Training:
General

Training is not public awareness – training has more depth and breadth.

If the purpose is to create awareness, the training session is public awareness.

Working with individual consumers on devices or troubleshooting problems is “Individual Assistance” under Public Awareness.

Training:
General

Training is provided to individuals (even if they attend as a group) and increases skills/competencies.

Technical assistance is provided to agencies and involves problem solving

Technical assistance may include training.

If you train as part of TA it can be included here – but if training was the ONLY TA activity, you don’t include it in TA as well

Training:
Geographic Distribution

Geographic distribution of those to whom you provided training – not where you provided the training.

For consumers, use county of residence.

For professionals, use county in which the professional provides services.

Training:
Training Topics

Training:
Notes

Describe one innovative or high-impact training* activity conducted during this reporting period.

Describe one transition training conducted during this reporting period.

Who conducted the training?

Who attended (including number)?

What was the topic, content, and/or approach?

What was the result?

Do not include overall descriptions of conferences.

Training

    No performance measures

   No customer satisfaction

   Coordination and Collaboration

   Notes

Technical Assistance:
General

TA is provided to agencies, not individuals.

Troubleshooting devices for individuals is “Individual Assistance” under Public Awareness.

Training focuses on increasing skills and is done for individuals (even in groups) – TA is problem solving for an entity.

If training was the only kind of TA you provided, this is training and not TA.

If training was only one part of TA, it can be both TA and training.

TA:
Frequency and Nature

1. How many major technical assistance activities did
you conduct during the reporting period? ___

(Respondents who enter “1” or more will receive balance of section.)

(If Item 1=0) You can see a read-only.

Complete this section for each major technical assistance activity that you conducted. If you have more than one activity to report, you will need to complete this section more than once. After you have completed your first entry, you will be given an opportunity to repeat this section in order to report additional activities.

TA:
Frequency and Nature

1. Recipient of technical assistance:

Radio buttons for “check all that apply”:

education agency or organization;

employer or business;

(3) provider of employment/training services;

(4) public or private agency or organization not otherwise classified above;

(5) manufacturer/ vendor;

(6) other (specify)

TA:
Frequency and Nature

3. For this technical assistance activity, identify the policy expertise areas and
product/service expertise areas that were addressed. If the technical assistance
activity included both policy and product/service expertise, select both.

Note that mandatory transition activities that are technical assistance activities are reported here under product/service expertise. Mandatory transition activities that are training activities are reported in the training section.

Radio buttons for “check all that apply”: (1) policy area; (2) product/service area

(If policy area) Identify the policy areas on which the technical assistance* focused. Choose all that apply.

Radio buttons: (1) ADA/504; (2) IDEA Part C; (3) IDEA Part B; (4) Section 508 and Section 255; (5) WIA/Rehabilitation Act/VR; (6) Medicaid; (7) Medicare; (8) Private insurance; (9) HAVA; (10) Older Americans Act; (11) SSI/SSDI/Work Incentives; (12) Olmstead (13) other (specify)

(If product/service area) Identify the product/service areas on which the technical assistance* focused. Choose all that apply.

Radio buttons: (1) Web accessibility; (2) accessible IT procurement; (3) AT purchasing (cost-effective options);(4) accessible voting systems; (5) AT eligibility determinations; (6) AT personnel development; (7) AT resource allocation; (8) AT service delivery options; (8) AT legislation/policy development; (9) specific AT device assistance; (10) transition–education; (11) transition–community living; (12) other (specify)

TA:
Frequency and Nature

4. Duration of technical assistance* during this reporting period:

Drop-down box: (1) less than 3 months; (2) 3 to 5 months; (3) 6 to 8 months;
(4) 9 to 12 months; (5) other (specify)

5. Approximate number of person hours expended by AT program staff to deliver the technical assistance:* (Numeric field)

6. Do you have additional activities to report? If so, select “Yes” and the system will repeat this section. If you select “no,” it will take you to the next section of the reporting form.

Drop-down box: (1) yes; (2) no

(Respondents who choose “1” will repeat Items 1 through 5.)

TA

Coordination and Collaboration

Description of TA Activity:

One high-impact or innovative

One transition

Public Awareness:
General

Public awareness is intended to reach large audiences and is not as in-depth as training.

Public awareness includes:

1. Public Awareness

Information Dissemination

Information and Referral (not to be confused with referral related to device demonstration!)

