THIS
IS
A
SAMPLE
GMS
FORM.
DO
NOT
USE
THIS
FORM
TO
SUBMIT
YOUR
FINAL
DATA
TO
OVW.
OMB
Clearance
#
1122-0011 Expiration
Date:08/30/2014
SEMI-ANNUAL PROGRESS REPORT FOR
Grants
to
Support
Tribal
Domestic
Violence
and
Sexual
Assault
Coalitions
Brief Instructions: This form must be completed for each Grant to Support Tribal Domestic Violence and Sexu- al Assault Coalition (Tribal Coalitions) grant received. The grant administrator or coordinator must ensure that the form is completed fully with regard to all grant activities.
All grantees should read through each section to determine which questions they must answer based on the activities engaged in under this grant during the current reporting period. Sections B, D and subsection A1 of this form must be completed by all grantees. In subsection A2 and section C, grantees must answer an initial question in each subsection about whether they engaged in certain activities during the current reporting period. If the response is yes, then the grantee must complete that subsection. If the response is no, the rest of that subsection is skipped.
For example, 1) if staff funded under this grant only provided training and technical assistance during the current reporting period, you would complete A1, A2, B, C1, C6, and D (and answer ‘no’ in C2-C5 and C7); or,
2) if staff funded under this grant provided training and technical assistance and developed products dur- ing the current reporting period, you would complete A, B, C1, C4, C5, C6, and D (and answer ‘no’ in C2, C3, and, C7).
The activities of volunteers or interns should be reported if they were coordinated or supervised by Tribal Co- alitions Program-funded staff or if Tribal Coalitions Program funds substantially support their activities.
For further information on filling out this form, refer to the separate set of instructions, which contains de- tailed definitions and examples, illustrating how questions should be answered.
Section Page
Number
Section A: |
General Information |
1 |
A1: |
Grant Information |
1 |
A2: |
Staff Information |
3 |
Section B: |
Purpose Areas |
4 |
Section C: |
Function Areas |
6 |
C1: |
Training |
6 |
C2: |
Education |
10 |
C3: |
System Advocacy |
13 |
C4: |
Policies |
17 |
C5: |
Products |
20 |
C6: |
Topics of Technical Assistance |
21 |
C7: |
Organizational Development and Capacity Building |
24 |
Section D: |
Narrative |
25 |
Tribal Coalitions Program Semi-annual Progress Report • Of fi ce on Violence Against Women
SECTION
A1
GENERAL INFORMATIONGrant information
1. Date
of
report
All grantees must complete this section.
Current
reporting
period
✔ January 1- June 30
✔ July 1-December 31 (Year)
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4. Grant
number
(the federal grant number assigned to your Tribal Coalitions Program grant)
5. Type
of
grantee
organization
(Check one.)
Established
tribal
coalition
Individual
Other non-profit
6. Type
of
Coalition
(Check
one.)
Sexual
assault
coalition
Domestic
violence
coalition
Dual sexual assault/domestic violence coalition
7. Point
of
contact
(person responsible for the day-to-day coordination of the grant)
First name MI Last name Agency/organization name (if different from grantee name)
Address
City State Zip
code
Telephone Facsimile
E-mail
8. What
percentage
of
your
tribal
coalition
operating
budget
is
funded
by
this
Tribal
Coalitions
Pro-
gram
grant?
9. What
tribal
population(s)
is(are)
served
by
your
Tribal
Coalitions
Program
grant?
10.
Did
this
tribal
coalition
exist
prior
to
receiving
Tribal
Coalitions
grant
funds?
Yes No
Tribal Coalitions Program Semi-annual Progress Report • 1 • Of fi ce on Violence Against Women
OMB
Clearance
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1121-0284 Expiration
Date:
(Report the total number of organizational members, including sexual assault programs, domestic vio- lence programs, other victim services agencies, and other organizational members. Report the total number of individual members of your tribal coalitions, if any. Individual members are individual per- sons, not programs.)
Coalition
members Number
Sexual assault programs/rape crisis centers Domestic violence programs
Dual sexual assault and domestic violence programs Tribal victim services agencies
Other organizational members
Total number of organizational members 0
Total number of individual members
Tribal Coalitions Program Semi-annual Progress Report • 2 • Of fi ce on Violence Against Women
SECTION
A2 Staff InformationWere Tribal Coalitions funds used to fund staff positions during the current reporting period?
Check yes if Tribal Coalitions funds were used to pay staff, including part-time staff and contractors.
Yes—answer
question
12
No—skip
to
section
B
12.
Staff
(Report the total number of full-time equivalent [FTE] staff funded by your Tribal Coalitions Program grant during the current reporting period. Report staff by the function(s) performed, not by title or loca- tion. Include employees who are part-time and/or only partially funded with these grant funds as well as consultants/contractors. If an employee or contractor was employed or utilized for only a portion of the reporting period, prorate appropriately. For example, if you hired a full-time administrator in October who was 100% funded with Tribal Coalition Program funds, you would report that as .5 FTEs. Report all FTEs in decimals, not percentages. One FTE is equal to 1,040 hours—40 hours per week x 26 weeks.
See separate instructions for examples of how to calculate FTEs.)
