1122-0007 Semi-annual Progress Report for the LAV Program

Semi-Annual Progress Report for Grantees of the Legal Assistance for Victims Grant Program

LAV semiform 5-19-08

OMB: 1122-0007

Document [pdf]
Download: pdf | pdf
OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
Date
Expiration
Date: 02/28/2007

U.S. Department of Justice
Office on Violence Against Women
SEMI-ANNUAL PROGRESS REPORT FOR
Legal Assistance to Victims Grant Program
Brief Instructions: This form must be completed for each Legal Assistance for Victims Program (LAV Program) grant received. The grant administrator or coordinator must ensure that the form is completed fully
with regard to all grant-funded activities. Grant partners, however, may complete sections relevant to their
portion of the grant. Grant administrators and coordinators are responsible for compiling and submitting a
single report that reflects all information collected from grant partners.
All grantees should read 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 E must be completed by
all grantees. In section A, subsection A1 must be answered. In section C, subsection C2 must be answered.
In Section D and subsections A2, C1, C3, C4, and C5, grantees must answer an initial question about
whether they engaged in certain activities during the current reporting period. If the response is yes, then the
grantee must complete that section or subsection. If the response is no, the rest of that section or subsection is skipped.
For example, 1) if you are a legal services organization providing legal services with staff funded under this
grant, you would complete sections A, B, D, E, and subsection C2 (and answer “no” in C1, C3, C4 and C5); or
2) if you receive funds for staff to provide training and technical assistance and funds for data collection, you
would complete sections A, B, and E, and subsections C1, C2, C4, and C5 (and answer “no” in C3).
The activities of volunteers or interns should be reported if they were coordinated or supervised by LAV Program-funded staff or if LAV Program grant 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
Section A:
A1:
A2:
Section B:
Section C:
C1:
C2:
C3:
C4:
C5:
Section D:
Section E:

General Information
Grant Information
Staff Information
Purpose Areas
Function Areas
Training
Coordinated Community Response
Products
Technical Assistance
Data Collection
Victim Services/Legal Services
Narrative

Page Number
1
1
3
4
5
5
8
10
11
12
13
21

LAV Program Semi-annual Progress Report • Office on Violence Against Women

SECTION

OMB Clearance # 1122-0007
OMB Clearance # 1121-0276
Expiration
Date
Expiration
Date: 02/28/2007

A1

GENERAL INFORMATION
Grant Information

All grantees must complete this section.

1.

Date of report

2.

Current reporting period

3.

Grantee name

4.

Grant number
(the federal grant number assigned to your LAV Program grant)
Supplement number
(if appropriate)
5.

January 1-June 30

July 1-December 31

(Year)

Type of grantee organization
(Check the one answer that best describes the organization receiving the LAV Program funds.)
Bar association
Bar foundation/IOLTA administrator
Law school
Legal aid/assistance (non-Legal Services Corporation)
Legal services organization (Legal Services Corporation funded)
State coalition
Tribal government/organization
Victim services (domestic violence)
Victim services (dual—domestic violence/sexual assault)
Victim services (sexual assault)
Other (specify):

5a. Is this organizationou a faith-based organization?
Yes
6.

No

Point of contact
(person responsible for the day-to-day coordination of the grant)
First name

MI

Last name

Agency/organization name
Address
City

State

Telephone

Zip code

Facsimile

E-mail
7.

Does this grant specifically address tribal populations?
(Check yes if your LAV Program grant focuses on tribal populations, and indicate which tribes or nations
you serve or intend to serve.)
Yes

No

If yes, which tribes/nations:

LAV Program Semi-annual Progress Report • 1 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
Date
Expiration
Date: 02/28/2007

8.

