Quarterly Progress Report:

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					QUARTERLY PROGRESS REPORT:                                                          INDIANA CRIMINAL JUSTICE INSTITUTE
Title II Formula Grant Program                                                                        Youth Division
Program Area 20: Mental Health                                                            101 West Washington Street, Suite 1170E
                                                                                                Indianapolis, Indiana 46204
                                                                                          Phone: 317/233-3340 Fax: 317/232-4979
Section I – Project Identification
1. Grant Number:                              2. Project Title:

3. Implementing Agency:                                             4. Name/Telephone Number /E-Mail
                                                                    Address of Person Completing the Report:

5. Report for Quarter Ending:

       12/31 (Due 1/20)                 3/31 (Due 4/20)                       6/30 (Due 7/20)                     9/30 (Due 10/20)


6. Is this the Final Progress Report for this grant?              Yes             No


7. How many volunteers, if any, does this project utilize?                8. Number of youth served (under the age of 18):
          White Female                White Male               Black Female              Black Male            Hispanic Female              Hispanic Male
          Other Female                Other Male
Section II – Project Progress                                                    At the start of the   At the end of         At the start    At the end of the
     Output Performance Measures – (for clarification on questions               reporting period      the reporting            of the       reporting period
please review pages 4 through 7)                                                                           period             reporting
                                                                                                                               period
1. Number of Memoranda of Understanding developed

2. Number of client service slots available during the reporting period

3. Number of Full-Time Equivalents funded by FG or Title V $

4. Number of program materials developed

5.   A. Number of program staff who participated in training

B. Total number of program staff

C. Percentage (Divide A/B)

6. Number of hours of training provided to program staff

                                                                                                                                                                 1
7. Number of planning activities undertaken

8. Number of policies or procedures created, amended, or rescinded
9. Number of program youth carried over from the previous reporting
period, plus new admissions during the reporting period.
(MANDATORY OUTPUT MEASURE)
Number of youth referred

10. A. Number of youth who are screened

      B. Number of youth in program

      C. Percentage (Divide A/B)

11. A. Number of program youth screened

      C. Number of youth in program

      C. Percentage (Divide A/B)

12. Total number of program youth service hours
14. A. Total number of days between intake and program exit across all
       clients served
      B. Number of cases closed

      C. Percent (A/B)


Section II – Project Progress                                                At the start of the   At the end of   At the start of   At the end of the
    Outcome Performance Measures - (for clarification on                     reporting period      the reporting   the reporting     reporting period
      questions please review pages 4 through 7)                                                       period          period
1.   A. Number of program youth with a new offense - (MANDATORY
         OUTCOME MEASURE)


     B.   Number of youth in program

                Percentage (Divide A/B)

2.   A. Number of program youth charged with probation or parole violation

     B.   Number of youth in program

                                                                                                                                                         2
    C. Percent (A/B)
     NUMBER AND PERCENT OF YOUTH EXHIBITING DESIRED CHANGE IN TARGETED
                               BEHAVIORS
Substance Use
3. Short-term measure:
    A. Number of program youth served during the program period with the noted
       behavioral change
    B. Total number of youth served during the reporting period
    C. Percent (A/B)
Long-term measure:
   A. Total number of youth who exited the program 6-12 months ago who had the
      noted behavioral change
   B. Total number of youth who exited the program 6-12 months ago
    C. Percent (A/B)
Antisocial behavior
3. Short-term measure:
    A. Number of program youth served during the program period with the noted
       behavioral change
    B. Total number of youth served during the reporting period
    C. Percent (A/B)
Long-term measure:
   A. Total number of youth who exited the program 6-12 months ago who had the
      noted behavioral change
    B. Total number of youth who exited the program 6-12 months ago

    C. Percent (A/B)

Family Relationships
3. Short-term measure:
    A. Number of program youth served during the program period with the noted
       behavioral change
    B. Total number of youth served during the reporting period

