Community College Consortia

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Overview

Cover Page
Front page
Instructions
Contacts
Mission & Vision
Service Area
Student Enrollement
CCC Milestones
Org chart
Staff
Sub-Recipients
Stakeholders
Consortium Key activities
Member CC Key activities
Gantt chart
Risk mitigation

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Sheet 1: Cover Page

	Form Approved
	OMB No. 0990-NEW
	Exp. Date 06/30/2010
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990- . The time required to complete this information collection is estimated to average 1 hour, 30 minutes to complete, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer

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Sheet 2: Front page

Jump to:
Instructions		ONC Community College Consortium Operations Plan
Contacts
Mission & vision		This operations plan template is a guide for each Community College Consortium (CCC) and member Community Colleges (CC) to describe their plan for contributing to the Program's shared goal of training 10,000 graduates per year over time. Please click on Instructions for abbreviated instructions on using this Operations Plan tool. Please see the accompanying "Guidelines for CCC Operations Planning" for detailed instructions and guidance on completing this plan.
Service area
Student Enrollement
CCC Milestones
Org chart
Staff
Sub-recipients
Stakeholders
Consortium Key activities
Member CC Key activities
Gantt chart		Version history
Risk mitigation		CCC/CC Update Version	CCC/CC Point of contact	CCC/CC approval date	ONC approval date	ONC approver
		1.00	Sally Smith	2/25/2010	2/28/2010	John Project Officer
Data entry field
Reference field
Calculated field
		e.g., XXXXXX	name of primary author	e.g., mm/dd/yy	e.g., mm/dd/yy	name of ONC approver

