MONITORING AND TECHNICAL ASSISTANCE REVIEW SYSTEM NOTEBOOK

The American Dream Belongs to Everyone.
ADMINISTRATION ON DEVELOPMENTAL DISABILITIES
Administration for Children and Families
United States Department of Health and Human Services
2008


TABLE OF CONTENTS
TABLE OF CONTENTS 2
PREFACE	6
SECTION 1 7
Overview of the DD Act and ADD 7
The DD Act 7
Developmental Disabilities 7
ADD 8
SECTION 2 10
Monitoring and Technical Assistance Review System (MTARS) 10
Overview of the MTARS 10
MTARS Monitoring Elements 11
Program Compliance 12
Accountability and Achievement of Program Goals	12
Program Collaboration 13
Fiscal Management 13
Technical Assistance 13
Program Innovation 14
Self-assessment Checklists 14
MTARS Activities and Phases 14
SECTION 3 16
MTARS Team 16
MTARS Team Structure 16
Selection of Non-federal Team Members 19
Team Member Responsibilities 19
Standards of Conduct 21
SECTION 4 22
Planning Activities 22
The Planning Phase 22
Selecting States to Review 22
Planning Activities 23
Training MTARS Reviewers 23
SECTION 5 24
Pre-Site Visit Activities 24
Site Visit Notification	24
ADD Staff Assignments and Preparations	24
Recruitment of MTARS Team Members 25
Grantee Self-Assessment and Preparation	25
Process for Completing the Self-Assessment Checklists 26
Step 1: Program Lead and Grantee discuss how to complete the checklists	28
Step 2: Grantee Completes Checklists and Sends to Program Team 28
Step 3: MTARS team members review the materials submitted by the grantee 28
Step 5: Grantee and Program Team Teleconference	29
Fiscal Review Guidance 29
Joint Entrance Meeting Videoconference 30
Public Forum Preparation 32
Site Visit Agenda 33
Other Site Visit Preparations 33
SECTION 6 34
MTARS Site Visit 34
Purpose of the Site Visit 34
Meetings 34
Program Team Meetings 35
MTARS Team Meetings 35
Public Forum 35
Interviews 36
The Interview Process 37
P&A Case Record Review 37
Note-taking 38
SECTION 7 39
Post-Site Visit Activities 39
Development of the Final Report	39
Process and Timeframes for Developing the Final Report 39
Report Distribution 43
Response to MTARS Report 44
Content of the Corrective Action Plan 44
Timeframes for Submitting the Corrective Action Plan 45
Timeframes for Implementing the Corrective Action Plan 45
Evaluating the Implementation of the Corrective Action Plan 45
TAB A – COMMONLY USED ACRONYMS 46
TAB B – GLOSSARY 48
TAB C.1 - COUNCIL COMPLIANCE CHECKLIST 52
TAB C.2 – COUNCIL PROGRAM OPERATION AND PRACTICES CHECKLIST 64
TAB C.3 - COUNCIL BEST OR INNOVATIVE PRACTICES CHECKLIST 72
TAB C.4 - STATE COUNCILS ON DEVELOPMENTAL DISABILITIES FISCAL REVIEW CHECKLIST 76
TAB C.5 - COUNCIL CHAIR CHECKLIST 81
TAB D.1 – P&A COMPLIANCE CHECKLIST 83
TAB D.2 – P&A PROGRAM OPERATION AND PRACTICES CHECKLIST	96
TAB D.3 - PROTECTION & ADVOCACY BEST OR INNOVATIVE PRACTICES CHECKLIST 100
TAB D.4 - PROTECTION & ADVOCACY SYSTEM CASE FILE REVIEW	104
TAB D.5 - PROTECTION & ADVOCACY SYSTEM FISCAL REVIEW CHECKLIST 107
TAB E.1 - UCEDD COMPLIANCE CHECKLIST 112
TAB E.2 – UCEDD PROGRAM OPERATIONS AND PRACTICES CHECKLIST 126
TAB E.3 - UCEDD BEST OR INNOVATIVE PRACTICES CHECKLIST 134
TAB E.4 - UCEDD FISCAL REVIEW CHECKLIST	138
TAB E.5 – UCEDD PROGRAM OPERATIONS AND PRACTICES CHECKLIST FOR THE CONSUMER ADVISORY COMMITTEE 144
TAB F – TIPS FOR EFFECTIVE TEAM WORK 173
TAB G – SAMPLE CONFERENCE CALL AGENDA 174
TAB H – MTARS HOTEL AMENITIES CHECKLIST	176
TAB I – MTARS TEAM COORDINATOR CHECKLIST 177
TAB J – PROGRAM TEAM LEAD CHECKLIST 183
TAB K – FORMAT OF THE CONTACT SHEET FOR MTARS TEAM MEMBERS 188
TAB L – SAMPLE JOINT ENTRANCE MEETING VIDEOCONFERENCE AGENDA 191
TAB M – SAMPLE NOTICE OF PUBLIC FORUM 192
TAB N - SAMPLE ON-SITE MEETING SCHEDULE	193
TAB O – PUBLIC FORUM CHECKLIST 196
TAB P – INTERVIEW TIPS 197
Sample Council Questions 199
Sample Protection and Advocacy System Questions	206
Sample UCEDD Questions 213
TAB Q – NOTE-TAKING TIPS 217
TAB R – FORMAT FOR MTARS REPORT 218
TAB S – SAMPLE COVER LETTER FOR THE MTARS REPORT 220

PREFACE

This notebook provides guidance on the Monitoring and Technical Assistance Review System (MTARS). The notebook is
intended to be used as a guide by ADD staff who manage MTARS and by MTARS reviewers who conduct the site visit
activities. The notebook is also designed to help Councils, P&As, and UCEDDs prepare for and participate in MTARS
activities.

The MTARS notebook describes procedures for every stage of the MTARS process, from selecting grantee sites to
review through follow-up activities after the monitoring visit. It is organized into the following seven sections:

1) Section 1: Overview of the DD Act and ADD
2) Section 2: Monitoring and Technical Assistance Review System
3) Section 3: MTARS Team
4) Section 4: Planning Activities
5) Section 5: Pre-Site Visit Activities
6) Section 6: MTARS Site Visit
7) Section 7: Post-Site Visit Activities

There are also a number of Tabs at the end of the notebook that provide additional information and resources
related to MTARS. There is a list of acronyms in Tab A and the glossary in Tab B that will help with understanding
words and concepts associated with MTARS that appear in the notebook.


SECTION 1

Overview of the DD Act and ADD
The DD Act
The Developmental Disabilities Assistance and Bill of Rights Act of 2000 (P.L. 106-402) (DD Act) contains three
complimentary grant programs designed to assist individuals with developmental disabilities in reaching their
maximum potential through increased independence, productivity, inclusion, and community integration. The three
grant programs are:

1) State Councils on Developmental Disabilities (Councils)
2) Protection and Advocacy (P&As) Systems
3) University Centers for Excellence in Developmental Disabilities (UCEDDs)

The DD Act also includes the Projects of National Significance (PNS), which is a discretionary grant program. PNS
grant projects do not fall under MTARS, but are reviewed through an alternate process.
Developmental Disabilities
There are approximately 4.5 million individuals with developmental disabilities in the United States. Developmental
disabilities (DD) are severe, life-long disabilities attributable to mental and/or physical impairments, manifested
before age 22. Developmental disabilities result in substantial limitations in three or more areas of major life
activities:

* self-care
* receptive and expressive language
* learning
* mobility
* self-direction
* capacity for independent living
* economic self-sufficiency

Without appropriate services and supports, the choices open to people with developmental disabilities including
where they live, work, and play are minimal. Limited options lead to people being isolated rather than fully
integrated and included in the mainstream of society. Persons with developmental disabilities often require
individually planned and coordinated services and supports. In order to live successfully in the community they
need services and supports related to housing, employment, education, civil and human rights protection, health
care, transportation, and recreation.
ADD
The Administration on Developmental Disabilities (ADD) is the Federal agency responsible for the implementation and
administration of the DD Act. Organizationally, ADD is located within the U.S. Department of Health and Human
Services and is part of the Department’s Administration for Children and Families. ADD’s mission is to improve and
increase services to and assure that individuals with developmental disabilities have opportunities to make their
own choices, contribute to society, have supports to live independently, and are free of abuse, neglect, financial
and sexual exploitation, and violations of their legal and human rights.

State Councils on Developmental Disabilities (Councils)
Councils pursue systems change that promotes improved outcomes for individuals with developmental disabilities and
their families. Councils pursue capacity building to develop and expand projects that successfully deliver services
and supports. Councils also support advocacy activities that promote self-determination and inclusion in the
community. Examples of Council activities include demonstration of new approaches, outreach, training, public
education, and providing information to policy-makers.

Protection and Advocacy (P&As) Systems
P&As protect the legal and human rights of individuals with developmental disabilities. P&A strategies include
legal, administrative, and other remedies (e.g., mediation and alternative dispute resolution); information and
referral; investigation of incidents of abuse and neglect; and education of policy-makers.

University Centers for Excellence in Developmental Disabilities (UCEDDs)
UCEDDs are either components of a university system, or are public or not-for-profit entities associated with a
university. UCEDDs are required to carry out four core functions:

1) Interdisciplinary pre-service preparation and continuing education
2) Community services, which includes services, training, and technical assistance
3) Research
4) Information dissemination

In terms of its organizational structure, the DD Act requires UCEDDs to be associated with a University. To meet
this requirement of the Act, the majority of UCEDDs are “housed” at a University and situated within a major
organizational unit of the University, such as a School of Medicine, School of Health Sciences, or a College of
Education. Within this unit, the UCEDD functions as an independent entity carrying out the core functions. The
UCEDD director reports to the leadership (such as a Dean or Provost) of the organizational unit.

Because they are generally independent entities within an organizational unit of the University, UCEDDs do not
recruit and formally admit students to their program. Instead, students are recruited from other academic programs
in the University, such as Pediatrics, Nursing, Education, Occupational Therapy, Dentistry, Nutrition, etc.
Students will typically spend part of their academic training with the UCEDD.



SECTION 2

Monitoring and Technical Assistance Review System (MTARS)
Overview of the MTARS
The Administration on Developmental Disabilities (ADD) uses the Monitoring and Technical Assistance Review System
(MTARS) to evaluate three of its grant programs:

1) State Developmental Disabilities Councils (Councils)
2) State Protection and Advocacy Systems (P&As)
3) University Centers for Excellence in Developmental Disabilities Education, Research and Services (UCEDDs).

Under the terms of the DD Act, ADD must conduct oversight to determine the extent to which grantees are helping
individuals with developmental disabilities and their families have more opportunities to live, participate, and
contribute to community life.

ADD established the MTARS to monitor individual grant programs, to address areas where grantees may benefit from
technical assistance, and to identify innovative practices that may assist other grantees.

The title Monitoring and Technical Assistance Review System was carefully and thoughtfully chosen to show the close
relationship between monitoring and technical assistance. MTARS is not strictly a monitoring process, nor is it
strictly a technical assistance process, but a balance of the two.

MTARS benefits ADD, the States experiencing an MTARS, and all ADD grantees nationwide. ADD relies on MTARS as a
significant component of its Federal stewardship and utilizes the information obtained from MTARS reviews to
strengthen its position when justifying its programs to Federal oversight agencies. MTARS recipients learn from
reviewers how to become even more effective in bettering the lives of individuals with developmental disabilities.
All grantees gain through the sharing of innovative practices that are highlighted through the MTARS process.

In addition, the information collected through the monitoring process helps ADD comply with the requirements of two
programs that seek to increase government accountability: the Government Performance and Results Act (GPRA) and the
Program Assessment Rating Tool (PART). GPRA was enacted by Congress in 1993 to promote program performance and to
provide greater accountability for results within Federal government by requiring agencies to develop measurable
goals and to report results to Congress. PART was developed by the Office of Management and Budget in 2002 to
complement GPRA by more closely aligning budget decisions with performance information. The PART assessment is
published as an element of the President’s budget and is used to supplement the budget analysis process so that
budget decisions reflect a program’s performance and effectiveness.
MTARS Monitoring Elements
Since 1999 MTARS has evolved from a primary focus on mere compliance with the law to one that is more dynamic and
takes into consideration the following six elements:

1) Program compliance with the DD Act
2) Accountability and achievement of program goals
3) Collaboration with other DD programs within the State
4) Fiscal management
5) Technical assistance needs
6) Innovative practices

This dynamic model reflects the climate of accountability in Federal Government. In this climate, there is an
increasing emphasis on justifying programs and budgets by showing their positive impact on people. It is no longer
sufficient to only document program compliance by describing procedures or processes. Rather, programs must show
how they are achieving goals of the DD Act thereby impacting people with disabilities. This Federal climate expands
responsibilities for Federal stewardship. It is also an opportunity to bring more attention to the impact grantees
have in the State.

In its role as federal steward, ADD has modified the MTARS process to include a number of elements that capture how
programs working alone or in collaboration with the network partners are achieving important outcomes for people
with developmental disabilities and their family members. The sections that follow describe in more detail the six
different elements of the MTARS.

