Program Performance Report

Reporting Period:*

Q1: October 1, 2024 through December 31, 2024Q2: October 1, 2024 through March 31, 2025Q3: October 1, 2024 through June 30, 2025Q4: October 1, 2024 through September 30, 2025

Agency Name*

Service Name:*

Contact Person's Name:*

Contact Person's Email*

example@example.com

Select One or More Counties Served:

Example:

Agency A: If your agency serves participants in Muskegon, Oceana, and Ottawa counties, select all three counties.
Agency B: If your agency only serves participants in Ottawa county, select only Ottawa county.

Select One or More Counties Served:*

MuskegonOceanaOttawa

Service Status Data: Fiscal Year-to-Date (FYTD): All cells must have an amount entered. Enter "0" for none.*

	Muskegon	Oceana	Ottawa
Number of Units Served:
Number of Unduplicated Participants:
African American/Black
American Indian/Eckimo-Aleut
Asian
Native Hawaiian/Other Pacific Islander
Hispanic Origin
Non-Minority
Total Greatest Economic Need (GEN):
Minority Economic Need:
Rural Participants (Oceana County Only):

Service Status Data: Fiscal Year-to-Date (FYTD): All cells must have an amount entered. Enter "0" for none.*

	Muskegon
Number of Units Served:
Number of Unduplicated Participants:
African American/Black
American Indian/Eckimo-Aleut
Asian
Native Hawaiian/Other Pacific Islander
Hispanic Origin
Non-Minority
Total Greatest Economic Need (GEN):
Minority Economic Need:
Rural Participants (Oceana County Only):

Service Status Data: Fiscal Year-to-Date (FYTD): All cells must have an amount entered. Enter "0" for none.*

	Oceana
Number of Units Served:
Number of Unduplicated Participants:
African American/Black
American Indian/Eckimo-Aleut
Asian
Native Hawaiian/Other Pacific Islander
Hispanic Origin
Non-Minority
Total Greatest Economic Need (GEN):
Minority Economic Need:
Rural Participants (Oceana County Only):

Service Status Data: Fiscal Year-to-Date (FYTD): All cells must have an amount entered. Enter "0" for none.*

	Ottawa
Number of Units Served:
Number of Unduplicated Participants:
African American/Black
American Indian/Eckimo-Aleut
Asian
Native Hawaiian/Other Pacific Islander
Hispanic Origin
Non-Minority
Total Greatest Economic Need (GEN):
Minority Economic Need:
Rural Participants (Oceana County Only):

Total Units:

Total of Unduplicated Participants

Total Minorities:

Total GEN:

Upload the Waiting List Report here:

What program or administrative changes have occurred that may affect contracted services? Please provide details such as changes in staffing, contact information, agency or program name, address, phone number, fax number, federal ID number, or any other relevant information:

Please describe any significant successes or challenges encountered in delivering services during the past quarter:

Is this report for kinship or caregiver support service?*

YesNo

Please provide the unduplicated participant total of individual and group support:*

Participant-Level Unit Reporting for NAPIS – Required only for Case Coordination & Support and Home Delivered Meals. Is this Program Performance Report for one of those two services?*

YesNo

Please continue to utilize the OSA Secure File Drop or Box for the submission of these unit reports.

For all other services, units are reported in aggregate within NAPIS. Unit documentation is not required to be uploaded to Box. Submitting this form completes the reporting process.

Signature*

*After clicking SUBMIT, if you receive a “Please Wait” message that lasts for more than one minute please email grants@seniorresourceswmi.org for support.