RYAN WHITE TITLE I PROGRESS REPORT

Agency: ______

Prepared by: ______

Date Submitted: ______

Progress Report Period : ٱJuly 17, 2005 (March – June)

ٱOct. 17, 2005 (July – Sept.)

ٱApril 28, 2006 (Annual)

  1. A) Service Delivery by Contractual Goals

Note Each Service Category by Contractual Goals

(Duplicate or modify tables as appropriate – i.e. for multiple service months can be combineto simply table)

Note Service Categories here / Note Goal Statement (s) here
Month(s) / Contracted
Clients (year) / Actual #
Clients / % / Contracted
Service Units (year) / Actual Service Units Delivered / %
March 2005
April
May
June
Total

Expected % rate of accomplishment for:

First period = 33%, Second period = 58%, and Final period = 100%

Progress level towards achieving contractual goal is:

ٱ below levelٱ actual levelٱ above level

  1. B) Service Deliveryby Desired outcomes

Note Service Categories here / Note Goal Statement (s) here
Month(s) / # Client Surveys Desired / # Client Surveys Completed / % / # of Desired Surveys / # of Surveys Completed / %
Cycle I
Cycle II
Total

Progress level towards achieving contractual goal is:

ٱ below levelٱ actual levelٱ above level

  • To view the number of Client surveys or Provider observations completed, please log onto link to e-COMPAS survey status. The number of desired surveys is a minimum of 20% of total clients contracted or actual (which ever is higher). Total number of desired surveys shall be no less than previous year(s) accomplishments.
  1. Enhancement of services(acutal or proposed)

Service Category / Enhancements
Service Category
  1. Barriers to accomplishing goals

Service Category / Barriers
Service Category
  1. Confirmation of Coordination of Care

A) AGREEMENTS & referral with Title I agencies

Name of Agency / County / Verbal or Written / # of Referrals Made / Other
(Contractual)
BarnertHospital / Passaic
BergenFamilyCenter / Bergen
Buddies of New Jersey, Inc. / Bergen
Catholic Community Services / Bergen
CASA, Inc / Passaic
CAPCO / Passaic
City of Passaic, DHS PassaicAlliance / Passaic
Friends for Life / Bergen
HackensackUniversityMedicalCenter / Bergen
HispanicMultiPurposeCenter / Passaic
Hyacinth AIDS Foundation / Passaic
Northeast Life Skills Associates / Passaic
Northeast New Jersey Legal Services / Passaic
PatersonCounselingCenter / Passaic
Paterson Division of Health / Passaic
St. Joseph’s / Passaic
St. Mary’s / Passaic
St. Paul’s Community Development Corp. / Passaic
Straight & Narrow / Passaic
Team Management 2000, Inc. / Bergen
  1. confirmation of Coordination of Care

B) NON-TITLE I AGENCIES

The following list is inclusive, but not exhaustive of actual providers. List can be modified as deemed appropriate or applicable.

Doctors
Name of Agency / County / Verbal or Written / # Referrals
Made / Other
(Contractual)
Dr. Saleh Knabash / Bergen
Great FallsMedicalCenter / Passaic
Dr. Steven Weisholtz / Bergen
Dr. Arnouk / Bergen
Dr. Timothy J. Eustace / Bergen
Dr. Okoye / Bergen
Dr. Slomowitz / Passaic
Dr. B. Reisman / Passaic
Dr. Dmetrienko / Bergen
Dr. Reza Farhanghar / Passaic
Dr. Nizar Kahf / Passaic
Madison Physical Therapy / Bergen
Willowbrook Med. Ctr. / Passaic
Dr. James Milder / Bergen
Dr. Knepp / Passaic
Dr. Enrico / Passaic
Dr. Korzin / Passaic
Dr. A. Howhannesian / Bergen
Dr. Wein / Passaic
Dr. Claudio Dicovski / Passaic
Dr. Mangot / Passaic
Dr. V. Meese / Bergen
Dr. Saporito / Bergen
Dr. Leiffer / Passaic
Dr. Oketie / Passaic
Dr. Nelson / Passaic
Dr. D. Haddadon / Bergen
Dr. Shah / Passaic
Dr. Sleicher / Bergen
Dr. Pepe / Bergen
Dr. Pendse / Passaic
Dr. Gazivode / Bergen
Dr. Jaffri / Passaic
Dr. Sacarro / Bergen
High Mt.Radiology / Passaic
Dr. Hasson / Bergen
Dr. Cainan / Bergen
Dr. Katz / Bergen
Dr. Rafi / Passaic
Dentists
Dr. D. Mayer / Passiac
Dr. Ritter / Bergen
Dr. Rosenblatt / Bergen
Family Dental Clinic / Bergen
Dr. Thomas / Bergen
Acupuncture
Sheila Mason / Bergen
Podiatrists
Dr. Cronin / Passaic
Dr. Henry slomowitz / Passaic
Pharmacies
K. Mart Pharmacy / Bergen
Shop Rite Pharmacy / Bergen
Downtown Pharmacy / Passaic
Steigner Pharmacy / Passaic
Liberty Pharmacy / Bergen
Health Care Pharmacy / Passaic
Prince Pharmacy / Bergen
Hamilton Pharmacy / Passaic
Hospitals
EnglewoodHospital / Bergen
BergenRegionalHospital / Bergen
LeoniaMedicalCenter / Bergen
HolyNameHospital / Bergen
BethIsraelHospital / Passaic
ValleyHospital / Bergen
GeneralHospital / Passaic
St. Joseph Medical / Passaic
Other Community Programs
Name of Agency / County / Verbal / Written
(note date) / Other
(Contractual)
Greater Paterson OIC / Passaic
BergenCountyJail (Male Population) / Bergen
BergenCounty One Stop / Bergen
Women’s Rights Center / Bergen
Passaic County Sheriff’s Department / Passaic
Eva’s Family Shelter / Passaic
Women of Encouragement / Passaic
Concerned Parents of Head Start / Passaic
NJ EmploymentCenter / Bergen
PassaicCountyBoard of Social Services / Passaic
BergenCounty Homeless Shelter / Bergen
Sister Peggy’s Women Shelter / Bergen
Shelter Our Sisters / Bergen
Paterson Community Health / Passaic
The Well of Hope
Drop-InCenter / Passaic
Peter’s Place / Bergen
Paterson YMCA / Passaic
  1. confirmation of Coordination of Care

C) COALITION MEETINGS

  1. Ryan White Title Grantee Provider Technical Meetings

March 18, 2005 (Case Managers only)
April 27, 2005
September 28, 2005
November 16, 2005
February 22, 2006
  1. confirmation of Coordination of Care

C) COALITION MEETINGS (continuation)

  1. Bergenor PassaicCounty CoalitionMeetings
  2. Ryan White Title I HIV Health Services Planning Council Meeting
  3. Case Management Case Consultation Meetings
  4. Other - Statewide Coordination of Care, Community Prevention, All Titles Conference, etc.

Month (s) / County / Planning Council / Case Management / Other / Other
March, 2005
April
May
June
Total Meetings Attended
  1. Staffing and Staffing Training/Professional Development

Staff/Title / Hired
Date / Training/
Professional Development / Dates

1