Example: Example: Number of substance counseling sessions to 120 sessions beneficiaries. Goals and Anticipated Outcomes First enter goals that align with and are related to the Proposed Project in the Goals column. For example, if the goal is to completing the Veterans Court program will have their criminal charges “clients dropped.” Then provide the anticipated outcome for the goal listed in the Outcomes” column. For “Anticipated example, of clients will complete the Veterans program.” “85% Additional lines may be added. Goals Anticipated Outcomes Example: Example: Clients completing the Veterans program 85% of clients will complete the Veterans Court will have their criminal charges dropped. program. Next, describe how you will determine if anticipated outcomes are met. Examples may include using a client satisfaction survey, following up with clients 30-90 days after receiving services to determine status, tracking pertinent client data. Project Eligibility Eligibility to receive services must be verified and documented. The RFA includes a list of specific your organization staff may use to verify eligibility of clients who can receive services and ensure that it is applicable to beneficiary definitions above in Beneficiaries #1 (Veteran, dependent, surviving spouse related) and #2 (any other applicable eligibility requirements). Select the forms your agency will use to verify eligibility. DD Form 214, Certificate of Release or Discharge from Active Duty NGB-22, National Guard Report of Separation and Record of Service NA Form 13038, Certification of Military Service Department of Veterans Affairs (VA) official letter or disability letter with character of service listed E-Benefits summary letter with character of service listed Honorable discharge certificate Uniform Services Identification Card State of Texas Issued Driver License with Veteran designation If dependents and surviving spouses are listed as eligible beneficiaries, include how their eligibility will be verified. Select the forms your agency will use to verify eligibility Dependents: Uniform Services Identification Card Marriage Certificate Birth Certificate Adoption Certificate Surviving Spouse:
Example: Number of substance counseling sessions to beneficiaries. Example: 120 sessions Goals and Anticipated Outcomes First enter goals that align with and are related to the Proposed Project in the Goals column. For example, if the goal is to “clients completing the Veterans Court program will have their criminal charges dropped.” Then provide the anticipated outcome for the goal listed in the “Anticipated Outcomes” column. For example, “85% of clients will complete the Veterans program.” Additional lines may be added. Goals Anticipated Outcomes Example: Clients completing the Veterans program will have their criminal charges dropped. Example: 85% of clients will complete the Veterans Court program. Next, describe how you will determine if anticipated outcomes are met. Examples may include using a client satisfaction survey, following up with clients 30-90 days after receiving services to determine status, tracking pertinent client data. Project Eligibility Eligibility to receive services must be verified and documented. The RFA includes a list of specific your organization staff may use to verify eligibility of clients who can receive services and ensure that it is applicable to beneficiary definitions above in Beneficiaries #1 (Veteran, dependent, surviving spouse related) and #2 (any other applicable eligibility requirements). Select the forms your agency will use to verify eligibility. DD Form 214, Certificate of Release or Discharge from Active Duty NGB-22, National Guard Report of Separation and Record of Service NA Form 13038, Certification of Military Service Department of Veterans Affairs (VA) official letter or disability letter with character of service listed E-Benefits summary letter with character of service listed Honorable discharge certificate Uniform Services Identification Card State of Texas Issued Driver License with Veteran designation If dependents and surviving spouses are listed as eligible beneficiaries, include how their eligibility will be verified. Select the forms your agency will use to verify eligibility Dependents: Uniform Services Identification Card Marriage Certificate Birth Certificate Adoption Certificate Surviving Spouse:
2-2018-19-Veteran-Treatment-Court-Appendix-I-Application.docx