ISBH

VINTON COUNTY MENTAL HEALTH

PEER SUPPORT OUTCOMES


Fiscal Year*
Reporting Period*

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

List only the number of new clients enrolled in program during current reporting period

List total number discharged or ended involvement for any reason - successfully, unsuccessfully, or neutrally

Of the total number discharged, or ended involvement, list how many were successful

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

Are you on target to meet projections?*

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 of New People Served


Additional Program Outcomes

Defined by customer sign-in logs

Defined by customer sign-in logs

Defined by 90 day Health and Well-being Review and Sign-in Logs

90 day Health and Wellbeing Review

Captured by activity log, program requirement and photos

Logs

Logs

Logs


Narratives

Briefly describe achievements for reporting period

Briefly describe program challenges for reporting period

Briefly describe any program improvements made during the reporting period

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

Optional field to share additional info such as a story demonstrating how people have benefited from program

Optional: Use file upload to attach and include any supporting documents

Drag and drop files here or

Agency Contact

List name of staff member providing data on this form

List email address of staff member providing data on this form

List phone number for staff member providing data on this form

Phone

Year End Reporting Only

Projections

Use this section to project total number served, number who ended involvement, and number who will continue in the next fiscal year: July 1-June 30.

Total number who will be discharged or end involvement for any reason (successfully, unsuccessfully or neutrally)

Of the total number of discharge or those ending involvement, how many will be successful