Brief One-page document to paste into a proposal
RequiredotherQ1
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Grant activity is defined as any proposed activity in the Bureau of Justice Assistance (BJA)-approved grant application that is implemented or executed with BJA grant funds. A. Yes ____ B. No ____
RequiredotherQ2
A prompt for a description, a selection or a short answer.
Select only one area type. A. Urban (a large city with 50,000 or more people) ____ B. Suburban (territory outside of a large city with a population of 2,500 to 50,000 or more people) C. Rural (territory that encompasses all people or housing not included within an urban, suburban, or tribal area) ____ D. Tribal (territory that contains a concentration of people who identify with a federally recognized t…
RequiredotherQ3
No rule matched this measure, so no tier is guessed.
A. Yes ____ B. No ____ (Skip to question 6)
RequiredoutputQ4
A count of services or people, held in the organization’s own records.
should be greater than or equal to the number entered in question 5. If not, check for data entry errors. A. Number of treatment court staff who successfully completed training during the reporting period
RequiredotherQ5
A count of services or people, held in the organization’s own records.
A. Number of treatment court staff who rated training as satisfactory or better during the reporting period ____ Adult Discretionary Treatment Court Program—Statewide Performance Measures 2
RequiredotherQ6
No rule matched this measure, so no tier is guessed.
A. Yes B. No C. If Yes, explain:
RequiredotherQ7
No rule matched this measure, so no tier is guessed.
A. Yes B. No C. If Yes, explain: REVISED DECEMBER 2014 The performance measure questions presented here are preliminary and may be subject to revision. This document is only to be used for planning and data collection purposes. Adult Discretionary Treatment Court Program—Statewide Performance Measures 3 In this module, you will identify the goals you hope to achieve with your funding. Once submitted, these goals ca…
RequiredotherQ1
A prompt for a description, a selection or a short answer.
RequiredotherQ2
A prompt for a description, a selection or a short answer.
RequiredotherQ3
A prompt for a description, a selection or a short answer.
RequiredotherQ4
No rule matched this measure, so no tier is guessed.
A. Yes B. No C. If Yes, explain: ____
RequiredotherQ5
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
A. Yes B. No C. If No, explain: ____
RequiredotherQ6
A prompt for a description, a selection or a short answer.
RequiredotherQ7
A prompt for a description, a selection or a short answer.
REVISED DECEMBER 2014 The performance measure questions presented here are preliminary and may be subject to revision. This document is only to be used for planning and data collection purposes.
RequiredotherQ1
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Grant activity is defined as any proposed activity in the Bureau of Justice Assistance (BJA)-approved grant application that is implemented or executed with BJA program funds. B. No (If No, explain):
RequiredotherQ1
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
For example, all funds have been expended and the award is in the process of closing out in the Justice Grants (JustGrants) system. A. Yes/No (If Yes, you must answer the questions in the Closeout section and the Goals and Objectives section. After completion, a final report will be created when closing out the Performance Measurement Tool [PMT] reporting requirements.)
RequiredotherQ2
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
There is grant activity when the grantee has obligated, expended, or drawn down grant funds to implement objectives proposed in the Bureau of Justice Assistance (BJA)-approved grant application. If Yes, the program becomes operational and should remain so until the grant closes out. If No, select all the reasons that apply for no grant activity during the reporting period and proceed to the Goals and Objectives sec…
RequiredotherQ3
A prompt for a description, a selection or a short answer.
Funding Source Dollar Amount Percent A. COSSUP grant funding <autocalc> B. Other (Non-COSSUP) BJA grant funding <autocalc> C. Other DOJ grant funding <autocalc> D. CDC grant funding <autocalc> E. SAMHSA grant funding <autocalc> F. Other federal grant funding <autocalc> G. State funding <autocalc> H. Local funding <autocalc> I. Private funding <autocalc> J. In-kind support <autocalc> K. Other <autocalc> If Other, ex…
RequiredotherQ4
A prompt for a description, a selection or a short answer.
A. Name: ____ B. Contact information: Phone number: ____ Email address: ____
RequiredotherQ5
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
A. Yes/No B. If Yes, describe: ____
RequiredotherQ6
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
A. Yes/No (If No, skip to question 9)
RequiredotherQ7
A planned or proposed figure, not a reported one.
A. Name: ____ B. Contact information: Agency name: ____ Phone number: ____ Email address: ____
RequiredotherQ8
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
A. Yes/No B. If Yes, describe: ____
RequiredotherQ9
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
A. Yes/No B. If Yes, provide the URL: ____
RequiredotherQ10
A prompt for a description, a selection or a short answer.
A. ____ A geographic area within a single city/county B. ____ A single city/county C. ____ Multiple geographic areas within a single state (e.g., multiple cities or counties) D. ____ The entire state E. ____ Multistate
RequiredotherQ11
A prompt for a description, a selection or a short answer.
A. ____ Urban (i.e., a large city with 50,000 or more people) B. ____ Suburban (i.e., a territory outside of a large city with a population of 2,500 to 50,000 people or more) C. ____ Rural (i.e., a territory that encompasses all people and housing not included within a suburban, urban, or tribal area) D. ____ Mixed (i.e., some combination of the above designations)
RequiredotherQ12
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
A tribal territory is one that contains a concentration of people who identify with a federally recognized tribe. [Carry forward] A. Yes/No B. If Yes, identify the tribal territory: ____
RequiredotherQ13
A prompt for a description, a selection or a short answer.
Select all that apply. A. ____ Analysis was not conducted during this reporting period B. ____ Analysis was conducted this reporting period, but findings were not applied in any way C. ____ Informed our understanding of the problem of focus D. ____ Informed decisions to improve program implementation E. ____ Incorporated into program evaluation (e.g., outcome, process) F. ____ Presented as results/recommendations t…
RequiredotherQ14
A prompt for a description, a selection or a short answer.
A. ____ We are not facing any major obstacles to providing services B. ____ Lack of public transportation C. ____ Limited availability of appropriate substance abuse treatment services D. ____ Limited availability of recovery support services E. ____ Limited public support for services and/or facilities F. ____ Limited hours of service G. ____ Limited client participation/commitment H. ____ Other, describe: ____…
RequiredotherQ15
A prompt for a description, a selection or a short answer.
Select all that apply. A. ____ No obstacles or barriers (N/A) B. ____ Access to data C. ____ Level of referrals to our program D. ____ Collaboration/Coordination between partner agencies E. ____ Hiring project staff F. ____ Staff turnover G. ____ Retaining treatment providers H. ____ Competing agency priorities I. ____ Funding J. ____ Legal obstacles K. ____ Concerns about confidentiality L. ____ Differences in pro…
RequiredotherQ1
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
For example, were all funds expended and is the award in the process of closing out in the Grants Management System? A. Yes/No (If Yes, answer the semiannual narrative questions.)
RequiredotherQ2
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
There is grant activity when the grantee has obligated, expended, or drawn down grant funds to implement objectives proposed in the Bureau of Justice Assistance (BJA)-approved grant application. If you select Yes, the program becomes Operational and should remain so until the grant closes out? Reason(s) for no grant activity during the reporting period. Select all that apply In procurement ☐ Project or budget not a…
RequiredotherQ3
A prompt for a description, a selection or a short answer.
