Forensic Monitor

Forensic Monitor

Conditional Release Plans

Number of Participants Carried Over from Previous Fiscal Year*

List only the number of clients carried over from previous fiscal year

Number of New Participants who were Admitted During the Fiscal Year*

Number Discharged*

List total number discharged or ended participation for any reason - successfully, unsuccessfully, or neutrally in the fiscal year

Number of Successful Discharges*

Of the total number who ended participation, list how many successfully completed the program this fiscal year

Number of Clients Continuing into Next Reporting Period*

List number who continue to be engaged and will receive services in next reporting period

Numbers Served By County

Please indicate numbers served by county of residence below. Totals for all counties should equal Number of Clients Carried over from Previous Fiscal Year + Number New People Served

Number Served who are Athens County Residents*

Number Served who are Hocking County Residents*

Number Served who are Vinton County Residents*

Number Served who Reside OUTSIDE of AHV Counties*

Additional Outcomes Reports

Number of Participants (above) who have Income and Benefits*

Number of Participants (above) who have New Criminal Charges this Fiscal Year*

Number of Participants (above) who have any Long-Term or Short-Term Placement in Hospital or Jail*

Information and Education Provided to Court/Ciminal Justice Staff*

Are you on target to meet projections?*

Yes

Not on Target? Please Explain*

Narrative

Program achievements*

Briefly describe achievements for reporting period

Program challenges*

Briefly describe program challenges for reporting period

Program improvements*

Briefly describe any program improvements made during the reporting period

Significant differences last year to this year*

Were there any significant differences between last year and this year? If so, please describe

What is the Name of the Risk Assessment Instrument being used by the Forensic Monitor and/or the Designated Community Providers for peple who are on Conditional Release Under the Jurisdiction of the Trial Court?*

Briefly describe what additional results might be achieved if extra resources were available*

Additional noteworthy remarks

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Agency Contact

Agency Representative Providing Data*

List name of staff member providing data on this form

Email Address for Person Providing Data*

List email address of staff member providing data on this form

Phone Number for Person Providing Data*

List phone number for staff member providing data on this form

Phone

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