OJJDP Performance Measures for Title II Formula Grant ... - Pa grants for school

***Please complete all sections of this form. Funds will not be dispersed until complete information is received.***

Section I Project Identification

1. OJA Grant Number:

2. Total Amount of Subgrant (Federal Funds Only): $

Year of OJA Funding: 1st 2nd 3rd

3. Subgrant Project Title:

4. Organization:

5. Contact Person:

Telephone # and Email Address:

|Report Period |1st Quarter |2nd Quarter |3rd Quarter |Final Report (Due 30 days after the end of the project period) |

|(for Formula grants) | |1st and 2nd quarter |1st, 2nd and 3rd quarter |The report must include cumulative numbers and outcomes for the |

| |Date |Cumulative Data |Cumulative Data |entire grant period. |

| | | | | |

| | |Date |Date | |

6. Implementing Organization Type:

Coalition Faith-based Organization Juvenile Justice

Non-profit community-based organization Other community-based organization

Other government agency Police/other law enforcement School/Other Education Unit of local government

7. Project Start Date:

8. Project End Date:

9. Federal Congressional District:

10. Is the implementing organization a faith-based program? Yes No

11. Does the subgrant implement an evidence-based program or practice? Yes No

12. If yes, select one source from which the program or practice model was cited:

a. Blueprints for Violence Prevention

b. CASEL (Collaborative for Academic, Social, and Emotional learning)

c. Centers for Disease Control and Prevention

d. Community Guide to Helping America’s Youth

e. Department of Education Safe, Disciplined, and Drug-free Schools

f. Drug Strategies, Inc.

g. Making the Grade

h. Hamilton Fish Institute

i. Institute for Medicine

j. NIDA Preventing Drug Abuse

k. National Institute of Justice What Works Report

l. OJJDP Model Programs Guide

m. Promising Practices Network

n. SAMSHA Model Programs

o. Surgeon General’s Youth Violence Report

p. Other (e.g., State model program resources)

Please indicate the name of the evidence-based program implemented or describe the evidence-based practice instituted:

Section II: Data Regarding Youth Served

Target Population for this Subgrant

Total Number of Youth Served:

Total Number of Youth referred:

What does “served” mean for this project? (i.e. youth showed up once, attended a minimum # of sessions, completed the program)

Please check the appropriate boxes to indicate for this subgrant:

1. The population actually served during the reporting period; and

2. The populations, if any, to which the program offers targeted services.

Targeted services include any services or approaches specifically designed to meet the needs of the population (e.g., gender specific, culturally based, developmentally appropriate services).

Table 1: Target Population Information

| | |1. Did you serve this group during the |2. Did this Subgrant provide targeted services|

| |Population |reporting period? |for any of the following groups? |

|RACE/E|American Indian/Alaskan Native | | |

|THNICI|Asian | | |

|TY |Black/African American | | |

| |Hispanic or Latino (of any race) | | |

| |Native Hawaiian and Other Pacific Islander | | |

| |Other Race | | |

| |White/Caucasian | | |

| |Youth population not directly served | | |

| |At-Risk Population (no prior offense) | | |

|J |First Time Offenders | | |

|U |Repeat Offenders | | |

|S |Sex Offenders | | |

|T |Status Offenders | | |

|I |Violent Offenders | | |

|C |Youth population not directly served | | |

|E | | | |

| | | | |

|G |Male | | |

|E |Female | | |

|N |Youth population not directly served | | |

|D | | | |

|E | | | |

|R | | | |

| |Population |1. Did you serve this group during the |2. Did this Subgrant provide targeted services|

| | |reporting period? |for any of the following groups? |

| |Under 11 | | |

|A |12 - 13 | | |

|G |14 - 15 | | |

|E |16 – 17 | | |

| |18 and over | | |

| |Youth population not directly served | | |

|G |Rural | | |

|E |Suburban | | |

|O |Tribal | | |

| |Urban | | |

| |Youth population not directly served | | |

|O |Mental Health | | |

|T |Pregnant | | |

|H |Substance Abuse | | |

|E |Truant/Dropout | | |

|R | | | |

Main Activities (Brief narrative about what was completed and how it was accomplished.)

