PAIMI Program Information Executive Director lntial Appointment Date 04/15/2013 (mm/dd/yyyy) Recent performance evaluation completed 09/27/2017 (mm/dd/yyyy) Date of previous performance evaluation 09/28/2016 (mm/dd/yyyy) Agency has written policy and procedures to guide the ED's evaluation process? Yes No 0 Input on ED's performance evaluation obtained from the following (check all that apply) ,. All agency employees/staff Yes O No ,. Senior managers Yes No Ci All board directors Yes No @: () All PAIMI Advisory Council members Yes O No @· Stakeholders Yes O No Ci Consumers r- Yes No @ ,. Family members of consumers Yes No ,. State mental health providers Yes O No Private mental health providers Yes 0 No <i: ,. Other Yesr No 12/22/2017 3:45 0930-0169 07/17/2017 07/31/2020 Printed: PM -Arkansas - 0MB No, Approved: Expires: Page 7 of 82
PAIMI Program Information Executive Director lntial Appointment Date 04/15/2013 (mm/dd/yyyy) Recent performance evaluation completed 09/27/2017 (mm/dd/yyyy) Date of previous performance evaluation 09/28/2016 (mm/dd/yyyy) Agency has written policy and procedures to guide the ED's evaluation process? Yes No 0 Input on ED's performance evaluation obtained from the following (check all that apply) All agency employees/staff Yes O No ,. Senior managers Yes Ci No ,. All board directors Yes @: No () All PAIMI Advisory Council members Yes O No @· Stakeholders Yes O No Ci Consumers Yes r- No @ Family members of consumers Yes No ,. State mental health providers Yes O No ,. Private mental health providers Yes 0 No <i: Other Yesr No ,. Printed: 12/22/2017 3:45 PM -Arkansas - 0MB No, 0930-0169 Approved: 07/17/2017 Expires: 07/31/2020 Page 7 of 82