Form 1122-0008 Semi-Annual Progress Report for Enhanced Training and Se

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Expiration Date: 08/31/2015

U.S. Department of Justice
Office on Violence Against Women
SEMI-ANNUAL PROGRESS REPORT FOR
Enhanced Training and Services to End Violence
and Abuse of Women Later in Life Program
Brief Instructions: This form must be completed for each Enhanced Training and Services to End Violence and Abuse of Women Later in Life Program (Elder Grants 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 of this form
must be completed by all grantees. In section A, subsection A1 must be completed by all grantees. In
section C, subsection C2 must be completed by all grantees. In section D and subsections A2, C1, C3
and C4, 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.
The activities of volunteers or interns should be reported if they were coordinated or supervised by Elder
Grants Program-funded staff or if Elder Grants Program funds substantially supported their activities.
For further information on filling out this form, refer to the separate instructions, which contain detailed
definitions and examples, illustrating how questions should be answered.

SECTION
Section A:
A1:
A2:
Section B:
Section C:
C1:
C2:
C3:
C4:
Section D:
Section E:

General Information
Grant Information
Staff Information
Purpose Areas
Function Areas
Training
Coordinated Community Response
Policies
Products
Victim Services
Narrative

Page Number

1
1
3
4
5
5
8
10
14
15
23

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A1

GENERAL INFORMATION
Grant Information

All grantees must complete this subsection.

(format date with 6 digits – 01/31/09)

1.

Date of report

2.

Current reporting period

3.

Grantee name

4.

Grant number
(the federal grant number assigned to your Elder Grants Program grant)

5.

Type of funded organization
(Check the one answer that best describes the organization receiving the Elder Grants Program funds.)

✔ January 1-June 30

✔

July 1-December 31

(Year)

Domestic violence program
Dual sexual assault/domestic violence program
Elder services agency
Sexual assault program
State
Tribal government or tribal organization
Unit of local government
Other (specify):

5a. Is this a faith-based organization?
Yes
No
6.

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 Elder Grants Program grant specifically address tribal populations?
(Check yes if your Elder Grants 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:

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8.

What percentage of your Elder Grants Program funds was directed to each of these areas?
(Provide appropriate percentage to reflect the time and/or resources you have devoted to each of
these areas during the current reporting period. The total should equal 100%.)
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, 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. Elder abuse is the physical, sexual, emotional, or financial abuse or neglect or abandonment of an older person by a family member, fiduciary agent, or caregiver.

Percentage of grant funds
Sexual assault

%

Domestic violence/dating violence

%

Stalking

%

Elder abuse, neglect, and/or exploitation1

%

TOTAL (must equal 100%)

1

0 %
100

Include here only abuse, neglect, and/or exploitation by non-intimate partners and non-family members that is not already included
under the preceding categories.

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A2

Staff Information

Were your Elder Grants Program funds used to fund staff positions during the current reporting period?
Check yes if Elder Grants 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 under this grant during the current
reporting period. Report staff by function(s) performed, not by title or location. Include employees who
are part-time and/or only partially funded with Elder Grants Program 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 victim advocate in October whose
salary was 100% funded under the Elder Grants Program, 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 for part-time staff or contractors.)

Staff
Administrator (fiscal manager, executive director)

FTE(s)

Counselor
Program coordinator (training coordinator)
Support staff (administrative assistant, bookkeeper, accountant)
Trainer
Translator/interpreter
Victim advocate (non-governmental, includes domestic violence, sexual assault,
dual)
Other (specify):
TOTAL

0.00

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B

PURPOSE AREAS

All grantees must complete this section.

10. Purpose areas
(Check all purpose areas that apply to activities supported by Elder Grants Program funds during the
current reporting period.)
Check ALL
that apply

Program purpose areas
Training programs to assist law enforcement, prosecutors, governmental agencies, victim
assistants, and relevant officers of Federal, State, tribal, territorial, and local courts in
recognizing, addressing, investigating, and prosecuting instances of elder abuse, neglect,
and exploitation, including domestic violence, dating violence, sexual assault, or stalking
against victims who are 50 years of age or older.
Providing or enhancing services for victims of elder abuse, neglect, and exploitation, including domestic violence, dating violence, sexual assault, or stalking, who are 50 years of age
or older.
Creating or supporting multidisciplinary collaborative community responses to victims of
elder abuse, neglect, and exploitation, including domestic violence, dating violence, sexual
assault, and stalking, who are 50 years of age or older.
Conducting cross training for victim service organizations, governmental agencies, courts,
law enforcement, and nonprofit, nongovernmental organizations serving victims of elder
abuse, neglect, and exploitation, including domestic violence, dating violence, sexual assault, and stalking, who are 50 years of age or older.