Program Compliance
ADD is the Federal steward that ensures its programs operate consistent with the Act and with regulations. The
program compliance element of the MTARS asks the question: Are ADD programs doing what the law requires? The
compliance element is concerned with process. Compliance is seen as the minimum at which ADD grantees must operate.

During an MTARS, grantees are asked to demonstrate compliance with the law by documenting how each meets
requirements regarding such areas as collaboration, program administration, organization administration, evaluation
and reports, and fiscal management.
Accountability and Achievement of Program Goals
While it is important to determine compliance with the Act, compliance in and of itself does not guarantee
effectiveness in implementing the purpose of the Act. MTARS is also concerned with outcomes and impact. The
accountability element of the MTARS asks the question: Are ADD programs making a difference in people’s lives?

Grantees are asked to demonstrate accountability with program activities based on four principles:

1) Responsiveness of grantees to stakeholders, that is the extent to which the grantee seeks and utilizes input
from stakeholders (e.g., individuals with developmental disabilities, family members, funding entities,
contractors, service providers, policy makers, etc.).
2) Relationship between goal and objective setting and actual outcomes, that is the extent to which grantee’s goals
and objectives are stated in measurable terms and achieved through the implementation of relevant activities that
achieve results.
3) Impact of ADD grantees on consumers and service systems, that is the kind of difference ADD grantees in a State
have made on people and service systems.
4) Validation of data, that is ensuring that the data collected by a grantee gives a full and accurate picture of
what the grantee is doing.

Program Collaboration
This element of the MTARS asks the question: Is the DD Network partnering in a strategic way to make a difference
in people’s lives? This element is concerned with outcomes and impact from a collaborative perspective. Grantees
are asked to provide evidence of collaboration with programs in the DD network and by documenting the number of
projects having substantive joint efforts among DD programs in the State, the extent of collaboration within a
project, the areas addressed by these joint efforts, and the impact of collaboration on project outcomes. MTARS
reviewers pay particular attention to grantees’ participation in each other’s planning process to identify barriers
and to pursue collaborative efforts to overcome those barriers.
Fiscal Management
This element of the MTARS asks the question: Are ADD programs adhering to fiscal management requirements? The
fiscal management element is concerned with monetary tracking and accountability. Grantees are asked to demonstrate
fiscal management through the appropriate oversight, monitoring, accounting, and use of ADD funds. To this end,
they are asked to document fiscal responsibility in the use of federal funds.
Technical Assistance
This element of the MTARS asks the question: What technical assistance will bring ADD Programs into compliance
and/or enhance program performance? The technical assistance element is concerned with process and outcomes/impact.

Technical assistance to ADD grantees is not limited to the needs that arise during an MTARS review. ADD, through
its technical assistance contracts and other resources, is ready to help grantees at any time to remedy issues and
address areas where help is needed to yield better outcomes.

Because MTARS is comprehensive in scope, involves follow-up activities, and has many opportunities for dialogue
with ADD staff, peers, and consumers, it is advantageous for grantees to disclose areas where they would like to
improve so that technical assistance resources can be activated early in the MTARS process.

Program Innovation
This element of the MTARS asks the question: What innovative practices will benefit other ADD programs? It is
concerned with program improvement, expansion, and awareness. The MTARS is one vehicle ADD uses to identify
innovative practices that can be added to the strategies used by other grantees to do an even better job. ADD is
proud of all the good work that grantees do each day to better the lives of individuals with developmental
disabilities and seeks innovative practices to recognize, promote, and disseminate throughout the nation.
Self-assessment Checklists
Given the variety of elements related to MTARS, ADD has created a set of self-assessment checklists to streamline
the review process. The self-assessment checklists are comprised of four parts:

1) Program Compliance
2) Program Operations and Practices
3) Innovative Practices
4) Fiscal

In addition, there is a checklist for the DD Council Chairperson.

The self-assessment checklists capture each element of the MTARS process (e.g., compliance, accountability,
collaboration, fiscal management, technical assistance, and innovative practices).

The checklists for each program appear in the back of this notebook. The DD Council Self-assessment checklists
appear in Tab C, the P&A Self-assessment checklists appear in Tab D and the UCEDD Self-assessment checklists appear
in Tab E.

ADD works with grantees to complete and fully utilize the checklists. This process is described in more detail in
Section 5 of the notebook.
MTARS Activities and Phases
In general, the MTARS spans the Federal fiscal year (October 1 – September 30). The process is divided into four
phases:

1) Planning
2) Pre-site visit
3) Site visit
4) Post-site visit

ADD utilizes the planning phase to organize and manage the MTARS activities for the year. It includes tasks such as
identifying the States to be reviewed, preparing a yearly budget, establishing review teams, making team
assignments, and training individuals who serve as reviewers.

The pre-site visit phase includes activities such as scheduling the visit, completing checklists, conducting the
site visit and, if possible, the public forum via videoconference, reviewing materials, discussing with grantees
findings from the review of materials, and preparing an agenda for the site visit.

The site visit activities include a public forum, if not conducted during the pre-site visit phase, interviews of
grantee staff, interviews of individuals associated with grantee activities, observation of grantee activities,
provision of technical assistance, and an exit meeting. Site visits are labor-intensive and generally take four
days to complete.

The post-site visit phase includes report writing, follow-up on technical assistance delivery and program
improvements, and the dissemination of innovative practices.


SECTION 3

MTARS Team
MTARS Team Structure
Generally, the MTARS Team is comprised of the following people:

* ADD Central Office Program Specialists
* Council Peer Reviewer
* P&A Peer Reviewer
* UCEDD Peer Reviewer
* Individuals with developmental disabilities/family members
* Fiscal Reviewer

The MTARS Team is managed by the Team Coordinator, who is an ADD Staff person.

ADD divides the larger MTARS Team into three Program Teams. The use of program teams makes it possible for
reviewers to focus on one program and accomplish more during the site visit. The Program Teams are:

1) DD Council Program Team
2) P&A Program Team
3) UCEDD Program Team

In cases where the are two or more UCEDDs in the State, ADD will have a team for each UCEDD.

Each of the Program Teams consists of a minimum of three people, including a/an:

1) ADD staff person
2) Peer
3) Individual with developmental disabilities or family member

The ADD Staff person serves as the Program Lead for the team.

The fiscal reviewer functions independently of the Program Teams. They schedule with the grantees a time during the
site visit week to visit the program to conduct the fiscal review. They meet with staff responsible for
fiscal-related matters. They typically spend one day at each program.

The Review Team members presented above is the norm. However, there may be instances when additional people
accompany the team. For example, an ADD manager may participate in MTARS. There may be additional ADD and/or
Regional Office staff who participates in the review as trainees or co-leads. Individuals with developmental
disabilities may request to bring a personal support person on the site visit. The personal support person is not
an active participant. See the Figure on the next page for an overview of the MTARS team configuration.

MTARS Team Configuration

Selection of Non-federal Team Members
Non-federal team members are selected by ADD. Factors that may be considered when selecting a non-federal team
member include:

* Currently working with State as part of an ADD technical assistance contract
* From a State with similar demographics
* From a State of similar size and geography
* From a grant program of similar size and with a similar area of emphasis
* Experience and expertise in area where technical assistance has been requested

Some non-federal team members may be selected from a pool of individuals who have participated in a prior review.
Other reviewers may be individuals who are newly trained in the MTARS process and participate as a reviewer for the
first time.
Team Member Responsibilities
Each member of the MTARS team has specific responsibilities.

The Team Coordinator is responsible for the following:

* Overall coordination of the review including joint aspects of the site visit planning, scheduling, and report
writing
* Providing (through the ADD Project Officer) peer, consumer and assistant names and itinerary information to the
ADD Logistics Contractor
* Developing the overall site visit agenda in coordination with the grantees and Program Leads
* Ensuring that team members receive information and materials in advance of the MTARS visit, including the MTARS
notebook
* Coordinating all Review Team meetings
* Coordinating the videoconference for the Entrance Meeting and Public Forum
* Taking the lead on the report

The Team Coordinator also serves as the Program Lead for one of the program teams.

The Program Lead is responsible for the following:

* Determining the MTARS team composition
* Selecting and recruiting appropriate peer and consumer reviewers
* Determining the agenda for respective program review
* Making individual team member assignments
* Making sure team members have information about the site visit
* Identifying areas/issues of focus during the site visit
* Drafting the report section pertaining to their respective program
* Arranging technical assistance
* Reporting all issues to the Team Coordinator

The Regional Office Reviewer may be involved with the following:

* Performing a review of grantees’ fiscal management
* Participating in training, teleconferences, and the site visit
* Providing notes to Program Lead for use in drafting report

The Peer Reviewer is assigned responsibility for:

* Functioning as an agent of the Federal government with a monitoring and oversight responsibility
* Reviewing grantee self-assessment checklists and related materials
* Participating in discussions with program team members about the grantee self-assessment checklists to identify
areas of inquiry for the site visit
* Providing technical assistance while on site
* Sharing experience and expertise that grantee may find useful for addressing specific administration, planning,
design, or other operational issues
* Participating in training, videoconferences, teleconferences, the site visit, and report writing
* Sharing responsibilities for conducting interviews
* Providing notes to Program Lead for use in drafting report

The Consumer is assigned responsibility for and contributes the following:

* Functioning as agent of Federal government with a monitoring and oversight responsibility
* Reviewing grantee self-assessment checklists and related materials
* Participating in discussions with program team members about the grantee self-assessment checklists to identify
areas of inquiry for the site visit
* Providing insight and suggestions regarding the grantee facility, level of services, and relationship with
individual with developmental disabilities and family members
* Serving as a consultant to the team and grantees on disability issues
* Participating in training, videoconferences, teleconferences, the site visit, and report writing
* Sharing responsibilities for conducting interviews
* Providing notes to Program Lead for use in drafting report

With these responsibilities comes a time commitment associated with the MTARS. Reviewers are expected to
participate in up to one day of training if they have not participated in an MTARS, the Entrance Meeting and Public
Forum videoconference, at least one team meeting to review grantee materials, at least one conference call with the
grantee in preparation for the site visit, and in a four day site visit. In addition, reviewers are expected to
read the materials relevant to their specific assignment. After the site visit, reviewers contribute to and comment
on the draft report. Non-federal reviewers are compensated for time associated with the training and on-site visit.

Standards of Conduct
MTARS team members have access to a great deal of sensitive information about the ADD programs. All information and
materials received and reviewed should be considered confidential. Team members should only discuss information
from the review with other MTARS team members and not grantees being reviewed and representatives from the
membership associations. See Tab F tips for effective team work and standards of conduct for team members.

SECTION 4

Planning Activities
The Planning Phase
The MTARS planning generally begins the first quarter (October 1 – December 31) of each Federal fiscal year. The
purpose of the planning phase is to organize and manage the MTARS activities for the year. It includes the
following tasks:

* Identifying the States to be reviewed
* Preparing a yearly budget
* Establishing review teams
* Making team assignments
* Planning for the training of reviewers
Selecting States to Review
Staff from ADD Central Office recommend States for review during the fiscal year. States most likely to be
recommended and selected for review are those with:

* Requests for technical assistance
* Significant program deficiencies
* Problems implementing Federal requirements
* Significant consumer complaints
* Longest time since last review

The number of States reviewed in a year depends in part on the availability of Federal funds to cover travel
expenses for the on-site visit. ADD attempts to conduct an MTARS of a State approximately every seven years. The
table below shows the States reviewed over the past several years.

States Reviewed
YEAR
STATES REVIEWED
1998
Oregon and New Jersey
1999
Maine
2000
Florida
2001
Connecticut, West Virginia, North Carolina, Tennessee, Ohio, Oklahoma, Missouri, Montana, and Idaho
2002
Vermont, New York, District of Columbia, Mississippi, Michigan, Louisiana, Iowa, Wyoming, Minnesota, and Washington
2003
Massachusetts, Texas, Kansas, and Nebraska

2004
Virginia, Alabama, Wisconsin, Arkansas, Colorado, and Utah
2005
New Hampshire, Delaware, Illinois, New Mexico, and South Dakota
2006
California and Maryland
2007
Pennsylvania and Georgia
2008
Arizona, Indiana, North Dakota, and Rhode Island
Planning Activities
ADD engages in a number of planning activities to prepare for the MTARS. First, ADD must identify how much money
can be spent on MTARS. A major factor is the budget that Congress and the President approve for the fiscal year
(October 1 to September 30). ADD also identifies the MTARS team members for different program teams and contacts
potential reviewers to invite them to participate. Another aspect of the planning activities is notifying programs
that they will be reviewed and identifying a date for the review.
Training MTARS Reviewers
ADD conducts training for all new members of a Review Team. The training is scheduled for up to one day. The
training agenda covers the major provisions of the DD Act, the activities associated with each phase of MTARS, and
each element of MTARS monitoring including collaboration, compliance, accountability, fiscal management, technical
assistance, and innovative practices.

The training is held in the Washington, D.C. metro area. The ADD Logistics Contractor will make travel arrangements
and pay for travel expenses for all non-federal reviewers and for any personal support personnel.