What percentage of your LAV Program grant funds was directed to each of these areas?
(Report the area(s) addressed by your LAV Program grant during the current reporting period and estimate the approximate percentage of funds [or resources] used to address each area [consider training,
victim services, etc.]. The grantee may choose how to make this determination.)
Throughout this form, the term sexual assault includes both assaults committed by offenders who are
strangers to the victim/survivor and assaults committed by offenders who are known to, or related by
blood or marriage to, or in a dating relationship with the victim/survivor. The term domestic violence/
dating violence applies to any pattern of coercive behavior that is used by one person to gain power
and control over a current or former intimate partner or dating partner. Stalking is defined as a course
of conduct directed at a specific person that would cause a reasonable person to fear for his or her
safety or the safety of others, or suffer substantial emotional distress. (See separate instructions for
more complete definitions.)
Percentage of grant funds
Sexual assault
Domestic violence/dating violence
Stalking
TOTAL

100%

LAV Program Semi-annual Progress Report • 2 • Office on Violence Against Women

SECTION

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
DateDate: 02/28/2007
Expiration

A2

Staff Information

Were LAV Program funds used to fund staff positions during the current reporting period?
Check yes if LAV Program grant 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 the LAV Program grant during
the current reporting period. Report staff by functions performed, not by title or location. Include employees who are part-time and/or only partially funded with these grant funds, as well as consultants/
contractors. 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 attorney in October who was 100%
funded with LAV Program funds, you would report that as .5 FTE. Report all FTEs in decimals, not percentages. One FTE is equal to 1,040 hours—40 hours per week x 26 weeks. See separate instructions
for examples of how to calculate FTEs.)
Staff

FTE(s)

Administrator (fiscal manager, executive director)
Attorney
Information technology staff
Law student/intern
Legal advocate (does not include attorney or paralegal)
Paralegal
Program coordinator (training coordinator, legal staff coordinator)
Support staff (administrative assistant, bookkeeper, accountant)
Trainer
Translator/interpreter
Victim advocate (includes domestic violence, sexual assault, and dual)
Other (specify):
TOTAL

LAV Program Semi-annual Progress Report • 3 • Office on Violence Against Women

SECTION

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
Expiration
DateDate: 02/28/2007

B

Purpose Areas

All grantees must complete this section.

10. Statutory purpose areas
(Check all purpose areas that apply to activities supported with LAV Program grant funds during the
current reporting period.)
Check ALL
that apply

Purpose areas

To implement, expand, and establish cooperative efforts and projects between domestic
violence and sexual assault victim services organizations and legal assistance providers
to provide legal assistance for victims of sexual assault, stalking, domestic violence, and
dating violence. (In most cases, this purpose area refers to legal services organizations.)
To implement, expand and establish efforts and projects to provide legal assistance for
victims of domestic violence, dating violence, stalking, and sexual assault by organizations with a demonstrated history of providing direct legal or advocacy services on behalf
of these victims. (In most cases, this purpose area refers to victim services organizations.)
To provide training, technical assistance and data collection to improve the capacity of
grantees and other entities to offer legal assistance to victims of domestic violence, dating violence, stalking, and sexual assault.

11. Special interest categoriess addressed by your grant
(In addition to the purpose areas identified above, the LAV Program Grant Application and Program
Guidelines may have identified several special interest categories or program priorities that would receive priority consideration. If your program addressed any of these special interest categories or priorities during the current reporting period, list them below.)

LAV Program Semi-annual Progress Report • 4 • Office on Violence Against Women

SECTION

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
Date
Expiration
Date: 02/28/2007

C1

FUNCTION AREAS
Training

Were your LAV Program funds used for training during the current reporting period?
Check yes if LAV Program-funded staff provided training or if grant funds directly supported the training.
Yes—answer questions 12-14
No—skip to C2
12. Training events provided
(Report the total number of training events during the current reporting period that were either provided by LAV Program-funded staff or directly supported by LAV Program funds. For purposes of this
reporting form, training provided to LAV Program-funded staff should not be counted. For purpposes of
this reporting form, training means providing information on sexual assault, dating violence, domestic
violence, and/or stalking that enables professionals )
Total number of training events provided
13. Number of people trained
(Report the number of people trained during the current reporting period by LAV Program-funded staff
or training supported by LAV Program funds. Use the category that is most descriptive of the people
who attended the training event. LAV Program-funded staff attending training events should not be
counted as people trained. If you do not know how many people to report in specific categories, you
may report the overall numberthem in “Multidisciplinary,” but this category should be used only as
a last resort. Students, community members, and victims should not be reported as people trained,
since they are not professionals responding to victims.)
People trained