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C1

FUNCTION AREAS
Training

Were your Elder Grants Program funds used for training during the current reporting period?
Check yes if Elder Grants Program-funded staff provided training or if grant funds were used to directly
support training.
Yes—answer questions 11-20
No—skip to C2
11. Number of people trained in the mandatory law enforcement training of trainers event
(Report the number of people who attended a mandatory training of trainers event provided during the
current reporting period by type of organization. For purposes of this reporting form, training means
providing information on elder abuse, neglect, and exploitation; sexual assault; domestic violence;
dating violence; and/or stalking that enables professionals to improve their response to victims/survivors as it relates to their role in the system.)
Type of organization

Number of people trained

Elder services agency
Law enforcement agency
Prosecutor
Victim service(s) organization
Other (specify):
TOTAL

0

12. Number of training events provided for law enforcement officers and/or detectives/investigators
(Report the total number of mandatory and advanced law enforcement training events supported with
Elder Grants Program funds provided to law enforcement officers and detectives/investigators during
the current reporting period.)
Total number of mandatory law enforcement training events provided
Total number of advanced law enforcement training events provided
13. Number of people trained in the mandatory and/or advanced law enforcement training events
(Report the total number of people who attended mandatory and/or advanced law enforcement
training events supported with Elder Grants Program funds.)
People trained

Mandatory training events
Four half-day
Two full-day
training events
training events

Advanced training event

Detectives/investigators
Law enforcement officers
TOTAL

0

0

0

14. Number of prosecutors trained in the prosecutors workshop
(Report the total number of prosecutors who attended a national prosecutors workshop on
elder abuse, neglect, and exploitation.)
Total number of prosecutors trained
15. Number of judges trained in the judicial institute
(Report the total number of judges who attended a national judicial institute on elder abuse, neglect,
and exploitation.)
Total number of judges trained
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16. Number of people trained in the mandatory direct services training of trainers event
(Report the number of people who attended a mandatory training of trainers event provided during the
current reporting period by type of organization. For purposes of this reporting form, training means
providing information on elder abuse, neglect, and exploitation; sexual assault; domestic violence;
dating violence; and/or stalking that enables professionals to improve their response to victims/survivors as it relates to their role in the system.)
Type of organization

Number of people trained

Elder services agency
Government agency (specify):
Prosecutor
Victim service(s) organization
Other (specify):
TOTAL

0

17. Number of people trained in the mandatory local direct services training events provided with Elder
Grants Program funds
(Report the total number of people trained at local direct services training events during the current reporting period by type of organization.)
Type of organization

Number of people trained

Elder services agency
Government agency (specify):
Prosecutor
Victim service(s) organization
Other (specify):
TOTAL

0

18. Cross-training events
(Report the total number of cross-training events provided for victim service(s) organizations, governmental agencies, courts, law enforcement, and nonprofit, nongovernmental organizations working with
older victims.)
Total number of cross-training events provided
19. Number of people trained in the cross-training events supported with Elder Grants Program funds
(Report the total number of people trained in cross-training events during the current reporting period
by type of organization.)
Type of organization

Number of people trained

Courts
Elder services agency
Government agency (specify):
Law enforcement
Prosecutor
Victim service(s) organization
Other (specify):
TOTAL

0

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20. (Optional) Additional information
(Use the space below to discuss the effectiveness of your training activities funded or supported by your
Elder Grants 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 include that we
held our first cross-disciplinary training to professionals in our community. Attendees stated upon the
completion of the training that having the opportunity to receive training across the disciplines allowed
them to fully understand the roles that each person can play in addressing elder abuse.) (Maximum 2000 characters)

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C2

Coordinated Community Response
All grantees must complete this subsection.