Staff FTE(s)
Administrator (executive director, fiscal manager)
Attorney
Communication specialist (public awareness, media relations)
Information technology staff
Program coordinator (training coordinator, outreach coordinator) Support staff (administrative assistant, accountant, bookkeeper) System advocate
Technical assistance provider Trainer/educator
Tribal cultural specialist Other (specify):
Total
0.00
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Tribal Coalitions Program Semi-annual Progress Report • 3 • Of fi ce on Violence Against Women
SECTION
grantees must complete this section.
Purpose Areas
(Check all purpose areas that apply to activities supported with Tribal Coalitions Program funds during the current reporting period.)
Check
ALL
that
apply
Purpose areas
Increasing awareness of domestic violence/dating violence and sexual assault against American Indian and Alaska Native women
Enhancing the response to violence against American Indian and Alaska Native women at the tribal, Federal, and State levels
Identifying and providing technical assistance to coalition membership and tribal com- munities to enhance access to essential services to American Indian women victimized by domestic/dating and sexual violence
OMB
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13a.
Program
priority
areas
addressed
by
your
grant
(In
addition
to
the
purpose
areas
identified
above,
the
Tribal
Coalition
Grant
Program
Application
and
Program
Guidelines
may
have
identified
several
program
priorities
that
would
receive
priority
consider-
ation.
If
your
project
addressed
any
of
these
priority
areas
during
the
current
reporting
period,
list
them
below.)
Culturally
specific
activities
(List
all
culturally-specific
activities
that
your
tribal
coalition
engaged
in
during
the
current
reporting
pe-
riod
in
the
community(ies)
you
serve.
Check
the
box
in
the
first
column
if
the
activity
was
funded
with
Tribal
Coalitions
Program
funds.)
Tribal Coalitions funded |
Activity |
|
a. |
|
b. |
|
c. |
|
d. |
|
e. |
|
f. |
Tribal
Coalitions
Program
Semi-annual
Progress
Report
•
4
•
Of
fi
ce
on
Violence
Against
Women
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Expi:
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15.
(OPTIONAL)
Additional
information
(Use
the
space
below
to
discuss
the
effectiveness
of
your
culturally-specific
activities
funded
or
sup-
ported
by
your
Tribal
Coalitions
Program
grant
and
to
provide
further
explanation
on
how
these
activi-
ties
increase
the
safety of
American
Indian/Alaska
Native
women.)
(Maximum
-
2000 characters)
Tribal Coalitions Program Semi-annual Progress Report • 5 • Of fi ce on Violence Against Women
OMB
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1121-0 10/31/2007
SECTION
C1
FUNCTION AREASTraining
Were your Tribal Coalitions Program funds used for training during the current reporting period?
Check yes if Tribal Coalitions Program-funded staff provided training or if Tribal Coalitions Program funds were used to directly support the training.
Yes—answer
questions
16-19
No—skip
to
subsection
C2
For the purposes of this reporting form, training means providing information on sexual assault, dating violence, domestic violence, and stalking that enables professionals to improve their response to vic- tims/survivors as it relates to their role in the system. Education means providing general information that will increase public awareness of sexual assault, domestic violence, dating violence, and stalking. In this subsection, report information on training activities. Education should be reported in subsection C2
16.
Type
and
number
of
training
events
provided
(Report the number of statewide, regional, and tribal-based training events by the type of training that were either provided by Tribal Coalitions Program-funded staff or directly supported with Tribal Coali- tions Program funds. Staff development training provided to Tribal Coalitions Program-funded staff should not be counted. Use the Sexual assault/Domestic violence columns if training events focused on both sexual assault and domestic violence.)
Type of training |
Total number of training events |
||||||||
Statewide |
Intra-state regions |
Tribal |
|||||||
Sexual |
Domestic |
Sexual |
Sexual |
Domestic |
Sexual |
Sexual |
Domestic |
Sexual |
|
assault/ |
assault/ |
assault/ |
|||||||
assault |
violence |
domestic |
assault |
violence |
domestic |
assault |
violence |
domestic |
|
violence |
violence |
violence |
|||||||
Computer-
based
training
Conferences
Teleconferences
Videoconfer- ences
Workshops/
seminars
Other (specify):
Tribal Coalitions Program Semi-annual Progress Report • 6 • Of fi ce on Violence Against Women
Number
of
people
trained
(Report
the
number
of
people
trained
during
the
current
reporting
period
by
Tribal
Coalitions
Program-
funded
staff
or
training
supported
by
Tribal
Coalitions
Program
funds.
Use
the
category
that
is
most
descriptive
of
the
people
attending
the
training
event.
Tribal
Coalitions
Program-funded
staff
attending
staff
development
training
should
not
be
counted.
If
you
do
not
know
how
many
people
to
report
in
spe-
cific
categories,
you
may
report
the
overall
number
in
“Multidisciplinary.”)
