Quarterly Report

Region:

Email

example@example.com

Reporting Timeframe

Collaboration and Strategic Planning Summary:

Use this section to highlight the status of your regional strategic plan. This will demonstrate collaboration and cross-system involvement in the program.

Steering Committee Updates

Rows	Committee Member?	Member Present at 75% of Meetings?
Child Welfare
Schools
Emergency Management Services (EMS)
Juvenile Justice
Pediatricians
Behavioral Health Providers
Autism specialists
Social support providers
Community Youth & family peer
BIPOC & Tribal affiliated agencies
MCO Care Coordinators
DDA Case Managers
FYSPRTs
Tribes
Regional CLIP Members
Behavioral Health Providers
Other

Website/Portal Highlights:

Use this section to document/highlight your regional portal.

Status of implementation:

Rows	YES	NO
Branding yes or no
Link to collaborative list of regional resources yes or no.
Easy access to the FOR HELP portal?

Analytics

Website Highlights

(Resources, News, Events, etc.):

Outcomes and/or stories which demonstrate
the impact of your regional program:

Use this section to help us tell the story of the impact of your regional program.

Number of Families served:

Survey results

Please provide a narrative and specific data you collected

Feedback from parent, youth, or community partner:

MDT outcomes

Trainings

Care coordination activities and outcomes

Consultations

Sharing knowledge and resources within the community related to the issue/concern the individual is looking for outside of an MDT

Highlight any community/outreach events in your region

Challenges and lessons learned:

Use this section to capture any themes or challenges you have identified in the implementation.

Program Capacity

Training needs for specific populations

Program TA needs

Other challenges