Select the services that best reflect the program design. A. Jail-based treatment services. Jail is defined as any confinement facility of a federal, state, or local law enforcement agency whose primary use is to hold persons pending adjudication of criminal charges, persons committed to confinement after adjudication of criminal charges for sentences of 1 year or less, or persons adjudicated guilty who are awaitin…
RequiredoutputQ4
A count of services or people, held in the organization’s own records.
and clinicians. Do NOT count the number of mentors, volunteers, or interns. A. Number of treatment staff B. Of those reported in ‘A’, how many are paid for at least partially using BJA program funds, including matching funds?
RequiredotherQ5
No rule matched this measure, so no tier is guessed.
Non-BJA Funds Funds Spent during Quarter BJA Funds (All Other Sources) Personnel Fringe benefits Supplies/Equipment Contract/consultant fees Construction Indirect costs Other
RequiredotherQ6
No rule matched this measure, so no tier is guessed.
A. Yes/No (If No, go to Question 8)
RequiredoutputQ7
A count of services or people, held in the organization’s own records.
training, or addiction-related trainings, as well as the number of treatment staff who received officer training and other security training sessions. A. Number of treatment staff cross trained
RequiredotherQ8
No rule matched this measure, so no tier is guessed.
A. Yes/No (If No, go to Question 8)
RequiredoutputQ9
A count of services or people, held in the organization’s own records.
related trainings, as well as the number of treatment staff who received officer training and other security training sessions. A. Number of custody staff cross trained The following questions pertain to individuals who are receiving services in your RSAT program. The following sections include the following: Risk Assessment and Treatment Planning, Number of Participants Receiving Services, Services Provided, Progr…
RequiredotherQ10
A count of services or people, held in the organization’s own records.
Measure Cumulative Total Total number of jail/prison-based participants enrolled as of the last day of the reporting period Number of NEW jail/prison-based participants admitted during the reporting period Risk Assessment and Treatment Planning
RequiredotherQ11
A count of services or people, held in the organization’s own records.
Measure Cumulative Total Number of jail/prison/juvenile-based participants administered a risk and needs assessment Number of jail/prison-based participants with high criminogenic risks/needs Number of jail/prison-based participants with an individualized treatment plan. Number should not exceed the number of new participants indicated in question 10
RequiredotherQ12
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
A risk and needs assessment is an instrument to help identify factors that may lead a participant to reoffend and services needed services to minimize those risks. The risk and needs assessment does not need to have been completed during the reporting period and could be completed by an outside entity. A. Yes/No
RequiredotherQ13
A prompt for a description, a selection or a short answer.
Services Provided
RequiredoutputQ14
A count of services or people, held in the organization’s own records.
RequiredoutputQ15
A count of services or people, held in the organization’s own records.
needs in terms of housing, employment/financial support, and ongoing therapeutic needs. These include enrollment in Medicaid or subsidized insurance programs, where available. They also include prerelease engagement with the community correctional agency that will be providing post-release supervision of the client, where relevant. Note: Blanket referrals to community self-help programs do not constitute “transitio…
RequiredoutputFY2026Q1
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refer to youth program participants. Program participant refers to an individual who started a program. Starting a program can be defined different ways in the context of your program. For example, starting a program can mean a formal agreement to participate in…
RequiredoutputFY2026Q2
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refer to youth program participants. Program participant refers to an individual who started a program. Discharged means the program participant is no longer participating in services or receiving services directly or indirectly through your program. Program ref…
RequiredoutputFY2026Q3
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refer to youth program participants. Program participant refers to an individual who started a program. Discharged means the program participant is no longer participating in services or receiving services directly or indirectly through your program. Program ref…
RequiredoutputFY2026Q4
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refer to youth program participants. Program participant refers to an individual who started a program. Tested for substance use means that a program official or another authorized individual administered a substance use test for the program participant. Reporti…
RequiredoutputFY2026Q5
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refer to youth program participants. Program participant refers to an individual who started a program. Assessed for mental health means that a program official or another authorized individual conducted an evaluation to identify a youth’s emotional, behavioral,…
RequiredoutputFY2026Q6
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
RequiredoutputFY2026Q7
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
RequiredoutputFY2026Q8
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
RequiredoutcomeFY2026Q9
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refer to youth program participants. Program participant refers to an individual who started a program. Discharged means the program participant is no longer participating in services or receiving services directly or indirectly through your program. Reporting p…
RequiredoutcomeFY2026Q10
Asks for a reported change in knowledge, attitude, behavior or condition.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refer to youth program participants. Program participant refers to an individual who started a program. Successful means the program participant met the program’s requirements, such as completing assessments, or prescribed treatment, or participating for an expe…
RequiredoutcomeFY2026Q11
Asks for a reported change in knowledge, attitude, behavior or condition.
12 more on the instruments page.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refer to youth program participants. Program participant refers to an individual who started a program. Successful means the program participant met your program’s requirements, such as completing assessments or prescribed treatment or participating for an expec…
RequiredoutcomeFY2026Q12
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refer to youth program participants. Program participant refers to an individual who started a program. Discharged means the program participant is no longer participating in services or receiving services directly or indirectly through the program. Reporting pe…
RequiredoutcomeFY2026Q13
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refer to youth program participants. Program participant refers to an individual who started a program. Discharged means the program participant is no longer participating in services or receiving services directly or indirectly through the program. Reporting pe…
RequiredoutcomeFY2026Q14
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
RequiredoutcomeFY2026Q15
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refer to youth program participants. Program participant refers to an individual who started a program. Discharged means the program participant is no longer participating in services or receiving services directly or indirectly through your program. Beginning o…
RequiredoutputFY2026Q1
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Families should only be counted once. Unique families should not be counted in more than one reporting period. Families refers to any combination or grouping of parent and child (including pregnant mothers) who are participating in the program. Starting a program is defined in the context of your program. For example, starting a program can mean a formal agreement to participate in the pr…
RequiredoutputFY2026Q2
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Families should only be counted once. Unique families should not be counted in more than one reporting period. Families refers to any combination or grouping of parent and child (including pregnant mothers) who are participating in the program. Discharged means the family is no longer participating in services or receiving services directly from or indirectly through your program. Reporti…
RequiredoutputFY2026Q3
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Families should only be counted once. Unique families should not be counted in more than one reporting period. Families refers to any combination or grouping of parent and child (including pregnant mothers) participating in the program. Discharged means the family is no longer participating in services or receiving services directly from or indirectly through your program. Beginning of th…
RequiredoutputFY2026Q4
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Families should only be counted once. Unique families should not be counted in more than one reporting period. Individuals refers to parents, and they should only be counted once. Unique individuals should not be counted in more than one reporting period. Tested for substance use means that a program official or another authorized individual applied a substance use test for the program pa…
RequiredoutcomeFY2026Q5
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Families should only be counted once. Unique families should not be counted in more than one reporting period. Families refers to any combination or grouping of parent and child (including pregnant mothers) who are participating in the program. Discharged means the family is no longer participating in services or receiving services directly from or indirectly through your program. Reporti…
RequiredoutcomeFY2026Q6
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Families should only be counted once. Unique families should not be counted in more than one reporting period. Families refers to any combination or grouping of parent and child (including pregnant mothers) who are participating in the program. Discharged means the family is no longer participating in services or receiving services directly from or indirectly through your program. Reporti…
RequiredoutcomeFY2026Q7
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Families should only be counted once. Unique families should not be counted in more than one reporting period. Families refers to any combination or grouping of parent and child (including pregnant mothers) who are participating in the program. Discharged means the family is no longer participating in services or receiving services directly from or indirectly through your program. Reporti…
RequiredoutcomeFY2026Q8
