordinating activities with the capacity building and advocacy activities carried out by the lead agency.'

(6)   effectively allocating funds made available under this section to improve the awareness of individuals with disabilities about the accessibility of assistive technology and assist such individuals in the acquisition, utilization, or maintenance of assistive technology devices or assistive technology services.

REPORTING PERIOD

The Secretary has transferred the administration of the PAAT program from the National Institute on Disability Research and Rehabilitation (NIDRR) to RSA. Prior to this change, NIDRR administered the program with a budget and reporting period beginning on April 1st and ending on March 31st of each calendar year. RSA has changed the budget and reporting period for the program to run concurrent with the Federal fiscal year, October 1st – September 30th of each year. This change is intended to reduce the reporting burden on the grantees and to bring about consistency of administration with other formula grants received by the P&As.

PART I: NON-CASE SERVICES

A.     INFORMATION & REFERRAL (I&R) SERVICES

Definition: I&R services are those services that include responses to individuals at meetings, one-time telephone discussions, and responses to requests for information from an individual. These services generally take less than one hour of service time. The agency typically would not have personal identifying information about the individuals who request and/or receive I&R services, except for possibly the name, address and telephone number. For purposes of this section of the report, individuals who receive I&R services are those who do not meet the definition of 'individual served' under Part II below.

A.1:        Enter the number of individuals who received I&R services under PAAT for the fiscal year. In other words, the agency was able to meet these individuals' needs by providing I&R services only and did not open a case file for these individuals. Count each individual requesting I&R services only once regardless of the number of times they made requests or the number of requests per call. (The intent is to obtain an unduplicated count.) 

If you are unable to provide an exact count because all I&R requests for the P&A agency are handled through one or more grants other than the PAAT grant, estimate the number of individuals whose requests were related to PAAT services. 

A.2:        Enter the number of I&R requests under PAAT for the fiscal year. This number may include multiple requests from the same individual within the fiscal year, i.e., the number entered in A2 can be greater than the number entered in A1.  However, the number entered in A.2 cannot be lower than the number entered in A.1.  If the number of requests is lower than the number of individuals, the system will generate an error message.

If you are unable to provide an exact count because all I&R requests for the P&A agency are handled through one or more grants other than the PAAT grant, estimate the number of requests that were related to PAAT services. 

Guidelines:

·        Include the number of times that the agency provided I&R services to individuals during the fiscal year. All agencies should maintain logs to respond accurately to this section. Such routine requests should not require maintenance of confidential client information, extensive research by agency staff or extended contact with the individual.

·        When counting follow-up mailings of letters, brochures or pamphlets, count only the number of individuals who actually requested the information, not the number of letters, brochures or pamphlets sent. Do not include the number of brochures, pamphlets or newsletters that are routinely distributed en masse or the number of individuals who attend workshops or trainings presented by agency staff. These data will be collected in another section of this report.

B.  TRAINING ACTIVITIES

A training session can take many forms, including in-person sessions and distance learning sessions (i.e., teleconference training or web-based training). It could include a very short presentation of 30 minutes or less, or might involve a full-day or multi-day conference. In answering questions B1 and B2, please count each discrete session as one training session.

·        First Example: The PAAT presents a daylong program on funding of AT. Three different funding sources are covered, but this is all one coordinated session. Under B1, this counts as one training session; under B2, the participants are also counted once.

·        Second Example: The PAAT delivers a two-day conference. Following a full-morning plenary session for all 150 conference attendees, the remainder of the conference is divided into four concurrent tracks or breakout sessions, allowing for 20 additional sessions over the remainder of the conference. Despite the much larger scope of this second event, the full conference should count as one training session under B1 and 150 should be entered once under B2. NOTE: The P&A can explain the larger scope of this second event as a narrative example under B3.

B.1:     Enter the number of training sessions presented by the staff for PAAT. This would include training sessions for individuals with disabilities, their families, and various community groups.

B.2:     Enter the number of individuals who attended these training sessions. If the agency did not maintain registration logs of these training sessions, it is acceptable to provide an estimate of the number of individuals who attended.

B.3:     Describe in detail two representative training sessions presented by the staff for PAAT. Include information about a) the topics and issues covered, b) the purpose of the training and c) a description of the attendees (i.e., consumers, service providers, advocates, etc).  If you wish to report on more than two representative training sessions, you may describe additional sessions as accomplishments in Question V.C. 

B.4:     Describe the agency's outreach efforts to previously unserved or underserved individuals. The definition of 'unserved and underserved individuals' contained in the Act can include individuals from minority communities, from rural areas, or from specific disability groups.

C. INFORMATION DISSEMINATED TO THE PUBLIC BY YOUR AGENCY

C.1:     Enter the number of radio and/or TV appearances that PAAT staff made during the fiscal year.

C.2:     Enter the number of articles that the agency staff wrote and had published for PAAT in newspapers, magazines, journals or other periodicals.

C.3:     Enter the number of videos or public service announcements (PSAs) aired pursuant to the agency's PAAT-related efforts. Do not include the number of times the videos or PSAs were aired. For example, the local radio station aired two of the agency's PSAs about architectural barriers thirty times each. For purposes of this section, there were two PSAs aired.

C.4:     Enter the total number of hits that were made on the agency's website during the fiscal year covered. Do not attempt to estimate or breakdown by Federal program.

C.5:     Enter the number of discrete publications, booklets or brochures that the agency disseminated for PAAT during the fiscal year. Include those brochures, booklets and publications that were disseminated en masse at trainings or via regular mailings to the agency's mailing list and include those brochures, booklets or publications that were disseminated to individuals at the individual's request. EXAMPLE: If an agency published 3 brochures and distributed each brochure to 100 people, report 3 (not 300) in this item.

C.6:     Under 'number,' enter the number of other information, not captured in C1. through C5. disseminated to the public at large for PAAT during the fiscal year. Under 'specify,' describe the 'other' means used to disseminate information to the public regarding PAAT activities.

D.  INFORMATION DISSEMINATED ABOUT YOUR AGENCY'S ACTIVITIES BY EXTERNAL MEDIA COVERAGE

The activities of a PAAT program or the services available through the PAAT program often are reported by the radio, TV, or print media, for example, with or without the encouragement of the PAAT. Where it is available, enter narrative information regarding any external media that provided coverage of the PAAT program's activities during the fiscal year. This narrative information should be included under the category that is most appropriate. If there is no information to report, type in 'N/A' or 'not applicable'.

PART II: CASE-SERVICES

A. INDIVIDUALS SERVED

Definitions: Refer to these definitions when completing Part II of the form.

  • Individual Served: To be considered an 'individual served' (i.e., a client), the individual must meet three criteria:
  1. The individual must be eligible for PAAT program services. An individual is eligible for PAAT services if he/she has a disability and is or would be enabled by an assistive technology device or assistive technology service to minimize deterioration in functioning, to maintain a level of functioning, or to achieve a greater level of functioning in any major life activity.
  2. The agency has opened a case file, which includes at least the individual's name, address, age, race, disability, signed release of information form (if appropriate), the individual's concern or complaint, and the action taken by the agency.

3.      The agency provided at least one 'significant service,' such as:

a.    At least one hour of case service time;

b.    A supervised referral that allows follow-up to assure that the referral was appropriate and completed;

c.    The completion of a second telephone call to the client when the time between telephone calls was used to obtain additional information about legal rights or how to obtain AT devices or AT services; or

d.    The provision of any allowable service beyond I&R services, as defined above.

·     Case File: This is the compilation of personal identifying information about an individual, documents, letters, complaints or issues raised, advocate's notes, etc., used in working with an individual served. It may contain many issues at any one time. In fact, many individuals served will present several issues to the agency during the course of the agency/client relationship. The case file is opened at the time the agency determines that it will provide at least one significant service for the individual. New issues may arise while still working with an individual. These new issues, if appropriate for agency intervention, should be added to the existing case file.

·     Multiple Case Files: When an individual is served on two or more separate legal problems, the PAAT program may have two or more case files for that same individual.

A.1:  Enter the number of individuals who had open case files at the beginning of the fiscal year, which were carried over from the prior fiscal year.

A.2:  Enter the number of individuals who first sought agency assistance and had a case file(s) opened during this fiscal year (new cases).

A.3:  The system will automatically add the numbers entered in A. 1 and A.2 in order to generate A.3. This is the total number of individuals served during this fiscal year under PAAT. Remember, no individual may be counted more than once per program in a fiscal year. This number will be used as a checkpoint reference in subsequent tables. For each subsequent field asking for a total of individuals served, the system will check against the total reported in II.A.3. If the totals do not match, the web system will give you an error message.

A.4:  Enter the total number of individuals who had a case (or all of their cases, if more than one was open at the start of the fiscal year) closed under PAAT during the fiscal year. Do not count an individual if he/she had multiple cases open at the start of the fiscal year and only some are closed. The total entered in A.4 reflects the number of individuals who were served during the fiscal year but are no longer being served by the agency.

A.5:  Total number of individuals still being served at the end of the fiscal year. The web system will generate this number by subtracting Part II.A.4 from Part II.A.3.

B.   PROBLEM AREAS/COMPLAINTS FOR INDIVIDUALS SERVED

Include in this category the types of problems/complaints that "individuals served" presented to PAAT during this fiscal year. The following list contains broad categories of the common types of complaints/problems individuals served present to PAAT. Please account for each problem/complaint in the most appropriate category. Multiple counts are permitted in case one individual presents more than one problem/complaint for PAAT intervention.

Guidelines:

  • Include in this section the types of problems or complaints that individuals served presented to the agency during this fiscal year. Include only those problems or complaints that were directly related to the individual's disability.

Example: An individual with a disability may have a housing problem that is not related in any way to the individual's disability. Although that individual with a disability might otherwise be eligible for the agency's services, the agency cannot represent that individual on the housing problem if that housing problem is not related to the individual's disability. The agency could, however, represent that same individual on a different issue, such as employment, that is related to the individual's disability.

  • Include in this section only those problems that are directly related to obtaining or retaining AT devices or AT services. (See definitions for AT devices and AT services under Part II.C, below.)

Example: An individual with a special education dispute regarding school discipline would not ordinarily get counted as a PAAT case as there would be no AT-related issue in the case. The same individual with a special education dispute involving the need for an adapted computer keyboard would get counted as a PAAT case as the issue involves the need for an AT device.

B.1:        Enter the number of individuals who sought PAAT assistance for complaints related to architectural barriers or other building accessibility problems. These complaints could relate to any aspect of accessibility to a building or structure, including the adjoining parking lot or garage, building entrance, interior rooms, signage, etc. Include complaints for both public and private buildings and structures.

