Copy of Reporting Form with changes tracked

State Coalitionsform rev FINALfixed-4-8-08.doc

Semi-annual Progress Report for Grants to State Sexual Assault and Domestic Violence Coalitions Program

Copy of Reporting Form with changes tracked

OMB: 1122-0010

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OMB Clearance # 1122-0010

Expiration Date 3/31/08OMB Clearance # 1122-00101-0280

Expiration Date 3/31/08 07/31/2004


U .S. Department of Justice

Office on Violence Against Women

Semi-Annual Progress Report for

Grants to State Sexual Assault and Domestic Violence Coalitions Program


Brief Instructions: This form must be completed for each Grants to State Sexual Assault and Domestic Violence Coalitions Program (State Coalitions Program) grant received. The grant administrator or coordinator must ensure that the form is completed fully with regard to all grant activities. Throughout this form, State Coalition Program funds include the 25% grant match.


All grantees should read through each section to determine which questions they must answer based on the activities engaged in under this grant during the current reporting period. Sections B and D of this form must be completed by all grantees. In section A, subsection A1 must be answered by all grantees. In subsection A2 and section C, grantees must answer an initial question in each subsection about whether they engaged in certain activities during the current reporting period. If the response is yes, then the grantee must complete that subsection. If the response is no, the rest of that subsection is skipped.


For example, (1) if you only provided training and technical assistance with staff funded under this grant during the current reporting period, you would complete sections A, B, C1, C6, and D (and answer ‘no’ in C2-C5 and

C7-C9); or, (2) if you provided training and technical assistance with staff funded under this grant and grant-funded staff developed products during the current reporting period, you would complete sections A, B, C1, C4, C6, and D (and answer ‘no’ in C2, C3, C5, C7-C9).


The activities of volunteers or interns should may be reported if they weare coordinated or supervised by State Coalitions Program grant-funded staff or if State Coalitions Program funds substantially supported their activities.


For further information on filling out this form, refer to the separate set of instructions, which contains detailed definitions and examples, illustrating how questions should be answered.


SECTION Page Number

Section A: General Information 1

Section A1: Granteneral Information 1

Section A2: Staff Information 2

Section B: Program Activities 3

Section C: Function Areas 4

C1 Training 4

C2 System Advocacy 7

C3 Policies 10

C34 Products 101

C4 Public Awareness 1123

C5 Technical Assistance 1234

C6 Standards of Service 1456

C7 Underserved Populations 1567

C8 Organizational Development and Capacity Building 17678

Section D: Narrative 18789

Appendix A: Status of Goals and Objectives Table 20

A . GENERAL INFORMATION


A1. Grant information

All grantees must complete this section.


1. Date of report


2. Current reporting period January 1-June 30 July 1-December 31 (Year)


3. Grantee name


4. Grant number (the federal grant numbers assigned to your State Coalitions Program grant)


____________________________________________________________

____________________________________________


5. Type of grantee organization (Check one.)

  • Dual Sexual Assault/Domestic Violence Coalition

  • Sexual Assault Coalition

  • Domestic Violence Coalition


6. Point of contact (person responsible for the day-to-day coordination or administration of the grant)


First Name _______________MI_____ Last Name


Agency/organization name


Address


City State Zip Code


Telephone Facsimile


E-mail


7. What percentage of your total operating budget is funded by the State Coalitions Program grant? (Do not include pass-through funding that the coalition awards to local sexual assault or domestic violence programs.) _________________


8. Coalition members (Report the total number of organizational members, including sexual assault programs, domestic violence programs, other victim services agencies, and other organizational members, as applicable to your state coalition. Report the total number of individual members, if applicable to your state coalition. Individual members are individual persons, not programs.)


Organizational members

Number

Sexual assault programs/rape crisis centers

Domestic violence programs

Sexual assault and domestic violence dual programs

Tribal victim services agencies

Other victim service providers

Other organizational members

Total number of organizational members

Total number of individual members







A 2. Staff Information

Were State Coalitions Program funds used to fund staff positions during the current reporting period? Check yes if State Coalitions Program funds were used to pay staff, including part-time staff and contractors.