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Families should only be counted once. Unique families should not be counted in more than one reporting period. Families refers to any combination or grouping of parent and child (including pregnant mothers) participating in the program. Discharged means the family is no longer participating in services or receiving services directly from or indirectly through your program. Beginning of th…
RequiredoutcomeFY2026Q9
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Families should only be counted once. Unique families should not be counted in more than one reporting period. Families refers to any combination or grouping of parent and child (including pregnant mothers) participating in the program. Discharged means the family is no longer participating in services or receiving services directly from or indirectly through your program. Beginning of th…
RequiredoutcomeFY2026Q10
Asks for a reported change in knowledge, attitude, behavior or condition.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to a parent. Unique individuals should only be counted once and should not be counted in more than one reporting period. Successful means the program participant has met all program requirements, such as completing assessments or prescribed treatment or p…
RequiredoutcomeFY2026Q11
Asks for a reported change in knowledge, attitude, behavior or condition.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to a parent. Unique individuals should only be counted once and should not be counted in more than one reporting period. Unsuccessful discharge refers to individuals discharged for a reason other than successful, such as a discharge due to loss of contact…
RequiredoutcomeFY2026Q12
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Families should only be counted once. Unique families should not be counted in more than one reporting period. Families refers to any combination or grouping of parent and child (including pregnant mothers) who are participating in the program. Successful means the family has met all program requirements, such as completing assessments or prescribed treatment or participating for an expec…
RequiredoutcomeFY2026Q13
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Families should only be counted once. Unique families should not be counted in more than one reporting period. Families refers to any combination or grouping of parent and child (including pregnant mothers) who are participating in the program. Discharged means the family is no longer participating in services or receiving services directly from or indirectly through your program. Reporti…
RequiredoutcomeFY2026Q14
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Families should only be counted once. Unique families should not be counted in more than one reporting period. Families refers to any combination or grouping of parent and child (including pregnant mothers) who are participating in the program. Successful means the family has met all program requirements, such as completing assessments or prescribed treatment or participating for an expec…
RequiredoutcomeFY2026Q15
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Families should only be counted once. Unique families should not be counted in more than one reporting period. Families refers to any combination or grouping of parent and child (including pregnant mothers) who are participating in the program. Unsuccessful discharge refers to families discharged for a reason other than successful, such as a discharge due to loss of contact or removal. •…
RequiredoutputFY2026Q1
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refer to youth. Program participant refers to an individual who started a program. Starting a program can be defined different ways in the context of your program. For example, starting a program can mean a formal agreement to participate in the program, or the…
RequiredoutputFY2026Q2
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth program participants. Program participant refers to an individual who started a program. Tested for substance use means that a program official or another authorized individual applied a substance use test for the program participant. Reporting p…
RequiredoutputFY2026Q3
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once during a reporting period. Also, unique individuals should not be counted in more than one reporting period. Individuals refer to youth program participants. Program participant refers to an individual who started a program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirec…
RequiredotherFY2026Q4
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth program participants. Program participant refers to an individual who started a program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Succe…
RequiredotherFY2026Q5
Asks for a reported change in knowledge, attitude, behavior or condition.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth program participants. Program participant refers to an individual who started a program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Succe…
RequiredotherFY2026Q6
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth program participants. Program participant refers to an individual who started a program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Unsuc…
RequiredotherFY2026Q7
Asks for a reported change in knowledge, attitude, behavior or condition.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth program participants. Program participant refers to an individual who started a program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Unsuc…
RequiredotherFY2026Q8
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth program participants. Program participant refers to an individual who started a program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Other…
RequiredoutputFY2026Q9
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth program participants. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Beginning of the award refers to the Project Period Start Date for your…
RequiredotherFY2026Q10
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth program participants. Program participant refers to an individual who started a program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Succe…
RequiredotherFY2026Q11
A count of services or people, held in the organization’s own records. The outcome sits in a record another agency holds. You hold the participant list and count it.
You count your own participants; the court or corrections record confirms the outcome.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth program participants. Program participant refers to an individual who started a program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Succe…
RequiredotherFY2026Q12
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth program participants. Program participant refers to an individual who started a program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Unsuc…
RequiredotherFY2026Q13
A count of services or people, held in the organization’s own records. The outcome sits in a record another agency holds. You hold the participant list and count it.
You count your own participants; the court or corrections record confirms the outcome.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth program participants. Program participant refers to an individual who started a program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Unsuc…
RequiredotherFY2026Q14
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
RequiredotherFY2026Q15
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
RequiredoutputFY2026Q1
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth or their family members who participate in the program. Starting a program can be defined differently in the context of your program. For example, starting a program can mean a formal agreement to participate in the program, or the first action a…
RequiredoutputFY2026Q2
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth or their family members who participate in the program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through the program. Program refers to the specific set of a…
RequiredoutputFY2026Q3
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth or their family members who participate in the program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Program refers to the specific set of…
RequiredoutputFY2026Q4
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth or their family members who participate in the program. Tested for substance use means that a program official or another authorized individual applied a substance use test for the program participant. Reporting period refers to the specific time…
RequiredoutputFY2026Q5
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
RequiredoutputFY2026Q6
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
RequiredoutputFY2026Q7
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
RequiredoutcomeFY2026Q8
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth or their family members who participate in the program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Successful means the program participa…
RequiredoutcomeFY2026Q9
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth or their family members who participate in the program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Unsuccessful discharges refers to indi…
RequiredoutcomeFY2026Q10
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth or their family members who participate in the program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Other discharge statuses could include…
RequiredoutcomeFY2026Q11
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth or their family members who participate in the program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Successful means the program participa…
RequiredoutcomeFY2026Q12
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth or their family members who participate in the program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Unsuccessful discharges refers to indi…
RequiredoutcomeFY2026Q13
A count of services or people, held in the organization’s own records.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth or their family members who participate in the program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Well-being refers to the individual’s…
RequiredoutcomeFY2026Q14
Asks for a reported change in knowledge, attitude, behavior or condition.
Unique means unduplicated. Individuals should only be counted once. Unique individuals should not be counted in more than one reporting period. Individuals refers to youth or their family members who participate in the program. Discharged means the program participant is no longer participating in services or receiving services directly from or indirectly through your program. Successful means the program participa…
RequiredoutcomeFY2026Q15
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
RequiredoutputATR-1
An output the funder classes as a count of activity.
RequiredoutputATR-2
An output the funder classes as a count of activity.
RequiredoutputATR-3
An output the funder classes as a count of activity.
a. Professional first responders: b. Other key community sector members: c. Nontraditional community sector members:
RequiredoutputATR-4
An output the funder classes as a count of activity.
RequiredoutputATR-5
An output the funder classes as a count of activity.
RequiredoutputATR-6
An output the funder classes as a count of activity.
