OMB Control Number 1205-0422
Expiration Date:  09/30/2013

Workforce Investment Act, Section 166
Indian and Native American Programs
General Reporting Instructions for the Supplemental Youth Services Program Report (ETA Form 9085)

Revised 2013

Public Burden Statement:  This reporting requirement is approved under the Paperwork Reduction Act of 1995, OMB Control No. 1205-0422. Persons are not required to respond to this collection of information unless it displays a currently valid OMB number and expiration date. Public reporting burden for this collection
of information, which is required for obtaining or retaining benefits (PL 105-220, Sec.
166), is estimated to average 24 hours per response, including time for reviewing instructions, searching existing data sources, gathering and reviewing the collection of information. The reason for the collection of information is general program oversight, evaluation and performance assessment. Send comments regarding this burden, to the U.S. Department of Labor, Employment and Training Administration, Division of Indian and Native American Program, 200 Constitution Avenue, NW, Room C-4311, Washington, D.C. 20210 (Paperwork Reduction Project 1205-0422).

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I.	GENERAL INSTRUCTIONS

Workforce Investment Act (WIA) Section 166 grantees are required to submit performance reports to the United States Department of Labor, Employment and Training Administration (USDOL/ETA) to comply with the record keeping and reporting requirements of the Supplemental Youth Services Program (SYSP).  The reports collect socio-economic information and participant characteristics on program participants at the time of enrollment. They also collect services received, achievements and outcomes that youth attained while participating in the program.

Information on SYSP report is collected for the most recent reporting period and cumulatively from the beginning of the report period.  SYSP reports will continue to be required on a semi-annual and annual basis.  The information contained on these reports will be used to determine the levels of participation, services received, and accomplishments for SYSP grant. 

II.	DUE DATES

The table below shows the due dates for the Section 166 SYSP reports.

SYSP Report Period	Due Date	
April – September (semi- annual)	November 14th	
April 1 – March 31 (annual)	June 30th	

Should the due date of the report fall on a Saturday, Sunday, or holiday, the report is due the prior business day.

III.  SUBMISSION PROCEDURES

Information contained on the SYSP Performance Report must be submitted directly to ETA’s
Enterprise Business Support System (EBSS) via www.etareports.doleta.gov.  (See attached format.)

	

										
Instructions for Completing the SYSP Report

Section I.  Grantee Identifying Information

Grantee Name and Address – Enter the grantee name and mailing address as it appears on the Notice of Obligation (NOO) or equivalent official document from the U.S. Department of Labor.

Grant Number – Enter the grant number as it appears on the appropriate NOO or equivalent official document from the U.S. Department of Labor.

Report End Date – Enter the last month, day, and year (mm/dd/yyyy) of the period for which the report is being prepared. 

Section II.  Participation/Exiter Summary

This section collects information on the number of individuals that participated in the SYSP during the report period and during the cumulative period from the beginning of the program year (including new and carry-over participants). It also includes the number of participants that exited the program during the report period and during the cumulative period from the beginning of the program year. Grantees are required to submit results for both the current period (Column B) and cumulative from the beginning of the program year (Column C). 

II.1 Total Participants - Enter the total number of youth participants who are enrolled in the SYSP for the reporting period (including new and carry-over participants). A participant is any individual who is determined eligible to participate in the program and receives a service funded by the program. Participant counts do not include individuals who only receive a determination of eligibility to participate in the program. Date of enrollment in the program begins on the day the participant first receives a service such as training assistance, supportive service or is enrolled in a program activity such as classroom training, job readiness, work experience, etc.

II.2 Total Exiters – Enter the total number of participants who exited from the program during the reporting period.

II.3 Total Current Participants - Enter the total number of youth participants who are currently enrolled in the program. This figure should equal the number of Total Participants (line II.1) minus the number of Total Exiters (line II.2) for the reporting period.

Section III.  Participant Characteristics Summary

This section collects information on the socio-economic characteristics of individuals participating in the program. The information reflects the characteristics of participants at the time of enrollment and includes all participants (including new and carry-over participants) for the current reporting period and

during the cumulative period from the beginning of the program year. Grantees are required to submit results for both the current period (Column B) and cumulative period from the beginning of the program year (Column C).