Goals and Objectives: (Please list all the goals and objectives from your application and provide a narrative on your progress toward achieving those goals and objectives and the activities used to achieve that progress).

Section III-Project Reporting Using Performance Indicators

(Please answer the “bolded” items on the following pages. These are required by the federal government)

PA 11. OUTPUT MEASURES

|# |Output Measure |Definition |Reporting Format |

|1 |Number of MOUs developed |The number of Memoranda of Understanding or interagency agreements developed |A. |

| | |during reporting period of the program. Include all formal partnership or |Number of Memoranda of Understanding |

| | |coordination agreements. Program records are the preferred data source. |developed |

| | | | |

|2 |Number of program slots |The number of client service slots available during the reporting period of the |A. |

| |available |program. If slots were lost over the reporting period, please report a negative |Number of client service slots |

| | |number. Program records are the preferred data source. |available during the reporting period |

| | | | |

| | | | |

|3 |Number of FTEs funded by FG|The number of staff, as measured through the number of Full-Time Equivalents, |A. |

| |$ |working for the program during the reporting period. To calculate FTE, divide the |Number of Full-Time Equivalents funded|

| | |number of staff hours used by the program by 2080. |by FG $ |

| | | | |

|4 |Number of program materials|The number of program materials that were developed during the reporting period. |A. |

| |developed |Include only substantive materials such as program overviews, client workbooks, |Number of program materials developed |

| | |lists of local service providers. Do not include program advertisements or | |

| | |administrative forms such as sign-in sheets or client tracking forms. Count the | |

| | |number of pieces developed. Program records are the preferred data source. | |

|5 |Number and percent of |The number and percent of program staff that are trained during reporting period. |A. |

| |program staff trained |Program staff include full and part-time employees and/or volunteers. The number |Number of staff who participated in |

| | |is the raw number of staff to receive any formal training relevant to the program |training |

| | |or their position as program staff. Include any training from any source or medium| |

| | |received during the reporting period as long as receipt can be verified. Training |B. |

| | |does not have to have been completed during the reporting period. To get the |Total number of program staff |

| | |percent divide the raw number by the total number of program staff. Program | |

| | |records are the preferred data source. |C. |

| | | |Percent (A/B) |

| | | | |

|6 |Number of hours of program |The number of training hours that program staff are provided during the reporting |A. |

| |staff training provided |period. Training includes in-house and external trainings. |Number of hours of training provided |

| | | |to program staff |

| | | | |

|7 |Number of planning |The number of planning activities undertaken during the reporting period. Planning|A. |

| |activities conducted |activities include meetings held, needs assessments undertaken. |Number of planning activities |

| | | |undertaken |

| | | | |

|8 |Number of program/agency |The number of program/agency policies or procedures created, amended, or rescinded|A. |

| |policies or procedures |during the reporting period. A policy is a plan or specific course of action that |Number of policies or procedures |

| |created, amended, or |guides the general goals and directives of the program or agency. Include policies|created, amended, or rescinded |

| |rescinded |that are either relevant to the topic area of the program or policies that affect | |

| | |program operations. | |

|9 |Number of program youth |An unduplicated count of the number of youth served by the program during the |A. |

| |served |reporting period. Definition of the number of youth served for a reporting |Number of program youth carried over |

| | |period is the number of program youth carried over from previous reporting |from the previous reporting period, |

| | |period, plus new admissions during the reporting period. In calculating the |plus new admissions during the |

| | |3-year summary, the total number of youth served is the number of participants |reporting period |

| | |carried over from the year previous to the first fiscal year, plus all new | |

