Copy of Reporting Form with changes tracked

OMB Clearance # 1122-0010

Expiration Date 3/31/08OMB Clearance # 1122-00101-0280

Expiration Date 3/31/08 07/31/2004

U .S. Department of Justice

Office on Violence Against Women

Semi-Annual Progress Report for

Grants to State Sexual Assault and Domestic Violence Coalitions Program

Brief Instructions: This form must be completed for each Grants to State Sexual Assault and Domestic Violence Coalitions Program (State Coalitions Program) grant received. The grant administrator or coordinator must ensure that the form is completed fully with regard to all grant activities. Throughout this form, State Coalition Program funds include the 25% grant match.

All grantees should read through 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 D of this form must be completed by all grantees. In section A, subsection A1 must be answered by all grantees. In subsection A2 and section C, grantees must answer an initial question in each subsection about whether they engaged in certain activities during the current reporting period. If the response is yes, then the grantee must complete that subsection. If the response is no, the rest of that subsection is skipped.

For example, (1) if you only provided training and technical assistance with staff funded under this grant during the current reporting period, you would complete sections A, B, C1, C6, and D (and answer ‘no’ in C2-C5 and

C7-C9); or, (2) if you provided training and technical assistance with staff funded under this grant and grant-funded staff developed products during the current reporting period, you would complete sections A, B, C1, C4, C6, and D (and answer ‘no’ in C2, C3, C5, C7-C9).

The activities of volunteers or interns should may be reported if they weare coordinated or supervised by State Coalitions Program grant-funded staff or if State Coalitions Program funds substantially supported their activities.

For further information on filling out this form, refer to the separate set of instructions, which contains detailed definitions and examples, illustrating how questions should be answered.

SECTION Page Number

Section A: General Information 1

Section A1: Granteneral Information 1

Section A2: Staff Information 2

Section B: Program Activities 3

Section C: Function Areas 4

C1 Training 4

C2 System Advocacy 7

C3 Policies 10

C34 Products 101

C4 Public Awareness 1123

C5 Technical Assistance 1234

C6 Standards of Service 1456

C7 Underserved Populations 1567

C8 Organizational Development and Capacity Building 17678

Section D: Narrative 18789

Appendix A: Status of Goals and Objectives Table 20

A . GENERAL INFORMATION

A1. Grant information

All grantees must complete this section.

1. Date of report

2. Current reporting period  January 1-June 30  July 1-December 31 (Year)

3. Grantee name

4. Grant number (the federal grant numbers assigned to your State Coalitions Program grant)

____________________________________________________________

____________________________________________

5. Type of grantee organization (Check one.)

• Dual Sexual Assault/Domestic Violence Coalition

• Sexual Assault Coalition

• Domestic Violence Coalition

6. Point of contact (person responsible for the day-to-day coordination or administration of the grant)

First Name _______________MI_____ Last Name

Agency/organization name

Address

City State Zip Code

Telephone Facsimile

E-mail

7. What percentage of your total operating budget is funded by the State Coalitions Program grant? (Do not include pass-through funding that the coalition awards to local sexual assault or domestic violence programs.) _________________

8. Coalition members (Report the total number of organizational members, including sexual assault programs, domestic violence programs, other victim services agencies, and other organizational members, as applicable to your state coalition. Report the total number of individual members, if applicable to your state coalition. Individual members are individual persons, not programs.)

Organizational members	Number
Sexual assault programs/rape crisis centers
Domestic violence programs
Sexual assault and domestic violence dual programs
Tribal victim services agencies
Other victim service providers
Other organizational members
Total number of organizational members
Total number of individual members

A 2. Staff Information

Were State Coalitions Program funds used to fund staff positions during the current reporting period? Check yes if State Coalitions 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 by State Coalitions Program grant during the current reporting period. Report staff by the function(s) performed, not by title or location. Include employees who are part-time and/or partially funded with these grant funds as well as consultants/contractors. Report grant-funded overtime. 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 administrator in October who was 100% funded with State Coalitions Program funds, you would report that as .5 FTEs. Report all FTEs in decimals, not percentages. One FTE is equal to 1,040 hours—40 hours per week x 26 weeks. full-time equivalent [FTE] staff funded by State Coalitions Program grant during the current reporting period. Include employees who are part-time and/or only partially funded with these grant funds as well as contractors. If an employee or contractor was not employed or utilized over the entire reporting period, report the average. Round to the second decimal. See separate instructions for examples of how tohow to calculate FTEs for part-time staff and contractors.)