SECTION 5

Pre-Site Visit Activities
Site Visit Notification
A formal notification of the MTARS visit is sent to each grantee from the Commissioner of ADD. The confirmation
letter describes the purpose of the MTARS and the site visit. It also identifies the dates for the site visit, the
due date for the self-assessment checklists, and the date for the Joint Entrance videoconference. Copies of the
notification are distributed to the following:

* Council Executive Director
* P&A Executive Director
* UCEDD Director
* ADD Staff on the Review Team

Following the notification, the MTARS Team Coordinator contacts the following individuals to begin coordinating
activities that will take place during the visit:

* Council Executive Director
* P&A Executive Director
* UCEDD Director

The MTARS Team Coordinator will schedule a conference call with all the grantees to provide an overview of the
MTARS process and discuss logistical issues. See Tab G for a sample conference call agenda. During the call, the
MTARS Team Coordinator will ask the grantees for hotel recommendations. To assist the grantees in making hotel
recommendations, ADD developed a list of hotel amenities that are needed by the team during a MTARS. See Tab H for
the hotel amenities checklist.
ADD Staff Assignments and Preparations
Once States have been identified for the MTARS, ADD makes staff assignments for conducting the MTARS. ADD staff is
assigned to the MTARS Team Coordinator and Program Lead roles. Several factors are taken into consideration when
making staff assignments, including programmatic concerns, grant assignments, and workload. ADD may assign
additional staff to the MTARS team as co-leads or trainees.

The MTARS Team Coordinator and Program Leads engage in a variety of activities to prepare for and conduct the
MTARS. The MTARS Team Coordinator ensures that overall logistics are managed and communicates across the team and
with the grantees. The MTARS Team Coordinator also has responsibility for overseeing the writing of the report. See
Tab I for the MTARS Team Coordinator’s checklist, which outlines all the steps to be carried out in the different
phases of the MTARS.

The Program Team Lead works with the grantee and team members to carry out all aspects of the review process,
including the analysis of the self-assessment checklists, the site visit activities, and report writing. See Tab J
for the Program Lead Checklist, which outlines all the steps to be carried out in the different phases of the MTARS.
Recruitment of MTARS Team Members
Once the State has been notified about the MTARS, ADD begins to recruit MTARS team members. In doing so, Program
Team leads contact the grantee to identify technical assistance needs. ADD uses this information to determine the
expertise needed on the team. In addition, ADD takes into consideration other factors, including the geographic
location of the State, the size of the program, the organizational structure of the program, and allotment.

Using this information, ADD develops a list of potential MTARS reviewers, which is approved by ADD administration.
Once approved, the Program Team lead begins contacting the proposed reviewers to determine their availability and
interest in participating in the MTARS.

Once the Program Team members are established, the Program Team lead sends the contact information for team members
to the MTARS team coordinator. The MTARS team coordinator develops a contact sheet for all the team members and
provides copies to the grantees and MTARS team members (see Tab K for sample contact sheet).
Grantee Self-Assessment and Preparation
To prepare for the site-visit, grantees complete the self-assessment checklist for their program. See Tab C for the
DD Council checklists, Tab D for the P&A checklists, and Tab E for the UCEDD checklists.

The self-assessment checklists are divided into four checklists related to the MTARS:

1) Program Compliance
2) Program Operations and Practices
3) Innovative Practice
4) Fiscal

In addition, there is a checklist for the DD Council Chairperson.

By completing the self-assessment checklists, the grantee is able to identify:

* Ways in which they are complying with the law
* Areas of collaboration
* Technical assistance needs
* Strengths and innovations of the programs

The use of the checklists streamlines communication between the grantee and Program Team. It is a means for
determining what should be highlighted during the site visit. It also identifies early on areas for technical
assistance that can be discussed while on-site or afterwards. Similarly, a grantee’s early identification of an
innovative practice enables the grantee to prepare presentations and assemble documentation that describe the
practice and show its results. Determining in advance what should be highlighted enables the grantee to ensure that
the appropriate documentation and staff are available to provide the information the grantee wishes to convey.

Process for Completing the Self-Assessment Checklists
The figure below shows an outline of the process for completing the self assessment checklists.


Process for Completing the Self Assessment Checklists

Step 1: Program Lead and Grantee discuss how to complete the checklists
ADD provides grantees with copies of the self-assessment checklists. Time is arranged to discuss the checklists
with the grantees and clarify how they are to be completed.
Step 2: Grantee Completes Checklists and Sends to Program Team
It is the responsibility of the grantee to complete the checklists. The grantees will have electronic copies of the
checklists so they can make comments to the team members regarding their activities directly on the form. Grantees
should provide supplemental information, such as reports, publications, personal testimonies, meeting minutes,
organizational charts, contracts, etc. to support information provided in the checklists. When providing
supplemental information, grantees should organize the materials in a notebook, on a CD ROM, or another electronic
format. Grantees are encouraged to provide program team members copies of the checklists and related documents in
electronic formats. Copies of all materials should be sent to all team members.

Please note that grantees do not need to submit to ADD staff copies of their PPRs/Annual Reports, State Plans,
Statements of Goals and Priorities, or 5-Year Applications. ADD has copies of these in the office and does not need
additional ones. However, the grantee should send copies of these documents to team members.
Step 3: MTARS team members review the materials submitted by the grantee
Once Program Team members have received the checklists and materials, they are responsible for reviewing them. Each
team member will read all documents and make notes regarding their findings. They will pay particular attention to
areas of compliance, items for improvement, and innovations. They will also identify items they would like to know
more about.

Step 4: Program Team Meets to Discuss Checklists
After the Program Team reviews all materials, they will meet either in person or through teleconference to discuss
their findings. The Program Team will use the checklists as the primary guide for their discussion. During the
call, the Program Team will identify the areas of inquiry for the grantee. These areas of inquiry may include the
following:

1) Collaboration
2) Organizational Administration
3) Council/Board/Consumer Advisory Committee Membership
4) Program Administration
5) Evaluation and Reporting
6) Designated State Agency
7) Compliance Issues
8) Potential Areas for Technical Assistance
9) Innovative Practices

The ADD Program Lead summarizes the areas of inquiry and shares that with the grantee.
Step 5: Grantee and Program Team Teleconference
The Program Team and grantee teleconference to discuss the review of the checklists and the areas of inquiry. The
grantee may be able to provide additional information that clarifies the questions of Program Team members. It is
also an opportunity for the Program Team and grantee to discuss areas where there may be concerns regarding program
compliance and any technical assistance needs. The Program Team and grantee can also discuss the strengths and
innovations of the program.

This teleconference is also an opportunity to discuss the site visit agenda. Based on discussions of the areas of
inquiry, the Program Team and grantee can develop a draft schedule for the site visit. From there, the grantee can
work to finalize the agenda.
Fiscal Review Guidance
In addition to the programmatic reviews, the grantee will also under a fiscal review to ensure that all Federal
grantees, including the DD Network grantees, meet specific fiscal reporting requirements (e.g., submittals of
financial reports and annual independent audits). Federal Fiscal Specialists from the Regional Office will
participate on the MTARS teams to conduct the fiscal reviews of the DD Councils, P&As and the UCEDDs during each
MTARS site visit.

The Fiscal Review Checklists are included with the self-assessment checklists that can be found in Tab C for the DD
Council, Tab D for the P&A, and Tab E for the UCEDD. The grantees will complete the fiscal checklists and return to
the MTARS Team Coordinator prior to the MTARS site visit.

The MTARS team requests that the grantees’ fiscal staff be available during the site visit and have the following
fiscal source documents available and ready for review onsite:
* Accounting Policies and Procedures manual
* 269’s – last three years
* Audits – last three years
* Inventory Records
* Vouchers - one year
* Credit Cards statements – one year
* Cash Disbursements – one year
* Staff flow Chart
* Program Income
* Indirect Cost Agreement and Cost Allocation Plan
* P&A Plan for Cost Allocation among federal funding streams, including records and methodology

The Fiscal Specialist, in consultation with the MTARS Team Coordinator and the grantee Executive Director and
Fiscal staff, will schedule the fiscal review of each of the DD programs. The Federal Fiscal Specialist will
conduct the fiscal review of the grantees and is expected, if possible, to participate in MTARS team meetings to
provide and exchange information.
Joint Entrance Meeting Videoconference
The Joint Entrance Meeting videoconference occurs at least one month before the site visit. The Council, P&A, and
UCEDDs officials and the entire Review Team participate in this meeting, to the extent possible, via
videoconference. The non-federal MTARS team members will be given the option of traveling to Washington, DC to
participate in the videoconference. Those who choose not to travel to Washington, DC for the videoconference may
participate from their own site in the videoconference or they may participate using other technologies, such as
teleconference and webinar.

The Team Coordinator begins the meeting by giving an overview of the MTARS process, purpose of the visit, and team
member roles and responsibilities.

The grantees coordinate the remainder of the Joint Entrance Meeting agenda providing information about the State,
including the State’s:

* Politics
* Economics
* Geography
* demographics (including cultural and unserved/underserved)
* service delivery system
* program emphasis and other information that will help the review team under State-related issues during the site
visit
* State waivers
* Institutional services, if any
* Governor’s plan, if any, for disability services
* Olmstead
* legislative initiatives
* Other pertinent issues/challenges

The Joint Entrance Meeting videoconference also includes brief overviews of the Council, P&A, and UCEDDs in order
to gain a picture of how the programs operate in the State.

The Joint Entrance Meeting videoconference should also include a presentation of the collaborative activities of
the Network. Such activities can include those that address critical barriers or issues in the State and that
promote systems change, capacity building, and advocacy. Each ADD grantee may want to explain its specific
contribution to the joint activities. Grantees should express contributions in terms of program activity (e.g.,
Council-demonstration project, policy, self-advocacy; P&A-legal advocacy; UCEDD-training, research, community
service, and information dissemination). Discussions should cover the successes/impact of the collaboration; what
has changed as a result of the collaboration; strength and weaknesses; and what is working and what is not.

This meeting will take place via videoconference with an agenda developed by the Council, P&A and UCEDD(s). In
States where there is more than one UCEDD, all Centers should participate in the meeting. ADD staff will
participate in the videoconference from the ADD central office in Washington, DC. Non-federal team members will be
given the option of traveling to Washington, DC to participate in the videoconference. For those non-federal team
members who choose not to come to Washington, DC, the grantees will work with the Team Coordinator to identify
alternative methods for participation, which may include teleconference and/or webinar.

The Joint Entrance Meeting videoconference should last approximately 4 – 6 hours depending on the content. Please
see Tab L for a sample Joint Entrance videoconference agenda. The grantees should develop a draft agenda to share
with the Team Coordinator for feedback.
Public Forum Preparation
As part of the pre-site visit activities, grantees schedule a cross-program public forum which may occur as part of
the Joint Entrance videoconference or on the first day of the site visit.

A public forum is an important part of the monitoring. It allows the team to gather comments from the public about
the activities of the Council, P & A, and UCEDD(s). The purpose is to gather information on their experiences with
these programs, how the programs have changed their lives, and how the programs can improve. It is important to
convey that the public forum is not the time to voice concerns or complaints about the State service delivery
system, such as Medicaid or special education, since ADD does not have oversight of such programs

Participants at the public forum are given 3 minutes to share their comments. Accommodations to the three minute
time limit will be provided to persons needing additional time.

It is recommended that grantees have people sign up in advance to speak at the public forum. In doing so, the
public forum runs smoothly and people can anticipate when to arrive based on the schedule. This also indicates
whether there will be enough time for everyone to speak. It is also recommended that the grantees schedule a block
of time, such as the last half hour of the scheduled time, for people who will be calling in to provide their
remarks.

The grantees must ensure that the method or facility used for the public forum is accessible to individuals with
developmental disabilities. The grantees are responsible for arranging audio and visual technology at any public
meeting site as well as teleconferencing hook-ups and e-mail for individuals. Grantee must also arrange for a
note-taker to be on-site for the main site and each remote sites who can record the comments from the public and a
time keeper who will ensure that comments are limited to 3 minutes.

Details about the opportunity for public comment along with an invitation to the general public to participate
should be published in a variety of accessible formats including newspapers, newsletters, etc. The notice must
include the purpose, date, time, and location, along with phone numbers and addresses of the ADD Regional Office. A
sample notice of a public forum appears in Tab M. This document must be approved by the Team Coordinator.
Site Visit Agenda
The grantee will be developing the site visit agenda based on input from the Program Team. The agenda should
include all activities (e.g., interviews, document reviews, case reviews, peer to peer discussions, team meetings,
technical assistance discussions) needed to make a determination about grantee performance and fulfill all the
expectations of an MTARS. Timeframes for each activity should be realistic so all that is needed is accomplished. A
sample of a detailed, on-site meeting schedule appears in Tab N.
Other Site Visit Preparations
Grantees should prepare for the site-visit by making certain adequate facilities are available for the review
activities. If the grantee does not have adequate meeting space, they should inform ADD so that alternative
arrangements can be made that satisfies all needs. The grantee should inform staff that participate in the review
of the purpose of the visit, their role, when they can expect members of the review team to arrive, and the time
and place they are scheduled to appear for a meeting or interview.

