| Title I FY 2006: MAI Report #1 | ||||||
| Grantee Name: | Denver, CO (*) | |||||
| Identifying Information | Report Date: | 8/29/2006 (*) | ||||
| Report prepared by: | John Doe (*) | |||||
| Phone: | 123-555-6780 (*) | |||||
| E-mail address: | jDoe@somewhere.us (*) | |||||
| Service Information | ||||||
| 1.Service or Activity: | Medical (*) | |||||
| 2.ETHNIC or RACIAL COMMUNITY TO RECEIVE THIS SERVICE (Select only ONE minority community. If more than one minority community will receive this service, prepare a separate report for each of those communities.) | Black (*) | |||||
| 3. New, Continuing, or Expanded Effort | Continued (*) | |||||
| Budget and Expenditure Information | ||||||
| Budgeted: | 4D. Spent | |||||
| $113,000 | Below, enter amount spent this FY: | |||||
| $120,000 | $119,200 | |||||
| Service Units | ||||||
| 5. Service Unit Name and Definition | One visit - Professional, diagnostic and therapeutic services rendered by MD, PA, or NP in office based setting | |||||
| 6. Record of service units provided | Planned | Actual | ||||
| 600 | 596 | |||||
| Record of Clients Served | ||||||
| Planned | Actual | |||||
| 150 | 155 | |||||
| 50 | 48 | |||||
| 0 | 0 | |||||
| 2 | 2 | |||||
| 15 | 12 | |||||
| Planned Outcomes | ||||||
| 8A. PLANNED CLIENT LEVEL OUTCOMES: Define from one to three planned outcomes measures to be tracked for this service. (Reminder: outcome measures should be consistent with HRSA guidance on selecting outcomes and indicators summarized and cited in the MAI Reporting Instructions) | Target Percent | |||||
| 70 | ||||||
| 8B. REVISED PLANNED CLIENT LEVEL OUTCOMES: If any planned outcome measures were redefined during the year, enter the revised outcome measure definitions. (Reminder: outcome measures should be consistent with HRSA guidance on selecting outcomes and indicators summarized and cited in the MAI Reporting Instructions) | Target Percent | |||||
| Year-End Outcome Results | ||||||
| 9A. Narrative Description of Outcomes Achieved | Documented Evidence for Target Population | |||||
| 9B. No. of Clients Served in Target Population | 9C. No. of Clients Achieving Outcome | 9D. Percent | 9E. Was Outcome Met, Exceeded, Not Met? | |||
| Narrative Description for, Outcome #1: Of 155 clients served with more than one CD4 count during the reporting period, 85 (55%) had improved CD4 counts, 33 (21%) maintained stable CD4 counts, and 37 (24%) had a decline in their CD4 count. This was an improvement over last year when 35% of clients had improved CD4 counts and another 40% had stable CD4 counts. | 155 | 118 | 76% | Exceeded | ||
| Narrative Description for Outcome #2: | ||||||
| Narrative Description for Outcome #3: | ||||||
| Title I FY 2006: MAI Report #2 | ||||||
| Grantee Name: | Denver, CO (*) | |||||
| Identifying Information | Report Date: | 8/29/2006 (*) | ||||
| Report prepared by: | John Doe (*) | |||||
| Phone: | 123-555-6780 (*) | |||||
| E-mail address: | jDoe@somewhere.us (*) | |||||
| Service Information | ||||||
| 1.Service or Activity: | Medical (*) | |||||
| 2.ETHNIC or RACIAL COMMUNITY TO RECEIVE THIS SERVICE (Select only ONE minority community. If more than one minority community will receive this service, prepare a separate report for each of those communities.) | Hispanic (*) | |||||
| 3. New, Continuing, or Expanded Effort | Continued (*) | |||||
| Budget and Expenditure Information | ||||||
| Budgeted: | 4D. Spent | |||||
| $77,000 | Below, enter amount spent this FY: | |||||
| $80,000 | $80,000 | |||||
| Service Units | ||||||
| 5. Service Unit Name and Definition | One visit - Professional, diagnostic and therapeutic services rendered by MD, PA, or NP in office based setting | |||||
| 6. Record of service units provided | Planned | Actual | ||||