Staff	FTE (s)Grant-funded staff
Administrator (fiscal manager, executive director)
Civil aAttorney
Communications specialist (public awareness, media relations)
Information technology staffpecialist
Paralegal
Program coordinator (training coordinator, outreach coordinator)
Support staff (secretary, administrative assistant, accountant, bookkeeper)
Systems advocate
Technical assistance provider
Trainer
Translator/Interpreter
Other (specify): ______________________________________
TOTAL

B . PROGRAM ACTIVITIES

All grantees must complete this section.

10. Program activities (Check all program activities your State Coalition engaged in during the current reporting period. Check the appropriate box to indicate whether the activity was supported with State Coalitions Program funds or another funding source.)

State Coalitions Program funded	Other funding source	Program activities
		Providing technical assistance to member programs.
		Expanding the technological capacity of coalitions and/or member programs.
		Developing or enhancing appropriate standards of services for member programs, including culturally appropriate services to underserved populations.
		Conducting statewide, regional and/or community-based meetings or workshops for victim advocates, survivors, legal service providers, and criminal justice representatives.
		Bringing local programs together to identify gaps in services and to coordinate activities.
		Increasing the representation of underserved populations in coordination activities, including providing financial assistance to organizations that serve underserved communities to participate in planning meetings, task forces, committees, etc. Encouraging the representation of underserved populations in coordination activities, including the provision of scholarship funding to underserved communities to participate in planning meetings, taskforces, committees, etc.
		Engaging in activities that promote coalition building at the local and/or state level.
		Coordinating federal, state and/or local law enforcement agencies to develop or enhance strategies to address identified problems.
		Engaging in systems advocacy to effect policy and/or procedural change in order to improve institutional responses to domestic violence and sexual assault.

11. Other activities (List all other activities, not included in question 10, which your State Coalition engaged in during the current reporting period. Check the appropriate box to indicate whether the activity was supported with State Coalitions Program funds or another funding source.)

State Coalitions Program funded	Other funding source	Activity
		a.
		b.
		c.
		d.
		e.
		f.

C. FUNCTION AREAS

C 1. Training

Were your State Coalitions Program funds used for training during the current reporting period? Check yes if State Coalitions Program-funded staff provided training or if State Coalitions Program funds were used to directly support the training.

• Yes--answer questions 12-14

• No--skip to C2

For the purposes of this reporting form, trainingtraining means providing information on sexual assault, dating violence, domestic violence, and stalking that enables a professionalserson to improve their response to victims/survivors as it relates to their role in the system. EducationEducation means providing general information that will increase public awareness of sexual assault, dating violence, domestic violence, or stalking. In this subsection, report information on training activities. Educational activities should be reported in subsection C54 Public Awareness.

12. Type and number of training events provided (Report the number of statewide, regional, and community-based training events by the type of training that were either provided by State Coalitions Program-grant funded staff or directly supported with State Coalitions Program funds. Staff development training provided to State Coalitions Program-funded staff should not be counted. Use the SA/DV columns if training events focused on both sexual assault and domestic violence.)

Type of training	Total number of training events
	Statewide			Regional			Community-based
	Sexual assault	Domestic violence	SA/ DV	Sexual assault	Domestic violence	SA/ DV	Sexual assault	Domestic violence	SA/ DV
Computer-based training
Conferences
Teleconferences
Videoconferences
Workshops/seminars
Other (specify): __________

1 3. Number of people trained (Report the number of people trained during the current reporting period by State Coalitions Program-funded staff or training supported by State Coalitions Program funds. Use the category that is most descriptive of the people attending the training event. If you do not know how many people to report in specific categories, you may report the overall number in “Multidisciplinary.” Please use only as a last resort. State Coalitions Program-funded staff attending staff development training should not be counted. Total person-hours are calculated by multiplying the number of people trained by the length of the individual training event.)

