[Recipient Name]

Recovery Plan

State and Local Fiscal Recovery

Funds
202x Report

Note: The Recovery Plan Performance Report will provide the public and Treasury information on the
projects that recipients are undertaking with program funding and how they are planning to ensure
program outcomes are achieved in an effective, efficient, and equitable manner. While this template
includes the minimum requirements for the Recovery Plan, each recipient is encouraged to add
information to the plan that they feel is appropriate to provide information to their constituents on efforts
they are taking to respond to the pandemic and promote an equitable economic recovery.

Each jurisdiction may determine the general form and content of the Recovery Plan, as long as it
meets the reporting requirements, and recipients are encouraged to tailor this template to best meet
their needs. Use of infographics, tables, charts, pictures, case studies, and other explanatory elements
are encouraged.
 Notes on using this template
All States and territories, and metropolitan cities and counties with a population that exceeds 250,000
residents that are recipients of State and Local Fiscal Recovery Funds (SLFRF) awards are required to
produce a Recovery Plan Performance Report (the “Recovery Plan”). The Recovery Plan provides
information on the recipient’s projects and how they plan to ensure program outcomes are achieved in an
effective and equitable manner. It will include key performance indicators identified by the recipient and
some mandatory indicators identified by Treasury. Each annual Recovery Plan must be posted on the
public-facing website of the recipient by or on the same date that the recipient submits the report to
Treasury.

The initial Recovery Plan will cover the period from the date of award to July 31, 2021 and must be
submitted to Treasury by August 31, 2021. Thereafter, the Recovery Plan will cover a 12-month period
and recipients will be required to submit the report to Treasury within 30 days after the end of the 12-
month period (by July 31).
Annual Report Period Covered Due Date
1 Award Date – July 31, 2021 August 31, 2021
2 July 1, 2021 – June 30, 2022 July 31, 2022
3 July 1, 2022 – June 30, 2023 July 31, 2023
4 July 1, 2023 – June 30, 2024 July 31, 2024
5 July 1, 2024 – June 30, 2025 July 31, 2025
6 July 1, 2025 – June 30, 2026 July 31, 2026
7 July 1, 2026 – December 31, 2026 March 31, 2027

Instructions:

This document is meant as a suggested template for applicable SLFRF recipients to assist them in
submitting their Recovery Plan. Recipients should consult the SLFRF Guidance on Recipient Compliance
and Reporting Responsibilities (Reporting Guidance) located at
https://home.treasury.gov/system/files/136/SLFRF-Compliance-and-Reporting-Guidance.pdf for detailed
guidance on the submission of this report.

Treasury encourages Recipients to tailor this report to best meet their needs in terms of format and
content. Treasury recommends the use of infographics, tables, charts, pictures, case studies, and other
explanatory elements in describing their programs.

Text in italics represents the requirements from the Reporting Guidance and is meant to serve as a
reference as recipients prepare their Recovery Plan. This instructions page and the text in italics should
be removed before the final transmitted report is published and submitted to Treasury.

Additional information around Expenditure Categories is located in Appendix 1 of the Reporting Guidance.

For More Information

More information about the State and Local Fiscal Recovery Fund program and associated reporting
requirements are located at www.treasury.gov/SLFRP .

Questions on reporting, eligible uses, or other general topics should be directed to [email protected].

[Recipient’s Name] 202x Recovery Plan Performance Report 1

 [Recipient’s Name}
202x Recovery Plan

Table of Contents

General Overview 3
Executive Summary 3
Uses of Funds 3
Promoting Equitable Outcomes 4
Community Engagement 5
Labor Practices 5
Use of Evidence 5
Table of Expenses by Expenditure Category 6

Project Inventory 8
Example Project 9
Additional Projects 9

Ineligible Activities: Tax Offset Provision 10

[Recipient’s Name] 202x Recovery Plan Performance Report 2

GENERAL OVERVIEW

Executive Summary
In this section, provide a high-level overview of the jurisdiction’s intended and actual uses of
funding including, but not limited to: the jurisdiction’s plan for use of funds to promote a
response to the pandemic and economic recovery, key outcome goals, progress to date on
those outcomes, and any noteworthy challenges or opportunities identified during the reporting
period. See Section C(1) on page 24 of the Reporting Guidance for additional information.

