Formative Data Collections for American Rescue Plan (ARP) Act Supplemental Funding Program Support

American Rescue Plan (ARP) Act Supplemental Funding Survey

Family Violence Prevention and Services Act (FVPSA) Grantee

Workforce, Partnerships, and Technical Assistance Needs Survey

Office of Family Violence Prevention and Services

Administration for Children and Families

U.S. Department of Health and Human Services

Thank you for your participation. In an effort to assess implementation of the ARP Act supplemental funding, we would like to request your participation in this survey. The information provided will be used to improve the Office of Family Violence Prevention and Services (OFVPS) training and technical assistance provided to you as a grantee. Please note your participation in this feedback survey is voluntary, and the information provided will be kept private.

Paperwork Reduction Act of 1995 (Pub. L. 104-13) Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions.

Please only include information that is funded through the ARP supplemental funding and do not include information that is funded exclusively with FVPSA core annual funding. You may find you have not provided services using ARP funding, so the answer “No” or “O” is acceptable for those questions or categories.

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 OMB # is 0970-0531 and the expiration date is 09/30/2025. If you have any comments on this collection of information, please contact Sabrina Peña at sabrina.pena@acf.hhs.gov and Holi Dahl at Holi.Dahl@acf.hhs.gov.

Workforce Support and Capacity Building

Total number of staff paid using ARP Act supplemental funding:

Instructional Note: Each full-time paid staff member should equal 1. If an employee is part-time, please use the numeric value of 0.5.

	Total
Total number of staff paid using ARP supplemental funding

Please share the type and total number of staff paid using FVPSA ARP supplemental funding:

Instructional Note: Each full-time paid staff member should equal 1. If an employee is being paid from more than one category, use fractions to denote the allotted time in each (i.e., 0.5 or 0.33). Please enter 0 in in fields that do not apply.

	Total
ARP DV Services Funding
ARP COVID-19 Testing, Vaccines, Mobile Health Units Funding
ARP Sexual Assault Services Funding
Total	[Auto Sum]

Types of workforce capacity building and supports being implemented with ARP supplemental funding.

	Please indicate if your ARP grant funds are supporting this support [Yes/No]	Please indicate the number of staff impacted
Hired more FVPSA funded staff
Trained staff on COVID-19 mitigation activities: implementation of mobile advocacy services; or virtual/remote services implementation
Hired bi-lingual staff
Hired data collection staff/consultant
Paid Interns
Hired COVID-19 mitigation staff/consultant
Hiring bonuses
Retention payments
Childcare
Transportation subsidies
Wellness services (employee assistance programs, onsite fitness center, yoga classes, smoking prevention, nap space, etc.)
Health services (health insurance, prescriptions, chiropractic care, vision, dental, etc.)
Contracted with an employment agency
Other		[Open Text ]

Technical Assistance Provided for Temporary Refuge and Shelter Services:

Rental Assistance and Hotel/Motel Vouchers

Please tell us about the number of technical assistance contacts provided for:

	Total TA Contacts
Shelter alternatives
Rental assistance
Hotel/motel vouchers
Other

Rental Assistance and Hotel/Motel Partnerships

Total number of partnerships related to temporary refuge: shelter alternatives, rental assistance, and hotel/motel vouches.

	Total Number of Partners
Public housing agency
Rental company
Hotels/motels
Private landlords
Faith-based organization providing housing
Tribal program providing housing
Culturally specific organization providing housing
Homeless services provider
Housing agency
Other

NOTE: FORCE LOGIC ONLY DISPLAY CATEGORIES WITH >0 in previous table

New Rental Assistance and Hotel/Motel Partnerships

How many of the Rental Assistance and Hotel/Motel Partnerships included in the previous table are newly formed partnerships as a result of receiving FVPSA ARP Funding.

Count each collaborator only once / count in multiple	Total Number of New Partners
Public housing agency
Rental company
Hotels/motels
Private landlords
Faith-based organization providing housing
Tribal program providing housing
Culturally specific organization providing housing
Homeless services provider
Housing agency
Other

COVID-19 Supportive Services

Please tell us about your COVID mitigation and response. For each type of allowable supportive service, total number of items provided:

	Total
Mobile advocacy client sessions conducted
Personal Protective Equipment items provided (masks, gowns, etc.)
COVID-19 test kits
COVID-19 mitigation supplies (I.e., cleaning supplies, hand sanitizer, etc.)
COVID-19 vaccines
COVID mitigation minor updates (i.e., non-construction modifications/renovations)

Health and Behavioral Health Partnerships

Please tell us more about the types of health and behavioral health partnerships that have been formed or enhanced with your organization’s ARP supplemental funding.