  • Yes--answer question 9

  • No--skip to Section B


9. Staff (Report the total number of full-time equivalent [(FTE)] staff funded by State Coalitions Program grant during the current reporting period. Report staff by the function(s) performed, not by title or location. Include employees who are part-time and/or partially funded with these grant funds as well as consultants/contractors. Report grant-funded overtime. If an employee or contractor was employed or utilized for only a portion of the reporting period, prorate appropriately. For example, if you hired a full-time administrator in October who was 100% funded with State Coalitions Program funds, you would report that as .5 FTEs. Report all FTEs in decimals, not percentages. One FTE is equal to 1,040 hours—40 hours per week x 26 weeks. full-time equivalent [FTE] staff funded by State Coalitions Program grant during the current reporting period. Include employees who are part-time and/or only partially funded with these grant funds as well as contractors. If an employee or contractor was not employed or utilized over the entire reporting period, report the average. Round to the second decimal. See separate instructions for examples of how tohow to calculate FTEs for part-time staff and contractors.)


Staff

FTE (s)Grant-funded staff

Administrator (fiscal manager, executive director)


Civil aAttorney


Communications specialist (public awareness, media relations)


Information technology staffpecialist


Paralegal


Program coordinator (training coordinator, outreach coordinator)


Support staff (secretary, administrative assistant, accountant, bookkeeper)


Systems advocate


Technical assistance provider


Trainer


Translator/Interpreter


Other (specify): ______________________________________


TOTAL




B . PROGRAM ACTIVITIES


All grantees must complete this section.


10. Program activities (Check all program activities your State Coalition engaged in during the current reporting period. Check the appropriate box to indicate whether the activity was supported with State Coalitions Program funds or another funding source.)

State Coalitions Program funded

Other funding source

Program activities

Providing technical assistance to member programs.

Expanding the technological capacity of coalitions and/or member programs.

Developing or enhancing appropriate standards of services for member programs, including culturally appropriate services to underserved populations.

Conducting statewide, regional and/or community-based meetings or workshops for victim advocates, survivors, legal service providers, and criminal justice representatives.

Bringing local programs together to identify gaps in services and to coordinate activities.

Increasing the representation of underserved populations in coordination activities, including providing financial assistance to organizations that serve underserved communities to participate in planning meetings, task forces, committees, etc. Encouraging the representation of underserved populations in coordination activities, including the provision of scholarship funding to underserved communities to participate in planning meetings, taskforces, committees, etc.

Engaging in activities that promote coalition building at the local and/or state level.

Coordinating federal, state and/or local law enforcement agencies to develop or enhance strategies to address identified problems.

Engaging in systems advocacy to effect policy and/or procedural change in order to improve institutional responses to domestic violence and sexual assault.


11. Other activities (List all other activities, not included in question 10, which your State Coalition engaged in during the current reporting period. Check the appropriate box to indicate whether the activity was supported with State Coalitions Program funds or another funding source.)


State Coalitions Program funded

Other funding source

Activity

a.

b.

c.

d.

e.

f.

C. FUNCTION AREAS

C 1. Training

Were your State Coalitions Program funds used for training during the current reporting period? Check yes if State Coalitions Program-funded staff provided training or if State Coalitions Program funds were used to directly support the training.

  • Yes--answer questions 12-14

  • No--skip to C2


For the purposes of this reporting form, trainingtraining means providing information on sexual assault, dating violence, domestic violence, and stalking that enables a professionalserson to improve their response to victims/survivors as it relates to their role in the system. EducationEducation means providing general information that will increase public awareness of sexual assault, dating violence, domestic violence, or stalking. In this subsection, report information on training activities. Educational activities should be reported in subsection C54 Public Awareness.


12. Type and number of training events provided (Report the number of statewide, regional, and community-based training events by the type of training that were either provided by State Coalitions Program-grant funded staff or directly supported with State Coalitions Program funds. Staff development training provided to State Coalitions Program-funded staff should not be counted. Use the SA/DV columns if training events focused on both sexual assault and domestic violence.)


