1st Quarter PHEP 2026-2027 Progress Report

Please Read Completely and Fully Understand These Instructions

1. Complete this progress report for your quarterly PHEP deliverables. Report ONLY on this quarter's progress.

2. Refer to the written guidance (Attachment A) provided to you at the beginning of the grant year for instruction on completing each deliverable. A copy of this guidance is available on the PHEP Deliverables Resource (PDR) webpage. PHEP will inform you of any changes in deliverable requirements during the year. Please contact the subject matter expert for the appropriate section if you have questions.

3. If a field asks for a number, please use the numerical form. Do not use text.

4. Required fields have a red asterisk. These fields must be completed or you will not be able to submit the form.

5. You do not need to complete the form in one session. To save your work and come back to it later, scroll to the bottom and click "Save." If you do not, you will lose your information. DO NOT close your browser without performing this step. The form will display a unique link that will take you to your saved form. You may also choose to have it emailed to you. This link is the ONLY way to retrieve your form.

6. You MUST log in to your saved report with your unique link EVERY 30 DAYS at a minimum to keep it active. Your form will be deleted from the server if you do not and you will have to start over.

7. You will receive an email response to your submission with all of the information you provided. However, we recommend saving the progress report to your computer as a PDF file before submitting it as a backup.

Uploading Documents:

Documents added to the form are not saved when you use the "Save" feature. You must upload required documents for deliverables as the last task before submitting the progress report.
Start file names with your jurisdiction’s name (e.g., Jurisdiction_Q1Budget).
Combine files into one if there is only one upload field. We prefer PDF files, but can accept several types.

Please begin by providing the following information:

Jurisdiction

Please Select

Name

First NameLast Name

Phone

Area CodePhone Number

Email

example@example.com

Confirm Email

example@example.com

DUE EVERY QUARTER

The progress report for these requirements is due 30 days after the end of every quarter of the budget period.

BA1: Budget Line-Item Expenses

Provide the actual dollar amount and supporting documentation for expenses in the listed line-item categories using the Budget Spreadsheet.

Are you submitting your BA1 budget items for Quarter 1 today?

Jurisdictions may submit their budget documentation separately using the Separate Budget Submission Form. Budget documentation is due within 30 days of the end of the quarter.

Upload the completed Budget Spreadsheet (Excel preferred).

Start the file name with the name of your jurisdiction (e.g., BEAVERHEAD_Q1 BUDGET SPREADSHEET)

Upload supporting documentation combined in a single document (PDF preferred).

Start the file name with the name of your jurisdiction (e.g., BEAVERHEAD_Q1 BUDGET SUPPORT DOCS)

BA2: Maintain the Montana Public Health Directory

Maintain and update contact information for all staff listed in the public health directory.

Did you complete BA2?

Indicate which categories needed to be updated for this quarter.

Explain if you have vacancies in the Public Health Directory for any of the following contacts: HAN Primary, HAN Secondary, HAN Tertiary, Preparedness Primary, Preparedness Secondary.

Share an explanation for the incomplete deliverable and any changes your jurisdiction will implement to improve BA2 completion.

BA3: DPHHS HAN Response

Test your DPHHS HAN response once each quarter. For any missed HAN Alert, HAN Advisory, or HAN Update notifications, jurisdictions should complete the HAN Corrective Action Plan prior to submitting their progress report for that quarter.

BA3 Complete?

Did your jurisdiction miss the 24-hour acknowledgement period for any HAN Alert, HAN Advisory, or HAN Update notifications issued this quarter?

Did your jurisdiction complete the HAN Improvement Plan on JotForm for each missed HAN Alert, HAN Advisory, and HAN Update this quarter?

BA4: 24/7 Communication System Implementation

Participate in quarterly testing of the 24/7 notification system initiated by DPHHS.

BA4 Complete?

Did you need to retest the 24/7 notification system following a failed test this quarter?

Please describe the issue that caused the initial 24/7 notification system test failure and any corrective action(s) taken.

Were changes made to your 24/7 protocol?

Please describe the changes that were made to the protocol.

Upload documentation stating that your 24/7 Communications Plan is current. (Required at least one quarter of the year.)

BA5: Reconcile Communicable Disease Cases with DPHHS Staff

Reconcile communicable disease investigations in the Montana Infectious Disease Information System (MIDIS) that were performed in the previous quarter to meet the timeliness and completeness standards set forth by DPHHS and the Administrative Rules of Montana (ARM 37.114.201, 37.114.204, and 37.114.205). Local and tribal health jurisdictions should report diseases as quickly and completely as possible.

BA5 Complete?

BA6: Essential Laboratory Contact Information List

Provide your jurisdiction’s local contact information for effective communication with the MT Laboratory Services Bureau (MTLSB) during a preparedness response event. Access the Contact Information Form FY 2026-2027 from the PDR under Public Health Laboratory Resources.

BA6 Complete?

Upload a copy of the Contact Information Form.

BA7: CBAT Kit Inspection and Inventory

Inspect and inventory the CBAT kit, add new supplies, and reseal it with new evidence tape. More information is available on the CBAT Kit White Page document on the PDR.

BA7 Complete?

Please acknowledge the following:

I certify to the best of my knowledge and belief that the information provided herein is true, complete, and accurate. I am aware that the provision of false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to criminal, civil, or administrative consequences including, but not limited to violations of U.S. Code Title 18, Sections 2, 1001, 1343 and Title 31, Sections 3729-3730 and 3801-3812.”Each such certification must be maintained pursuant to the requirements of § 200.334.