Public Law 102-477 Annual Report

1. Public Law 102-477 Annual Report

2. Public Law 102-477 Statistical Report Enter the name of the Tribal Nation or Consortium Enter your report period.

3. Participant Requirements To be considered a participant they: Must complete an application. Submit supporting documentation. Eligible to receive services.

4. Participant is 22 years or older at program entry. If the participant receives cash assistance at any time, DO NOT report him/her in the Adult column, report as cash assistance recipient.

5. Participant is a Youth if 21 years or younger at program entry. If the participant receives cash assistance at any time, DO NOT report him/her in the Youth column, report as cash assistance recipient.

6. Criteria for Reporting Cash Assistance Recipients No age requirement. Participant must be deemed eligible to receive or is receiving cash assistance, such as General Assistance funds (BIA) or Temporary Assistance for Needy Families (DHHS). If the participant received cash assistance at any time during enrollment, or 60 days prior to enrollment, they should be reported in the Cash Assistance Recipient column.

7. Criteria for Reporting Cash Assistance Recipients Dependents of participants receiving cash assistance should not be reported as receiving cash assistance. Only report the individual receiving the service through your program. You can report participants as cash assistance recipients even if you do not have GA or TANF in your 477 program. We want to show a clearer picture of the individuals you serve through your program.

8. Participants Served I.A. Total Participants Report the total number of participants served in the 477 program (include current and terminated individuals) during your program year.

9. Participants Served I.B. Total Terminees Report the total number of participants that have either successfully or unsuccessfully ceased enrollment in your 477 program during your program year.

10. Participants Served I.B. Total Terminees If a terminee is 22 years & older count him/her in the Adult column, unless at the time of enrollment the person was considered a youth For example, If the participant enrolled at age 20 and terminated at 23, that participant is reported as a youth at termination.

11. Participants Served I.B. Total Terminees If a terminee is 21 years and younger they should be counted in the Youth column. If the participant was a cash assistance recipient at any time during enrollment, or 60 days prior to enrollment, he/she should be reported in the Cash Assistance Recipient column, regardless of age.

12. Participants Served I.C. Total Current Participants The total number of participants considered to have been served at any time during the reporting period, but have not yet completed & terminated from the program as of the last day of the report period. Simply put---those remaining in your program that have not been terminated.

13. Terminee Outcomes Only report participants that have terminated at any time during the reporting period, whether or not they have been successful in meeting their stated short or long range goals. These are the individuals reported in I.B. Total Terminees. Participant information can be recorded at any time within 90 days following the completion or termination from the program. Do Not include characteristics of all participants.

14. Terminee Outcomes Terminees may be counted once in each of the positive termination categories (i.e. employment objective, education/training objective, miscellaneous objective achieved). Terminees reported as “Other (non-positive) may not be countedin any of the three positive termination categories.

15. Terminee Outcomes II.A. Total with Employment Objective Count all terminees who have been terminated with an employment objective in their individualized service plan. Note: The Total with Employment Objective cannot exceed the actual number of terminees reported for Adult, Youth, and Cash Assistance Recipient columns (section I.B).

16. If you have 58 Total Adult Terminees reported, then the number of adults reported in II. A. Total with Employment Objective, and II. B. Total with Educational/Training Objective, cannot be more than 58. However they can be counted with both employment and educational objectives, because all terminees could have had both an employment and educational objective. Ok Not Ok Ok Not Ok

17. Terminee Outcomes II.A.1. Entered Unsubsidized Employment Report the number of terminees that have entered employment, whom do not receive any subsidy. Include self-employment.

18. Terminee Outcomes II.A.2. Other Employment Outcomes Terminees whom have an employment objective and met that goal. This includes terminees who have been successfully assisted in retaining an existing job with supportive services or successfully completes an OJT assignment but were not retained in employment.

19. Terminee Outcomes II.A.3. Employment Objective Not Achieved Report terminees that had an employment objective but did not meet any of their employment goals.

20. Earnings Gain! If you report terminees as entering unsubsidized employment you must report II.A.4. Earnings Gain. Unsubsidized Employment and Earnings Gain are directly related!

21. Terminee Outcomes II.A.4. Earnings Gain For those terminees entering unsubsidized employment, calculate the hourly wage of the last job held within the last six (6) months prior to program enrollment and compare that rate with the rate at the time of termination from the program.

22. Example of Earnings Gain If a terminee earned $5.15/hour at a job held six months prior to enrollment in the program and terminated the program gaining unsubsidized employment earning $6.25/hour, the earnings gain for the individual is $1.10. Not all earning gains are positive.

23. Example of Earnings Gain If the terminee was unemployed for six months prior to entering the program, their hourly rate at entry is $0. If that terminee gains unsubsidized employment earning $6.50/hour, the gain would be $6.50/hour.