People trained
Advocacy organization staff
(NAACP, AARP)
Attorneys (does not include prosecutors)
Bar association/volunteer lawyer
program staff
Batterer intervention program
staff
Child welfare workers/advocates
Court personnel (judges, clerks)
Disability organization staff (nongovernmental)
Domestic violence coalition staff
(state or tribal)
Elder organization staff (nongovernmental)
Faith-based organization staff
Government agency staff (vocational rehabilitation, food stamps,
TANF)
Health professionals (doctors,
nurses)
Immigrant organization staff
Law enforcement officers
Legal services staff (does not
include attorneys)

Number

Number

People trained
Law students
Mental health professionals
Multidisciplinary (various disciplines at
same training)
Prosecutors
Sex offender treatment providers
Sexual assault coalition staff (state or
tribal)
Social services organization staff (nongovernmental—food bank, homeless
shelter)
Supervised visitation and exchange
center staff
Translators/interpreters
Tribal government/Tribal government
agency staff
Victim advocates (non-governmental,
includes sexual assault, domestic violence, and dual)
Victim-assistants (governmental, includes victim-witness specialists/coordinators)
Volunteers
Other (specify):
TOTAL

LAV Program Semi-annual Progress Report • 5 • Office on Violence Against Women

Number

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
Date: 02/28/2007
Expiration
Date

14. Training content areas
(Indicate all topics covered in training events provided or directly supported with your LAV Program
funds during the current reporting period. Check all that apply.)
Confidentiality
Consumer/finance (credit, debt,
bankruptcy, tax, etc.)
Dating violence laws
Dating violence overview, dynamics
and services
Divorce/custody/visitation/child
support
Domestic violence laws
Domestic violence overview,
dynamics and services
Housing
Identifying legal issues
Immigration
Protection orders (including full
faith and credit)
Public benefits (TANF, disability,
food stamps, unemployment)
Relocation
Representation/advocacy for victims/survivors within the criminal
justice system
Representation/advocacy for victims/survivors within the educational system
Response to victims/survivors who
have been trafficked
Safety planning
Serving underserved/unserved
populations
Sexual assault laws
Sexual assault overview, dynamics
and services
Stalking laws
Stalking overview, dynamics and
services
Other (specify):

Issues specific to victims/survivors who:
are American Indian or Alaska Native
are Asian
are black or African American
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 proficiency
have mental health issues
have substance abuse issues
live in rural areas
Other (specify):

LAV Program Semi-annual Progress Report • 6 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
Date: 02/28/2007
Expiration
Date

15. (Optional) Additional information
(Use the space below to discuss the effectiveness of training activities funded or supported by your LAV
Program grant and to provide any additional information you would like to share about your training activities beyond what you have provided in the data above. An example might be an increased number
of referrals of sexual assault victims/survivors to your organization from both governmental and nongovernmental victim advocates following a training provided to both groups on identifying legal issues
for these victims/survivors.)

LAV Program Semi-annual Progress Report • 7 • Office on Violence Against Women

SECTION

OMB Clearance # 1122-0007
OMB Clearance # 1121-0276
Expiration
DateDate: 02/28/2007
Expiration

C2

Coordinated Community Response
All grantees must answer this subsection.

16. Coordinated community response activities
(Check the appropriate boxes to indicate the agencies or organizations, even if they are not memorandum of understanding memorandum of understanding [MOU] partners, that you provided victim/
survivor referrals to, received victim/survivor referrals from, engaged in consultation regarding victims/
survivors with, provided technical assistance regarding victims/survivors to, and/or attended meetings
with, during the current reporting period, according to the usual frequency of the interactions. If the
interactions were not part of a regular schedule, you will need to estimate the frequency with which
these interactions occurred during the current reporting period. If LAV-funded staff participated in a
task force or work group, indicate that under “Meetings” by checking the frequency of the meetings and
the types of organizations participating. In the last column, indicate the agencies or organizations with
which you have an [MOU] for purposes of the LAV Program grant.)
Agency/organization

Advocacy organization
(NAACP, AARP)

Victim/survivor referrals,
consultations, technical assistance
Daily
Weekly Monthly