Type of training

Total number of training events

Statewide

Regional

Community-based

Sexual assault

Domestic violence

SA/
DV

Sexual assault

Domestic violence

SA/
DV

Sexual assault

Domestic violence

SA/ DV

Computer-based training










Conferences










Teleconferences










Videoconferences










Workshops/seminars










Other (specify): __________














1 3. Number of people trained (Report the number of people trained during the current reporting period by State Coalitions Program-funded staff or training supported by State Coalitions Program funds. Use the category that is most descriptive of the people attending the training event. If you do not know how many people to report in specific categories, you may report the overall number in “Multidisciplinary.” Please use only as a last resort. State Coalitions Program-funded staff attending staff development training should not be counted. Total person-hours are calculated by multiplying the number of people trained by the length of the individual training event.)


People trained

Number

Person-hours

Advocacy organization staff (NAACP, AARP)



Attorneys/law students (does not include prosecutors)



Batterer intervention program staff



Board members



Child welfare worker/children’s advocates



Community advocacy organization staff (NAACP, Gray Panthers)



Corrections personnel (probation, parole, and correctional facilities staff)



Court personnel (judges, clerks)



Educators (teachers, administrators, etc.)



Faith-based organization staff



Government agency staff (vocational rehabilitation, food stamps, TANF)



Health professionals (doctors, nurses, does not include sexual assault forensic examiners (SAFE) or sexual assault nurse examiners (SANE)excluding forensic examiners)



Immigration organization staff



Law enforcement officers



Legal services staff (does not include attorneys)



Mental health professionals



Military command staffresponse professionals



Multidisciplinary (various disciplines at same training)group



Prosecutors



Sex offender treatment program staff



Sexual assault forensic examiners/Sexual assault nurse examiners



Social service organization staff (non-governmental – food bank, homeless shelter)



Substance abuse treatment provider



Translators/Interpreters



Tribal government/Tribal government agency staff



University/school faculty or staff



Victim advocates (sexual assault)



Victim advocates (non-governmental, includes domestic violence, sexual assault, dual)



Victim advocates (dual-sexual assault and domestic violence)



Victim-witness specialists assistants (governmental, includes victim-witness specialist/coordinator)



Volunteers



Other (specify):__________________________________________________



TOTAL





14. Training content areas (Indicate all topics addressed in training events provided with by your State Coalitions Program funds during the current reporting period. Check all that apply)



Sexual assault, domestic violence/dating violence, and stalking

  • Advocate response

  • Child witnesses

  • Confidentiality

  • Cyberstalking

  • Dating violence overview, dynamics, and services

  • Domestic violence overview, dynamics, and services

  • Drug facilitated sexual assault

  • Forensic evidence collection and documentation

  • Mandatory reporting requirements

  • Response to victims/survivors who are incarcerated

  • Response to victims/survivors who have been trafficked

  • Safety planning for victims/survivors

  • Sexual assault overview, dynamics, and services

  • Stalking overview, dynamics, and services

  • Supervised visitation and exchange

  • Other (specify): _________________________


Justice system

  • Civil court procedures

  • Criminal court procedures

  • Decreasing dual arrests/identifying predominant aggressor

  • Domestic violence statues/codes

  • Firearms and domestic violence

  • Immigration

  • Judicial response

  • Law enforcement response

  • Pro-arrest policies

  • Probation response

  • Prosecution response

  • Protection orders (including full faith and credit)

  • Sexual assault forensic examinations

  • Sexual assault statutes/codes

  • Stalking statutes/codes

  • Tribal jurisdiction and Public Law 280

  • Other (specify): _______________________


Underserved populations

Issues specific to victims/survivors who:

  • live in rural areas

  • are American Indian or Alaska Native

  • are Asian

  • are black or African American

are disabled

are elderly

  • are Hispanic or Latino

  • are homeless or living in poverty

  • are immigrants, refugees, or asylum seekers

  • are lesbian, gay, bisexual, transgender, or intersex

  • are Native Hawaiian or other Pacific Islander

  • have disabilities

  • have limited English proficiencyanguage barriers

  • have mental health issuesproblems

  • have substance abuse issuesproblems

  • Other (specify):