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Sheet 3: Instructions

Jump to Front Page		def'n of sub-recipients; add risk mitigation;
Legend
Data entry field
Reference field
Calculated field		ONC Regional Extension Center Operations Plan -- Description and Abbreviated Instructions
		Please see the "REC Operations Planning Guidelines" for more detailed information on the Operational Plan
		General instructions	The Operations Plan is the principle planning document for the CCC. Like a business plan, it describes the goals & objectives of the CCC and how the CCC proposes to achieve these goals & objectives.
			This Operations Plan template is provided to each REC as an aid to creating a realistic plan for meeting the REC's goals, and to standardize basic data collection and terminology to allow tracking and information-sharing across RECs.
			This template is designed to capture structured data consistently across the entire CCC program. Please do not alter the templates outside of the data input fields shaded in orange, as indicated in the legend to the left.
			In addition to the brief instructions provided here, more detailed guidance can be found in the "CCC Operational Planning Guideline" document.
		Contacts	Please enter contact information for the CCC and its Sub-Recipients as appropriate. (Note: Sub-recipients are those organizations or contractors that will receive Federal money for performing CCC activities.) This will be the main input to ONC's CCC contact list so please keep it updated as often as necessary.
		Mission & vision	The Mission Statement and Vision Statements are vital for setting the course of the CCC over the next two years. The Mission & Vision section is designed to capture the CCCs high-level statement about who it serves, what it would like to accomplish, why its services are valuable, and ultimately how the CCC's activities will train the requisite number of HIT professionals. Ideally, the mission and vision should define the CCCs ambitions in a way that is meaningful to the CCCs member Community Colleges and stakeholders. Key questions that the mission statement should address are: • Who will the CCC serve? • What does the CCC want to accomplish? • What value will the CCC provide and why is it well-positioned to accomplish its objectives? Key question that the vision statement should address are: • The training capacity that the consortium will achieve after two years • Percent of students that are employed in Health Information Technology
		Service area	Geographic service area defines the state/territory, counties, and zip codes in which the REC will operate. For multi-state RECs, please enter state, county, and zip codes for each state separately in the columns provided. County and zip code information may be pasted into the worksheet from sources such as www.downloadzipcode.com or the US Postal Service.
		Student enrollment	The consortium as a whole will provide training in all the ONC defined six workforce roles. Number of students enrolled in each of the six workforce roles? What are the professionals backgrounds of the students?
		CCC Milestones	The CCC’s goals for the operating year are listed in this section and should relate to the goals, objectives outlined in the applications. The CCC should identify specific goals for achieving the six main milestones identified in the FOA, which are: Enrollment • Milestone 1: Number of students enrolled in the programs supported by this initiative • Milestone 2: Number of students graduating from programs supported by this initiative Workforce Training Roles • Milestone 3: Training in how many of the six workforce roles are being provided Employment and Earnings • Milestone 4: Employment rate – percent of students employed in first quarter after exit from the program • Milestone 5: Employment retention rate – percent of students employed in first quarter after exit from the program and still employed in the second and third quarters • Milestone 6: Average earnings Please enter the number of new students that you expect to enroll in a given milestone in a given session. For example, if 50 students are expected to enroll in September 2010, record “50” for Milestone 1 (M1) for September, 2010. If an additional 25 students are expected to enroll in January 2011, record “25” for January. The spreadsheet will automatically calculate
		Org chart	The Org chart tab highlights the CCC’s relationships with its stakeholders and sub-recipients.
		Staff	Recognizing that each CCC will have its own job titles for categories, and that individuals may perform more than one function, the Staff tab provides a grid to map CCC personnel to the key CCC functions. As these named individuals will be responsible for participating in National Coordination committee meetings, collaborative learning activities, please provide the names of the individuals who are actually in charge of the function. Please note any positions that have been newly created so these may be reported to meet ARRA reporting requirements. Listed below are definitions of the core functional roles that the CCC is responsible for performing.
		Sub-recipients	Sub-recipients are organizations who will receive federal funds through the Community College Consortium lead awardee. Please fill out all of the information requested.
		Stakeholders	Each CCC will have a wide variety of stakeholders with whom it will have formal as well as informal relationships that taken together will form the CCCs approach to achieving its objectives. Identifying stakeholder roles, responsibilities, and expectations are critical inputs to the development of a meaningful Operations Plan. Making this information available to ONC and other CCCs will greatly facilitate the development of learning communities and channels for knowledge-sharing across CCCs. The CCC should list all partnerships including partners, contractors and stakeholders with contact information.
		Key activities	To accomplish the goals and objectives of the program each CCC will need to engage in the following activities: 1) Outreach plan for recruiting students and finding employment and placement for the graduates of the program. This would include developing program publicity plan and materials, developing a program Web site 2) Consortia Committee Participation Coordination - Creating a regional partnership of entities that are interested in workforce development. 3) Educational Materials/ Curriculum – design the program in sufficient detail to get the program approved. 4) Dissemination of nationally developed curriculum material. In cases were the nationally developed curriculum developed material is not used, the material should be reviewed to ensure the course materials meet the standards of the centrally developed curriculum. 4) Admission Process – establish admissions criteria and other policies; develop application forms and other materials. 5) Progress reporting and program evaluation – forms and procedures for course evaluation, forms and procedures for overall program evaluation.
		Gantt chart	The Gantt chart is simply a timeline of the Key activities defined above. The template is designed to provide a simple depiction of the activities and high-level timelines associated with each function. Please enter a "1" into the chart cells to change the color and illustrate the activity timeline. (Note: the months are calculated based on the project start date in the Baseline section)
		Risk mitigation	The HIT programs in the Community Colleges will be new six month programs. The plan should identify barriers and challenges to achieving the goals, objectives and outcomes (outlined on page 14 of the program announcement). It is important that potential risks are identified and that risk mitigation steps are put in place early in the implementation of the HIT programs. This will ensure that CCC managers will be aware of potential risks, will monitor the programs for these risks, and will be prepared to respond rapidly. Risks and mitigation steps may also be shared with other CCCs so all may benefit. This section should also include ALL grant restrictions specified in the CCC’s Notice of Grant Award.