B.2:        Enter the number of individuals who sought PAAT assistance for complaints related to education. Do not include those complaints that relate to post-secondary education (B.7).

B.3:        Enter the number of individuals who sought PAAT assistance for complaints related to employment discrimination.

B.4:        Enter the number of individuals who sought PAAT assistance for complaints related to Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) work incentives. Work incentive issues likely to involve AT include SSI's Plan for Achieving Self Support, SSI's blind work expenses or impairment related work expenses under either SSI or SSDI.

B.5.a-d: Enter the number of individuals who sought PAAT assistance for complaints related to healthcare for each of the available subcategories (Medicaid, Medicare, private health insurance, other). The web system will generate a total (B5) based on numbers reported in B.5.a-d.

B.6:        Enter the number of individuals who sought PAAT assistance for complaints related to housing.

B.7:        Enter the number of individuals who sought PAAT assistance for complaints related to post- secondary education.

B.8:        Enter the number of individuals who sought PAAT assistance for complaints related to rehabilitation services. This category would include enforcement of rights against state vocational rehabilitation agencies under Title I of the Rehabilitation Act, against employment networks under the Ticket to Work program or against private rehabilitation agencies.

B.9:        Enter the number of individuals who sought PAAT assistance for complaints related to transportation.

B.10.a-c: Enter the number of individuals who sought PAAT assistance for complaints related to voting for each of the available subcategories (accessible polling place/equipment, registration, other). The web system will generate a total (B 10) based on the numbers reported in 10.a-c.

B.11 and B.12: Enter the number of individuals who sought assistance from PAAT for complaints not otherwise covered by the above list of categories and specify the 'other' problem area. Note: The listing in the parenthetical includes potential categories of cases that could fit into 'other.' (Abuse, access to records, advance directives, employment preparation, other financial benefits, government benefits/services, immigration, neglect, non- medical insurance, privacy rights, suspicious death, and unnecessary institutionalization.)

B.13: The web system will automatically generate the total number of cases by problem area by adding lines B.1-B.12 and placing the total on line B.13.

C.     ASSISTIVE TECHNOLOGY DEVICE/SERVICE

The AT Act defines AT device and AT service as follows:

·        AT device: The term "assistive technology device" means any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified or customized, that is used to increase, maintain or improve functional capabilities of individuals with disabilities.

·        AT service: The term "assistive technology service" means any service that directly assists an individual with a disability in the selection, acquisition or use of an assistive technology device.

The goal of the AT Act, in funding the PAATs, is to provide advocacy services to individuals with disabilities to enable eligible clients to obtain appropriate AT devices and AT services.

Use this section to enter the number of AT devices or AT services granted as a result of casework.

C.1: Report the unduplicated number of individuals who received an AT device or AT service as a result of the PAAT's casework during the fiscal year. If an individual received two or more AT devices, two or more AT services, or some combination of AT devices or services, you still only count the individual once.

C.2.a-m: Enter the number of AT devices, by category, and AT services (C.2.l), obtained by individuals with disabilities as a result of PAAT casework. Report all of the AT devices and AT services obtained by all individuals during the fiscal year. The count should include individuals who received more than one device or service, through one or more cases in the fiscal year.

·     Example: If the PAAT successfully represented a person in a Medicaid hearing for a wheelchair, count this as one device under the category of devices for mobility (C.2.b). If the PAAT also arranged for a wheelchair evaluation in order to successfully represent the person in the Medicaid hearing, you should separately count the wheelchair evaluation as a separate AT service under C.2.l.

·     Example: If, during the same fiscal year and for the same individual above, the PAAT helped him/her obtain an augmentative communication device through a Medicaid hearing, report this under C.2.a, a device for communication. Similarly, if the PAAT helped the same individual obtain from a school district training to learn to use the device, report this as an AT service under C.2.l.

D. CLOSING CASE FILES

This section contains a list of the reasons an agency might give for closing the case file of an individual served. Choose one primary (most appropriate) reason for closing each case file. Do not itemize a reason for resolving each issue raised. The number of case files may, in some situations, be greater than the total number of individuals served (Part II.A.3) to account for those situations when an individual had multiple case files closed during the fiscal year. Estimated counts are not acceptable.

D.1:       All Issues Resolved in Client's Favor: Enter the number of PAAT case files that were closed by the agency in which all of the issues were resolved in the individual's favor.

D.2:       Some Issues Resolved in Client's Favor: Enter the number of PAAT case files that were closed by the agency in which some of the issues were resolved in the individual's favor.

D.3:       Other Representation Obtained: Enter the number of PAAT case files that were closed by the agency because the individual obtained other representation. Include those times when the agency referred the individual to another advocate/attorney, as well as when the individual sought representation by someone other than an agency advocate/attorney.

D.4:       Individual Withdrew Complaint: Enter the number of PAAT case files that were closed by the agency when the individual withdrew the complaint because he/she did not want to pursue resolution of the problem at this time.

D.5:       Services Not Needed Due to Death, Relocation, etc.: Enter the number of PAAT case files that were closed by the agency because the individual no longer needed the agency services due to the individual's death, relocation, etc.

D.6:     Individual Not Responsive to Agency: Enter the number of PAAT case files that were closed by the agency because the individual stopped communicating with the agency or failed to provide necessary information.

D.7:     Case Lacked Legal Merit: Enter the number of PAAT case files that were closed by the agency because the staff determined, after exploring the facts and the law further, that the individual's complaint lacked legal merit.

D.8:     Conflict of Interest: Enter the number of PAAT case files that were closed by the agency because the staff determined, after exploring the facts and the law further, that the agency could not represent the individual (due to a conflict with other current or former clients, or a conflict with other potential or existing agency litigation).

D.9:     Lack of Resources: Enter the number of PAAT case files that were closed by the agency because the agency lacked sufficient staff or resources to represent the individual.

D.10: Not Within Priorities: Enter the number of PAAT case files that were closed by the agency because the staff determined that the case was not appropriate under the scope of the program's priorities.

D.11: Issue Not Resolved in Client's Favor: Enter the number of PAAT case files that were closed by the agency in which the issue or issues were not resolved in the individual's favor.

D.12: Other: Enter the number of PAAT case files that were closed by the agency for a reason not covered by D. 1-11, and specify/describe the reason. This response should be reserved for rare instances when a reason for closure clearly does not fit into any of the above categories.

D.13: Total: The web system will automatically generate the total number of case files closed by adding lines 1-12 and placing the total on line 13.

E. INTERVENTION STRATEGIES FOR CLOSED CASES

Guidelines: Agencies engage in a variety of intervention strategies to resolve complaints raised by the individuals served. Although agencies generally use more than one type of strategy to serve a client, choose the highest level of intervention strategy used by the agency on behalf of the individual to resolve the complaint (i.e., close the case). The number of cases (E.9) may be greater than the total number of individuals with cases closed (Part II.A.4) to account for situations when an individual had multiple case files closed during the fiscal year. Estimated counts are not acceptable.

Example 1: The agency may have engaged in investigation, negotiation, and alternative dispute resolution (ADR) activities on behalf of an individual served in order to resolve the complaint. The agency provided all three of these services during the course of one case file. The agency should account for this individual in mediation/ADR (E.5) since this was the highest level of service provided to this particular individual.

Example 2: The agency may have opened and closed two different case files on behalf of an individual served during the fiscal year. During the course of working with the individual on the first case, the agency provided short-term assistance and advice (E.1). However, in the second case, the agency represented the individual at a formal administrative hearing. The agency should account for this individual in short-term assistance (E.1) for the first case file and administrative hearing (E.6) for the second case file.

E.1:        Enter the number of PAAT case files closed in which the highest level of intervention provided by the agency was short-term assistance. In these cases, the agency was able to assist the individual by providing legal advice or extended I&R services or by performing brief research or letter writing on behalf of the individual.

E.2:        Enter the number of PAAT case files closed in which the highest level of intervention provided by the agency was to engage in systemic or other policy-making activities to resolve the individual's complaint. For example, the agency may have been successful in changing an agency policy on a particular issue, raised by many individuals, without resorting to formal administrative (E.6) or legal remedies (E.7 or E.8).

E.3:        Enter the number of PAAT case files closed in which the highest level of intervention provided by the agency was investigating or monitoring a particular situation. In these cases, the agency was able to assist the individual by investigating the complaint or monitoring a situation or facility. Upon investigation, the agency may have determined that the case lacked merit, the agency did not have sufficient resources to proceed further or the case did not fall within the agency's priorities.

E.4:        Enter the number of PAAT case files closed in which the highest level of intervention provided by the agency was negotiation. In these cases, the agency was able to affect a resolution for the individual by engaging in direct negotiations with the adverse party in an informal environment. Do not include negotiations using a formal mediator or another form of ADR (E.5).

E.5:        Enter the number of PAAT case files closed in which the highest level of intervention provided by the agency was mediation or another form of ADR. In these cases, the agency assisted the individual by engaging in mediation or another form of ADR to resolve the dispute between the individual and another party.

E.6:        Enter the number of PAAT case files closed in which the highest level of intervention provided by the agency was representation at or assistance in preparing for a formal administrative hearing. Do not include any legal services provided beyond the administrative hearing stage (i.e., services provided in state or federal court (E.7)).

E.7:        Enter the number of PAAT case files closed in which the highest level of intervention provided by the agency was representation in litigation. In these cases, the agency assisted the individual in pursuing legal recourse in the judicial system to resolve the individual's complaint. Do not include class actions (E. 8).

E.8:        Enter the number of PAAT case files closed in which the highest level of intervention provided by the agency was representation in a class action. In these cases, the agency assisted individuals as a class in pursuing legal recourse in the judicial system to resolve multiple individuals' complaints.

E.9:        The web system will automatically generate the total number of case files closed by adding lines E.1-E.8 and placing the total on line E.9.  The total number of cases reported in this question should equal the total number you reported in Question II.D.13, 'Primary reason for closing a case file.'  If it does not, the system will generate an error message.

PART III: STATISTICAL INFORMATION FOR INDIVIDUALS SERVED

A.       AGE OF INDIVIDUALS SERVED

Enter the number of individuals served in each of the age categories listed. Record the individual's age as of the beginning of the fiscal year, October 1. Do not count an individual more than once, regardless of the number of case files that were opened or closed on the individual's behalf. The total reported in this section should match the total number of individuals served (Part II.A.3). If the numbers do not match, the system will generate an error message.

B.       GENDER OF INDIVIDUALS SERVED

Enter the number of individuals served according to their gender. Do not count an individual more than once, regardless of the number of case files that were opened or closed on the individual's behalf. The total number entered should match the total number of individuals served (Part II.A.3). If the numbers do not match, the system will generate an error message.