21. Coordinated community response activities
(Check the appropriate boxes to indicate the agencies or organizations, even if they are not MOU partners, that you provided onsite consultation to; attended invitational meetings with; engaged in planning, development, and/or implementation of training with; or engaged in partnership, team building,
and cross training with during the current reporting period. In the last column, indicate the agencies or
organizations with which you have a memorandum of understanding [MOU] for purposes of the Elder
Grants Program.)

Agency/Organization

Onsite
consultation

Invitational
meetings

Planning,
development,
implementation
of training

Partnership,
team building
MOU
and cross
Partner
training

Mandatory partnership with:
Elder program
Law enforcement
Prosecutor’s office
Victim service(s) organization
(domestic violence)
Victim service(s) organization
(sexual assault)
Partnership with:
Advocacy organization
Batterer intervention program
Community advocacy
organization (NAACP, AARP)
Corrections (probation, parole,
correctional facilities staff)
Court
Disability advocacy organization
Faith-based organization
Financial organization (banks)
Health organization
Legal organization (legal services, bar association, law school)
Mental health organization
Sex offender management/sex
offender treatment provider
Social service organization (nongovernmental, senior center, fire
department)
Tribal government/Tribal
organization
Other victim service(s) organization
Other (specify):
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22. (Optional) Additional Information
(Use the space below to discuss the effectiveness of your CCR activities funded or supported by your
Elder Grants Program grant and to provide any information you would like to share about your CCR
activities beyond what you have provided in the data above. An example might be improved information
to victims who are older regarding community resources and greater coordination between the prosecutor’s office and the local victim services agency as a result of meetings between the governmental
and non-governmental advocates.) (Maximum - 2,000 characters)

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C3

Policies

Were your Elder Grants Program funds used to develop, substantially revise, or implement policies or
protocols during the current reporting period?
Check yes if Elder Grants Program-funded staff developed, substantially revised, or implemented
policies or protocols, or if Elder Grants Program funds were used to directly support the development,
revision, or implementation of policies or protocols.
Yes—answer questions 23-24
No—skip to C4

23. Types of protocols and/or policies developed, substantially revised or implemented during the current reporting period (check all that apply.)
Victim services
Appropriate response to underserved populations
Appropriate response to victims/survivors with substance abuse issues and/or
mental health diagnoses
Appropriate response to victims/survivors who are elderly
Appropriate response to victims/survivors who have disabilities
Confidentiality
Mandatory training standards for staff and volunteers
Procedures for anonymous, confidential, or Jane Doe reporting of sexual assault
Other (specify):
Law enforcement
Appropriate response to underserved populations
Appropriate response to victims/survivors who are elderly
Appropriate response to victims/survivors who have disabilities
Identifying primary aggressor/discouraging dual arrest
Immediate access to protection order information
Mandatory training on sexual assault, domestic violence/dating violence, and /or
stalking
No charge to sexual assault victim/survivor for any costs associated with forensic
exam
No charge to victims/survivors for any costs related to the prosecution of sexual assault, domestic violence/dating violence, and/or stalking
No victims/survivors polygraphed
Policies to protect victims from internet disclosure of identifying information
Procedures for anonymous, confidential, or Jane Doe reporting of sexual assault
Protection order enforcement (including full faith and credit)
Providing information to victims/survivors about victim services
Sexual assault response and protocols
Other (specify):
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Prosecution
Appropriate response to underserved populations
Appropriate response to victims/survivors who are elderly
Appropriate response to victims/survivors who have disabilities
Mandatory training on sexual assault, domestic violence/dating violence, and/or
stalking
No charge to victims/survivors for any costs related to the prosecution of sexual
assault, domestic violence/dating violence, stalking, and/or child sexual abuse
No victims/survivors polygraphed
Policies to protect victims from internet disclosure of identifying information
Protection order enforcement (including full faith and credit)
Sexual assault response and protocols
Victim-witness notification
Violation of protection orders
Other (specify):