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Sheet 4: Contacts

Jump to Front Page
Legend		Primary contact information - (Lead Institution)
Data entry field		Lead Institution information
Reference field		Organization name		enter name
Calculated field		Street address		e.g., 12 Main Street
		City		e.g., Springfield
		State		pick from drop-down list
		Zip code		e.g., 01234-0000
		Website		e.g., www.myrecname.org
		DUNS number		9 digit Dun and Bradstreet Data Universal Numbering System number
		Primary contacts at Lead Institution
		CCC primary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@myrecname.org
		CCC secondary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@myrecname.org
		ONC GMO name		enter first and last name of ONC Grant Management Officer
		telephone number		enter 10 digit phone number
		email address		e.g., name@hhs.gov
		ONC PO name		enter first and last name of ONC Project Officer
		telephone number		enter 10 digit phone number
		email address		e.g., name@hhs.gov
		Additional contact information - (CCC Sub-Recipient Office)
		Sub-Recipient information
		Organization name		enter name
		Street address		e.g., 12 Main Street
		City		e.g., Springfield
		State		pick from drop-down list
		Zip code		e.g., 01234-0000
		Website		e.g., www.organization.org
		DUNS number		9 digit Dun and Bradstreet Data Universal Numbering System number
		Primary contacts
		Sub-Recipient primary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Sub-Recipient secondary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Additional contact information - (CCC Sub-Recipient Office)
		Sub-Recipient information
		Organization name		enter name
		Street address		e.g., 12 Main Street
		City		e.g., Springfield
		State		pick from drop-down list
		Zip code		e.g., 01234-0000
		Website		e.g., www.organization.org
		DUNS number		9 digit Dun and Bradstreet Data Universal Numbering System number
		Primary contacts
		Sub-Recipient primary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Sub-Recipient secondary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Additional contact information - (CCC Sub-Recipient Office)
		Sub-Recipient information
		Organization name		enter name
		Street address		e.g., 12 Main Street
		City		e.g., Springfield
		State		pick from drop-down list
		Zip code		e.g., 01234-0000
		Website		e.g., www.organization.org
		DUNS number		9 digit Dun and Bradstreet Data Universal Numbering System number
		Primary contacts
		Sub-Recipient primary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Sub-Recipient secondary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Additional contact information - (CCC Sub-Recipient Office)
		Sub-Recipient information
		Organization name		enter name
		Street address		e.g., 12 Main Street
		City		e.g., Springfield
		State		pick from drop-down list
		Zip code		e.g., 01234-0000
		Website		e.g., www.organization.org
		DUNS number		9 digit Dun and Bradstreet Data Universal Numbering System number
		Primary contacts
		Sub-Recipient primary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Sub-Recipient secondary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Additional contact information - (CCC Sub-Recipient Office)
		Sub-Recipient information
		Organization name		enter name
		Street address		e.g., 12 Main Street
		City		e.g., Springfield
		State		pick from drop-down list
		Zip code		e.g., 01234-0000
		Website		e.g., www.organization.org
		DUNS number		9 digit Dun and Bradstreet Data Universal Numbering System number
		Primary contacts
		Sub-Recipient primary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Sub-Recipient secondary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Additional contact information - (CCC Sub-Recipient Office)
		Sub-Recipient information
		Organization name		enter name
		Street address		e.g., 12 Main Street
		City		e.g., Springfield
		State		pick from drop-down list
		Zip code		e.g., 01234-0000
		Website		e.g., www.organization.org
		DUNS number		9 digit Dun and Bradstreet Data Universal Numbering System number
		Primary contacts
		Sub-Recipient primary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Sub-Recipient secondary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Additional contact information - (CCC Sub-Recipient Office)
		Sub-Recipient information
		Organization name		enter name
		Street address		e.g., 12 Main Street
		City		e.g., Springfield
		State		pick from drop-down list
		Zip code		e.g., 01234-0000
		Website		e.g., www.organization.org
		DUNS number		9 digit Dun and Bradstreet Data Universal Numbering System number
		Primary contacts
		Sub-Recipient primary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Sub-Recipient secondary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Additional contact information - (CCC Sub-Recipient Office)
		Sub-Recipient information
		Organization name		enter name
		Street address		e.g., 12 Main Street
		City		e.g., Springfield
		State		pick from drop-down list
		Zip code		e.g., 01234-0000
		Website		e.g., www.organization.org
		DUNS number		9 digit Dun and Bradstreet Data Universal Numbering System number
		Primary contacts
		Sub-Recipient primary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Sub-Recipient secondary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Additional contact information - (CCC Sub-Recipient Office)
		Sub-Recipient information
		Organization name		enter name
		Street address		e.g., 12 Main Street
		City		e.g., Springfield
		State		pick from drop-down list
		Zip code		e.g., 01234-0000
		Website		e.g., www.organization.org
		DUNS number		9 digit Dun and Bradstreet Data Universal Numbering System number
		Primary contacts
		Sub-Recipient primary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Sub-Recipient secondary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Additional contact information - (CCC Sub-Recipient Office)
		Sub-Recipient information
		Organization name		enter name
		Street address		e.g., 12 Main Street
		City		e.g., Springfield
		State		pick from drop-down list
		Zip code		e.g., 01234-0000
		Website		e.g., www.organization.org
		DUNS number		9 digit Dun and Bradstreet Data Universal Numbering System number
		Primary contacts
		Sub-Recipient primary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Sub-Recipient secondary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Additional contact information - (CCC Sub-Recipient Office)
		Sub-Recipient information
		Organization name		enter name
		Street address		e.g., 12 Main Street
		City		e.g., Springfield
		State		pick from drop-down list
		Zip code		e.g., 01234-0000
		Website		e.g., www.organization.org
		DUNS number		9 digit Dun and Bradstreet Data Universal Numbering System number
		Primary contacts
		Sub-Recipient primary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Sub-Recipient secondary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Additional contact information - (CCC Sub-Recipient Office)
		Sub-Recipient information
		Organization name		enter name
		Street address		e.g., 12 Main Street
		City		e.g., Springfield
		State		pick from drop-down list
		Zip code		e.g., 01234-0000
		Website		e.g., www.organization.org
		DUNS number		9 digit Dun and Bradstreet Data Universal Numbering System number
		Primary contacts
		Sub-Recipient primary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org
		Sub-Recipient secondary contact name		enter first and last name
		telephone number		enter 10 digit phone number
		email address		e.g., myname@organization.org