RequiredoutputATR-7
An output the funder classes as a count of activity.
a. Naloxone administration: b. Safety around fentanyl, carfentanil and other dangerous and illicit drugs: c. Establishing policies and procedures for the implementation of evidence-based trauma-informed care practices:
RequiredoutputATR-8
An output the funder classes as a count of activity.
a. Naloxone administration: b. Safety around fentanyl, carfentanil and other dangerous and illicit drugs: c. Establishing policies and procedures for the implementation of evidence-based trauma-informed care practices:
RequiredoutputATR-9
An output the funder classes as a count of activity.
a. Naloxone administration: b. Safety around fentanyl, carfentanil and other dangerous and illicit drugs: c. Establishing policies and procedures for the implementation of evidence-based trauma-informed care practices:
RequiredoutputQPR-1
A count of services or people, held in the organization’s own records.
RequiredoutputQPR-2
A count of services or people, held in the organization’s own records.
a. Number of naloxone kits distributed to professional first responders: b. Number of naloxone kits distributed to other key community sector members: c. Number of naloxone kits distributed to nontraditional community sector members: d. Number of naloxone kits distributed to other community members:
RequiredoutputQPR-3
A count of services or people, held in the organization’s own records.
RequiredoutputQPR-4
A count of services or people, held in the organization’s own records.
RequiredoutputQPR-5
A count of services or people, held in the organization’s own records.
RequiredoutputQPR-6
A count of services or people, held in the organization’s own records.
RequiredoutputATR-1
An output the funder classes as a count of activity.
RequiredoutputATR-2
An output the funder classes as a count of activity.
a. Injectable: $ b. Auto-injector: $ c. Intranasal spray: $
RequiredoutputATR-3
An output the funder classes as a count of activity.
RequiredoutputATR-4
An output the funder classes as a count of activity.
a. Professional first responders: b. Other key community sector members: c. Nontraditional community sector members: d. Other community members: Education/training
RequiredoutputATR-5
An output the funder classes as a count of activity.
RequiredoutputATR-6
An output the funder classes as a count of activity.
a. Professional first responders: b. Other key community sector members: c. Nontraditional community sector members: d. Other community members:
RequiredoutputATR-7
An output the funder classes as a count of activity.
a. Professional first responders: b. Other key community sector members: c. Nontraditional community sector members: d. Other community members:
RequiredoutputATR-8
An output the funder classes as a count of activity.
RequiredoutputQPR-1
An output the funder classes as a count of activity.
RequiredoutputQPR-2
An output the funder classes as a count of activity.
a. Injectable: $ b. Auto-injector: $ c. Intranasal spray: $
RequiredoutputQPR-3
A count of services or people, held in the organization’s own records.
a. Number of PDO grant-purchased naloxone kits distributed: ____ b. Number of non-PDO grant-purchased naloxone kits distributed: ____
RequiredoutputQPR-4
A count of services or people, held in the organization’s own records.
a. Professional first responders: b. Other key community sector members: c. Nontraditional community sector members: d. Other community members: Education/training
RequiredoutputQPR-5
A count of services or people, held in the organization’s own records.
RequiredoutputQPR-6
A count of services or people, held in the organization’s own records.
a. Professional first responders: b. Other key community sector members: c. Nontraditional community sector members: d. Other community members:
RequiredoutputQPR-7
A count of services or people, held in the organization’s own records.
a. Professional first responders: b. Other key community sector members: c. Nontraditional community sector members: d. Other community members:
RequiredoutputATR-1
A planned or proposed figure, not a reported one.
RequiredoutputATR-2
A planned or proposed figure, not a reported one.
a. Prescribing health care providers (1) Physicians: (2) Physician assistants: (3) Nurse practitioners: (4) Dentists: b. Pharmacists: c. Non-prescribing service providers: d. Other individuals: [If I.B.2.d = 0 , then skip to I.B.4]
RequiredoutputATR-3
A planned or proposed figure, not a reported one.
a. (Specified other type 1): b. (Specified other type 2): x. (Specified other type x):
RequiredoutputATR-4
A planned or proposed figure, not a reported one.
RequiredoutputATR-5
A planned or proposed figure, not a reported one.
a. Prescribing health care providers (1) Physicians: (2) Physician assistants: (3) Nurse practitioners: (4) Dentists: b. Pharmacists: c. Non-prescribing service providers: d. Other individuals: [If I.B.5.d = 0 , then skip to I.B.7]
RequiredoutputATR-6
A planned or proposed figure, not a reported one.
a. (Specified other type 1): b. (Specified other type 2): xc.. (Specified other type x):
RequiredoutputATR-7
An output the funder classes as a count of activity.
a. Physicians: b. Physician assistants: c. Nurse practitioners: d. Pharmacists: e. Dentists: f. Other service providers:
RequiredoutputATR-8
An output the funder classes as a count of activity.
a. (Specified other type 1): b. (Specified other type 2): xc.. (Specified other type x): Projected naloxone-related spending and distribution For reporting purposes, “naloxone” refers to naloxone or other FDA-approved opioid overdose-reversing medication or device.
RequiredoutputATR-9
An output the funder classes as a count of activity.
a. Injectable: $ b. Intranasal: $ c. Auto-injector: $
RequiredoutputATR-10
An output the funder classes as a count of activity.
a. Co-payments: $ b. Other cost sharing: $
RequiredoutputATR-11
An output the funder classes as a count of activity.
RequiredoutputQPR-1
A count of services or people, held in the organization’s own records.
a. Primary trainings: b. Secondary trainings: c. Tertiary trainings: [If II.B.1.a = 0 and II.B.1.b ≠ 0, then skip to II.B.5] [If II.B.1.a = 0 and II.B.1.b = 0, then skip to II.B.7]
RequiredoutputQPR-2
A count of services or people, held in the organization’s own records.
RequiredoutputQPR-3
A count of services or people, held in the organization’s own records.
a. Prescribing health care providers (1) Physicians: (2) Physician assistants: (3) Nurse practitioners: (4) Dentists: b. Pharmacists: c. Non-prescribing service providers: d. [Other type 1 specified in ATR]: e. [Other type 2 specified in ATR]: x. [Other type X specified in ATR]: y. Other individuals: [If II.B.3.y = 0 and II.B.1.b ≠ 0, then skip to II.B.5] [If II.B.3.y = 0 and II.B.1.b = 0, then skip to II.B.7]
RequiredoutputQPR-4
A count of services or people, held in the organization’s own records.
a. (Specify other type 1): b. (Specify other type 2): x. (Specify other type X): [If II.B.1.a ≠ 0 and II.B.1.b = 0, then skip to II.B.7]
RequiredotherA1
No rule matched this measure, so no tier is guessed.
RequiredotherA2
A prompt for a description, a selection or a short answer.
RequiredotherA3
A prompt for a description, a selection or a short answer.
Answer categories: Baseline | Reassessment (for clients in care at 3 or 6 months) | Annual (for clients in care for more than 12 months) | Record closeout
RequiredotherA4
No rule matched this measure, so no tier is guessed.
RequiredotherA5
No rule matched this measure, so no tier is guessed.
RequiredotherA6
No rule matched this measure, so no tier is guessed.
Answer categories: Completed the program | No contact | Withdrew from/Refused treatment | Referred out | Transferred to a different grant program | Incarceration | Moved | Death | Other
RequiredotherA6a
No rule matched this measure, so no tier is guessed.