People trained Number
Attorneys/law
students
(does
not
include
prosecutors)
Batterer intervention program/offender accountability staff |
|
|
|
Child protective service workers |
|
|
|
Children’s advocates (not affiliated with CPS) |
|
|
|
Correction personnel (probation, parole, and correctional facility staff) |
|
|
|
Court personnel (tribal—judges, clerks) |
|
|
|
Court personnel (non-tribal—judges, clerks) |
|
|
|
Domestic violence program staff (tribal) |
|
|
|
Domestic violence program staff (non-tribal) |
|
|
|
Educators (teachers, administrators, etc.) |
|
|
|
Faith-based organization staff |
|
|
|
Federal agency staff (BIA, IHS, FBI) |
|
|
|
Health professionals (doctors, nurses; does not include forensic examiners) |
|
|
|
Law enforcement officers (tribal) |
|
|
|
Law enforcement officers (non-tribal) |
|
|
|
Legal services staff (does not include attorneys) |
|
|
|
Mental health professionals |
|
|
|
Military command staff |
|
|
|
Multidisciplinary (various disciplines at same training) |
|
|
|
Other government agency staff (vocational rehabilitation, food stamps, TANF) |
|
|
|
Prosecutors (tribal) |
|
|
|
Prosecutors (non-tribal) |
|
|
|
Sexual assault forensic examiners/sexual assault nurse examiners (SAFE/SANE) |
|
|
|
Sexual assault program staff (tribal) |
|
|
|
Sexual assault program staff (non-tribal) |
|
|
|
Social service organization staff (non-government—food bank, homeless shelter, etc.) |
|
|
|
Tribal community groups |
|
|
|
Tribal elders |
|
|
|
Tribal government/tribal government agency staff |
|
|
|
Victim assistants (governmental, includes victim-witness specialist/coordinator) |
|
|
|
Volunteers |
|
|
|
OMB
Clearance
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2007
Other
(specify):
0
Tribal Coalitions Program Semi-annual Progress Report • 7 • Of fi ce on Violence Against Women
Training content areas
(Indicate all topics covered in training events provided with your Tribal Coalitions Program-funds during the cur- rent reporting period. Check all that apply.)
Sexual
assault,
domestic
violence/dating
violence
and
stalking
Advocacy for American Indian and/or Alaska Na- tive women
Child
custody
in
the
context
of
violence
against
women
Child
witnesses
in
the
context
of
domestic
violence/dating
violence
Confidentiality
Cultural
issues
specific
to
American
Indians
and/or
Alaska
Natives
Dating
violence
overview,
dynamics,
and
services
Domestic
violence
overview,
dynamics,
and
ser-
vices
Drug
facilitated
sexual
assault
Dynamics
and
history
of
violence
against
Ameri-
can
Indian
and/or
Alaska
Native
women
Historical
trauma
Indian
Child
Welfare
Act
Safety planning for victims/survivors
Sexual
assault
overview,
dynamics,
and
services
Stalking
overview,
dynamics,
and
services
Supervised
visitation
and
exchange
Other (specify):
Organizational
community
response
Coalition
development
Collaboration
Coordinated
community
response
Discrimination
and
oppression
issues
Evaluation
Federal
agency
response
to
sexual
assault
and
domestic
violence/dating
violence
(IHS,
BIA,
FBI,
USAO)
Outreach
Program
accessibility
Program
rules
Public benefits (TANF, disability, food stamps, unemployment, etc.)
Response
teams
(DART,
DVRT,
SART)
Strategic
planning
Technology
Tribal strategies to address sexual assault or do- mestic violence/dating violence, or stalking
Victim
service
administration
and
operations
Other
(specify):
Other underserved populations
Issues specific to American Indian and Alaska Native victims/survivors who
are
elderly
are
homeless
or
living
in
poverty
are
isolated
or
institutionalized
are
lesbian,
gay,
bisexual,
transgender,
or
intersex
have
disabilities
have
mental
health
issues
live
in
rural
areas
live
in
urban
areas
Other
(specify):
Justice system
Court
procedures
Decreasing
dual
arrests/identifying
predomi-
nant
aggressor
Domestic
violence
statues/code
development
Evidence
analysis,
collection,
and
preservation
Evidence-based
prosecution
Firearms
and
domestic
violence/dating
violence
Judicial
response
Law
enforcement
response
(including
protocols,
arrest
policies,
and
evidence
collection)
Mandatory
reporting
requirements
Pro-arrest
policies
Prosecution
response
Protection
orders
(including
full
faith
and
credit)
Sex
offender
registry(ies)
Sexual
assault
forensic
examinations
Sexual
assault
statutes/codes
Stalking
statutes/codes
Tribal
jurisdiction
and
Public
Law
280
Other
(specify):
OMB
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Exp
10/31/2007
OMB
Clearance
#
1121-0284 Expi:
10/31/2007
(Use
the
space
below
to
discuss
the
effectiveness
of
your
training
activities
funded
or
supported
by
your
Tribal
Coalitions
Program
grant
and
to
provide
further
explanation
on
how
these
activities
increase
the
safety
of
American
Indian/Alaska
Native
women.)
(Maximum
-
2000
characters)
Tribal Coalitions Program Semi-annual Progress Report • 9 • Of fi ce on Violence Against Women
OMB
Clearance
#
1121- 67
SECTION
Were your Tribal Coalitions Program funds used for education activities during the current reporting pe- riod?
Check yes if Tribal Coalitions Program-funded staff engaged in education activities or if Tribal Coalitions Program were used to directly support education activities.
Yes—answer
questions
20-23
No—skip
to
C3
For the purposes of this reporting form, education means providing general information that will increase public awareness of sexual assault, domestic violence, dating violence, and stalking. Training means provid- ing information on sexual assault, domestic violence, dating violence, and stalking that enables a profes- sional to improve her/his response to victims/survivors of sexual assault, domestic violence, dating violence, and stalking. In this subsection, report information on education activities. Training should be reported in subsection C1.
