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pdfCMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
CMHS Programmatic Progress Report (PPR) Template
Overview/Instructions
1) Report work completed in the prior 12-month grant period.
2) Submit a .PDF of your completed PPR in the eRA Commons Terms Tracking System no later than 90 days after
the end of each 12-month budget period.
Template Version
CMHS Program
Report Sections
Section I. Grant and Report Information
Section II. Grant Management
Section III. Project Activity Accomplishments
Section IV. Progress Reporting
Section V. Disparity Impact Statement (DIS)
OPTIONAL Section
Section I. Grant and Report Information
1. Grantee Name
2. Grant Number
3. Unique UEI
4. Project Period
4a. Start Date
4b. End Date
5. Reporting Period
5a. Start Date
5b. End Date
6. Report Frequency
Select
7. Person
Completing
Report
7a. Name
7b. Email
7c. Position
7d. Phone Number
1
6a. Final report?
0
--------------------------------------------------------------------------------------------------------------------------------------------------------Public reporting burden for this collection of information is estimated to average 8 hours per year. Send comments
regarding this burden estimate or any other aspect of this collection of information to SAMHSA Reports Clearance
Officer, Room 15E57B, 5600 Fishers Lane, Rockville, MD 20857. An agency may not conduct or sponsor, and a
person is not required to respond to a collection of information unless it displays a currently valid OMB control
number. The control number for this project is 0930-0395.
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CMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
Section II. Grant Management
Key Personnel Changes
•
•
Enter the first and last name of required key personnel, as specified in the NOFO.
Check the “Change in Key Personnel” box and provide the reason for the change, if any key personnel changes
occurred during the reporting period.
Position
First and Last Name
Change in
Key
Reason for Personnel Change
Personnel
Project
Director
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CMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
Section II. Grant Management (Continued)
Project Budget
•
•
Describe any changes to your grant project’s budget that occurred during the reporting period.
Describe any challenges you had in implementing the project budget or spending dispersed funds during the
reporting period. Describe project plans or actions to overcome any challenges you list below.
Budget Changes
Greater than 25
percent of Total
Award or Greater
than $250,000
(if any)
Budget Changes
Less than 25
percent of Total
Award
(if any)
Project Budget or
Spending
Challenges
(if any)
Plans or Actions
to Overcome
Challenges
(if project
experienced
challenges)
Project Scope and Implementation
•
Describe any significant changes that occurred during the reporting period for each item below. If no changes
in project scope or implementation occurred, please enter “None”.
Scope or
Change(s)
(if any)
Project
Implementation
Change(s)
(if any)
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CMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
Section III. Project Activity Accomplishments
Required Project Activities
•
•
•
Describe your project’s progress achieved during the reporting period in conducting each activity below.
Explain how your project met the goals and objectives stated in your grant application.
Discuss any challenges your project had for each activity and plans/actions for overcoming the challenge.
1 Required activity: Provide specialized and individualized support to individuals with SMI and COD to choose,
acquire, and maintain competitive employment. Provide comprehensive treatment and recovery support
services for SMI and/or COD in conjunction with vocational services. Assess for housing status and collaborate
with homeless and housing service providers to link to the local HUD Coordinated Entry housing system.
1a
Accomplishments
1b
Challenges/
Barriers (if any)
1c
Plan/Action for
Overcoming
Challenges/
Barriers (if project
experienced
challenges)
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CMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
Section III. Project Activity Accomplishments (Continued)
Required Project Activities (Continued)
2
Required activity: Conduct supported employment fidelity assessments no later than 90 days after
service delivery begins and annually thereafter.
2a
Accomplishments
2b
Challenges/
Barriers (if any)
2c
Plan/Action for
Overcoming
Challenges/
Barriers (if project
experienced
challenges)
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CMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
Section III. Project Activity Accomplishments (Continued)
Required Project Activities (Continued)
3
Required activity: Develop and implement an employer engagement strategy.
3a
Accomplishments
3b
Challenges/
Barriers (if any)
3c
Plan/Action for
Overcoming
Challenges/
Barriers (if project
experienced
challenges)
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CMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
Section III. Project Activity Accomplishments (Continued)
Required Project Activities (Continued)
4
Required activity: Develop and implement a strategy to respond to the unique needs of individuals who are
unsuccessful in finding employment.
4a
Accomplishments
4b
Challenges/
Barriers (if any)
4c
Plan/Action for
Overcoming
Challenges/
Barriers (if project
experienced
challenges)
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CMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
Section III. Project Activity Accomplishments (Continued)
Required Project Activities (Continued)
5
Required activity: Develop and implement a strategy for long-term employment stability.