SECTION 6

MTARS Site Visit
Purpose of the Site Visit
The primary purpose of the site visit is to:
* gather information that answers the gaps and issues identified during the pre-visit phase
* document the impact grantee’s efforts have on people, innovative practices
* further explore potential compliance and other issues not identified or fully understood prior to the visit
* respond to technical assistance needs

Site visits enable ADD to review the Council, P&A, and UCEDD(s) in each State both as separate entities and as a
network. The information obtained during the site visits helps ADD:

* verify grantee compliance
* gauge overall effectiveness and consumer satisfaction
* assess grantee fiscal management
* identify and provide technical assistance
* promote innovative practices

The four-day visit gives the Review Team many opportunities to gather information directly from Councils, P&A’s,
and UCEDDs as well as from their partners and the public. Meetings, interviews, document reviews, presentations,
and observations are the main components of the information-gathering process. Presentations about grantee
activities and accomplishments, along with first-hand observation of grantee projects provide significant insight
about the philosophy, values, direction, and goals of the grantee.
Meetings
The site visit includes the following meetings:

* Program Team Meetings
* MTARS Team Meetings
* Joint Exit Meeting

Details on each meeting follow.
Program Team Meetings
Program Team meetings are held, as needed, in the late afternoon or evening to discuss the day’s interviews,
presentations, strengths, weaknesses, technical assistance needs, and recommendations. Each team member
participates in this process so that all perspectives are included. Program Teams must meet the last afternoon of
the site visit to develop the findings from the MTARS that will be included in the final report and shared at the
Exit Meeting.
MTARS Team Meetings
MTARS Review Team meetings are held, as needed. There may be a meeting planned for the evening before the site
visit begins so MTARS team members have an opportunity to review the week’s agenda and ask questions. There is a
meeting of the MTARS team the afternoon before the joint exit meeting to discuss findings with regard to
collaboration that are shared at the Joint Exit meeting.

Joint Exit Meeting
At the Joint Exit meeting, the Review Team presents to the ADD grantees its findings, including strengths, areas of
compliance, and recommendations for program improvement. In this way, the grantees are alerted to what to expect in
the final MTARS report. The following items may be discussed as findings:

1) Collaboration
2) Organizational Administration
3) Council/Board/Consumer Advisory Committee Membership
4) Program Administration
5) Evaluation and Reporting
6) Designated State Agency
7) Compliance Issues
8) Potential Areas for Technical Assistance
9) Innovative Practices
10) Fiscal Review Findings
Public Forum
A cross-program public forum is scheduled for the first day of the site visit if it did not occur before the site
visit. This provides an important opportunity to collect comments from the public about Council, P & A and
UCEDD(s). Representatives from the Council, P&A, and UCEDD(s) are invited to attend the public forum. The Team
Coordinator introduces the forum. Review Team members listen to all participants but do not respond to comments or
questions except for purposes of clarification. Members of the Review Team may talk by phone or meet briefly during
the site visit with individuals who wish to speak with them privately.

The grantees ensure that there is a notetaker to record participant’s remarks. The grantees also make arrangements
for a timekeeper at each site who has the responsibility of ensuring that participants keep their remarks to 3
minutes. It is recommended that grantees have people sign up in advance of the public forum and that time be set
aside for those who will be calling in the share their remarks. See Tab O for a Public Forum checklist.
Interviews
Interviews are a vital part of the information-gathering process and are important in verifying the accuracy of the
written material provided by a grantee. The Review Team may interview:

* individuals with developmental disabilities
* families
* grantee officials
* board members
* grantee staff
* State and local officials
* service providers
* university officials and students
* sub-grantees
* Consumer Advisory Committee members

It is suggested that the team interview, at a minimum, the following individuals or groups:

* Council: Chairperson, Executive Director, Council members, financial officer, and other key staff, contractors,
grantees
* Designated State Agency: Head or other representative, financial officer and other staff
* P&A: Board/Advisory Council President and members, Executive Director, accountant/bookkeeper and other key P&A
staff
* University Center(s): Director, faculty, staff, Dean, Provost/University President, trainees, Consumer Advisory
Committee members, and community collaborators
* Consumers: Individuals and families benefiting from grantee activities
* Governor Liaisons (Council and P&A)

Although interviews are scheduled prior to the site visit, Review Team members may meet with others as time permits.
The Interview Process
Before beginning the interviews, the Program Lead discusses the interview process with team members and alerts them
to any specific issues that require attention. The MTARS team determines who will lead the interview process. Each
interview should be time-limited to accommodate the schedule of site visit activities. Program Team members should
keep the interview moving smoothly from topic to topic so that vital questions have been addressed before the
interview ends.

MTARS team members should put interviewees at ease by introducing themselves, and providing information about the
purpose of MTARS. Interviewees should be advised that site visit findings are based only in part on interviews and
that the Federal Government and the Review Team will protect the confidentiality of those who are interviewed.

Interview Questions
Interview questions allow the team to collect information on many topics including:

* mission and purpose
* planning priorities and goals
* program evaluation and monitoring
* outcomes and progress on goals
* project implementation
* outreach
* consumer representation
* program administration
* policies and procedures
* staff hiring and supervision
* training
* recordkeeping and reporting

See Tab P for interview tips and for sample interview questions that may be asked of program representatives doing
the on-site review.
P&A Case Record Review
One method used to assess the level and quality of services provided by the State protection and advocacy grantee
and to check whether individuals with developmental disabilities are being served is to review actual case records.
A Case File Review Protocol for MTARS appears in Tab D.4 for this purpose.

Regulations at 45 CFR Part 92(e) permit ADD reviewers to have access to P&A client and case eligibility records for
purposes of monitoring system compliance pursuant to Section 104(b) of the Act. ADD respects client confidentiality
and thus does not require that identifying information such as name, address, and social security number be
disclosed. There are several options for making the information available to MTARS reviewers and guaranteeing
confidentiality. For example, the file can be given to the reviewer with identifying information covered. Prior to
the site visit, the P&A Program Lead contacts the Executive Director to determine how case files be reviewed.
Note-taking
In order to summarize what they learn during the site visit and to record sufficient detail to support their
findings and recommendations, Review Team members should take thorough notes. Tab Q includes note-taking tips that
Review Team members will find helpful for recording impressions of their meetings, interviews, and document
reviews. To ensure accuracy, notes should be taken when information is fresh in Review Team members’ minds.

SECTION 7

Post-Site Visit Activities
Development of the Final Report
After each MTARS site visit, the MTARS team prepares a consolidated written report covering all aspects of the
review. The report outlines the purpose of the review, describes the procedures followed, information about the
State, and findings regarding Network collaboration. In addition, the report includes sections that summarize
findings from the review of each program. The format for this part of the report is based on the self-assessment
checklists for each program and includes the following categories:

* Organizational Administration
* Council/Board/Consumer Advisory Committee Membership
* Program Administration
* Designated State Agency
* Evaluation and Reports
* Compliance
* Recommendations
* Innovative Approaches

A sample report format appears in Tab R.

Program Team leads develop draft reports for their respective program. The MTARS Team Coordinator develops the
parts of the report that address Network collaboration and other relevant information such as State demographics.
Process and Timeframes for Developing the Final Report
Developing and finalizing the final report should be accomplished within six months after the review. Certain parts
of the report (e.g., those pertaining to specific grant programs) may require more time to finalize pending
resolution of issues. The table below outlines the general times for completing the final report, however, it is
understood that other work priorities may affect the completion of the report.

Timeline for Completing Report

TIMELINE
MTARS TEAM COORDINATOR
PROGRAM TEAM LEAD
Non-federal Team Members
Grantees
By time of site visit
First draft of Part 1: Purpose And Scope of the Review & Part 2: State Developmental Disabilities Network (e.g.,
collaboration) complete and sent to Program Team Leads

Two weeks after site visit
Each reviewer submits his/her notes to the Program Team Lead

6 weeks after site visit
Program Team Lead compiles all input into a single draft report and circulates draft report to the Program Team,
including Parts 1 & 2

8 weeks after site visit
Review reports and return comments on the individual program report and Parts 1 & 2 to the Program Team Lead

10 weeks after site visit
Incorporate non-federal team member’s comments into Parts 1 and 2 of the report and send revised document to
Program team leads
* Send edits to Parts 1 & 2 to MTARS team coordinator
* After addressing comments of Program Team members, Program Team Lead finalize their section of report
* Sends to grantees draft individual program report and Parts 1 and 2 for their review

12 weeks after site visit
* Review individual report and Parts 1 and 2
* Submit comments on the report to program team lead

14 weeks after site visit
Review comments from grantees on Parts 1 and 2 making changes as necessary
* Send comments on Parts 1 and 2 to the Team Coordinator
* Review comments from grantee on the individual report and make changes as necessary
* Submit final individual program report to the MTARS team coordinator

16 weeks after site visit
* Compile all reports into one document
* Submit full report to editor

18 weeks after site visit
After receiving the report back from Editor, send to Program Team Lead for final review of the individual program
reports

20 weeks after site visit
Review Editor remarks on Parts 1 and 2 and make changes as necessary,
Review Editor remarks and make changes as necessary, returning report to MTARS Team Coordinator when done

22 weeks after site visit
* Submits full report to ADD Administration for final review and sign off
* Prepares cover letters for the report
* FINAL REPORT ISSUED

Report Distribution
The final report is issued by the ADD Commissioner. The MTARS report is distributed to the following:

* Council Executive Director
* Council Chairperson
* P&A Executive Director
* P&A Board Chairperson
* UCEDD Director
* Review Team members
* Governor’s Liaison(s)

See Tab S for a sample cover letter for the MTARS report.
Response to MTARS Report
The MTARS report will identify strengths and innovative practices, and recommendations to strengthen particular
aspects of the program. The report may identify compliance issues if the team has determined that the grantee has
not complied with the requirements in the DD Act.

Each grantee should submit a response to the ADD Commissioner addressing the findings in the report. The response
should describe a corrective action plan if there were any compliance issues, how recommendations listed in the
report will be addressed, and requests for technical assistance if needed. If the report includes recommendations
on collaboration, ADD expects the network to develop together a joint action plan.

The response should be submitted within 60 days of the MTARS report sent by the Commissioner. Federal officials may
provide assistance in the development of action plans and periodically will review the status of action taken by
the program to resolve deficiencies.
Content of the Corrective Action Plan
If a program is found to be out of compliance with the DD Act, they must submit to ADD within 60 days a corrective
action plan. The format of the corrective action plan may vary, but the plan must include the following:

* Each factor associated with compliance where improvement is needed.
* A plan or strategy to bring each factor into compliance, including action steps, timeframes for action steps and
responsible staff.
* Measurable benchmarks of progress to indicate that compliance has been achieved by the State DD program.
* Description of how progress on the plan will be evaluated and reported to the Central and Regional Offices.

If the amount of progress to be achieved through the Corrective Action Plan appears to be insufficient, ADD will
negotiate with the grantee to identify steps that sufficiently move the grantee towards the expected type or level
of progress. When determining the amount of progress to be achieved, consideration should be given to current or
prior efforts to improve performance.
Timeframes for Submitting the Corrective Action Plan
A grantee required to prepare a corrective action plan must submit its plan to the Commissioner for approval within
60 calendar days of receiving the final MTARS report that identifies elements of noncompliance and need for
improvement. The Central Office will review the action plan and notify the grantee in writing of approval or
disapproval within 30 days. If ADD determines that revisions to the corrective action plan are needed, the grantee
must develop and submit the revisions to the Commissioner within 30 calendar days of receiving written notice that
the action plan was not approved.
Timeframes for Implementing the Corrective Action Plan
It is expected that the time period for completing the corrective action plan will not exceed 1 year. Not all
components of the plan will require a full year to implement, and this timeframe is provided as an outside limit
for those elements of the corrective action plan requiring more extensive planning and action steps.
Evaluating the Implementation of the Corrective Action Plan
ADD central office evaluates the grantee’s compliance with the terms and conditions of its approved corrective
action plan, including the achievement of the benchmarks included in the plan.

The grantee must provide quarterly written progress reports to ADD staff. The quarterly progress reports must
include sufficient detail to describe the progress made during the reporting period and must indicate whether
specific timeframes in the corrective action plan are not being met.

