Form 1 ECSH Data Indicators for OMB-approval. The ECSH Data Ind

ECSH Data Indicators

The purpose of these data indicators is to help the Office of Refugee Resettlement (ORR) assess the progress of the Ethnic Community Self-Help (ECSH) Program in terms of the Program’s three main objectives. ¹

Please report on the following ECSH Data Indicators for activities conducted during the past six-months of the budget period. Instructions are included underneath each item. This report follows the semi-annual reporting deadlines of April 30^th and October 30^th. This information is requested in addition to the Performance Progress Report (SF-PPR).

1. Recipient Organization

2. Federal Grant Number

Enter name of the grantee organization.

Enter grant/award number contained in the award document.

3. Reporting Period End Date

Enter ending date of the reporting period. The following period and dates shall be used: 3/31 and 9/29.

4. Number of New Enrollments this Reporting Period

Enter the number of refugees (and other populations eligible for ORR services) enrolled into the ECSH Program for the first time during this reporting period.

5. Number of Refugees Served

Enter the total number of refugees (and other populations eligible for ORR services) served during this reporting period.

6. Number of Clients Served According to Status

Refugee
Asylee
Other status eligible for ORR services

Enter the number of clients served according to status during this reporting period.

7. Types of Services Provided

Navigation services	English language training
Cultural/community orientation	Employability services
Health-related services	Academic enrichment/college preparation
Home management services	Emotional wellness services
Transportation	Referral services
Translation and interpretation services	Citizenship preparation/civic engagement
Case management services

Check all boxes that apply to the services provided during this reporting period.

7a. Other Services Provided

List other types of services provided during this reporting period that are not included in item 7 above.

8. Number of Clients Who Completed Services

Enter the total number of clients who completed services

during this reporting period.

OMB Approval Number: 0970-XXXX
Expiration Date: XX/XX/XXXX

9. Number of New Partnerships Developed

Enter the number of new partnerships developed through the program during this reporting period.

10. Ways that New Partnerships Strengthened Organizational Development

Partner	How the partnership has strengthened organizational development

Enter the name of the partner in the left column. In the right column, enter how the partnership has strengthened the organization’s development during this reporting period. This could include strengthening referral mechanisms, staff capacity building, increasing the ability to provide a broader range of services, etc.

11. Types of Training Provided to Staff

Case management	Cultural orientation provision
Case documentation	Public benefits
Interpretation	Health services and systems
Cultural sensitivity and awareness	Non-profit management
Self-care	Board development

Check all boxes that apply to the training provided to, or attended by, staff and other members of the organization, such as the Board of Directors, during this reporting period.

11a. Other Training Provided to Staff

List other types of training provided to, or attended by, staff and other members of the organization, such as the Board of Directors, during this reporting period that are not included in item 11 above.

12. Types of Community Engagement Activities Conducted

OMB Approval Number: 0970-XXXX
Expiration Date: XX/XX/XXXX

List the types of community engagement activities conducted for refugee AND receiving communities, as applicable, during this reporting period. These activities could include informational workshops, refugee community meetings, community-wide service projects, etc.

THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13)

Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information.

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.

OMB Approval Number: 0970-XXXX
Expiration Date: XX/XX/XXXX

1 ECSH Data Indicators and ECSH Program objectives are referred to in Funding Opportunity HHS-2016-ACF-ORR-1129 in Section I. Program Description.

2