| | |admissions during the 3 reporting fiscal years. Program records are the preferred | |

| | |data source. | |

|10 |Number of service hours |The number of hours of service completed by program youth during the reporting |A. |

| |completed |period. Service is any explicit activity (such as program contact, counseling |Total number of program youth service |

| | |sessions, course curriculum, community service, etc.) delivered by program staff |hours |

| | |or other professionals dedicated to completing the program requirements. Program | |

| | |records are the preferred data source. | |

|11 |Average length of stay in |The average length of time (in days) that clients remain in the diversion program.|A. |

| |diversion program |Include data for clients who both complete program requirements prior to program |Total number of days between intake |

| | |exit and those who do not. Program records are the preferred data source. |and program exit across all program |

| | | |youth exiting program |

| | | | |

| | | |B. |

| | | |Number of cases closed |

| | | | |

| | | |C. |

| | | |A/B |

| | | | |

PA 11. OUTCOME MEASURES

|# |Outcome Measure |Definition |Reporting Format |Reporting Term |

|1 |Number and percent of |The number and percent of participating program youth who |Total number of program youth served |Short |

| |program youth who offend|were arrested or seen at a juvenile court for a delinquent | | |

| |during the reporting |offense during the reporting period. Appropriate for any |Number of program youth tracked during this | |

| |period |youth-serving program. Official records (police, juvenile |reporting period | |

| |(9/30/2010) |court) are the preferred data source. | | |

| | | |Of B, number of program youth who had an | |

| | |The number of youth tracked should reflect the number of |arrest or delinquent offense during this | |

| | |program youth that are followed or monitored for arrests or |reporting period | |

| | |offenses. Ideally this number should be all youth served by | | |

| | |the program during this reporting period. |Number of program youth who were recommitted| |

| | | |to a juvenile facility during this reporting| |

| | |Ex. If I am serving 100 youth in my program, A would be 100. |period | |

| | |If I am following up with 50 of them, B would be 50. Of | | |

| | |these 50 program youth I’m tracking, if 25 of them were |Number of program youth who were sentenced | |

| | |arrested or had a delinquent offense during this reporting |to adult prison during this reporting period| |

| | |period, then C would be 25. | | |

| | | | | |

| | | |Number of youth who received another | |

| | | |sentence during this reporting period | |

| | | | | |

| | | |Percent offending (C/B) | |

| | | | | |

|1 |Number and percent of |The number and percent of participating program youth who |Number of program youth who exited the |Long |

| |program youth who offend|were arrested or seen at a juvenile court for a delinquent |program 6-12 months ago that you are | |

| |during the reporting |offense during the reporting period. Appropriate for any |tracking | |

| |period (Long Term) |youth-serving program. Official records (police, juvenile | | |

| |(9/30/2010) |court) are the preferred data source. |Of A, the number of program youth who had an| |

| | | |arrest or delinquent offense during this | |

| | |The number of youth tracked should reflect the number of |reporting period | |

| | |program youth that are followed or monitored for arrests or | | |

| | |offenses 6-12 months after exiting the program. |Number of program youth who were recommitted| |

| | | |to a juvenile facility during this reporting| |

| | |Ex. I have a lot of youth who exited my program 6-12 months |period | |

| | |ago, but we are only tracking 100 of them, so A is 100. Of | | |

| | |these 100 program youth that exited the program 6-12 months |Number of program youth who were sentenced | |

| | |ago 65 had a new arrest or delinquent offense during this |to adult prison during this reporting period| |

| | |reporting period, so B is 65. | | |

| | | | | |

| | | |Number of youth who received another | |

| | | |sentence during this reporting period | |

| | | | | |

| | | |Percent of Long Term offending (B/A) | |

| | | | | |

|1 |Number and percent of |The number and percent of participating program youth who |Total number of program youth served |Short |