4. Male – Enter the total number of male participants enrolled for the reporting period.

5. Female – Enter the total number of female participants enrolled for the reporting period.

6. High School / Pre-High School Student – Enter the total number of youth participants who, at enrollment, are attending middle school, junior high school, high school or alternative school whether full or part-time. Participants that are between school terms (such as summer break) and intend to return to school should be included in this line item. [Lines 6 - 9 must equal Line 1 - Total Participants].

7. High School Graduate or Equivalent – Enter the total number of youth participants who, at enrollment, had received a high school diploma or equivalent (GED), but who are not attending post- secondary education (i.e., vocational/technical school, tribal college, community college, four year college, etc.) [Lines 6 - 9 must equal Line 1 - Total Participants].

8. Post High School Student – Enter the total number of youth participants who, at enrollment had received a high school diploma or a GED certificate and are currently attending post-secondary education (i.e., vocational/technical school, tribal college, community college, four year college, etc.). Participants that are between school terms (such as semester break) and intend to return to school should be included in this line item [Lines 6 - 9 must equal Line 1 - Total Participants].

9. School Dropout – Enter the total number of youth participants who, at enrollment, are no longer attending any school and who had not received a secondary school diploma or its recognized equivalent [Lines 6 - 9 must equal Line 1 - Total Participants].

10. Pregnant and/or Parenting Youth – Enter the total number of youth participants who, at enrollment, are pregnant and/or parenting, or who are providing custodial care for one or more dependents under age 18 as appropriate. Parenting youth and youth providing custodial care may also include male youth.

11. Offender – Enter the total number of youth participants who, at enrollment: (a) are or have been subject to any stage of the criminal justice process, for whom services under WIA may be beneficial; or (b) who require assistance in overcoming artificial barriers to employment resulting from a record of arrest or conviction.

12. Foster Child - Enter the total number of youth participants who, at enrollment, are under foster care as determined by the tribe or State.

13. Public Assistance Recipient - Enter the total number of youth participants who, at enrollment, were listed on the welfare grant and were receiving cash payments from a means-tested, income transfer program, receiving Food Stamps or commodities. The income transfer programs include TANF (SSA Title IV), [General Assistance (Tribal, BIA, State, or local government)], Refugee Assistance (PL 96-212), and SSI (SSA Title XVI).

14. Basic Skills Deficiency - Enter the total number of youth participants, who, at enrollment, have English reading, writing, or computing skills at or below the 8th grade level on a generally accepted standardized test or a comparable score on a criterion-referenced test.

15. Individuals with a Disability - Enter the total number of youth participants, who, at enrollment, have a physical (motion, vision, and hearing) or mental (learning or developmental) impairment which substantially limits one or more of such person’s major life activities and have a record of such an impairment.

16. In-School youth – Enter the total number of youth participants, who, at enrollment, are attending middle school, secondary (i.e., high school) or post-secondary school. The total for this line item should equal the sum of lines 6 and 8 above.

17. Out-of-school youth – Enter the total number of youth participants, who, at enrollment, are a high school graduate or equivalent but are not attending post-secondary education (i.e., vocational/technical school, tribal college, community college, four year college, etc.) or are a school dropout. The total for this line item should equal the sum of lines 7 and 9 above.

18. Age 14 -18 - Enter the total number of youth participants, who, at enrollment, are between the age of 14 and 17.

19. Age 19 -21 - Enter the total number of youth participants, who, at enrollment, are between the age of 19 and 21.

20. Eligible Veterans - Enter the total number of youth participants who, at enrollment, have served at least one day in the active military, naval, or air service, and who were discharged or released from such service under conditions other than dishonorable.  This also includes veterans who served full-time in reserve and national guard units activated for Federal service.  This does not include full-time duty performed strictly for training purposes, such as weekend or annual training.  Activated for Federal service also does not include full-time duty performed by national guard personnel who are mobilized by State authorities.  State mobilizations usually occur in response to an event such as natural disasters or public emergencies.  [Note: Eligible Veterans must be given priority of service.]

