Wilson-Fish Alternative Program Fiscal Year Recipient Report

OMB Control Number: 0970-0490; Expiration date: 01/31/2020

Wilson-Fish Alternative Program Fiscal Year Recipient Report

Instructions

The Wilson-Fish (WF) Alternative Program Fiscal Year (FY) Recipient Report will categorize the clients served by a WF program within the previous federal FY, by immigration status, arrival year, cash assistance type, and type of WF benefits and services accessed. The Office of Refugee Resettlement (ORR) will use this information collection to (a) compare WF programs’ projected arrivals and funding amounts, (b) better understand each WF program’s client populations and those clients’ use of various WF benefits and services, and (c) compare with the populations and benefits/service use by clients served by ORR’s Cash and Medical Assistance Program (CMA).

Item	Data Element	Instructions
1.	WF Agency/State or County	Enter the name of the WF agency and the state or county in which it administered the Refugee Resettlement Program.
2.	Federal Fiscal Year	Enter the Federal Fiscal Year represented in the report.

Chart A: FY Recipients of WF Assistance and Services by Immigration Status

Item	Data Element	Instructions
1.	Number of FY Arrivals	Enter the actual number of FY ORR-eligible arrivals by immigration status: refugee, Cuban/Haitian entrant, asylees, trafficking victim, or Special Immigrant Visa holders (Iraqis and Afghans only). "Arrival" means arrival to the U.S. or, for non-refugee individuals, the date when the individual became eligible for ORR benefits and services. Note that secondary migrants will not be an unduplicated number. Secondary migrants may possess any status listed above. Therefore, each secondary migrant must be included both in their category by immigration status and in the secondary migrant column. Also note that the numbers in this row should not exceed those in the row for Item #7.
2.	Number of RCA Recipients from FY Arrivals	Enter the number of Refugee Cash Assistance (RCA) recipients from FY arrivals, by immigration status. This number should include Supplement Security Income (SSI)-eligible clients who received RCA while pending SSI approval and Matching Grant (MG) enrollees who accessed RCA upon the conclusion of their participation in the MG program. This number should not include TANF clients who received an RCA differential.
3.	Number of RCA Differential Recipients from FY Arrivals	For programs who offer an RCA differential to TANF-eligible clients: Enter the number of RCA differential recipients from FY arrivals, by immigration status. This number should include MG enrollees who accessed the RCA differential upon the conclusion of their participation in the MG program.
4.	Number of RMA Recipients from FY Arrivals	Enter the number of Refugee Medical Assistance (RMA) recipients (those who accessed insurance, medical screening[s], or both), from FY arrivals, by immigration status. Leave blank if your program does not offer RMA, or if your program’s RMA is funded through Cash and Medical Assistance (CMA) rather than WF funds.
5.	Number of RMA-only Recipients from FY Arrivals	Enter the number of RMA recipients from FY arrivals, who received RMA but not RCA, WF-Intensive Case Management (WF-ICM), or Refugee Social Services (RSS), by immigration status. Note that this will be a sub-set of Item #4. Leave blank if your program does not offer RMA, or if your program’s RMA is funded through CMA rather than WF funds.
6.	Number of RSS-only Recipients from FY Arrivals	Enter the number of RSS recipients from FY arrivals, who received RSS but not RCA, RMA, or WF-ICM, by immigration status. Note: This includes all forms of RSS, not only employment or employability services.
7.	Total Number of Unduplicated WF Recipients from FY Arrivals	Do not enter any numbers in this row. These fields are automatically calculated, adding Items #2, 3, 5, and 6 to capture unduplicated clients accessing RCA, RMA only, and RSS only, by immigration status.
8.	Number of RCA Carryover Recipients	Enter the number of FY RCA recipients who arrived in the previous FY, by immigration status. This number should include SSI-eligible clients who received RCA while pending SSI approval and MG enrollees who accessed RCA upon the conclusion of their participation in the MG program. This number should also include TANF clients who received an RCA differential, as applicable.
9.	Number of RCA Differential Carryover Recipients	For programs who offer an RCA differential to TANF-eligible clients: Enter the number of RCA differential recipients who arrived in the previous FY, by immigration status. This number should include MG enrollees who accessed the RCA differential upon the conclusion of their participation in the MG program.
10.	Number of RMA Carryover Recipients	Enter the number of FY RMA recipients (those who accessed insurance, medical screening[s], or both) who arrived in the previous FY, by immigration status. Leave blank if your program does not offer RMA, or if your program’s RMA is funded through CMA rather than WF funds.
11.	Number of RMA-only Carryover Recipients	Enter the number of FY RMA recipients from previous FY arrivals, who received RMA but not RCA, WF-ICM, or RSS, by immigration status. Note that this will be a sub-set of Item #10. Leave blank if your program does not offer RMA, or if your program’s RMA is funded through CMA rather than WF funds.
12.	Number of RSS-only Carryover Recipients	Enter the number of RSS recipients who arrived in prior years and received FY RSS services but not RCA, RMA, or WF-ICM, by immigration status. Note: This includes all forms of RSS, not only employment or employability services.
13.	Total Number of Unduplicated Carryover Recipients	Do not enter any numbers in this row. These fields are automatically calculated, adding Items #8, 9, 11, and to capture unduplicated carryover clients accessing RCA, RMA only, and RSS only, by immigration status.
14	Total Number of FY Unduplicated WF Recipients	Do not enter any numbers in this row. These fields are automatically calculated, adding Items #7 and 13 to capture unduplicated FY WF recipients, by immigration status.
15.	Total Number of FY RCA and RCA Differential Recipients	Do not enter any numbers in this row. These fields are automatically calculated, adding Items # 2, 3, 8, and 9 to capture total FY RCA and RCA differential recipients, by immigration status.
16.	Total Number of FY RMA Recipients	Do not enter any numbers in this row. These fields are automatically calculated, adding Items #4 and 10 to capture total FY RMA recipients, by immigration status.