Courts
Accelerated trial schedules
Appropriate response to underserved populations
Appropriate response to victims/survivors who are elderly
Appropriate response to victims/survivors who have disabilities
Dedicated domestic violence docket
Full faith and credit for protection orders
Immediate access to obtaining protection orders
Judicial monitoring of sexual assault and/or domestic violence offenders
Mandatory training on sexual assault, domestic violence, dating violence, and/or
stalking
No charge to victims/survivors for any costs related to the prosecution of sexual
assault, domestic violence/dating violence, stalking, and/or child sexual abuse
Policies to protect victims from internet disclosure of identifying information
Policy against mutual restraining orders
Procedures for courtroom security
Protection order enforcement (including full faith and credit)
Sexual assault response and protocols
Standard protection order form
Other (specify):

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Probation and parole
Appropriate response for cases involving underserved populations
Appropriate response for cases involving victims/survivors who are elderly
Appropriate response to victims/survivors who have disabilities
Mandatory training on sexual assault, domestic violence, dating violence, and/or
stalking
Policies to protect victims from internet disclosure of identifying information
Strategies to assist and protect victim/survivor during probation and parole
Victim inclusion in offender supervision planning process/sex offender management
Victim notification
Other (specify):
Adult protective services
Appropriate services for older adults
Appropriate services for persons with disabilities
Appropriate services for underserved populations
Collaboration with advocacy organizations and the justice system when
appropriate
Policies on information sharing and confidentiality that focuses on victim safety
Policies on training on elder abuse, domestic abuse and sexual assault
Policies that allow for and encourage participation in the CCR
Other (specify):
Aging network
Policies on attending training on domestic abuse, elder abuse, and sexual assault
Policies that allow for and encourage participation in the CCR
Policies that increase the identification and referral of possible cases of abuse,
neglect, and exploitation to adult protective services (APS), law enforcement, and/
or advocacy organizations as appropriate
When appropriate, offering safety planning and information about the dynamics of
abuse
Other (specify):

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24. (Optional) Additional information
(Use the space below to discuss the effectiveness of policies you have developed or implemented that
were funded or supported by your Elder Grants Program grant and to provide any additional information you would like to share about your activities relating to the developing, revising, or implementing of
policies beyond what you have provided in the data above. An example might be implementing policies
to ensure that mandatory reporting requirements are being met.) (Maximum - 2,000 characters)

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C4

Products

Were your Elder Grants Program funds used to develop, substantially revise, or distribute products during
the current reporting period?
Check yes if Elder Grants Program-funded staff developed products or if Elder Grants Program funds
directly supported the development, substantial revision, or distribution of products.
Yes—answer question 25
No—skip to section D
25. Use of Elder Grants Program funds for product development, substantial revision, or distribution
(Report the number of products developed, substantially revised, or distributed with Elder Grants Program
funds during the current reporting period. Report the number of new products/materials developed or substantially revised during the current reporting period; the title/topic and intended audience of each product
developed, substantially 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 revised during the current reporting period, whether or
not they were used or distributed, and on products that were previously developed but 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
Other
used or
languages
distributed

Brochures

Manuals

Training
Materials

Other
(specify):

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D

VICTIM SERVICES

Were your Elder Grants Program funds used to provide victim services to victims/suvivors during the
current reporting period?
Check yes if Elder Grants Program-funded staff provided victim services or if Elder Grants Program
funds were used to support victim services during the current reporting period.
Yes--answer questions 26 - 32
No--skip to section E
26. 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, stalking and/
or elder abuse, neglect or exploitation was directed. If the victim/survivor experienced more than one
victimization, that person should be counted only once under the primary victimization. Do not report
secondary victims here.)

Victims/survivors
A. Served: Victims/survivors who received
the service(s) they requested, if those
services were funded by your Elder Grants
Program
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 Elder Grants Program
TOTAL SERVED AND PARTIALLY SERVED
(26A+26B)
C. Victims/survivors seeking services
who were not served: Victims/survivors
who sought services and did not receive
the service(s) they were seeking, if those
services were funded by your Elder Grants
Program

2

Sexual
assault

Domestic
violence/
dating
violence

Stalking

Elder abuse,
neglect, or
exploitation2

TOTAL

0

0

0

0

0

0

0

0

Include here only abuse, neglect, and/or exploitation by non-intimate partners and non-family members that is not already included
under the preceding categories.