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Sheet 5: Mission & Vision

Jump to Front Page
Legend		Mission statement for the CCC Program
Data entry field		Double-click on box to type directly into it; use alt-enter to start new paragraph
Reference field		Example: The Mission of CCC is to train a skilled workforce to support the adoption of EHRs, exchange health information among health care providers and public health authorities, and the redesign of workflows within health care settings to gain the quality and efficiency benefits of EHRs, while maintaining individual privacy and security.
Calculated field
		Vision statement for the REC program
		Double-click on box to type directly into it; use alt-enter to start new paragraph
		Example: Our vision for 2012 is 10,000 students trained in HIT to facilitate a transformed health system through the use of health information technology (HIT).

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Sheet 6: Service Area

Jump to Front Page									Pick from drop-down list
Legend		Geographic Service Area
Data entry field		For in counties in top of sheet; scroll down to fill in zip codes							Fill in full-name of county
Reference field		Community College Name #1		Community College Name #2		Community College Name #3		Community College Name #4
Calculated field		State or territory #1		State or territory #2		State or territory #3		State or territory #3
		Texas		Alabama
		Full names of counties (Boroughs for Alaska, Parishes for Louisiana)		Full names of counties (Boroughs for Alaska, Parishes for Louisiana)		Full names of counties (Boroughs for Alaska, Parishes for Louisiana)		Full names of counties (Boroughs for Alaska, Parishes for Louisiana)
		Aurora
		State or territory #1		State or territory #2		State or territory #3		State or territory #3
		South Dakota
		Zip Codes Represented		Zip Codes Represented		Zip Codes Represented		Zip Codes Represented
		57001
		57002
		57003
		57004
		57005
		57006
		57007
		57010
		57012
		57013
		57014
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		57016
		57017
		57018
		57020
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		57024
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		57027
		57028
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		57301		57301		57301		57301
		57311		57311		57311		57311
		57312		57312		57312		57312
		57313		57313		57313		57313
		57314		57314		57314		57314
		57315		57315		57315		57315
		57317		57317		57317		57317
		57319		57319		57319		57319
		57321		57321		57321		57321
		57322		57322		57322		57322
		57323		57323		57323		57323
		57324		57324		57324		57324
		57325		57325		57325		57325
		57326		57326		57326		57326
		57328		57328		57328		57328
		57329		57329		57329		57329
		57330		57330		57330		57330
		57331		57331		57331		57331
		57332		57332		57332		57332
		57334		57334		57334		57334
		57335		57335		57335		57335
		57337		57337		57337		57337
		57339		57339		57339		57339
		57340		57340		57340		57340
		57341		57341		57341		57341
		57342		57342		57342		57342
		57344		57344		57344		57344
		57345		57345		57345		57345
		57346		57346		57346		57346
		57348		57348		57348		57348
		57349		57349		57349		57349
		57350		57350		57350		57350
		57353		57353		57353		57353
		57354		57354		57354		57354
		57355		57355		57355		57355
		57356		57356		57356		57356
		57358		57358		57358		57358
		57359		57359		57359		57359
		57361		57361		57361		57361
		57362		57362		57362		57362
		57363		57363		57363		57363
		57364		57364		57364		57364
		57365		57365		57365		57365
		57366		57366		57366		57366
		57367		57367		57367		57367
		57368		57368		57368		57368
		57369		57369		57369		57369
		57370		57370		57370		57370
		57371		57371		57371		57371
		57373		57373		57373		57373
		57374		57374		57374		57374
		57375		57375		57375		57375
		57376		57376		57376		57376
		57379		57379		57379		57379
		57380		57380		57380		57380
		57381		57381		57381		57381
		57382		57382		57382		57382
		57383		57383		57383		57383
		57384		57384		57384		57384
		57385		57385		57385		57385
		57386		57386		57386		57386
		57399		57399		57399		57399
		57401		57401		57401		57401
		57402		57402		57402		57402
		57420		57420		57420		57420
		57421		57421		57421		57421