24. Calculating the Average Gain Add all gains (+) and any losses (-). Divide the total of gains/losses by the number of terminees entering unsubsidized employment. The result is the average gain. Report the average gain dollar amount in II.A.4.

25. Terminee Outcomes II.B. Total with Educational/Training Objective Report the number of termineeswho have terminated from the program and had an educational/training objective. Include terminees gaining knowledge such as completing a semester or more of classes or long/short term classroom training measurement.

26. Terminee Outcomes II.B.1. Degree/Certificate Attempted/Attained The first number is the total number of terminees thatattempted a degree/certificate, whether or not they attained the degree/certificate. The second number is the total number of terminees that attained a degree/certificate.

27. Terminee Outcomes II.B.2. Other Education Outcome Report terminees that had an educational goal, were terminated from the program, and met a goal other than attainment of a certificate or degree.

28. Terminee Outcomes II.B.3. Education Objective Not Achieved Report terminees who had educational goals and terminated from the program without meeting any of their goals.

29. Terminee Outcomes II.C. Miscellaneous Objective Achieved Report all terminees that met one or more of their short or long-term goals. For example, a terminee may have acquired a driver’s license, or may have had applying for other supportive services as a goal, e.g. LIHEAP. The miscellaneous objective cannot be reported elsewhere on the report.

30. Terminee Outcomes Report only the terminees that failed to meet their short and long-term goals as stated in their development plan. If a terminee met one or more of their goals but not their final goal, they should be counted in sections II.A., II.B., or II.C.

31. Terminee Characteristics III. Terminee Characteristics Report only those terminees who have their cases closed and were included in I.B. Total Terminees. Do Not include characteristics of all participants, only terminees.

32. Terminee Characteristics III.A./B. Female/Male Report the number of females/males reported in section I.B. Total Terminees. The total of females + males should equal the total number of terminees reported in section I.B.

33. Terminee Characteristics III.C. Education Level Report the education level of the terminees reported in section I.B. Total Terminees at time of enrollment into the program. The total sum of education level (1-4) should equal the total number of terminees reported in section I.B.

34. Example III.C. Education Level If you reported 58 total terminees in section I.B., then the total of education levels should equal 58. The same is true for the Youth and Cash Assistance Recipients columns.

35. Terminee Characteristics III.D. Veteran Report all terminees that have served in the military and are considered veterans.

36. Participant Activities Report ALL participants (current or terminated). Report the type of activities, goals, and objectives established for participants through their development plan. If a participant was involved in more than 1 activity, goal, or objective, count the participant once in each category of activity that applies. The total number of participants reported in this section may be greater than the total number of participants reported in section I.A. Total Participants.

37. Participant Activities IV.A. Employment Report participants engaged in employment activities, such as, job referrals, Work Experience, job interviewing, supportive work services, and job related goals.

38. Participant Activities IV.B. Education/Training Report participants engaged in any educational or training activity, including OJT, Adult Basic Education, GED prep, and related services.

39. Participant Activities IV.C. Miscellaneous Objective /Supportive Services Report participation in non-employment and non-education activities. Examples of this activity are transportation assistance, housing assistance, assistance in obtaining a driver’s license, childcare when furnished to adults as supportive services, and similar assistance.

40. Participant Activities IV.D. Other/Service Referral Report any other services or referrals provided to participants. Examples are

41. Child Care Development Activities V.A. Families Receiving Child Care Report the number of family units provided with child care services that are funded through the 477 budget.

42. Child Care Development Activities V.B.1-3. Children Receiving Child Care Report the number of children served. The total of the three age categories should add up to the total number of children reported receiving child care. Report services provided through the program whether or not the 477 budget includes funds from formal child care programs, such as CCDF.

43. Child Care Development Activities V.C.1-4. Care Received Report the type of childcare provider used most often by each child. The types of providers should add up to the total number of children receiving child care.

44. Jobs Creation/Economic Development VI. A. Jobs Creation/Economic Development Report the number of new jobs (not participants) created as a result of you 477 program. Report the number of Indians/Alaska Natives employed as a result of the new jobs created. Report the number of businesses assisted by your 477 program. This may include supportive services such as, counseling services for existing employees, training for employees, OJT placements, recruitment and advertisement of positions, and related support.

45. Who completed this report? The individual completing the report should include their name (printed & signed), phone number, and date the report was completed, so we have contact information in the event of a discrepancy. OMB Control No. 1076-0135 Expiration Date: 09/30/10

46. Suggestions Keep a binder of activities your program offers for reference to assist with writing the narrative report. Keep a log of all participants as they terminate the program within the program year. If you report statistical data manually, code participant files to identify adults, youth, and cash assistance recipients, for easy reference.