People trained	Number	Person-hours
Advocacy organization staff (NAACP, AARP)
Attorneys/law students (does not include prosecutors)
Batterer intervention program staff
Board members
Child welfare worker/children’s advocates
Community advocacy organization staff (NAACP, Gray Panthers)
Corrections personnel (probation, parole, and correctional facilities staff)
Court personnel (judges, clerks)
Educators (teachers, administrators, etc.)
Faith-based organization staff
Government agency staff (vocational rehabilitation, food stamps, TANF)
Health professionals (doctors, nurses, does not include sexual assault forensic examiners (SAFE) or sexual assault nurse examiners (SANE)excluding forensic examiners)
Immigration organization staff
Law enforcement officers
Legal services staff (does not include attorneys)
Mental health professionals
Military command staffresponse professionals
Multidisciplinary (various disciplines at same training)group
Prosecutors
Sex offender treatment program staff
Sexual assault forensic examiners/Sexual assault nurse examiners
Social service organization staff (non-governmental – food bank, homeless shelter)
Substance abuse treatment provider
Translators/Interpreters
Tribal government/Tribal government agency staff
University/school faculty or staff
Victim advocates (sexual assault)
Victim advocates (non-governmental, includes domestic violence, sexual assault, dual)
Victim advocates (dual-sexual assault and domestic violence)
Victim-witness specialists assistants (governmental, includes victim-witness specialist/coordinator)
Volunteers
Other (specify):__________________________________________________
TOTAL

14. Training content areas (Indicate all topics addressed in training events provided with by your State Coalitions Program funds during the current reporting period. Check all that apply)

Sexual assault, domestic violence/dating violence, and stalking

• Advocate response

• Child witnesses

• Confidentiality

• Cyberstalking

• Dating violence overview, dynamics, and services

• Domestic violence overview, dynamics, and services

• Drug facilitated sexual assault

• Forensic evidence collection and documentation

• Mandatory reporting requirements

• Response to victims/survivors who are incarcerated

• Response to victims/survivors who have been trafficked

• Safety planning for victims/survivors

• Sexual assault overview, dynamics, and services

• Stalking overview, dynamics, and services

• Supervised visitation and exchange

• Other (specify): _________________________

Justice system

• Civil court procedures

• Criminal court procedures

• Decreasing dual arrests/identifying predominant aggressor

• Domestic violence statues/codes

• Firearms and domestic violence

• Immigration

• Judicial response

• Law enforcement response

• Pro-arrest policies

• Probation response

• Prosecution response

• Protection orders (including full faith and credit)

• Sexual assault forensic examinations

• Sexual assault statutes/codes

• Stalking statutes/codes

• Tribal jurisdiction and Public Law 280

• Other (specify): _______________________

Underserved populations

Issues specific to victims/survivors who:

• live in rural areas

• are American Indian or Alaska Native

• are Asian

• are black or African American

are disabled

are elderly

• are Hispanic or Latino

• are homeless or living in poverty

• are immigrants, refugees, or asylum seekers

• are lesbian, gay, bisexual, transgender, or intersex

• are Native Hawaiian or other Pacific Islander

• have disabilities

• have limited English proficiencyanguage barriers

• have mental health issuesproblems

• have substance abuse issuesproblems

• Other (specify):

Organizational community response

• Board roles and fiuduiciary responsibilies

• Collaboration

• Coordinated community response

• Community response to sexual assault

• Discrimination and oppression issues

• Emergency preparedness

• Evaluation

• Outreach to diverse/underserved populations

• Program accessibility

• Program rules

• Response teams (DART, DVRT, SART)

• Safety planning

• Standards of service

• Strategic planning

• Technology

• Technology safety issues

• Victim service administration and operations

• Other (specify): _________________________

15. (Optional) Additional information (Use the space below to discuss the effectiveness of training activities funded or supported by your State Coalitions-funded Program grant and to provide any additional information you would like to share about training activities beyond what you have provided in the data above. An example might include a change in how area hospitals respond to victims of domestic violence, sexual assault and stalking after a state-wide training for hospital staff.

CC2. System Advocacy

Were your State Coalitions Program funds used for system advocacy during the current reporting period? Check yes if State Coalitions Program-funded staff engaged in system advocacy or if State Coalitions Program funds directly support supported system advocacy. (System advocacy is an activity intended to effect policy and/or procedural change in order to improve institutional response to sexual assault and/or domestic violence.)

• Yes--answer questions 165-197

• No--skip to C3

165. System advocacy activities (Indicate the system advocacy activities convened or participated in with State Coalitions Program funds during the current reporting period. Check all that apply.)