		57422		57422		57422		57422
		57424		57424		57424		57424
		57426		57426		57426		57426
		57427		57427		57427		57427
		57428		57428		57428		57428
		57429		57429		57429		57429
		57430		57430		57430		57430
		57432		57432		57432		57432
		57433		57433		57433		57433
		57434		57434		57434		57434
		57435		57435		57435		57435
		57436		57436		57436		57436
		57437		57437		57437		57437
		57438		57438		57438		57438
		57439		57439		57439		57439
		57440		57440		57440		57440
		57441		57441		57441		57441
		57442		57442		57442		57442
		57445		57445		57445		57445
		57446		57446		57446		57446
		57448		57448		57448		57448
		57449		57449		57449		57449
		57450		57450		57450		57450
		57451		57451		57451		57451
		57452		57452		57452		57452
		57454		57454		57454		57454
		57455		57455		57455		57455
		57456		57456		57456		57456
		57457		57457		57457		57457
		57460		57460		57460		57460
		57461		57461		57461		57461
		57465		57465		57465		57465
		57466		57466		57466		57466
		57467		57467		57467		57467
		57468		57468		57468		57468
		57469		57469		57469		57469
		57470		57470		57470		57470
		57471		57471		57471
		57472		57472		57472
		57473		57473		57473
		57474		57474		57474
		57475		57475		57475
		57476		57476		57476
		57477		57477		57477
		57479		57479		57479
		57481		57481		57481
		57501		57501		57501
		57520		57520		57520
		57521		57521		57521
		57522		57522		57522
		57523		57523		57523
		57528		57528		57528
		57529		57529		57529
		57531		57531		57531
		57532		57532		57532
		57533		57533		57533
		57534		57534		57534
		57536		57536		57536
		57537		57537		57537
		57538		57538		57538
		57540		57540		57540
		57541		57541		57541
		57543		57543		57543
		57544		57544		57544
		57547		57547		57547
		57548		57548		57548
		57551		57551		57551
		57552		57552		57552
		57553		57553		57553
		57555		57555		57555
		57559		57559		57559
		57560		57560		57560
		57562		57562		57562
		57563		57563		57563
		57564		57564		57564
		57566		57566		57566
		57567		57567		57567
		57568		57568		57568
		57569		57569		57569
		57570		57570		57570
		57571		57571		57571
		57572		57572		57572
		57574		57574		57574
		57576		57576		57576
		57577		57577		57577
		57579		57579		57579
		57580		57580		57580
		57584		57584		57584
		57585		57585		57585
		57601		57601		57601
		57620		57620		57620
		57621		57621		57621
		57622		57622		57622
		57623		57623		57623
		57625		57625		57625
		57626		57626		57626
		57630		57630		57630
		57631		57631		57631
		57632		57632		57632
		57633		57633		57633
		57634		57634		57634
		57636		57636		57636
		57638		57638		57638
		57639		57639		57639
		57640		57640		57640
		57641		57641		57641
		57642		57642		57642
		57644		57644		57644
		57645		57645		57645
		57646		57646		57646
		57648		57648		57648
		57649		57649		57649
		57650		57650		57650
		57651		57651		57651
		57652		57652		57652
		57656		57656		57656
		57657		57657		57657
		57658		57658		57658
		57659		57659		57659
		57660		57660		57660
		57661		57661		57661
		57701		57701		57701
		57702		57702		57702
		57703		57703		57703
		57706		57706		57706
		57709		57709		57709
		57714		57714		57714
		57716		57716		57716
		57717		57717		57717
		57718		57718		57718
		57719		57719		57719
		57720		57720		57720
		57722		57722		57722
		57724		57724		57724
		57725		57725		57725
		57730		57730		57730
		57732		57732		57732
		57735		57735		57735
		57737		57737		57737
		57738		57738		57738
		57741		57741		57741
		57744		57744		57744
		57745		57745		57745
		57747		57747		57747
		57748		57748		57748
		57750		57750		57750
		57751		57751		57751
		57752		57752		57752
		57754		57754		57754
		57755		57755		57755
		57756		57756		57756
		57758		57758		57758
		57759		57759		57759
		57760		57760		57760
		57761		57761		57761
		57762		57762		57762
		57763		57763		57763
		57764		57764		57764
		57766		57766		57766
		57767		57767		57767
		57769		57769		57769
		57770		57770		57770
		57772		57772		57772
		57773		57773		57773
		57775		57775		57775
		57776		57776		57776
		57779		57779		57779
		57780		57780		57780
		57782		57782		57782
		57783		57783		57783
		57785		57785		57785
		57787		57787		57787
		57788		57788		57788
		57790		57790		57790
		57791		57791		57791
		57792		57792		57792
		57793		57793		57793
		57794		57794		57794
		57799		57799		57799

