Title X Objectives How Writing Measurable Objectives Helps DSHS Evaluate the Success of Your Title X Project

Federal Requirements The Title X Family Planning program is located in the US Department of Health and Human Services and administered within the Office of Public Health and Science, Office of Population Affairs (OPA) by the Office of Family Planning (OFP). When DSHS competes for federal funds, part of the Title X federal grant application requires a detailed work plan with goals and objectives.

FY 2008 State Goals DSHS’ FY 2008 federal grant application contains the following goals: 1. To enhance and improve fiscal/administrative functions to ensure efficient family planning program operations.

FY 2008 State Goals 2. To assure the provision of high quality clinical and educational family planning and related health services in order to improve the overall health of Texans. 3. To promote individual and community health for at-risk and hard-to-reach populations.

Objectives Each goal in the State Work Plan has multiple objectives. Objectives developed by Title X contractors support the State Title X grant application. Title X contractors report objectives on a schedule and in a format that allows DSHS to report results to OPA.

SMART Objectives OPA promotes the use of the SMART format for reporting objectives. SMART stands for: Specific – Objectives should specify what they want to achieve. Measurable – You should be able to measure whether you are meeting the objectives or not. Achievable - Objectives should be achievable and attainable.  

SMART Objectives Realistic – You should realistically be able to achieve the objectives with the resources you have. Time – The timeframe in which objectives will be achieved.

Objectives & Funding Failure to: write quality, measurable objectives, and complete objectives in accordance with the Program Work Plan could result in reduced federal funding for Texas family planning services.

Tracking Progress through Objectives Well written, measurable objectives can assist contractors to track the progress of their Title X projects.

Tracking Progress through Objectives By taking a baseline measurement (where you start), identifying your objective, figuring out how you’re going to achieve the objective, identifying who is responsible for meeting the objective, setting a due date, and evaluating progress once the objective is complete, you can track the progress of your project.

Examples of Objectives The following examples come from actual objectives submitted by Title X contractors. Examples that were written using the SMART format are followed by examples that were not.

Examples of Objectives The first set of examples show responses to the Objective 3 requirement: Create an objective related to counseling minors on resisting attempts to be coerced into engaging in sexual activities.

SMART Objectives Example 1 Activities Responsible Entity Time Frame Result/ Evaluation By February 1, 2008, 100% of clinical staff will have received updated training on counseling minors, and a system will be in place to enhance monitoring of implementation Assess current counseling skills of staff. Review, revise and audit client forms to ensure proper counseling documentation. Director of Clinical Operations Quality & Risk Management Coordinator 9/07 – 12/07 9/07 Assessments in personnel files. Forms on file.

SMART Objectives Example 1 Activities Responsible Entity Time Frame Result/ Evaluation By February 1, 2008, 100% of clinical staff will have received updated training on counseling minors, and a system will be in place to enhance monitoring of implementation Provide updated training to all clinic staff on counseling techniques and awareness of sexual coercion. Director of Clinical Operations 1/08 Training logs on file.

SMART Objectives Example 1 Activities Responsible Entity Time Frame Result/ Evaluation By February 1, 2008, 100% of clinical staff will have received updated training on counseling minors, and a system will be in place to enhance monitoring of implementation Ensure that counseling materials are available at all clinic sites and staff are trained in their use. (Pamphlets approved by I&E Committee.) Education Supervisor Ongoing Order forms and observation audits on file.

SMART Objectives Example 1 Activities Responsible Entity Time Frame Result/ Evaluation By February 1, 2008, 100% of clinical staff will have received updated training on counseling minors, and a system will be in place to enhance monitoring of implementation Assess minors during intake process and provide counseling and information as appropriate. Conduct chart audits to determine documentation compliance. Clinicians, clinic managers and Health Care Assistants Quality & Risk Management Coordinator Ongoing. Ongoing – part of teen oversight project. Observation audits on file. Oversight audits on file.

Non-SMART Objectives Example 1 Activities Responsible Entity Time Frame Result/ Evaluation All family planning staff will be educated and trained regarding appropriate techniques and information necessary for counseling minors about sexual coercion. Annual in-service for all staff presented by Licensed Independent Counselor. Program Director August 2008 Staff survey.

Non-SMART Objectives Example 2 Activities Responsible Entity Time Frame Result/ Evaluation Contractor will encourage responsible adolescent sexual behavior by counseling minors on resisting attempts to be coerced into engaging in sexual activities. Family Planning (FP) Nurse will provide verbal counseling and written education and counseling to minors who seek services at the health center. Family Planning Nurse, Medical Staff Each Visit Documentation in the patient’s medical record.