Tab A – Commonly Used Acronyms

ACF Administration for Children and Families
AC Advisory Council
ADA Americans with Disabilities Act
ADD Administration on Development Disabilities
ATC Assistive Technology Center
BOD Board of Directors
CMHS Center for Mental Health Services
CAP Client Assistance Program
CCD Consortium of Citizens with Disabilities
CMS Centers for Medicine and Medicaid Services
CO Central Office
DD Developmental Disabilities
DD Act Developmental Disabilities Assistance and Bill of Rights Act
DHHS Department of Health and Human Services
DSA Designated State Agency
EDS Electronic Data Submission
FY Fiscal Year
GPRA Government Performance and Results Act of 1993
ICF/MR Intensive Care Facility/Mental Retardation
IDEA Individuals with Disabilities Education Act
ILCs Independent Living Centers
LD Learning Disability
MOU Memorandum of Understanding
MR Mental Retardation
MTARS Monitoring & Technical Assistance Review System
NIDRR National Institute on Disability Rehabilitation Research
OMB Office of Management & Budget
OSERS Office of Special Education Rehabilitation Services
P&A Protection & Advocacy System
PAAT Protection & Advocacy for Obtaining Assistive Technology
PABSS Protection & Advocacy for Beneficiaries of Social Security
PADD Protection & Advocacy for Persons with Developmental Disabilities
PAIMI Protection & Advocacy for Individuals with Mental Illness
PAIR Protection & Advocacy for Individual Rights
PIP Program Improvement Plan
PNS Projects of National Significance
PPR Program Performance Report
PR Public Relations
RFP Request for Proposal
RO Regional Office
SAMHSA Substance Abuse and Mental Health Services Administration
SCDD State Council on Developmental Disabilities
SGP Statement of Goals and Priorities
RSA Rehabilitation Services Administration
Rehab Act Rehabilitation Act
TA Technical assistance
Tech Act Technology-Related Assistance for Individuals with Disabilities Act
UCEDD University Centers for Excellence in Developmental Disabilities Education, Research, and Service

Tab B – Glossary
1. Areas of Emphasis
Activities that affect the quality of life of individuals with developmental disabilities, including:
* quality assurance
* housing
* education and early intervention
* transportation
* child care
* recreation
* health care
* formal and informal community supports
* employment

2. Child Care-Related Activities
Advocacy, capacity-building and efforts at systems change aimed at providing families of children with
developmental disabilities access to and use of child care services; includes before, after and out-of-school care
and should be located in families’ communities.

3. Compliance
Meeting the requirements of the DD Act.

4. Culturally Competent
Services, supports or other assistance that are responsive to the beliefs, interpersonal styles, attitudes,
language and behaviors of those receiving the services; services that respect the cultural differences and
preferences of individuals with developmental disabilities.

5. DD Network
The State Councils on Developmental Disabilities (Councils), Protection and Advocacy Agencies(P&As) and University
Centers on Excellence in Developmental Disabilities Education (University Centers, UCEDDs) that are within each
State.

6. Developmental Disability
Developmental disabilities (DD) are severe, life-long disabilities attributable to mental and/or physical
impairments, manifested before age 22. Developmental disabilities result in substantial limitations in three or
more areas of major life activities:
* self-care
* receptive and expressive language
* learning
* capacity for independent living
* mobility
* economic self-sufficiency
* self-direction

Persons with developmental disabilities require individually planned and coordinated services and supports (e.g.,
education, civil and human rights protection, health care) for life or for an extended period of time in order to
live in the community.

7. Early Intervention Activities
Advocacy, capacity-building and efforts at systems change that result in improving access to the support and
modifications that individuals with developmental disabilities need to:
* maximize their educational potential;
* benefit from lifelong education; and
* participate in all aspects of student life.

8. Employment-Related Activities
Advocacy, capacity-building and efforts at systems change that result in improved opportunities for individuals
with developmental disabilities to:
* get, keep or advance in paid employment, including supported or self-employment;
* work in integrated, community settings.

8. Grantees
State Councils on Developmental Disabilities, Protection and Advocacy Agencies and University Centers of Excellence
in Developmental Disabilities Education. These grantees make up the DD Network in each State.

9. Health-Related Activities
Advocacy, capacity building and efforts at systems change that result in access for individuals with developmental
disabilities to coordinated health, mental health, preventive health programs and other human and social services.

10. Housing-Related Activities
Advocacy, capacity building and efforts at systems change that result in access for individuals with developmental
disabilities to housing and housing supports and services, such as assistance with renting, owning or modifying an
apartment or home.

11. Inclusion
Acceptance by individuals without disabilities of the presence and participation of individuals with developmental
disabilities in social, educational, work and community activities. Inclusion enables individuals with
developmental disabilities to:
* have friendships and relationships with people they choose;
* live in homes close to community resources, with regular contact with the larger community;
* have access to and participate in the same community activities and types as employment as everyone else;
* live, learn, work and enjoy life in regular contact with individuals without disabilities.

13. Integration
The equal right of individuals with developmental disabilities to have access to and use the same community
resources as other people.

14. Organizational Procedures
The organizational structure, policies and processes that are the foundation of how a grantee operates.

15. Protection And Advocacy Systems
Protection and Advocacy (P&A) systems protect the legal and human rights of individuals with developmental
disabilities. P&A strategies include legal, administrative, and other remedies; information and referral;
investigation of incidents of abuse and neglect; and education of policy-makers. There is one P&A in each State.

16. Quality Assurance Activities
Advocacy, capacity building and efforts at systems change aimed at establishing systems to assure that individuals
with developmental disabilities:
* do not experience physical or sexual abuse, neglect, financial exploitation or violation of their legal or human
rights;
* are not subject to inappropriate restraint or seclusion

Quality assurance activities also include (1) training in leadership, self-determination and self-advocacy for
individuals with developmental disabilities, their families and their guardians, and (2) activities related to
interagency coordination and integration of service systems.

17. Recreation-Related Activities
Advocacy, capacity building and efforts at systems change that lead to improved access to and use of community
recreational, leisure and social activities for individuals with developmental disabilities.

18. State Council on Developmental Disabilities
State Councils on Developmental Disabilities (SCDD) pursue systems change in aspects of service/support
availability, design or delivery that promotes better lives for individuals with developmental disabilities and
their families. Councils:
* work to improve the capacity of projects to deliver services and supports;
* support advocacy activities that promote self-determination and inclusion in the community;
* support demonstrations of new approaches;
* sponsor outreach training;
* do public education;
* provide information to policy-makers.

19. Transportation-Related Activities
Advocacy, capacity building and efforts at systems change that lead to improved access to and use of transportation
for individuals with developmental disabilities.

20. University Centers For Excellence In Developmental Disabilities (University Centers, UCEDDs)
University Centers for Excellence in Developmental Disabilities (UCEDD) are either components of a university
system, or are public or not-for-profit entities associated with a university. UCEDDs:
* conduct interdisciplinary pre-service preparation of students and fellows
* sponsor community service activities
* conduct and sponsor research
* disseminate information and research findings.

Tab C.1 - Council Compliance Checklist

I. COLLABORATION
I.1 DD Network Collaboration
Document
Interview
Comments
The Council maintains collaborative relationships with the P&A and the UCEDD. Sec.104(a)(3)(D)(iii)

* Executive Director
* Council members
* Community members/Public forum

I.2 Community Collaborations
Document
Interview
Comments
The Council actively participates in community networks and has a range of collaborating partners. Sec. 101(b)(3)

* State agency members of Council
* Self-advocacy orgs.
* Community orgs.

II. ORGANIZATIONAL ADMINISTRATION
II.1 Staff
Document
Interview
Comments
Council recruits and hires Director of Council and supervises and annually evaluates Director. Director hires,
supervises and annually evaluates staff. Sec. 125(c)(9)

* Council Chair
* Executive Director

Staff while working for the Council are solely responsible for assisting the Council in carrying out duties of the
Council. Sec.125(c)(10)

* Council staff
* Council Chair
* Executive Director

Council hires and maintains staff and obtains services of professional, consulting, technical, and clerical staff
(qualified by training and experience) to carry out functions of Council. (State shall not apply hiring freezes,
RIFs, etc.) Sec.125(c)(8)(B)

* Executive Director
* Council Chair

III. MEMBERSHIP
III.1 Membership policies
Document
Interview
Comments
Membership recommendations solicited by Governor from a broad range of organizational sources including non-State
agency members of the Council. Sec125(b)(1)(B)

* Non-state agency members of Council
* Council Chair

Members reflect the State’s diverse geographic locations, race, and ethnicity. Sec.125(b)(1)(C)

* Council members
* Council Chair
* Executive Director

The Council has provisions to rotate membership. Sec.125(b)(2)

* Council members
* Council Chair
* Executive Director

The Council has provisions that allow continuation of membership until a new member is appointed. Sec.125(b)(2)

* Council members
* Council Chair
* Executive Director

The Council has a process to notify Governor re: membership and vacancies. Sec. 125(b)(2)

* Council members
* Council Chair
* Executive Director

III.2 Membership requirements
Document
Interview
Comments
60% of membership represent individuals with DD in the following categories: Sec.125(b)(3); Sec.125(b)(5)
* 1/3 individuals with DD
* 1/3 parents and guardians of children with developmental disabilities or immediate relatives of guardians of
adults with developmental disabilities
* 1/3 combination
> at least one is immediate relative or guardian of an individual with developmental disabilities who resides or
previously resided in an institution or an individual with developmental disabilities who currently/previously
resided in an institution in the State. Sec.125(b)(6)
> The above individuals cannot be employees of a State agency that receives funds or provides services under this
subtitle and not a managing employee of any other entity that receives funds or provides services under the
subtitle. Sec.125(b)(3)(B)

* Council members
* Council Chair
* Executive Director

Other required members:
Sec.125(b)(4)
> Rep. of the Rehab Act
> IDEA
> Older American Act
> Title V and XIX of the Social Security Act
> Local and nongovernmental agencies, and private nonprofit groups concerned with services for individuals with
developmental disabilities in the State in which such agencies and groups are located

* Council members
* Council Chair
* Executive Director

Representatives of agencies and organizations:
> Have the authority to engage in policy planning and implementation of behalf of department, agency or program.
Sec.125(b)(3)(B)(i)
> Recuse themselves from any discussions that may involve conflict of interest. Sec.125(b)(3)(B)(ii)
> No member of the Council will cast a vote on any matter that would provide direct financial benefit to the member
or otherwise give the appearance of a conflict of interest. Sec.124(c)(5)(D)

* Non-state agency members of the Council
* Council Chair

IV. PROGRAM ADMINISTRATION
IV.1 Five Year State Plan
Document
Interview
Comments
Establishes a Council Sec.124(c)(1)

* Executive Director
* Council Chair

Identifies Designated State Agency (DSA)

* Executive Director
* Council Chair

Describes the results of a comprehensive review and analysis of the extent to which services, supports, and other
assistance are available to individuals with developmental disabilities and their families and the extent of unmet
needs for services, supports, and other assistance in the State. Sec.124(c)(2,3)

* Executive Director
* Council Chair
* Council members

Includes 5-year goals developed through data-driven strategic planning, for advocacy, capacity building, and
systemic change in the areas of emphasis related to identified unmet/met needs and an annual goal to:
> Establish or strengthen a program for the direct funding of a State self-advocacy organization led by individuals
with developmental disabilities
> Support opportunities for who are considered leaders to provide leadership training to individuals with
developmental disabilities who may become leaders
> Support and expand participation of to individuals with developmental disabilities in cross-disability and
culturally diverse leadership coalitions
Sec.124(c)(4)(A)

* Executive Director
* Council Chair
* Council members

The 5-year goals;
> are consistent with indicators of progress
> reflect strategies to be used in achieving each goal
* reflect methods to determine if each goal has been achieved Sec.124(c)(B)

* Executive Director
* Council Chair
* Council members

Plan must include assurances related to:
> uses of funds
> State financial participation
> conflict of interest
> urban and rural poverty areas
> program accessibility standards
> individualized services
> human rights
> minority participation
> employee protections
> staff assignments
> noninterference
> state quality assurances
> other assurances
Sec.124(c)(5)

* Executive Director
* Council Chair
* Council members

Is based on public input. Sec.124(d)(1)

* Executive Director
* Council Chair
* Council members
* Community partners/organizations

Includes evidence of the plan being submitted to the Secretary and approved by the Secretary. Sec.124(d)(2,3)

* Executive Director
* Council Chair
* Council partners/organizations
* DSA

IV.2 State Plan Implementation
Document
Interview
Comments
The Council shall implement the State Plan by conducting and supporting advocacy, capacity building, and systemic
change activities such as:
> Outreach
> Training
> Technical Assistance
> Supporting and Educating Communities
> Interagency collaboration and coordination
> Coordination with related councils, committees, and programs
> Barrier elimination, systems design, and redesign
> Coalition development and citizen participation
> Informing policymakers
> Demonstration of new approaches to services and supports
> Other activities
Sec.125(c)(5)

* Executive Director
* Council Chair
* Council members
* Community partners/organizations

V. EVALUATION AND REPORTS
Program Performance Report
Document
Interview
Comments
The Council annually prepares and transmits to the Secretary a report containing information about the progress
made in achieving the goals. The report includes:

> Extent to which each goal of Council was achieved. Sec.125(c)(7)(A)

* Executive Director/staff
* Council Chair

> Description of strategies that contributed to achieving goals. Sec.125(c)(7)(B)

* Executive Director/staff
* Council Chair

> Extent to which each goal was not achieved, describes factors that impeded goal achievement. Sec.125(c)(7)(C)

* Executive Director/staff
* Council Chair

> Separate information on self-advocacy goal. Sec.125(c)(7)(D)

* Executive Director/staff
* Council Chair
* Consumer members of Council

> As appropriate an update on results of comprehensive review and analysis, and
> Information on consumer satisfaction with Council supported or conducted activities. Sec.125(c)(7)(E)

* Executive Director/staff
* Council Chair
* Consumer members of Council

> Description of adequacy of health care and other services, supports and assistance that individuals with
developmental disabilities:
o in Intensive Care Facilities/Mental Retardation (ICF/MR) receive;
o served through Home Community Based Waivers receive. Sec.125(c)(7)(F)

