Example Semi-annual Report.pdf

Attachment 1

Example Semi-annual Report Page 1 of 19

Indian Health Service

Special Diabetes Program for Indians (SDPI) Community-Directed Grant Program Fiscal Year (FY) 2010 Semi-Annual Progress Report Template

Instructions

1. Complete this report using information from:

a. Your FY 2010 funding application, including the Project Narrative.

b. Your FY 2010 Notice of Award (NOA).

c. Other sources as necessary.

2. Grantees with sub-grantees must complete and submit a separate Progress Report for the parent and each sub-grantee. Copies of the Project Narrative for the parent and each sub-grantee must also be submitted.

3. Grantees with more than three Best Practices or more than three objectives for a

Best Practice will need to use the Additional Objectives and Additional Best Practices templates to provide information.

4. Submit your completed report AND a copy of the Project Narrative submitted with your FY 2010 funding application via email to grantspolicy@ihs.gov and bonnie.bowekaty@ihs.gov.

mailto:grantspolicy@ihs.gov� mailto:bonnie.bowekaty@ihs.gov�

Example Semi-annual Report Page 2 of 19

Part 1) Program Information

1.1) Date: 5/12/2010

Program Identifiers: Provide the following information.

1.2) IHS Area Aberdeen

1.3) Grantee Name First Nation Health

1.4) Grant ID/Award Number (item 3 on NOA) H1234567890

1.5) Is your program a sub-grantee? No

1.6) Name of person submitting report a. First: Jane

b. Last: Doe

c. Title: ABCD

1.7) Contact Information a. Phone: 123-456-7890

b. Email: janedoe@firstnation.org

1.8) Budget cycle Cycle 2: Jan 1-Dec 31

1.9) Budget period start date (item 8 on NOA) 01/25/2010

1.10) Budget period end date (item 8 on NOA) 03/21/2010

1.11) Semi-annual or annual Semi-annual is due approximately 6 months from the start of the Budget cycle. Annual is due 90 days from the budget period end date.

1: Semi-annual

Program Resources If you are a sub-grantee, provide funding information specific to your program instead of information from the NOA. If you are a parent of sub-grantees, provide information from your NOA.

1.12) Funding Amount ($) (item 19 on NOA) 987,654

1.13) Amount of funds obligated to date Starting from the beginning of the Budget cycle.

This information can be obtained from your fiscal office.

493,827 as of 5/4/2010 (date)

1.14) Percent (%) of funds obligated to date 50.00

Example Semi-annual Report Page 3 of 19

Part 2) Project Narrative and Budget Changes

2.1) Were any major changes made to Best Practices chosen, goals, objectives, or measures from the Project Narrative submitted with your FY 2010 funding application? Yes

A major change is

• selecting a new Best Practice

• dropping a Best Practice

• changing the goal for a selected Best Practice

• adding or deleting objectives and/or measures

• modifying the budget by >25%

If major changes were not made, continue to Part 3.

If major changes were made, answer the following questions.

2.2) Briefly describe the changes made. We had to drop one objective for Foot Care and revise our timeline.

2.3) Briefly describe why the changes were necessary. Our coordinator had to unexpectedly fill a vacancy in the clinic for 3 months. While this was temporary, we got behind. We told our ADC and he said because it was not a permanent staffing loss that we did not need to report it to DGO. Our ADC thought we could still do the things we had planned but that we needed to revise our timeline and drop 1 of our objectives for the Foot Care best practice.

2.4) Were there changes in staffing for key personnel? No

2.5) Were these changes communicated to the following?

a) Your Area Diabetes Consultant? Yes

b) IHS Division of Grants Operations? No

c) IHS Division of Diabetes? No

d) Leader (from Project Narrative Part A, Section 2)

Yes

e) Tribal or organization leadership (e.g., CEO, Tribal chairperson, Health Director)

Yes

NOTE that per the FY 2010 Grant Terms and Conditions for the Grants for Special Diabetes Program for Indians included in the Notice of Award, GMO prior approval is required for any of the following post award changes. Providing information about changes in this form is not a substitute for obtaining prior approval for these changes.

a. Change the approved scope of work.

b. Change in the Program Director or a reduction of 25% or more in time and effort devoted to the project; or continuing the project for more than 3 months without the active direction of an approved Project Director.

c. An action requiring additional funds.

d. Deviation from grant terms & conditions.