Chart B: FY Arrivals by Case Composition Type

Item	Data Element	Instructions
1.	Number of FYArrivals	Enter the number of FY ORR-eligible arrivals (not Recipients) by case composition type, as described in Items 1.a.-1.d. below. "Arrival" means arrival to the U.S. or, for non-refugee individuals, the date when the individual became eligible for ORR benefits and services. This number is not related to the program’s number of actual Recipients of ORR-funded benefits and/or services.
1.a.	RCA Type	Enter the number of FY ORR-eligible arrivals (not Recipients) eligible for RCA in the state/county in which the WF program operates. This is assessed by case composition; this number is not related to the program’s number of actual RCA Recipients.
1.b.	TANF Type	Enter the number of FY ORR-eligible arrivals (not Recipients) eligible for TANF in the state/county in which the WF program operates. This is assessed by case composition; this number is not related to the program’s number of actual TANF Recipients or RCA Differential Recipients.
1.c.	SSI eligible	Enter the number of FY ORR-eligible arrivals (not Recipients) who were presumptively SSI-eligible due to age. This number is not related to the number of clients who received SSI or RCA pending SSI approval.
1.d.	Total	Do not enter a number in this field; it is automatically calculated from Items #1.a, 1.b, and 1.c. Note: The number here should match the number in Chart A, Item #1 (Number of FY Arrivals), Column g. (Total).
2.	Percentage of Total Arrivals	Do not enter any numbers in this row. These fields are automatically calculated.

Chart C: FY Cash Assistance Recipients by Cash Assistance Type

Item	Data Element	Instructions
1.	Number of Recipients from FY Arrivals	This shows the number of FY cash assistance recipients from FY arrivals by their cash assistance type, as described in Items #1.a. through 1.d. below.
1.a.	RCA	Do not enter any numbers in this field. This field is linked to Chart A, Item #2.g.
1.b.	RCA Differential	Do not enter any numbers in this field. This field is linked to Chart A, Item #3.g.
1.c.	SSI	Enter the number of FY SSI recipients who were FY arrivals. This number should include SSI-eligible clients who received RCA while pending SSI approval. As such, this number will be a subset of Item #1.a., above.
1.d.	Former MG Enrollees	Enter the number of FY arrivals who accessed RCA or an RCA differential upon the conclusion of participation in the MG program. This number will duplicate some clients counted in Items #1.a. and 1.b., above.
1.e.	Total	Do not enter a number in this field. This field is automatically calculated, adding Items #1.a. and 1.b. (but excluding Items #1.c. and #1.d.) to capture an unduplicated number of FY arrivals who were RCA and RCA differential recipients.
2.	Number of Recipients from Previous FY Arrivals	This shows the number of FY cash assistance recipients who arrived in the previous FY by their cash assistance type, as described in Items #2.a. through 2.d. below.
2.a.	RCA	Do not enter any numbers in this field. This field is linked to Chart A, Item #8.g.
2.b.	TANF	Do not enter any numbers in this field. This field is linked to Chart A, Item #9.g.
2.c.	SSI	Enter the number of FY SSI recipients who arrived in the previous FY. This number should include SSI-eligible clients who received RCA while pending SSI approval. As such, this will be a subset of Item #2.a. above.
2.d.	Former MG Enrollees	Enter the number of previous FY arrivals who accessed RCA or an RCA differential upon the conclusion of participation in the MG program. This number will duplicate some clients counted in Items #2.a. and 2.b., above.
2.e.	Total	Do not enter a number in this field. This field is automatically calculated, adding Items #2.a. and 2.b. (but excluding Items #2.c. and 2.d.) to capture an unduplicated number of previous FY arrivals who were FY RCA and RCA differential recipients.
3.	Total	Do not enter any numbers in this row. These fields are automatically calculated.

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

Public reporting burden for this collection of information is estimated to average 2 hours 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.

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