20.
Education
events
(Report the total number of education events provided during the current reporting period.)
Total
number
of
education
events
provided
21.
People
educated
with
Tribal
Coalitions
Program
funds
(Report the number of people attending education events during the current reporting period. Use the category that is most descriptive of the people who attended the educational event.)
People
attending
event
Number
Tribal
Non-tribal
Community businesses (retail stores, pharmacies) |
|
|
Community
groups
(service
or
social
groups)
Community
members
Faith-based
groups
Parents/guardians |
|
|
|
|
|
|
Students
Tribal
elders
Tribal government/tribal government agency staff
Victims/survivors (do not count psychoeducational support groups)
Women’s groups Other (specify):
Total 0 0
Tribal Coalitions Program Semi-annual Progress Report • 10 • Of fi ce on Violence Against Women
22.
Topics
of
education
events
provided
with
Tribal
Coalitions
Program
funds
(Indicate all topics covered in education provided with your Tribal Coalitions Program funds during the current reporting period. Check all that apply.)
Sexual assault, domestic violence, dating vio- lence, and stalking
Dating
violence
overview,
dynamics
and
ser-
vices
Domestic
violence
overview,
dynamics
and
services
Historical
trauma
Indigenous
awareness
programs
Mandated
reporting
of
child
victimization
Safety
planning
Sex
offender
registry(ies)
Sexual
assault
overview,
dynamics,
and
ser-
vices
Stalking
overview,
dynamics,
and
services
VAWA
Youth
awareness
of
sexual
assault,
domestic
violence/dating
violence,
and
stalking
Workplace
violence
Other
(specify):
How to help American Indian or Alaska Na- tive victims/survivors who:
are
elderly
are
homeless
or
living
in
poverty
are
isolated
or
institutionalized
are
lesbian,
gay,
bisexual,
transgender,
or
intersex
have
disabilities
have
mental
health
issues
have
substance
abuse
issues
live
in
rural
areas
live
in
urban
areas
Other
(specify):
10/31/2007
Tribal Coalitions Program Semi-annual Progress Report • 11 • Of fi ce on Violence Against Women
OMB
Clearance
#
1121-0284 10/31/2007
(Use
the
space
below
to discuss
the
effectiveness
of
your
education
activities
funded
or
supported
by
your
Tribal
Coalitions
Program
grant
and
to
provide
further
explanation
on
how
these
activities
increase
the
safety
of
American
Indian/Alaska
Native
women.)
(Maximum
-
2000
characters)
Tribal Coalitions Program Semi-annual Progress Report • 12 • Of fi ce on Violence Against Women
OMB Clearance # 1121-0284
Expiration Date: 10/31/2007
SECTION
C3 System AdvocacyWere your Tribal Coalitions Program funds used for system advocacy during the current reporting period?
Check yes if Tribal Coalitions Program-funded staff engaged in system advocacy or if Tribal Coalitions Program funds were used to directly support system advocacy. (System advocacy is an activity intended to effect policy and/or procedural change in order to improve institutional response to sexual assault and/or domestic violence.)
Yes—answer
questions
24-27
No—skip
to
C4
24.
System
advocacy
activities
(Indicate the system advocacy activities convened or participated in with Tribal Coalitions Program funds during the current reporting period. Check all that apply.)
Systems advocacy |
Sexual assault |
Domestic violence |
Appointed
tribal
and
state
commissions
Community,
regional,
statewide
task
force/caucus
Multidisciplinary
working
groups
Project-specific
interagency
working
groups
Tribal
systems
advocacy
Other (specify):
Tribal Coalitions Program Semi-annual Progress Report • 13 • Of fi ce on Violence Against Women
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25.
Improved
system
response
(Report
the
total
number
of
statewide,
regional,
and
local
meetings
convened
and/or
attended
by
Tribal
Coalitions
Program--funded
staff
during
the
current
reporting
period.
Report
based
on
the
primary
group
in
attendance.
If
there
were
multiple
agencies
or
organizations
at
the
meeting,
count
the
meeting
as
a
multidisciplinary
meeting.
Each
meeting
should
be
counted
only
once.)
