Tools and Information for Sexual and Domestic Violence Service Providers

This page will be continually updated when new versions of any of these documents are released. Each service provider will receive agency-specific versions of the reporting tools they should submit to DPH; you can always check here for the most recent, non-program specific version of each tool and its instructions.

Service models

The nine service models are:  

3 Residential Models

• Emergency Shelter (ES)
• Domestic Violence, Substance Misuse and Trauma Shelter (DVSMT)
• Housing Stabilization (HS)

6 Community Based Service Models

• General Community Based Domestic Violence Services (GCBDVS)
• Comprehensive Rape Crisis Centers (RCC)
• Sexual/Domestic Violence Victim Services for Communities Experiencing Inequities (SDVEI) (also known as the “Equities” contracts)
• Children Exposed to Domestic Violence Services (CEDV)
• Supervised Visitation Services (SVS)
• Certified Intimate Partner Abuse Education Services (IPAE)

Reporting tools

Here is a breakdown of the reporting tools you need to use effective July 1, 2019:

• Activity Report Form (ARF) – For all service models, except IPAEP. Use to report prevention, education, trainings, meetings, etc. Note: RPE-funded RCCs use the RPE-specific ARF.
• FY20 EIM Invoice Assessments – For all service models – NOTE: This is for viewing only. The invoice assessments are on EIM and should be reported directly on EIM with your monthly invoicing. Each service model has its own invoice assessment.
• Quarterly Service Reports – Group Services - For all service models, except IPAEP and SDVEI Legal Programs. Use to report group counseling and group services.
• Quarterly Service Reports – Individual Services and Client Demographics - For all service models, except IPAEP. Use to report client demographics and one-on-one services. NOTE: SDVEI legal programs have a separate reporting template for this
• Rape Crisis Data Form (Also known as “Incident Form”) – For RCCs only. A version of this form specific to each RCC will be emailed to the RCCs. NOTE: Do not submit this report to DPH. DPH does not collect individual-level data. Use this form internally to collect information on incidents of sexual violence. DPH will periodically request aggregated data reports based on these forms.

If you have any questions, please do not hesitate to contact us!