Scope of Work Template.docx

DOCX document 33 KB Posted

Attached to
FY27 Notice of Funding Opportunity - Family Preservation and Support Services
Solicitation number
40DHHS-S3725
Issued by
Nevada

About this file

This Scope of Work Template is a standardized form used by the Nevada Division of Social Services for subrecipient agreements under grant-funded programs. The document provides a structured framework for nonprofit entities and government agencies to define deliverables and performance metrics for subawards. The template requires subrecipients to articulate primary and secondary goals, establish specific objectives with corresponding activities, identify expected outcomes, define timelines from initiation to completion, specify target populations, and outline evaluation measures with corresponding tools for tracking progress. The example provided illustrates a cancer screening promotion program with objectives including community outreach activities, social media campaigns, and educational mailings designed to increase awareness among women aged 40-64, with monthly reporting requirements to the state.

The template emphasizes accountability and measurable results by requiring subrecipients to document specific activities conducted, populations served, and quantifiable outcomes achieved. Compliance with the scope of work section is formalized through signature on the subaward cover page. The structure allows for flexible goal development across multiple objectives and activities, with provisions to add additional lines to accommodate all programmatic goals. Evaluation mechanisms include both activity counts and outcome-based metrics tracked through specified evaluation tools such as screening databases and program data systems. This framework supports the state's competitive bid process for selecting multiple qualified entities to deliver emergency assistance and stabilization services to families impacted by substance use disorders.

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Text version

SECTION B

Description of Services, Scope of Work and Deliverables

Subrecipient’s name, hereinafter referred to as Subrecipient, agrees to provide the following services and reports according to the identified timeframes:

Scope of Work for: Subrecipient (form amended 2.4.2021)

Goal 1: Describe the primary goal the program wishes to accomplish with this subaward.

Objective
Activities
Expected Outcomes
Timeline: Begin-Completion
Target Population
Evaluation Measure (indicator)
Evaluation Tool

1.1

1.2

Goal 2: Describe the secondary goal the program wishes to accomplish with this subaward.

Objective
Activities
Expected Outcomes
Timeline: Begin-

Completion

Target Population
Evaluation Measure (indicator)
Evaluation Tool

2.1

2.2

Note: Add lines to the table as applicable to accomplish all the goals of the subaward.

Compliance with this section is acknowledged by signing the subaward cover page of this packet.

Example:SAMPLE

Goal 1: Outreach and Education- Promote Breast and Cervical Cancer screening especially among high-risk and disparate populations

Objective
Activities
Expected Outcomes
Timeline Begin/Completion
Target Population
Evaluation Measure (indicator)
Evaluation Tool
1.1: Through June 29, 2015 conduct 3 public education and targeted outreach activities
Conduct targeted outreach in the community through group or one-on-one education and in reach with participating providers to promote cancer screening
Awareness of WHC and importance of cancer screening
Provide a report to the state by the 15th of each month
Women aged 40-64
# of public education activities conducted

# of outreach activities conducted Pre-CaST, CaST-Referral Source

Utilize small /social media including rack cards, website, and Facebook page to promote screening services, especially during cancer awareness months
Awareness of WHC and importance of cancer screening
Provide a report to the state by the 15th of each month
Women aged 40-64
Hit rate of small/social media
Pre-CaST, CaST-Referral Source
Conduct one mailing of educational materials to WHC client list on ACA before new enrollment period
Educational postcards mailed to promote enrollment in an insurance product
By October, 2014
All WHC women
# of educational postcards mailed

# of women who transitioned into Medicaid Program data

File details come from the government source that posted it. Updated .