Answer categories: Suicide | Overdose | Other behavioral health cause | Other cause | Not documented in record
RequiredotherB1
A prompt for a description, a selection or a short answer.
Answer categories: SELECT ALL THAT APPLY | Medicare | Medicaid | Private Insurance or Employer Provided | TRICARE, CHAMPUS, CHAMPVA or other veteran or military health care | Indian Health Service Tribal Health Care | An assistance program [for example, a medication assistance program] | Any other type of health insurance or health coverage plan | None | Not documented in records or not documented in records using…
RequiredotherB2
No rule matched this measure, so no tier is guessed.
Answer categories: Yes – Behavioral health reasons, for example mental health or substance use disorder | Yes – other health reasons, for example injury or illness | No | Not documented in records or not documented in records using this standard
RequiredotherB3
No rule matched this measure, so no tier is guessed.
Answer categories: Yes – Behavioral health reasons, for example mental health or substance use disorder | Yes – other health reasons, for example injury or illness | No | Not documented in records or not documented in records using this standard
RequiredotherB4
No rule matched this measure, so no tier is guessed.
Answer categories: Yes | No | Not documented in records or not documented in records using this standard
RequiredotherB4a
No rule matched this measure, so no tier is guessed.
Answer categories: Suicide risk | Other risk of harm to self or others (e.g. NSSI, homicidal thoughts) | Mental health | Substance use other than overdose | Overdose | Other | Not documented in records or not documented in records using this standard
RequiredotherB5
No rule matched this measure, so no tier is guessed.
Answer categories: Yes | No | Not documented in records or not documented in records using this standard
RequiredotherB6
No rule matched this measure, so no tier is guessed.
Answer categories: Yes | No | Not applicable | Not documented in records or not documented in records using this standard
RequiredotherB7
No rule matched this measure, so no tier is guessed.
Answer categories: Yes | No | Not applicable | Not documented in records or not documented in records using this standard
RequiredoutcomeA1
A prompt for a description, a selection or a short answer.
Answer categories: I consider myself to be in recovery from substance use issues | I consider myself to be in recovery from mental health issues | I consider myself to be in recovery from substance use and mental health issues | I do not consider myself to be in recovery for substance use or mental health issues | I prefer not to answer
RequiredoutcomeA2
A prompt for a description, a selection or a short answer.
Item text continues: I am physically fine most days. ... b. My mental health is fine most Answer categories: days. ... | c. My substance use does not | cause problems in my life. ... | d. I have stable housing. ... | e. I have a steady job or am | involved in things like school, | training, or volunteering. ...…
RequiredoutcomeA3
Asks for a reported change in knowledge, attitude, behavior or condition.
12 more on the instruments page.
RequiredoutcomeA4
A prompt for a description, a selection or a short answer.
Answer categories: CHECK ALL THAT APPLY | Improve the symptoms that led me to services (for example distress, anxiety) | Reduce my drug and/or alcohol use | Gain access to medical services I need | Enroll in or finish education (for example GED, degree, vocational training) | Get or maintain a job | Live in stable housing | Be a better parent or caregiver | Improve my friendships and relationships | Comply with cou…
RequiredotherA1
A prompt for a description, a selection or a short answer.
Answer categories: White – Provide details below. | German | Irish | English | Italian | Polish | French | Enter, for example, Scottish, Norwegian, Dutch, etc. ____ | Hispanic or Latino – Provide details below. | Mexican or Mexican American | Puerto Rican | Cuban | Salvadoran | Dominican | Colombian | Enter, for example, Guatemalan, Spaniard, Ecuadorian, etc. ____ | B…
RequiredotherA2
A prompt for a description, a selection or a short answer.
Answer categories: Female | Male
RequiredotherA3
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Yes | No | Prefer not to answer
RequiredotherA3a
No rule matched this measure, so no tier is guessed.
Answer categories: CHECK ALL THAT APPLY | American Sign Language (ASL) | Arabic | Chinese | French | Portuguese | Spanish | Other Language – specify: ____ | Prefer not to answer
RequiredotherA4
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Yes, currently serving | Yes, served in the past | No | Prefer not to answer
RequiredotherA5
No rule matched this measure, so no tier is guessed.
Answer categories: glasses? ... | c. Because of a physical, mental, or emotional condition, do you have serious | difficulty concentrating, remembering, or making decisions? ... | d. Do you have serious difficulty walking or climbing stairs? ... | e. Do you have dif…
RequiredotherB1
No rule matched this measure, so no tier is guessed.
Answer categories: Very hard | Somewhat hard | Not hard at all | Prefer not to answer
RequiredotherB2
A prompt for a description, a selection or a short answer.
Answer categories: I have a steady place to live | I have a place to live today but I am worried about losing it in the future | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living | outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | Prefer not to answer
RequiredotherB3
A prompt for a description, a selection or a short answer.
Answer categories: House or apartment | Your partner’s place | A friend or relative’s and paying rent | A friend or relative’s and not paying rent | Permanent housing program | Transitional housing program | Domestic violence shelter | Emergency shelter | Voucher hotel or motel | Hotel or motel you pay for | Residential drug or alcohol program | Jail or prison | Car or other vehicle | Abandoned building | Anywhere…
RequiredotherB4
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Employed, full time or part time (includes temporary, seasonal, hours change each week) | Not employed, seeking employment | Not employed, not seeking employment (includes if you are in school and not seeking a job, retired, | not looking for work because of a disability, a homemaker, etc.) | Other – specify: ____ | Prefer not to answer
RequiredotherB5
A prompt for a description, a selection or a short answer.
Answer categories: Less than high school diploma | High school degree or GED | Some vocational, technical, college, or university credit(s) | Associate's degree or technical/vocational certificate | 4-year degree or higher | Prefer not to answer
RequiredotherB6
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Enrolled, attending regularly | Enrolled, not attending regularly | Not enrolled | Prefer not to answer
RequiredotherB7
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: CHECK ALL THAT APPLY | Yes, it has kept me from medical appointments or from getting my medications | Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need | No | Prefer not to answer
RequiredoutcomeC1
A prompt for a description, a selection or a short answer.
Answer categories: I consider myself to be in recovery from substance use issues | I consider myself to be in recovery from mental health issues | I consider myself to be in recovery from substance use and mental health issues | I do not consider myself to be in recovery for substance use or mental health issues | I prefer not to answer
RequiredoutcomeC2
A prompt for a description, a selection or a short answer.
Item text continues: I am physically fine most days. ... b. My mental health is fine most Answer categories: days. ... | c. My substance use does not | cause problems in my life. ... | d. I have stable housing. ... | e. I have a steady job or am | involved in things like school, | training, or volunteering. ...…
RequiredoutcomeC3
Asks for a reported change in knowledge, attitude, behavior or condition.
12 more on the instruments page.
RequiredoutcomeC4
A prompt for a description, a selection or a short answer.
Answer categories: CHECK ALL THAT APPLY | Improve the symptoms that led me to services (for example distress, anxiety) | Reduce my drug and/or alcohol use | Gain access to medical services I need | Enroll in or finish education (for example GED, degree, vocational training) | Get or maintain a job | Live in stable housing | Be a better parent or caregiver | Improve my friendships and relationships | Comply with cou…
RequiredotherA1
No rule matched this measure, so no tier is guessed.