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27. Reasons that victims/survivors seeking services were not served or were partially served
(Check all that apply.)
Reasons not served or partially served
Conflict of interest
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 victim/survivors who have disabilities
Lack of child care
Program reached capacity
Program rules not acceptable to victim/survivor
Program unable to provide service due to limited resources/priority-setting
Services inappropriate or inadequate for victims/survivors with mental health issues
Services inappropriate or inadequate for victims/survivors with substance abuse issues
Services not appropriate for victim/survivor
Services not available for victims/survivors accompanied by male adolescents
Transportation
Other (specify):

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28. Demographics of victims/suvivors served or partially served
(Based on the primary victims/survivors reported in 26A and 26B, 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 questions 26A and 26B.
However, the total number of victims/survivors reported under “Race/ethnicity” should not be less than the
total number of victims/survivors reported in questions 26A and 26B. 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 questions 26A and 26B. Those victims/survivors for whom gender, age, and/
or race/ethnicity is not known should be reported in the “Unknown” category. Do not report demographics
for secondary victims.)
Race/ethnicity (Victims/survivors should not be counted more than
once in either the category “American Indian or Alaska Native” or in the
category “Native Hawaiian or other Pacific Islander.”)
American Indian or Alaska Native

Number of victims/
survivors

Asian
Black or African American
Hispanic or Latino
Native Hawaiian or other Pacific Islander
White
Unknown
TOTAL RACE/ETHNICITY (should not be less than
26A and 26B)

0,

the sum of

0

Number of victims/
survivors

Gender
Female
Male
Unknown
TOTAL GENDER (should equal

0,

the sum of 26A and 26B)

0

Number of victims/
survivors

Age
50-59
60-75
76-84
85+
Unknown
TOTAL AGE (should equal

0

, the sum of 26A and 26B)

Other demographics

0

Number of victims/
survivors

People with disabilities
People with limited English proficiency
People who are immigrants/refugees/asylum seekers
People who live in rural areas

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

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OMB Clearance # 1122-0008
Expiration Date: 08/31/2015

29. Victims/survivors’ relationship to offender
(For those victims/survivors reported as served and partially served in 26A and 26B, report the victim/survivor’s 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
0 ;
0;
the total number in the domestic violence/dating violence column must be at least
0;
the total number in the stalking column must be at least
and the total number in the elder abuse, neglect, or exploitation column
0 .)
must be at least
Number of victim/survivor relationships by victimization
Victim/survivor’s relationship to offender

Domestic
violence/dating
violence

Sexual
assault

Elder abuse,
neglect, or
exploitation

Stalking

Current or former spouse or intimate partner
Parent/grandparent
Other family or household member
Dating relationship
Aquaintance (neighbor, employee, co-worker,
etc.)
Stranger
Patient/client care receiver
Relationship unknown
TOTAL

0

0

0

Elder Grants Program Semi-annual Progress Report • 18 • Office on Violence Against Women

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0

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OMB Clearance # 1122-0008
Expiration Date: 08/31/2015

30A. Victim services
(Report the number of primary victims/survivors from 26A and 26B who received Elder Grants Program-funded
services. 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 a service was provided to the victim/survivor.
The total for each type of service should not be higher than
0 , the total of 26A and 26B .
Shelter services should be reported in question 30B. Do not report secondary victims receiving services.)

Number of
victims/survivors
served

Type of service
Civil legal advocacy/court accompaniment (Assisting a victim/survivor with civil legal issues, including preparing paperwork for a protection order and accompanying victim/survivor to a protection order hearing, administrative hearing, or other civil court proceeding.
Does not include advocacy by attorneys and/or paralegals)
Civil legal assistance (Civil legal services provided by an attorney and/or paralegal)
Counseling/support group (Individual or group counseling or support provided by a volunteer, peer, or professional)
Criminal justice advocacy/court accompaniment (Assisting a victim/survivor with criminal
legal issues including notifying the victim/survivor of case status, hearing dates, plea
agreements, and sentencing terms; preparing paperwork such as victim impact statements; accompanying a victim/survivor with to a criminal court proceeding or law enforcement interview; and all other advocacy within the criminal justice system)
Crisis intervention (Crises intervention is a process by which a person identifies, assesses,
and intervenes with an individual in crisis so as to restore balance and reduce the effects
of the crisis in her/his life. In this category, report crisis intervention that occurs in person and/or over the telephone)
Financial counseling (Actions designed to assist those who are having difficulty managing
their finances to ensure the proper use o0f their income/resources and prevent mismanagement and financial exploitation by others)
Forensic exam (Exam conducted by a sexual assault nurse examiner or by a sexual assault forensic examiner)
Hospital/clinic/other medical response (Accompanying a victim/survivor to or meeting a
victim/survivor at the hospital, clinic, or medical office)
Language services (Interpretation, translation)
Transportation
Victim/survivor advocacy (Actions designed to assist the victim/survivor in obtaining
support, resources, or services, including employment, health care, victim’s
compensation, etc.)
Other (specify):