C.       RACE AND ETHNICITY OF INDIVIDUALS SERVED

The categories for reporting race and ethnicity in the PAAT annual reporting form conform to the Office of Management and Budget (OMB) 1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity,[1] and are used by other federal programs. If an agency wants to collect data for race or ethnic subcategories, the agency must be able to aggregate the data reported into the OMB minimum standard set of race and ethnicity categories.

OMB encourages self-identification of race. When respondents are allowed to self-identify or self-report their race, agencies should adopt a method that allows respondents to mark or select more than one of the five minimum race categories.

The five minimum categories for reporting race are:

AMERICAN INDIAN OR ALASKA NATIVE – A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.

ASIAN – A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

BLACK OR AFRICAN AMERICAN – A person having origins in any of the black racial groups of Africa.

NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER – A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

WHITE – A person having origins in any of the original people of Europe, the Middle East, or North Africa.

Agency staff must respect the client's right to not report his or her race. Agencies should report the number of clients with missing or unknown race information in the 'unknown/not reported' race category (C.1.g). Agency staff should be familiar with the OMB definitions for each race category so that they can assist clients who may have questions. Further, agencies should consider providing the definition of each race category in their data collection forms if space and formatting permit.

According to the 1997 OMB guidance, when self-identification is used agencies should adopt a data collection method that allows respondents to self-report more than one race. When respondents are allowed to self-identify with or self-report more than one race:

  • Agencies should adopt a method that allows respondents to mark or select more than one of the five minimum race categories.
  • The method for respondents to report more than one race should take the form of multiple responses to a single question and not a single 'multiracial' category.
  • When a list of races is provided to respondents, the list should not contain a 'multiracial' category.
  • Based on research conducted so far, two recommended forms for the instruction accompanying the multiple-response question are 'Mark one or more…' and 'Select one or more…'
  • Provision should be made to report, at a minimum, the number of individuals identifying with more than one race. On the PAAT reporting form, individuals who selected more than one race are reported on line C.1.f.

C.1: RACE OF INDIVIDUALS SERVED: Enter the number of individuals served according to their stated racial origin. Do not count an individual more than once, regardless of the number of case files that were opened or closed on the individual's behalf. The number entered should match the total number of individuals served (Part II.A.3). If the numbers do not match, the system will generate an error message.

C.1.a: Enter the number of individuals served by PAAT who consider themselves to be an American Indian or Alaskan Native.

C.1.b: Enter the number of individuals served by PAAT who consider themselves to be Asian. Do not include those individuals who consider themselves to be Native Hawaiian or another Pacific Islander (C.1.d). Do include those individuals who consider themselves to be Arab-American.

C.1.c: Enter the number of individuals served by PAAT who consider themselves to be Black or African-American.

C.1.d: Enter the number of individuals served by PAAT who consider themselves to be a Native Hawaiian or other Pacific Islander.

C.1.e: Enter the number of individuals served by PAAT who consider themselves to be White or Caucasian.

C.1.f: Enter the number of individuals served by PAAT who consider themselves to belong to more than one racial or ethnic group.

C.1.g: Enter the number of individuals served by PAAT whose race is unknown.

C.1.h: Enter the total of individuals served by PAAT by adding the numbers within each column and placing the sum in the total row. The number entered should match the total number of individuals served (Part II.A.3). If the numbers do not match, the system will generate an error message.

C.2: ETHNICITY OF INDIVIDUALS SERVED: Enter the number of individuals served according to their stated ethnic origin. Remember that a person of Hispanic/Latino ethnicity may be of any race. Do not count an individual more than once, regardless of the number of case files that were opened or closed on the individual's behalf.

The two minimum OMB categories for reporting ethnicity are:

HISPANIC OR LATINO (ALL RACES) – A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

NOT HISPANIC OR LATINO (ALL RACES) – A person not of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

C.2.a: Enter the number of individuals served by PAAT who consider themselves to be Hispanic or Latino.

C.2.b: Enter the number of individuals served by PAAT who do not consider themselves to be Hispanic or Latino.

C.2.c: Enter the number of individuals served by PAAT whose ethnicity is unknown or not reported.

C.2.d: Enter the total of individuals served by PAAT by adding the numbers within each column and placing the sum in the total row. The number entered should match the total number of individuals served (Part II.A.3). If the numbers do not match, the system will generate an error message.

D. LIVING ARRANGEMENTS OF INDIVIDUALS SERVED

Report information about the living arrangements for all individuals served by PAAT during the fiscal year. Do not count an individual more than once, regardless of the number of case files that were opened or closed on the individual's behalf. Report the living arrangement when the case was opened if it was a new case; or report the living arrangement at the beginning of the fiscal year if the case was carried over from the prior reporting period.

D.1:     Enter the number of individuals served who live in a community residential home. Include situations in which an entity other than the resident is responsible for the funding, administration, and day-to-day care and upkeep of the residence (e.g. supervised apartments, semi-independent living, halfway houses, board and care, and group homes of 14 or less).

D.2:     Enter the number of individuals served who live in a foster care setting and are part of the state's foster care system.

D.3:     Enter the number of individuals served who are homeless. These individuals may spend an occasional night with friends or relatives or in a shelter; however, they have no fixed address.

D.4:     Enter the number of individuals served who live in a jail, prison, or some other detention center.

D.5:     Enter the number of individuals served who live in a public or private nursing facility.

D.6:     Enter the number of individuals served who live with their parents, guardian, or another relative.

D.7:     Enter the number of individuals served who live independently. These individuals may live alone or may share housing with a roommate, spouse or significant other. The individual must be responsible for his/her own housing. Do not include individuals who live independently in public housing (D.10).

D.8:     Enter the number of individuals served who live in a private institution, such as intermediate care facilities (ICFs), residential treatment centers, hospitals, psychiatric hospitals, and detox centers. Do not include individuals who live in a nursing facility (D.5).

D.9:     Enter the number of individuals served who live in a public institution, such as publicly funded ICFs, residential treatment centers, hospitals, psychiatric hospitals, and detox centers. Do not include individuals who live in a nursing home (D.5).

D.10: Enter the number of individuals served who live independently in public housing.

D.1 1: Enter the number of individuals served who live in a Veteran's Administration (VA) Hospital.

D.12 and D.13: Enter the number of individuals served who have some other living arrangement that is not listed in this section. Provide a description of the living arrangement of any individual counted in this category.

D.14: Enter the number of individuals served for whom the agency has no information abouttheir living arrangements.

D.15: The web system will automatically generate a total by adding lines D. 1-D. 14 and placing the total on line D. 15. This number should match the number in Part II.A.3. If the numbers do not match, the system will generate an error message.

E. PRIMARY DISABILITY OF INDIVIDUALS SERVED

Guidelines: Report information about the primary disability of the individuals served by the agency under PAAT. The primary disability, for purposes of this report, is the individual's disability that is directly related to the issues or complaints raised by the primary complaint of the individual served. Do not count an individual more than once during a fiscal year.

Example 1: An individual is deaf and also has an orthopedic impairment that requires the use of a wheelchair. The individual came to the agency because the local pizzeria is inaccessible for wheelchair-users. The agency should report this individual under orthopedic impairment (E.23) because the issue raised focuses on building accessibility problems. The fact that the individual also is deaf (E. 10) is not relevant to this particular complaint.

Example 2: If an individual with the same disabilities described above came to the agency complaining that the county hospital refused to provide an interpreter to explain the diagnostic testing she was to undergo, the agency should report this individual under deafness (E. 10) because the issue dealt with interpreter services. The fact that the individual also has an orthopedic impairment is not relevant to this particular complaint.

Resources on Disabilities: You may want to consult a medial text for definitions or descriptions of the disabilities that are listed in E. 1-32. A resource, which can be found on the web in a word-searchable format, is the Merck Manual (www.merck.com/mrkshared/mmanual/home.jsp).

E.1:        Enter the number of individuals served who have Attention Deficit Disorder with or without hyperactivity.

E.2:        Enter the number of individuals served who are infected with the human immunodeficiency virus (HIV), regardless of whether the individual is symptomatic or asymptomatic.

E.3:        Enter the number of individuals served who are lacking an extremity or multiple extremities.

E.4:        Enter the number of individuals served who are afflicted with an autoimmune disorder (e.g. Chronic Fatigue Syndrome).

E.5:        Enter the number of individuals served who have autism or autism spectrum disorder.

E.6:        Enter the number of individuals served who, with best correction (i.e., with eyeglasses), are legally blind in both eyes.

E.7:        Enter the number of individuals served with visual impairments other than blindness in both eyes (E6).

E.8:        Enter the number of individuals served who have cancer.

E.9:        Enter the number of individuals served who have cerebral palsy.

E.10:    Enter the number of individuals served who are deaf.

E.11:    Enter the number of individuals served who are hard-of-hearing or hearing impaired but are not deaf (E.10).

E.12:    Enter the number of individuals served who are deaf-blind. These individuals meet the criteria for both deafness (E.10) and blindness (E.6).

E.13:    Enter the number of individuals served who have diabetes.

E.14:    Enter the number of individuals served who have digestive disorders (e.g. Irritable Bowel Syndrome).

E.15:    Enter the number of individuals served who have epilepsy.

E.16:    Enter the number of individuals served who have genitourinary conditions.

E.17:    Enter the number of individuals served who have a cardiac or other circulatory system impairment or condition.

E.18:    Enter the number of individuals served who have a mental illness that is not specifically covered by another category.

E.19:    Enter the number of individuals served with any degree of mental retardation (i.e., mild, moderate, severe/profound).

E.20:    Enter the number of individuals served who have multiple sclerosis.

E.21:    Enter the number of individuals served who have muscular dystrophy.

E.22:    Enter the number of individuals served with any form of muscular or skeletal impairment not specifically covered by another category.

E.23:    Enter the number of individuals served who have an orthopedic impairment. These individuals may be paralyzed, or may have some other functional impairment involving the limbs, digits, trunk, back or spine.

E.24:    Enter the number of individuals served with any form of neurological disorder or impairment not specifically covered by another category. This total should include individuals affected by strokes and Acquired Brain Injury (ABI).

E.25:    Enter the number of individuals served who have a respiratory system disorder or impairment.

E.26:    Enter the number of individuals served who have a skin condition.

E.27:    Enter the number of individuals served with a specific learning disability (not including mental retardation (E. 19)).

E.28:    Enter the number of individuals served with speech impairments, such as cleft palate and harelip with speech imperfections, laryngectomies, stuttering, etc.

E.29:    Enter the number of individuals served with spina bifida.

E.30:    Enter the number of individuals served who have substance abuse conditions (i.e., current or former alcohol and/or drug addictions).

E.31:    Enter the number of individuals served who have Tourette Syndrome.

E.32:    Enter the number of individuals served who have a traumatic brain injury (TBI).

