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PRO-GRAM C OMMI-INI C ATI ON:
<br />Inform partners and Public about
<br />program successes and related best
<br />practices, including social media posts
<br />andpublication.
<br />Write a success story related to LSPAN
<br />projects.
<br />PROGRAM EVALUATION:
<br />Participate in performance measure
<br />data collection and program evaluation
<br />activities in collaboration with DOH.
<br />PROGRAM IMPLEMENTATION:
<br />Report quarterly expenditures using
<br />DOH provided template.
<br />PROGRAM iMPLEMENTATION:
<br />Finalize Work Plan andBudget
<br />Workbook using DOH-Provided
<br />templates.
<br />PROGRAM IMPLEMENTATI ON:
<br />Implement finalized community work
<br />plan focused on LSPAN that include:
<br />. Addressing atleast two (2) state
<br />strategies required bY this grant
<br />funding.
<br />r Achieving potcy, systems, or
<br />environmenta I changes consistent
<br />with the strategies.
<br />r Identifyingandreaching
<br />oopulations with health disparities.
<br />Activity
<br />PROGRAM ADMINISTRATION:
<br />Perform administrative duties related to
<br />LSPAN
<br />J
<br />4
<br />2c
<br />2b
<br />1c
<br />2a
<br />#
<br />Task Deli erables/Outcomes
<br />Qua progress
<br />repo ts to DOH via
<br />Shar :Point site or email
<br />ork Plan to
<br />DOI contractmanager
<br />via r rnail
<br />Qua terly progress
<br />rep( ts to DOH via
<br />Sha :Point site oremail
<br />Re; :rt quarterly
<br />exp ndituresusing
<br />DO l-provided
<br />tem rlate.
<br />Qur rlerly progress
<br />repr rts to DOH via
<br />Sha ePoint site or email
<br />copres o any
<br />rele'ant communication
<br />pro .ucts with quarterlY
<br />pro tress reports to
<br />DO I via SharePoint
<br />site rrr email
<br />On, success story using
<br />Exhibit A, Statement of Work
<br />Template Created SePtemb er202l
<br />Reimbunementfor
<br />actual costs, not to
<br />exceed total contract
<br />funding. See Program
<br />Specific Requirements
<br />Reimbursement for
<br />actual costs, not to
<br />exceed totalcontract
<br />funding. See Program
<br />Specific Requirements
<br />Reimbursement for
<br />actualcosts, notto
<br />exceed total contract
<br />funding. See Progam
<br />Specific Requirements
<br />Reimbursement for
<br />actualcosts, notto
<br />exceed total contract
<br />funding. See Program
<br />Specific Requirements
<br />Reimbursement tbr
<br />actualcosts, notto
<br />exceed totalcontract
<br />funding. See Program
<br />Specific Requirements
<br />Payment Information
<br />and/or Amount
<br />Reimbursement for
<br />actualcosts, notto
<br />exceed total contract
<br />funding. See Program
<br />Specific Requirements
<br />r January 17 ,2}z}(covering September 30, 2021-December30, 2021)
<br />r April 15, \O2z(covering December 31,2}Zl}4arch30,2022)
<br />. July 15,2\2z(covering March3l, 2022June29,2022)
<br />r October 17,z}2z(covering June 30, 2022-September29,2022)
<br />Year 4-FFY21:
<br />Draftdue: hily1,2022
<br />Final due: July 29,2022
<br />Year
<br />Year 4-FFY21:
<br />r January 17 ,2022 (covering September 30, 2021-December3},202l)
<br />. April 15,2022 (covering December 31, 2021March30,2022)
<br />15,2022 (covering March 31, 2022Iune 29,2022)Julya
<br />a June 3 0. 2A22 - Seotember 29, 2022\October 17 . 2022 (covering
<br />Year 4-FFY21:
<br />r January 17,2}22(covering September 30,2021 -December30, 2021 )
<br />. April 15, 2}2z(covering December31.,2021March30,2022)
<br />. July 15,2\22(covering March3l, 2022 June 29'2022)
<br />r October 17,z}z2(covering June 30, 2022'Seplember29,2022)
<br />July 15,2022
<br />March25,2
<br />Final due: Year 4 - FFY2l
<br />Year
<br />Due Date/Time Fname
<br />a
<br />a
<br />a
<br />a
<br />January 17 ,2022 (covering September.30 ,2021'December30, 2021)
<br />April 1 5, 2022 (cov ein'g Decemb er 3 1, 202 | March 3 0, 2022)
<br />Juiy 15, 2022 (covermg March 3 1 , 2022 J:une 29,2022)
<br />Year
<br />202292422-June 32022October 17
<br />DO
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