Meetings
Weekly

Monthly Quarterly

Corrections (probation,
parole, and correctional
facility)
Court
Domestic violence organization
Educational institution/
organization
Faith-based organization
Government agency (INS,
Social Security, TANF)
Health/mental health
organization
Law enforcement
Legal organization (legal
services, bar association,
law school)
Prosecutor’s office
Sexual assault organization
Sex offender management/sex offender treatment provider
Social service
organization (non-governmental)
Tribal government/Tribal
government agency
Other (specify):
LAV Program Semi-annual Progress Report • 8 • Office on Violence Against Women

MOU
Partner

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
DateDate: 02/28/2007
Expiration

16a. Number of communities with improved CCR capacity
(Provide the number of communities that have improved their capacity to respond to domestic violence,
dating violence, sexual assault, and stalking as a result of the coordinated community response activities described above. For purposes of this question, a community may be defined as a city or town that
you serve, but in larger metropolitan areas a “community” may be a neighborhood or borough.)
Number of communities
17. (Optional) Additional information
(Use the space below to discuss the effectiveness of CCR activities funded or supported by your LAV
Program grant and to provide any additional information you would like to share about those activities
beyond what you have provided in the data above. An example might be an improved judicial response
to victims/survivors requesting protection orders, as the result of meetings of a regional task force that
included victim advocates, legal services attorneys, and judges.)

LAV Program Semi-annual Progress Report • 9 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
DateDate: 02/28/2007
Expiration
SECTION

C3

Products

Were your LAV Program funds used to develop, substantially revise, or distribute products during
the current reporting period?
Check yes if LAV Program-funded staff developed products, or if LAV Program funds directly supported
the development, revision, or distribution of products.
Yes—answer question 18
No—skip to C4
18. Use of LAV Program funds for product development, substantial revision, or distribution
(Report the number of products developed, substantially revised, or distributed with LAV 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 of 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 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

Brochures

Client
education
materials

Manuals

Training
curricula

Training
materials

Other
(specify):

LAV Program Semi-annual Progress Report • 10 • Office on Violence Against Women

Other
languages

SECTION

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
DateDate: 02/28/2007
Expiration

C4

Technical Assistance

Were your LAV Program funds used to provide technical assistance during the current reporting
period?
Check yes if grant-funded staff provided technical assistance or if grant funds directly supported the
provision of technical assistance.
Yes—answer question 19
No—skip to C5
19. Technical assistance provided
(Indicate the area[s] of technical assistance addressed and the type of recipient. Technical assistance
is any of a wide variety of activities designed to facilitate individual or agency change in some systematic manner by providing expertise to solve a problem. Check all that apply.)
Sexual assault Domestic violence/ Stalking
dating violence
Attorneys
Friends of the court/mediators/guardians ad litem
Judges
Legal services staff
Prosecutors
Victim advocates
Other (specify):

LAV Program Semi-annual Progress Report • 11 • Office on Violence Against Women

SECTION

OMB
Clearance # 1122-0007
OMB Clearance # 1121-0276
Expiration
Date
Expiration
Date: 02/28/2007

C5

Data Collection

Were your LAV Program funds used to develop, install, expand, or coordinate data collection
systems during the current reporting period?
Check yes if LAV Program funds or LAV Program-funded staff were used to develop, install, expand, and/
or coordinate data collection systems.
Yes—answer question 20
No—skip to section D
20. Use of LAV Program funds for data collection systems
(Check all that apply.)
Develop new data collection system
Install data collection systems
Expand existing data collection system
Coordinate existing data collection
Purchase computers and other equipment

LAV Program Semi-annual Progress Report • 12 • Office on Violence Against Women

SECTION

OMB Clearance # 1122-0007
OMB Clearance # 1121-0276
Expiration
Date
Expiration
Date: 02/28/2007