* Executive Director/staff
* Council Chair

> An accounting of the manner in which funds paid to the State for a fiscal year were expended. Sec.125(c)(7)(G)

* Executive Director/staff
* Council Chair

Includes description of:
> resources made available to carry out activities to assist individuals with developmental disabilities that are
directly attributable to Council activities
> resources made available for such activities that are undertaken by the Council in collaboration with other
entities. Sec.125(c)(7)(H)

* Executive Director/staff
* Council Chair

Includes description of how Council will widely disseminate the annual report to affected constituencies and
general public and assure report is available in accessible formats. Sec.125(c)(7)(I)

* Executive Director/staff
* Council Chair

Determine needs that require amendment of 5-year strategic State Plan required under section 124. Sec.125(c)(3)(C)

* Council Chair and members

VI. FISCAL
VI.1 Fiscal Requirements
Document
Interviews
Comments
> Council has authority to prepare, approve, and implement a budget to fund programs, projects, and activities.
Sec125(c)(8)
> Not less than 70% of funds expended for activities related to goals. Sec.124(c)(B)(i)
> Funds contribute to achievement of purpose of subtitle in various political subdivisions. Sec.124(c)(5)(B)(ii)
> Funds used to supplement, and not supplant, the non-Federal funds that would otherwise be made available for the
purposes for which funds under Sec122 are provided. Sec124(c)(B)(iii)
> Funds used to complement or augment rather than duplicate or replace services for individuals with developmental
disabilities and their families who are eligible for Federal assistance. Sec.124(c)(5)(B)(iv)
> Funds are made available to public or private entities. Sec.124(c)(5)(B)(v )
> There is reasonable State financial participation in the cost of carrying out the plan. Sec.124(c)(5)(C)
> Federal allotments can be expended or obligated for two years (year of award plus one more year). 45 CFR 1386.1
> Obligations of Federal allotments are liquidated by the third year (i.e. within two years of end of year of
award). 45 CFR 1386.2
> Expenditures and obligations are reported semiannually by SF269/ADD-02 45 CFR 1386.32

* Council Chair and members
* Executive Director

VI.2 Fiscal Policies
Documents
Interview
Comments
Council has policies to reimburse members of the Council for reasonable and necessary expenses (including expenses
for child care and personal assistance services) for attending Council meetings and performing Council duties.
Sec.125(c)(8)(A)(I)

* Executive Director
* Council fiscal staff

Council has policies to pay a stipend to a member of the Council if such member is not employed or must forfeit
wages for other employment to attend Council meetings and perform other Council duties. Sec.125(c)(8(A))(II)

* Executive Director
* Council fiscal staff

Council has policies to support Council member and staff travel to authorized training and technical assistance
activities including in-service training and leadership development activities. Sec.125(c)(8)(A)(III)

* Executive Director
* Council fiscal staff

Council has policies to carry out appropriate subcontracting activities. Sec.125(c)(8)(A)

* Executive Director
* Council fiscal staff

Council directs expenditures of funds for grants, contracts, interagency agreements that are binding contracts and
other activities authorized by State plan approval. Sec.125(c)(8)(C)

* Executive Director
* Council fiscal staff

Federal and non-Federal Share
> In general, Federal share of cost of all projects in State not more than 75% of the aggregate necessary.
Sec.126(a)(1)
> Federal share of cost for projects in rural and poverty areas may not be more than 90% of aggregate necessary.
Sec.126(a)(2)
> Projects undertaken by Council or Council staff, Federal share of cost not more than 100% of costs necessary.
Sec.126(a)(3)

* Executive Director
* Council fiscal staff

Grantee shall keep records that disclose:
> Amount and disposition of assistance by recipient
> Total cost of project or undertaking in connection with assistance given
> Amount of project costs supplied by other sources
> Such other records that will facilitate an effective audit
Sec.103

* Executive Director
* Council fiscal staff
* Grantees

VII. DESIGNATED STATE AGENCY
VII.1 DD Act requirements for DSA
Document
Interview
Comments
Council shall periodically review DSA and activities carried out under this subtitle by DSA and make any
recommendations for change to Governor. Sec.125(c)(6)

* Council Chair
* Executive Director
* DSA

The Council may request a review of and change in the DSA by the Governor. Sec.125(d)(2)(C)

* Council Chair
* Executive Director
* DSA

Type of agency designated as DSA:
> Council, if such Council may be DSA under laws of State
> State agency that does not provide or pay for services for individuals with developmental disabilities
> A State office, including the immediate office of the Governor of the State or a State planning office
Sec.125(d)(A)

* Council Chair
* Executive Director
* DSA

Designation before Enactment:
DSA determined prior to June 30, 1994 may be a State agency that provides or pays for services for individuals with
developmental disabilities. Sec.125(d)(2)(B)(i)

* Council Chair
* Executive Director
* DSA

Not more than 20% of federal allotment is awarded to the DSA by Council for service of demonstrations that
contribute to the achievement of the DD Act and are explicitly authorized by the Council. Sec.124(c)(5)(B)(vii)

* Council Chair
* Executive Director
* DSA
* Council fiscal staff

VII.2 Responsibilities of DSA
Document
Interviews
Comments
> Receives, accounts for, and disburses funds under subtitle based on State Plan. Sec125(d)(3)(C)(i)
> Provides the appropriate fiscal control and fund accounting procedures as may be necessary to assure proper
disbursement of, and accounting for, funds paid to the State. Sec125(d)(3)(C)(ii)
> Keeps and provides access to records as Secretary and Council may determine necessary and timely financial
reports regarding status of expenditures, obligations, and liquidation by agency or Council, and use of Federal and
non-Federal shares. Sec125(d)(3)(D)
> Provides required non-Federal share. Sec125(d)(3)(E)
> Assists in obtaining appropriate State Plan assurances and consistency with State law. Sec125(d)(3)(F)
> Enters into MOU at request of Council. Sec125(d)(3)(G)

* Council Chair
* Executive Director
* DSA
* Council fiscal staff

Tab C.2 – Council Program Operation and Practices Checklist
I. COLLABORATION
Collaboration
Comments
Collaboration is an integral part of the Council scope of work. The DD Act includes requirements for collaboration
across the DD network and with community partners. In addition, Council’s have unique opportunities to collaborate
with local, state, and national organizations and agencies. Effective collaboration strengthens the Council’s
ability to outreach and engage multiple audiences in projects and activities.
The Council uses its multi-state agency membership to forge interagency collaboration, coordination, and
communication that enhances services and supports to people with developmental disabilities and family members in
furthering the mission of the Council.
> Systems change, advocacy and capacity building activities are directed to a variety of State agencies and other
organizations that affect the lives of people with developmental disabilities. Sec.124(c)(4)(A); 125(c)(5)(G)
> The Council, the P&A, and the UCEDD collaborate to further the values of the DD Act. Sec.124(c)(3)(D)

The Council participates in interagency activities and coalitions and other statewide committees and bodies in the
state that are relevant to its mission and priorities. Sec.125(c)(5)(I)

The Council supports and conducts activities to promote interagency collaboration and coordination to better serve,
support, assist or advocate for individuals with developmental disabilities and their families. Sec.125(c)(5)(F)

The Council supports and conducts activities to enhance coordination of services with other councils, entities, or
committees authorized by Federal or State law, concerning individuals with developmental disabilities; parent and
information training centers. Sec.125(c)(5)(G)

II. ORGANIZATIONAL ADMINISTRATION
Mission
Comments
The Council has a clear mission statement governed by the federal mission in the DD Act and by the Federal
definition of State Councils Sec.101(B)

Governance
Comments
The Council has an organizational structure that supports the development, implementation, and evaluation of the
State plan, policy and system change initiatives, and enhancement of community capacity and competence.
> The Council has written policies in place that govern participation, attendance, membership terms and rotation,
election of officers, and membership term limits. Sec.125(b)
> The Council has written descriptions of the roles and responsibilities of Council members, officers, chairs,
staff, committees and subgroups. Sec.101(b); 125(c)
> The Council makes recommendations to the Governor for membership on the Council. Sec.125(b)(B)
> Council members are appointed by the Governor in a timely fashion. Sec.125(b)

Policies and Procedures
Comments
The Council operates under written policies and procedures to ensure that activities are carried out in an
efficient, effective and fiscally responsible fashion, are accountable to the public, and are consistent with the
values and mission of the Council.
> The Council has written administrative policy and procedures that includes such things as a conflict of interest
policy, bylaws, a description of the role of the DSA, fiscal and personnel policies, and any other policies
relevant to the operation of the Council. Sec.125(c)(8); 125(d)
> Staff and Council members have the opportunity to travel as needed to conduct Council business. Sec.125(c)(8)
> Provisions are in place to ensure that Council decisions are free from conflict of interest and favoritism.
Sec.125(b)(3)(B)(ii); 124(C)(4)(D)

Staff
Comments
The Council is staffed by a sufficient number of qualified individuals with the skills necessary to manage Council
activities, carry out the Council mission, support Council members, administer and oversee Council funded
activities, and who are committed to individuals with developmental disabilities and families.
The Council:
> program and administrative priorities are reflected in the size of the staff complement and in the allocation of
individual staff members. Sec.125(c)(8)
> determines the staffing pattern for the Council, ensures that it is designed to carry out state plan activities,
coordination, planning and advocacy, and carries out staff assignments on the organization design. Sec.125(c)(8)(9)
> staff have the qualifications and experience necessary to perform the duties. Sec.125(c)(8)
> hires, supervises and evaluates the director who in turn hires, supervises and evaluates Council staff.
Sec.125(c)(9)
> establishes an Executive Director evaluation process, evaluation criteria and performance criteria. Sec.125(c)(9)
> is an equal opportunity employer and follows all federal and state guidelines and laws as appropriate in
employment practices. Sec.125(c)(9)
> staff is responsible solely for assisting the Council in carrying out its duties and are not assigned duties by
the DSA or any other agency or office of the State. Sec.125(c)(10)

III. MEMBERSHIP

Comments
Council members make a commitment to serve the public interest and share a commitment to all people with
developmental disabilities by supporting their independence, productivity, integration and inclusion. The Council
provides opportunities, training, and encouragement for members and other advocates to gain and use leadership
skills to promote independence, productivity, integration and inclusion and attain leadership in the developmental
disabilities movement.
Council practices encourage the participation of individuals with developmental disabilities and family members in
leadership positions on the Council. Sec.124(c)(4)(iii)

New members are provided with an orientation to the values, mission, and federal mandates of the Council and their
roles and responsibilities as Council members. Sec.125(c)(1-2)

Council members are provided with information about the service system for individuals with developmental
disabilities and family members in the state. Sec.124(c)(3); 125(c)(4-5)
Council members play active roles in developing the five-year State plan and in evaluating progress.

Members attend and participate in Council and committee meetings on a regular basis. Sec.124(c)(3); 125(c)(4-5)

The Council facilitates the attendance and participation of individuals with developmental disabilities and their
families on the Council through a variety of supports including scheduling of Council meetings, provision of
stipends for respite, reimbursing travel expenses, communication and personal assistance and other means necessary
to ensure meaningful involvement. Sec.125(c)(8)

Council members participate in other organizations and forums that affect people with disabilities.
Sec.124(c)(4)(III)

IV. PROGRAM ADMINISTRATION
Planning
Comments
State plan priorities, Council activities and advocacy efforts reflect the Council’s mission, the expressed needs
of individuals with developmental disabilities and families in the State, and the specific legal, political, and
financial context within which the Council functions.
The Council:
> carries out systematic planning activities that link current state priorities to objectives, funding, policy
initiatives and implementation timelines. Sec.124(c)(1-5)
> has policies governing the planning process including roles & responsibilities of members and staff. Sec.125(c)
> has policies governing State Plan implementation and the RFP process and roles and responsibilities of Council
members and staff. Sec.125(c)(4)
> State plan and objectives are consistent with the Council’s mission statement and federal requirements.
Sec.124(c)(3)(E)
> goals and objectives are measurable
> state plan is evaluated annually to determine progress toward meeting goals and objectives, appropriateness of
activities, barriers having an impact on attainment of goals
> state plan is adjusted as needed to address barriers to attaining goals, or goals that have become inappropriate
> actively seeks input from individuals with developmental disabilities, their families and the public regarding
the state plan and priorities. Sec.124(d)
> planning process reflects the state’s cultural diversity and addresses the state’s unserved and underserved
minorities. Sec.124(c)(5); 125(c)(3)
> projects and activities are derived from the approved State Plan. Sec.125(c)(5)
> takes into account the political, legal, and financial context in the state in preparation for developing
priorities. Sec.124(c)(3)
> State plan is widely disseminated throughout the state. Sec.125(c)(7)

Community Competence
Comments
The Council supports grassroots and community development that promotes independence, inclusion,
self-determination, integration, participation and contribution.
The Council:
> sponsors training, demonstration projects and other activities that support model practices and their
replication. Sec.125(c)
> funded projects and activities are based upon the expressed needs and preferences of individuals with
developmental disabilities and families. Sec.125(a)
> funded projects and activities are designed with the collaboration of individuals with developmental disabilities
and families. Sec.125(a)
> projects and activities include individuals with developmental disabilities who are unserved and underserved
minorities and are representative of the cultural and geographic diversity of the state. Sec.124(c)(5)(E)
> projects and activities are fully accessible, programmatically and physically, as designed by the ADA and related
legislation. Sec.124(c)(5)(F)