Answer categories: Very hard | Somewhat hard | Not hard at all | Prefer not to answer
RequiredotherA2
A prompt for a description, a selection or a short answer.
Answer categories: I have a steady place to live | I have a place to live today but I am worried about losing it in the future | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living | outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | Prefer not to answer
RequiredotherA3
A prompt for a description, a selection or a short answer.
Answer categories: House or apartment | Your partner’s place | A friend or relative’s and paying rent | A friend or relative’s and not paying rent | Permanent housing program | Transitional housing program | Domestic violence shelter | Emergency shelter | Voucher hotel or motel | Hotel or motel you pay for | Residential drug or alcohol program | Jail or prison | Car or other vehicle | Abandoned building | Anywhere…
RequiredotherA4
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Employed, full time or part time (includes temporary, seasonal, hours change each week) | Not employed, seeking employment | Not employed, not seeking employment (includes in school not seeking, retired, due to disability, | homemaker, etc.) | Other – specify: ____ | Prefer not to answer
RequiredotherA5
A prompt for a description, a selection or a short answer.
Answer categories: Less than high school diploma | High school degree or GED | Some vocational, technical, college, or university credit(s) | Associate's degree or technical/vocational Certificate | 4-year degree or higher | Prefer not to answer
RequiredotherA6
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Enrolled, attending regularly | Enrolled, not attending regularly | Not enrolled | Prefer not to answer
RequiredotherA7
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: CHECK ALL THAT APPLY | Yes, it has kept me from medical appointments or from getting my medications. | Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need. | No | Prefer not to answer
RequiredoutcomeB1
A prompt for a description, a selection or a short answer.
Answer categories: I consider myself to be in recovery from substance use issues | I consider myself to be in recovery from mental health issues | I consider myself to be in recovery from substance use and mental health issues | I do not consider myself to be in recovery for substance use or mental health issues | I prefer not to answer
RequiredoutcomeB2
A prompt for a description, a selection or a short answer.
Item text continues: I am physically fine most days. ... b. My mental health is fine most Answer categories: days. ... | c. My substance use does not | cause problems in my life. ... | d. I have stable housing. ... | e. I have a steady job or am | involved in things like school, | training, or volunteering. ...…
RequiredoutcomeB3
Asks for a reported change in knowledge, attitude, behavior or condition.
12 more on the instruments page.
RequiredoutcomeB4
A prompt for a description, a selection or a short answer.
Answer categories: CHECK ALL THAT APPLY | Improve the symptoms that led me to services (for example distress, anxiety) | Reduce my drug and/or alcohol use | Gain access to medical services I need | Enroll in or finish education (for example GED, degree, vocational training) | Get or maintain a job | Live in stable housing | Be a better parent or caregiver | Improve my friendships and relationships | Comply with cou…
RequiredotherA1
A prompt for a description, a selection or a short answer.
Answer categories: White – Provide details below. | German | Irish | English | Italian | Polish | French | Enter, for example, Scottish, Norwegian, Dutch, etc. ____ | Hispanic or Latino – Provide details below. | Mexican or Mexican American | Puerto Rican | Cuban | Salvadoran | Dominican | Colombian | Enter, for example, Guatemalan, Spaniard, Ecuadorian, etc. ____ | B…
RequiredotherA2
A prompt for a description, a selection or a short answer.
Answer categories: Female | Male
RequiredotherA3
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Yes | No | Prefer not to answer
RequiredotherA3a
No rule matched this measure, so no tier is guessed.
Answer categories: CHECK ALL THAT APPLY | American Sign Language (ASL) | Arabic | Chinese | French | Portuguese | Spanish | Other Language – specify: ____ | Prefer not to answer
RequiredotherA4
No rule matched this measure, so no tier is guessed.
Answer categories: when wearing glasses? ... | c. Because of a physical, mental, or emotional condition, does your child | have serious difficulty concentrating, remembering, or making decisions? | d. Does your child have serious difficulty walking or climbing stairs? ... | e. Does your child have difficulty dressing or bath…
RequiredotherB1
No rule matched this measure, so no tier is guessed.
Answer categories: Very hard | Somewhat hard | Not hard at all | I am not the person responsible for paying for the basics for my child | Prefer not to answer
RequiredotherB2
A prompt for a description, a selection or a short answer.
Answer categories: My child has a steady place to live | My child has a place to live today but I am worried they may lose it in the future | My child does not have a steady place to live (My child is temporarily staying with others, in a hotel, in | a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or | in a park) | Prefer not to answer
RequiredotherB3
A prompt for a description, a selection or a short answer.
Answer categories: Your house or apartment | Your partner’s place | A friend or relative’s and paying rent | A friend or relative’s and not paying rent | Permanent housing program | Transitional housing program | Domestic violence shelter | Emergency shelter | Voucher hotel or motel | Hotel or motel you pay for | Residential drug or alcohol program | Jail or prison | Car or other vehicle | Abandoned building | Anyw…
RequiredotherB4
A prompt for a description, a selection or a short answer.
Answer categories: Preschool – Kindergarten | Grade 1 – Grade 5 | Grade 6 – Grade 8 | Grade 9 - 12 | High school degree or GED | Prefer not to answer
RequiredotherB5
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Enrolled, attending regularly | Enrolled, not attending regularly | Not enrolled | Prefer not to answer | Thank you for completing this baseline form. | Public reporting burden for this collection of information is estimated to average 10 minutes per response at | baseline. Send comments regarding this burden estimate, or any other aspect of this collection of information, to | the Substance Abus…
RequiredotherA1
No rule matched this measure, so no tier is guessed.
Answer categories: Very hard | Somewhat hard | Not hard at all | I am not the person responsible for paying for the basics for my child | Prefer not to answer
RequiredotherA2
A prompt for a description, a selection or a short answer.
Answer categories: My child has a steady place to live | My child has a place to live today but I am worried they may lose it in the future | My child does not have a steady place to live (My child is temporarily staying with others, in a hotel, in | a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or | in a park) | Prefer not to answer
RequiredotherA3
A prompt for a description, a selection or a short answer.
Answer categories: Your house or apartment | Your partner’s place | A friend or relative’s and paying rent | A friend or relative’s and not paying rent | Permanent housing program | Transitional housing program | Domestic violence shelter | Emergency shelter | Voucher hotel or motel | Hotel or motel you pay for | Residential drug or alcohol program | Jail or prison | Car or other vehicle | Abandoned building | Anyw…
RequiredotherA4
A prompt for a description, a selection or a short answer.
Answer categories: Preschool – Kindergarten | Grade 1 – Grade 5 | Grade 6 – Grade 8 | Grade 9 - 12 | High school degree or GED | Prefer not to answer
RequiredotherA5
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Enrolled, attending regularly | Enrolled, not attending regularly | Not enrolled | Prefer not to answer | Thank you for completing this reassessment form. | Public reporting burden for this collection of information is estimated to average 5 minutes per response. Send | comments regarding this burden estimate, or any other aspect of this collection of information, to the Substance | Abuse and Men…
RequiredotherA1
A prompt for a description, a selection or a short answer.