Systems advocacy	Sexual assault	Domestic violence/Dating violence
Appointed, state-level commissions
Community, regional, statewide task force/caucus
Multidisciplinary working groups
Project-specific interagency working groups
Tribal systems advocacy
Other (specify): _________________________

1 7. Improved system response (Report the total number of statewide, regional, and local meetings convened and/or attended by State Coalitions Program-funded staff during the current reporting period.)

Agency/organization	Number of meetings convened		Number of meetings attended
	Sexual assault	Domestic violence/ Dating violence	Sexual assault	Domestic violence/ Dating violence
Advocacy organization (NAACP, AARP)
Batterer intervention program
Child welfare
Community advocacy organization (NAACP, Gray Panthers)
Corrections (probation, parole, correctional facility)
Court (state or local)
Crime victim compensation
Domestic violence program
Dual sexual assault and domestic violence program
Educational institution/organization
Faith-based organization
Federal criminal justice
Other federal entities/officials
Government agency ((INS, Social Security, TANF)
Health/mental health organization
Law enforcement (state or local)
Legal services organization (legal services, bar association, law school)
Multi-disciplinary group/task force
OrganizationsPeople representing underserved populations
Prosecutor’s office (state or local)
Sex offender management/sex offender treatment provider
Sexual Assault Forensic Examiners/Sexual Assault Nurse Examiners program (SAFE/SANE)
Sexual assault program
Social services organization (non-governmental - food bank, homeless shelter)
Substance abuse services
Tribal government/Tribal government agency
University/school
Victims/survivors
Other (specify): _______________________

187. Coordination activities (Indicate methods used during the current reporting period to coordinate state victim services activities and/or to collaborate and coordinate with federal, state, and local entities engaged in activities to reduce or end violence against women. Check all that apply.)

• E-mail

• E-mail listserv

• Facsimilex

• Newsletters

• Telephone/conference call

• Toll-free telephone number

• Tracking availability of victim services

• U. S. mail

• Webinar

• Web site

• Other (specify):

19. (Optional) Additional Iinformation (Use the space below to discuss the effectiveness of your system advocacy activities funded or supported by your State Coalitions-funded Program grant and to provide any additional information you would like to share about your system advocacy activities beyond what you have provided in the data above. An eExamples might includinclude:e We convened a multi-disciplinary task force of domestic violence programs, sexual assault programs and tribal government agencies which met for one in-person and 3 follow-up phone sessions to develop policies and procedures for more effectively serving tribal populations in our state resulting in an on-going collaboration with tribal leaders and a new level of trust.…………….

C3. Policies

W ere your State Coalitions Program funds used to develop, substantially revise, or implement policies or protocols during the current reporting period? Check yes if State Coalitions Program-funded staff developed, substantially revised, or implemented policies or protocols or if State Coalitions Program funds were used to directly support the development or implementation of policies or protocols.

• Yes--answer question 18

• No--skip to C4

18. Types of policies and/or protocols developed, substantially revised, or implemented during the current reporting period (Check all the types of policies or protocols developed, substantially revised, or implemented with State Coalitions Program funds during the current reporting period. Use the SA column for policies and/or protocols addressing sexual assault and the DV column for those addressing domestic violence.)

Victim services

SA	DV
		Appropriate response to underserved populations
		Confidentiality
		Mandatory training standards for staff and volunteers
		Staff, board, and/or volunteers represent the diversity of your service area
		Standards of service
		Victim/survivor informed about Crime Victims Compensation and Victim Impact Statements
		Other (specify) : ______________________

Health care

SA	DV
		Advocate response to emergency room
		Appropriate response to underserved populations
		Forensic evidence collection and documentation
		Forensic exams not billed to victim
		Mandatory training on sexual assault, domestic violence, and stalking
		Routine screening and referrals for sexual assault, domestic violence, and stalking
		Other (specify): ____________________

Law enforcement

SA	DV
		Appropriate response to underserved populations
		Identifying primary aggressor/discouraging dual arrest
		Immediate access to protection order information
		Mandatory training on sexual assault, domestic violence, and stalking
		No victims polygraphed
		Pro-arrest/mandatory arrest
		Protection order enforcement (including full faith and credit)
		Providing information to victims/survivors about victim services
		Other (specify): ______________________