30B. Shelter services
(Report the number of victims/survivors and accompanying family members who received emergency shelter
and /or transitional housing provided with Elder Grants Program funds during the current reporting period. This
should be an unduplicated count for both victims/survivors and for family members. This means that each victim survivor and each family member who received shelter services during the current reporting period should
be counted only once. Report the total number of bed nights provided in emergency shelter and /or transitional
housing to victims/survivors and family members. The number of bed nights is computed by multiplying the
number of victims/survivors and family members by the number of nights they stayed in the shelter. The number
of bed nights will typically be significantly higher than the number of victims/survivors and family members. For
example, one victim and her three children all stayed in the shelter for 10 nights. The number of bed nights would
be 4 multiplied by 10, or 40.)

Shelter service

Number of victims/
survivors

Number of family
members

Number of bed nights

Emergency shelter
Transitional housing
Elder Grants Program Semi-annual Progress Report • 19 • Office on Violence Against Women
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OMB Clearance # 1122-0008
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30C. Hotline calls
(Report the number of hotline calls received from victims/survivors, and the total number of hotline
calls received, on phone lines paid for with Elder Grants Program funds or answered by Elder Grants
Program-funded staff during the current reporting period. Victims/survivors whose calls are reported
here should not be reported as victims served in question 26 unless they also received at least one of
the services listed in question 30A Victim services or question 30B Shelter services. Victims/survivors
who receive services such as crisis intervention or victim advocacy over the telephone, in addition to
basic hotline information and/or referrals, should also be reported in question 30A. Hotline calls that
include victim advocacy or crisis intervention services are those that require more time than the average call and involve a more intensive focus on the immediate needs and situation of the victim. For
examples of when to report only the hotline call and when to report both the hotline call and a service
or services in question 30A, see separate instructions.)
Type of service

Number of calls from
victims/survivors

Total number of
calls

Hotline calls (Crisis or information and referral calls
received by an agency’s hotline or office telephone)
30D. Victim-witness notification/outreach to victims/survivors
(Report the number of unsolicited letters, phone calls, or visits to victims/survivors of specific incidents
of sexual assault, domestic violence, dating violence, stalking, or elder abuse, neglect, or exploitation
identified in police reports or court documents, informing them of services and/or providing information about the criminal justice system. Victims/survivors who are the recipients of these notifications/
outreach activities should not be reported as victims served in question 26 unless they also received
at least one of the services reported in question 30A Victim services or question 30B Shelter services.
Victims who receive services such as criminal justice advocacy over the telephone should be reported
in question 30A.)

Type of service

Number of
notification/outreach
activities to
victims/survivors

Victim-witness notification/outreach to victims/survivors
(unsolicited letters, phone calls, or visits)

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

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31. Protection orders
(Report the total number of temporary and/or final protection orders requested and granted for which
Elder Grants Program-funded victim services staff provided assistance to victims/survivors during the
current reporting period. These orders may also be referred to as protection from abuse, protection
from harassment or anti-harassment orders, restraining orders, or no-contact or stay-away orders.)
Sexual assault protection orders

Temporary orders

Final orders

Temporary orders

Final orders

Temporary orders

Final orders

Number requested
Number granted
Domestic violence/dating
violence protection orders
Number requested
Number granted
Stalking protection orders
Number requested
Number granted

Elder Grants Program Semi-annual Progress Report • 21 • Office on Violence Against Women

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32. (Optional) Additional information
(Use the space below to discuss the effectiveness of victim services funded or supported by your Elder
Grants Program grant and to provide any additional information you would like to share about your victim services activities beyond what you have provided in the data above. An example might include that
your agency, as a result of Elder Grants Program funding, was able to provide medical accompaniment
to an increased percentage of sexual assault survivors. This resulted in a higher percentage of victims
also seeking additional support services.) (Maximum - 2,000 characters)

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

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SECTION

OMB Clearance # 1122-0008
Expiration Date: 08/31/2015

E

NARRATIVE

All grantees must answer question 33.
Please limit your responses to the space provided.
33. Report on the status of your Elder Grants Program grant goals and objectives for the current
reporting period.