Organizational community response

  • Board roles and fiuduiciary responsibilies

  • Collaboration

  • Coordinated community response

  • Community response to sexual assault

  • Discrimination and oppression issues

  • Emergency preparedness

  • Evaluation

  • Outreach to diverse/underserved populations

  • Program accessibility

  • Program rules

  • Response teams (DART, DVRT, SART)

  • Safety planning

  • Standards of service

  • Strategic planning

  • Technology

  • Technology safety issues

  • Victim service administration and operations

  • Other (specify): _________________________




15. (Optional) Additional information (Use the space below to discuss the effectiveness of training activities funded or supported by your State Coalitions-funded Program grant and to provide any additional information you would like to share about training activities beyond what you have provided in the data above. An example might include a change in how area hospitals respond to victims of domestic violence, sexual assault and stalking after a state-wide training for hospital staff.




CC2. System Advocacy

Were your State Coalitions Program funds used for system advocacy during the current reporting period? Check yes if State Coalitions Program-funded staff engaged in system advocacy or if State Coalitions Program funds directly support supported system advocacy. (System advocacy is an activity intended to effect policy and/or procedural change in order to improve institutional response to sexual assault and/or domestic violence.)

  • Yes--answer questions 165-197

  • No--skip to C3


165. System advocacy activities (Indicate the system advocacy activities convened or participated in with State Coalitions Program funds during the current reporting period. Check all that apply.)


Systems advocacy

Sexual assault

Domestic violence/Dating violence

Appointed, state-level commissions

Community, regional, statewide task force/caucus

Multidisciplinary working groups

Project-specific interagency working groups

Tribal systems advocacy

Other (specify): _________________________




1 7. Improved system response (Report the total number of statewide, regional, and local meetings convened and/or attended by State Coalitions Program-funded staff during the current reporting period.)


Agency/organization

Number of meetings convened

Number of meetings attended

Sexual assault

Domestic violence/ Dating violence

Sexual assault

Domestic violence/

Dating violence

Advocacy organization (NAACP, AARP)





Batterer intervention program





Child welfare





Community advocacy organization (NAACP, Gray Panthers)





Corrections (probation, parole, correctional facility)





Court (state or local)





Crime victim compensation





Domestic violence program





Dual sexual assault and domestic violence program





Educational institution/organization





Faith-based organization





Federal criminal justice





Other federal entities/officials





Government agency ((INS, Social Security, TANF)





Health/mental health organization





Law enforcement (state or local)





Legal services organization (legal services, bar association, law school)





Multi-disciplinary group/task force





OrganizationsPeople representing underserved populations





Prosecutor’s office (state or local)





Sex offender management/sex offender treatment provider





Sexual Assault Forensic Examiners/Sexual Assault Nurse Examiners program (SAFE/SANE)





Sexual assault program





Social services organization (non-governmental - food bank, homeless shelter)





Substance abuse services





Tribal government/Tribal government agency





University/school





Victims/survivors





Other (specify): _______________________
























187. Coordination activities (Indicate methods used during the current reporting period to coordinate state victim services activities and/or to collaborate and coordinate with federal, state, and local entities engaged in activities to reduce or end violence against women. Check all that apply.)


  • E-mail

  • E-mail listserv

  • Facsimilex

  • Newsletters

  • Telephone/conference call

  • Toll-free telephone number

  • Tracking availability of victim services

  • U. S. mail

  • Webinar

  • Web site

  • Other (specify):




19. (Optional) Additional Iinformation (Use the space below to discuss the effectiveness of your system advocacy activities funded or supported by your State Coalitions-funded Program grant and to provide any additional information you would like to share about your system advocacy activities beyond what you have provided in the data above. An eExamples might includinclude:e We convened a multi-disciplinary task force of domestic violence programs, sexual assault programs and tribal government agencies which met for one in-person and 3 follow-up phone sessions to develop policies and procedures for more effectively serving tribal populations in our state resulting in an on-going collaboration with tribal leaders and a new level of trust.…………….





