    C. Percent (A/B)
Long-term measure:
   A. Total number of youth who exited the program 6-12 months ago who had the
      noted behavioral change
   B. Total number of youth who exited the program 6-12 months ago
    C. Percent (A/B)

                                                                                 3
Social Competencies
3. Short-term measure:
     A. Number of program youth served during the program period with the noted
        behavioral change
     B. Total number of youth served during the reporting period
    C. Percent (A/B)
Long-term measure:
     A. Total number of youth who exited the program 6-12 months ago who had the
        noted behavioral change
     B. Total number of youth who exited the program 6-12 months ago

     C. Percent (A/B)

5.   A. Number of youth complying with the Mental Health aftercare plan

     B. Number of youth in the program

     C. Percent (A/B)
6. A. Number of program families satisfied with the program during the reporting
      period
     B. Total number of program families served by the program during the
        reporting period
     C. Percent (A/B)

7.   A. Number of program youth who report being satisfied with the program
        during the reporting period
     B.   Total number of program youth served by the program during the
          reporting period
     C.   Percentage (Divide A/B)
8.   A. Number of program staff trained during the reporting period who report
        increased knowledge
     B. Total number of program staff trained during the reporting period
     C. Percent age (Divide A/B)

The ORIGINAL and ONE COPY should be mailed to the Youth Division of ICJI at the address above, or one copy can be sent electronically to JJReports@cji.in.gov.




                                                                                                                                                                 4
                PROGRAM AREA 20. MENTAL HEALTH SERVICES
                                      OUTPUT PERFORM ANCE MEASURES

      OUTPUT
#                     OBJECTIVE                               DEFINITION                               REPORTING FORMAT
      MEASURE
                                       The number of Memoranda of Understanding or
    Number of        Increase          interagency agreements developed during reporting
                                                                                                  Number of Memoranda of
1   MOUs             organizational    period. Include all formal partnership or coordination
                                                                                                  Understanding developed
    developed        capacity          agreements. Program records are the preferred data
                                       source.
                                       The number of client service slots available during the
     Number of       Increase
                                       reporting period. If slots were lost over the reporting    Number of client service
2   program slots    organizational
                                       period, please report a negative number. Program           slots available
      available      capacity
                                       records are the preferred data source.
                                       The number of staff funded by Formula Grants or Title
    Number of
                     Increase          V, as measured through the number of Full-Time             Number of Full-Time
    FTEs funded
3                    organizational    Equivalents, working for the program during the            Equivalents funded by FG or
    with FG or
                     capacity          reporting period. To calculate FTE, divide the number of   Title V $
    Title V $
                                       staff hours used by the program by 2080.
                                       The number of program materials that were developed
                                       during the reporting period. Include only substantive
    Number of                          materials such as program overviews, client workbooks,
                     Increase
    program                            lists of local service providers. Do not include program   Number of materials
4                    organizational
    materials                          advertisements or administrative forms such as sign-in     developed
                     capacity
    developed                          sheets or client tracking forms. Count the number of
                                       pieces developed. Program records are the preferred
                                       data source.
                                       The number and percent of program staff who are
                                       trained in graduated sanctions during reporting period.
                                       Program staff includes full and part-time employees
                                       and/or volunteers. The number is the raw number of         A. Number of program
    Number and                         program staff to receive any formal training relevant to      staff who participated in
                     Increase
    percent of                         the program or their position as program staff. Include       training
5                    organizational
    program staff                      any training from any source or medium received during     B. Total number of
                     capacity
    trained                            the reporting period as long as receipt can be verified.      program staff
                                       Training does not have to have been completed during       C. Percent (A/B)
                                       the reporting period. To get the percent divide the raw
                                       number by the total number of program staff. Program
                                       records are the preferred data source.
    Number of
    hours of         Increase          The number of training hours in mental health provided
                                                                                                  Number of hours of training
6   program staff    organizational    to program staff during the reporting period. Training
                                                                                                  provided to program staff
    training         capacity          includes in-house and external trainings.
    provided
    Number of
                     Improve           The number of planning activities undertaken during the
    planning                                                                                      Number of planning activities
7                    planning and      reporting period. Planning activities include meetings
    activities                                                                                    undertaken
                     development       held, needs assessments undertaken, etc.
    conducted
    Number of                          The number of program/agency policies or procedures
    program/agen                       created, amended, or rescinded during the reporting
    cy policies or   Improve           period. A policy is a plan or specific course of action    Number of policies or
8   procedures       planning and      that guides the general goals and directives of the        procedures created,
    created,         development       program or agency. Include policies that are relevant to   amended, or rescinded
    amended, or                        the topic area of the program or policies that affect
    rescinded                          program operations.