5a
Accomplishments
5b
Challenges/
Barriers (if any)
5c
Plan/Action for
Overcoming
Challenges/
Barriers (if project
experienced
challenges)
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CMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
Section III. Project Activity Accomplishments (Continued)
Required Project Activities (Continued)
6
Required activity: Provide training on behavioral health implementation for the national Culturally and
Linguistically Appropriate Services (CLAS) standards to all program staff. Translate tools and resources
available to recipients of services. Provide, increase, or enhance access to services for people of all racial/
ethnic/marginalized groups in the community. Create conflict and grievance resolutions processes that are
culturally and linguistically appropriate.
6a
Accomplishments
6b
Challenges/
Barriers (if any)
6c
Plan/Action for
Overcoming
Challenges/
Barriers (if project
experienced
challenges)
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CMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
Section III. Project Activity Accomplishments (Continued)
Required Project Activities (Continued)
7
Required activity: Develop a sustainability plan that identifies mechanisms for sustaining activities funded by
this grant and delineates steps necessary for exercising those mechanisms.
7a
Accomplishments
7b
Challenges/
Barriers (if any)
7c
Plan/Action for
Overcoming
Challenges/
Barriers (if project
experienced
challenges)
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CMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
Section IV. Progress Reporting
Infrastructure Development, Mental Health Prevention and Promotion (IPP)
For each indicator below:
•
•
Check the “Goal Met” box to indicate if your project met the goal as entered in SPARS.
For unmet goals:
o Describe any barriers or setbacks the grant encountered during the reporting period.
o State the project plan or action for overcoming challenges in achieving project goals.
IPP
Indicator
Goal
Met*
Barrier/Setback in Achieving Goal
(if any)
Plan or Action to Overcome Challenge
(for any barrier or setback)
TR4
R1
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CMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
Section IV. Progress Reporting (Continued)
Infrastructure Development, Mental Health Prevention and Promotion (IPP) (Continued)
IPP
Indicator
Goal
Met*
Barrier/Setback in Achieving Goal
(if any)
Plan or Action to Overcome Challenge
(for any barrier or setback)
AC1
O1
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CMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
Section IV. Progress Reporting (Continued)
Client-Level Services
For each measure below:
•
•
Check the “Goal Met” box to indicate if your project met the goal as entered in SPARS.
For unmet goals:
o Describe any barriers or setbacks the grant encountered during the reporting period.
o State the project plan or action for overcoming challenges in achieving project goals.
Client-Level
Services
Measure
Goal
Met*
Barrier/Setback in Achieving Goal
(if any)
Plan or Action to Overcome Challenge
(if any barrier or setback)
Number of
Clients
Served this
Year
Number of
Cumulative
Unique
Clients
Served over
the Project
Period
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CMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
Section IV. Progress Reporting (Continued)
Program-Specific Measures
•
For each program-specific measure below, report according to guidance provided.
Measure
Value
Notes
Employed
During
Enrollment
(Count)
Employed 90+
Days (Count)
Employed at
Exit (Count)
Employed at
180 Days
(Count)
Median Hourly
Salary ($)
Median
Weekly Hours
Worked
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CMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
Section V. Disparity Impact Statement (DIS)
Status and Updates
•
Provide an update on your project’s DIS addressing the questions below.
Progress
towards DIS
Goals?
Barriers
Encountered
Serving
Populations
of Focus?
Efforts to
Overcome
Barriers?
DIS Tracking,
Monitoring
and/or
Evaluation
Activities?
Adjustments
to the
Quality
Improvement
Plan?
(if any)
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CMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
Optional Section
Other Accomplishments/Concerns/Activities – OPTIONAL SECTION
Answering any item in this section is NOT REQUIRED.
•
Describe other accomplishments, concerns or activities you did not include above but which are important for
successful implementation of your grant.
Other
Accomplishments
Other Concerns
Questions
Additional
Comments
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CMHS PPR
SEP_2023_1
OMB No. 0930-0395
Expiration Date 6/28/2026
Optional Section (Continued)
Grantee Success Story – OPTIONAL SECTION
Answering any item in this section is NOT REQUIRED.
If you choose, we encourage you to share one or two success stories. This may include an example of how the
grant had a positive impact, or positive feedback you received about the grant.
• Before you share a story here:
o Be aware that SAMHSA may share the stories you provide with people outside of the agency.
o Make certain your story does not include information that can be used to identify individuals.
o Get permission from anyone you describe (clients, participants, or staff).
•
Grantee
Success
Story #1
Grantee
Success
Story #2
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| File Type | application/pdf |
| Author | KSB (SAMHSA/CMHS) |
| File Modified | 2024-01-03 |
| File Created | 2023-12-19 |