Prosecution

SA	DV
		Appropriate response to underserved populations
		Mandatory training on sexual assault, domestic violence, and stalking
		No victims polygraphed
		Vertical prosecution
		Victim witness notification
		Other (specify): _____________________

Court

SA	DV
		Accelerated trial schedules
		Appropriate response to underserved populations
		Dedicated sexual assault or domestic violence docket
		Full faith and credit for protection orders
		Immediate access to obtaining protection orders
		Judicial monitoring of sexual assault, domestic violence, and stalking offenders
		Mandatory training on sexual assault, domestic violence, and stalking
		Policy against mutual restraining orders
		Procedures for courtroom security
		Other (specify): _______________________

Probation and parole policies

SA	DV
		Strategies to assist and protect victim during probation and parole
		Perform checks on police logs, criminal and civil databases
		Special procedures for cases involving diverse, underserved populations
		Offender accountability
		Other (specify): ________________

C34. Products

Were your State Coalitions Program funds used to develop, substantially revise, or distribute products during the current reporting period? Check yes if State Coalitions Program-funded staff developed products or if State Coalitions Program funds directly supported the development, revision, or distribution of products.

• Yes--answer question 201816

• No--skip to section C45

20189. Use of State Coalitions Program funds for product development, substantial revision, or distribution (Report the number of products developed, substantially revised, or distributed with State Coalitions Program grant funds during the current reporting period. Report the number of new products developed or substantially revised during the current reporting period; the title/topic and intended audience for each product developed, 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 substantially revised during the current reporting period, whether or not they were used or distributed, and on products that were previously developed or revised but were 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 used or distributed	Other languages
Brochures
Manuals
Newsletter
Training curricula
Training materials
Reports
Fact sheets
Web site (report number of page views in the used or distributed column)
Videos
Other (specify): ________________

CC45. Public Awareness

W ere your State Coalitions Program funds used for public awareness activities during the current reporting period? Check yes if State Coalitions Program-funded staff were used to support public awareness activities or if State Coalitions Program funds were used to directly support public awareness activities.

• Yes--answer question 21-221920

• No--skip to C56

210. Public awareness activities (Indicate the activitiesoutreach events that were supported with State Coalitions Program funds during the current reporting period. Indicate, by checking the appropriate box[box [es] whether the focus of the activity was sexual assault, domestic violence, stalking, or a combination of those issues. Check all that apply.)

Activities	Sexual assault	Domestic violence/Dating violence	Stalking
Community organizing/community events (rallies, speak outs, take back the night, vigils)
Clothesline Project
Educational exhibits (clothesline project, silent witness, information tables)
Concerts
Domestic Violence Awareness Month
Media campaigns (press conferences, public service announcements, articles)
Rallies/Speak Outs
Sexual Assault Awareness Month
Silent Witnesses
Stalking Awareness Month
Tabling at public events
Take Back the Night March
TheaterP productions for public awareness (video series, theater productions)
Video series
Vigils
Women’s History Month activities
Other (specify):_________________

22. (Optional) Additional Iinformation (Use the space below to discuss the effectiveness of your public awareness activities funded or supported by your State Coalitions-funded Program grant and to provide any additional information you would like to share about your public awareness activities beyond what you have provided in the data above. An example might include developing a video series documenting most effective advocacy provided to victims in rural communities, resulting in more awareness of the challenges and successes involved in this work being brought to community events, and to training sessions.

C56. Technical Assistance

W ere your State Coalitions Program funds used to provide technical assistance during the current reporting period? Check yes if State Coalitions Program-funded staff provided technical assistance or if State Coalitions Program funds directly supported the provision of technical assistance.

• Yes--answer questions 23-250-2121-22

• No--skip to C67

2301. Number of technical assistance activities (Report the total number of technical assistance activities provided to programs during the current reporting period, indicating whether they were site visits or other types of consultations. Consultations may include in-person, telephonic, electronic, or other types of contact. Each contact should be counted as one activity.)