	Total
Total number health and behavioral partnerships

Please include the total number of partners supported/engaged for each type of partnership. Partnerships reported above may be included in more than one category below.

	Total
Hospital/Health Centers
Medical clinics
State health department health care authorities/providers
Health associations
Private COVID-19 testing providers
Home Visitation or Visiting Nursing providers
State Behavioral Health/Mental Health agencies
Substance Use Treatment providers
Indian Health Services
Urban Indian Organizations
American Indian or Alaska Native Health Boards
Tribal health clinics
Culturally Specific Healthcare or Health Services providers
Sexual Assault Nurse Examiners associations/agencies

Innovative Projects

Please share the type and total number of innovative projects funded with FVPSA ARP supplemental funding:

	Total
Survivor engagement, services, or support innovation
Health and domestic violence innovation
Health and sexual assault innovation
Mental health innovation
Substance use innovation
Mobile services innovation
Virtual services innovation
Culturally specific communities innovation
LGBTQ communities innovation
American Indian and Alaska Native services innovation
Youth services innovation
COVID mitigation innovation
Other
Total	[Auto Sum]

Grant Funds Spending Challenges

What challenges do you experience spending ARP Act supplemental funds? (check all that apply)

	Implementation
	Difficulty finding appropriate/sufficient shelter
	Difficulty finding appropriate/sufficient sub-awardees
	Difficulty implementing remote/virtual services
	Difficulty finding ARP activity authorized supplies
	Difficulty implementing mobile advocacy services
	Difficulty implementing telehealth or mobile health services
	Difficulty implementing innovative services
	Difficulty finding appropriate/sufficient workforce

	Funding
	Having sufficient other funds to expend prior to ARP funds
	Difficulty identifying appropriate ARP and COVID-19 risk mitigating activities
	Complications of tracking and allocating funds from multiple grants simultaneously
	Difficulty drawing down funds through the Payment Management System

	Regulatory or Policy limitations
	Having to use other to use funds that expire before using ARP funds
	Local regulations limiting spending flexibility
	State regulations limiting spending flexibility
	Federal regulations limiting spending flexibility
	Tribal government/Tribal Council approval is pending, delayed, or was denied.

	NONE
	Other (Please Specify)

Training and Technical Assistance

Types of Training and technical assistance your coalition needs: (check all that apply)

	Training Needed	Technical Assistance Needed
Assessing, planning, adapting workforce capacity
Assessing, planning, adapting organizational programs/processes
Assessing, planning, adapting supportive services
Assessing, planning, adapting client risks
Supporting underserved populations
Supporting culturally specific populations
Providing mobile advocacy
Providing remote/virtual services
Providing sexual assault supportive services
Providing mobile health unit services including contracted
Providing linguistically appropriate services, referrals, and staff
Providing culturally specific services, referrals, and staff
COVID-19 testing activities
Provisioning virus testing supplies
COVID-19 contact tracing
COVID-19 education
COVID-19 vaccine promotion or confidence building
Support services for acute virus infection symptoms
Providing telehealth direct crisis intervention services
Innovating new service pilots
Improving current processes and/or best practices
Removing barriers to health or behavioral health services
Improving collaboration with established partners
Developing new partnerships with health care providers
Flexible funding
None
Other (comment box, "Please specify")

Conveying impact through a story:

Share a brief story about an individual client or service/community that benefited from FVPSA ARP Act supplemental funding. Please do NOT share personally identifiable information. (Limited to 2,000 characters)

Title of Story:

Story Category:

	Type Please check all categories that apply to the impact story.
Survivor engagement, services, or support impact
Health and domestic violence impact
Health and sexual assault impact
Mental health impact
Substance use impact
Mobile services impact
Virtual services impact
Culturally specific communities impact
LGBTQ communities impact
American Indian and Alaska Native services impact
Youth services impact
COVID mitigation impact
Other

Story Link: Please provide the story website link or resource link if one is available.

Story Narrative:

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