Individual Assistance

Public Awareness Activities

Public Awareness:
Individual Assistance

Report the number of individuals to whom you provided individual assistance, by primary type of information/assistance provided.

Provide a count of the number of individuals assisted, rather than the number of contacts made.

If one person made three phone calls in one week, that should be counted as one person assisted, not three.

If the three phone calls are for different purposes, select the primary purpose.

Public Awareness:
Individual Assistance

Public Awareness:
I&R

Public Awareness:
I&R

Each individual assisted with information and/or a referral should be counted only once, regardless of the number of contacts made.

Coordination and Collaboration

Notes

Coordination and Collaboration
or State Improvement not
Previously Addressed

Additional Coordination and Collaboration

same as in other sections

Additional State Improvement Initiatives

same as in other sections

Expenditures and Other Financial Information

In this table, report:

a.   The amount of AT Act funds expended for each state-level activity.

b.   The total amount of AT Act funds expended for all state-level activities.*

c.   The amount of AT Act funds expended for each state leadership activity (not including mandatory transition).

d.   The amount of AT Act funds expended for transition activities.

e.   The total amount of AT Act funds expended for all state leadership activities.

Expenditures and Other Financial Information

Integrated Programs:

Enter MD into the rows for which you cannot individually report expenditures.

Then report the total amount of funds used for “integrated activities” in the integrated activities row.

Funding only should be reported as integrated when the activities are truly integrated.

For example, your device demonstration and device loan programs may share both staff and devices, making it difficult to know how much funds are used for each activity.

Expenditures and Other Financial Information

Additional and
Leveraged Funds

Enter the sources and amounts of non-AT Act funds that you received during this reporting period

Indicate to which activities those funds were allocated.

Report each source and amount in the reporting period that it was received, even if not all of the funds were expended.

Do not report AFP endowments or matching funds.

If funds were used for neither State-level or State Leadership activities report in “Other” and complete narrative section.

Additional and
Leveraged Funds

Additional and
Leveraged Funds

2. (If “other” is selected in Item B.1, Row 1) You indicated that funds from (name of funding source) were used for activities other than the state-level and state leadership activities.

a. Describe the “other” activities for which these funds
     were used.

b. How many individuals were served with these
     additional funds? If you are unable to report this
     number, enter “MD” for missing data and provide an
     explanation under “Notes” at the end of this section.
     (Numeric field)

c. What outcomes were accomplished with these
     additional funds? (Narrative field)


	Training is not public awareness – training has more depth and breadth.
	If the purpose is to create awareness, the training session is public awareness.
	Working with individual consumers on devices or troubleshooting problems is “Individual Assistance” under Public Awareness.


	Training is provided to individuals (even if they attend as a group) and increases skills/competencies.
	Technical assistance is provided to agencies and involves problem solving
	Technical assistance may include training.
	If you train as part of TA it can be included here – but if training was the ONLY TA activity, you don’t include it in TA as well


	Geographic distribution of those to whom you provided training – not where you provided the training.
	For consumers, use county of residence.
	For professionals, use county in which the professional provides services.


	Describe one innovative or high-impact training* activity conducted during this reporting period.
	Describe one transition training conducted during this reporting period.
	Who conducted the training?
	Who attended (including number)?
	What was the topic, content, and/or approach?
	What was the result?
	Do not include overall descriptions of conferences.


	No performance measures
	No customer satisfaction
	Coordination and Collaboration
	Notes


	TA is provided to agencies, not individuals.
	Troubleshooting devices for individuals is “Individual Assistance” under Public Awareness.
	Training focuses on increasing skills and is done for individuals (even in groups) – TA is problem solving for an entity.
	If training was the only kind of TA you provided, this is training and not TA.
	If training was only one part of TA, it can be both TA and training.


	1. How many major technical assistance activities did you conduct during the reporting period? ___
	(Respondents who enter “1” or more will receive balance of section.)
	(If Item 1=0) You can see a read-only.
	Complete this section for each major technical assistance activity that you conducted. If you have more than one activity to report, you will need to complete this section more than once. After you have completed your first entry, you will be given an opportunity to repeat this section in order to report additional activities.