                                                                                                                                  5
       OUTPUT
#                       OBJECTIVE                          DEFINITION                                REPORTING FORMAT
       MEASURE
                                    An unduplicated count of the number of youth served by
                                    the program during the reporting period. Definition of the
                                    number of youth served for a reporting period is the
                                    number of program youth carried over from previous
                                                                                                 Number of program youth
     NUMBER OF                      reporting period, plus new admissions
                      Improve                                                                    carried over from the
      PROGRAM                       during the reporting period. In calculating the 3-year
9                     program                                                                    previous reporting period,
       YOUTH                        summary, the total number of youth served is the
                      activities                                                                 plus new admissions during
       SERVED                       number of participants carried over from the year
                                                                                                 the reporting period.
                                    previous to the first fiscal year, plus all new
                                    admissions during the 3 reporting fiscal years. Program
                                    records are the preferred data source.

                                    The number of youth referred to mental health services
                      Improve       during the reporting period. Include all youth who
       Number of
10                    program       received at least one program service and met the            Number of youth referred
     youth referred
                      activities    program’s minimum criteria for participation. Program
                                    records are the preferred data source.
                                                                                                 A. Number of youth who are
     Number of                      The number of youth screened at the intake procedure
                      Improve                                                                       screened
     youth                          during the reporting period. Include all youth who met
11                    program                                                                    B. Number of youth in
     screened/                      the program’s minimum criteria for participation.
                      activities                                                                    program
     assessed                       Program records are the preferred data source.
                                                                                                 C. Percent (A/B)
       Number of
        program                                                                                  A. Number of program youth
                                    The number of program youth who received formal
       youth with     Improve                                                                       who are screened
                                    psychological/ psychiatric evaluations to diagnosis and
12       formal       program                                                                    B. Number of youth in
                                    treat psychopathology during the reporting period.
     psychological/   activities                                                                    program
                                    Program records are the preferred data source.
      psychiatric                                                                                C. Percent (A/B)
      evaluations
                                    The number of hours of service completed by program
                                    youth during the reporting period. Service is any explicit
     Number of        Improve       activity (such as program contact, counseling sessions,
                                                                                                 Total number of program
13   service hours    program       course curriculum, community service, etc.) delivered by
                                                                                                 youth service hours
     completed        activities    program staff or other professionals dedicated to
                                    completing the program requirements. Program records
                                    are the preferred data source.
                                                                                                 A. Total number of days
                                    The average length of time (in days) that clients remain
                                                                                                    between intake and
     Average          Improve       in the program. Include data for clients who both
                                                                                                    program exit across all
14   length of stay   program       complete program requirements prior to program exit
                                                                                                    youth exiting program
     in program       efficiency    and those who do not. Program records are the
                                                                                                 B. Number of cases closed
                                    preferred data source.
                                                                                                 C. A/B




                                                                                                                              6
                         PROGRAM AREA 20. MENTAL HEALTH
                                    OUTCOME PERFORM ANCE MEASURES