Example Semi-annual Report Page 4 of 19

e. Audiovisuals & publications in excess of $25,000 per product.

f. Drawings/specifications for alterations & renovations over $50,000.

g. Carryover of unobligated balances in excess of 25 percent of the total amount awarded or $250,000, whichever is less.

Example Semi-annual Report Page 5 of 19

Part 3) Best Practice Information

Provide the information requested for each Best Practice that is being implemented. If there are activities outside of Best Practices, document those as if they were part of a Best Practice.

If you have more than three objectives for a Best Practice, use the Additional Objectives template to report them.

If you have more than three Best Practices, use the Additional Best Practices template to report them.

Example Semi-annual Report Page 6 of 19

Best Practice 1

3.1) Best Practice: Depression Care Diabetes

3.2) Goal: Improve rates of screening for depression among people with diabetes who have no previous diagnosis of depression.

3.3) Did you encounter major challenges in implementing this Best Practice? Yes

If yes, answer the following questions and then go to the next page.

3.4) What major challenges did you encounter in implementing this Best Practice?

(No more than six items.)

1. Our coordinator was assigned to temporarily fill a clinic position and was not able to help much at the beginning of the year. That meant we lost time and had to revise our original timeline and streamline some activities.

3.5) How have you or how do you plan to overcome these challenges? We talked to our ADC and revised our timeline and some activities. Our coordinator has returned and we are now on track with our new timeline.

If no, go to the next page.

Example Semi-annual Report Page 7 of 19

Best Practice 1, Objective 1

3.1.1) Objective: Increase the number of people with diabetes who receive a screening for depression from baseline 15% to 80% by December 31, 2010.

List major activities completed to date towards meeting this objective, including dates.

3.1.2a) Depression screening champion in clinic was identified in (January) 3.1.2b) Depression screening tool was identified (January/February) 3.1.2c) Training and workshop sessions on tool developed (March)

List major activities planned from now until end of budget period towards objective, including target dates.

3.1.3a) Conduct 2 training sessions and 2 workshops with clinic staff (June 1) 3.1.3b) Implement screening tool in clinic (July 1) 3.1.3c) Evaluate process and revise as needed (August 1)

Document the measures you are using and how you are collecting information about them in the table below. If there are more than 5 measures, report on the measures for which you have baseline and current data or are most relevant to major activities completed to date.

3.1.4) Measure 3.1.5) Baseline or beginning value (collected prior to starting activities)

3.1.6) Most recent value or 6 month value (collected after activities completed to date)

3.1.7) Data source

1 percent of people with diabetes screened for depression

15% screened

20% screened as of May 1

Diabetes Audit Data

RPMS

Depression screening log

2 Number of trainings and workshops conducted

3.1.8) How would you rate your progress toward meeting this objective to date? 2=In progress

3.1.9) Provide a brief explanation for your answer to the previous question. We are not as far along as we had planned because our coordinator had to temporarily fill a vacant clinic staff position. This put us behind. With the help of our ADC we revised our timeline and activities.

After time spent identifying champion, tools and training, along with other objectives in this Best Practice meeting measures and being maintained, more efforts will be placed to increase % of DM patients screened for depression.

Example Semi-annual Report Page 8 of 19

Best Practice 1, Objective 2

3.2.1) Objective: Refer 100% of people with diabetes who have a positive screen for depression to a provider for appropriate depresssion care by December 31.

3.2.2a) Identified staff person to track and record positive depression screens (e.g. all positive depression screening scores must be tracked to determine if referrals have been made).