Agency/organization/people |
Number of meetings convened |
Number of meetings attended |
||||
Sexual assault |
Domestic violence |
Sexual assault |
Domestic violence |
|||
American Indian or Alaska Native women |
|
|
|
|
|
|
Batterer intervention program/offender accountability staff |
|
|
|
|
|
|
Child advocacy organization (not affiliated with CPS) |
|
|
|
|
|
|
Child welfare agency |
|
|
|
|
|
|
Corrections (probation, parole, correctional facility) |
|
|
|
|
|
|
Court (tribal) |
|
|
|
|
|
|
Court (non-tribal) |
|
|
|
|
|
|
Crime victim compensation |
|
|
|
|
|
|
Domestic violence program (tribal) |
|
|
|
|
|
|
Domestic violence program (non-tribal) |
|
|
|
|
|
|
Dual sexual assault and domestic violence program (tribal) |
|
|
|
|
|
|
Dual sexual assault and domestic violence program (non-tribal) |
|
|
|
|
|
|
Educational institution/university/school |
|
|
|
|
|
|
Faith-based organization |
|
|
|
|
|
|
Federal agency staff (IHS, BIA, FBI) |
|
|
|
|
|
|
Government agency staff (state and local) |
|
|
|
|
|
|
Health/mental health organization |
|
|
|
|
|
|
Law enforcement agency (tribal) |
|
|
|
|
|
|
Law enforcement agency (non-tribal) |
|
|
|
|
|
|
Legal services organization (legal services, bar association, law school) |
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|||
Multi-disciplinary group/task force |
|
|
|
|
|
|
People representing other underserved populations |
|
|
|
|
|
|
Prosecutor’s office (tribal) |
|
|
|
|
|
|
Prosecutor’s office (non-tribal) |
|
|
|
|
|
|
|
|
|
Sexual
assault
nurse
examiner/sexual
assault
forensic
examiner
program
(SANE/SAFE)
Sexual
assault
program
(tribal)
Sexual
assault
program
(non-tribal)
Social
services
organization
(food
bank,
homeless
shelter)
Substance
abuse
services
Tribal
community
groups
Tribal
elders
Tribal
government/tribal
government
agency
Victims/survivors
Other
(specify):
Total
0
0
0
0
OMB
Clearance
#
1121-0284
Expiration
Date:
10/31/2007
(Indicate other methods used during the current reporting period to coordinate tribal victim services ac- tivities and/or to collaborate and coordinate with federal, state, and local entities engaged in activities to reduce or end violence against women. Check all that apply.)
E-mail
E-mail
listserv
Fax
Newsletter
Telephone/conference
call
Toll-free
telephone
number
Tracking
availability
of
victim
services
U.S.
Mail
Web
site
Other
(specify):
Tribal Coalitions Program Semi-annual Progress Report • 15 • Of fi ce on Violence Against Women
OMB
Clearance
#
1121-0284
Expiration
Date:
10/31/2007
(Use
the
space
below
to
discuss
the
effectiveness
of
system
advocacy
activities
funded
or
supported
by
your
Tribal
Coalitions
Program
grant
and
to provide
further
explanation
on
how
these
activities
increase
the
safety
of
American
Indian/Alaska
Native
women.)
(Maximum
-
2000
characters)
Tribal Coalitions Program Semi-annual Progress Report • 16 • Of fi ce on Violence Against Women
SECTION
Were your Tribal Coalitions Program funds used to develop, or substantially revise policies or protocols during the current reporting period?
Check yes if Tribal Coalitions Program-funded staff developed, or substantially revised policies or proto- cols or if Tribal Coalitions Program funds were used to directly support the development, or substantial revision of policies or protocols.
Yes—answer
questions
28-29
No—skip
to
C5
28.
Types
of
policies
and/or
protocols
developed,
or
substantially
revised
during
the
current
reporting
period.
(Check all the policies or protocols developed, or substantially revised with Tribal Coalitions Program funds during the current reporting period. Use the SA column for policies and/or protocols addressing sexual assault and the DV column for those addressing domestic violence.)
Victim services
SA DV
Appropriate
response
to
underserved
popula-
tions
Confidentiality
Procedures
for
anonymous,
confidential,
or
Jane
Doe
reporting
of
sexual
assault
Training
standards
for
staff
and
volunteers
Staff, board, and/or volunteers represent the diversity of your service area
Standards
of
service
Victim/survivor
informed
about
Crime
Victims
Compensation
and
Victim
Impact
Statements
Other
(specify):
Law enforcement
SA DV
Appropriate
response
to
underserved
popula-
tions
Prosecution
SA DV
Appropriate
response
to
underserved
popula-
tions
Mandatory
training
on
sexual
assault,
domes-
tic
violence/dating
violence,
and/or
stalking
No
charge
to
victims/survivors
for
any
costs
related
to
the
prosecution
of
sexual
assault,
domestic
violence/dating
violence
and/or
stalking
No
victims/survivors
polygraphed
Protection order enforcement (including full faith and credit)
Sexual
assault
response
and
protocols
Stalking
response
and
protocols
Vertical
prosecution
Victim
witness
notification
Other
(specify):
Identifying
primary
aggressor/discouraging
dual
Court
arrest
Immediate
access
to
protection
order
informa-
tion
Mandatory
training
on
sexual
assault,
domestic
violence/dating
violence,
and/or
stalking
No
charge
to
sexual
assault
victims/survivors
for
any
cost
associated
with
forensic
exam
No
victims/survivors
polygraphed
Pro-arrest/mandatory
arrest
Procedures for anonymous, confidential, or Jane Doe reporting of sexual assault
Protection
order
enforcement
(including
full
faith
and
credit)
Providing
information
to
victims/survivors
about
victim
services
Sexual
assault
response
and
protocols
Stalking
response
and
protocols
Other
(specify):
SA DV
Accelerated
trial
schedules
Appropriate
response
to
underserved
popula-
tions
Dedicated
sexual
assault
or
domestic
vio-
lence/dating
violence
docket
Full
faith
and
credit
for
protection
orders
Immediate
access
to
obtain
protection
orders
Judicial monitoring of sexual assault, domes- tic violence/dating violence, and/or stalking offenders
Mandatory
training
on
sexual
assault,
domes-
tic
violence/dating
violence,
and/or
stalking
No
charge
to
sexual
assault
victims/survivors
for
any
cost
associated
with
forensic
exam
Policy
against
mutual
restraining
orders
Procedures
for
courtroom
security
Other
(specify):
OMB
Clearance
#
11 10/31/2007
Tribal Coalitions Program Semi-annual Progress Report • 17 • Of fi ce on Violence Against Women
OMB
Clearance
#
1121-02
10/31/2007
SA DV
Mandatory
training
on
sexual
assault,
domestic
violence/dating
violence,
and/or
stalking
Strategies
to
assist
and
protect
victims/survivors
during
probation
Perform
checks
on
police
logs,
criminal
and
civil
databases
Special
procedures
for
cases
involving
diverse,
underserved
populations
Offender
monitoring
Other (specify):
Health care
SA DV
Advocate
response
in
emergency
room
Appropriate
response
to
underserved
populations
Forensic
evidence
collection
and
documentation
Forensic
exams
not
billed
to
victim/survivor
Mandatory
training
on
sexual
assault,
domestic
violence,
and/or
stalking
Routine
screening
and
referrals
for
sexual
as-
sault,
domestic
violence/dating
violence,
and/or
stalking
Other
(specify):
Tribal Coalitions Program Semi-annual Progress Report • 18 • Of fi ce on Violence Against Women
OMB
Clearance
#
1121-028 10/31/2007
29.
