Blue Hills Community Health Alliance (CHNA 20) 2016 Community Grant Mid-Year Report Form This mid-year report will assist CHNA 20 in assessing where current grant recipients are in their program cycles and what progress has been made towards your desired goals for your use of grant funds. It will also alert us to any potential challenges or roadblocks that may be hindering your efforts, so that we can offer help and support as needed. Our goal is to see all grant recipients achieve success in their efforts, and we are available for guidance throughout the grant cycle in order to help you reach your desired outcomes. Organization Name: Contact Name, Phone and Email: Project Title: Population Served a. What population are you currently serving through your CHNA 20-funded project? b. How many people are impacted by your current project? Collaboration a. As outlined in the original RFP, CHNA 20 is committed to supporting efforts to develop and foster collaborations and partnerships. If applicable, please name at least one collaboration or partnership that you are currently pursuing as part of this grant. In no more than 5 sentences, describe the planned collaboration and give a brief report on its status. Activities a. Please list three activities you have completed so far that are contributing to the progress of your grant-funded project or program. Examples of activities might include staff planning meetings, creation of important documents or marketing materials, entering into a collaborative agreement with another agency, gathering key data, or completing work sessions or events. b. Please list up to three future activities that you have planned to continue moving your project or program forward. We ask that you include dates, times, and locations if that information is available to you. Project Changes a. Have you made any significant changes to your original project plan? (Yes/No) If yes, what changes were made, and what was the reason for the adjustment?
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Challenges a. Please describe any challenges you may have encountered in executing your project or program as planned. b. We want to see you succeed in your efforts. How can CHNA 20 help you with any of the challenges you have listed? c. Would you like to be contacted by a representative of CHNA 20 to discuss assistance to keep your project on track? (Yes/No) No thank you. Evaluation a. Evaluation of a program's success is a vital part of a healthy grant funded program. How do you plan to measure the success of your efforts? b. Have you begun collecting any data or evidence to assist you with the evaluation process? If so, what types of materials have you collected? Thank you! We look forward to learning more about your work.
Please return this report to CHNA 20 by email or post by January 31, 2016. Contact information for CHNA 20: Arlene Goldstein Program Manager CHNA 20 180 Old Colony Avenue, Suite 300 Quincy, MA 02170 agoldstein@baystatecs.org 617-471-8400 x155
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