---

Sheet 7: Student Enrollement

Jump to Front Page
Legend		CCC Student Enrollment
Data entry field			Number
Reference field		Number trained in each workforce role
Calculated field		Total number of Students	85
		Practice Workflow/Information Redesign	30
		Clinician/Practitioner consultant	10
		Implementation Support Specialist	15	Note: The total number of students should match estimate provided in your FOA response
		Implementation Managers	10
		Technical Software Support staff	10
		Trainers	10
		Students Professional Backgrounds		Note: This is the number for all the students in the consortium
		Information Technology	20
		Health related profession	30

---

Sheet 8: CCC Milestones

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Legend

Data entry field

CCC/CC Milestones

Reference field

Calculated field

Baseline version (last approved milestone baseline)

Baseline document name

Date

Northern Virginia Community College

4/14/10

enter document name here

mm/dd/yy

CCC starting month

April-10

Note: this date drives baseline months

Month 2010

Student Enrollment

Measures

April

May

June

July

August

September

October

November

December

January

February

March

Total

Milestone baseline

M1: Number of students enrolled in the program

40

45

85

M2: Number of students graduating from programs

-

M3: Training in how many workforce roles

-

Employment and Earnings

Measures

Q 1

Q2

Q3

Q4

Milestone baseline

M1: Employment rate - percent of students employed in first quarter after exit from program

M2: Employment retention - percent of students still employed in second and third quarter