3.2.2b) Referral and tracking protocol developed and tested (March-April) 3.2.2c) Begin weekly tracking. (May)

3.2.3a) Training/workshop is planned for several staff members (including 2 back-ups) on how to use the referral and tracking process system (May 15) 3.2.3b)Follow-up on referrals to ensure that patient is seen by a provider and if not phone call and/or home visit will be scheduled within 1 week. (May 15-December 31) 3.2.3c)

3.2.4) Measure 3.2.5) Baseline or

(collected prior to starting activities)

3.2.6) Most recent value or 6 month value (collected after activities completed to date)

3.2.7) Data source

1 Percent of referrals made to provider for possible depression

No referrals made in 2009 as no system in place

2 of 10 people were identified as depressed through screening and these 2 were referred to providers as of May 1).

Screening log Referral log Tracking log

2 Number of weeks tracking completed

0 in 2009 1 as of May 1)

3 Number of referrals that were seen by provider

0 2 referraks were seen by May 1

4 # trainings/workshops

0 in 2009 0 in 2010; 3 planned

3.2.8) How would you rate your progress toward meeting this objective to date? 2=In progress

3.2.9) Provide a brief explanation for your answer to the previous question. We got behind due to a staffing issue but have started tracking referrals for depression While 100% of DM patients with positive screens for depression are being referred, only 20% of DM pts are

Example Semi-annual Report Page 9 of 19 being screened. This objective will be tracked while increased effort is put into advancing the first objective.

Example Semi-annual Report Page 10 of 19

Best Practice 1, Objective 3

3.3.1) Objective: To increase percent of people with diabetes and diagnosed depression who receive tretment for depression from baseline of 20% to 80% who receive treatment by December 31.

3.3.2a) Identified and trained behavioral health staff to track depression treatment 3.3.2b) Assessed baseline percent of people with diabetes being treated for depression 3.3.2c) Met with behavioral health staff to review treatment documentation policies.

3.3.3a) Create reports to follow progress and improve system 3.3.3b) 3.3.3c)

3.3.4) Measure 3.3.5) Baseline or

(collected prior to starting activities)

3.3.6) Most recent value or 6 month value (collected after activities completed to date)

3.3.7) Data source

1 percent of people receiving depression treatment

20% treated in

50% of people (1 person) receiving treatment (of 2 referred) as of May 1

Diabetes Audit Data Depression registry

RPMS

3.3.8) How would you rate your progress toward meeting this objective to date? 2=In progress

3.3.9) Provide a brief explanation for your answer to the previous question. Just starting to track treatment but we have a system in place.

To report on more objectives for this Best Practice, use the Additional Objectives template.

Example Semi-annual Report Page 11 of 19

Best Practice 2

4.1) Best Practice: Foot Care

4.2) Goal: To conduct annual comprehensive foot exams and provide evidence-based education on foot care for people with diabetes.

4.3) Did you encounter major challenges in implementing this Best Practice? Yes

4.4) What major challenges did you encounter in implementing this Best Practice?

Our coordinator was temporarily assigned to the clinic to fill a vacancy. This meant that we were without her for 2 months.

4.5) How have you or how do you plan to overcome these challenges? We talked it over with our ADC and he suggested that we drop 1 of our 3 objectives and revise our timeline and try our best to stay on track.

Example Semi-annual Report Page 12 of 19

Best Practice 2, Objective 1

4.1.1) Objective: To increase the number of patients with diabetes who receive a comprehensive foot exam at least annually from baseline (50% in 2009) to 80% by December 31, 2010.

4.1.2a) Identified a foot care provider/champion. (January) 4.1.2b) Held monthly diabetes team meetings and identified foot care screening and education procedures, including DDTP's online Foot Care training, and local podiatrists that will accept patient referrals. (January - March) 4.1.2c)

4.1.3a) Conduct in-service training for providers and community health workers on foot care examination protocol. (May 25) 4.1.3b) Re-assess foot care examination rate (May, August and December) 4.1.3c)

4.1.4) Measure 4.1.5) Baseline or

(collected prior to starting activities)

4.1.6) Most recent value or 6 month value (collected after activities completed to date)

4.1.7) Data source

1 foot care examination 50% in 2009 66% as of May 1 Diabetes Audit Data

RPMS

2 ahmpion ID'd No Yes Adm meeting documents

3 Number of monthly team meetings held

5 in 2009 4 from Jan - April

Meeting documents

4 # inservice trainings on foot care

0 in 2009 0 in 2010; 4 planned

4.1.8) How would you rate your progress toward meeting this objective to date? 2=In progress

4.1.9) Provide a brief explanation for your answer to the previous question. Still lots of work to do to get more foot examinations done, but we are making progress.

