CHNA 20 Year 1 Substance Abuse Prevention Coalition Report In an effort to assess the Start-up Substance Abuse Prevention Coalition Program, CHNA 20 is asking grantees to complete a Year 1 program report. This update will be used by CHNA 20 as part of its ongoing data collection efforts, which help in assessing the impact of CHNA 20's funding, activities, and resource allocation within the communities it serves. Information collected will also be considered in CHNA 20's future planning of initiatives and service delivery to its members. Please complete and return your program report to CHNA 20 by November 30, 2015. Name of Coalition: Towns Your Coalition Serves: How many Sectors Are Currently Represented in Your Coalition? 12 Sectors Representative(s )? Y /N 1. Youth (persons <= 18 years of age) 2. Parents 3. Business community 4. Media 5. Schools 6. Youth-serving organizations 7. Law enforcement agencies 8. Religious or fraternal organizations 9. Healthcare professionals 10. State, local or tribal agencies with expertise in the field of substance abuse 11. Civic and volunteer groups 12. Other organizations
I. Population/Demographic Information 1. Key population or demographic your coalition is targeting: 2. Number of people you expect to be directly impacted by your coalition now and over the next year:
3. Additional coalition reach (Are there others you can identify who may be indirectly impacted by the work you are doing)? II. Collaborative Work Summary CHNA 20 has a particular interest in supporting work that increases meaningful collaborations. How would you rate the effectiveness of your SA Coalition in both internal and external collaboration in the following areas? 1. Planning a. Within coalition Inconsistent Met expectations Exceeded expectations b. With community partners Inconsistent Met expectations 2. Activities a. Within coalition Inconsistent Met expectations b. With community partners Inconsistent Met expectations 3. Integration a. Within coalition Inconsistent
Exceeded expectations Exceeded expectations Exceeded expectations
Met expectations
Exceeded expectations
b. With community partners Inconsistent Met expectations
Exceeded expectations
4. Do you envision collaborating after the SA Coalition program is no longer funded (Yes/No) Additional comments: III. Challenges Often, the process of building a coalition involves overcoming unexpected challenges in order to reach your goals. CHNA 20 views these challenges not as a negative factor, but rather as an opportunity to gain new insights and knowledge that can strengthen your work in the future. 1. Please describe any challenges you may have encountered in building your coalition and any insights you have gained. 2. Does your coalition plan to do anything different in Year 2? IV. Evaluation of CHNA 20's Support Part of CHNA 20â&#x20AC;&#x2122;s intention in collecting reports from grant recipients is to help improve the services of the organization to its members. Please evaluate CHNA 20's role. 1. Communication from CHNA 20 regarding the SA Coalition program Inconsistent Met expectations Exceeded expectations 2. Opportunities for professional development/trainings offered by CHNA 20
Inconsistent
Met expectations
Exceeded expectations
3. Additional support and/or guidance offered by CHNA 20 (Ex: Technical Assistance) Inconsistent Met expectations Exceeded expectations Additional comments: V. Summary of Key Activities 1. Please describe your coalition activities for Year 1 and any particular achievements you feel should be highlighted. 2. Please describe the coalition activities you plan to do in Year 2 3. Please include how your coalition focuses on building coalition capacity, substance abuse prevention and/or reducing substance abuse rates VI. Sustainability CHNA 20 is always interested in finding ways to sustain and build upon programs and projects that are valuable to the communities we serve. Your thoughts on the sustainability of your coalition will help us to shape future policies and decisions about resource allocation to our members. 1. Do you currently plan to sustain your coalition after Year 2? (Yes/No) IX. Budget 1. Please provide a brief description of your use of funds in Year 1. 2. What are your plans for use of funds in Year 2?