Uses of Funds
Describe in further detail your jurisdiction’s intended and actual uses of the funds, such as how
your jurisdiction’s approach would help support a strong and equitable recovery from the
COVID-19 pandemic and economic downturn. Describe any strategies employed to maximize
programmatic impact and effective, efficient, and equitable outcomes. Given the broad eligible
uses of funds and the specific needs of the jurisdiction, explain how the funds would support the
communities, populations, or individuals in your jurisdiction. Address how you are promoting
each of the following Expenditure Categories, to the extent they apply:
a. Public Health (EC 1)
b. Negative Economic Impacts (EC 2)
c. Services to Disproportionately Impacted Communities (EC 3)
d. Premium Pay (EC 4)
e. Water, sewer, and broadband infrastructure (EC 5)
f. Revenue Replacement EC 6)

Where appropriate, include information on your jurisdiction’s use (or planned use) of other
federal recovery funds including other programs under the American Rescue Plan such as
Emergency Rental Assistance, Housing Assistance, and so forth, to provide broader context on
the overall approach for pandemic recovery.
See Section C(2) on page 24 of the Reporting Guidance for additional information.

[Recipient’s Name] 202x Recovery Plan Performance Report 3

Promoting equitable outcomes
In this section, describe efforts to date and intended outcomes to promote equity. Each annual
report to follow must provide an update, using qualitative and quantitative data, on how the
recipients’ approach achieved or promoted equitable outcomes or progressed against equity
goals during the performance period.

Describe efforts to promote equitable outcomes, including how programs were designed with
equity in mind. Include how your jurisdiction will consider and measure equity at the various
stages of the program, including:

a. Goals: Are there particular historically underserved, marginalized, or adversely affected

groups that you intend to serve?
b. Awareness: How equal and practical is the ability for residents or businesses to become
aware of the services funded by the SLFRF?
c. Access and Distribution: Are there differences in levels of access to benefits and services
across groups? Are there administrative requirements that result in disparities in ability to
complete applications or meet eligibility criteria?
d. Outcomes: Are intended outcomes focused on closing gaps, reaching universal levels of
service, or disaggregating progress by race, ethnicity, and other equity dimensions where
relevant for the policy objective?

Describe how your jurisdiction’s planned or current use of funds prioritizes economic and
racial equity as a goal, names specific targets intended to produce meaningful equity results
at scale, and articulates the strategies to achieve those targets. Explain how your
jurisdiction’s overall equity strategy translates into the specific services or programs offered
by your jurisdiction in the following Expenditure Categories:

a. Negative Economic Impacts (EC 2): assistance to households, small businesses,

and non-profits to address impacts of the pandemic, which have been most severe
among low-income populations. This includes assistance with food, housing, and
other needs; employment programs for people with barriers to employment who
faced negative economic impacts from the pandemic (such as residents of low-
income neighborhoods, minorities, disconnected youth, the unemployed, formerly
incarcerated people, veterans, and people with disabilities); and other strategies that
provide disadvantaged groups with access to education, jobs, and opportunity.
b. Services to Disproportionately Impacted Communities (EC 3): services to address
health disparities and the social determinants of health, build stronger
neighborhoods and communities (e.g., affordable housing), address educational
disparities (e.g., evidence-based tutoring, community schools, and academic, social-
emotional, and mental health supports for high poverty schools), and promote
healthy childhood environments (e.g., home visiting, child care).

Describe your jurisdiction’s efforts to date and intended outcomes to promote equity using
qualitative and quantitative data on how the jurisdiction’s approach achieved or promoted
equitable outcomes or progressed against equity goals. Describe any constraints or
challenges that impacted project success in terms of increasing equity.

[Recipient’s Name] 202x Recovery Plan Performance Report 4

 Describe the geographic and demographic distribution of funding, including whether it is
targeted toward traditionally marginalized communities.

See Section C(3) on pages 24 and 25 of the Reporting Guidance for additional information.

Community Engagement
Describe how your jurisdiction’s planned or current use of funds incorporates written, oral, and
other forms of input that capture diverse feedback from constituents, community-based
organizations, and the communities themselves. Where relevant, this description must include
how funds will build the capacity of community organizations to serve people with significant
barriers to services, including people of color, people with low incomes, limited English
proficiency populations, and other traditionally underserved groups.
See Section C(4) on page 25 of the Reporting Guidance for additional information.

Labor Practices
Describe workforce practices on any infrastructure projects being pursued (EC 5). How are
projects using strong labor standards to promote effective and efficient delivery of high-quality
infrastructure projects while also supporting the economic recovery through strong employment
opportunities for workers? For example, report whether any of the following practices are being
utilized: project labor agreements, community benefits agreements, prevailing wage
requirements, and local hiring.
See Section C(5) on page 25 of the Reporting Guidance for additional information.