D

VICTIM SERVICES/LEGAL SERVICES

Were your LAV Program funds used to provide victim services and/or legal services to victims/
survivors during the current reporting period?
Check yes if LAV Program grant-funded staff provided these services to victims/survivors, or if grant
funds were used to support these services.
Yes—answer questions 21-24 and 25-31 as appropriate. Provide information only on victims/
survivors served with LAV Program funds. If your LAV Program funds were used to work with
pro bono attorneys and/or law students, also answer questions 32-33.
No—skip to section E
21. Number of victims/survivors served, partially served, and victims/survivors seeking services who
were not served
Please do not answer this question without referring to the separate instructions for further explanation
and examples of how to distinguish among these categories.
(Report the following, to the best of your ability, as an unduplicated count for each category during the
current reporting period. This means that each victim/survivor who was seeking or who received services during the current reporting period should be counted only once in that reporting period. For purposes of this question, victims/survivors are those against whom the sexual assault, domestic violence,
dating violence or stalking was directed. If the victim/survivor presented with more than one victimization, that person should be counted only once under the primary victimization. Do not report secondary victims here.)
Sexual Domestic violence/
Stalking TOTAL
assault
dating violence
A. Served: victims/survivors who received the
service(s) they requested, if those services were
funded by your LAV Program grant
B. Partially served: victims/survivors who received
some service(s), but not all of the services they requested, if those services were funded by your LAV
Program grant
TOTAL SERVED AND PARTIALLY SERVED (21A + 21B)
C. Victims/survivors seeking services who were not
served: victims/survivors who sought service(s) and
did not receive the service(s) they were seeking, if
those services were funded by your LAV Program grant
22. Reasons victims/survivors seeking services were not served or were partially served
(Check all that apply.)
Conflict of interest
Program reached capacity
Did not meet statutory requirements
Hours of operation
Insufficient/lack of culturally appropriate services
Insufficient/lack of language capacity (including sign language)
Insufficient/lack of services for people with
disabilities
Lack of child care

Program unable to provide service due to limited resources/priority-setting
Services inappropriate or inadequate for victims/survivors with substance abuse issues
Services inappropriate or inadequate for victims/survivors with mental health issues
Services not appropriate for victim/survivor
Transportation
Other (specify):

Need not documented

LAV Program Semi-annual Progress Report • 13 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
Date: 02/28/2007
Expiration
Date

23. Demographics of victims/survivors served or partially served
(Based on the victims/survivors reported in 21A and 21B, report the total numbers for all that apply. Because victims/survivors may identify in more than one category of race/ethnicity, the total for
“Race/ethnicity” may exceed the total number of victims/survivors reported in 21A and 21B. However,
the total number of victims/survivors reported under “Race/ethnicity” should not be less than the total
number of victims/survivors reported in 21A and 21B. The total number of victims/survivors reported
under “Gender” and the total number reported under “Age” should equal the total number of victims/
survivors reported in 21A and 21B. Those victims for whom gender, age, and/or race/ethnicity are not
known should be reported in the “Unknown” category.)
Race/ethnicity (victims/survivors should not be counted more than once
Number of victims/
in either the category “American Indian and Alaska Native” or in the categosurvivors
ry “ Native Hawaiian and other Pacific Islander” )
American Indian and Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian and other Pacific Islander
White
Unknown
TOTAL RACE/ETHNICITY (should not be less than the sum of 21A and 21B)
Gender
Female
Male
Unknown
TOTAL GENDER (should equal the sum of 21A and 21B)
Age
0-12
13-17
18-24
25-59
60 +
Unknown
TOTAL AGE (should equal the sum of 21A and 21B)
Other demographics
People with disabilities
People with limited English proficiency
People who are immigrants/refugees/asylum seekers
People who live in rural areas

LAV Program Semi-annual Progress Report • 14 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
DateDate: 02/28/2007
Expiration

24. Victims’/survivors’ relationship to offender
(For those victims/survivors reported as served and partially served in questions 21A and 21B, report
the victim/survivor relationship to the offender by type of victimization. If a victim/survivor experienced
more than one type of victimization and/or was victimized by more than one perpetrator, count the victim/survivor in all categories that apply. The total number of relationships in the sexual assault column
must be at least [insert sum of sexual assault victims/survivors reported in 21A and 21B]; the total
number in the domestic violence/dating violence column must be at least [insert sum of domestic violence victims/survivors reported in 21A and 21B]; and the total number in the stalking column must be
at least [insert sum of stalking victims/survivors reported in 21A and 21B].)
Number of victims/survivors relationships
Victim’s relationships to offender
Domestic violence/ Stalking
Sexual
dating violence
assault
Current or former spouse or intimate partner
Other family or household member
Dating relationship
Acquaintance (neighbor, employee, co-worker,
schoolmate, student, etc.)
Stranger
Relationship unknown
TOTAL
25. Victim services provided by lawyers
(Report the number of victims/survivors from 21A and 21B who received the following services from
LAV Program-funded lawyers during the current reporting period by type of service. Count each victim/
survivor only once for each type of service that victim/survivor received during the current reporting
period; do not report the number of times that service was provided to the victim/survivor. The total for
each type of service should not be higher than the total of 21A and 21B [insert total of 21A and 21B].
Note that question 27 below addresses the provision of legal services to victims/survivors.)
Victim services provided by lawyers