E.33:    Enter the number of individuals served who have other impairments or disabling diseases or conditions that are not covered by the above categories. Specify/describe the disability of any individual counted in this category.

E34: The web system will automatically generate a total by adding lines E.1-E.33 and placing the total on line E.34. The number generated should equal the total number of individuals served (Part II.A.3). If the numbers do not match, the system will generate an error message.

F. GEOGRAPHIC LOCATION

Report the general geographic location of each individual served under PAAT. Information collected in this section of the report will assist RSA to analyze an agency's outreach efforts under the PAAT program.

F.1:      Enter the number of individuals served who live in an urban/suburban location. Urban is defined as a metropolitan area with a population of more than 50,000.

F.2:      Enter the number of individuals served who live in a rural location. Rural is defined as any area that does not qualify as urban (see definition above).

F.3:      Enter the number of individuals served who could not be identified as coming from an urban/suburban or rural location. This will include those instances where information on geographic location was not collected. This could also include those individuals who are homeless, those living in a motor home or those who otherwise have no permanent residence. Provide a description of the geographic location or living arrangement for each case listed as 'other.'

F.4:      Enter the number of individuals served whose geographic location is unknown.

F.5:      The web system will automatically generate the total number of individuals served by adding lines F.1-F.4 and placing the total on line F.5. This number should equal the total number of individuals served (Part II.A.3). If the numbers do not match, the system will generate an error message.

 


PART IV: SYSTEMIC ACTIVITIES AND LITIGATION

Definitions: Refer to these definitions when completing Part IV of this form.

·        Systemic Activity: A systemic activity, in the context of PAAT work, is one that is intended to result in a permanent change to policies or practices of a governmental or non-governmental entity, making AT devices or AT services more readily available for a class of persons with disabilities.

·        Non-Litigation Systemic Activity: This includes any systemic activity that occurs outside the context of a PAAT's representation of individuals through litigation. See examples under A.2, below.

·        Systemic Litigation and Systemic Class Action Activity: This includes any litigation, whether on behalf of one or more individuals, or a class of individuals, when one of the outcomes sought is to make a permanent change in policies or practices of a governmental or non-governmental entity, making AT devices or AT services more readily available for a class of persons with disabilities. Class actions, by their very nature, will almost always be classified as systemic litigation. A lawsuit or court appeal brought on behalf of one individual can be considered systemic litigation if one of the outcomes sought is systemic in nature (see B.3 below).

·        Note:  When answering the questions in this section, you should be describing activity that was performed, at least in part, through your PAAT program and which relates to AT-related systemic change.

  1. NON-LITIGATION SYSTEMIC ACTIVITIES: The information collected in this section of Part IV focuses on the agency's non-litigation systemic activities in general. This category goes beyond any systemic efforts made on behalf of individuals served.

A.1:          Enter the number of policies or practices that were changed as a result of systemic activities under PAAT. Do not include those policies or practices that were changed as a result of litigation (Part IV.B). For each number reported, the web system will generate the appropriate number of text boxes to be completed for A.2.

A.2:          Describe the systemic activity completed during the fiscal year. (a) Identify the policy or practice that was changed, as a result of your agency's non- litigation systemic activity, along with a description of the negative impact upon individuals with disabilities. (b) Include information regarding the manner in which this change will benefit individuals with disabilities in the state. (c) If possible, estimate the number of individuals potentially affected by such policy changes and (d) the method used to determine this estimate. If you are unable to estimate the number of individuals affected, enter 'MD' for missing data. (e) Include one case example of how this systemic activity related to the policy/practice changed. If appropriate, provide the agency's plans for continuing to address these issues during the next fiscal year.

Example: PAAT staff assisted in the development of new power wheelchair criteria for the state Medicaid agency, by participating on an advisory board that included input from the medical and legal communities to ensure that the criteria were consistent with medical standards and federal statutory requirements.

  1. Policy or practice changed. Medicaid policy would only allow a power wheelchair if it was necessary for use in the individual's home. This was a problem for many persons with disabilities who had no ability to access any locations outside of their homes. The policy change now allows persons to obtain power wheelchairs if they have no functional mobility using a manual wheelchair.
  1. Benefit to individuals with disabilities. With the new criteria, individuals with disabilities are now able to obtain power wheelchairs to allow them to travel outside the home to participate in medical, educational, work and social activities.
  2. Estimated number of individuals potentially affected by the policy or practice change. Of those individuals who are eligible for Medicaid, it is estimated that ___ (number) will now be able to obtain a power wheelchair as a result of the new criteria.
  3. Determination of estimate. Based on the state's Medicaid population, it is estimated that ___ (number) of people have a mobility impairment that would require the use of a power wheelchair. Of that number, we estimated that ___ percent would not be able to obtain a power wheelchair without the policy change.

      Tips for estimating the number of individuals 'potentially affected' by a change.  Reporters should take reasonable steps to estimate how many individuals are potentially affected by the change.  Often, this will involve educated estimates where no easily obtained data are available.  In the example below, the numbers are estimates and can be debated; however, the analysis shows a reasonable method to come up with a good estimate.

·        When a system or program includes both AT users and non users, do not count everyone enrolled as potentially affected.  For example, if a school district includes 1,000 children enrolled in special education, the number potentially affected by a system-wide change in AT policy would not be 1,000, but a lesser number based on the expected number of AT users.

·        When your systemic change affects all AT users within a system or program (e.g., all special education students enrolled in a school district who use AT), you should estimate what that number is based on the number of expected AT users in the system:  'There are 1,000 children enrolled in special education within the school district and we estimate that 300, or 30 percent, would use AT devices or services during a school year.'

·        When your specific change relates solely to those who use a particular kind of AT device (e.g., special education students who use augmentative communication devices), your number will be less that the total number of AT users:  'There are 1,000 special education students in the school district and we estimate that 15, or 1.5 percent of those students use or will have need of an augmentative communication device.'

  1. Case example of PAAT agency's systemic activity related to this policy/practice change. PAAT staff assisted in the development of new power wheelchair criteria for the state Medicaid agency, by participating on an advisory board that included input from the medical and legal communities to ensure that the criteria were consistent with medical standards and federal statutory requirements.

A.3:             Enter the number of ongoing non-litigation systemic activities undertaken. These are activities that have not yet resulted in a change in policies or practices, but the agency believes have potential to result in such change. Litigation activities should not be included here; report on them in Part IV.B. The number entered in this section will determine the number of boxes the web system will generate in order to collect descriptive information on these activities (A.4).

A.4:             Describe each of the agency's non-litigation systemic activities reported in A.3 that have not yet resulted in change, but have potential to do so in the future. The web system will generate text boxes to match the number of activities reported in A.3. For each activity, describe: (a) how the activity may benefit individuals with disabilities; (b) the number of individuals potentially affected by the activity; (c) the method used to determine that estimate; and (d), the policy or practice that may change as a result of the activity.

B.  LITIGATION/CLASS ACTIONS: This section focuses on the litigation case work that the PAAT was involved in during the fiscal year and any changes resulting from the efforts of the agency to engage in litigation on behalf of an individual or in a class action on behalf of many individuals.

B.1:     Report information on the PAAT-related litigation for your agency. 

B.1.a:  Enter the total number of non-class action lawsuits that were pending at start of fiscal year (carryover from prior fiscal year).

B.1.b:  Enter the total number of non-class action lawsuits newly filed during fiscal year.

B.1.c:  Total number of non-class action lawsuits pending during the fiscal year (system-generated).

B.1.d:  Enter the total number of non-class action lawsuits closed during the fiscal year.

B.1.e:  Total number of non-class action lawsuits still pending at the end of the fiscal year (system-generated).

[If the total shown in IV.B.1.c is 1 or more, you will be asked to answer Questions 2 and 3. If the total is zero, the system will skip to Question 4.]

 

B.2: Describe the agency's on-going non-class action litigation activities. Using a case example that demonstrates the potential impact of the agency's non-class action activities, explain (a) the issue that prompted the litigation; (b) the negative impact on individuals with disabilities; and (c) the potential benefit to individuals with disabilities resulting from such litigation. If possible, (d) estimate the number of individuals that potentially affected changes resulting from the litigation and (e) the method used to determine this estimate.

For B.2 and B.3, you should report only non-class action litigation that seeks to achieve a systemic outcome (B.2 – on going; B.3 – completed). A case brought on behalf of one individual can seek both a specific outcome for the individual and a broader, systemic outcome that will benefit many individuals.

Example for B.2, On-Going Systemic Non-Class Action Litigation Activities:

a.         Issue prompting the litigation. A school district in the state's largest city (name of city) refused, as part of its special education program, to pay for AT evaluations for students who are blind or severely visually impaired.

b.         The negative impact upon individuals with disabilities. A major component of identifying an appropriate AT intervention, such as the use of adapted computer equipment, is an AT evaluation by a competent AT evaluator. Under the existing policy, it was difficult to obtain the AT evaluation, often resulting in the purchase of inappropriate AT for the blind/visually impaired student or, the student not obtaining any AT device or service because there is no professional support.

c.         Benefit to individuals with disabilities from this litigation. Our pending case, [case name], challenges the school district's policy as a violation of the Individuals with Disabilities Education Act (IDEA). While filed on behalf of three individuals to obtain AT evaluations in their cases, the lawsuit also seeks an order declaring that the school district's policy and practice is illegal. If the lawsuit is successful, other blind and visually impaired students can be expected to benefit from the policy change. We are also hopeful that similar students in other school districts will benefit if the court publishes an opinion in this case.

  1. Estimate of individuals potentially affected by changes resulting from the litigation. Approximately [number] students, who are currently enrolled or who will be enrolled in the [name] school district, can be expected to benefit from a positive result in this litigation during the next five years.
  2. Method used to determine estimate. Based on data provided by the school district and projecting new enrollees during the next five years, we estimate that [number] blind/visually impaired students are currently enrolled and an additional [number] students will be enrolled with the school district during the next five years. All of these students could potentially benefit from a positive result in this case.

B.3: Describe the agency's completed systemic non-class action litigation activities. Using a case example that demonstrates the potential impact of the agency's completed non-class action activities, explain (a) the issue that prompted the litigation, (b) the negative impact upon individuals with disabilities and (c) the benefit to individuals with disabilities resulting from such litigation. If possible, (d) estimate the number of individuals potentially affected by changes resulting from the litigation and (e) the method used to determine this estimate.  If you do not have any completed activities to report, enter 'N/A' in items a-e. 

