XXXX
Program Sustainability Plan
Template
2011
Prepared by the Center for Training and Research Translation
UNC Center for Health Promotion and Disease Prevention (SIP 4-09 Cooperative Agreement Number U48-DP001944)
XXXXX Sustainability Plan Template
Acknowledgements
{Thank everyone involved in developing the plan.}
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XXXXX Sustainability Plan Template
Sustainability Plan Template and Instructions
Program Summary
I. ............................................................................................................................4
Overview of the Sustainability Planning Process.............................................................................4
II. Key Elements for Sustainability........................................................................5
III. Action Plans for Priority Domains...................................................................7
Priority Domain #1...........................................................................................................................7
Priority Domain #2.........................................................................................................................10
Priority Domain #3.........................................................................................................................13
IV. Sustainability Plan Follow-up.. .......16
V. Appendicies
Sustainability Framework (Appendix A)
Select Section Examples (Appendix B)
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XXXXX Sustainability Plan Template
I. Program Summary
INSTRUCTIONS: Describe the program and the efforts you intend to sustain. Limit to three pages. The Program
Summary should include:
A brief overview of your program
Overall program goals
Groups responsible for implementing program components
Resources devoted to program implementation (e.g., partners, sources of funding)
Efforts you plan to continue revise and continue or ask another organization to take on.
II. Overview of the Sustainability Planning Process
INSTRUCTIONS: Include a brief description of the process you followed to create the program sustainability
plan. Consider the results of your sustainability assessment profile. What actions did you take, who was involved
in the process, what informed your decisions, etc
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XXXXX Sustainability Plan Template
III. Key Elements for Sustainability
INSTRUCTIONS: Describe the current status of each of the eight sustainability domains.
Refer to the sustainability framework, your sustainability assessment results, and discussions with your
planning group.
Highlight areas of strength and areas in need of improvement.
Text
Political Support Text
Text
Text
Text
Funding Stability Text
Text
Text
Text
Text
Partnerships Text
Text
Text
Organizational Capacity Text
Text
Text
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XXXXX Sustainability Plan Template
Text
Program Evaluation Text
Text
Text
Text
Program Adaptation Text
Text
Text
Text
Text
Communications Text
Text
Text
Strategic Planning Text
Text
Text
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IV. Acton Plans for Priority Domains
INSTRUCTIONS: Choose 2-3 priority domains to work on. Complete sections A-D for the priority
domains you have decided to focus on.
Priority Domain #1: [Insert domain name]
A. Rationale
INSTRUCTIONS: In a brief narrative, describe why this is a priority domain. List the areas you
are focusing on for this domain, including the specific indicators from the framework and the
major goal you want to achieve. (Note: if your needs for this domain do not correspond to the
indicators listed in the framework for this domain, that is ok.)
B. Action Steps
INSTRUCTIONS: Complete the chart below including action steps, the person/group responsible
and the timeframe for completing the step. Be specific and realistic.
SAMPLE: See Appendix B
Action Steps Responsibility Timeframe
(How will you get to where you want to be?) (Who will make it happen?) (When will it happen?)
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C. Resources
INSTRUCTIONS: Describe the resources needed to carry out the action steps described above.
What information do you need to successfully execute the action steps?
What, if any, costs will be involved?
What resources or assistance do you need?
D. Progress Monitoring
INSTRUCTIONS: Use the chart below to document your accomplishments and what helped you
accomplish the action steps for Priority Domain 1.
What helped you
Action Steps Accomplished Date accomplish this action?
{Specific action completed} Month/Year {List 2-4 contributors}
{Specific action completed} Month/Year {List 2-4 contributors}
{Specific action completed} Month/Year {List 2-4 contributors}
{Specific action completed} Month/Year {List 2-4 contributors}
{Specific action completed} Month/Year {List 2-4 contributors}
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XXXXX Sustainability Plan Template
INSTRUCTIONS: Denote the challenges you faced working in Priority Domain 1 in the space
below. Include the action steps you have yet to accomplish and what hindered your progress.