Recipients of technical assistance	Number of site visits	Number of other technical assistance consultations
Batterer intervention program
Corrections (probation, parole, and correctional facility)
Court (state or local)
Disability organization
Domestic violence program
Dual sexual assault and domestic violence program
Elder organization
Faith-based organization
Forensic examiner program
Government agency
Health care provider (excluding forensic examiner)
Immigration organization
Law enforcement (state or local)
Legal services/attorneys/law students
Mental health care provider
Military command staff
Other sState cCoalition
Prosecutor’s office (state or local)
Sexual assault program
Stalking program
Tribal sexual assault or domestic violence program
University/school
Youth program
Other (specify): _______________________________
TOTAL

(Optional) Additional Information (Use the space below to discuss the effectiveness of your technical assistance activities and to provide any additional information you would like to share about your technical assistance activities beyond what you have provided in the data above.

2 43412. Topics of technical assistance (Check the topics that apply to technical assistance provided with State Coalitions Program funds during the current reporting period. The technical assistance provided may be categorized by more than one topic. Check all that apply.)

Topics of technical assistance	Sexual assault	Domestic violence/ Dating violence
Board development
Civil codes
Coordinated community response
Court response
Creating/sustaining diverse organizations
Criminal codes
Curricula and training issues
Developing or enhancing appropriate services for elder victims
Developing or enhancing appropriate services for victims who have disabilities
Developing or enhancing culturally appropriate services for underserved populations
Forensic evidence collection and documentation
Grant writing/reporting
Law enforcement response
Local policies and practices
Program development
Program evaluation
Probation and parole response
Prosecution response
Response to dating violence victims/survivors
Response to domestic violence victims/survivors
Response to sexual assault victims/survivors
Response to stalkingdomestic violence victims/survivors
Safety planning
Standards of service
State policies and practices
Technology and technology capacity (data collection systems and confidentiality)
Technology safety and security
Victim service administration and operations Other (specify): _____________________________________
Other (specify): __________________________________________________

254. (Optional) Additional iInformation (Use the space below to discuss the effectiveness of your technical assistance activities funded or supported by your State Coalitions-funded Program grant and to provide any additional information you would like to share about your technical assistance activities beyond what you have provided in the data above. An example might include site visits to organizations working with older women in 3 counties to document best practices when working with older victims of domestic violence, resulting in open conversations with those providing services and requests for more training on effective advocacy for this underserved population.

23. (Optional) Additional Information (Use the space below to discuss the effectiveness of your technical assistance activities and to provide any additional information you would like to share about your technical assistance activities beyond what you have provided in the data above. An example might include site visits to organizations working with older women in 3 counties to document best practices when working with older victims of domestic violence, resulting in open conversations with those providing services and requests for more training on effective advocacy for this underserved population.

C67. Standards of Service

W ere your State Coalitions Program funds used to develop or enhance standards of service for member programs/agencies during the current reporting period? Check yes if State Coalitions Program-funded staff were used to develop or enhance standards of service or if State Coalitions Program funds were used to directly support the development or enhancement of standards of service.

• Yes--answer question 2623

• No--skip to C78

2623. Development or enhancement of standards of service for member programs/agencies (Indicate if State Coalitions Program funds were used to develop, implement, or enhance standards of service or provide training on standards of service for member programs. Check all that apply.)

	Sexual assault	Domestic violence/Dating violence
Developing standards of service for members programs/agencies
Implementing standards of service for members
Enhancing standards of service for members programs/agencies
Training on standards of service for members

C78. Underserved Populations

W ere your State Coalitions Program funds used to develop or enhance standards of service for underserved populations or to encourage the representation of underserved populations in coordination activities during the current reporting period? Check yes if State Coalitions Program-funded staff were used to develop or enhance services for underserved populations or if State Coalitions Program funds directly supported representation of underserved populations in coordination activities.

• Yes--answer question 27-293-244-25

• No--skip to C89

2734. Activities addressing underserved populations (Check all activities in which State Coalitions Program funds were used to develop or enhance services for underserved populations or to encourage the representation of underserved populations in coordination services. Check the boxes in the appropriate columns to indicate whether the activities you engaged in were for sexual assault or domestic violence programs/services.)

Activity	Sexual assault	Domestic violence/ Dating Violence
Developing/distributing materials for underserved populations
Developing policy
Identifying gaps in services
Identifying underserved populations
Increasing organizational capacity for anti-oppression work
Supporting representatives of historically underserved groups to participate in meetings
Coordinating a task force/caucus to address issues concerning underserved populations
Training/technical assistance regarding culturally appropriate services for historically underserved populations
Other (specify): ___________________________________________________________________

2845. Underserved populations (Indicate which underserved populations were addressed in the activities indicated in question 246. Check all that apply.)

