CHNA 20 Boards of Health Collaboration Y1 Report In an effort to assess the Boards of Health Collaboration 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. Project name: Towns your project serves: Names of public health nurses involved in the project: I. Population/Demographic Information 1. Key population or demographic your project is targeting: 2. Number of people you expect to be directly impacted by your project now and over the next year: 3. Additional project 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 within our catchment area. How would you rate the effectiveness of your BoH collaboration in the following areas? 1. Planning Inconsistent Met expectations Exceeded expectations 2. Activities Inconsistent
Met expectations
Exceeded expectations
3. Integration Inconsistent
Met expectations
Exceeded expectation
4. Do you envision collaborating after the BoH project is no longer funded (Yes/No) Additional comments: III. Challenges Often, the process of implementing a grant-funded project 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 executing your project and any insights you have gained. 2. In Year 2 of the project do you plan to do anything different? IV. Evaluation of CHNA 20's Support Part of the intention of CHNA 20 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 BoH Collaboration 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 Inconsistent Met expectations Exceeded expectations Additional comments: V. Summary of KeyActivities 1. Please describe the activities of your project for Year 1 and any particular achievements you feel should be highlighted. 2. Please describe the activities you plan to do in Year 2 of your project. 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 project will help us to shape future policies and decisions about resource allocation to our members. 1. Do you currently plan to sustain, repeat, or replicate your project 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?