C3. Policies

W ere your State Coalitions Program funds used to develop, substantially revise, or implement policies or protocols during the current reporting period? Check yes if State Coalitions Program-funded staff developed, substantially revised, or implemented policies or protocols or if State Coalitions Program funds were used to directly support the development or implementation of policies or protocols.

  • Yes--answer question 18

  • No--skip to C4


18. Types of policies and/or protocols developed, substantially revised, or implemented during the current reporting period (Check all the types of policies or protocols developed, substantially revised, or implemented with State Coalitions Program funds during the current reporting period. Use the SA column for policies and/or protocols addressing sexual assault and the DV column for those addressing domestic violence.)


Victim services

SA

DV

Appropriate response to underserved populations


Confidentiality

Mandatory training standards for staff and volunteers


Staff, board, and/or volunteers represent the diversity of your service area

Standards of service

Victim/survivor informed about Crime Victims Compensation and Victim Impact Statements


Other (specify) : ______________________


Health care

SA

DV

Advocate response to emergency room

Appropriate response to underserved populations


Forensic evidence collection and documentation


Forensic exams not billed to victim

Mandatory training on sexual assault, domestic violence, and stalking

Routine screening and referrals for sexual assault, domestic violence, and stalking

Other (specify): ____________________


Law enforcement

SA

DV

Appropriate response to underserved populations

Identifying primary aggressor/discouraging dual arrest


Immediate access to protection order information

Mandatory training on sexual assault, domestic violence, and stalking


No victims polygraphed

Pro-arrest/mandatory arrest



Protection order enforcement (including full faith and credit)



Providing information to victims/survivors about victim services



Other (specify): ______________________

Prosecution

SA

DV

Appropriate response to underserved populations

Mandatory training on sexual assault, domestic violence, and stalking

No victims polygraphed

Vertical prosecution

Victim witness notification

Other (specify): _____________________

Court

SA

DV

Accelerated trial schedules

Appropriate response to underserved populations

Dedicated sexual assault or domestic violence docket



Full faith and credit for protection orders



Immediate access to obtaining protection orders



Judicial monitoring of sexual assault, domestic violence, and stalking offenders



Mandatory training on sexual assault, domestic violence, and stalking


Policy against mutual restraining orders

Procedures for courtroom security

Other (specify): _______________________


Probation and parole policies

SA

DV

Strategies to assist and protect victim during probation and parole

Perform checks on police logs, criminal and civil databases

Special procedures for cases involving diverse, underserved populations

Offender accountability

Other (specify): ________________










C34. Products

Were your State Coalitions Program funds used to develop, substantially revise, or distribute products during the current reporting period? Check yes if State Coalitions Program-funded staff developed products or if State Coalitions Program funds directly supported the development, revision, or distribution of products.

  • Yes--answer question 201816

  • No--skip to section C45


20189. Use of State Coalitions Program funds for product development, substantial revision, or distribution (Report the number of products developed, substantially revised, or distributed with State Coalitions Program grant funds during the current reporting period. Report the number of new products developed or substantially revised during the current reporting period; the title/topic and intended audience for each product developed, revised, or distributed; and the number of products used or distributed. If a product was created in or translated into a language other than English, including Braille, indicate the language. Report on products that were newly developed or substantially revised during the current reporting period, whether or not they were used or distributed, and on products that were previously developed or revised but were used or distributed during the current reporting period.) Do not report the number of products printed or copied; only report the number developed or revised—in most cases that number will be one for each product described —and/or the number used or distributed. See separate instructions for examples of how to report under “developed or revised” and “used or distributed.”)


Products

Number developed or revised

Title/topic

Intended audience

Number used or distributed

Other languages

Brochures

Manuals

Newsletter

Training curricula

Training materials

Reports

Fact sheets

Web site (report number of page views in the used or distributed column)

Videos

Other (specify):

________________







CC45. Public Awareness

W ere your State Coalitions Program funds used for public awareness activities during the current reporting period? Check yes if State Coalitions Program-funded staff were used to support public awareness activities or if State Coalitions Program funds were used to directly support public awareness activities.