Example for B.3, Systemic Completed Non-Class Action Litigation Activities:

NOTE: This example takes the same information used in example B.2 and assumes the court has issued a decision favorable to the plaintiffs.

a.         Issue prompting the litigation. A school district in the state's largest city (name of city) refused, as part of its special education program, to pay for AT evaluations for students who are blind or severely visually impaired.

b.         The negative impact upon individuals with disabilities. A major component of identifying an appropriate AT intervention, such as the use of adapted computer equipment, is an AT evaluation by a competent AT evaluator. Under the existing policy, it was difficult to obtain the AT evaluation, often resulting in the purchase of inappropriate AT for the blind/visually impaired student or, the student not obtaining any AT device or service because there is no professional support.

c.         The benefit to individuals with disabilities from this completed litigation. Our case, [case name], challenged the school district's policy as a violation of the federal Individuals with Disabilities Education Act (IDEA). While filed on behalf of three individuals to obtain AT evaluations in their cases, the lawsuit also sought an order declaring that the school district's policy and practice illegal. During the fiscal year, the court issued a published opinion ordering AT evaluations for the three named plaintiffs and ordering the school district's policy to be illegal under the law referenced above. The three named plaintiffs will directly benefit from this decision as they will now receive AT evaluations, meaning they are more likely to get appropriate AT devices and services.

Also, because the school's policy was declared illegal, other blind and visually impaired students can be expected to benefit from the policy change. We are also hopeful that similar students in other school districts will benefit as this decision is circulated and publicized throughout the state.

  1. Estimate the number of individuals potentially affected by changes resulting from the litigation. Approximately [number] students, who are currently enrolled or who will be enrolled in the [name] school district, can be expected to benefit from the positive result in this litigation during the next five years.
  2. The method used to determine this estimate. Based on data provided by the school district and projecting new enrollees during the next five years, we estimate that [number] blind/visually impaired students are currently enrolled and an additional [number] students will be enrolled with the school district in the next five years. All of these students could potentially benefit from a positive result in this case.

B.4:        Enter the total number of class action lawsuits that were pending during the fiscal year. This number would include both the new lawsuits that were filed during the fiscal year (B.4.a) and the lawsuits that were pending as the fiscal year began (i.e., carried over from the previous year) (B.4.b).

B.4.a: Enter the total number of new class action lawsuits that were filed by PAAT for the reporting fiscal year.

B.4.b: Enter the total number of class action lawsuits that were pending as the fiscal year began and which are a carryover from the previous fiscal year.

B.4.c: Enter the total number of class action lawsuits closed during the fiscal year. The number of pending cases carried forward to the next fiscal year is equivalent to the total of B.4.a and b minus B.4.c.

[If your answer to Question IV.B.4 is zero, the web system will automatically skip to Section C.  If your answer is 1 or more, it will ask you to answer Question 5.

If your answer to Question IV.B.4.c is 1 or more, the web system will ask you to answer Question 6.]

For B.5 and B.6, report only class action litigation that seeks to achieve a systemic outcome (B.5 – on going; B.6 – completed). A case brought on behalf of one or more individuals can seek both a specific outcome for the individuals and a broader, systemic outcome that will benefit a class or classes of individuals.

B.5:        Describe the agency's on-going systemic class action litigation activities. Using a case example that demonstrates the potential impact of the agency's class action activities, explain (a) the issue that prompted the litigation, (b) the negative impact upon individuals with disabilities and (c) the potential benefit to individuals with disabilities from such litigation. If possible, (d) estimate the number of individuals potentially affected by changes resulting from the litigation and (e) the method used to determine this estimate.

Example: Our PAAT program has filed a class action lawsuit, [name of case], challenging the policy that is summarized below.

  1. Issue prompting the litigation. Our state Medicaid agency routinely denies funding for augmentative communication devices (ACDs) if the device is a dual-purpose device, capable of achieving speech output and can also be used for word processing. Currently, only devices that are totally dedicated to speech production can be approved.
  2. The negative impact upon individuals with disabilities. Many of the newer ACDs available are dual-purpose devices and are typically available at the same cost or less cost than dedicated devices. With the current restriction, many individuals must settle for an ACD that is not fully appropriate for their needs.
  3. The potential benefit to individuals with disabilities from this litigation. If this case is resolved favorably, the named plaintiffs and class members will be able to obtain dual-purpose ACDs if the requested device is considered medically necessary. Individuals will be able to obtain an ACD that is most appropriate for them, even if the device can also be used as a personal computer.
  4. Estimate the number of individuals potentially affected by changes resulting from the litigation. Approximately [number] individuals who are currently enrolled in the Medicaid program have severe speech impairments, and need or will be in need, of an ACD. Approximately [number] of those individuals can be expected to need an ACD that will be classified as a dual-purpose device.
  5. The method used to determine this estimate. These estimates are based on both information obtained in lawsuit discovery and through estimates provided by the [name of professional association] regarding the number of potential ACD users in the general population.

B.6: Describe the agency's completed systemic class action litigation activities. Using a case example that demonstrates the potential impact of the agency's class action activities, explain (a) the issue that prompted the litigation, (b) the negative impact upon individuals with disabilities and (c) the potential benefit to individuals with disabilities from such litigation. If possible, (d) estimate the number of individuals potentially affected by changes resulting from the litigation and (e) the method used to determine this estimate.

Example: Our PAAT program settled a class action lawsuit, [name of case], resulting in a change to the policy summarized below.

a. Issue prompting the litigation. Our state Medicaid agency had, prior to the settlement, routinely denied funding for augmentative communication devices (ACDs) if the device was a dual-purpose device, capable of achieving speech output and also available for word processing (i.e., only devices that were totally dedicated to speech production could be approved).

  1. The negative impact upon individuals with disabilities. Many of the newer ACDs available are dual-purpose devices and are typically available at the same cost or less cost than dedicated devices. With the existing restriction, many individuals were required to settle for an ACD that was not fully appropriate for their needs.
  2. The benefit to individuals with disabilities from this litigation. Under the terms of this settlement, the named plaintiffs and class members will be able to obtain ACDs if the requested device is considered medically necessary, without regard to whether the device is dedicated for speech only or a dual-purpose device. This means that individuals can seek the device that is most appropriate for them, even if the ACD could also be used as a personal computer. An individual whose Medicaid prior approval application for a dual-purpose device was previously denied, and who purchased the dual-purposed device with cash or borrowed funds, now can be potentially reimbursed for the payment.
  3. Estimate the number of individuals potentially affected by changes resulting from the litigation. Approximately [number] individuals, who are currently enrolled in the Medicaid program, have severe speech impairments, and are or will be in need of an ACD. Approximately [number] of those individuals can be expected to need an ACD that will be classified as a dual-purpose device.
  4. The method used to determine this estimate. These estimates are based on information obtained in lawsuit discovery and through estimates provided by the [name of professional association] regarding the number of potential ACD users in the general population.

C. LITIGATION-RELATED MONITORING: If your PAAT engaged in litigation-related monitoring during the fiscal year, describe any monitoring conducted by PAAT related to court orders or case settlements by providing the major areas of monitoring and the groups likely to be affected. Monitoring activities include conducting reviews in order to examine issues related to matters that were resolved as part of an individual or class action lawsuit.

Example: You might report that your PAAT settled a case one year earlier (i.e., during the year preceding your reporting year): 'During reporting year____________________________ , our PAAT settled a lawsuit that had been filed in the federal court. The case, [case name], challenged a state Medicaid agency policy that limited Medicaid payments for power wheelchairs to cover only standard power wheelchairs, without any allowance for specialty features, such as specialized seating, smaller or wider frames, tilt 'n space features or specialized controls to allow a user to control the wheelchair with head movements. The settlement of the lawsuit involved publishing of new regulations and agency policy to allow approval, on a case-by-case basis, of requests for wheelchairs with specialty features so long as they are both medically necessary and the least costly effective alternative. During the current reporting year, we continued to monitor the settlement of the lawsuit in the following ways.

  1. Major areas of monitoring: Our monitoring included regular communication by email and regular mail with three primary groups: equipment vendors, service providers who are regularly involved in submission of prior-approval requests for power wheelchair funding and attorneys/advocates who regularly represent individuals in Medicaid fair hearings involving denials of requests for durable medical equipment. The purpose of the monitoring is to determine whether the Medicaid agency is now regularly approving power wheelchairs with specialty features or if old patterns of denial continue.
  2. Groups likely to be affected: The individuals likely to be positively affected by this ongoing monitoring are children and adults with severe physical disabilities who can be expected to need power wheelchairs with specialty features.
  3. Major outcomes of the litigation-related monitoring during the fiscal year: The most significant outcomes of the monitoring involved stakeholders in the Medicaid DME prior approval system (i.e., vendors, service providers) who are once again willing to prepare and submit prior approval requests to the Medicaid agency for the more expensive power wheelchairs with specialty features. In the process of monitoring, we have managed to educate these key stakeholders about the major change in policy that resulted from the litigation.
  4. Case example(s) that demonstrate the impact of litigation-related monitoring: The best example of how this is working is the following excerpt from a major DME vendor who serves individuals in the eastern part of our state: 'Thank you for the updated information you provided about the policy changes for Medicaid approval of power wheelchairs with specialty features. During the past quarter, we started submitting requests for wheelchairs with power tilt 'n space features after having nearly abandoned considering these for Medicaid payment. Within this three-month time period, we can report having three new power wheelchairs with tilt 'n space approved, after having no such wheelchairs approved during the previous two years.'

PART V: PRIORITIES

A. PRIORITIES:

In this section, you will see information from your last report, showing (1) the priorities your PAAT planned to address during the fiscal year covered by this report, and (2) the need/issue/barrier addressed by each priority.  (This is the information you entered in Question V.B last year.)

Please review this information and update it (if needed) to reflect what actually occurred during the year.  You may edit an existing priority, delete a priority, or add a new one not previously reported.

You may also modify information on the need/issue/barrier addressed by each priority. 

Provide the information requested in this section for each of the priorities and objectives set by the PAAT for the fiscal year covered by this report.  You may enter as many priorities as needed. 

Please indicate whether each priority was 'met,' 'partially met/continuing,' or 'not met.' 

A.1:     Describe the priority. Include enough information so that the fundamental issue is clear.

Example: Removing barriers to the funding of power wheelchairs through the Medicaid program.

A.2:     Description of Need, Issue or Barrier Addressed: Describe the need, issue or barrier addressed by this priority. It is not enough to identify an issue as a priority. Explain why this issue is a priority and the desired effect it will have on individuals with disabilities.

Example: In the example above, the barrier that will be addressed by this priority is that the Medicaid program has one reimbursement rate to cover funding of all power wheelchairs, without allowances for specialty features like special seating systems or tilt- n-space systems.

A.3:   Outcome: For each priority, indicate whether the goal was met, partially met/continuing or not met.