| 400 | 402 | |||||
| Record of Clients Served | ||||||
| Planned | Actual | |||||
| 100 | 105 | |||||
| 20 | 21 | |||||
| 0 | 0 | |||||
| 4 | 3 | |||||
| 10 | 11 | |||||
| Planned Outcomes | ||||||
| 8A. PLANNED CLIENT LEVEL OUTCOMES: Define from one to three planned outcomes measures to be tracked for this service. (Reminder: outcome measures should be consistent with HRSA guidance on selecting outcomes and indicators summarized and cited in the MAI Reporting Instructions) | Target Percent | |||||
| 70 | ||||||
| 8B. REVISED PLANNED CLIENT LEVEL OUTCOMES: If any planned outcome measures were redefined during the year, enter the revised outcome measure definitions. (Reminder: outcome measures should be consistent with HRSA guidance on selecting outcomes and indicators summarized and cited in the MAI Reporting Instructions) | Target Percent | |||||
| Year-End Outcome Results | ||||||
| 9A. Narrative Description of Outcomes Achieved | Documented Evidence for Target Population | |||||
| 9B. No. of Clients Served in Target Population | 9C. No. of Clients Achieving Outcome | 9D. Percent | 9E. Was Outcome Met, Exceeded, Not Met? | |||
| Narrative Description for, Outcome #1: Of 105 clients served with more than one CD4 count during the reporting period, 68 (65%) had improved CD4 counts, 13 (12%) maintained stable CD4 counts, and 24 (23%) had a decline in their CD4 count. This was an improvement over last year when 20% of clients had improved CD4 counts and another 40% had stable CD4 counts. | 105 | 81 | 77% | Exceeded | ||
| Narrative Description for Outcome #2: | ||||||
| Narrative Description for Outcome #3: | ||||||
| Grantee Name: | Denver, CO (*) |
| Fiscal Year: | 2007 (*) |
| Report Date: | 8/29/2006 (*) |
| Prepared by: | John Doe (*) |
| Title: | Ryan White Program Director (*) |
| E-mail Address: | jDoe@somewhere.us (*) |
| Telephone: | 123-555-6780 (*) |
| FY Title I MAI Award: | 200,000.00 |
| MAI $$ Approved for Carryover from prior Fiscal Year: | 10,000.00 |
| FY MAI funds to be used for grantee administration: | 10,000.00 |
| (*) denotes information pulled from the web form |
| 1.Name of EMA: | Denver, CO (*) | |||||
| 2. Report Date: | 8/29/2006 (*) | Fiscal Year: | 2007 (*) | |||
| 3. Report prepared by: | John Doe (*) | |||||
| 4 E-mail address: | jDoe@somewhere.us (*) | Telephone: | 123-555-6780 (*) | |||
| 5. Total Funds Available: | $210,000.00 | |||||
| 6. Grantee Administration: | $10,000.00 | |||||
| 7. Funds for Services: | $200,000.00 | |||||
| Funds Budgeted on Each Report Format | Funds Spent | Percent of Funds | Number Clients Served | |||
| Report # | Report Name | Service/Allocation Category | Budgeted Amount | |||
| #1 | Medical-Black | Medical (*) | $120,000.00 | $119,200.00 | 99.33% | 155 |
| #2 | Medical-Hispanic | Medical (*) | $80,000.00 | $80,000.00 | 100.00% | 105 |
| Total Budget & Expenditures for ALL Services | $200,000.00 | $199,200.00 | 99.60% | 260 | ||
| (*) denotes information pulled from the web form | ||||||
| Report# | Report Name | Service or Activity | Effort (New, Continue, Expanded) | Race/Ethnicity | Planned Budget Info | Planned FY MAI funds budgeted for this service to this client group | Planned MAI carryover budgeted for this service to this client group | Planned Total MAI funds budgeted for this service to this client group | Amount Spent | Amount spent in FY | Service Unit Name and Definition | Planned record of service units provided | Actual record of service units provided | Planned Total Unduplicated Number of Clients | Planned Total Unduplicated Number of Women | Planned Total Unduplicated Number of Infants | Planned Total Unduplicated Number of Children | Planned Total Unduplicated Number of Youth | Final Total Unduplicated Number of Clients | Final Total Unduplicated