M3: Average earnings

---

Sheet 9: Org chart

Jump to Front Page

Legend

Data entry field

Reference field

Calculated field

CCC relationships with sub-recipients, partners, and stakeholders

Please modify the diagram as appropriate to show how your CCC connects with other stakeholders and partners

CCC Staff organization chart

Please modify the diagram as appropriate to show the organization of your CCC and its Sub-Recipients

This should include only staff for organizations that will receive funding through the CCC

---

Sheet 10: Staff

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Legend		Staff list
Data entry field		CCC/CC functional role	Organization	Name	Title	Newly Hired? (Y/N)	Phone number	Email
Reference field		Authorized Representative
Calculated field		Project Director
		Finance Lead
		Education and Outreach Coordinator
		Curriculum Specialist
		Training, Retention & Placement Manager
		Faculty
		Faculty
		Faculty
		Other (please specify)
		Other (please specify)
		Role as defined in FOA		First name last name	Position title	Y or N	e.g., xxx-xxx-xxxx
						Y
						N

---

Sheet 11: Sub-Recipients

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Legend		Sub-recipient list
Data entry field		Sub Recipient Name	Description of Role in CCC	DUNS number	Street Address	City	State	Congressional District	Amount of Award	Amount of Award Distributioned	Sub Award Date
Reference field
Calculated field

---

Sheet 12: Stakeholders

Jump to Front Page
Legend
Data entry field
Reference field
Calculated field
		Stakeholders
		Organization type	Organization name	Contact Name	Phone	Email	Role	Level of Stakeholder Support (levels below)	Affliated National Organization
		Information Technology Employers
		Health Care Employers
		National Association of State Directors of Career Technical Education Consortium
		Regional Extension Centers
		Federally Qualified Health Centers
		Rural Health Centers
		Other Community Health Centers
		State/Local/Tribal Government (Public health, health care, or other partnering institution)
		State Health Information Exchange Coordinator
		State Medicaid Director
		Health Plans
		Hospital Systems
		Public Hospital
		Critical Access Hospitals
		Laboratories
		Local workforce programs
		Medicare Quality Improvement Organizations
		Federal Stakeholders (HHS regional office, VA, IHS, etc.)
		Other (please specify)
		Other (please specify)
		Other (please specify)
		Other (please specify)
		Other (please specify)
		Other (please specify)
								Level 1 – Stakeholder is involved with REC
								Level 2 – Stakeholder intends to make financial contribution to REC
								Level 3 – Stakeholders has committed Senior Level Executive(s) and/or Board Members to REC
								Level 4 – Stakeholders has committed Senior Level Executive(s) and/or Board Members to REC -and- intends to make financial contribution to REC

---

Sheet 13: Consortium Key activities

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Legend
Data entry field
Reference field		Consortium Key activities
Calculated field		Insert rows as necessary below
		Service area	Description of each activity	Goal of each activity	Outcome
		Outreach/Collaboration				General description of the approach to this domain of activities
		Develop Outreach Communication plan	Set plan for CCC to communicate with associations and organization affiliated with healthcare industry to identify students and faculty for new program	To insure transparency among all healthcare and IT stakeholders and partners of new program and needs	Get support from organizations/ associations to help local MCC with student recruitment and hiring of faculty	Short description of each activity and the goal for the activity
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Consortia Committee Participation/Coordination
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Education Materials/Curriculum
		Develop process for approving existing CC curriculum
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Dissemination of Nationally Developed Materials
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Support for faculty recruitment/CC organization support
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Progress Reporting and Program Evaluation
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Other
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Other
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Other
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)

---

Sheet 14: Member CC Key activities

Jump to Front Page
Legend
Data entry field
Reference field		Member Community College Key activities
Calculated field		Insert rows as necessary below
		Service area	Description of each activity	Goal of each activity	Dates/Outcomes	Challenges Requiring Support and/or Assistance
		Identify Faculty					General description of the approach to this domain of activities
		activity 1 (please specify)					Short description of each activity and the goal for the activity
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Partnerships
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Student Recruitment
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Establish Program Elements
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Career Placement
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Progress Reporting and Program Evaluation
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Certification
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Participation In Consortium Activites
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Collaboration with ONC Programs
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Other
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)
		Other
		activity 1 (please specify)
		activity 2 (please specify)
		activity 3 (please specify)
		activity 4 (please specify)
		activity 5 (please specify)

