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.
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Grant Invoice Template and Submission Tool
| Template and Submission Tool |
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| Grant Invoice Template - updated 5/8/23 |
| Grant Invoice Submission Tool - updated 1/03/22 |
Logic Model Template
Training & Event Data Collection
Prevention
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 |
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| NOMs SurveyGizmo |
Centers of Excellence Grants
| Reporting Forms |
|---|
| Quarterly Report Form |
| Budget, Budget Narrative & Workplan |
Law Enforcement Drug Disposal Project
| Reporting Forms |
|---|
| Budget Form |
| Budget Narrative |
| Expense Form |
| Monthly Metric Report |
Overdose Data to Action (OD2A) Grants
| Reporting Forms |
|---|
| Budget and Budget Narrative Template (optional, DSU-created) |
| Quarterly Reporting Template |
| Reporting Portal (Alchemer) |
|---|
| OD2A Grant Reporting |
Prevention Bridge Grant
Prevention Leads
| Guidance Documents |
|---|
| Workplan Template |
| Budget Template |
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Reporting Forms |
|---|
| VPLO Budget, Budget Narrative and Workplan |
| VPLO Quarterly Report |
Regional Prevention Partnerships
| Reporting Forms |
|---|
| RPP Budget Form |
| RPP Quarterly Report |
| RPP Workplan Template |
| RPP Budget Narrative |
Regional Prevention Partnership County Profiles available on the Data & Reports page.
| FY20 RPP Strategy Proposal Process |
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| 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 |
School Grants
| Guidance Documents |
|---|
| CRAFFT and GAIN SS Training Webinar |
Vaping Prevention Grant
| Guidance Documents |
|---|
| Workplan Template |
| Budget Template |
| Reporting Forms |
|---|
| Quarterly Report Form |
| Budget, Budget Narrative, and Workplan |
Intervention
Public Inebriate Program
| Reporting Forms |
|---|
| Quarterly Reporting Form-FY22/FY23 |
| Quarterly Reporting Form-FY24 |
Treatment
All Treatment 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 - FY24 |
Opioid Treatment Programs / "Hubs"
Information for opioid treatment programs, sometimes known as “hubs.”
| Guidance Documents |
|---|
| Drug Toxicology Screening Protocol |
| Transfer Protocol |
Recovery
Recovery Housing Programs
| Reporting Forms |
|---|
| Recovery Housing FY24 |
Recovery Services
Contact Us
Substance Use Programs (DSU)
Vermont Department of Health
802-651-1550
ahs.vdhdsu@vermont.gov
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