Critical Supports Semi-Annual Programmatic Report
Reporting Period: October 1, 2018 - March 31, 2019
Federation Name
JFNA Grant Award Number
(CS1-X)
Federation Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Name of staff who prepared this report
Email of staff who prepared this report
example@example.com
Which reporting period does this represent?
October 1, 2018-March 31, 2019
April 1, 2019-September 30, 2019
Convening Leadership Councils
Which types and how many individuals agreed to participate in your Leadership Council? Check all that apply. (Note: In order to avoid duplication, please think about in what context is this person representing: a hospital or him/herself as an individual)
*
Which types and how many organizations agreed to participate in your Leadership Council? Check all that apply.
1
2
3
4
5
6
7
8
9
10
N/A
Jewish Social Service Agency
Jewish Community Center
Local Aging Service Provider (e.g. Senior Center, Adult Daycare)
Local Healthcare Provider Agency (e.g. Clinic, Urgent Care)
University (if it's a hospital, check hospital)
Hospital or Rehab Center
Local Government Agency (e.g. Department of Mental Health, Department of Housing, Department of Public Health)
Local Aging Agency (e.g. Area Agency on Aging, State Unit on Aging)
Hospice
Low Income Housing Residence
Institutional Care Facility (e.g. Assisted Living Facility, Nursing Home, Independent Living Facility)
Other
How many organizations were invited to participate on your Leadership Council?
1-5
6-10
11-15
16-20
21-25
26 or more
How did you decide which organizations or individuals to invite?
(Max 250 words)
If any organization or individual chose not to participate, please say why.
(Max 250 words)
How many organizations/individuals are participating on your Leadership Council at this time?
1-5
6-10
11-15
16-20
21-25
26 or more
How many times has your Leadership Council met?
1
2
3
4
5
6
7
8
9
10
11 or more times
Please attach your agenda/s for your Leadership Council meetings.
Browse Files
Cancel
of
If your Leadership Council has not met, please say when it is scheduled to meet and what the agenda will cover.
(Max 150 words)
For each meeting, please summarize the main points and next steps.
(Max 250 words)
Has your Leadership Council created plans to distribute funds to agency partners?
Yes
No
If yes, please describe these plans, and how you will monitor the use of grant funds for this project.
(Max 250 words)
If not, please explain the status.
(Max 250 words)
What steps have you taken to incorporate PCTI care into your Leadership Council?
(Max 250 words)
What steps have you taken to include Holocaust survivors in the program planning process?
(Max 250 words)
Please upload your Diamond reports for this reporting period.
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Cancel
of
Implementing Critical Supports for Holocaust Survivors
Have you created any materials for your project? If yes, please upload them and describe their purpose.
Browse Files
(Example: outreach materials, newsletters)
Cancel
of
Provide an update on your plans to evaluate your project, and share any evaluation tools you plan to use. Include the number of Holocaust survivors you plan to serve through your leadership council, and how you are tracking progress toward this goal. Describe and share any data you have collected at this point.
Provide an update on your progress towards raising the matching funds required for this project.
(Max 200 words)
Provide an update on how you might sustain your project at the end of the grant period.
(Max 500 words)
Describe any challenges you have encountered in implementing your project, any actions taken to address them, and any anticipated changes to your projected as a result of those challenges.
(Max 500 words)
Describe any lessons learned at this point in your project.
(Max 500 words)
Legal Professionals
Medical Professionals
Dentists
Mental Health Professionals
Number
Number
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