        OUTCOME                                                                                                   TERM
#                        OBJECTIVE                    DEFINITION                     REPORTING FORMAT
        MEASURE
                                                                                                             SHORT   LONG
                                         The number and percent of program
     * NUMBER                                                                     A. Number of program
                                         youth who were rearrested or seen
     AND PERCENT                                                                     youth with a new
                                         at juvenile court for a new
     OF PROGRAM         Reduce                                                       offense
1                                        delinquent offense. Appropriate for                                  X          X
     YOUTH WHO          delinquency                                               B. Number of youth in
                                         any youth-serving program. Official
     OFFEND OR                                                                       program
                                         records (police, juvenile court) are
     REOFFEND                                                                     C. Percent (A/B)
                                         the preferred data source.
     Number and                                                                   A. Number of program
     percent of                          The number and percent of program           youth charged with
     program youth                       youth who have been charged with            probation or parole
                        Increase
2    charged with                        a formal probation or parole                violation                X          X
                        accountability
     formal probation                    violation. Official records are the      B. Number of youth in
     or parole                           preferred data source.                      program
     violations                                                                   C. Percent (A/B)
     ** NUMBER
     AND PERCENT
     OF YOUTH
                        Improve
     EXHIBITING
3                       prosocial        Select as many as apply from 3A-3D
     DESIRED
                        behaviors
     CHANGE IN
     TARGETED
     BEHAVIORS
                                         Short-term definition: The number        Short-term
                                         and percent of program youth who         measure:
                                         have exhibited a desired change in
                                         substance use during the reporting
                                                                                  A. Number of program
                                         period. Self-report, urinalysis, or
                                                                                      youth served during
                                         staff ratings are the most likely data
                                                                                      the program period
                                         sources.
                                                                                      with the noted
                                                                                      behavioral change
                                                                                  B. Total number of youth
                                                                                      served during the
                                                                                      reporting period
                                                                                  C. Percent (A/B)
                        Improve
                                         Long-term definition: Number and
3A   Substance use      prosocial                                                 Long-term                   X          X
                                         percent of program youth who
                        behaviors                                                 measure:
                                         exhibited a desired change in
                                         substance use 6 months to 12
                                         months after exiting the program.        A. Total number of youth
                                         Self-report, urinalysis, or staff            who exited the
                                         ratings are the most likely data             program 6-12 months
                                         sources.                                     ago who had the
                                                                                      noted behavioral
                                                                                      change
                                                                                  B. Total number of youth
                                                                                      who exited the
                                                                                      program 6-12 months
                                                                                      ago
                                                                                  C. Percent (A/B)
                        Improve          Short-term definition: The number        Short-term
       Antisocial                        and percent of program youth who         measure:
3B                      prosocial                                                                             X          X
       behavior                          have exhibited a desired change in
                        behaviors
                                                                                                                             7
        OUTCOME                                                                                            TERM
#                     OBJECTIVE                 DEFINITION                    REPORTING FORMAT
        MEASURE
                                                                                                      SHORT   LONG
                                  antisocial behavior during the           A. Number of program
                                  reporting period. Self-report or staff       youth served during
                                  ratings are the most likely data             the program period
                                  sources.                                     with the noted
                                                                               behavioral change
                                                                           B. Total number of youth
                                                                               served during the
                                                                               reporting period
                                                                           C. Percent (A/B)

