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Appendix B: AmeriCorps Seniors Senior 

Companion Program Performance Measure 

Instructions

References and Authorities Definitions, Suggestions regarding Data 

Collection, and Additional Notes

Last Updated: October 2023 

This document explains specific performance measure instructions for the AmeriCorps Seniors Senior 

Companion Program. It contains the menu of available service activities and output and outcome measures, with 

additional information on how to use each of them. This document should be used in tandem with the Notice of 

Funding Opportunity.

Contents

AmeriCorps Seniors SCP Performance Measure Requirements ....................................................................................... 2

Complete List of AmeriCorps Seniors SCP National Performance Measures ................................................................ 3

Focus Area: Healthy Futures .................................................................................................................................................. 3

Other Community Priorities................................................................................................................................................... 3

Healthy Futures Focus Area Focus Area Notes: .................................................................................................................. 4

Other Community Priorities Notes: ...................................................................................................................................... 5

Change Log ............................................................................................................................................................................... 6

Independent Living Performance Measure Survey ............................................................................................................ 7

Respite Performance Measure Survey .................................................................................................................................. 9
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AmeriCorps Seniors Senior Companion Program 

Performance Measure Requirements

Measured in Unduplicated Volunteers*

1. Primary Focus Area: The AmeriCorps Seniors Senior Companion Program Primary Focus Area is 

Healthy Futures, Aging inPlace.

2. Work Plans: All unduplicated AmeriCorps Seniors volunteers or Volunteer Service Years (VSY), which 

is 1 VSY equals 1,044 hours of service, must be placed in the work plan. The maximum cost per 

unduplicated volunteer or VSY in all Performance Measures included in the Work Plan may not exceed 

the allowable cost per volunteer or VSY as stated below.

3. National Performance Measures. Every national performance measure output must be paired with a single 

outcome. For each Performance Measure, applicants must select one output and one of the associated outcomes. 

While beneficiaries may receive benefits associated with more than one available outcome, select only one outcome 

for each beneficiary served. “Other Community Priorities” work plans are not considered national performance 

measures.

4. Other Community Priorities. A work plan consisting of “Other Community Priorities” may be created by the 

grantee to address community activities not captured in national performance measures.

5. Unduplicated Volunteers. Count Volunteer Service Years (VSY), which is calculated by taking the total hours of 

services spent on each performance measure divided by 1044 hours. To complete the Performance Measures module, 

stipended programs must enter volunteer service years into the number of unduplicated volunteer section of the work 

plans.

• Example: $90,000 of federal funding has a minimum of 10 VSYs equals 10,440 hours of service 

(10 multiplied by 1,044).

6. Maximum Cost per Unduplicated Volunteer in Outcome Assignments. For every $9,000 in base federal 

funding, at least one AmeriCorps Seniors VSY * must be placed in the work plan that result in national 

performance measure outcomes in the Education focus area.

• Example: $90,000 of federal funding divided by $9,000 equals minimum of 10 VSYs placed into 

unduplicated volunteer outcome assignment.

7. Rounding Unduplicated Volunteers in Outcome Assignments. Common arithmetic rules should be used to 

determine how to round unduplicated volunteers in outcome-based work plans. Grantees should round to the 

nearest whole number. For example, an AmeriCorps Seniors FGP grantee with $98,000 in federal funding would 

require 10.08 unduplicated volunteers in work plans that result in national performance measure 

outcome. Since 10.08 is less than 10.5, this would be rounded down to 10 unduplicated volunteers in 

work plans that result in national performance measure outcomes. 

In contrast, a grantee with $178,000 in federal funding (19.78 volunteers in outcome-based work plans) 

would round up and require 20 unduplicated volunteers in work plans that result in national 

performance measures outcomes.

8. COVID-19 Performance Measure Resources:

i. AmeriCorps Seniors Performance Measures- COVID

ii. AmeriCorps Seniors Pandemic Recovery: A Pathway Forward- Updated March 2021
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Complete List of AmeriCorps Seniors Senior Companion Program National 

Performance Measures

These selection rules specify allowable output/outcome pairings for National Performance Measures. Applicants must 

follow these selection rules when using National Performance Measures. Applicants may not select any National 

Performance Measures that may appear in eGrants if they are not present on this list. Please see the NOFO for 

additional information about application requirements.

Applicants who experience issues finding the appropriate measures in the Performance Measure Module 

of eGrants, should select the category title, “Outcome Work Plans.” For the Other Community Priorities 

measure, applicants should select the “Output Only Work Plans” category. More detailed instructions 

are included in the AmeriCorps Seniors Grant Application Instructions. 