(OPTIONAL)
Additional
information
(Use the space below to discuss the effectiveness of policies you have developed or implemented that were funded or supported by your Tribal Coalitions Program grant and to provide further explanation on
how
these
policies
increase
the
safety of
American
Indian/Alaska
Native
women.)
(Maximum
-
2000 characters)
Tribal Coalitions Program Semi-annual Progress Report • 19 • Of fi ce on Violence Against Women
SECTION
Were your Tribal Coalitions Program funds used to develop, substantially revise, or distribute products during the current reporting period?
Check yes if Tribal Coalitions Program-funded staff developed products or if Tribal Coalitions Program funds were used to directly supported the development, revision, or distribution of products.
Yes—answer
question
30
No—skip
to
section
C6
30.
Use
of
Tribal
Coalitions
Program
funds
for
product
development,
substantial
revision,
or
distribution
(Report
the
number
of
products
developed,
substantially
revised,
or
distributed
with
Tribal
Coalitions
Program
funds
during
the
current
reporting
period.
Report
the
number
of
new
products
developed
or
substantially
revised
during
the
current
reporting
period;
the
title/topic;
the
intended
audience
for
each
product
developed,
revised,
or
distributed;
and,
the
number
of
products
used
or
distributed.
If
a
product
was
created
in
or
translated
into a
language
other
than
English,
including
Braille,
indicate
the
language.
Report
on
products
that
were
newly
developed
or
substantially
revised
during
the
current
reporting
period
whether
or
not
they
were
used
or
distributed,
and
on
products
that
were
previously
de-
veloped
or
revised
but
were
used
or
distributed
during
the
current
reporting
period.
Do
not
report
the
number
of
products
printed
or
copied;
only
report
the
number
developed
or
revised—in
most
cases
that
number
will
be
one
for
each
product
described—and/or
the
number
used
or
distributed.
See
separate
instructions
for
examples
of
how
to
report
under
“developed
or
revised”
and
“used
or
distributed.”)
Products
Number developed or revised
Title/topic Intended audience
Number used or distributed
Other languages
OMB
Clearance
#
1121-0284
Expiration
Date:
10/31/2007
Brochures Manuals Newsletter Training curricula Training materials Reports
Web site
(report number of page views in the used or distrib- uted column)
Videos
Other (specify):
Tribal Coalitions Program Semi-annual Progress Report • 20 • Of fi ce on Violence Against Women
SECTION
C6 Technical AssistanceWere your Tribal Coalitions Program funds used to provide technical assistance during the current re- porting period?
Check yes if Tribal Coalitions Program-funded staff provided technical assistance or if Tribal Coalitions Program funds were used to directly support the provision of technical assistance.
Yes—answer
questions
31-33
No—skip
to
C7
31.
Number
of
technical
assistance
activities
(Report the total number of technical assistance activities provided to programs during the current reporting period, indicating whether they were site visits or other types of consultations. Consultations may include in-person, telephonic, electronic, or other types of contact. Each contact should be count- ed as one activity.)
Recipients
of
technical
assistance Number
of
site
visits
Number of other technical assistance consultations
OMB
Clearance
#
1121-02
10/31/2007
Court (non-tribal)
Disability organization
Domestic violence program (tribal)
Domestic violence program (non-tribal)
Dual sexual assault and domestic violence program Elder organization
Faith-based organization
Federal agencies (BIA,CIA,FBI,IHS) Health/mental health organization Law enforcement (tribal)
Law enforcement agency (non-tribal)
Legal services organization (legal services, bar association, law school)
Military command staff Order tribal coalition Prosecutor’s office (tribal)
Prosecutor’s office (non-tribal)
Sexual assault forensic examiners/sexual assault nurse examiner Sexual assault program (tribal)
Sexual assault program (non-tribal)
Tribal community groups
Tribal government/Tribal government agency University/school
Youth program Other (specify):
Total 0 0
Tribal Coalitions Program Semi-annual Progress Report • 21 • Of fi ce on Violence Against Women
OMB
Cle 0/31/2007
32.