Example Semi-annual Report Page 13 of 19

Best Practice 2, Objective 2

4.2.1) Objective: Increase the percent of people with diabetes who receive evidence-based foot care education 35% baseline by to 60% by December 31, 2010.

4.2.2a) Reviewed current foot care education materials. (January-February) 4.2.2b) Conducted baseline survey of staff on foot care education. (March) 4.2.2c) Provided training/workshop on foot care to staff and community health workers (March-April)

4.2.3a) Implement evidence-based foot care education (May-December) 4.2.3b) 4.2.3c)

4.2.4) Measure 4.2.5) Baseline or

(collected prior to starting activities)

4.2.6) Most recent value or 6 month value (collected after activities completed to date)

4.2.7) Data source

1 foot care patient education

35% in 2009 40% as of May 1, 2010 RPMS

2 number of clinic staff trained in foot care education

3 (2009) 6 as of May 2010 training log

4.2.8) How would you rate your progress toward meeting this objective to date? 2=In progress

4.2.9) Provide a brief explanation for your answer to the previous question. we are making progress but we are just starting our foot education program.

Example Semi-annual Report Page 14 of 19

Best Practice 2, Objective 3

4.3.1) Objective:

4.3.2a) 4.3.2b) 4.3.2c)

4.3.3a) 4.3.3b) 4.3.3c)

4.3.4) Measure 4.3.5) Baseline or

(collected prior to starting activities)

4.3.6) Most recent value or 6 month value (collected after activities completed to date)

4.3.7) Data source

4.3.8) How would you rate your progress toward meeting this objective to date? Choose one

4.3.9) Provide a brief explanation for your answer to the previous question.

Example Semi-annual Report Page 15 of 19

Best Practice 3

5.1) Best Practice: Choose one

5.2) Goal:

5.3) Did you encounter major challenges in implementing this Best Practice? Choose one

5.4) What major challenges did you encounter in implementing this Best Practice?

5.5) How have you or how do you plan to overcome these challenges?

Example Semi-annual Report Page 16 of 19

Best Practice 3, Objective 1

5.1.1) Objective:

5.1.2a) 5.1.2b) 5.1.2c)

5.1.3a) 5.1.3b) 5.1.3c)

5.1.4) Measure 5.1.5) Baseline or

(collected prior to starting activities)

5.1.6) Most recent value or 6 month value (collected after activities completed to date)

5.1.7) Data source

5.1.8) How would you rate your progress toward meeting this objective to date? Choose one

5.1.9) Provide a brief explanation for your answer to the previous question.

Example Semi-annual Report Page 17 of 19

Best Practice 3, Objective 2

5.2.1) Objective:

5.2.2a) 5.2.2b) 5.2.2c)

5.2.3a) 5.2.3b) 5.2.3c)

5.2.4) Measure 5.2.5) Baseline or

(collected prior to starting activities)

5.2.6) Most recent value or 6 month value (collected after activities completed to date)

5.2.7) Data source

5.2.8) How would you rate your progress toward meeting this objective to date? Choose one

5.2.9) Provide a brief explanation for your answer to the previous question.

Example Semi-annual Report Page 18 of 19

Best Practice 3, Objective 3

5.3.1) Objective:

5.3.2a) 5.3.2b) 5.3.2c)

5.3.3a) 5.3.3b) 5.3.3c)

5.3.4) Measure 5.3.5) Baseline or

(collected prior to starting activities)

5.3.6) Most recent value or 6 month value (collected after activities completed to date)

5.3.7) Data source

5.3.8) How would you rate your progress toward meeting this objective to date? Choose one

5.3.9) Provide a brief explanation for your answer to the previous question.

Example Semi-annual Report Page 19 of 19

To report on more than three Best Practices, use the Additional Best Practices template.