Number of victims/survivors

Safety planning
Support services (assisting the victim/survivor to obtain resources or
services including employment, health care, child care, etc.)
Pro se clinics/group services
26. Victim services provided by other staff
(Report the number of victims/survivors from 21A and 21B who received the following services from
other LAV Program-funded staff [e.g., paralegals, advocates, case managers, etc.] during the current
reporting period by type of service. Count each victim/survivor only once for each type of service received during the current reporting period; do not report the number of times that service was provided
to the victim/survivor. The total for each category of service should not be higher than the total of 21A
and 21B [insert total of 21A and 21B].)
Victim services provided by other staff

Number of victims/survivors

Safety planning
Support services (assisting the victim/survivor to obtain resources or
services including employment, health care, child care, etc.)
Non-attorney legal advocacy (assisting the victim/survivor in preparing
legal paperwork, accompanying her to court or administrative
proceedings, etc.)
Pro se clinics/group services
LAV Program Semi-annual Progress Report • 15 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
DateDate: 02/28/2007
Expiration

27. Legal issues
(Report the total number of new and pending matters in which the following legal issues were addressed by
LAV-funded staff during the current reporting period. Count a victim/survivor once for each category of legal issue for which they received assistance. A pending matter is one that was open as of the first day of the
current reporting period; a new matter is one that was opened during the current reporting period.)
Number of victims/survivors
Legal issues
Pending
New

A. Protection orders (temporary and final, enforcement of existing PO)
B. Family law matters
Divorce
Custody/visitation
Establishment of paternity
Child/spousal support
Other family law matters
C. Consumer/finance (credit, debt, bankruptcy, tax, etc.)
D. Employment
E. Income maintenance (TANF, disability, food stamps, unemployment)
F. Housing
G. Immigration
VAWA self-petition
Cancellation of removal
Green card application
U visa
T visa
Other immigration matters
H. Criminal issues (sexual assault, domestic violence/dating violence, stalking. Does not include defending victims accused of criminal activities.)
I. Educational issues
J. Other (specify):
28. Number of victims/survivors who received assistance with multiple legal issues
(Report the number of victims/survivors who received LAV Program-funded services in more than one of
the categories [A-J] listed in question 27 during the current reporting period. For purposes of this question,
consider all family law matters [section B] as one category and all immigration matters [section G] as one
category.)

LAV Program Semi-annual Progress Report • 16 • Office on Violence Against Women

OMB
Clearance
# 1122-0007
OMB
Clearance
# 1121-0276
Expiration
Date
Expiration
Date: 02/28/2007

29. Comprehensive services
(If victims/survivors received other needed legal services for matters such as those listed in question 27
from other sources [i.e., from your organization but with non-LAV funds, or from another source, such as pro
bono attorneys], describe those sources. You may provide data to demonstrate that those additional needs
of victims/survivors were met. Please limit your response to two pages.)

LAV Program Semi-annual Progress Report • 17 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance # 1121-0276
Expiration
Date
Expiration Date: 02/28/2007