Use of Evidence
Identify whether SLFRF funds are being used for evidence-based interventions and/or if
projects are being evaluated through rigorous program evaluations that are designed to build
evidence. Specifically, in this section, recipients should describe their overall approach for using
evidence and evaluation, including how a Learning Agenda (either narrowly focused on SLFRF
or broadly focused on the recipient’s broader policy agenda) could support their overarching
evaluation efforts in order to create an evidence-building strategy for their jurisdiction. However,
detailed evidence information for each project should be included in the Project Inventory (see
details in the Project Inventory section below).
See Section C(6) on page 26 of the Reporting Guidance for additional information.

[Recipient’s Name] 202x Recovery Plan Performance Report 5

Table of Expenses by Expenditure Category
In this section, list the amount of funds used in each Expenditure Category. The table should
include cumulative expenses to date within each category, and the additional amount spent
within each category since the last annual Recovery Plan.
Jurisdictions may modify the table as needed by deleting unused rows where they have not
expended any funds or by adding columns to more clearly characterize their program
expenditures over time.
For the initial Recovery Plan, the amounts listed for “Cumulative expenditures to date” and
“Amount spent since last Recovery Plan” will be equal.

Category Cumulative Amount spent

expenditures to since last
date ($) Recovery Plan
1 Expenditure Category: Public Health    
1.1 COVID-19 Vaccination
1.2 COVID-19 Testing
1.3 COVID-19 Contact Tracing
1.4 Prevention in Congregate Settings (Nursing
Homes, Prisons/Jails, Dense Work Sites,
Schools, etc.)
1.5 Personal Protective Equipment
1.6 Medical Expenses (including Alternative Care
Facilities)
1.7 Capital Investments or Physical Plant Changes
to Public Facilities that respond to the COVID-
19 public health emergency
1.8 Other COVID-19 Public Health Expenses
(including Communications, Enforcement,
Isolation/Quarantine)
1.9 Payroll Costs for Public Health, Safety, and
Other Public Sector Staff Responding to
COVID-19
1.10 Mental Health Services
1.11 Substance Use Services
1.12 Other Public Health Services
2 Expenditure Category: Negative Economic    
Impacts
2.1 Household Assistance: Food Programs
2.2 Household Assistance: Rent, Mortgage, and
Utility Aid
2.3 Household Assistance: Cash Transfers
2.4 Household Assistance: Internet Access
Programs
2.5 Household Assistance: Eviction Prevention
2.6 Unemployment Benefits or Cash Assistance to
Unemployed Workers

[Recipient’s Name] 202x Recovery Plan Performance Report 6

 Category Cumulative Amount spent
expenditures to since last
date ($) Recovery Plan
2.7 Job Training Assistance (e.g., Sectoral job-
training, Subsidized Employment, Employment
Supports or Incentives)
2.8 Contributions to UI Trust Funds*
2.9 Small Business Economic Assistance (General)
2.10 Aid to nonprofit organizations
2.11 Aid to Tourism, Travel, or Hospitality
2.12 Aid to Other Impacted Industries
2.13 Other Economic Support
2.14 Rehiring Public Sector Staff
3 Expenditure Category: Services to    
Disproportionately Impacted Communities
3.1 Education Assistance: Early Learning
3.2 Education Assistance: Aid to High-Poverty
Districts
3.3 Education Assistance: Academic Services
3.4 Education Assistance: Social, Emotional, and
Mental Health Services
3.5 Education Assistance: Other
3.6 Healthy Childhood Environments: Child Care
3.7 Healthy Childhood Environments: Home Visiting
3.8 Healthy Childhood Environments: Services to
Foster Youth or Families Involved in Child
Welfare System
3.9. Healthy Childhood Environments: Other
3.10 Housing Support: Affordable Housing
3.11 Housing Support: Services for Unhoused
persons
3.12 Housing Support: Other Housing Assistance
3.13 Social Determinants of Health: Other
3.14 Social Determinants of Health: Community
Health Workers or Benefits Navigators
3.15 Social Determinants of Health: Lead
Remediation
3.16 Social Determinants of Health: Community
Violence Interventions
4 Expenditure Category: Premium Pay    
4.1 Public Sector Employees
4.2 Private Sector: Grants to other employers
5 Expenditure Category: Infrastructure    
5.1 Clean Water: Centralized wastewater treatment
5.2 Clean Water: Centralized wastewater collection
and conveyance