Topics
of
technical
assistance
(Check the topics that apply to technical assistance provided with Tribal Coalitions Program funds dur- ing the current reporting period. The technical assistance provided may be categorized by more than one topic. Check all that apply.)
Topics
of technical
assistance Sexual
assault
Domestic
violence
Coordinated community response Court response
Curricula and training issues
Developing or enhancing culturally appropriate services for un- derserved populations
Developing or enhancing appropriate services for elder victims/ survivors
Developing or enhancing appropriate services for victims/survi- vors who have disabilities
Forensic evidence collection and documentation Law enforcement response
Probation response Program development Program evaluation Prosecution response
Response to dating violence victims/survivors Response to domestic violence victims/survivors Response to sexual assault victims/survivors Response to stalking victims/survivors
Safety planning
Sex offender registry(ies) Standards of service
Technology and technology capacity (data collection systems and confidentiality)
Technology safety and security Tribal codes
University/school
Victim service administration and operations Other (specify):
Tribal Coalitions Program Semi-annual Progress Report • 22 • Of fi ce on Violence Against Women
OMB 10/31/2007
(Use
the
space
below
to
discuss
the
effectiveness
of
technical
assistance
activities
funded
or
support-
ed
by
your
Tribal
Coalitions
Program
grant
and
to
provide
further
explanation
on
how
these
activities
increase
the
safety of
American
Indian/Alaska
Native
women.)
(Maximum
-
2000
characters)
Tribal Coalitions Program Semi-annual Progress Report • 23 • Of fi ce on Violence Against Women
SECTION
C7
Organizational Development and Capacity Building
Were your Tribal Coalitions Program grant funds used for organizational development and/or capacity building during the current reporting period?
Check yes if Tribal Coalitions Program funded staff engaged in organizational development and/or capacity building activities, or if Tribal Coalitions Program funds were used to directly support organiza- tional development and/or capacity building.
Yes—answer
questions
34-35
No—skip
to
section
D
34.
Coalition
development
and
capacity
building
(Check
all
activities
that
were
engaged
in
with
Tribal
Coalitions
Program
funds
during
the
current
re-
porting
period.)
Board member development Communication (TTY, language lines, etc.) Develop personnel policies
Emergency preparedness
Activity
10/31/2007
Evaluation/outcome measures, development or tracking Identify gaps in service
Internet/e-mail/listserv development Office space (opening/maintaining) Outreach to underserved populations Software purchase or development Staff development
Strategic planning
Technology security and safety Toll-free telephone line operation
Web site development or enhancement Other (specify):
35.
Do
you
consider
system
privacy
and/or
security
when
purchasing
or
developing
software?
Yes
No
Tribal Coalitions Program Semi-annual Progress Report • 24 • Of fi ce on Violence Against Women
SECTION
D NARRATIVE
All
grantees
must
answer
question
36.
Please limit your response to the space provided.
36.
Report
on
the
status
of
the
goals
and
objectives
for
the
tribal
coalitions
(Report
on
the
status
of
the
goals
and
objectives
for
your
grant
as
of
the
end
of
the
current
reporting
period,
as
they
were
identified
in
your
grant
proposal
or
as
they
have
been
added
or
revised.
Indicate
whether
the
activities
related
to
your
objectives
for
the
current
reporting
period
have
been
completed,
are
in
progress,
are
delayed,
or
have
been
revised.
Comment
on
your
successes
and
challenges,
and
provide
any
additional
explana-
tion
you
feel
is
necessary
for
us
to
understand
what
you
have
or
have not
accomplished
relative
to
your
goals
and
objectives.
If
you
have
not
accomplished
objectives
that
should
have been
accomplished
during the current reporting period, you must provide an explanation.)
Page 26.
All
grantees
must
answer
questions
37
and
38
on
an
annual
basis.
Please
submit
this
information
on
the
January
to
June
reporting
form
only.
PLEASE LIMIT YOUR RESPONSE TO TWO PAGES FOR EACH QUESTION.
37.
What
do
you
see
as
the
most
significant
areas
of
remaining
need,
with
regard
to
improving
services
to
victims/survivors
of
sexual
assault,
domestic
violence/dating
violence
and
stalking,
increasing
victims/survivors
safety
and
enhancing
community
response
(including
offender
accountability
for
both
batterers
and
sex
offenders)?
(Consider
geographic
area
served,
service
delivery
systems,
types
of
victimization,
jurisdictional
issues,
and
challenges
and
barriers
unique
to
the
tribal
communities
served by your tribal coalitions.)
Page 29.
38.
What
has
the
Tribal
Coalitions
Program
funding
allowed
you
to
do
or
maintain
that
you
could
not
do
without
receiving
this
funding?
(For
example,
has
the
funding
enabled
you
to
identify
and
eliminate
gaps
in
services;
improve services
to
tribal
populations;
or,
improve
criminal
justice
response
to
Ameri-
can
Indian
and/or
Alaska
Native
women?
Provide
specific
examples
in
your
answer
[e.g.,
opened
an
office with two full-time staff].)
Page 31.
Questions
39
and
40
are
optional.
PLEASE LIMIT YOUR RESPONSE TO TWO PAGES FOR EACH QUESTION.
39.
Provide
additional
information
regarding
the
effectiveness
of
your
grant-funded
program.