30. Legal outcomes
(For all cases closed or issues resolved during the current reporting period for which services were provided by LAV Program-funded lawyers, paralegals, or specially appointed advocates, report the number
and type of outcome for each issue addressed and resolved. Include all outcomes in all matters.) L
Information/ Brief Administrative Court Negotiated resolution Victim/ Other
Legal issue
survivor result
referral/ services
decision
decision Filed
No filed withdrew
advice only
action
action
Protection
orders (temporary and final,
enforcement of
existing PO)
Divorce
Custody/
visitation
Establishment
of paternity
Child/spousal
support
Other family
law matters
Consumer/
finance (credit,
debt, bankruptcy, tax, etc.)
Employment
Income maintenance (TANF,
disability, food
stamps, unemployment)
Housing
VAWA self-petition
Cancellation of
removal
Green card application
U Visa
T Visa
Other immigration matters
Criminal issues
Educational issues
Other (specify):
LAV Program Semi-annual Progress Report • 18 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
Date
Expiration
Date: 02/28/2007

31. (Optional) Additional information
(Use the space below to discuss the effectiveness of the legal services you have provided to victims
and to share any additional information about your legal services activities beyond what you have provided in the data above. An example might be that you are requesting and obtaining protection orders
that address child and spousal support as well as custody and visitation on a regular basis on behalf of
victims/survivors.)

LAV Program Semi-annual Progress Report • 19 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
Date
Expiration
Date: 02/28/2007

32. a. Pro bono attorneys
(Report the total number of pro bono attorneys recruited, trained, mentored or coordinated using LAV
funds during the current reporting period.)
Recruited
Trained
Mentored
Coordinated
b. Cases accepted
(Report the number of cases accepted by pro bono attorneys during the current reporting period.)
c. Cases completed
(Report the number of cases completed by pro bono attorneys during the current reporting period.)

33. a. Volunteer law students
(Report the total number of law students recruited, trained, mentored, or coordinated using LAV funds
during the current reporting period.)
Recruited
Trained
Mentored
Coordinated

b. Cases worked on
(Report the number of cases worked on by law students during the current reporting period.)

LAV Program Semi-annual Progress Report • 20 • Office on Violence Against Women

SECTION

OMBOMB
Clearance
# 1122-0007
Clearance # 1121-0276
Expiration
Date
Expiration Date: 02/28/2007

E

NARRATIVE

All grantees must answer question 34.
34. Report on the status of your LAV Program grant goals and objectives as of the end of the current
reporting period.
(Report succinctly on the status of the goals and objectives for your LAV Program grant as of the end of
the current reporting period, as they were identified grant proposal 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 briefly 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 providing direct legal services must answer question 35.
PLEASE LIMIT YOUR RESPONSE TO 8,000 CHARACTERS FOR THIS QUESTION.
35. Describe the nature of the outcomes achieved for victims/survivors during the current reporting
period. Discuss the reasons for those outcomes and, if appropriate, any systemic patterns or practices that you believe were contributing factors to the outcomes of specific cases or to cases in
general involving victims/survivors.
All grantees must answer questions 36 and 37 on an annual basis. Submit responses on the January to
June reporting form only.
PLEASE LIMIT YOUR RESPONSE TO 8,000 CHARACTERS FOR EACH QUESTION.
36. What do you see as the most significant areas of remaining need, with regard to meeting the civil
legal needs of victims/survivors of sexual assault, domestic violence, dating violence, and stalking?
(Consider geographic regions, underserved populations, service delivery systems, types of legal problems, and challenges and barriers unique to your state or service area.)
37. What has LAV Program funding allowed you to do that you could not do prior to receiving this funding?
(e.g., expanding service areas and populations served, expanding range of services offered to victims/
survivors)
Question 38 and 39 are optional.
PLEASE LIMIT YOUR RESPONSE TO 8,000 CHARACTERS FOR EACH QUESTION.
38. Provide any additional information that you would like us to know about your LAV Program grant
and/or the effectiveness of your grant.
(If you have any other data or information that you have not already reported in answer to previous
questions on this form that demonstrate the effectivenes of your LAV Program-funded program, please
provide it below. Feel free to discuss any of the following: systems-level changes, community collaboration, the removal or reduction of barriers and challenges for victims/survivors, promising practices,
positive or negative unintended consequence.)
39. 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; if you funded
staff-e.g., advocates and attorneys-- but did not report any corresponding victim services or legal services, 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.
LAV Program Semi-annual Progress Report • 21 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
Date
Expiration
Date: 02/28/2007

Report on the status of your LAV Program grant goals and objectives as of the end of the current reporting
period. - Question #34

Status (100 characters)
Goals/Objectives (1,750 characters)