Victims/survivors who:

• live in rural areas

• are American Indian or Alaska Native

• are Asian

• are black or African American

• are disabled

• are elderly

• are Hispanic or Latino

• are homeless or living in poverty

• are immigrants, refugees, or asylum seekers

• are lesbian, gay, bisexual, transgender, or intersex

• are Native Hawaiian or other Pacific Islander

• have disabilities

• have limited English proficiencyanguage barriers

• have mental health issuesproblems

• have substance abuse issuesproblems

• Other (specify):

29. (Optional) Additional iInformation (Use the space below to discuss the effectiveness of your activities to reach underserved populations funded or supported by your State Coalitions-funded Program grant and to provide any additional information you would like to share about your activities to reach underserved populations beyond what you have provided in the data above. An example might include: We are identifying gaps in service for immigrants and refugees in our state through interviews with service providers for this underserved population. This has resulted in the identification of the need to include immigrants and refugees in two upcoming meetings to develop action steps.)

C 89. Organizational Development and Capacity Building

Were your State Coalitions Program funds used for organizational development and/or capacity building during the current reporting period? Check yes if State Coalitions Program-funded staff were used for organizational development and/or capacity building activities or if State Coalitions Program funds were used to directly support organizational development and/or capacity building.

• Yes--answer questions 230-315-26

• No--skip to D

3026.5. Coalition development and capacity building (Check all of the activities that were engaged in with State Coalitions Program funds during the current reporting period.)

Anti-oppression work
Board of directors
Communication (TTY, language lines, etc.)
Emergency preparedness
Equipment purchase (computers, printers, faxes, telephones, cell phones, etc.)
Evaluation/outcome measures
Identifying gaps in service
Internet capacity/e-mail accounts/listserv
Office space
Outreach to diverse/underserved populations
Personnel policies
Software purchase or development
Staff development
Strategic planning
Technology security and safety
Toll-free telephone line
Web site development or enhancement
Other (specify):______________________

31267. Do you consider system privacy and/or security when purchasing or developing software?

• Yes

• No

D . NARRATIVE

All grantees must answer question 32278.

Please limit your response to four pages for this question.

32.278. Report on the status of the goals and objectives for the State Coalitions Program grant (Using Appendix A as a guide, rReport 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 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.)

All grantees must answer questions 33289 and 34 2930 on an annual basis. Please submit this information on the January to June reporting form only.

Please limit your response to two pages for each question.

33289. What do you see as the most significant areas of remaining need, with regard to improving services to victims/survivors or sexual assault, domestic violence, dating violence and stalking, increasing victim/survivor safety, and enhancing community response (including and offender accountability for both batterers and sex offenders)? (Consider geographic regions, underserved populations, service delivery systems, types of victimization, and challenges and barriers unique to your state.)

34.2930. What has the State Coalitions Program funding allowed you to do or maintain that you could not do without receiving this funding? (For example, has the funding enabled you to identify gaps in services, improve culturally appropriate services to underserved populations, staff coalition office full time, or increase the participation rate of historically underserved communities in coordination meetings? Provide specific examples in your answer.)

Questions 335-36 are01 is optional.

Please limit your response to two pages for this question.

3510. Provide any additional information that you would like us to know about your State Coalitions Program grant and/or the effectiveness of your grant. (If you have other data or information regarding your program that would more fully or accurately reflect the effectiveness of your State Coalitions Program-funded program than the data you have been asked to provide on this form, answer this question. If you have not already done so elsewhere on this form, you may want to report on systems-level changes, community collaboration, the removal or reduction of barriers and challenges for victims/survivors, use of volunteers and/or interns to complete activities, promising practices, and positive or negative unintended consequences.)

361. 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.)

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, 810 7^th Street, NW, Washington, DC 20531.

APPENDIX A

Use this table only as a guide for the reporting format.

Goals/Objectives (Describe your goals and objectives, as outlined in your grant proposal, or as revised)	Key Activities	Status (e.g., completed, in progress, delayed, revised)	Comments (successes, challenges, explanations)

State Coalitions Page 10 2/4/20210

State Coalitions 2/4/202104/20/2004