(If
you
have
other
data
or
information
that
you
have
not
already
reported
in
answers
to
previous
questions
that
demonstrate
the
effectiveness
of
your
Tribal
Coalitions
Program
grant,
please
provide
it
below.
Refer
to the separate instructions for a fuller explanation and examples.)
Page 33.
40.
Provide
any
additional
information
that
may
provide
explanation
about
the
data
submitted.
(If
you
have
any
information
that
could
be
helpful
in
understanding
the
data
submitted,
please
answer
this
question.
For
example,
if
two
grant
reports
were
submitted,
you
may
explain
how
the
data
was
ap-
portioned
to
each
report;
if
you
funded
staff
but
did
not
report
any
activities,
you
may
explain
why;
or
if
you
did
not
use
program
funds
to support
either
staff
or
activities
during
the
reporting
period,
please
explain how program funds were used, if you have not already done so.)
Public Reporting Burden
Page 35.
OMB
Clearance
#
1121-0284
Expiration
Date:
10/31/2007
Paperwork Reduction Act Notice. Under the Paperwork Reduction Act, a person is not required to re- spond to a collection of information unless it displays a currently valid OMB control number. We try to create forms and instructions that are accurate, can be easily understood, and which impose the least possible burden on you to provide us with information. The estimated average time to complete and file this form is 60 minutes per form. If you have comments regarding the accuracy of this estimate, or suggestions for making this form simpler, you can write to the Office on Violence Against Women, U.S. Department of Justice, 800 K Street, NW, Washington, DC 20531.
Tribal Coalitions Program Semi-annual Progress Report • 25 • Of fi ce on Violence Against Women
Report on the status of the goals and objectives for the tribal coalitions - Question #36
Back to Instructions
Goals/Objectives
Status
Key Activities
Comments
Goals/Objectives
Key Activities
Comments
Status
OMB
Clearance
#
1121-0284
Expiration
Date:
10/31/2007
Tribal Coalitions Program Semi-annual Progress Report • 26 • Of fi ce on Violence Against Women
Report on the status of the goals and objectives for the tribal coalitions - Question #36 (cont. 1)
Back to Instructions
Goals/Objectives
Status
Key Activities
Comments
Goals/Objectives
Key Activities
Comments
Status
OMB
Clearance
#
1121-0284 Expiration
Date:
10/31/2007
Tribal Coalitions Program Semi-annual Progress Report • 27 • Of fi ce on Violence Against Women
Report on the status of the goals and objectives for the tribal coalitions - Question #36 (cont. 2)
Back to Instructions
Goals/Objectives
Status
Key Activities
Comments
Goals/Objectives
Key Activities
Comments
Status
OMB
Clearance
# 31/2007
Tribal Coalitions Program Semi-annual Progress Report • 28 • Of fi ce on Violence Against Women
Back
to
Instructions
OMB Clearance # 1122-0011 Expiration Date: 06/30/2011
OMB
Clearance
#
1121-0284 Expiration
Date:
10/31/2007
Tribal Coalitions Program Semi-annual Progress Report • 29 • Of fi ce on Violence Against Women
OMB
Clearance
#
1121-0284 E
Tribal Coalitions Program Semi-annual Progress Report • 30 • Of fi ce on Violence Against Women
OMB
Clearance
#
1121- 0/31/2007
What has the Tribal Coalitions funding allowed you to do or maintain that you could not do without receiving this funding? - Question #38
Tribal Coalitions Program Semi-annual Progress Report • 31 • Of fi ce on Violence Against Women
Back
to
Instructions
OMB
Clearanc
10/31/2007
What has the Tribal Coalitions funding allowed you to do or maintain that you could not do without receiving this funding? - Question #38 (cont.)
Tribal Coalitions Program Semi-annual Progress Report • 32 • Of fi ce on Violence Against Women
ICBacR to lnstructionsj
OMB Clearance # 1122-0011 Expiration Date: 06/30/2011
Provide
additional
information
regarding
the
effectiveness
of
your
grant-funded
program.
-
Question
#39
Tribal Coalitions Program Semi-annual Progress Report • 33 • Office on Violence Against Women
ICBacR
to
lnstructionsj
OMB Clearance # 1122-0011 Expiration Date: 06/30/2011
Provide
additional
information
regarding
the
effectiveness
of
your
grant-funded
program.
-
Question
#39
(cont.)
Tribal Coalitions Program Semi-annual Progress Report • 34 • Office on Violence Against Women
tsacR to lnstructionsj OMB Clearance # 1122-0011
Expiration Date: 06/30/2011
Provide a ny additional information that may provide explanation about the data submitted. - Question #40
Tribal Coalitions Program Semi-annual Progress Report • 35 • Office on Violence Against Women
BacR
to
lnstructionsj
OMB Clearance # 1122-0011 Expiration Date: 06/30/2011
Provide a ny additional information that may provide explanation about the data submitted. - Question #40
(cont.)
Tribal Coalitions Program Semi-annual Progress Report • 36 • Office on Violence Against Women
OMB
Clearance
# 2007
Validate
Tribal Coalitions Program Semi-annual Progress Report • 37 • Of fi ce on Violence Against Women
THIS
IS
A
SAMPLE
GMS
FORM.
DO
NOT
USE
THIS
FORM
TO
SUBMIT
YOUR
FINAL
DATA
TO
OVW.
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