Key Activities (1,750 characters)

Comments (500 characters)

Goals/Objectives

Status

Key Activities

Comments

LAV Program Semi-annual Progress Report • 22 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
Date
Expiration
Date: 02/28/2007

Report on the status of your LAV Program grant goals and objectives as of the end of the current reporting
period. - Question #34 (cont. 1)

Status
Goals/Objectives

Key Activities

Comments

Goals/Objectives

Status

Key Activities

Comments

LAV Program Semi-annual Progress Report • 23 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance # 1121-0276
Expiration
Date
Expiration Date: 02/28/2007

Report on the status of your LAV Program grant goals and objectives as of the end of the current reporting
period. - Question #34 (cont. 2)

Status
Goals/Objectives

Key Activities

Comments

Goals/Objectives

Status

Key Activities

Comments

LAV Program Semi-annual Progress Report • 24 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance # 1121-0276
Expiration
Date
Expiration Date: 02/28/2007

Describe the nature of the outcomes achieved for victims/survivors during the current reporting period.
Discuss the reasons for those outcomes and, if appropriate, any systemic patterns or practices that you
believe were contributing factors to the outcomes of specific cases or to cases in general involving victims/
survivors. - Question #35

LAV Program Semi-annual Progress Report • 25 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
DateDate: 02/28/2007
Expiration

Describe the nature of the outcomes achieved for victims/survivors during the current reporting period.
Discuss the reasons for those outcomes and, if appropriate, any systemic patterns or practices that you
believe were contributing factors to the outcomes of specific cases or to cases in general involving victims/
survivors. - Question #35 (cont.)

LAV Program Semi-annual Progress Report • 26 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
Expiration
DateDate: 02/28/2007

What do you see as the most significant areas of remaining need, with regard to meeting the civil legal needs
of victims/survivors of sexual assault, domestic violence, dating violence, and stalking? - Question #36

LAV Program Semi-annual Progress Report • 27 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance # 1121-0276
Expiration
Date
Expiration Date: 02/28/2007

What do you see as the most significant areas of remaining need, with regard to meeting the civil legal needs
of victims/survivors of sexual assault, domestic violence, dating violence, and stalking? - Question #36
(cont.)

LAV Program Semi-annual Progress Report • 28 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
Date
Expiration
Date: 02/28/2007

What has LAV Program funding allowed you to do that you could not do prior to receiving this funding?
- Question # 37

LAV Program Semi-annual Progress Report • 29 • Office on Violence Against Women

OMB Clearance
# 1122-0007
OMB Clearance
# 1121-0276
Expiration
Expiration
Date Date: 02/28/2007

What has LAV Program funding allowed you to do that you could not do prior to receiving this funding?
- Question # 37 (cont.)

LAV Program Semi-annual Progress Report • 30 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
DateDate: 02/28/2007
Expiration

Provide any additional information that you would like us to know about your LAV Program grant and/or the
effectiveness of your grant. - Question # 38

LAV Program Semi-annual Progress Report • 31 • Office on Violence Against Women

OMB Clearance
# 1122-0007
OMB Clearance
# 1121-0276
Expiration
Date Date: 02/28/2007
Expiration

Provide any additional information that you would like us to know about your LAV Program grant and/or the
effectiveness of your grant. - Question # 38 (cont.)

LAV Program Semi-annual Progress Report • 32 • Office on Violence Against Women

OMB Clearance
# 1122-0007
OMB Clearance
# 1121-0276
Expiration
Expiration
Date Date: 02/28/2007

Provide any additional information that you would like us to know about the data submitted. - Question # 39

LAV Program Semi-annual Progress Report • 33 • Office on Violence Against Women

OMBOMB
Clearance
# 1122-0007
Clearance
# 1121-0276
Expiration
Expiration
DateDate: 02/28/2007

Provide any additional information that you would like us to know about the data submitted. - Question # 39
(cont.)

LAV Program Semi-annual Progress Report • 34 • Office on Violence Against Women


File Typeapplication/pdf
File TitleLAV semiform 4-10-08.indd
Authorlmichaud
File Modified2008-07-28
File Created2008-05-19

© 2024 OMB.report | Privacy Policy