Answer categories: White – Provide details below. | German | Irish | English | Italian | Polish | French | Enter, for example, Scottish, Norwegian, Dutch, etc. ____ | Hispanic or Latino – Provide details below. | Mexican or Mexican American | Puerto Rican | Cuban | Salvadoran | Dominican | Colombian | Enter, for example, Guatemalan, Spaniard, Ecuadorian, etc. ____ | B…
RequiredotherA2
A prompt for a description, a selection or a short answer.
Answer categories: Female | Male
RequiredotherA3
No rule matched this measure, so no tier is guessed.
Answer categories: when wearing glasses? ...
RequiredotherB1
No rule matched this measure, so no tier is guessed.
Answer categories: Very hard | Somewhat hard | Not hard at all | I am not the person responsible for paying for the basics for my child | Prefer not to answer
RequiredotherB2
A prompt for a description, a selection or a short answer.
Answer categories: My child has a steady place to live | My child has a place to live today but I am worried they may lose it in the future | My child does not have a steady place to live (My child is temporarily staying with others, in a hotel, in | a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or | in a park) | Prefer not to answer
RequiredotherB3
A prompt for a description, a selection or a short answer.
Answer categories: Your house or apartment | Your partner’s place | A friend or relative’s and paying rent | A friend or relative’s and not paying rent | Permanent housing program | Transitional housing program | Domestic violence shelter | Emergency shelter | Voucher hotel or motel | Hotel or motel you pay for | Residential drug or alcohol program | Jail or prison | Car or other vehicle | Abandoned building | Anyw…
RequiredotherA1
No rule matched this measure, so no tier is guessed.
Answer categories: Very hard | Somewhat hard | Not hard at all | I am not the person responsible for paying for the basics for my child | Prefer not to answer
RequiredotherA2
A prompt for a description, a selection or a short answer.
Answer categories: My child has a steady place to live | My child has a place to live today but I am worried they may lose it in the future | My child does not have a steady place to live (My child is temporarily staying with others, in a hotel, in | a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or | in a park) | Prefer not to answer
RequiredotherA3
A prompt for a description, a selection or a short answer.
Answer categories: Your house or apartment | Your partner’s place | A friend or relative’s and paying rent | A friend or relative’s and not paying rent | Permanent housing program | Transitional housing program | Domestic violence shelter | Emergency shelter | Voucher hotel or motel | Hotel or motel you pay for | Residential drug or alcohol program | Jail or prison | Car or other vehicle | Abandoned building | Anyw…
RequiredotherA1
A prompt for a description, a selection or a short answer.
Answer categories: White – Provide details below. | German | Irish | English | Italian | Polish | French | Enter, for example, Scottish, Norwegian, Dutch, etc. ____ | Hispanic or Latino – Provide details below. | Mexican or Mexican American | Puerto Rican | Cuban | Salvadoran | Dominican | Colombian | Enter, for example, Guatemalan, Spaniard, Ecuadorian, etc. ____ | B…
RequiredotherA2
A prompt for a description, a selection or a short answer.
Answer categories: Female | Male
RequiredotherA3
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Yes | No | Prefer not to answer
RequiredotherA3a
No rule matched this measure, so no tier is guessed.
Answer categories: CHECK ALL THAT APPLY | American Sign Language (ASL) | Arabic | Chinese | French | Portuguese | Spanish | Other Language – specify: ____ | Prefer not to answer
RequiredotherA4
No rule matched this measure, so no tier is guessed.
Item text continues: ... c. Because of a physical, mental, or emotional condition, do you have Answer categories: serious difficulty concentrating, remembering, or making decisions? | d. Do you have serious difficulty walking or climbing stairs? ... | e. Do you have difficulty dressing or bathing? ...…
RequiredotherB1
A prompt for a description, a selection or a short answer.
Answer categories: I have a steady place to live | I have a place to live today but I am worried about losing it in the future | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living | outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | Prefer not to answer
RequiredotherB2
A prompt for a description, a selection or a short answer.
Answer categories: My parent/guardian’s house or apartment | Your partner’s place | A friend or relative’s and paying rent | A friend or relative’s and not paying rent | Permanent housing program | Transitional housing program | Domestic violence shelter | Emergency shelter | Voucher hotel or motel | Hotel or motel you pay for | Residential drug or alcohol program | Jail or prison | Car or other vehicle | Abandoned…
RequiredotherB3
A prompt for a description, a selection or a short answer.
Answer categories: Preschool – Kindergarten | Grade 1 – Grade 5 | Grade 6 – Grade 8 | Grade 9 – 12 | High school degree or GED | Prefer not to answer
RequiredotherB4
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Enrolled, attending regularly | Enrolled, not attending regularly | Not enrolled | Prefer not to answer | Thank you for completing this baseline form. | Public reporting burden for this collection of information is estimated to average 10 minutes per response. Send | comments regarding this burden estimate, or any other aspect of this collection of information, to the Substance | Abuse and Mental…
RequiredotherA1
A prompt for a description, a selection or a short answer.
Answer categories: I have a steady place to live | I have a place to live today but I am worried about losing it in the future | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living | outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | Prefer not to answer
RequiredotherA2
A prompt for a description, a selection or a short answer.
Answer categories: My parent/guardian's house or apartment | Your partner’s place | A friend or relative’s and paying rent | A friend or relative’s and not paying rent | Permanent housing program | Transitional housing program | Domestic violence shelter | Emergency shelter | Voucher hotel or motel | Hotel or motel you pay for | Residential drug or alcohol program | Jail or prison | Car or other vehicle | Abandoned…
RequiredotherA3
A prompt for a description, a selection or a short answer.
Answer categories: Preschool – Kindergarten | Grade 1 – Grade 5 | Grade 6 – Grade 8 | Grade 9 - 12 | High school degree or GED | Prefer not to answer
RequiredotherA4
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Enrolled, attending regularly | Enrolled, not attending regularly | Not enrolled | Prefer not to answer | Thank you for completing this reassessment form. | Public reporting burden for this collection of information is estimated to average 5 minutes per response. Send | comments regarding this burden estimate, or any other aspect of this collection of information, to the Substance | Abuse and Men…
RequiredoutputTS1
A count of services or people, held in the organization’s own records.
For annual targets, enter the total number of individuals your grant plans to serve through one or more grant services during the federal fiscal year specified. For quarterly reporting, enter the total number of unduplicated new individuals served with one or more grant services during the quarter. Total of new individuals served
RequiredoutputTS2
An output the funder classes as a count of activity.
Enter the number of new individuals served by sex. Each individual may be reported only under one sex. a. Female b. Male
RequiredoutputTS3
An output the funder classes as a count of activity.
Enter the number of new individuals served for each of the following age groups. Each individual may be reported only under one age group. a. 0-9 years b. 10-17 years c. 18-20 years d. 21-24 years e. 25-44 years f. 45-64 years g. 65+ years h. Age not available
RequiredoutputTS4
An output the funder classes as a count of activity.
Enter the number of new individuals served by military status. Each individual may be reported only under one military status group. a. Veteran b. Active Duty c. Reserve Status d. Military status not available
RequiredoutputAW1
A count of services or people, held in the organization’s own records.
RequiredoutputAW2
A count of services or people, held in the organization’s own records.