A.3.a: Implementation problems: For each outcome marked 'not met' or 'partially met', the web system will automatically ask grantees to describe any external or internal implementation problems.

A.4:   Total Number of Cases Handled: Provide the number of cases handled under the priority.

A.5:   Illustrative Cases/Activity: If you indicated in A.3 that the priority objectives were met or partially met, you will be asked to provide at least one case summary that demonstrates the impact of the priority. Identify the facts and issue of the case, the resolution of the case, and how the individual served benefited.

Example: Using the example in A.2 above: an individual was denied a power wheelchair with tilt-n-space features because all durable medical equipment vendors refused to accept the low payment rate authorized by Medicaid; the matter was taken into state or federal court; and the court ruled that the Medicaid agency must pay for the wheelchair at the higher payment rate so long as other funding criteria are met.

B. PRIORITIES for the CURRENT FISCAL YEAR (the year following the reporting period): In this section, provide information on each of the priorities set by your P&A agency for the PAAT program for the current fiscal year.  You may enter as many priorities as needed. 

B.1:     Describe the priority. Include enough information so that the fundamental issue is clear.

B.2:     Description of Need, Issue or Barrier Addressed: Describe the need, issue or barrier addressed by this priority. It is not enough to identify an issue as a priority. Explain why this issue is a priority and the desired effect it will have on individuals with disabilities.

C. AGENCY ACCOMPLISHMENTS: Describe your agency's significant accomplishment(s) that are not addressed in detail in other sections of the reporting form. PAAT may choose to report accomplishment that were not originally identified as priorities. If these accomplishments are covered under priorities (Part V.A), enter the priority number here and do not provide any further description unless necessary to explain why this priority is considered a significant accomplishment. If all information has been covered in other sections of the report, enter 'N/A' or 'not applicable'.

PART VI: AGENCY ADMINISTRATION

A. AGENCY FUNDING

Sources of Funds Received for PAAT Program Activities. Rounding to the nearest dollar, enter the amount of funds received and used from each of the sources indicated during the fiscal year covered.

A.1:     Federal P&A (AT Act funds): Enter the amount of funds received and used as the PAAT grant from the U.S. Department of Education, Rehabilitation Services Administration (RSA) during the fiscal year. (Note: The PAAT program was formerly administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Oversight for the PAAT was moved from NIDRR to RSA in February 2004.)

A.2:     Federal AT Act Funds carried forward from previous Fiscal year (if applicable): Enter the amount of funds carried forward and used from funds received as the PAAT grant from the US Department of Education, RSA, during the previous fiscal year.

A.3:     Program Income: Enter the amount of program income, if any, generated through PAAT activities and used during the fiscal year. Program income includes attorney's fees awarded by the courts and non-P&A federal funds, including grants from your State AT Act Project.

A.4-A.5: Other: Enter the amount of funds received for PAAT work from any other source and used during the fiscal year. 'Other' sources could include non-P&A federal funds, state funds, private grants, and/or 'other' sources. The web system will provide a space for you to specify/describe the other funding source.

A.6: Total: The web system will automatically generate the total amount of PAAT funds received and used from all sources by adding A.1-5.

B. DESCRIPTION OF PAAT PROGRAM STAFF

B.1:     Provide a brief narrative on the way your agency has chosen to staff the PAAT grant.

Report the number of staff and full time equivalents (FTE) by type of position. FTE refers to the amount of time over the course of the reporting period that an individual is assigned to the PAAT program. Compute FTE staff by converting part-time staff to decimals. For example, a person employed half-time (20 hours of a 40 hour week) would be 0.5 FTE, and a person working 30 hours a week would be 0.75 FTE. Both positions together would equal 1.25 FTEs.

·        Professional staff includes attorneys, advocates, I&R staff, caseworkers and other individuals providing direct client service.

·        Administrative staff includes secretaries, receptionists, bookkeepers and other individuals who are not providing direct client services.

C. CONSUMER INVOLVEMENT

C.1:     Briefly describe any consumer-responsive activities that are not reported elsewhere in this reporting form. These activities might include a PAAT Advisory Board or forums to obtain input for your PAAT planning and priority setting. Enter 'N/A' or 'not applicable' if appropriate.

C.2:     Consumer Involvement in P&A Agency Staff and Board. In this item, report:

  • The number of persons with a disability serving on the agency's staff and board (including the Board of Directors or, if appropriate, the corresponding state government-level advisory body. 
  • The number of persons serving on the agency's staff and board who have a family member with a disability.  (NOTE:  An individual who has a disability and also has a family member with a disability may be counted in both categories.) 
  • The total number of all persons on the agency's staff and board. 

Consider all staff, whether or not they have worked on PAAT activities during the fiscal year since this question addresses consumer involvement in the entire P&A agency, not just PAAT.

D.       GRIEVANCES FILED: Agencies are required to establish grievance procedures to handle any complaints by clients regarding the services received/not received from the agency under PAAT. Enter the number of PAAT grievances filed with the agency during the fiscal year.

E.        COLLABORATIVE EFFORTS

E.1: Collaboration with other P&A programs and activities: Many P&A agencies have used P&A resources from programs other than the PAAT to collaborate on AT-related issues. Provide a brief description of the work your P&A agency has done, during the fiscal reporting year, using funding from P&A programs other than the PAAT program. Do not report activities conducted in full or part with PAAT funds. Enter 'N/A' or 'not applicable', if appropriate.

  • Example: 'Our PAAT project funds a full-time advocate (1.0 FTE) and a part-time attorney (.10). The advocate carries a caseload of administrative hearings, primarily involving Medicaid. The attorney supervises the advocate, but does not have sufficient time available to work on litigation. Our P&A has been using our PADD and PAIR attorney staff to handle AT-related issues that must go into court to be resolved. During the fiscal year, our PADD program handled two AT-related Medicaid appeals in state court and our PAIR program continued to litigate, in federal court, a case that was filed two years ago to challenge the payment levels available for power wheelchairs.'

E.2: All other collaboration: In addition to collaboration within the P&A agency, many P&As collaborate with programs outside their agency. This could include collaboration with State AT Act Projects, other advocacy agencies, private attorneys, long-term care programs or other disability service programs. Describe these efforts. Enter 'N/A' or 'not applicable', if appropriate.

  • Example: 'During the fiscal year, our PAAT worked with the our State AT Act Project to deliver a series of six training sessions at locations within the state. These half-day sessions were co-presented by PAAT and AT Act Project staff and focused on how to obtain AT through Medicaid, Medicare, private insurance, special education programs and state vocational rehabilitation agencies.'


[1] Retrieved November 18, 2003, from http://www.whitehouse.gov/omb/fedreg/ombdir15.html.


 

Completing the Annual Protection and Advocacy
for Assistive Technology (PAAT) Program Performance Report
Questions and Answers

As Updated September 2007

On March 14, 2005, the Office of Management and Budget (OMB) approved the Annual Protection and Advocacy for Assistive Technology (PAAT) Program Performance Report (PPR), as a data collection instrument, through January 31, 2008 (OMB # 1820-0661). Protection and Advocacy (P&A) programs were required to use this new PPR and web-based reporting format, for the first time, when they reported on PAAT activity for fiscal year (FY) 2005 covering the period October 1, 2004 through September 30, 2005. P&A programs will once again be required to use this PPR and web-based system for completing their FY 2006 reports. The FY 2006 report will be due no later than December 31, 2006. Subject to any revisions to the PPR form and instructions that could be necessitated by the work of the P&A Common Definitions Workgroup, this form is approved for reporting PAAT activity for FY 2005, 2006, and 2007.

The Rehabilitation Services Administration (RSA), within the U.S. Department of Education, will use this web-based PPR to meet specific data collection requirements found in section 5(f) of the Assistive Technology Act of 1998, as amended. In general, grantees must report annually using this web-based PPR, with the report due on or before December 31st of each year.   Through a grant from RSA, RTI International hosted the web-based reporting system for this newly approved form during the first year of reporting (i.e., for the FY 2005 reports submitted during late 2005). Effective September 18, 2006, RTI has transferred hosting of the web-based system to RSA. Effective October 2007, RSA migrated the system into the RSA-MIS (Management Information System) which is located at http://rsamis.ed.gov/ RSA will host the system for all FY 2007 reporting - - again, with those reports due no later than December 31, 2007. RSA's Program Specialist for the PAAT program is Fred Isbister, fred.isbister@ed.gov, (202)245‑7385.

Some users in P & A agencies may already be familiar with the MIS from entering SF269s: for this group of users send your MIS user ID to RSAMIS.Technical.Support@ed.gov and ask for additional access to the PAAT Repformance Report. People who have never used the MIS will need to request user IDs. Note: your old user IDs and passwords will NOT work in the new system, as your old passwords did not meet the security requirements for federal systems. You must request a new user ID.

Requesting a user ID can be done on-line. Perform the following steps.

Each user at an agency must have their own user ID: do not share user IDs and passwords.

If you forget your password, follow these steps.

If you cannot get this to work after giving it your best effort, contact Ken Schellenberg at RSA, RSAMIS.Technical.Support@ed.gov.

RSA has contracted to have both Neighborhood Legal Services, Inc. (NLS) and the National Disability Rights Network (NDRN) provide technical assistance to P&A programs and their staff as they encounter problems with completing the form (NLS) or using the web-based system (NDRN).

This series of Questions and Answers is designed to provide answers to some of the most frequently asked questions about the new, web-based PPR. This document should be viewed as supplementing the PPR Instruction Manual that has been made available to all P&A programs and which will be available online through the RSA system. Based on the first year's experience with this new web-based reporting system, we have edited these Questions and Answers.

For answers to additional questions, you have the following technical assistance (TA) resources:

For TA related to completing the report form itself, please contact: Jim Sheldon, National AT Advocacy Project, Neighborhood Legal Services, Inc., (716) 847-0650 ext. 262, jsheldon@nls.org.

For TA related to technical questions about the web-based system and how to enter and save data, your primary contact is Ken Schellenberg, RSA, (202) 245-6589, RSAMIS.Technical.Support@ed.gov. You can also contact Matt Hayden at NDRN, (202) 408-9514, ext. 128, matt.hayden@ndrn.org.

General Questions

Q. Can more than one individual from my P&A program be involved in completing the web-based PPR?

A. Yes. Two or more individuals from your program can share responsibility for reporting. However, we encourage you to have one person who is primarily responsible for the report and deciding when the data, as entered, are final. Also, while more than two individuals may be involved with gathering information or drafting narrative answers for the report, it is generally a good idea to limit actual data entry to no more than two individuals.

