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MAIN APPLICATION <br />m.) Work Statement <br />This form is used to document program activities, program goals, performance measures, <br />and actual results. (Add more rows as needed) If this is a new program, you will only <br />document the projected information. <br />• Program Activities should outline major activities the agency implements to accomplish its <br />program goals. <br />• Program Goal should explain what the program is trying to achieve /accomplish. Goals are <br />statements about what the program should accomplish. SMART Goals <br />• Performance Measures describe how you will evaluate the degree in which you achieved <br />the stated goals. <br />• Actual Program Results use program results to indicate the actual measureable <br />achievement of goals. If goals were not met, please explain. <br />Main Application 1/24/2016 2:59:42 PM P a g e 1 7 o f 5 8 <br />Actual <br />Estimated <br />Projected <br />2014 -15 <br />2015 -16 <br />2016 -17 <br />Crisis Intervention: <br />Crisis Intervention: Provide <br />Crisis Intervention: <br />Provide direct services <br />direct services to victims of <br />Provide direct services to <br />to victims of domestic <br />domestic violence <br />victims of domestic <br />violence including crisis <br />including crisis <br />violence including crisis <br />Program Activity 1 <br />intervention, support <br />intervention, support <br />intervention, support <br />groups and advocacy in <br />groups and advocacy in <br />groups and advocacy in <br />order to reduce trauma <br />order to reduce trauma <br />order to reduce trauma <br />and increase clients' <br />and increase clients' ability <br />and increase clients' ability <br />ability to make choices <br />to make choices <br />to make choices <br />increasing their safety <br />increasing their safety and <br />increasing their safety and <br />and that of their children <br />that of their children <br />that of their children <br />85% of clients who <br />85% of clients who meet <br />85% of clients who meet <br />meet with crisis <br />with crisis response staff <br />with crisis response staff <br />response staff will <br />will develop a safety plan <br />will develop a safety plan <br />develop a safety plan <br />that meets their needs and <br />that meets their needs and <br />Program Goal <br />that meets their needs <br />helps them feel that they <br />helps them feel that they <br />and helps them feel that <br />they have options to <br />have options to improve <br />have options to improve <br />improve their safety. At <br />their safety. At least 800 <br />their safety. At least 1,000 <br />least 650 clients will be <br />clients will be served in FY <br />clients will be served in FY <br />served in FY 14 -15. <br />15 -16. <br />16 -17. <br />All clients who meet in <br />_ <br />person with crisis <br />All clients who meet in person <br />All clients who meet in <br />Performance Measures <br />response staff or attend <br />with crisis response staff or <br />person with crisis response <br />support group are asked to <br />attend support group are <br />staff or attend support group <br />fill out a survey and <br />asked to fill out a survey and <br />are asked to fill out a survey <br />are tracked. <br />responses are tracked. <br />and responses are tracked. <br />Program Results <br />-responses <br />94% safety planned; 88% <br />better understood options I <br />94% at Q2 <br />85% <br />Main Application 1/24/2016 2:59:42 PM P a g e 1 7 o f 5 8 <br />