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.
Grant Invoice Template and Submission Tool
| Template and Submission Tool |
|---|
| Grant Invoice Template - updated 5/8/23 |
| Grant Invoice Submission Tool - updated 1/03/22 |
Training & Event Data Collection
| Guidance Documents |
|---|
| Reporting Instructions |
| Wording for Event Attendee Evaluations |
| Data Collection Tool |
| Reporting Forms |
|---|
| Reporting Form |
| Grantee Quarterly Reporting and Evaluation Summary Form |
Logic Model Template
| Resources |
|---|
| Logic Models Overview |
| Logic Model Templates |
National Outcome Measures (NOMs)
The National Outcome Measures (NOMs) are the federal Substance Abuse and Mental Health Services Administration's (SAMHSA) approach to performance measures. States are required to report on National Outcome Measures for both prevention and treatment programs as part of block grant requirements.
National Outcome Measures are broken down into sub-categories called “domains”. Vermont is collecting data from prevention grantees to report on the three domains in bold below. DSU grantees are required to collect the data throughout their grant period and submit it as part of their regular reporting activities for the grant.
- 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
| Guidance Document |
|---|
| NOMs Data Collection Form |
| Reporting Form |
|---|
| NOMs SurveyGizmo |
Law Enforcement Drug Disposal Project
| Reporting Forms |
|---|
| Budget Form |
| Budget Narrative |
| Expense Form |
| Monthly Metric Report |
OD2A Community Action Grants
| Reporting Forms |
|---|
| Budget and Budget Narrative Template (optional, DSU-created) |
| Evaluation Template |
| Workplan Template |
| Quarterly Reporting Template |
| Reporting Portal (Alchemer) |
|---|
| OD2A Grant Reporting |
Centers of Excellence Grants
| Reporting Forms |
|---|
| Quarterly Report Form |
| Budget, Budget Narrative & Workplan |
Regional Prevention Partnerships
| Reporting Forms |
|---|
| RPP Budget Form FY23 |
| RPP Quarterly Report FY23 |
| RPP Workplan Template FY23 |
| RPP Budget Narrative FY23 |
Regional Prevention Partnership County Profiles available on the Data & Reports page.
| 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 |
Vaping Prevention Grant
| Guidance Documents |
|---|
| Implementation Workplan |
| Reporting Forms |
|---|
| Quarterly Report Form |
Public Inebriate Program
| Reporting Forms |
|---|
| Quarterly Reporting Form-FY22/FY23 |
All Providers
| Guidance Documents |
|---|
| Medicaid Rate Sheet |
| Substance Abuse Treatment Information System Manual – For Legacy Systems |
| Substance Abuse Treatment Information System Manual – For EHR Extracts (2019) |
Drug Court
| Reporting Forms |
|---|
| Quarterly Reporting Form - FY23 |
| Quarterly Reporting Form - FY22 |
Opioid Treatment Programs / "Hubs"
Information for opioid treatment programs, sometimes known as “hubs.”
| Guidance Documents |
|---|
| Drug Toxicology Screening Protocol |
| Transfer Protocol |
Recovery Services
| Guidance Documents |
|---|
| Standards for Recovery Services |
| GPRA Interview Best Practices |
| GPRA Technical Skills Training |
| GPRA FAQ Guidance Document |
| GPRA Error Resubmission Process |
Recovery Housing Programs
| Reporting Forms |
|---|
| Recovery Housing FY23 |
Contact Us
Substance Use Programs (DSU)
Vermont Department of Health
108 Cherry Street, Suite 207
Burlington, VT
802-651-1550
[email protected]
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Last Updated: May 30, 2023