(Report succinctly 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 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.) Page 24.

All grantees must answer questions 34 and 35 on an annual basis. Submit this information on the
January to June reporting form only.
Please limit your responses to the space provided. (8,000 characters)
34. What do you see as the most significant areas of remaining need, with regard to obstacles faced by
individuals who are older?

(Consider the following issues among others: responsiveness of the criminal justice system at the local, state,
and federal levels to people/individuals who are older; cross-training of elder advocates and sexual and domestic
violence advocates; community, regional, or state-based issues; particular racial, ethnic, cultural, or social issues
that need to be addressed in training.) Page 27.

35. What has Elder grants Program funding allowed you to do that you could not do prior to receiving
this funding?
(For example, expand training to new law enforcement jurisdictions; conduct outreach to older victims.)

Page 29.

Questions 36 and 37 are optional.
Please limit your responses to the space provided. (8,000 characters)
36. Provide any additional information that you would like us to know about your Elder Grants Program
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 that
demonstrate the effectiveness of your Elder Grants Program-funded program, please provide it below.) Page 31.

37. 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.) Page 33.

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, 800 K Street, NW, Washington, DC 20531.
Elder Grants Program Semi-annual Progress Report • 23 • Office on Violence Against Women

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OMB Clearance # 1122-0008
Expiration Date: 08/31/2015

Back to Instructions

Report on the status of your Elder Grants Program grant goals and objectives for the current reporting period.
Question #33

Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

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

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THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.
OMB Clearance # 1122-0008
Expiration Date: 08/31/2015

Back to Instructions

Report on the status of your Elder Grants Program grant goals and objectives for the current reporting period.
Question #33 (cont.)

Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

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

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THIS IS A SAMPLE GMS FORM. DO NOT USE THIS FORM TO SUBMIT YOUR FINAL DATA TO OVW.
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Expiration Date: 08/31/2015

Back to Instructions

Report on the status of your Elder Grants Program grant goals and objectives for the current reporting period.
Question #33 (cont. 2)

Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

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

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Back to Instructions

OMB Clearance # 1122-0008
Expiration Date: 08/31/2015

What do you see as the most significant areas of remaining need, with regard to obstacles faced by individuals
who are older?
Question #34

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Back to Instructions

OMB Clearance # 1122-0008
Expiration Date: 08/31/2015

What do you see as the most significant areas of remaining need, with regard to obstacles faced by individuals
who are older?
Question #34 (cont.)

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

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Back to Instructions

OMB Clearance # 1122-0008
Expiration Date: 08/31/2015

What has Elder Grants Program funding allowed you to do that you could not do prior to receiving this funding?
Question #35

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Back to Instructions

OMB Clearance # 1122-0008
Expiration Date: 08/31/2015

What has Elder Grants Program funding allowed you to do that you could not do prior to receiving this funding?
Question #35 (cont.)

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

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Back to Instructions

OMB Clearance # 1122-0008
Expiration Date: 08/31/2015

Provide any additional information that you would like us to know about your Elder Grants Program grant
and/or the effectiveness of your grant.
Question #36

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Back to Instructions

OMB Clearance # 1122-0008
Expiration Date: 08/31/2015

Provide any additional information that you would like us to know about your Elder Grants Program grant
and/or the effectiveness of your grant.
Question #36 (cont.)

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

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OMB Clearance # 1122-0008
Expiration Date: 08/31/2015

Provide any additional information that you would like us to know about the data submitted.
Question #37

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OMB Clearance # 1122-0008
Expiration Date: 08/31/2015

Provide any additional information you would like us to know about the data submitted.
Question #37 (cont.)

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

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Validate

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