| Instructions for performance reporting for ACL/CDC supplemental funding to Expand COVID-19 Vaccine Access for People with Disabilities | 
	
		| Complete the tables of quantitative and qualitative data for service activities conducted between April 1, 2021 and September 30, 2022. | 
	
		| • Enter data for the full project period 4/1/21 through 9/30/22. | 
	
		| • Ensure that the information you enter is complete and correct. | 
	
		| • Enter the information in the column as specified in both Quantitative and Qualitative worksheets. | 
	
		| • If a list of valid values is provided, select only from these values. Do not add or change any values. | 
	
		| • Do not add or delete any columns in the worksheets. | 
	
		| •Do not change the sequence of the columns. | 
	
		| • Do not delete worksheets. | 
	
		| • In the Quantitative worksheet, enter digits only (no letters, punctuation, or symbols). | 
	
		| • In the Qualitative worksheet, enter up to 2,500 characters to describe your narrative, successes, and challenges for the service activities | 
	
		| completed. Completion of all service activities was not required. For service activities not completed, enter N/A. | 
	
		| • In the Qualitative worksheet, enter up to 2,500 characters to describe collaborations with ACL partners, collaborations with other | 
	
		| community-based organizations, lessons learned, and recommendations for future activities. These fields are not optional. | 
	
		| • Direct any questions related to the completion of this spreadsheet to Sheryl Matney (smatney@nacdd.org) or Cherie Moon (cmoon@nacdd.org) | 
	
		| • Upload completed data sheets as an attachment in the annual PPR due January 1, 2023. | 
	
	
	
		| Project Title | Expand COVID-19 Vaccine Access for People with Disabilities | 
	
		| Council Name | 
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		| Project Timeline | April 1, 2021 - September 30, 2022 | 
	
		| Service Activity | Number of people Served | 
	
		| Education about the importance of receiving a vaccine | Number of people with disabilities reached by your education activities. | 
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		| Number of all other people (including family members, direct support providers, personal care attendants, and other support providers) reached by your education. | 
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		| Identifying people unable to independently travel to a vaccination | Number of people unable to independently travel to a site. | 
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		| Providing technical assistance (TA) to local health departments or other entities on vaccine accessibility | Number of local health departments or other entities assisted with TA on vaccine appointments. | 
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		| Helping with scheduling a vaccine appointment | Number of people helped in scheduling vaccine appointments. | 
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		| Arranging or providing accessible transportation | Number of people assisted with accessible transportation to a vaccination site. | 
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		| Providing companion/personal support | Number of people assisted with companion/personal support to receive vaccines. | 
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		| Reminding people of their second vaccination appointment if needed | Number of people who needed and received a reminder of their second vaccination appointment | 
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		| Overall outcome:  Number of people vaccinated as a result of implementing one or more of the service activities | 
	
		| Number of people with disabilities vaccinated as a result of implementing one or more of the service activities | 
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		| Total number of all other people vaccinaated as a result of implementing one or more of the service activities. | 
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		| Project Title | Expand COVID-19 Vaccine Access for People with Disabilities | 
	
		| Council Name | 
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		| Project Timeline | April 1, 2021 - September 30, 2022 | 
	
		| Service Activity | Narrative | Successes | Challenges | 
	
		| Education about the importance of receiving a vaccine. | Describe the type of education activities conducted (e.g., one-on-one assistance, brochures/pamplets/fliers, social media postings, social stories). | Describe the most successful/effective education activities implemented | Describe challenges that limited your ability to educate others about the importance of the vaccine. | 
	
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		| Character Count | 0 | 0 | 0 | 
	
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		| Service Activity | Narrative | Successes | Challenges | 
	
		| Identifying people unable to independently travel to a vaccination site. | Describe the strategy to identify people unable to independently travel to a vaccination site. | Describe the most commonly cited reasons for why they could not travel to the site. | Describe successes achieved as a result of identifying people to independently travel to a site (i.e., were people able to vaccinated at an alternative site?) | Describe challenges that limited your ability to identify people unable to independently travel to a site. | 
	
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		| Character count | 0 | 0 | 0 | 0 | 
	
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		| Service Activity | Narrative | Successes | Challenges | 
	
		| Providing TA to local health departments or other entities on vaccine accessibility | Describe the types of strategies/TA activities to assist local health departments or other entities on vaccine accessibility. | Describe successes achieved as a result of TA activities provided to local health departments. | Describe challenges that limited your ability to provide TA to local health departments or other entities on vaccine accessibility. | 
	
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		| Character count | 0 | 0 | 0 | 
	
		| Service Activity | Narrative | Successes | Challenges | 
	
		| Helping with scheduling a vaccine appointment | Describe the types activities used to assist people in scheduling vaccines. | Describe successes achieved as a result of assistance provided to help schedule vaccine appointments. | Describe challenges that limited your ability to help with scheduling a vaccine appointment. | 
	
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		| Character count | 0 | 0 | 0 | 
	
		| Service Activity | Narrative | Successes | Challenges | 
	
		| Providing companion or personal support | Describe the types activities to provide companion/personal support services for people to receive vaccines. | Describe successes achieved as a result of providing companion/personal support services for people to receive vaccines. | Describe challenges that limited your ability to provide companion/personal support services. | 
	