  • Yes--answer question 21-221920

  • No--skip to C56


210. Public awareness activities (Indicate the activitiesoutreach events that were supported with State Coalitions Program funds during the current reporting period. Indicate, by checking the appropriate box[box [es] whether the focus of the activity was sexual assault, domestic violence, stalking, or a combination of those issues. Check all that apply.)


Activities

Sexual assault

Domestic violence/Dating violence

Stalking

Community organizing/community events (rallies, speak outs, take back the night, vigils)

Clothesline Project

Educational exhibits (clothesline project, silent witness, information tables)

Concerts

Domestic Violence Awareness Month

Media campaigns (press conferences, public service announcements, articles)

Rallies/Speak Outs

Sexual Assault Awareness Month

Silent Witnesses

Stalking Awareness Month


Tabling at public events

Take Back the Night March

TheaterP productions for public awareness (video series, theater productions)

Video series

Vigils

Women’s History Month activities

Other (specify):_________________



22. (Optional) Additional Iinformation (Use the space below to discuss the effectiveness of your public awareness activities funded or supported by your State Coalitions-funded Program grant and to provide any additional information you would like to share about your public awareness activities beyond what you have provided in the data above. An example might include developing a video series documenting most effective advocacy provided to victims in rural communities, resulting in more awareness of the challenges and successes involved in this work being brought to community events, and to training sessions.




















C56. Technical Assistance

W ere your State Coalitions Program funds used to provide technical assistance during the current reporting period? Check yes if State Coalitions Program-funded staff provided technical assistance or if State Coalitions Program funds directly supported the provision of technical assistance.

  • Yes--answer questions 23-250-2121-22

  • No--skip to C67


2301. Number of technical assistance activities (Report the total number of technical assistance activities provided to programs during the current reporting period, indicating whether they were site visits or other types of consultations. Consultations may include in-person, telephonic, electronic, or other types of contact. Each contact should be counted as one activity.)


Recipients of technical assistance

Number of site visits

Number of other technical assistance consultations

Batterer intervention program



Corrections (probation, parole, and correctional facility)



Court (state or local)



Disability organization



Domestic violence program



Dual sexual assault and domestic violence program



Elder organization



Faith-based organization



Forensic examiner program



Government agency



Health care provider (excluding forensic examiner)



Immigration organization



Law enforcement (state or local)



Legal services/attorneys/law students



Mental health care provider



Military command staff



Other sState cCoalition



Prosecutor’s office (state or local)



Sexual assault program



Stalking program



Tribal sexual assault or domestic violence program



University/school



Youth program



Other (specify): _______________________________



TOTAL


















(Optional) Additional Information (Use the space below to discuss the effectiveness of your technical assistance activities and to provide any additional information you would like to share about your technical assistance activities beyond what you have provided in the data above.






2 43412. Topics of technical assistance (Check the topics that apply to technical assistance provided with State Coalitions Program funds during the current reporting period. The technical assistance provided may be categorized by more than one topic. Check all that apply.)


Topics of technical assistance

Sexual assault

Domestic violence/

Dating violence

Board development

Civil codes

Coordinated community response

Court response

Creating/sustaining diverse organizations

Criminal codes

Curricula and training issues

Developing or enhancing appropriate services for elder victims

Developing or enhancing appropriate services for victims who have disabilities

Developing or enhancing culturally appropriate services for underserved populations

Forensic evidence collection and documentation

Grant writing/reporting

Law enforcement response

Local policies and practices

Program development

Program evaluation

Probation and parole response

Prosecution response

Response to dating violence victims/survivors

Response to domestic violence victims/survivors

Response to sexual assault victims/survivors

Response to stalkingdomestic violence victims/survivors

Safety planning

Standards of service

State policies and practices

Technology and technology capacity (data collection systems and confidentiality)

Technology safety and security

Victim service administration and operations

Other (specify): _____________________________________

Other (specify): __________________________________________________


254. (Optional) Additional iInformation (Use the space below to discuss the effectiveness of your technical assistance activities funded or supported by your State Coalitions-funded Program grant and to provide any additional information you would like to share about your technical assistance activities beyond what you have provided in the data above. An example might include site visits to organizations working with older women in 3 counties to document best practices when working with older victims of domestic violence, resulting in open conversations with those providing services and requests for more training on effective advocacy for this underserved population.