Focus Area: Healthy Futures

Objective Selection Rules Service Activity

Outputs Outcomes

Aging in Place H4A: Number of 

individuals 

served

H9A: Number of individuals who 

report having increased social 

support or improved capacity for 

independent living

H14: Number of caregivers of 

older adults and individuals with

disabilities who reported 

having increased social 

support

• Companionship

• Nutrition/Food Support 

• Legal Services 

Transportation

• Medical Services 

• Opioid/Drug Intervention 

• Elder Justice: Fraud and Scam

Prevention

• Respite Services

Access to Care H4A: Number of 

individuals 

served

H15A: Number of individuals 

with developmental disabilities 

receiving services that promote 

integration and inclusion (for 

legacy programming only)

• Outreach 

• Education/Training 

• Referrals

• Medical Services

• Counseling/Coaching

• Opioid/Drug Intervention

• Disability Inclusion

Other Community Priorities

Objective Selection Rules Service Activity

Outputs Outcomes

Other SC1: Grantee met their

target for community 

priority activity (Yes/No)

None N/A
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Healthy Futures Focus Area Focus Area Notes:

• These performance measures are intended to measure the impact of activities that meet health needs within 

communities including access to care, aging in place, and addressing childhoodobesity.

• These activities must be carried out by National Service Participants or by volunteers directly recruited 

and/or supported by National Service Participants.

• All individuals counted under these measures must be programbeneficiaries, not National Service 

Participants.

 Applicants that select output H4A may select outcome H9A, H14, orH15A.

H4A (output) Number of individuals served

Definition 

of Key 

Terms

Individuals: recipients of AmeriCorps-supported services related to improving healthrelated outcomes

Served: substantive engagement of individuals with a specific health-related goal in mind. 

Cannot consist solely of mass dissemination of information such as email blasts, social media 

posts, or distributing pamphlets.

How to 

Measure/ 

Collect Data

Tracking mechanism that ensures an unduplicated count of individuals who have received 

services

H9A (outcome) Number of individuals who report having increase social support or improved capacity for 

independent living

Definition 

of Key 

Terms

Individuals: those reported in H4A or V1, V7A, V8

How to 

Measure/ 

Collect Data

Survey, interview, caseworker assessment, or other instrument capable of measuring changes 

in social support or perceived social support and/or independent living capacity at the 

individual beneficiary level. When possible, pre-post assessments should be utilized.

AmeriCorps is providing a mandatory survey instrument for the AmeriCorps Seniors 

Senior Companion Program and recommends its use for AmeriCorps Seniors RSVP:

Independent Living Survey.

H14 (outcome) H14: Number of caregivers of older adults and individuals with disabilities who reported 

having increased social support

Definition 

of Key 

Terms

Individuals: those reported in H4A or V1, V7A, V8

Older Adults: Individual age 65 or older

Respite Services: Services that provide temporary relief from the stresses of caregiving by 

providing short term assistance to and adult who is the primary caregiver for another person.

Social ties/perceived social support: Relationships with other people and or the belief that 

these people will offer (or have offered) effective help during times of needs.

How to 

Measure/ 

Collect Data

Programs should collect data for this measure from surveys, interview, caseworker 

assessment, or other instrument capable of measuring changes in food security at the 

individual beneficiary level. When possible, pre-post assessments should be utilized.

CNCS is providing a mandatory survey instrument for both the AmeriCorps Seniors Senior 

Companion Program and recommends its use for AmeriCorps Seniors RSVP: AmeriCorps

Seniors Respite Care Performance Measure Survey.
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H15A (outcome) H15A Number of individuals with developmental disabilities receiving services that 

promote integration and inclusion

NOTE AmeriCorps Seniors applicants may only select this measure if they have historically 

supported programming in this area.

Definition 

of Key 

Terms

Individuals: those reported in H4A

How to 

Measure/ 

Collect Data

Survey, interview, caseworker assessment, or other instrument capable of measuring

changes in social support or perceived social support and/or independent living capacity at 

the individual beneficiary level. When possible, pre-post assessments should be utilized.

Other Community Priorities Notes:

• Community Priority Service Activities ensure that AmeriCorpsSeniorsprograms cancontinue to engage in 

appropriate service activities that may not necessarily lead to national performance measures 

outcomes but do support the intent of the authorizing legislation.

• This work plan is designed to ensure that an activity supported by appropriated funds is represented in the 

grant application while minimizing data collection burden.

• These activities must be carried out by National Service Participants or by volunteers directly recruited 

and/or supported by National Service Participants.

• All individuals counted under these measures must be programbeneficiaries, not National Service 

Participants.

SC1 (output) Yes/ No met all Applicant-Determined Community Priority Service Activity Targets

Definition 

of Key

Terms

Community Priority Service Activity:

1. Service activity conducted by AmeriCorps Seniors volunteers that may not 

necessarily lead to national performance measures but:

a. Provides opportunities for senior service to meet unmet local and state

needs;

b. Empowers people 55 years of age or older to contribute to their communities 

through service, enhance the lives of those who serve and those whom they

serve, and provide communities with valuable services; and

c. Provides opportunities for people 55 years of age or older to share their 

knowledge, experiences, abilities, and skills for the betterment of their 

communities and themselves.