| |program youth who |were arrested or seen at a juvenile court for a new | | |

| |re-offend during the |delinquent offense during the reporting period. Appropriate |Number of program youth tracked during this | |

| |reporting period |for any youth-serving program. Official records (police, |reporting period | |

| |(9/30/2010) |juvenile court) are the preferred data source. | | |

| | | |Of B, the number of program youth who had a | |

| | |The number of youth tracked should reflect the number of |new arrest or delinquent offense during this| |

| | |program youth that are followed or monitored for new arrests |reporting period | |

| | |or offenses. Ideally this number should be all youth served | | |

| | |by the program during this reporting period. |Number of program youth who were recommitted| |

| | | |to a juvenile facility during this reporting| |

| | |Ex. If I am serving 100 youth in my program, A would be 100. |period | |

| | |If I am following up with 50 of them, B would be 50. Of | | |

| | |these 50 program youth I’m tracking, if 25 of them were |Number of program youth who were sentenced | |

| | |arrested or had a delinquent offense during this reporting |to adult prison during this reporting period| |

| | |period, then C would be 25. | | |

| | | | | |

| | | |Number of youth who received another | |

| | | |sentence during this reporting period | |

| | | | | |

| | | |Percent recidivism (C/B) | |

| | | | | |

|1 |Number and percent of |The number and percent of participating program youth who |Number of program youth who exited the |Long |

| |program youth who |were arrested or seen at a juvenile court for a new |program 6-12 months ago that you are | |

| |re-offend during the |delinquent offense during the reporting period. Appropriate |tracking | |

| |reporting period |for any youth-serving program. Official records (police, | | |

| |(9/30/2010) |juvenile court) are the preferred data source. |Of A, the number of program youth who had a | |

| | | |new arrest or delinquent offense during this| |

| | |The number of youth tracked should reflect the number of |reporting period | |

| | |program youth that are followed or monitored for new arrests | | |

| | |or offenses 6-12 months after exiting the program. |Number of program youth who were recommitted| |

| | | |to a juvenile facility during this reporting| |

| | |Ex. I have a lot of youth who exited my program 6-12 months |period | |

| | |ago, but we are only tracking 100 of them, so A is 100. Of | | |

| | |these 100 program youth that exited the program 6-12 months |Number of program youth who were sentenced | |

| | |ago 65 had a new arrest or delinquent offense during this |to adult prison during this reporting period| |

| | |reporting period, so B is 65. | | |

| | | |Number of youth who received another | |

| | | |sentence during this reporting period | |

| | | | | |

| | | |Percent of Long Term recidivism (B/A) | |

| | | | | |

|2a |Substance abuse |The number and percent of program youth who have exhibited a |A. |Short |

| | |decrease in substance abuse during the reporting period. |Number of program youth served during the | |

| | |Self-report or staff rating are most likely data sources. |program period with the noted behavioral | |

| | | |change | |

| | | | | |

| | | |B. | |

| | | |Number of youth in the program who received | |

| | | |services for this behavior. | |

| | | | | |

| | | |C. | |

| | | |Percent (A/B) | |

| | | | | |

|2b |Antisocial behavior |The number and percent of youth who have exhibited a decrease|A. |Short |

| | |in antisocial behavior during the reporting period. |Number of program youth served during the | |

| | |Self-report or staff ratings are the preferred data |program period with the noted behavioral | |

| | |source. Anti-social behavior: A pervasive pattern of behavior|change | |

| | |that displays disregard for and violation of the rights of | | |

| | |others, societal mores, or the law (such as deceitfulness, |B. | |

| | |irritability, consistent irresponsibility, lack of remorse, |Number of youth in the program who received | |

| | |failure to conform to social norms). |services for this behavior. | |

| | | | | |

| | | |C. | |

| | | |Percent (A/B) | |

| | | | | |

|2c |Family relationships |Number and percent of program youth who exhibited an |A. |Short |

| | |improvement in family relationships during the reporting |Number of program youth served during the | |