[Recipient’s Name] 202x Recovery Plan Performance Report 7

 Category Cumulative Amount spent
expenditures to since last
date ($) Recovery Plan
5.3 Clean Water: Decentralized wastewater
5.4 Clean Water: Combined sewer overflows
5.5 Clean Water: Other sewer infrastructure
5.6 Clean Water: Stormwater
5.7 Clean Water: Energy conservation
5.8 Clean Water: Water conservation
5.9 Clean Water: Nonpoint source
5.10 Drinking water: Treatment
5.11 Drinking water: Transmission & distribution
5.12 Drinking water: Transmission & distribution:
lead remediation
5.13 Drinking water: Source
5.14 Drinking water: Storage
5.15 Drinking water: Other water infrastructure
5.16 Broadband: “Last Mile” projects
5.17 Broadband: Other projects
6 Expenditure Category: Revenue Replacement    
6.1 Provision of Government Services
7 Administrative and Other    
7.1 Administrative Expenses
7.2 Evaluation and data analysis
7.3 Transfers to Other Units of Government
7.4 Transfers to Nonentitlement Units
(States and Territories only)

See Section C(7) on page 27 of the Reporting Guidance for additional information.

Project Inventory
In this section, jurisdictions should provide a description of each project undertaken. See
Section C(8) on page 27 of the Reporting Guidance for additional information. Below is an
example of how to present the information noted in the Reporting Guidance, which incorporates
project details as well as evidence and performance measure information outlined in the
relevant sections above. This information should be replicated for all of the jurisdiction’s
projects.

Example Project
Project [Identification Number]: [Project Name]
Funding amount: [Funding amount]
Project Expenditure Category: [Category number, Category Name]

[Recipient’s Name] 202x Recovery Plan Performance Report 8

 Project overview
 A description of the project that includes an overview of the main activities of the project,
the approximate timeline, primary delivery mechanisms and partners, if applicable, and
intended outcomes.
 Link to the website of the project if available
 How project contributes to addressing climate change (for infrastructure projects under
EC 5)
Use of Evidence
 Briefly describe the goals of the project, and whether SLFRF funds are being used for
evidence-based interventions, the evidence base for the interventions, and/or if projects
are being evaluated through rigorous program evaluations that are designed to build
evidence. If a recipient is conducting a program evaluation in lieu of reporting the
amount of spending on evidence-based interventions, they must describe the evaluation
design (see Reporting Guidance for additional details that should be included).
 Identify the dollar amount of the total project spending that is allocated towards
evidence-based interventions for each project in the Public Health (EC 1), Negative
Economic Impacts (EC 2), and Services to Disproportionately Impacted Communities
(EC 3) Expenditure Categories.

See Section C(6) on page 26 of the Reporting Guidance for additional information.

Additional Projects
Project [Identification Number]: [Project Name]
Funding amount: [Funding amount]
Project Expenditure Category: [Category number, Category Name]

Performance Report

 For the Project Inventories in Section 8, include key performance indicators for your
jurisdiction’s major SLFRF funded projects. Report key performance indicators for each
project, or group projects with substantially similar goals and the same outcome
measures. Jurisdictions may choose to include some indicators for each individual
project as well as crosscutting indicators. Include both output and outcome measures.
See Section C(9) on page 27 of the Reporting Guidance for additional information.
 In addition, you must include the mandatory performance indicators if your jurisdiction
has projects in the relevant areas (this information may be included in each recipient’s
Recovery Plan as they determine most appropriate). Provide data disaggregated by
race, ethnicity, gender, income, and other relevant factors, if possible. Data should be
presented in a table and each annual report should include updated data for the
performance period as well as prior period data.
a. Household Assistance (EC 2.2 & 2.5) and Housing Support (EC 3.10-3.12):

[Recipient’s Name] 202x Recovery Plan Performance Report 9

 Number of people or households receiving eviction prevention services
(including legal representation)
 Number of affordable housing units preserved or developed
b. Negative Economic Impacts (EC 2):
 Number of workers enrolled in sectoral job training programs
 Number of workers completing sectoral job training programs
 Number of people participating in summer youth employment programs
c. Education Assistance (EC 3.1-3.5):
 Number of students participating in evidence-based tutoring programs
d. Healthy Childhood Environments (EC 3.6-3.9):
 Number of children served by childcare and early learning (pre-school/pre-
K/ages 3- 5)
 Number of families served by home visiting
See Section C(10) on page 27 of the Reporting Guidance for additional information.

Ineligible Activities: Tax Offset Provision (States and territories only)

For the initial reporting year, States and territories will report the following items related to the
Tax Offset Provision 31 CFR 35.8. Baseline revenue or revenue-increasing covered charges
are not required at this time.

Item Amount
a. Revenue-reducing Covered Changes $

See Section C(11) on page 28 of the Reporting Guidance for additional information.
Additional guidance will be forthcoming for reporting requirements regarding the tax offset
provision.

[Recipient’s Name] 202x Recovery Plan Performance Report 10