Amendment 2 - Laserfiche WebLink

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Task Number Task/ Activity/Description 0 Race/ethnicity 0 Gender 0 Age • % SNAP eligible per site • Setting type -school, church, etc . • Top Key Messages delivered per project LHJs are required to submit data electronically or within the template provided by DOH. 2.2 Evaluation Data and Reports The following evaluation activities* and information is required for all projects based on your approved project/plan • Formative • Process • PSE • Outcome • Qualitative *Please Note: the deliverables may change based on state evaluation team requirements . Exhibit A, Statements of Work Revised as of March 15, 2018 I AMENDMENT #2 *May Support PHAB Payment Standards/Measures Deliverables/Outcomes Due Date/Time Frame Information and/or Amount week after data is collected. I l. Collect and report any 1. Due: Submit within See payment formative and process data Quarterly reporting listed information as completed based on above in task 2.0 . referenced in task approved project plan. number 1.0. 2. Submit PSE progress and 2. Due: quarterly outcomes based on approved • 2nd quarter due by project plan. 04/06/18 • 3rd quarter due by 07/06/18 • Final report for all other work due 09/21/18. 3. Conduct and submit/mail 3. Due: Within 30 days after pretest surveys for each completed. Submit all project class series. pretests surveys/data when they are completed for a specific project. 4. Conduct and submit/mail 4. Due: Within 30 days after posttest surveys for each completed. Submit all project class series. posttest surveys/data when they are completed for a specific project. 5. Capture and submit 5. Due: Submit within qualitative (success stories, Quarterly reporting listed pictures) information per above in task 2.0 along with your approved work plan. photo releases. Page 14 of 18 Contract Number CLH18249-2