Consider which actions steps you will revise or delete and indicate how you plan to move forward
in this domain.
SAMPLE: See Appendix B
Challenges:
Plans to move forward:
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Priority Domain #2: [Insert domain name]
A. Rationale
INSTRUCTIONS: In a brief narrative, describe why this is a priority domain. List the areas you
are focusing on for this domain, including the specific indicators from the framework and the
major goal you want to achieve. (Note: if your needs for this domain do not correspond to the
indicators listed in the framework for this domain, that is ok.)
B. Action Steps
INSTRUCTIONS: Complete the chart below including action steps, the person/group responsible
and the timeframe for completing the step. Be specific and realistic.
Action Steps Responsibility Timeframe
(How will you get to where you want to be?) (Who will make it happen?) (When will it happen?)
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C. Resources
INSTRUCTIONS: Describe the resources needed to carry out the action steps described above.
What information do you need to successfully execute the action steps?
What, if any, costs will be involved?
What resources or assistance do you need?
D. Progress Monitoring
INSTRUCTIONS: Use the chart below to document your accomplishments and what helped you
accomplish the action steps for Priority Domain 2.
What helped you
Action Steps Accomplished Date accomplish this action?
{Specific action completed} Month/Year {List 2-4 contributors}
{Specific action completed} Month/Year {List 2-4 contributors}
{Specific action completed} Month/Year {List 2-4 contributors}
{Specific action completed} Month/Year {List 2-4 contributors}
{Specific action completed} Month/Year {List 2-4 contributors}
INSTRUCTIONS: Denote the challenges you faced working in Priority Domain 2 in the space
below. Include the action steps you have yet to accomplish and what hindered your progress.
Consider which actions steps you will revise or delete and indicate how you plan to move forward
in this domain.
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Challenges:
Plans to move forward:
Priority Domain #3: [Insert domain name]
A. Rationale
INSTRUCTIONS: In a brief narrative, describe why this is a priority domain. List the areas you
are focusing on for this domain, including the specific indicators from the framework and the
major goal you want to achieve. (Note: if your needs for this domain do not correspond to the
indicators listed in the framework for this domain, that is ok.)
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B. Action Steps
INSTRUCTIONS: Complete the chart below including action steps, the person/group responsible
and the timeframe for completing the step. Be specific and realistic.
Action Steps Responsibility Timeframe
(How will you get to where you want to be?) (Who will make it happen?) (When will it happen?)
C. Resources
INSTRUCTIONS: Describe the resources needed to carry out the action steps described above.
What information do you need to successfully execute the action steps?
What, if any, costs will be involved?
What resources or assistance do you need?
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D. Progress Monitoring
INSTRUCTIONS: Use the chart below to document your accomplishments and what helped you
accomplish the action steps for Priority Domain 3.
What helped you
Action Steps Accomplished Date accomplish this action?
{Specific action completed} Month/Year {List 2-4 contributors}
{Specific action completed} Month/Year {List 2-4 contributors}
{Specific action completed} Month/Year {List 2-4 contributors}
{Specific action completed} Month/Year {List 2-4 contributors}
{Specific action completed} Month/Year {List 2-4 contributors}
INSTRUCTIONS: Denote the challenges you faced working in Priority Domain 3 in the space
below. Include the action steps you have yet to accomplish and what hindered your progress.
Consider which actions steps you will revise or delete and indicate how you plan to move forward
in this domain.
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Challenges:
Plans to move forward:
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IV. Sustainability Plan Follow-up
INSTRUCTIONS: In a brief narrative, describe the process you will use to review the action plans
and make modifications.
How do you plan to monitor your progress on sustainability moving forward?
Who is responsible for evaluating and documenting progress?
When will you assess your progress?
When will you set new goals?
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