Non-SMART Objectives Example 2 Activities Responsible Entity Time Frame Result/ Evaluation Contractor will encourage responsible adolescent sexual behavior by counseling minors on resisting attempts to be coerced into engaging in sexual activities. FP Nurse will screen for possibility of sexual coercion and provide personal safety plan information to adolescents. Family Planning Nurse, Medical Staff Each Visit Documentation in the patient’s medical record.

Non-SMART Objectives Example 2 Activities Responsible Entity Time Frame Result/ Evaluation Contractor will encourage responsible adolescent sexual behavior by counseling minors on resisting attempts to be coerced into engaging in sexual activities. FP Nurse will provide monthly outreach presentations to the youth and staff at local youth centers, schools and faith-based organizations. Family Planning Nurse, Medical Staff Monthly An outreach log of activities and attendees will be maintained, including agenda items, target audience, start and end time, and type and amount of materials distributed.

Non-SMART Objectives Example 2 Activities Responsible Entity Time Frame Result/ Evaluation Contractor will encourage responsible adolescent sexual behavior by counseling minors on resisting attempts to be coerced into engaging in sexual activities. Community Participation Committee will review and evaluate materials and discuss ways to reach adolescents. Family Planning Nurse, Medical Staff Bi-Annual Outreach logs, reports to Community Participation Committee, meeting minutes.

Objective 4 Create an objective that relates to the provision of family planning services and related preventive health services to hard to reach populations such as uninsured or underinsured individuals, males, persons with Limited English Proficiency (LEP), adolescents, or other vulnerable or at risk populations.

SMART Objectives Example 1 Activities Responsible Entity Time Frame Result/ Evaluation By the end of FY08, contractor will link 1,200 low-income, uninsured, underinsured, males and LEP individuals to services. Promotora workers will do education and outreach in low-income, rural neighborhoods and set client appointments for nearby clinics. Education Supervisor 9/1/07 – 8/31/08 Activity log and appointment logs.

SMART Objectives Example 1 Activities Responsible Entity Time Frame Result/ Evaluation By the end of FY08, contractor will link 1,200 low-income, uninsured, underinsured, males and LEP individuals to services. Multiple life skills training sessions will be presented to four boot camps, alternative schools, and substance abuse centers. Participants will be referred to contractor clinics. Male Involvement Coordinator 9/1/07 – 8/31/08 Logs of dates, activities and contacts. Log of referrals receiving services.

SMART Objectives Example 1 Activities Responsible Entity Time Frame Result/ Evaluation By the end of FY08, contractor will link 1,200 low-income, uninsured, underinsured, males and LEP individuals to services. Education and outreach will be done in coordination with social service agencies working with vulnerable and at-risk populations. Education Supervisor 5/31/08 Log of dates, activities and contacts.

SMART Objectives Example 1 Activities Responsible Entity Time Frame Result/ Evaluation By the end of FY08, contractor will link 1,200 low-income, uninsured, underinsured, males and LEP individuals to services. A media campaign to promote family planning and health services will be conducted in collaboration with another contractor. Community Services Director 9/1/07 – 8/31/08 Log of materials.

Non-SMART Objectives Example 1 Activities Responsible Entity Time Frame Result/ Evaluation Survey referral methods of patients to see most adequate advertising strategy. Increase awareness of clinic services by advertising in Spanish. Staff Each visit. Program period. Monthly evaluation. Evaluate referrals.

Non-SMART Objectives Example 1 Activities Responsible Entity Time Frame Result/ Evaluation Continue with bilingual quarterly educational classes. Send educational materials to other health agencies and prison. Staff Quarterly. Evaluate areas that need more advertising. Monitor referral status.

Quarterly Progress Reports Each quarter, contractors submit the Title X Contractor Objectives Report, also know as the Quarterly Progress Report. Due dates for FY 08 reports are: Quarter 1: December 31, 2007 Quarter 2: March 31, 2008 Quarter 3: June 30, 2008 Quarter 4: October 31, 2008

Quarterly Progress Reports Contractors are not required to report on all objectives each quarter. Quarter 1: Report on Objective 1 (numbers served) only. Quarter 2: Report on Objectives 1-6 --- all objectives. Quarter 3: Report on Objective 1 only. Quarter 4: Report on Objectives 1-6.

Quarterly Progress Reports Contractors must use the objectives format provided by DSHS when reporting objectives. When reporting on progress made toward completion of Objectives 2-6, contractors should include information up through the second and fourth quarters.

Quarterly Progress Reports Any significant deviation from submitted objectives must be discussed with your assigned Contract Manager. Contract Managers are: Debbie Brookshire, HSR 1, 2, 9 and 10 Sharon Drane, HSR 3, 4, 5 and 6 Leroy Torres, HSR 7, 8 and 11

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