Assessment 3 Project Implementation Plan and Logic Model

ORAL HEALTH SERVICE EXPANSION (OHSE)
SAMPLE IMPLEMENTATION PLAN

Outline the activities required to provide new and/or expanded oral health services, including hiring/contracting at least 1.0 FTE new, onsite
licensed dental provider within 120 days of the Notice of Award. The Implementation Plan WILL count against the page limit. Applicants may
choose the focus areas and goals stated below or provide different focus areas and goals based on actions steps necessary for implementation of
the proposed OH project.

Goal
On separate rows, identify the goals for
each focus area. Goals should describe

measureable results.

Key Action Steps
Identify the action steps that

must occur to accomplish each
goal.

Person/Area Responsible
Identify who will be

responsible and
accountable for carrying

out each action step.

Time Frame
Identify the expected

time frames for carrying
out each action step.

Comments
As desired, provide

supplementary
information.

Focus Area: Create Operational Oral Health Site within 120 Days

Goal A1: Convert unutilized storage
space into two dental operatories. 1. Gut storage space 1. Contractor (TBD) 1. 30 days of award

2. Install plumbing and
electrical outlets 2. Contractor (TBD) 2. 60 days of award

3. Finish room (drywall,
cabinets) 3. Contractor (TBD) 3. 90 days of award

Goal A2: Order dental equipment. 1. Action Step 1. Person Responsible 1. Time Frame

2. Action Step 2. Person Responsible 2. Time Frame

Focus Area: Onboard Dental Providers within 120 Days
Goal B1: Create dental provider
recruitment plan. 1. Action Step 1. Person Responsible 1. Time Frame

2. Action Step 2. Person Responsible 2. Time Frame

Goal B2: 1. Action Step 1. Person Responsible 1. Time Frame

2. Action Step 2. Person Responsible 2. Time Frame