23. (Optional) Additional Information (Use the space below to discuss the effectiveness of your technical assistance activities and to provide any additional information you would like to share about your technical assistance activities beyond what you have provided in the data above. An example might include site visits to organizations working with older women in 3 counties to document best practices when working with older victims of domestic violence, resulting in open conversations with those providing services and requests for more training on effective advocacy for this underserved population.




C67. Standards of Service

W ere your State Coalitions Program funds used to develop or enhance standards of service for member programs/agencies during the current reporting period? Check yes if State Coalitions Program-funded staff were used to develop or enhance standards of service or if State Coalitions Program funds were used to directly support the development or enhancement of standards of service.

  • Yes--answer question 2623

  • No--skip to C78


2623. Development or enhancement of standards of service for member programs/agencies (Indicate if State Coalitions Program funds were used to develop, implement, or enhance standards of service or provide training on standards of service for member programs. Check all that apply.)

Sexual assault

Domestic violence/Dating violence

Developing standards of service for members programs/agencies

Implementing standards of service for members

Enhancing standards of service for members programs/agencies

Training on standards of service for members











C78. Underserved Populations

W ere your State Coalitions Program funds used to develop or enhance standards of service for underserved populations or to encourage the representation of underserved populations in coordination activities during the current reporting period? Check yes if State Coalitions Program-funded staff were used to develop or enhance services for underserved populations or if State Coalitions Program funds directly supported representation of underserved populations in coordination activities.

  • Yes--answer question 27-293-244-25

  • No--skip to C89


2734. Activities addressing underserved populations (Check all activities in which State Coalitions Program funds were used to develop or enhance services for underserved populations or to encourage the representation of underserved populations in coordination services. Check the boxes in the appropriate columns to indicate whether the activities you engaged in were for sexual assault or domestic violence programs/services.)


Activity

Sexual assault

Domestic violence/

Dating Violence

Developing/distributing materials for underserved populations

Developing policy

Identifying gaps in services

Identifying underserved populations

Increasing organizational capacity for anti-oppression work

Supporting representatives of historically underserved groups to participate in meetings

Coordinating a task force/caucus to address issues concerning underserved populations

Training/technical assistance regarding culturally appropriate services for historically underserved populations

Other (specify):

___________________________________________________________________


2845. Underserved populations (Indicate which underserved populations were addressed in the activities indicated in question 246. Check all that apply.)


Victims/survivors who:

  • live in rural areas

  • are American Indian or Alaska Native

  • are Asian

  • are black or African American

  • are disabled

  • are elderly

  • are Hispanic or Latino

  • are homeless or living in poverty

  • are immigrants, refugees, or asylum seekers

  • are lesbian, gay, bisexual, transgender, or intersex

  • are Native Hawaiian or other Pacific Islander

  • have disabilities

  • have limited English proficiencyanguage barriers

  • have mental health issuesproblems

  • have substance abuse issuesproblems

  • Other (specify):








29. (Optional) Additional iInformation (Use the space below to discuss the effectiveness of your activities to reach underserved populations funded or supported by your State Coalitions-funded Program grant and to provide any additional information you would like to share about your activities to reach underserved populations beyond what you have provided in the data above. An example might include: We are identifying gaps in service for immigrants and refugees in our state through interviews with service providers for this underserved population. This has resulted in the identification of the need to include immigrants and refugees in two upcoming meetings to develop action steps.)



















C 89. Organizational Development and Capacity Building

Were your State Coalitions Program funds used for organizational development and/or capacity building during the current reporting period? Check yes if State Coalitions Program-funded staff were used for organizational development and/or capacity building activities or if State Coalitions Program funds were used to directly support organizational development and/or capacity building.

  • Yes--answer questions 230-315-26

  • No--skip to D


3026.5. Coalition development and capacity building (Check all of the activities that were engaged in with State Coalitions Program funds during the current reporting period.)




Anti-oppression work

Board of directors

Communication (TTY, language lines, etc.)

