Scope of Work Template.docx
DOCX document 33 KB Posted
- 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
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