2. Community priority service activities shall not include any prohibitedactivities.

Applicant- Determined Community Priority Service Activity Targets: Target goals for 

Community Priority Service Activity that are identified by the program. Unlike national 

performance measure outputs, these targets are not reported to AmeriCorps. Instead,

grantees will report yes/no that they have achieved the target goals for all their Community 

Priority Service Activities.
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Change Log

This table lists all changes made to this document since September 2018.

Date Change(s)

October 2018 • The Appendix now provides clarification on how grantees should properly round 

unduplicated volunteers in National Performance Measure WorkPlans.

• Minor edits were made to the Other Community Priority notes.

September 2019 • A few cosmetic updates were made to the document

• Instructions on what to select, should performance measure options be missing in 

eGrants were added (pg. 3 ) 

• A link to the Senior Corps Independent Living and Respite CarePerformance 

Measure Surveys were added to measures H9A and H14 (pg. 4)

March 2020 • Update to the cost per VSY threshold from $6,000 to $6,500. Updatedthreshold is 

effective as of April 1, 2020.

October 2020 • Updated branding of CNCS to AmeriCorps, Senior Corps to AmeriCorps 

Seniors and Senior Companion Program volunteers to AmeriCorps Seniors

Volunteers.

September 2021 • Updated Unduplicated volunteer section and added COVID-19 resources. 

• Added Independent Living Survey and Respite Survey. 

October 2023 • Updated Cost Per Volunteer Calculation
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Independent Living Performance Measure Survey

This 1st question is about how many hours of service that you may have 

received in the past 4 weeks from your AmeriCorps Seniors volunteer.

Tell us how many TOTAL HOURS in a typical week you received services. 

Here is an example of how Mrs. Jones would answer question #1:

AHer AmeriCorps Seniors volunteer usually spends one hour on Monday 

with and two hours on Wednesday. Therefore, the total hours a week that 

she receives services is 3 hours a week.

1. In a typical week, my AmeriCorps Seniors volunteer is with 

me for hours

Please turn the page for the questions 2-13

Thank you for taking the time to complete this survey. We would like to 

know how the AmeriCorps Seniors volunteer who has been assisting you 

has affected your life.

All information will be kept confidential; please do not disclose your name. 

You may choose not to answer a question.
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Because I Have a AmeriCorps Seniors volunteer ...

Strongly 

Disagree

Somewhat 

Disagree

Somewhat 

Agree

Strongly 

Agree

2) ... I feel less lonely.

3) ... I feel I have close ties to 

other people.

4) ... I am able to do the things I 

need to do.

5) ... I am able to do most things 

I want to do.

6) ... I am more satisfied with 

my life.

7) ... I can remain living in my 

own home.

8) ... I am able to get to the 

grocery store.

9) ... I am able to get to medical 

appointments.

10) ... I am able to take care of 

other necessary 

errands/appointments.

11) ... I am eating regularly 

scheduled meals. 

12) Overall, I am satisfied with 

my AmeriCorps Seniors 

volunteer.

13) Overall, AmeriCorps 

Seniors Program has met my 

expectations.
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Respite Performance Measure Survey

This 1st question is about how many hours of respite service that you may 

have received in the past 4 weeks from your AmeriCorps Seniors volunteer.

Tell us how many TOTAL HOURS in a typical week you received respite 

services. 

Here is an example of how Mrs. Jones would answer question #1:

Her AmeriCorps Seniors volunteer usually spends one hour on Monday with 

and two hours on Wednesday providing respite services. Therefore, the total 

hours a week that she receives respite services is 3 hours a week.

1. In a typical week, my AmeriCorps Seniors volunteer is with 

me for hours 

of respite

Please turn the page for the questions 2-12

Thank you for taking the time to complete this survey. We would like to 

know how the AmeriCorps Seniors volunteer who has been providing 

respite care you has affected your life (as the caregiver).

All information will be kept confidential; please do not disclose your name. 

You may choose not to answer a question.
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Because I Have a AmeriCorps Seniors volunteer assisting with 

Respite Care ...

Strongly 

Disagree

Somewhat 

Disagree

Somewhat 

Agree

Strongly 

Agree

2) ... I feel less lonely.

3) ... I feel I have close ties to 

other people.

4) ... I am able to do the things I 

need to do.

5) ... I am able to do most things 

I want to do.

6) ... I am more satisfied with 

my life.

7) ... The person I care for is able 

to remain at home.

8) ... I am able to get short-term 

rest and relief.

9) ... I am able to find time to 

run errands.

10) ... I am able find time to 

attend to my personal and

health care needs.

11) Overall, I am satisfied with 

the Caregiver Respite

AmeriCorps Seniors 

volunteer.

12) Overall, AmeriCorps

Seniors program has met my 

expectations.