                                  Long-term definition: Number and         Long-term
                                  percent of program youth who             measure:
                                  exhibited a desired change in
                                  antisocial behavior 6 months to 12
                                                                           A. Total number of youth
                                  months after exiting the program.
                                                                               who exited the
                                  Self-report or staff ratings are the
                                                                               program 6-12 months
                                  most likely data sources.
                                                                               ago who had the
                                                                               noted behavioral
                                                                               change
                                                                           B. Total number of youth
                                                                               who exited the
                                                                               program 6-12 months
                                                                               ago
                                                                           C. Percent (A/B)
                                  Short-term definition: The number        Short-term
                                  and percent of program youth who         measure:
                                  have exhibited a desired change in
                                  family relationships during the
                                                                           A. Number of program
                                  reporting period. Self-report or staff
                                                                               youth served during
                                  ratings are the most likely data
                                                                               the program period
                                  sources.
                                                                               with the noted
                                                                               behavioral change
                                                                           B. Total number of youth
                                                                               served during the
                                                                               reporting period
                                                                           C. Percent (A/B)
                     Improve
     Family                       Long-term definition: Number and
3C                   prosocial                                             Long-term                   X          X
     relationships                percent of program youth who
                     behaviors                                             measure:
                                  exhibited a desired change in family
                                  relationships 6 months to 12 months
                                  after exiting the program. Self-         A. Total number of youth
                                  report or staff ratings are the most         who exited the
                                  likely data sources.                         program 6-12 months
                                                                               ago who had the
                                                                               noted behavioral
                                                                               change
                                                                           B. Total number of youth
                                                                               who exited the
                                                                               program 6-12 months
                                                                               ago
                                                                           C. Percent (A/B)
                                  Short-term definition: The number        Short-term
                     Improve      and percent of program youth who         measure:
     Social
3D                   prosocial    have exhibited a desired change in                                   X          X
     competencies
                     behaviors    social competencies during the
                                                                           A. Number of program
                                                                                                                      8
       OUTCOME                                                                                                         TERM
#                       OBJECTIVE                     DEFINITION                    REPORTING FORMAT
       MEASURE
                                                                                                               SHORT      LONG
                                        reporting period. Self-report or staff       youth served during
                                        ratings are the most likely data             the program period
                                        sources.                                     with the noted
                                                                                     behavioral change
                                                                                 B. Total number of youth
                                                                                     served during the
                                                                                     reporting period
                                                                                 C. Percent (A/B)

                                        Long-term definition: Number and         Long-term
                                        percent of program youth who             measure:
                                        exhibited a desired change in social
                                        competencies 6 months to 12
                                                                                 A. Total number of youth
                                        months after exiting the program.
                                                                                     who exited the
                                        Self-report or staff ratings are the
                                                                                     program 6-12 months
                                        most likely data sources.
                                                                                     ago who had the
                                                                                     noted behavioral
                                                                                     change
                                                                                 B. Total number of youth
                                                                                     who exited the
                                                                                     program 6-12 months
                                                                                     ago
                                                                                 C. Percent (A/B)
                                        The number and percent of program
                                                                                 A. Number of program
                                        youth who have successfully fulfilled
                                                                                    youth who exited the
                                        all program obligations and
    NUMBER AND                                                                      program having
                                        requirements. Program obligations
    PERCENT OF                                                                      completed program
                                        will vary by program, but should be
    PROGRAM                                                                         requirements
                                        a predefined list of requirements or
    YOUTH              Increase                                                  B. Total number of youth
4                                       obligations that clients must meet                                         X
    COMPLETING         accountability                                               who exited the
                                        prior to program completion.
    PROGRAM                                                                         program during the
                                        Program records are the preferred
    REQUIREMENT                                                                     reporting period (both
                                        data source. The total number of
    S                                                                               successfully and
                                        youth (B value) includes those youth
                                                                                    unsuccessfully)
                                        who have exited successfully and
                                                                                 C. Percent (A/B)
                                        unsuccessfully.
                                                                                 A. Number of program
    Number and                                                                      youth complying with
                                        The number and percent of program
    percent of                                                                      mental health aftercare
                       Increase         youth who are complying with their
5   program youth                                                                   plan                                      X
                       accountability   individual mental health aftercare
    complying with                                                               B. Number of youth in the
                                        plan.
    aftercare plan                                                                  program
                                                                                 C. Percent (A/B)
                                                                                 A. Number of program
                                        The number and percent of program           families satisfied with
                                        families satisfied with the program in      the program during the
    Number and
                                        areas such as staff relations and           reporting period
    percent of         Increase
                                        expertise, general program               B. Total number of
6   program families   program                                                                                     X
                                        operations, facilities, materials, and      program families
    satisfied with     support
                                        service. Example data sources: self         served by the program
    program
                                        report data, assessment forms, or           during the reporting
                                        focus groups.                               period
                                                                                 C. Percent (A/B)
    Number and         Increase         The number and percent of program        A. Number of program
7   percent of         program          youth satisfied with the program in         youth satisfied with the   X
    program youth      support          areas such as staff relations and           program during the
                                                                                                                                  9
        OUTCOME                                                                                                     TERM
#                        OBJECTIVE                   DEFINITION                     REPORTING FORMAT
        MEASURE
                                                                                                               SHORT   LONG
    satisfied with                      expertise, general program                  reporting period
    program                             operations, facilities, materials, and   B. Total number of
                                        service. Self-report data collected         program youth served
                                        using program evaluation or                 by the program during
                                        assessment forms are the expected           the reporting period
                                        data source.                             C. Percent (A/B)
                                        The number and percent of program
                                        staff who gained a greater               A. Number of program
                                        knowledge of the mental health              staff trained during the
    Number and                          program area through trainings or           reporting period who
    percent of                          other formal learning opportunities.        report increased
                       Increase
    program staff                       Appropriate for any program whose           knowledge
8                      program                                                                                  X
    with increased                      staff received program-related           B. Total number of
                       support
    knowledge of                        training. Training does not need to         program staff trained
    program area                        have been given by the program.             during the reporting
                                        Self-report data collected using            period
                                        training evaluation or assessment        C. Percent (A/B)
                                        forms are the expected data source.