Emergency preparedness

Equipment purchase (computers, printers, faxes, telephones, cell phones, etc.)

Evaluation/outcome measures

Identifying gaps in service

Internet capacity/e-mail accounts/listserv

Office space

Outreach to diverse/underserved populations

Personnel policies

Software purchase or development

Staff development

Strategic planning

Technology security and safety

Toll-free telephone line

Web site development or enhancement

Other (specify):______________________


31267. Do you consider system privacy and/or security when purchasing or developing software?

  • Yes

  • No

D . NARRATIVE


All grantees must answer question 32278.

Please limit your response to four pages for this question.

32.278. Report on the status of the goals and objectives for the State Coalitions Program grant (Using Appendix A as a guide, rReport on the status of the goals and objectives for your grant as of the end of the current reporting period, as they were identified in your grant proposal or as they have been added or revised. Indicate whether the activities related to your objectives for the current reporting period have been completed, are in progress, are delayed, or have been revised. Comment on your successes and challenges, and provide any additional explanation you feel is necessary for us to understand what you have or have not accomplished relative to your goals and objectives. If you have not accomplished objectives that should have been accomplished during the current reporting period, you must provide an explanation.)


All grantees must answer questions 33289 and 34 2930 on an annual basis. Please submit this information on the January to June reporting form only.

Please limit your response to two pages for each question.

33289. What do you see as the most significant areas of remaining need, with regard to improving services to victims/survivors or sexual assault, domestic violence, dating violence and stalking, increasing victim/survivor safety, and enhancing community response (including and offender accountability for both batterers and sex offenders)? (Consider geographic regions, underserved populations, service delivery systems, types of victimization, and challenges and barriers unique to your state.)

34.2930. What has the State Coalitions Program funding allowed you to do or maintain that you could not do without receiving this funding? (For example, has the funding enabled you to identify gaps in services, improve culturally appropriate services to underserved populations, staff coalition office full time, or increase the participation rate of historically underserved communities in coordination meetings? Provide specific examples in your answer.)


Questions 335-36 are01 is optional.

Please limit your response to two pages for this question.


3510. Provide any additional information that you would like us to know about your State Coalitions Program grant and/or the effectiveness of your grant. (If you have other data or information regarding your program that would more fully or accurately reflect the effectiveness of your State Coalitions Program-funded program than the data you have been asked to provide on this form, answer this question. If you have not already done so elsewhere on this form, you may want to report on systems-level changes, community collaboration, the removal or reduction of barriers and challenges for victims/survivors, use of volunteers and/or interns to complete activities, promising practices, and positive or negative unintended consequences.)


361. Provide any additional information that you would like us to know about the data submitted. (If you have any information that could be helpful in understanding the data you have submitted in this report, please answer this question. For example, if you submitted two different progress reports for the same reporting period, you may explain how the data was apportioned to each report; or if you funded staff—e.g., victim advocates, law enforcement officers, etc.-- but did not report any corresponding victim services or law enforcement activities, you may explain why; or if you did not use program funds to support either staff or activities during the reporting period, please explain how program funds were used, if you have not already done so.)













Public Reporting Burden

Paperwork Reduction Act Notice. Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. We try to create forms and instructions that are accurate, can be easily understood, and which impose the least possible burden on you to provide us with information. The estimated average time to complete and file this form is 60 minutes per form. If you have comments regarding the accuracy of this estimate, or suggestions for making this form simpler, you can write to the Office on Violence Against Women, U.S. Department of Justice, 810 7th Street, NW, Washington, DC 20531.

APPENDIX A


Use this table only as a guide for the reporting format.


Goals/Objectives (Describe your goals and objectives, as outlined in your grant proposal, or as revised)

Key Activities

Status (e.g., completed, in progress, delayed, revised)

Comments (successes, challenges, explanations)



















State Coalitions Page 10 2/4/20210

State Coalitions 2/4/202104/20/2004

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File TitleCOALITIONS Page 3 DRAFT
AuthorJAtkins
Last Modified ByAnita St. Onge
File Modified2008-04-08
File Created2008-04-08

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