Number of Women | Final Total Unduplicated Number of Infants | Final Total Unduplicated Number of Children | Final Total Unduplicated Number of Youth | Planned Outcome #1 and Indicator(s) | Target Percent #1 | Planned Outcome #2 and Indicator(s) | Target Percent #2 | Planned Outcome #3 and Indicator(s) | Target Percent #3 | Revised Planned Outcome #1 and Indicator(s) | Revised Target Percent #1 | Revised Planned Outcome #2 and Indicator(s) | Revised Target Percent #2 | Revised Planned Outcome #3 and Indicator(s) | Revised Target Percent #3 | Narrative Valueription for Outcome #1 | No. of Clients Served in Target Population | No. of Clients Achieving Outcome | Percent | Was Outcome Met, Exceeded, Not Met? | Narrative Valueription for Outcome #2 | No. of Clients Served in Target Population | No. of Clients Achieving Outcome | Percent | Was Outcome Met, Exceeded, Not Met? | Narrative Valueription for Outcome #3 | No. of Clients Served in Target Population | No. of Clients Achieving Outcome | Percent | Was Outcome Met, Exceeded, Not Met? |
| #1 | Medical-Black | Medical (*) | Continued (*) | Black (*) | 113000 | 7000 | 120000 | 119200 | One visit - Professional, diagnostic and therapeutic services rendered by MD, PA, or NP in office based setting | 600 | 596 | 150 | 50 | 0 | 2 | 15 | 155 | 48 | 0 | 2 | 12 | Planned Outcome #1 and Indicator(s): At a minimum, 70 percent of clients served will achieve improved or stable CD4 counts by the end of the reporting period. | 70 | Planned Outcome #2 and Indicator(s): | Planned Outcome #3 and Indicator(s): | Planned Outcome #1 and Indicator(s): | Planned Outcome #2 and Indicator(s): | Planned Outcome #3 and Indicator(s): | Narrative Description for, Outcome #1: Of 155 clients served with more than one CD4 count during the reporting period, 85 (55%) had improved CD4 counts, 33 (21%) maintained stable CD4 counts, and 37 (24%) had a decline in their CD4 count. This was an improvement over last year when 35% of clients had improved CD4 counts and another 40% had stable CD4 counts. | 155 | 118 | 0.761290322580645 | Exceeded | Narrative Description for Outcome #2: | Narrative Description for Outcome #3: | |||||||||||||||
| #2 | Medical-Hispanic | Medical (*) | Continued (*) | Hispanic (*) | 77000 | 3000 | 80000 | 80000 | One visit - Professional, diagnostic and therapeutic services rendered by MD, PA, or NP in office based setting | 400 | 402 | 100 | 20 | 0 | 4 | 10 | 105 | 21 | 0 | 3 | 11 | Planned Outcome #1 and Indicator(s): At a minimum, 70 percent of clients served will achieve improved or stable CD4 counts by the end of the reporting period. | 70 | Planned Outcome #2 and Indicator(s): | Planned Outcome #3 and Indicator(s): | Planned Outcome #1 and Indicator(s): | Planned Outcome #2 and Indicator(s): | Planned Outcome #3 and Indicator(s): | Narrative Description for, Outcome #1: Of 105 clients served with more than one CD4 count during the reporting period, 68 (65%) had improved CD4 counts, 13 (12%) maintained stable CD4 counts, and 24 (23%) had a decline in their CD4 count. This was an improvement over last year when 20% of clients had improved CD4 counts and another 40% had stable CD4 counts. | 105 | 81 | 0.771428571428571 | Exceeded | Narrative Description for Outcome #2: | Narrative Description for Outcome #3: |
| 1. FY 2006 Title I MAI Award: | 2.MAI $$ Approved for Carryover from Prior Fiscal Year: | 3.Total Title I MAI Funds Available for use in FY: | FY 2006MAI Funds to be Used for Grantee Administration | Percent of FY 2006 MAI Funds to be Used for Grantee Administration |
| 200000 | 10000 | 210000 | 10000 | 5.00% |
| File Type | application/vnd.ms-excel |
| Author | Christy Kwon |
| Last Modified By | HRSA |
| File Modified | 2006-10-24 |
| File Created | 2006-03-10 |