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		| Character count | 0 | 0 | 0 | 
	
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		| Service Activity | Narrative | Successes | Challenges | 
	
		| Reminding people of their second vaccination appointment if needed. | Describe the types activities to provide people with reminders on their second vaccination appointment. | Describe successes achieved as a result of providing reminders to people on their second vaccination appointment. | Describe challenges that limited your ability to provide people reminders on their second vaccination appointment. | 
	
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		| Character count | 0 | 0 | 0 | 
	
		| Collaboration with ACL partners (ADRC's, AAA, CIL, P&A, UCEDD) | 
	
		| Describe the nature of collaboration and join activities with ACL partners, including successes and challenges in your collaboration efforts. | 
	
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		| Character count | 0 | 
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		| Collaboration with other community-based organizations. | 
	
		| Describe the collaboration and joint activities with other community-based organizations, including successes and challenges in your collaboration efforts. | 
	
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		| Character count | 0 | 
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		| Overall Lessons Learned | 
	
		| Describe the leading key lessons learned as a result of your overall implementation activities. | 
	
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		| Character Count | 0 | 
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		| Recommendations for future activities. | 
	
		| Provide recommendations for ACL to consider that will maximize the impact of future responses to disasters or pandemics. | 
	
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		| Character count | 0 | 
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		| SCDD | 
	
		| AL - Alabama Council on Developmental Disabilities | 
	
		| AK - Governor's Council on Disabilities and Special Education | 
	
		| AR - Governor's Developmental Disabilities Council | 
	
		| AS - American Samoa Developmental Disabilities Council | 
	
		| AZ - Arizona Developmental Disabilities Planning Council | 
	
		| CA - California State Council on Developmental Disabilities | 
	
		| CNMI - CNMI Council on Developmental Disabilities | 
	
		| CO - Colorado Developmental Disabilities Council | 
	
		| CT - Connecticut Council on Developmental Disabilities | 
	
		| DC - D.C. Developmental Disabiilties Council | 
	
		| DE - Delaware Developmental Disabilities Council | 
	
		| FL - Florida Developmental Disabilities Council | 
	
		| GA - Georgia Council on Developmental Disabilities | 
	
		| GU - Guam Developmental Disabiilties Council | 
	
		| HI - Hawaii State Council on Developmental Disabilities | 
	
		| IA - Iowa Developmental Disabilities Council | 
	
		| ID - Idaho State Council on Developmental Disabilities | 
	
		| IL - Illinois Council on Developmental Disabilities | 
	
		| IN - Governor's Council for People with Disabilities | 
	
		| KS - Kansas Council on Developmental Disabilities | 
	
		| KY - Commonwealth Council on Developmental Disabilities | 
	
		| LA - Louisiana Developmental Disabilities Council | 
	
		| MA - Massachusetts Developmental Disabilities Council | 
	
		| MD - Maryland Developmental Disabilities council | 
	
		| ME - Maine Developmental Disabilities Council | 
	
		| MI - Michigan Developmental Disabilities council | 
	
		| MN - Governor's Council on Developmental Disabilities | 
	
		| MS - Mississippi Developmental Disabilities Council | 
	
		| MO - Missouri Developmental Disabilities Council | 
	
		| MT - Montana Council on Developmental Disabilities | 
	
		| NC - North Carolina Council on Developmental Disabilities | 
	
		| ND - North Dakota State Council on Developmental Disabilities | 
	
		| NE - Nebraska Council on Developmental Disabilities | 
	
		| NH - New Hampshire Developmental Disabilities Council | 
	
		| NJ - New Jersey Council on Developmental Disabilities | 
	
		| NM - New Mexico Developmental Disabilities Planning Council | 
	
		| NV - Nevada Governor's Council on Developmental Disabilities | 
	
		| NY - New York State Developmental Disabilities Council | 
	
		| OH - Ohio Developmental Disabilities Council | 
	
		| OK - Developmental Disabilities Council of Oklahoma | 
	
		| OR - Oregon Council on Developmental Disabilities | 
	
		| PA - Pennsylvania Developmental Disabilities Council | 
	
		| PR - Puerto Rico Council on Developmental Disabilities (CEDD) | 
	
		| RI - Rhode Island Developmental Disabilities Council | 
	
		| SC - South Carolina Developmental Disabilities Council | 
	
		| SD - South Dakota Council on Developmental Disabilities | 
	
		| TN - Tennessee Council on Developmental Disabilities | 
	
		| TX - Texas Council on Developmental Disabilities | 
	
		| UT - Utah Developmental Disabilities Council | 
	
		| VA - Virginia Board for People with Disabilities | 
	
		| VI - Virgin Islands Developmental Disabilities Council | 
	
		| VT - Vermont Developmental Disabilities Council | 
	
		| WA - Washington State Developmental Disabilities Council | 
	
		| WV - West Virginia Developmental Disabilities Council | 
	
		| WI - Wisconsin Board for People with Developmental Disabilities | 
	
		| WY - Wyoming Governor's Council on Developmental Disabiilties |