Q. Can more than one individual be completing sections of the web-based PPR at the same time?

A. We discourage this. It's very easy to overwrite each other's work.

Q. Is it possible to complete part of the PPR on one day and come back to the website and finish it on another day?

A. Yes. The web-based PPR system is set up so that the user (i.e., individual completing the report) can complete the report over a period of days, weeks, or even months. So, for example, the user could complete the 'Agency Information' section in September and then work on other parts of the PPR during October and November before completing it in December.

User tip: Always save your data before you leave the RSA system. In fact, it is always best to save your data from time to time as computer crashes or other interruptions with your work could occur from time to time.

Q. Are we required to complete the web-based PPR sequentially, i.e., finishing section I, then going to section II, etc.?

A. Generally speaking, the report can be completed in any sequence that makes sense for the individual entering the data. So, for example, if you find it easiest to complete Part VI ('Agency Administration') first before going to other parts of the report you can do so.

Q. If I am working on one section of the PPR (Part VI, for example), have not finished with that section and want to go to another section of the form (such as Part III) can I do so? Will the data from the section I left still be there when I go back to it?

A. As noted above, it is possible to complete different parts of the PPR without following any specific sequence. It is also possible to partly complete one part of the form, save the data, then begin working on another part of the form.

User tip: Whenever you plan to move from one section or part of the form to another it is necessary to save data. In fact, as a result of feedback from those P&As that did FY 2004 reports using an earlier version of the form and web-based system, a change was made to encourage users to 'save' data before moving to another part of the form. Do not use your web browser's 'back' button to move back to the main menu so that you can move to a different part or section of the PPR without first saving your data; otherwise, you will lose all data entered since the last time you saved.

Q. My agency uses one data collection system for collecting information agency wide. How can I find out if there is an easy way to export data directly from our system into RSA's web-based system?

A. As this is written, the only way to move data from another database or from a word processing program (i.e., Word or WordPerfect) is using the 'cut and paste' function. There is currently no linkage between the RSA system and NDRN's DADS database. (NDRN refers to the National Disability Rights Network, formerly NAPAS.) In general, any TA questions that involve what you can or cannot do from a technology standpoint are questions that should be directed to either NDRN or RSA. Again, your contact for TA at NDRN is Matt Hayden, matt.hayden@ndrn.org; your contact at RSA is Ken Schellenberg, RSAMIS.Technical.Support@ed.gov.

Q. I work in a P&A program in which several attorneys and advocates are providing services under the PAAT program. What if I complete a section of the report (Part I, 'Non-Case Services,' for example) and then learn of additional data that were not entered in this section of the report. Is it too late to enter the data?

A. Generally, you will be able to edit sections of the web-based PPR after you have entered and saved the data but before you have 'locked' the data. Individuals who are completing the report will be able to lock data, section by section, preventing the inadvertent editing of a section that is already completed. If you wish to edit a section or part of the PPR in which data is already locked, contact Ken Schellenberg at RSA, RSAMIS.Technical.Support@ed.gov. If the deadline for submitting the report, December 31st , has not already passed, he should be able to unlock the section of the report and allow you to edit the report.

Q. In reviewing the questions, my P&A program realizes that there is some information that we have not collected or not collected in the format that would allow us to report accurately using the new PPR. How do we respond if we have not collected the data for all sections of the report?

A. During the first year of reporting, RSA understood that your PAAT program may not have collected data which allows you to accurately answer every question in the report. For some sections, such as Part I.B.2. (requesting the number of individuals who have attended training sessions), the instructions indicate that it is appropriate to estimate in answering the question. For other sections, such as Part I.C. 4. (requesting the number of website hits), the instructions specifically say you should not estimate. Since P&A agencies are now aware that the web-based PPR will ask you to report on this range of information, your PAAT should make every effort to collect data that will allow you to answer the range of questions in the PPR.

Q. I have worked with other web-based reporting systems and have encountered the problem of being 'timed out,' i.e., kicked off the site, without data saved, if no activity has occurred on the site after a period of time. Will we face this issue when reporting on the RSA system?

A. We hope not. We recognize that individuals completing web-based reports may be called away from this activity for significant lengths of time and that these interruptions may be unpredictable. However, for security reasons, the ED network closes a session after one hour of inactivity. We encourage you to save your work before leaving your computer, and to lock your workstation when you do so to prevent unauthozied users from access the Department's system.

Q. Some web-based reporting systems limit the amount of narrative information that can be entered in text boxes. Will we face this issue when reporting on the RSA website?

A. No. While we encourage you to use brevity in answering the questions that call for a narrative response, the maximum number of characters allowed is so large that you will not encounter this problem.

Q. When completing the narrative sections of the PPR is it acceptable to use a series of short phrases rather than complete sentences?

A. A good general rule is that P&A agencies should be meticulous about the way written information is presented. You should carefully proofread to correct mistakes in grammar, punctuation, sentence structure, and spelling. Generally, you should report information using complete sentences.

Q. Will I be able to save a copy of the report to a word processing program, such as Word or WordPerfect, at the time I enter data on the RSA system? We like to retain our reports for a range of future uses.

A. The web-based system offers you the ability to print and the ability to save to an MS Word document.

Agency Information

Q. Our P&A program is a division of a larger entity. Do I indicate the name of the parent agency in this section or should I enter the name of our P&A program?

A. When in doubt, it is important to be consistent in terms of other communications between your P&A and the Rehabilitation Services Administration (RSA) which awards your PAAT grant. If the grant award and correspondence generally is sent in the name of the parent agency, use that name; if the grant award and correspondence is sent in the name of the P&A agency, use that name. If in doubt, we recommend using both names.

Q. Two individuals from my agency will be involved in preparing the report and entering the data in the RSA system. Can I enter both names on the report or must we limit the report to one name?

A. You can enter both names on the web-based PPR, listing first the individual with primary responsibility for the report. You can then enter both email address and indicate separate office locations if the individuals are located in two separate offices. You should avoid listing more than two names in this part of the PPR.

Part I: Non-Case Services

A. Information and Referral Services

Q. Early in the grant year we served a client under the 'case services' category (Part II of PPR). Later in the grant year this client called us on an unrelated issue and we were able to handle this under the I&R category. Can we, in this case, report the earlier service under case services and the later service under I&R services?

A. Yes. So long as both of these are discreet and separate services, it is appropriate to report one individual receiving service under the I&R category and separately report one individual served under the case services category. For example, the case service could involve representation at a Medicaid hearing and the I&R service could involve answering a question about how to seek an AT evaluation through the special education program.

B. Training Activities

Q. Our P&A program is fairly large and has four separate offices, but our PAAT staff work out of our main office in the state capital. During our annual statewide meeting for priority setting and staff training, our PAAT staff did a 90–minute training session for our statewide attorney and advocate staff on how to obtain funding for AT. Even though this was an in-house training event, can we report this on the PPR as a training event?

A. Based on your description, it is appropriate to report this as a training event. This would appear to fall within the scope of your PAAT's overall strategy to get more AT devices into the hands of individuals with disabilities who need them. Even though the trainees are employees of your agency, the clientele of your agency can be expected to benefit from this training just as they might if you were presenting to a similar audience of individuals not employed by your agency.

User tip: As an alternative to reporting this as training or, more likely, in addition to reporting this as training, you should consider reporting this under Part VI.E.1. ('Collaboration with Other P&A Programs and Activities'). A goal for PAATs under the AT Act is to involve the entire P&A staff in delivery of AT-related advocacy services to eligible clients. In-house training of attorneys and advocates who are not assigned to the PAAT grant could help to further that goal.

Q. Under agency outreach, the PPR asks us to report our outreach efforts to underserved individuals and then, in the Instruction Manual, describes as examples outreach to minority communities, to rural areas, or to specific disability groups. During our first 10 years of PAAT funding, we recorded almost no service to the over 65 population. Could outreach to senior citizens groups be reported under this 'unserved or underserved' category?

A. If you have determined that this particular group has not, historically, been well served by your PAAT or by your P&A program as a whole, reporting outreach to reach this group would be appropriate in this section. In your narrative, you should explain how you determined that this was an unserved or underserved group.

C. Information Disseminated to the Public by Your Agency

Q. My P&A program has a website but we do not collect information on hits to our site. How should I answer this question?

A. If you have not kept data under this category you will not be able to report a number in answer to this question. In that case, you would enter 'MD' for 'missing data.' Before deciding you cannot answer this question, however, you may want to check with your agency's webmaster to see if there is already a 'web counter' on your site or if one can be installed. It is possible that your webmaster can easily retrieve information that has not been requested in the past.

D. Information Disseminated About Your Agency's Activities by External Media Coverage

Q. I believe that a radio station (or local newspaper) reported on a case handled by our PAAT program. Nobody seems to remember the details of this external media coverage. How should we answer this question?

A. Since this section of the PPR asks for a narrative response and not just a number, you would need to enter N/A for 'not applicable' if this was the only external coverage for the reporting year. Knowing that the PPR will ask for this information in future years, your PAAT program should develop a system for collecting this information.

Part II: Case Services

A. Individuals Served

Q. Our PAAT program represented one individual on two very different cases that were new during the grant year: a Medicaid hearing involving 25 hours of attorney/advocate service and litigation under the Americans with Disabilities Act involving more than 50 hours of service. When we answer Part II.A.2. ('Additional Individuals Served During the Fiscal Year'), can we report this as two new cases?

A. No. The instructions are very clear that an individual only gets counted once in II.A.2. even if he or she is represented in two or more distinct matters.

Q. Using this same example of the individual with an open Medicaid case and a separate open ADA case, assume that we complete the Medicaid case and close it during the grant year but will continue the ADA litigation into the next grant year. Can we report a closed case under Part II.A.4. ('Total Number of Individuals with All Their Cases Closed During the Fiscal Year')?

A. No. Here again, the instructions are clear. If an individual was served on two or more cases during the year and at least one of those remains open at the end of the year this individual will not get counted in II.A.4.

User tip: Even though the completed Medicaid case in this example will not get captured, statistically, in answer to Part II.A.4, this activity will get captured when you complete Parts II.D. (reason for closing a case file) and II.E. (highest intervention strategy used for a closed case). See discussion immediately below.

B. Problem Areas/Complaints

Q. The instructions say that we can identify more than one problem area for open cases on which we served individuals during the grant year. Our PAAT program generally opens separate cases, for the same individual, if the problem area or complaint is discreet and not the same for each case. Is our practice acceptable or are we expected to report these all as one case?

A. Your agency's approach is acceptable. Maintaining separate case files for different problem areas is a sound approach to casework; likewise, reporting different problem areas for the same individual as distinct 'cases' is also a sound approach to reporting on this PPR. Note: When you report the reason for closing a case file (Part II.D.) or the highest intervention strategy used for the closed case (Part II.E.), you will be reporting two or more closed cases, for the same individual, separately.

