Form ORR-6 Performance Report

OMB Control No. 0970-0036

Form ORR-6 

Schedule B: Cash and Medical Assistance, Medical Screening,

and Unaccompanied Refugee Minors

State: _________ Period: 1 2  3   FY: 20_____ Date: _________

I. Refugee Cash Assistance
Persons			Cases
A. New RCA enrollees at the end of the previous reporting period
B. Recipients at end of this reporting period
C. New RCA enrollees during this reporting period
II. Refugee Medical Assistance		Persons
A. Number of persons enrolled in RMA at end of reporting period
III. Medical Screening
Total recipients of medical screenings during reporting period
Recipients of medical screenings during reporting period funded by RMA
IV. Unaccompanied Refugee Minors Program
A. Minors in care at end of previous reporting period
B. Entered care
C. Left care
D. Minors in care at end of this reporting period

Form ORR-6 (08/31/2010)

 

 

 

OMB Control No. 0970-0036

Form ORR-6

Schedule C: Services Report

Page 1: Employment Services

45 CFR 400.154 (a)

State/Grantee: ___________________ Period: 1 2 3 FY 20______

Grant # and Name: _________________ Date: ________________________

				M	F
A. Total Caseload for Employment Services
B. Entered Employment				1. Full Time		2. Part Time		3. Grant
Cash Assistance Status		Time in U.S.		M	F	M	F	Termination
a.	RCA	1.	0-4 mos
		2.	5 - 8 mos
b.	TANF	1.	0 - 12 mos
		2.	> 12 mos
c.	Other CA	1.	0 - 12 mos
		2.	> 12 mos
d.	No CA	1.	0 - 12 mos
		2.	> 12 mos
Total
C. Avg. Hourly Wage Employment Entry				1.		2.
D. Health Benefits Available				1.
E. Employed 90 Days Later				1.		2.
a)	RCA at entered employment
b)	TANF at entered employment
c)	Other CA at entered employment
d)	No CA at entered employment
Total

Form ORR-6 (08/31/2010)

OMB Control No. 0970-0036

Form ORR-6

Schedule C: Services Report

Page 2: Employability Services

45 CFR 400.154 (b) – (k)

State: _____________ Period: 1 2 3 FY: 20_____

Grant # and Name: ________________ Date: _____________

		M	F
1. ELT
A.	Total active participants this reporting period
	0 - 12 mos in U.S.
	> 12 mos in U.S.
2. OJT
A.	Total active participants this reporting period
	0 - 12 mos in U.S.
	> 12 mos in U.S.
B.	Completions (unduplicated)
3. Skills	Training
A.	Total active participants this reporting period
	> 12 mos in U.S.
	0 - 12 mos in U.S.
B.	Completions (unduplicated)
4. Case	Management
A.	Total active participants this reporting period
	> 12 mos in U.S.
	0 - 12 mos in U.S.
5. Other	Employability Services
A.	Total active participants this reporting period
	0 - 12 mos in U.S.
	> 12 mos in U.S.

Form ORR-6 (08/31/2010)

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