                               TITLE V AND FORMULA GRANTS PERFORMANCE MEASURE KEY
Short-Term = Occurs during or by the end of the program
Long-Term = Occurs 6 months to 1 year after program completion
Annual Term = Occurs once a year

BOLD         = Mandatory measure
*            = Mandatory for intervention programs only
**           = Mandatory for prevention programs only




                                                                                                                              10
                         QUARTERLY PROGRESS REPORT INSTRUCTIONS
                                               for
                                Title II Formula Grant Program

This form is to be used to report progress toward meeting the project objectives approved in your original grant
application or subsequent grant amendment requests*. Please be sure that the objectives you proposed match
exactly the objectives you are currently working to achieve. Any changes to project objectives must be
discussed with the Youth Division Director and approved via a Grant Amendment Request PRIOR TO
IMPLEMENTATION. Failure to do so will result in an interruption of funds to your project.

NOTE: Quarterly Progress Reports should reflect the number of volunteers, number of youth served,
progress towards objectives and project activities during the previous quarter only. The Final
Progress Report should provide the total number of volunteers, total number of youth served, final
level of progress towards objectives and complete project activities for the entire grant period.

SECTION I – Project Identification

7. In the space provided, indicate the number of volunteers utilized for the project currently being funded by
   the Title II Formula & Title IIe Challenge Grant program during the reporting period.

8. In the spaces provided, indicate the number of youth receiving direct services by the funded project by race
   and gender during the reporting period. If the project is designed to serve a population other than youth
   (i.e. provide training to juvenile justice professional) please attach a brief explanation of the population
   served and the number served.

SECTION II – Project Progress: Output Measures

Completing the tables:

   Answer the questions by indicating the achievement numbers for each corresponding question.
   PLEASE NOTE: Mandatory Output Measures and Outcome Measures are BOLDED and noted. You must
   report on Mandatory Output and Outcome Measures.


ELECTRONIC SUBMISSION

ICJI encourages subgrantees to submit the Quarterly Progress Report form electronically via the Youth
Division’s reporting e-mail address JJReports@cji.in.gov. The form is in a Microsoft Word template format.
Each time you open the form it will appear as a new document that allows you to record quarterly and/or final
progress report data. Once complete you will need to use the “Save As” function in Microsoft Word to assign a
filename to the document. Documents should be named using the following format: Grant Number – Quarter,
e.g. 05JF006 – 1st Qtr; 05JF006 – 2nd Qtr, etc.


Direct any questions to the Youth Division Director at 317/233-3340.




________________________________
 *Quarterly Progress Reports submitted not using this form will result in an interruption of funds to
your project.



                                                                                                                 11

				
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