Systems Advocacy
Comments
The Council engages in systems change, advocacy and capacity building that improves services and supports for
individuals with developmental disabilities.
The Council:
> develops priorities for systems change that are consistent with its goals and objectives. Sec.125(a)
> assists in building coalitions of individuals and organizations concerned about developmental disabilities issues
and utilizes participation in such coalition to further systems change, advocacy and capacity building.
Sec.125(c)(5)(I)
> assists individuals with developmental disabilities and their families to advocate for systems change.
Sec.125(c)(5)(C)
> presents information, strategies, findings, and recommendations to federal, state, or local policymakers.
Sec.125(c)(5)(J)
> pursues a range of strategies to meet its systems change, advocacy and capacity building. Sec.125(c)(5)

Public Awareness
Comments
The Council engages in activities that illustrate and promote valued social roles for people with developmental
disabilities and the values of independence, self-determination, integration and inclusion.
The Council:
> actively promotes positive images of individuals with developmental disabilities through public education and
other outreach strategies. Sec.125(c)(5)(E)
> enhances opportunities for individuals with developmental disabilities to assume valued roles in their
communities. Sec.125(c)(5)(C)
> materials are easily understood and available in a variety of formats. Sec.124(c)(5)F)
> materials are translated as necessary to accommodate the needs of significant cultural and ethnic minority groups
in the state. Sec.124(c)(5)(I)))

V. EVALUATION AND REPORTS
The Council regularly evaluates its effectiveness and whether its performance is consistent with its mission and
priorities and the values and provisions of the DD Act.
> The Council regularly provides opportunities for public comment on its performance by interested persons and
groups. Sec.124(d)
> There are quality assurance practices to assess the consistency of activities with the Council’s mission and
priorities and legal mandates. Sec.124(c)(4); 125(c)(2)
> There is a system for measuring the progress of Council-funded activities and the extent to which they succeed in
meeting the Councils mission, goals and objectives. Sec.125(c)(3)
> The Council evaluates its grant activities based on outcomes of increased independence, productivity, integration
and inclusion of people supported by the activities. Sec.125(c)(3)
> Individuals with developmental disabilities participate in outcome evaluations of grant-funded activities.
Sec.125(c)(1)

Data management
Comments
The Council has data management systems (written policies and procedures that are followed by competent staff) in
place that support ADD requirements.
Data management occurs on some schedule (e.g. staff and contractors are expected to provide data at certain times;
quality checks are performed at certain times)

* Quality checks are in place to verify accuracy of reporting.
* Quality control of data is done with primary sources
* Data definitions and data entry instructions exist and are used
* Reported outcomes are consistent with the 5-year state plan and amounts of funds made available for particular
effort

VI. FISCAL
Activities funded by the Council reflect the values of the DD Act and the State plan. Councils ensure that a wide
range of people and organizations committed to these values throughout the state or territory have access to
Council funds and support, including organizations and entities consisting of individuals with developmental
disabilities and families.

The Council:
> prepares, approves and executes its budget consistent with the DD Act. Sec.125(c)(5)(B)
> funded activities are consistent with the Council’s priorities and its mission and values. Sec.101(b)
> funded activities do not replace or supplant activities of other state agencies and non-federal funds.
Sec.124C(c)(5)
> has a method to determine the non-federal share to be required for each project/activity and uses its ability to
vary match depending on the nature of the activity. (the Council has a method to determine the non-federal share to
be required for each project/activity with a match in the aggregate of 25% of project expenditures, 10% for
projects addressing poverty areas.) Sec. 126
> funds direct services only as a part of a short term strategy for systems change leading to funding from other
sources. Sec.125(c)(5)(K)(i)
> has procedures for financial oversight of Council funded activities. Sec.125(c)(5)(B)
> provides special funding and technical assistance to entities that address the needs of urban and rural poverty
areas. Sec.124(c)(5)(E)

VII. DESIGNATED STATE AGENCY
> The DSA is expressly limited to receiving, disbursing, and accounting for funds in a manner consistent with law,
providing assurances, and providing administrative support as requested by the Council.Sec.125(d)(3)
> If the DSA provides or pays for services to people with developmental disabilities, the Council routinely
evaluates whether its placement continues to allow the Council’s independence, and if necessary, makes a
recommendation to the Governor regarding a more appropriate placement. Sec.125(c)(6)
> The DSA does not interfere with the planning, implementation and personnel of the Council.

Tab C.3 - Council Best or Innovative Practices Checklist

Instructions: The elements below are criteria to use to identify a best or innovative practice. Although a practice
does not need to excel in every one of the elements, it must be noticeably superior to what is regarded as common
practice among grantees to qualify as a best or innovative practice. Reviewers should rely on information provided
by the grantee and will need to use their personal judgment when determining if a practice does qualify as a best
practice. A best practice may be a research or evaluation project, policy analysis, data assessment, outreach
initiative or awareness effort. It may provide direct service or supported opportunity to people with developmental
disability, indirect support to family and
community care givers or interdisciplinary training for students, fellows, professionals and policymakers. It may
involve leadership development, community work or clinical practice. While best practices are diverse in their
workings, they share these common characteristics:

ELEMENT #1: It reaches the population of focus
Grantee should explain how the practice reaches the population of focus and improves the lives of people with
developmental disability, who are people with severe and multiple disabilities, without regard to disability label.

ELEMENT #2: It is an effort characterized by quality
Grantee demonstrates how this practice rises above the routine and can be fairly characterized as an outstanding or
significant achievement due to model or innovative methods which are reasonable in cost; supported by individuals,
families, policymakers and professionals; easily taught; replicable and adaptable by others.

ELEMENT #3: Its impact is measurable
Grantee can quantify the impact on people with developmental disabilities, families, community care givers,
students, fellow, professionals, direct services and policy makers. Grantee can quantify
the result of the practice with respect to leadership development, community work, litigation, mediation or
clinical practice. Grantee describes the impact in terms of increased services, new individual supports, additional
access to enriching community opportunities, improved awareness, better compliance monitoring, new legal precedent
or a trained workforce. Grantee demonstrates that impacts are sustainable.

ELEMENT #4: It addresses the aspirations of individuals
Grantee demonstrates how the practice supports individuals with developmental disabilities in exercising choice,
self determination and control of resources and how the practice contributes to the ability of
individuals with developmental disabilities to live in the community in full and unqualified integration and
inclusion with non-disabled peers and associates. The practice may, for example, provide access to safe
and appropriate child care, after school services, public transportation, recreation, leisure and social
activities; but it will certainly do so in the most integrated setting. It is often a practice which provides an
opportunity to contribute and participate in the community, develop new friendships and lead a meaningful and
productive life.

ELEMENT # 5: It is respectful in its methods
Grantee demonstrates how the practice reflects a social service philosophy that uses the strengths, resources and
capabilities of the individual, respects the individual’s dignity and priorities. It and views the individual as
the primary decision maker in the service delivery process. The design, focus and direction of such a practice are
derived from the involvement of people with developmental disabilities and their families. They support access to
generic services rather than isolation within services specific to disability. They are cultural competent and
reflect the meaningful preferences of many different communities.

ELEMENT #6: It safeguards those it intends to benefit
A best practice is one which is free of risk, abuse, exploitation, neglect or violation of civil rights.

Use the checklists below to describe best or innovative practices by identifying 2 or 3 of the most significant
accomplishments during the past five years (or since the last MTARS visit). In your description, discuss the steps
that the Council took to achieve the significant accomplishment.

BEST OR INNOVATIVE PRACTICES
Accomplishment
Description and Relevant Comments
Describe accomplishment 1 –
* Was it related to a goal in the 5-year application?
* Were there barriers to its completion?
* If so, how were they resolved?
* What community partners were involved?
* What was the impact on consumers?
* What was the impact on the community and/or state?
* Was the impact systemic?
* Was the impact statewide?

Describe accomplishment 2 –
* Was it related to a goal in the 5-year application?
* Were there barriers to its completion?
* If so, how were they resolved?
* What community partners were involved?
* What was the impact on consumers?
* What was the impact on the community and/or state?
* Was the impact systemic?
* Was the impact statewide?

Describe accomplishment 3 –
* Was it related to a goal in the 5-year application?
* Were there barriers to its completion?
* If so, how were they resolved?
* What community partners were involved?
* What was the impact on consumers?
* What was the impact on the community and/or state?
* Was the impact systemic?
* Was the impact statewide?

Tab C.4 - State Councils on Developmental Disabilities Fiscal Review Checklist

COUNCIL QUESTIONS
Review Prompt
Yes
No
N/A
Comments
Section 122(b) Are the amounts paid to a State for a fiscal obligated by the end of the 2nd fiscal year?

Section 124(c)(5)(B)(i) Was at least 70 percent of Federal funds expended for Area of Emphasis activities?

Section 126(a)(1) Was the Federal share of the cost of all projects in the State 75% or less of the total aggregate
necessary cost? [Exceptions §126(a)(2) and §126(a)(3)]

Section 126(a)(2) Is the Federal share of all costs of projects whose activities or products target individuals
with developmental disabilities who live in urban and rural poverty areas 90% or less of the aggregate necessary
costs?

Section 126(a)(3) Is the Federal share of all costs of projects undertaken by the Council not more than 100 percent
of the aggregate necessary costs?

Section 126(c)(1) The non-Federal share of the cost of any project supported by an allotment under this subtitle
may be provided in cash or in kind, fairly evaluated, including plant, equipment and services. Describe the type of
non-Federal funds received by the Council.
(The non-Federal share required by each recipient of a grant from a Council may vary)

Section 124(c)(5)(B)(iii); (iv) Has the System provided assurances to the HHS Secretary that the DD funds will be
used to supplement, and not supplant, non-Federal funds?

DESIGNATED STATE AGENCY (DSA)
Review Prompt
Yes
No
N/A
Comments
Section 125(d)(4)(B) With the agreement of the DSA, the Council may use or contract with agencies other than the
DSA to perform the functions of the DSA. Is there a contract?

Section 125(d)(3)(C)(i) Does the Designated State Agency receive, account for, and disburse funds? Describe.

Section 125(d)(3)(C)(ii) Does the Designated State Agency provide for such fiscal control and fund accounting
procedures as may be necessary to assure the proper disbursement of, and accounting for, funds? Describe.

Section 125(d)(3)(D) The Designated State Agency shall keep and provide access to such records as the Secretary and
Council may determine to be necessary.

Does the DSA provide timely financial reports at the request of the Council regarding the status of expenditures,
obligations, and liquidation by the agency or the Council, and the use of Federal and non-Federal shares.

Section 125(d)(3)(G) On the request of the Council, the DSA shall enter into a memorandum of understanding with the
Council delineating the roles and responsibilities of the DSA. Is there a MOU?

Section 124(c)(5)(B)(vi) At the request of the State a portion of such funds provided to such State shall be
available to pay up to ½ (or the entire amount if the Council is the designated State agency) of the expenditures
found to be necessary by the Secretary for the proper and efficient - provided not more than 5 percent of such
funds provided to such State for any fiscal year, or $50,000, whichever is less .

Does the Council pay the State for DSA functions? How much?

Section 124(c)(5)(B)(vii) Not more than 20 percent of such funds will be allocated to the DSA for service
demonstrations by such agency. If the Council funds demonstration projects with the DSA, is the percentage 20% or
less of their allocation?

FEDERAL FINANCIAL STATUS REPORTS & A-133 AUDITS
Review Prompt
Yes
No
N/A
Comments
45 CFR 74.21; 74.52; 92.20 Financial data and records were used in preparing the SF-269s for the budget period.

a. Does the grantee’s SF-269 reports correspond with the accounting records?
b. Can the grantee readily identify how financial data from its accounting records were transferred to the Federal
financial reports?
c. Does the grantee maintain documentation that supports the line items reported?

Does the System have adequate and audited fiscal controls/policies and record-keeping procedures?

45 CFR 72.26; 92.26 Does the organization prepare audited financial statements and have an A-133 audit annually?

Do subcontractors of the System also meet audit requirements and record-keeping procedures?

PROCUREMENT
Review Prompt
Yes
No
N/A
Comments
45 CFR 74.43; 92.36 Are procurement transactions, whether negotiated or advertised, and regardless of dollar value,
conducted in a manner providing maximum open and free competition?

PROPERTY
Review Prompt
Yes
No
N/A
Comments
45 CFR 74.34; 92.32 Does System’s property management standards for nonexpendable personal property include the
following procedural requirements:

a. Description of property
b. Serial Number
c. Source of equipment
d. Name on title
e. Acquisition date
f. Cost of equipment
g. % of Federal dollar (program dollars) used
h. Current location, use, and condition of equipment
i. Disposition data, including sale price, if applicable

45 CFR 74.34; 92.32 Is there evidence of the Council conducting a physical inventory of property at least once
every two years and verifying this with property records?

45 CFR 74.34; 92.32 Is a control system in effect to ensure adequate safeguards to prevent loss, damage, or theft
to the property? Is any loss, damage, or theft of nonexpendable personal property investigated and fully documented?