| | |period. Self-report, staff rating are most likely data |program period with the noted behavioral | |

| | |sources. Anti-social behavior: A pervasive pattern of |change | |

| | |behavior that displays disregard for and violation of the | | |

| | |rights of others, societal mores, or the law (such as |B. | |

| | |deceitfulness, irritability, consistent irresponsibility, |Number of youth in the program who received | |

| | |lack of remorse, failure to conform to social norms). |services for this behavior. | |

| | | | | |

| | | |C. | |

| | | |Percent (A/B) | |

| | | | | |

|2d |Social competencies |The number and percent of program youth who exhibited an |A. |Short |

| | |improvement in social competencies during the reporting |Number of program youth served during the | |

| | |period. Self-report, staff rating are most likely data |program period with the noted behavioral | |

| | |sources. |change | |

| | | | | |

| | | |B. | |

| | | |Number of youth in the program who received | |

| | | |services for this behavior. | |

| | | | | |

| | | |C. | |

| | | |Percent (A/B) | |

| | | | | |

|3 |Number and percent of |The number and percent of program youth who have successfully|A. |Short |

| |program youth completing|fulfilled all program obligations and requirements. Program |Number of program youth who exited the | |

| |program requirements |obligations will vary by program, but should be a predefined |program having completed program | |

| | |list of requirements or obligations that clients must meet |requirements | |

| | |prior to program completion. Program records are the | | |

| | |preferred data source. The total number of youth include |B. | |

| | |those who exited successfully or unsuccessfully. |Total number of youth who were in the | |

| | | |program during the reporting period | |

| | | | | |

| | | |C. | |

| | | |Percent (A/B) | |

| | | | | |

|4 |Number and percent of |The number and percent of program families satisfied with the|A. |Short |

| |program families |program in areas such as staff relations and expertise, |Number of program families satisfied with | |

| |satisfied with program |general program operations, facilities, materials, and |the program during the reporting period | |

| | |service. Self-report data collected using program evaluation | | |

| | |or assessment forms are the expected data source. | | |

| | | |B. | |

| | | |Total number of program families served by | |

| | | |the program during the reporting period | |

| | | | | |

| | | | | |

| | | |C. | |

| | | |Percent (A/B) | |

| | | | | |

|5 |Number and percent of |The number and percent of program youth satisfied with the |A. |Short |

| |program youth satisfied |program in areas such as staff relations and expertise, |Number of program youth satisfied with the | |

| |with program |general program operations, facilities, materials, and |program during the reporting period | |

| | |service. Self-report data collected using program evaluation | | |

| | |or assessment forms are the expected data source. |B. | |

| | | |Total number of program youth served by the | |

| | | |program during the reporting period | |

| | | | | |

| | | |C. | |

| | | |Percent (A/B) | |

| | | | | |

|6 |Number and percent of |The number and percent of program staff who gained a greater |A. |Short |

| |program staff with |knowledge of the program area through trainings or other |Number of program staff trained during the | |

| |increased knowledge of |formal learning opportunities. Appropriate for any program |reporting period who report increased | |

| |program area |whose staff received program-related training. Training does |knowledge of diversion programs | |

| | |not need to have been given by the program. Self-report data | | |

| | |collected using training evaluation or assessment forms are |B. | |

| | |the expected data source. |Number of program staff trained during the | |

| | | |reporting period returning surveys | |

| | | | | |

| | | |C. | |

| | | |Percent (A/B) | |

| | | | | |

|7 |Number and percent of |The number and percent of program youth who have been charged|A. |Short |

| |program youth formally |with a formal probation violation. Official records are the |Number of first-time offenders formally | |

| |processed |preferred data source. |processed | |

| | | | | |

| | | |B. | |

| | | |Number of first time offenders | |

| | | | | |

| | | |C. | |

| | | |Percent (A/B) | |

| | | | | |

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