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

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

File Upload

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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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