SAMHSA 988 State Territory Grant (Cohort 2) - Quarterly Report Template (FINAL)

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SAMHSA 988 State & Territory Grant Program
Project Period MM-DD-YY to MM-DD-YY
Quarterly Report Template 

Grant information
Award Number
Add your grant number here
Project Title
Add project title here
State/Territory
Your state/territory
Project Period
MM-DD-YY to MM-DD-YY
Reporting period
Month, YEAR; Month, YEAR; and Month, YEAR

☐ Please check this box to confirm you’ve submitted the most recent quarter’s SPARS data. If not, please explain:

[statement here – delete this line if you’ve checked the box]


Required activities: Fiscal & operational analysis of implementation

Please include detailed analysis for each of the required activities – do not leave any blank. Please also ensure you cover all goals and objectives you identified in the Project Narrative of your application. Are you reaching your outcomes? If not, what adjustments are you proposing?

    1. Distribute funds to selected local, regional, and/or statewide/territorial Lifeline crisis centers to maintain and expand the workforce to answer at least 90% of total calls (i.e., total # of routed calls), chats, and texts originating in your state/territory as reported in the monthly broad state metrics report form the 988 Network Administrator. 

[statement here – how did you distribute funds? Are you engaged with all local crisis centers in your state/territory? Any concerns re needed coverage or workforce development?]

    2. Develop and implement a comprehensive state or territory-wide 988 communication strategy in line with SAMHSA’s 988 partner toolkit. Ensure the input of community-based leadership is evaluated and embedded within the state or territory communication plan to meet local 988 connection and support. 

[statement here] 

    3. Enhance statewide data collection to improve 988 service and communication, with specific focus on high-risk populations and populations with high numbers of suicide deaths and attempts, by enhancing the collection of demographic data and resource referral and utilization, while safeguarding individual information consistent with applicable Federal and State privacy laws.

[statement here – what are your high-risk populations and those with high numbers of suicide deaths and attempts? How are you improving 988 service and communication for them? 

You are also required to report the total # of calls, chats, and tests that include suicide attempt in progress, emergency rescue with law enforcement, emergency rescue without law enforcement, mobile crisis outreach referrals, and those in which the individual is experiencing a substance use crisis. 

If you are able to collect the required demographic data outlined in the NOFO (race, ethnicity, age, gender identify, sexual orientation, and military status), you must also include those data for each of the PPA indicators above by calls, chats, texts. Please report as collected based on the demographic table included in the quarterly report template below. ] 


State/Territory Quarterly Reporting Updates (Cohort 2)
Month 1
Month 2
Month 3
Quarter Total
Contacts and Dispositions
Instructions: Please list the number of contacts that fall into each category below.
Total number of contacts (phone))




Total number of contacts (chat)




Total number of contacts (text)




Number of contacts that resulted in emergency rescue (phone) – without law enforcement




Number of contacts that resulted in emergency rescue (chat) – without law enforcement




Number of contacts that resulted in emergency rescue (text) – without law enforcement




Number of contacts that resulted in emergency rescue (phone)– with law enforcement




Number of contacts that resulted in emergency rescue (chat)– with law enforcement




Number of contacts that resulted in emergency rescue (text)– with law enforcement




Number of contacts that included suicide attempts in progress




Number of contacts that resulted in mobile crisis outreach referrals




Number of contacts that identify individuals in substance use crisis




Individuals Served by Age 
Instructions: Please list the number of unique individuals contacted that fall into each category below.
0-12




13-17




18-25




26-29




30-39




40-49




50-59
60-65
66 and older




Information Missing or Unknown




Individuals Served by Military Status 




Instructions: Please list the number of unique individuals contacted that…




 Ever been in the United States Armed Forces?




 Never been in the United States Armed Forces




Information Missing or Unknown




If yes to “Ever been in the United States Armed Forces?”




Instructions:  Please list the number of unique individuals contacted that…
Currently on active duty in the United States Armed Forces 
In a Reserve component




Now separated or retired from the military




Individuals Served by Ethnicity 




Instructions: Please list the number of unique individuals contacted that identify their ethnicity as…
 Hispanic, Latino, or Spanish origin or descent
Not Hispanic, Latino, or Spanish origin or descent




Information Missing or Unknown




Individuals Served by Race 




Instructions: Please list the number of unique individuals contacted that identify their race as…(Mixed race individuals should be captured by selecting all categories that apply.)




 American Indian or Alaska Native, including North American, Central American, and South American Indians




 Asian, including Asian Indian, Chinese, Filipino, Japanese, Korean, and
Vietnamese




 Black or African American




 Native Hawaiian or Other Pacific Islander, including Guamanian, Chamorro, and Samoan
White
Other




Information Missing or Unknown




Individuals Served by Gender




Instructions: Please list the number of unique individuals contacted that identify their gender as…




Male




Female




Transgender




 Uses a different term




Information Missing or Unknown




Individuals Served by Sexual Orientation 




Instructions: Please list the number of unique individuals contacted that identify their sexual orientation as…




Heterosexual, that is straight




Gay or Lesbian




Bisexual




 Uses a Different Term




 Not sure about sexual orientation 




 Caller/chatter/texter doesn’t know what this question is asking




Information Missing or Unknown






    4. Enhance the state or territory’s capacity to ensure referral connections post-988 contact, including all referrals for those imminent danger or referred for mobile crisis support or crisis stabilization services.

[statement here – are mobile crisis dispatched from 988 centers? If not, please include how mobile crisis is dispatched.] 



    5. Engage with the state or territory’s substance use policy team and 988 Lifeline crisis centers to develop appropriate protocols and referral resources for 988 contacts requiring substance use crisis care.

[statement here] 


    6. Report on state/territory 988 Lifeline crisis center Key Performance Indicators (KPIs)



    7. Please outline any ongoing data variances between center data and Vibrant data or any other challenges in this area. 

[statement here]




Allowable Activities: Fiscal & operational analysis of implementation 
(Please include detailed analysis for each of the allowable activities only if they apply to you. If not, please remove this section.)

    1. Work with 988 crisis centers to support integrated peer services by hiring credentialed peers with lived experience that reflect the characteristics of the communities served. Peers should be hired with attention to common characteristics such as gender, race, primary language, ethnicity, religion, tribal/American Indian/Alaska Native status, Veteran status, gender identity and sexual orientation, disabilities, lived experiences and age. This plan should include (1) integrating peers within 988 crisis operations, (2) having peers help coordinate 988 emergency and mobile crisis services, and (3) including peers in follow-up contacts to 988. Provide contracts or subawards to state or territory Lifeline crisis centers for the workforce needed to provide local, regional, tribal, and/or statewide/territorial covered chat and/or text Lifeline services.

[statement here]

    2. Develop an evaluation plan measuring effectiveness, return on investment (ROI), or the quality of 988 services within the state or territory.

[statement here]

    3. In collaboration with SAMHSA and the 988 Network Administrator, develop new population-based 988 centers or services to improve the linguistic and cultural services of the state or territory’s 988 response. 

[statement here]