Blue Hills Community Health Alliance (CHNA 20) Multi-year Grant Program Mid-Year Report Y1 PART 2: RESULTS ACCOUNTABILITY PROJECT WORKPLAN TEMPLATES Please complete the following templates to highlight the activities/strategies you are planning or implementing, and the outcomes you expect in Year One. The Project Workplan Templates are similar to those you were asked to submit during the grant application process. Goal (s): PHASE ONE (Capacity building, project planning, implementation) Activity/Strategy
Desired Outcome
Outcome Measurement (indicator)
Assessment Method (tool)
* Please use the following list for outcome category number 1. 2. 3. 4. 5. 6.
Capacity building Community organizing Education and/or training Providing direct services Advocacy Other (please describe): _______________________
Outcome Category* (1-6)
Status/ Timeline
PROGRESS TOWARDS PROJECT GOALS Please fill out the table below to help us understand your progress toward project goals. See definitions for change below. Project Goal
Status, 6.1.15
Status, 11.1.15
Ex. Increase # of families accessing nutrition assistance program by 20%
150 families are signed up through the NAP
165 families are signed up through the NAP
Measured Outcome 10% increase in families accessing nutrition assistance program (50% of goal)
Change* BC
*Please use the following change definitions: 1. Knowledge Change (KC) is defined as a program goal that has increased the grasp of key 2. 3. 4. 5. 6.
information or concepts among your program population. Attitude Change (AC) is defined as a program goal that has affected the general perspective or orientation among your program population regarding a concept. idea or action. Behavior Change (BC) is defined a program goal that has improved the habits and functions of your program population in specific, measurable ways. Environmental Change (EC) is defined as a program goal that has measurably improved the safety, accessibility, appropriateness or usability of a physical area or community. System/Policy Change (S/PC) is defined as a program goal that has made progress towards changing the way things are done, organizational practices, or legal/municipal regulations. Other ____________________________________________________________________
PART 3: FINANCIAL ACCOUNTIBILITY MATRIX Total Project Budget Year 1
CHNA 20 Expenses for this Project A. Personnel Costs
% FTE
Budgeted Costs
Actual CHNA 20 Expenditures Funds ($)
B. Total NonPersonnel Project Expenses
B. Administrative Costs
Total Expenses (A+B+C)
List all Revenue Sources for the Program, including CHNA 20 Description
Amount
Other/ In-kind ($)
Projected Costs through yearend
Total revenue from all Sources for this Project