---

Sheet 15: Gantt chart

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Legend

Gantt chart

Data entry field

Please type a "1" in the cell indicating activity/month as per your plan

Reference field

Insert rows as necessary below

Calculated field

Service area

Apr-2010

May-2010

Jun-2010

Jul-2010

Aug-2010

Sep-2010

Oct-2010

Nov-2010

Dec-2010

Jan-2011

Feb-2011

Mar-2011

Apr-2011

May-2011

Jun-2011

Jul-2011

Aug-2011

Sep-2011

Oct-2011

Nov-2011

Dec-2011

Jan-2012

Feb-2012

Mar-2012

Outreach/Collaboration

Develop Outreach Communication plan

1

1

activity 2 (please specify)

activity 3 (please specify)

activity 4 (please specify)

activity 5 (please specify)

Consortia Committee Participation/Coordination

activity 1 (please specify)

activity 2 (please specify)

activity 3 (please specify)

activity 4 (please specify)

activity 5 (please specify)

Review of Education Materials

activity 1 (please specify)

activity 2 (please specify)

activity 3 (please specify)

activity 4 (please specify)

activity 5 (please specify)

Dissemination of Nationally Developed Materials

activity 1 (please specify)

activity 2 (please specify)

activity 3 (please specify)

activity 4 (please specify)

activity 5 (please specify)

Admission Process

activity 1 (please specify)

activity 2 (please specify)

activity 3 (please specify)

activity 4 (please specify)

activity 5 (please specify)

Admission Process

activity 1 (please specify)

activity 2 (please specify)

activity 3 (please specify)

activity 4 (please specify)

activity 5 (please specify)

Progress Reporting and Program Evaluation

activity 1 (please specify)

activity 2 (please specify)

activity 3 (please specify)

activity 4 (please specify)

activity 5 (please specify)

Designated Faculty

activity 1 (please specify)

activity 2 (please specify)

activity 3 (please specify)

activity 4 (please specify)

activity 5 (please specify)

Other

activity 1 (please specify)

activity 2 (please specify)

activity 3 (please specify)

activity 4 (please specify)

activity 5 (please specify)

Other

activity 1 (please specify)

activity 2 (please specify)

activity 3 (please specify)

activity 4 (please specify)

activity 5 (please specify)

---

Sheet 16: Risk mitigation

Jump to Front Page		better risk examples
Legend		Key risks and mitigation steps
Data entry field		Insert rows as necessary below; please indicate "none" as applicable; double-click on cell to see entire cell
Reference field		Category	Detailed description	Risk/restriction mitigation steps	Risk Likelihood [1=least likely, 10=most likely]	Risk Impact [1=least impact, 10=most impact]
Calculated field		Grant restrictions
		Operation Plans from MCC	Wil not receive operation plans from MCC in time to lift grant restriction	Work with MCC to complete the operation plan in time	7	10
		restriction 2 (please specify)
		restriction 3 (please specify)
		Outreach/Collaboration
		risk 1 (please specify)
		risk 2 (please specify)
		risk 3 (please specify)
		Consortium Committee Participation and Coordination
		risk 1 (please specify)
		risk 2 (please specify)
		risk 3 (please specify)
		Avaliabity Education Materials/Curriculum
		risk 1 (please specify)
		risk 2 (please specify)
		risk 3 (please specify)
		Organization
		risk 1 (please specify)
		risk 2 (please specify)
		risk 3 (please specify)
		Sustainability
		risk 1 (please specify)
		risk 2 (please specify)
		risk 3 (please specify)
		Other (please specify)
		risk 1 (please specify)
		risk 2 (please specify)
		risk 3 (please specify)
		Other (please specify)
		risk 1 (please specify)
		risk 2 (please specify)
		risk 3 (please specify)