Reporting Forms & Guidance Documents

Reporting Forms & Guidance Documents

As a grantee, you are required to submit reports according to the schedule specified in your grant. Find your program's reporting forms and guidance documents below.

All Providers 

Grant Invoice Template
Grantee-Developed Marijuana Information for Communities

With the enactment of Act 86 effective July 1, 2018, ADAP is sharing some examples of grantee-developed marijuana information for communities. These examples are not vetted nor necessarily endorsed by the Department of Health.

Prevention

National Outcome Measures (NOMs)

What are NOMs?

The National Outcome Measures are the federal Substance Abuse and Mental Health Services Administration's approach to performance measures. States are required to report on National Outcome Measures for both prevention and treatment programs as part of their block grant requirements. National Outcome Measures are broken down into sub-categories called “domains”. For Prevention National Outcome Measures, each state is only being asked to collect data in 3 of the 8 domains. The other five domains are being pre-populated by existing data sources.

What are the National Outcome Measures Domains?

  • Domain 1: Reduced Morbidity – Abstinence from Drug or Alcohol Use
  • Domain 2: Employment/Education
  • Domain 3: Crime and Criminal justice
  • Domain 4: Social Connectedness
  • Domain 5: Access/Capacity*
  • Domain 6: Retention
  • Domain 7: Cost Effectiveness*
  • Domain 8: Use of Evidence-based Practices and Strategies*

* Vermont is collecting data from prevention grantees to report on the three domains in bold.

What domains are Alcohol and Drug Abuse Programs Prevention Grantees required to provide?

Alcohol & Drug Abuse Programs grantees will need to provide detailed data for the "Access/Capacity" domain and budget data for the "Cost Effectiveness" domain. Alcohol & Drug Abuse Programs will submit the information for the "Evidence-based Practice" domain based on grantee information from the original applications for funding.

How will grantees provide this information?

Alcohol & Drug Abuse Programs grantees will collect the data throughout their grant period and submit it as part of their regular reporting activities for the grant. Special forms have been designed for grantees to use to report this data to Alcohol & Drug Abuse Programs. Additional forms have been provided by Alcohol & Drug Abuse Programs to assist grantees in collecting the data.

What data is collected for the Access/Capacity domain?

This domain captures information about the number of people served by race, ethnicity, age and gender:

  • Individual-based programs and population-based programs: total number served by age, gender, race and ethnicity.
  • Institute of Medicine category delineated for each grant-funded program. These are: universal-indirect, universal-direct, indicated and selected.
Guidance Document
NOMs Data Collection Form
Reporting Form
NOMs SurveyGizmo
Law Enforcement Drug Disposal Project
OD2A Community Action Grants
Prevention Network Grant
Regional Prevention Partnerships
Reporting Forms
RPP Quarterly Report FY21
RPP Budget Form FY21
RPP Budget Narrative FY21
RPP Workplan Template FY21
RPP Workplan Guidance FY21
Guidance Documents
RPP Strategic Plan FY21
RPP Guidance FY21
RPP Resources FY21
RPP Timeline FY21
RPP Logic Model Template FY21
RPP Logic Model Example FY21
RPP Virtual Event Resource Guide FY21
RPP Substance Misuse Prevention for Young Adults FY21
Appendix A1: Underage Drinking Logic Model
Appendix A2: Binge Drinking Logic Model
Appendix A3: Prescription Drug Logic Model
Appendix A4: Marijuana and Other Illicit Drug Logic Model
Appendices B1-B4: Interventions and Intervening Variables Grid
Planning Tools
RPP Advising & Training of Peer Leadership/Youth Empowerment Groups in Schools FY21
RPP Community Education & Outreach: Youth Cannabis Use Prevention FY21
RPP Drug Impairment Training for Education Professionals (DITEP)/Youth Mental Health First Aid Training FY21
RPP eCheck-Up: Alcohol FY21
RPP eCheck-Up: Cannabis FY21
RPP Enhance Local Law Enforcement Efforts FY21
RPP Evidence-Based School Curriculum FY21
RPP Fraudulent ID Enforcement Checks FY21
RPP Gay Straight Alliances (GSA) in Schools FY21
RPP Guiding Good Choices FY21
RPP Local Policy Enhancements to Prevent Cannabis FY21
RPP Local Policy Enhancements to Prevent Underage Drinking FY21
RPP Mentoring FY21
RPP Nurturing Parenting Program FY21
RPP Regional Capacity Building FY21
RPP Retailer Recognition for Passing Compliance Checks FY21
RPP School Screening and Referral FY21
RPP Sticker Shock FY21
RPP Strengthening Families Program for Youth FY21
RPP Support Responsible Beverage Service Trainings Provided by DLL FY21

Regional Prevention Partnership County Profiles available on the Data & Reports page.

2020 Media Guidance
2020 Grantee Media Guidance
FY20 RPP Strategy Proposal Process
RPP Strategy Proposal Process FY21 - UPDATE COMING SOON
RPP Strategy Proposal Form (Due no later than 12/31/2019)
RPP Strategy Proposal Questions & Resources List
RPP Submission Scoring Rubric
RPP Example Completed Submission

Intervention

Public Inebriate Program

Treatment

Opioid Treatment Programs / "Hubs"

Information for opioid treatment programs, sometimes known as “hubs.”  

Guidance Documents
Buprenorphine Billing Codes for Hubs
Drug Toxicology Screening Protocol
Transfer Protocol
Medication Assisted Treatment - Screening Form

 

Recovery

Transitional Housing Programs