Last updated 2/11/15

GRANTEE SUMMARY REPORT

TEMPLATE
Grantee Name:

Grant Type:

BASIC INFORMATION

Legal name of Grantee:

Descriptive Title of Project:
Year Grant was Awarded :
Implementation Grant
Main Point of Contact for the Grant :
Agency/organization that received the grant funding:

BACKGROUND
Provide a summary description of the grantee. Include:

A brief summary of who the grantee is

PAST SAMHSA GRANTS

Grantees history and past SOC grants (e.g., this may include prior SOC
community grants, expansion planning grants, or Circles of Care grants for
Tribal grantees)

EXISTING SYSTEM SUPPORTS

Include a description of any other events that lay the foundation for expansion
opportunities, such as:
o Infrastructure (e.g., in services, systems, training);
o Policy/administrative changes (especially funding changes such as
Medicaid waivers, etc.);
o Needs assessments

GOALS, ACTIVITIES, STRATEGIES

A summary of the grantees vision or what they hope to accomplish with the
grant.
A section describing the goals of the grant
A summary of the major activities planned to accomplish stated goals

OTHER CONTEXTUAL FACTORS

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If mentioned in the Introductory Call, these factors could include:

o Status of current activities or accomplishments to date
o Administrative changes that impact implementation, such as change in
governor or other administrative decision makers
o Major grantee staffing changes
o Relevant legislation or legal actions that may impact the grantees
work, etc.

POPULATION SERVED
[Provide a general description of the population of children and families that
are served by the expansion grant. For example, what is the age range of the
children/youth being served, what type of population are the youth from (e.g.,
child welfare, juvenile justice), what behavioral health issues are the focus,
etc.]
DEFINITION OF EXPANSION, AND THE LOCAL AND STATE SERVICE
SYSTEMS
EXPANSION
What are the grantees plans for expansion, e.g., introducing new services or
expanding services to new areas; introducing new SOC policies and practices or
expanding them to new areas?
STATE
State role in the expansion award (include whether it is a state or local grant, how
the state and local levels will work together to promote expansion) Geographic area
covered by the Local site or sites (multi county area, territory, Tribe)
LOCAL SERVICE SYSTEMS
Regional or local service systems involved in expansion (e.g., counties or regions
within the state/tribe/territory) and how they will work with the state/tribe/territory.
GRANT STRUCTURE
MANAGEMENT GROUPS
o

Include any description of their management entities the

group that is actually conducting day-to-day operations of the grant
and include any of their responsibilities and who is part of the group
(may be called an implementation team, administrative team, may
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have the word state at the beginning, such as State Implementation

Team or State Administrative TeamSIT or SAT)
GOVERNANCE
o

Include any descriptions of their governance board with a

description of their responsibilities and an overview of who may be a
part of this group (may be called steering committees, advisory
boards, coordinating councils, etc.)

PARTNER ORGANIZATIONS/MAJOR COLLABORATORS

CHANGES SINCE TIME OF APPLICATION

Major changes since time of application that affect the vison, goals, strategies,
activities or administration of the grant.
ADDITIONAL SUMMARY DOCUMENTS
Include additional documents that were reviewed in order to create the summary
report.

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