RequiredoutputAW3
A count of services or people, held in the organization’s own records.
setting to encourage care seeking, improve access to care, linkages to care, and retention in care. Outreach Result For annual targets, enter the total number of connections your grant plans to contact through outreach during the federal fiscal year specified. For quarterly reporting, enter the total number of connections your grant contacted through outreach during the quarter.
RequiredoutputO1
A count of services or people, held in the organization’s own records.
RequiredoutputO2
A count of services or people, held in the organization’s own records.
RequiredoutputO3
A count of services or people, held in the organization’s own records.
RequiredoutputPA1
A count of services or people, held in the organization’s own records.
RequiredoutputPA2
A count of services or people, held in the organization’s own records.
RequiredoutputPA3
A count of services or people, held in the organization’s own records.
RequiredoutputPA4
A count of services or people, held in the organization’s own records.
RequiredoutputPA5
A count of services or people, held in the organization’s own records.
Results are attainment: actual divided by the promised value, for rows where the source gives both. Medians mix every measure a program reports; the measure pages split them.
Results by kind of promised value: 118 with a target printed beside the result; 105 with a goal set before the period. These are agency-reported program figures, not individual grantees.
Example results (a fixed pick, not a ranking)
1 shown
Department of Human Services · FY2009
Unduplicated clients served as a percent of the desired capacity (patient service data)
25.00% → 35.50% (142% of target) · %
Source document| Reporting entity | Period | Measure | Promised | Actual | Unit | % of target | Source |
|---|---|---|---|---|---|---|---|
| Department of Human Services | FY2009 | Unduplicated clients served as a percent of the desired capacity (patient service data) | 25.00% | 35.50% | % | 142% | document |
Results by kind of promised value: 55 with a target printed beside the result; 51 with a goal set before the period. These are agency-reported program figures, not individual grantees.
Example results (a fixed pick, not a ranking)
1 shown
Department of Human Services · FY2020
Average monthly full-time equivalents
65.0 → 65.0 (100% of target)
Source document| Reporting entity | Period | Measure | Promised | Actual | Unit | % of target | Source |
|---|---|---|---|---|---|---|---|
| Department of Human Services | FY2020 | Average monthly full-time equivalents | 65.0 | 65.0 | 100% | document |
Results by kind of promised value: 39 with a target printed beside the result; 31 with a goal set before the period. These are agency-reported program figures, not individual grantees.
Example results (a fixed pick, not a ranking)
1 shown
Department of Human Services · FY2018
Percent of clients discharged from alcohol and other drug treatment who are abstinent from alcohol use at discharge (final and transfer discharged)
72.00% → 70.00% (97% of target) · %
Source document| Reporting entity | Period | Measure | Promised | Actual | Unit | % of target | Source |
|---|---|---|---|---|---|---|---|
| Department of Human Services | FY2018 | Percent of clients discharged from alcohol and other drug treatment who are abstinent from alcohol use at discharge (final and transfer discharged) | 72.00% | 70.00% | % | 97% | document |
Results by kind of promised value: 15 with a target printed beside the result. These are agency-reported program figures, not individual grantees.
Example results (a fixed pick, not a ranking)
1 shown
Substance Abuse Drug Courts · 2007
Juvenile Drug Courts: Increase percentage of clients receiving services who: d) Experienced no/reduced alcohol or illegal drug related health, behavioral or social, consequences
90% → 91.2% (101% of target) · %
Source document| Reporting entity | Period | Measure | Promised | Actual | Unit | % of target | Source |
|---|---|---|---|---|---|---|---|
| Substance Abuse Drug Courts | 2007 | Juvenile Drug Courts: Increase percentage of clients receiving services who: d) Experienced no/reduced alcohol or illegal drug related health, behavioral or social, consequences | 90% | 91.2% | % | 101% | document |
Results by kind of promised value: 13 with a target printed beside the result. These are agency-reported program figures, not individual grantees.
Example results (a fixed pick, not a ranking)
1 shown
Substance Abuse Treatment Programs of Regional and National Significance · 2006
Drug treatment professionals trained by the program that adopt proven treatment methods
89% → 93% (104% of target) · %
Source document| Reporting entity | Period | Measure | Promised | Actual | Unit | % of target | Source |
|---|---|---|---|---|---|---|---|
| Substance Abuse Treatment Programs of Regional and National Significance | 2006 | Drug treatment professionals trained by the program that adopt proven treatment methods | 89% | 93% | % | 104% | document |
Results by kind of promised value: 12 with a target printed beside the result. These are agency-reported program figures, not individual grantees.
Example results (a fixed pick, not a ranking)
1 shown
Access to Recovery · 2006
Percentage of individuals receiving services who are currently employed or engaged in productive activities.
57% → 50% (88% of target) · %
Source document| Reporting entity | Period | Measure | Promised | Actual | Unit | % of target | Source |
|---|---|---|---|---|---|---|---|
| Access to Recovery | 2006 | Percentage of individuals receiving services who are currently employed or engaged in productive activities. | 57% | 50% | % | 88% | document |
Results by kind of promised value: 11 with a target printed beside the result. These are agency-reported program figures, not individual grantees.
Example results (a fixed pick, not a ranking)
1 shown
Drug Courts · 2007
Ratio of Program Expenditures to Management and Administrative (M&A) Expenditures
$18.15 → $17.05 (94% of target) · $
Source document| Reporting entity | Period | Measure | Promised | Actual | Unit | % of target | Source |
|---|---|---|---|---|---|---|---|
| Drug Courts | 2007 | Ratio of Program Expenditures to Management and Administrative (M&A) Expenditures | $18.15 | $17.05 | $ | 94% | document |
Results by kind of promised value: 9 with a target printed beside the result. These are agency-reported program figures, not individual grantees.
Example results (a fixed pick, not a ranking)
1 shown
Substance Abuse Prevention and Treatment Block Grant · 2000
Number of persons served (treatment)
1,525,688 → 1,599,701 (105% of target) · count
Source document| Reporting entity | Period | Measure | Promised | Actual | Unit | % of target | Source |
|---|---|---|---|---|---|---|---|
| Substance Abuse Prevention and Treatment Block Grant | 2000 | Number of persons served (treatment) | 1,525,688 | 1,599,701 | count | 105% | document |
Each item comes from one funder, one program or one department; none is a government-wide rule.
Showing clauses from HHS. All clauses
Quote
“you may enter a '0' and then TBD for targets in the work plan”
It lets you write: Enter 0 as the target, mark it TBD, and commit to revising it within six months.
Source document, 2023Quote
“grantees can revise annual goals in consultation with their GPO during the first quarter of each fiscal year”
It lets you write: Set annual goals and state that you will revise them with your project officer in each year's first quarter.
Source document, 2022Paraphrase
Baseline estimates are confirmed or updated within six months of award.
It lets you write: Give a baseline estimate and commit to confirming or updating it within six months of award.
Source document, 2026Paraphrase
Future-year milestones may be renegotiated based on prior-year data.
It lets you write: List milestones for year 1 and state that later-year milestones will be renegotiated from year-1 data.
Source document, 2025Paraphrase
A baseline assessment is done after award, and targets are set from it.
It lets you write: Plan a post-award baseline assessment and set the targets from its results.
Source document, 2026Quote
“confirm or request adjustment to their patient target by the deadline in their email”
It lets you write: Existing awardees can ask for an adjusted patient target during the renewal process.
Source document, 2022