C. Assistive Technology Devices/Services

Q. During the report year, we assisted the same individual in obtaining three different AT devices from three different funding sources: a wheelchair through Medicaid, an adapted computer for use in college through his vocational rehabilitation agency, and a hearing aid through a private insurance company. Under Part II.C.1, do we report this as one individual or as three individuals?

A. No matter how many devices your PAAT helped the individual to obtain, you still only report this as one individual in answer to Part II.C.1. By contrast, in the example presented you would report separately in answer to Part II.C.2: one device for mobility (II.C.2.b.), one device for hearing or seeing (II.C.2.c.), and one device to aid with school or learning (II.C.2.j.).

E. Intervention Strategy for Closed Cases

Q. During the grant year, we achieved a very significant success at the administrative hearing level but did not close this case because one issue that was decided unfavorably will be taken to court in the next year. Can we still report this here under II.E.6. for an intervention at an administrative hearing?

A. No. You should only report the intervention strategy for cases that were closed during the grant year.

User tip: For open cases in which you have already achieved significant success for your client, consider reporting this in another part of the PPR. For example, you might be able to report this under Part IV.A. ('Non-Litigation Systemic Activities') or under Part V.C. ('Agency Accomplishments').

Part III: Statistical Information for Individuals Served

General Questions

Q. This section of the PPR includes several categories of data collection that do not match up to the way our PAAT program has been collecting information. For example, we have kept data on the age range of individuals served but it does not track the age categories/age ranges called for in the PPR (Part III.A.). In the categories related to living arrangements (Part III.D.) and geographic location of the individuals served (Part III.E.), we have not collected this kind of data to date. How do we answer these parts of the PPR?

A. As noted in various parts of the Instruction Manual and elsewhere in this document, P&As may find that they are unable to answer or answer completely certain sections of the PPR. The three sections you referenced each have an 'unknown' category. For those cases in which you did not collect the information, you may need to report some or all of the individuals served under the unknown category.

User tip: If it is possible to go back to case files and report the information requested, we strongly urge you to do so. This may be easier, for example, on the age categories than for geographic locations of individuals; it may also be easier in a P&A in which all files are located in the same office or in which the information could be generated through a computer run. P&As should plan to begin collecting this information for future grant years and reports.

C. Race and Ethnicity of Individuals Served

Q. Historically and during the past year, my P&A agency categorized an individual who is Hispanic/Latino under the race category. We have not collected, separately, on the race of an individual classified as Hispanic/Latino. How do we answer III.C.1. ('Race of individuals served') if the only information we have is that the individual is self-reported as Hispanic/Latino?

A. You can report these individuals under II.C.2. as Hispanic/Latino; however, under II.C.1., you will have to report them under subsection g. ('Unknown/not reported'). As stated elsewhere, for future grant years your P&A should plan to separately collect the data that the PPR seeks.

D. Primary Disability of Individuals Served

Q. Is it possible to have one primary disability for one problem area and a separate primary disability for a second problem area? For example, if the person has severe cerebral palsy and a hearing impairment, could we answer cerebral palsy (III.E.9.) for the case involving a power wheelchair and answer either deafness or hard of hearing/hearing impaired (not deaf) (III.E.10. or 11.) for the case involving a hearing aid?

A. While this suggestion would seem to follow, the instructions make clear that only one primary disability gets reported for each individual served during the grant year. This is because the total called for on line III.E.34. is required to match the total reported in II.A.3.

Part IV: Systemic Activities and Litigation

A. Non-Litigation Systemic Activities

Q. Our P&A regularly has staff members serve on state or local advisory groups which provide us the opportunity to offer guidance to the government agency when it develops policies or makes changes to existing policies/practices. Often, we believe that our staff's input through the advisory group was a major factor leading to the policy change. Can we report that in this section even though the connection to policy change is not totally clear?

A. It is always best to report that activity which is most directly connected to the policy or practice change. When no such activity exists, it would be appropriate to report the kind of activity that you describe, acknowledging that you believe your P&A staff involvement contributed to the policy change. (See the example used in the Instruction Manual which is very close to the involvement described in this question.)

B. Litigation/Class Actions

Q. Our P&A agency has filed, but not yet completed, a state court appeal following a Medicaid denial of funding for an item of durable medical equipment (DME). While state policy currently allows funding for the DME in question, the agency routinely denies prior approval requests. A good court decision could help establish precedent for the kind of evidence needed to support a prior approval request. Can this be reported as systemic activity?

A. Definitely. To date, many of the important legal developments involving AT (or DME in your example) have involved individual cases filed in state courts. What is important is that you explain why the case your PAAT has filed could result in a systemic change that will benefit others.

C. Litigation-Related Monitoring

Q. Last year, a private law firm filed and settled a major lawsuit that challenged limitations on payment rates for three different categories of DME. Our P&A was not involved with the litigation, but we have been playing a role with monitoring the enforcement of the court-approved settlement. For example, in collaboration with the plaintiffs' attorneys we have distributed informational materials at conferences and training programs, and invited readers of our newsletter to call our PAAT project if the Medicaid agency limits the payment rates, for example, for certain classifications of patient lifts. Can we report this activity here even though our P&A was not involved in the litigation?

A. Yes. It would be appropriate to report activity related to the enforcement of a court order or settlement even if your P&A did not work on the litigation. The new PPR recognizes the importance of collaborations both within the P&A agency and between your PAAT project and other outside entities. To the extent that your litigation monitoring involves collaboration, you are encouraged to separately report or reference that collaboration in Part VI.E. of the PPR.

Part V: Priorities

A. Priorities

Q. To date, our grant from RSA has not required a particular level of detail for our agency's priorities under our PAAT project. Since our PAAT project receives funding of less than $100,000 for a statewide project, our priorities are fairly general, stating that 'our priority is to accept Medicaid and other third party insurance cases in which the AT sought will allow the individual to achieve a greater degree of independence.' Is this sufficient detail for reporting the priority under the new PPR?

A. A good measure of whether the priority is detailed enough is whether it allows the P&A to answer all the required questions under Part A, 1 through 5. Your description seems to accomplish this, assuming you can separately state the need, issue, or barrier addressed through this priority to answer A.2. Presumably, the barrier involved in your priority would be to overcome limitations to independence.

User tip: For reporting purposes, your PAAT may want to reference Medicaid cases and other third–party insurance cases as two separate priorities, allowing you to separately report the number of cases handled under each category. If one of the two or more priorities is considered to be primary and the others secondary, you should indicate that.

Q. Last year we reported what our priorities would be for what was then the 'current fiscal year' (i.e., the year covered by this report). After that report was submitted, our P&A agency reviewed its PAAT priorities in March, deleting one and adding a new one. Is this acceptable?

A. It is expected that some P&A agencies will edit their PAAT priorities after the grant year begins and even after the report for the previous grant year has been submitted. The web-based PPR will, for future years, automatically preload the priorities you reported during the previous years' reporting. However, when completing the report you will have the opportunity to edit/delete previously reported priorities and add any new priorities.

B. Priorities for the Current Fiscal Year

Q. Our priorities have been the same for the past several years. Is there any requirement that our priorities change from year to year?

A. There is no requirement that your PAAT project come up with new priorities each year.

User tip: A P&A may wish to consider the annual PPR as an opportunity to annually revisit the PAAT priorities. To the extent that your agency has decided to fine tune its priorities, zeroing in on a particular type of AT for example within a pre-designated priority category, you may wish to edit your priorities to reflect this.

C. Agency Accomplishments

Q. In addition to casework and training that has been reported elsewhere, during the past year we have established lines of communication with decision makers at Medicaid and two major private insurance companies. This has allowed us resolve numerous cases without the need for hearings, litigation, or other appeals. Can this be reported here?

A. Absolutely. Any activity that results in more individuals getting the AT devices and services they need should be considered for reporting in this section of the PPR. You could also consider reporting the outcome of any training you did for DME vendors or health providers in an effort to help them submit better prior-approval packets. Wherever possible, it would be helpful to provide specifics on how this has resulted in positive outcomes.

Part VI: Agency Administration

A. Agency Funding

Q. Our PAAT receives an annual grant of $50,000. For the grant year that ended September 30, 2006, we received permission to carry over $10,000 into the next year (i.e., 2006-07). During the reporting year, 2006-07, our agency used $55,000 to carry out our PAAT program activities. How do we report this in answering VI.A.1. and 2?

A. You should report $45,000 under VI.A.1. ('Federal P&A (AT Act funds)') and $10,000 under VI.A.2. ('Federal AT Act Funds carried forward from previous Fiscal Year (if applicable)'). You always exhaust carry over funds first, then report spending from current year funding (i.e., 2006-07 funding in this example). In this example, it appears you will need permission to carry $5,000 in 2006-07 funds into the 2007-08 grant year.

Q. AT-related advocacy has become a significant priority for our P&A, with considerable resources being devoted to AT work from our P&A for Developmentally Disabled (PADD) and P&A for Individual Rights (PAIR) grants. Are we required in this section to list these PADD and PAIR resources under the 'other' categories of this section (VI.A.4. or 5.)?

A. No. These contributions and any other in-kind contributions to AT-related advocacy would not get reported here.

User tip: The contributions of your PADD and PAIR staff can be reported as collaborative activity under Part VI.E.1.

B. Description of PAAT Program Staff

Q. The PPR asks us to list, by number and full-time equivalent amount the professional and administrative staff assigned to the PAAT project. We always assign a pro rata percentage of time to the grant to cover the cost of our Executive Director and Financial Administrator. Since the instructions do not refer to either of these positions under administrative staff, are we expected to include them in the answer to VI.B.2?

A. If your agency pays a part of these salaries out of PAAT funds, you should report them here.

C. Consumer Involvement

Q. The PPR asks about consumer involvement in our P&A agency staff. Our P&A agency has several individuals with disabilities working for the agency, but none of them was employed by the PAAT program during the past year. Do we still report these individuals in answer to Part VI.C.2?

A. Yes. The PPR seeks information on the number of individuals with disabilities that were employed by your agency during the reporting year whether or not they worked on the PAAT project.

D. Grievances Filed

Q. My agency received a grievance from a potential PAAT client who later withdrew the grievance when we were able to explain why we were unable to handle his appeal. Does this still get reported?

A. Yes. Since this person did file a grievance it should be reported.

E. Collaborative Efforts

Q. Our PAAT project uses donated space at a Center for Independent Living for meeting with clients. Can this be reported as an outside collaboration under Part VI.D.2?

A. This clearly can be reported here since the collaboration allows you to serve more individuals within an existing budget.

User tip: If this collaboration comes with other benefits as well, you should report that here. For example, if your collaborating agency is also helping you to publicize the PAAT project and schedule appointments that is an added benefit of the collaboration.