PAYROLL, ACCOUNTING & INTERNAL CONTROLS
Review Prompt
Yes
No
N/A
Comments
45 CFR 1386.20(a) Has the System implemented the necessary procedures to assure the proper disbursement of and
accounting for Federal funds? Describe.

Does the organization have formal travel policies or consistently followed procedures?

Do policies require prior approval of expenditures, documentation of amounts charged, and limit the amount and
types of expenses that can be incurred?

45 CFR 74.21(b)(5); 92.20(b)(7) Are cash requirements and/or cash draw downs on letter of credit limited to
immediate needs? (check last bank statement for unreasonably large cash balances).

Tab C.5 - Council Chair Checklist

* Were you informed of the MTARS Review and involved in gathering the materials to be submitted to ADD?


* Did you have the opportunity to review the submitted materials?


* Are you involved/aware of the Public Forum opportunity?


* What do you think or believe the purpose of the MTARS visit is to be?


* As Council Chair, what do you perceive your roles to be other than chairing council meetings?


* What kinds of staff support do you receive in carrying out your duties as Chair?


* Tell us about your relationship with the Executive Director.


* How do you evaluate the Executive Director (forms/timeline)?


* What happens after the Executive Director’s evaluation – raise, etc.?


* Do you have interactions with the rest of the staff? If so, please describe?


* Is an Orientation Session held for new members? If so, tell us about the information covered in that session.


* Do you feel well versed in the issues facing the Council in the following areas: 1) personnel; 2) membership; 3)
financial; 4) state and national issues? If not, what prevents you from being more knowledgeable?


* How does your Council prepare its State Plan and annual amendments?


* In your opinion, what are the three most significant projects the Council is working on at the current time?

Tab D.1 – P&A Compliance Checklist

I. COLLABORATION
I.1 DD Network Collaboration
Document
Interview
Comments
The P&A maintains collaborative relationships with the Council and the UCEDD. Sec.104(a)(3)(D)(iii)

II. ORGANIZATIONAL ADMINISTRATION
II.1 Staff
Document
Interview
Comments
The P&A hires and maintains sufficient numbers and types of qualified staff to carry out its functions and is not
subject to State policies such as hiring freezes, reductions in force, and prohibitions on travel that would impact
the staff or functions of the system funded with Federal funds. Sec.143(a)(2)(K)

P&A staff are trained and experienced in the investigation of abuse and neglect.
45 CFR 1386.21(e)

P&A staff are trained and experienced in the representation of individuals with developmental disabilities
regarding rights violations. 45 CFR 1386.21(e)

II.2 Authority and Independence
Document
Interview
Comments
The P&A has the authority to pursue legal, administrative and other appropriate remedies to ensure the protection
of the rights of individuals with developmental disabilities individuals with developmental disabilities who are,
or may be, eligible for treatment, services or habilitation or who are being considered for a change in living
arrangements, with particular attention to members of ethnic and racial minority groups.
Sec.143(a)(2)(A)(i)

The P&A has the authority to provide information and referral to programs and services. Sec.143(a)(2)(A)(ii)

The P&A has the authority to investigate incidents of abuse and neglect of individuals with developmental
disabilities if the incidents are reported to the system or if there is probable cause to believe that the
incidents occurred. Sec.143(a)(2)(B)

The P&A has policies or practices that preserve the authority of the P&A and do not restrict the remedies which may
be sought on the behalf of individuals with developmental disabilities. 45 CFR 1386.21(c)

The P&A has policies or practices that do not compromise the authority of the P&A to pursue remedies through
litigation, legal action or other forms of advocacy. 45 CFR 1386.21(c)

The P&A is not administered by the State Council on Developmental Disabilities. Sec143(a)(2)(F)

The P&A is independent of any agency that provides treatment, services, or habilitation to individuals with
developmental disabilities.
Sec.143(a)(2)(G)

No State law diminishes the required authority of the P&A. 45CFR 1386.21(f)

The P&A is free from any State policies which impact the ability of the staff or the functions of the P&A which
would prevent the P&A from carrying out its mandates under the Act. 45 CFR 1386.21(d)

If the P&A is in state government, there are specific provisions which protect its operations from hiring freezes,
training limitations, restrictions on obtaining and maintaining equipment, materials and supplies and services.
Sec.143(1)(2)(K)

III. MEMBERSHIP
III.1 Board Composition & Selection
Document
Interview
Comments
If the P&A is organized as a private nonprofit entity with a multimember governing board, or a public system with a
multimember governing board, such governing board shall be selected according to the policies and procedures of the
system. Sec.144(a)

The governing board shall be composed of members who broadly represent or are knowledgeable about the needs of the
individuals served by the system. Sec.144(1)(A)

A majority of the board members shall be individuals with disabilities, including individuals with developmental
disabilities who are eligible for, have received or are receiving services through the system; or parents, family
members, guardians, advocates, or authorized representatives of such individuals. Sec.144(1)(B)

The board may include a representative of the State Council on Developmental Disabilities, the University Center
for Excellence in Developmental Disabilities Education, Research and Service (UCEDD) in the State, and
self-advocacy organizations. Sec.144(1)(C)

Not more than 1 /3 of the members of the governing board may be appointed by the chief executive officer of the
State involved, in the case of any State in which such officer has the authority to appoint members of the board.
Sec.144(a)(2)

The membership of the governing board shall be subject to term limits set by the system to ensure rotating
membership. Sec.144(a)(3)

Vacancies are filled in a timely manner. Sec.144(a)(4)

Board members are not selected or appointed to represent any agency providing treatment, services or habilitation.
Sec143(a)(2)(G)

III.2 Governing Board Duties
Document
Interview
Comments
The P&A has policies and practices that provide a voice for individuals with developmental disabilities on its
governing board or advisory board. 45 CFR 1386.21(g)

III.3 Advisory Council
Document
Interview
Comments
If the P&A is organized as a public system without a multimember governing or advisory board, the system shall
establish an advisory council. Sec.144(a)(5); 45 CFR 1386.21(g)

The advisory Council shall advise the system on policies and procedures to be carried out by the P&A.
Sec144(a)(5)(A); 45 CFR 1386.21(g)

IV. PROGRAM ADMINISTRATION
IV.1 Planning
Document
Interview
Comments
By January 1 of each year, the P&A shall submit an Annual Statement of Goals and Priorities (SGP) that describes
> the priorities and selection criteria for P&A’s individual advocacy casework;
> the systemic advocacy work and training activities,
> the outcomes the P&A strives to accomplish;
> how the P&A operates; and,
> how it coordinates with other P&A programs in the State.
45 CFR 1386.23(c).

Annually, members of the public, including individuals with developmental disabilities, and other advocates shall
be given an opportunity to comment on the goals, priorities and activities of the P&A. Sec.143(a)(2)(D)
Each fiscal year, the P&A shall:
> obtain formal public input on its Statement of Goals and Priorities (SGP);
> provide for broad distribution of the proposed SGP for the next fiscal year in a manner accessible to individuals
with development disabilities and the representatives and allow at least 45 days from the date of distribution for
comment;
> provide the State Council on Developmental Disabilities and the University Center a copy of the proposed SGP for
comments concurrently with the public notice;
> incorporate or address comments received in the final SGP submitted to the Department; and,
> address how the P&A, State Council on Developmental Disabilities, and the University Center will collaborate with
each other and with other public and private entities. 45 CFR 1386.23(d).

On an annual basis, the P&A develops, submits to the Secretary, and takes action with regard to goals (each of
which is related to 1 or more areas of emphasis) and priorities, developed through data driven strategic planning,
for the system's activities. Sec.143(a)(2)(C)

IV.2 Confidentiality
Document
Interview
Comments
The P&A has policies and practices to keep confidential all information contained in a client’s record. 45 CFR
1386.22(e)(1)

The P&A system has written policies governing access to, storage of, duplication of, and release of client
information. 45 CFR 1386.22(e)(2)

The P&A has policies and practices that assure the P&A has written consent from the client or his or her guardian
before releasing information to individuals not otherwise authorized to receive it. 45 CFR 1386.21(i).

The P&A has authority to keep confidential the names and identity of individuals who report incidents of abuse and
neglect.
45 CFR 1386.22(e)(3).

IV.3 Client Eligibility & Case Selection
Document
Interview
Comments
The P&A has developed case or client acceptance criteria as part of its annual priority setting process. 45 CFR
1386.21(c)

Clients are informed at the time they apply for services of the case or acceptance criteria. 44 CFR 1386.21(c)

IV.4 Legal Representation
Document
Interview
Comments
The P&A represents individuals with developmental disabilities in lawsuits against the State or any agency or
instrumentality of the state without limitation. Sec.144(b)(1).

The P&A provides assistance in a manner that is consistent with section 5 of the Assisted Suicide Funding
Restriction Act of 1997. Sec.144(b)(3).

IV.5 Investigations of Abuse and Neglect
Document
Interview
Comments
The P&A investigates incidents of abuse and neglect of individuals with developmental disabilities if the incidents
are reported to the system or if there is probable cause to believe that the incidents occurred. Sec.143(a)(2)(B).

The P&A has access to individuals with developmental disabilities and records as provided in the Act and
regulations. Sec.143(a)(2)(H), (I) and (J)

IV.6 Access to Individuals with Developmental Disabilities
Document
Interview
Comments
The P&A has access at reasonable times to any individual with a developmental disability in a location in which
services, supports and other assistance are provided. Sec.143(a)(2)(H); 45 CFR 1386.22(f)

The P&A has the opportunity to interview any facility service recipient, employee, or other persons, including the
person thought to be the victim of an incident of abuse or neglect, who might be reasonably believed by the P&A to
have knowledge of the incident under investigation. 45 CFR 1386.22(f)

The P&A has opportunity to inspect, view and photograph all areas of a facility’s premises that might be reasonably
believed by the P&A to have been connected with an incident of abuse or neglect. 45 CFR 1386.22(f)

The P&A and all of its authorized agents have unaccompanied access to all residents of a facility at reasonable
times to monitor compliance with respect to the rights and safety of service recipients. 45 CFR 1386.22(g)

The P&A and all of its authorized agents have unaccompanied access to all residents of a facility at reasonable
times to provide:
> information and training on, and referral to, programs addressing the needs of individuals with developmental
disabilities and the P&A services including the name, address, and telephone number of the P&A;
> other information and training about individual rights. 45 CFR 1386.22(g)

The P&A has unaccompanied access to all residents of a facility including the opportunity to meet and communicate
privately with individuals, both formally and informally, by telephone, mail and in person. 45 CFR 1386.22(h)

IV.7 Access to Records
Document
Interview
Comments
The P&A shall have access to records of clients if such person, legal guardian, conservator or other legal
representative has authorized such access or where a complaint has been received about the individual or there is
probable cause that the individual has been subject to abuse or neglect. Sec.143(a)(2)(I).

The P&A shall have access to the records that are relevant to conducting an investigation not later than 3 business
days after the system makes a written request for the records and have immediate access not later than 24 hours
after the system makes such a request to the records without consent from another party. Sec.143(a)(2)(J).

The State provides the P&A with a copy of each independent review of an ICF/MR within the state not later then 30
days after the availability of such review about the adequacy of health care and other services, supports and
assistance received by individuals with developmental disabilities through home and community-based waivers.
Sec.143(a)(3).

IV.8 Grievances
Document
Interview
Comments
The P&A shall establish a grievance procedure for clients or prospective clients to ensure that individuals with
developmental disabilities have full access to services of the system. Sec.143(a)(2)(E)

V. EVALUATION AND REPORTS
Program Performance Report
Document
Interview
Comments
By January 1 of each year the P&A shall submit an Annual Program Performance Report in a format designated by the
Secretary. Sec. 144 (e);
45 CFR 1386.23(a); 45 CFR 1386.23

VI. FISCAL

Document
Interviews
Comments
Grantee shall keep records that disclose:
> Amount and disposition of assistance by recipient
> Total cost of project or undertaking in connection with assistance given
> Amount of project costs supplied by other sources
> Such other records that will facilitate an effective audit
Sec.103

In a State in which the system is housed in a State agency, the State may use not more than 5 percent of any
allotment under this subsection for the costs of monitoring the administration of the system.
Sec.142(a)(5)

Attorney fees are considered program income and must be added to the funds committed to the program and used to
further the objectives of the program. This requirement shall apply to all attorney fees, including those earned by
contractors and those received after the project period in which they were earned. 45 CFR 1386.24(b)

Expenditures and obligations are reported semiannually by SF 269. 45 CFR 1386.23(b)

The P&A may use its allotments to bring lawsuits in its own right to redress incidents of abuse or neglect,
discrimination and other rights violations impacting on individuals with developmental disabilities to obtain
access to records and when it appears on behalf of named plaintiffs or a class of plaintiff for such purposes. 45
CFR 1386.25

Funds have been obligated within one year of the close of the Federal fiscal year in which they were awarded.
Sec.142(c)

Obligated funds have been liquidated within two years of the close of the Federal fiscal year in which they were
awarded. 45 CFR 1386.3(a)

The P&A provides assurances to the Secretary that funds will be used to supplement, and not supplant, non-Federal
funds. Sec.143(a)(2