| Please provide an answer for each question below. If the question does not apply, please place an N/A in the space provided. |
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| Indicate the Michigan State Department for which you work: |
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| Please indicate what Bureau, Division, Section, Unit and/or Sub-unit of the above named state-level department for which you work. |
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| We are interested in the programs, services, policies, laws, ordinances, etc. you currently implement and/or enforce related to any of the 8 key areas. There is space for up to 7 programs, services, etc. When you have completed filling in information for your programs, etc., please make sure you answer questions 8-10. |
| 1a. Name of program, service, policy, law, or ordinance. |
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| 1b. Please describe the program, service, policy, law, or ordinance: goal, length of existence, stable funding, mandated? |
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| 1c. Which of the 8 key areas does this program, service, policy, law, or ordinance address? Check all that apply. (Please refer to Descriptions of 8 key areas) |
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| 1d. Who is the client or target population? |
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| 1e. Which age group is targeted with this program, service, policy, law, or ordinance? Check all that apply. |
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| 1f. Which geographic areas (region of state, whole state, counties etc.) are covered by the program, service, policy, law, or ordinance? |
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| 1g. Which partners or sub-contractors (if any) do you work with on this program, service, policy, law, or ordinance? |
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| 2a. Name of program, service, policy, law, or ordinance. |
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| 2b. Please describe the program, service, policy, law, or ordinance: goal, length of existence, stable funding, mandated? |
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| 2c. Which of the 8 key areas does this program, service, policy, law, or ordinance address? Check all that apply. (Please refer to Descriptions of 8 key areas) |
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| 2d. Who is the client or target population? |
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| 2e. Which age group is targeted with this program, service, policy, law, or ordinance? Check all that apply. |
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| 2f. Which geographic areas (region of state, whole state, counties etc.) are covered by the program, service, policy, law, or ordinance? |
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| 2g. Which partners or sub-contractors (if any) do you work with on this program, service, policy, law, or ordinance? |
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| 3a. Name of program, service, policy, law, or ordinance. |
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| 3b. Please describe the program, service, policy, law, or ordinance: goal, length of existence, stable funding, mandated? |
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| 3c. Which of the 8 key areas does this program, service, policy, law, or ordinance address? Check all that apply. (Please refer to Descriptions of 8 key areas) |
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| 3d. Who is the client or target population? |
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| 3e. Which age group is targeted with this program, service, policy, law, or ordinance? Check all that apply. |
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| 3f. Which geographic areas (region of state, whole state, counties etc.) are covered by the program, service, policy, law, or ordinance? |
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| 3g. Which partners or sub-contractors (if any) do you work with on this program, service, policy, law, or ordinance? |
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| 4a. Name of program, service, policy, law, or ordinance. |
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| 4b. Please describe the program, service, policy, law, or ordinance: goal, length of existence, stable funding, mandated? |
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| 4c. Which of the 8 key areas does this program, service, policy, law, or ordinance address? Check all that apply. (Please refer to Descriptions of 8 key areas) |
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| 4d. Who is the client or target population? |
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| 4e. Which age group is targeted with this program, service, policy, law, or ordinance? Check all that apply. |
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| 4f. Which geographic areas (region of state, whole state, counties etc.) are covered by the program, service, policy, law, or ordinance? |
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| 4g. Which partners or sub-contractors (if any) do you work with on this program, service, policy, law, or ordinance? |
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| 5a. Name of program, service, policy, law, or ordinance. |
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| 5b. Please describe the program, service, policy, law, or ordinance: goal, length of existence, stable funding, mandated? |
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| 5c. Which of the 8 key areas does this program, service, policy, law, or ordinance address? Check all that apply. (Please refer to Descriptions of 8 key areas) |
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| 5d. Who is the client or target population? |
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| 5e. Which age group is targeted with this program, service, policy, law, or ordinance? Check all that apply. |
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| 5f. Which geographic areas (region of state, whole state, counties etc.) are covered by the program, service, policy, law, or ordinance? |
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| 5g. Which partners or sub-contractors (if any) do you work with on this program, service, policy, law, or ordinance? |
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| 6a. Name of program, service, policy, law, or ordinance. |
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| 6b. Please describe the program, service, policy, law, or ordinance: goal, length of existence, stable funding, mandated? |
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| 6c. Which of the 8 key areas does this program, service, policy, law, or ordinance address? Check all that apply. (Please refer to Descriptions of 8 key areas) |
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| 6d. Who is the client or target population? |
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| 6e. Which age group is targeted with this program, service, policy, law, or ordinance? Check all that apply. |
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| 6f. Which geographic areas (region of state, whole state, counties etc.) are covered by the program, service, policy, law, or ordinance? |
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| 6g. Which partners or sub-contractors (if any) do you work with on this program, service, policy, law, or ordinance? |
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| 7a. Name of program, service, policy, law, or ordinance. |
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| 7b. Please describe the program, service, policy, law, or ordinance: goal, length of existence, stable funding, mandated? |
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| 7c. Which of the 8 key areas does this program, service, policy, law, or ordinance address? Check all that apply. (Please refer to Descriptions of 8 key areas) |
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| 7d. Who is the client or target population? |
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| 7e. Which age group is targeted with this program, service, policy, law, or ordinance? Check all that apply. |
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| 7f. Which geographic areas (region of state, whole state, counties etc.) are covered by the program, service, policy, law, or ordinance? |
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| 7g. Which partners or sub-contractors (if any) do you work with on this program, service, policy, law, or ordinance? |
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| 8. Anything else you would like to tell us about these or other relevant programs/strategies? |
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| 9. Focusing on the 8 key areas, if you had unlimited resources, what other policies laws, ordinances, practices, programs or services would you want to implement or enhance? |
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| 10. Is there anyone else in your department/agency we should talk to for any information about programs, services, policies, laws, ordinances, enforcement practices related to the 8 key areas? Please provide contact information. |
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