ORR-6 Schedule D

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Overview

RSI
SOR
YM
RHP
ARSI S2S

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Sheet 1: RSI

Schedule D: Refugee Support Services (RSS) Part I - Refugee School Impact (RSI) Set-Aside		ORR-6 OMB Control No. 0970-0036 Expires XX/XX/XXXX
1. Program Name:
2. Reporting Period:		3. Fiscal Year:
4. State/Grantee:		5. Date:
A. Type of the Participant		Total Year-To-Date Unduplicated
1. Eligible Refugee Students (RSI)		0
2. Eligible Refugee Parents (RSI)		0
B. Primary Contracted Service Provider		Total Year-To-Date Unduplicated
1. School (Grade K-5)		0
2. School (Grade 6-8)		0
3. School (Grade 9-12)		0
4. Resettlement Agency		0
5. Other Local Agency (provide type/name of agency)		0
6. Other Local Agency (provide type/name of agency)		0
7. Other Local Agency (provide type/name of agency)		0
C. Completions by Type		Total Year-To-Date Unduplicated
1. Parent/Student Orientation		0
2. Grade Promotion		0
3. Other completion (provide type)		0
4. Other completion (provide type)		0
5. Other completion (provide type)		0
D. TRENDS
1. Analyze and reflect on the data reported in sections A-C. Report overall observations in data trends and explain anomalies in data, including trends based on new program components and/or initiatives..

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Sheet 2: SOR

Schedule D: Refugee Support Services (RSS) Part II - Services to Older Refugees (SOR) Set-Aside		ORR-6 OMB Control No. 0970-0036 Expires XX/XX/XXXX
1. Program Name:
2. Reporting Period:		3. Fiscal Year:
4. State/Grantee:		5. Date:
A. Type of the Participant		Total Year-To-Date Unduplicated
1. Eligible Older Refugees (SOR)		0
B. Primary Contracted Service Provider		Total Year-To-Date Unduplicated
1. Resettlement Agency		0
2. Area Agency on Aging		0
3. Other Local Agency (provide type/name of agency)		0
4. Other Local Agency (provide type/name of agency)		0
5. Other Local Agency (provide type/name of agency)		0
C. Completions by Type		Total Year-To-Date Unduplicated
1. SSI		0
2. Citizenship		0
3. Other completion (provide type)		0
4. Other completion (provide type)		0
5. Other completion (provide type)		0
D. TRENDS
1. Analyze and reflect on the data reported in sections A-C. Report overall observations in data trends and explain anomalies in data, including trends based on new program components and/or initiatives..

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Sheet 3: YM

Schedule D: Refugee Support Services (RSS) Part III - Youth Mentoring (YM) Set-Aside		ORR-6 OMB Control No. 0970-0036 Expires XX/XX/XXXX
1. Program Name:
2. Reporting Period:		3. Fiscal Year:
4. State/Grantee:		5. Date:
A. Type of the Participant		Total Year-To-Date Unduplicated
1. Eligible Youth Mentees (YM)		0
B. Primary Contracted Service Provider		Total Year-To-Date Unduplicated
1. School (Grade 9-12)		0
2. Resettlement Agency		0
3. Other Local Agency (provide type/name of agency)		0
4. Other Local Agency (provide type/name of agency)		0
5. Other Local Agency (provide type/name of agency)		0
C. Completions by Type		Total Year-To-Date Unduplicated
1. Parent/Student Orientation		0
2. Grade Promotion		0
3. Other completion (provide type)		0
4. Other completion (provide type)		0
5. Other completion (provide type)		0
D. TRENDS
1. Analyze and reflect on the data reported in sections A-C. Report overall observations in data trends and explain anomalies in data, including trends based on new program components and/or initiatives..

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Sheet 4: RHP

Schedule D: Refugee Support Services (RSS) Part IV - Refugee Health Promotion (RHP) Set-Aside										ORR-6 OMB Control No. 0970-0036 Expires Expires XX/XX/XXXX
1. Program Name:
2. Reporting Period:									3. Fiscal Year:
4. State/Grantee:									5. Date:
A. Eligible Refugee Health Promotion (RHP) Participants										Total Year-To-Date
1. Total unduplicated number of participants who received RHP services
B. Health Education and Outreach
1. Program includes one or more health education/outreach activity
										Total Year-To-Date
2. Unduplicated number of participants who attended group health education classes
3. Unduplicated number of participants who demonstrated increased knowledge due to attending health education classes
4. Unduplicated number of participants who received individual targeted health outreach services
5. Data explanation (e.g., data discrepancies or anomalies):
C. Health Care Navigation and Support
1. Program includes one or more health care navigation/support activity
										Total Year-To-Date
2. Unduplicated number of participants who received medical navigation/support services
3. Unduplicated number of participants who completed their plan of care due to receiving medical navigation/support services
4. Unduplicated number of participants who received mental health navigation/support services
5. Unduplicated number of participants who completed their plan of care due to receiving mental health navigation/support services
6. Data explanation (e.g., data discrepancies or anomalies):
D. Wellness Groups
1. Program includes one more more wellness groups activity
										Total Year-to-Date
2. Unduplicated number of participants who attended wellness groups
3. Unduplicated number of participants who demonstrated improvement in their well-being due to attending wellness groups
4. Data explanation (e.g., data discrepancies or anomalies):
E. Other Activity (Add a new section for each distinct "other activity.")
1. Program includes an "other activity"
2. Other Activity
a. Activity title
b. Related scope of service
c. Total unduplicated year-to-date number of ORR-eligible participants who engaged in the "other activity"
d. Total unduplicated year-to-date number of service provider participants who engaged in the "other activity"
e. Activity outcomes met year-to-date
f. Data explanation (i.e., "other activity" outcomes, and data discrepancies or anomalies):

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Sheet 5: ARSI S2S

Schedule D: Refugee Support Services (RSS)   Part V - Afghan Refugee School Impact Support to Schools (ARSI S2S) Set-Aside		ORR-6 OMB Control No. 0970-0036 Expires XX/XX/XXXX
1. Program Name:
2. Reporting Period:		3. Fiscal Year:
4. State/Grantee:		5. Date:
A. Type of the Participant		Total Year-To-Date Unduplicated
1. Eligible Refugee Students (ARSI S2S)		0
2. Eligible Refugee Parents (ARSI S2S)		0
B. Primary Contracted Service Provider		Total Year-To-Date Unduplicated
1. School (Grade K-5)		0
2. School (Grade 6-8)		0
3. School (Grade 9-12)		0
C. Completions by Type		Total Year-To-Date Unduplicated
1. Parent/Student Orientation		0
2. Grade Promotion		0
3. Other completion (provide type)		0
4. Other completion (provide type)		0
5. Other completion (provide type)		0
D. TRENDS
1. Analyze and reflect on the data reported in sections A-C. Report overall observations in data trends and explain anomalies in data, including trends based on new program components and/or initiatives.