	1. Recipient of technical assistance:
	Radio buttons for “check all that apply”:
	education agency or organization;
	employer or business;
	(3) provider of employment/training services;
	(4) public or private agency or organization not otherwise classified above;
	(5) manufacturer/ vendor;
	(6) other (specify)


	3. For this technical assistance activity, identify the policy expertise areas and product/service expertise areas that were addressed. If the technical assistance activity included both policy and product/service expertise, select both.
	Note that mandatory transition activities that are technical assistance activities are reported here under product/service expertise. Mandatory transition activities that are training activities are reported in the training section.
	Radio buttons for “check all that apply”: (1) policy area; (2) product/service area
	(If policy area) Identify the policy areas on which the technical assistance* focused. Choose all that apply.
	Radio buttons: (1) ADA/504; (2) IDEA Part C; (3) IDEA Part B; (4) Section 508 and Section 255; (5) WIA/Rehabilitation Act/VR; (6) Medicaid; (7) Medicare; (8) Private insurance; (9) HAVA; (10) Older Americans Act; (11) SSI/SSDI/Work Incentives; (12) Olmstead (13) other (specify)
	(If product/service area) Identify the product/service areas on which the technical assistance* focused. Choose all that apply.
	Radio buttons: (1) Web accessibility; (2) accessible IT procurement; (3) AT purchasing (cost-effective options);(4) accessible voting systems; (5) AT eligibility determinations; (6) AT personnel development; (7) AT resource allocation; (8) AT service delivery options; (8) AT legislation/policy development; (9) specific AT device assistance; (10) transition–education; (11) transition–community living; (12) other (specify)


	4. Duration of technical assistance* during this reporting period:
	Drop-down box: (1) less than 3 months; (2) 3 to 5 months; (3) 6 to 8 months; (4) 9 to 12 months; (5) other (specify)
	5. Approximate number of person hours expended by AT program staff to deliver the technical assistance:* (Numeric field)
	6. Do you have additional activities to report? If so, select “Yes” and the system will repeat this section. If you select “no,” it will take you to the next section of the reporting form.
	Drop-down box: (1) yes; (2) no
	(Respondents who choose “1” will repeat Items 1 through 5.)


	Coordination and Collaboration
	Description of TA Activity:
	One high-impact or innovative
	One transition


	Public awareness is intended to reach large audiences and is not as in-depth as training.
	Public awareness includes:
	1. Public Awareness
	Information Dissemination
			Information and Referral (not to be confused with referral related to device demonstration!)
			Individual Assistance


	Report the number of individuals to whom you provided individual assistance, by primary type of information/assistance provided.
	Provide a count of the number of individuals assisted, rather than the number of contacts made.
	If one person made three phone calls in one week, that should be counted as one person assisted, not three.
	If the three phone calls are for different purposes, select the primary purpose.


	Each individual assisted with information and/or a referral should be counted only once, regardless of the number of contacts made.

	Coordination and Collaboration
	Notes


	Additional Coordination and Collaboration
			same as in other sections
	Additional State Improvement Initiatives
			same as in other sections


	In this table, report:
	a. The amount of AT Act funds expended for each state-level activity.
	b. The total amount of AT Act funds expended for all state-level activities.*
	c. The amount of AT Act funds expended for each state leadership activity (not including mandatory transition).
	d. The amount of AT Act funds expended for transition activities.
	e. The total amount of AT Act funds expended for all state leadership activities.


	Integrated Programs:
	Enter MD into the rows for which you cannot individually report expenditures.
	Then report the total amount of funds used for “integrated activities” in the integrated activities row.
	Funding only should be reported as integrated when the activities are truly integrated.
	For example, your device demonstration and device loan programs may share both staff and devices, making it difficult to know how much funds are used for each activity.


	Enter the sources and amounts of non-AT Act funds that you received during this reporting period
	Indicate to which activities those funds were allocated.
	Report each source and amount in the reporting period that it was received, even if not all of the funds were expended.
	Do not report AFP endowments or matching funds.
	If funds were used for neither State-level or State Leadership activities report in “Other” and complete narrative section.


	2. (If “other” is selected in Item B.1, Row 1) You indicated that funds from (name of funding source) were used for activities other than the state-level and state leadership activities.
	a. Describe the “other” activities for which these funds were used.
	b. How many individuals were served with these additional funds? If you are unable to report this number, enter “MD” for missing data and provide an explanation under “Notes” at the end of this section. (Numeric field)
	c. What outcomes were accomplished with these additional funds? (Narrative field)