21. Eligible Spouses- Enter the total number of youth participants, who at enrollment, is a spouse of a veteran.  This includes any veteran who died of a service-connected disability; any member of the Armed Forces serving on active duty, who at the time of application, is listed in one or more of the following categories and has been so listed for a total of more than 90 days:  1) missing in action; 2) captured in the line of duty by a hostile force; or is 3) forcibly detained or interned in the line of duty by a foreign government or power;  any veteran who has a total disability resulting from a service-connected disability, as evaluated by the Department of Veterans Affairs; or Any veteran who died while a disability was in existence.  [Note: Eligible Spouses, who meet program eligibility requirements, must be given priority of service.]

Section IV.  Participant Goals and/or Attainment Summary

This section collects information on goals achieved and other outcomes attained by individuals participating in the Program. Grantees are required to certify and submit results for both the current period (Column B) and cumulative period from the beginning of the program year (Column C).

22.	Completed Work Readiness – Enter the number of youth participants enrolled for the reporting period that had a measurable increase in work readiness skills including world-of-work awareness, labor market knowledge, occupational information, values clarification and personal understanding, career planning and decision making, and job search techniques (resumes, interviews, applications, and follow- up letters). They also encompass survival/daily living skills such as using the phone, telling time, shopping, renting an apartment, opening a bank account, and using public transportation. They also include positive work habits, attitudes, and behaviors such as punctuality, regular attendance, presenting a neat appearance, getting along and working well with others, exhibiting good conduct, following instructions and completing tasks, accepting constructive criticism from supervisors and co-workers, showing initiative and reliability, and assuming the responsibilities involved in maintaining a job. This category also entails developing motivation and adaptability, obtaining effective coping and problem- solving skills, and acquiring an improved self image.

23. Completed Internship or Vocational Exploration Program - Enter the total number of youth participants enrolled for the reporting period who completed, during the course of their program participation, a work internship or a vocational exploration program designed to provide exposure to alternative career areas.

24. Completed Career Assessment - Enter the total number of youth participants enrolled for the reporting period who completed, during the course of their program participation, a formal career assessment of occupational interests, values, skills, or aptitudes, leading to an identification of careers for which the participant may be suited.

25. Entered Unsubsidized Employment (Including Military) - Enter the total number of youth participants enrolled for the reporting period who, upon termination, entered non-WIA funded employment, including entry into the Armed Forces or self-employment. [Note: Youth participants who, upon termination in the youth program, are hired as regular full time “employees” of the WIA program may also be counted in this line item even though they entered WIA funded employment].

26. Remained in School - Enter the total number of youth participants enrolled for the reporting period who were at-risk of dropping out of school but, who were retained in school as a result of continuing active participation in the SYSP.

27. Returned to School Full Time - Enter the total number of youth participants enrolled for the reporting period who, at intake, were not attending school (exclusive of summer), and had not obtained a high school diploma or equivalent and returned to full-time secondary school (e.g., junior high school, middle school, and high school) including alternative school as a result of participating in the SYSP.

28. Enrolled in Job Corps - Enter the total number of youth participants enrolled for the reporting period who enrolled in Job Corps.

29. Improved Basic Skills by at Least Two Grade Levels - Enter the total number of youth participants enrolled for the reporting period who advanced at least two grade levels in either reading or math skills as a result of participation in the SYSP. [Note: Skill gain must be achieved through active program participation and must be documented through standardized testing].

30. Attained High School Diploma - Enter the total number of youth participants enrolled for the reporting period who attained a State-recognized high school diploma while enrolled in the SYSP as a result of program participation.

31. Attained GED - Enter the total number of youth participants enrolled for the reporting period who attained a State-recognized GED while enrolled in the SYSP as a result of program participation.

32. Completed Occupational Skills Training - Enter the total number of youth participants enrolled for the reporting period who completed occupational skills training while enrolled in the SYSP as a result of program participation. [Note: occupational skills training include vocational education and on-the-job training].

33. Completed Leadership Skills Training - Enter the total number of youth participants enrolled for the reporting period who completed during the course of their program participation training that is intended to impart leadership skills. This category includes providing exposure to post-secondary educational opportunities; community and service learning projects; peer-centered activities (including peer mentoring and tutoring); organizational and team work training (including team leadership training);  training in decision-making (including determining priorities); citizenship training (including life skills training such as parenting and budgeting of resources); positive social behaviors; any organized group counseling program; or "youth camp."

34. Entered Other (Non–SYSP) Training Program -  Enter the total number of youth participants enrolled for the reporting period who entered other training, including occupational skills training or post secondary education, using funds other than those from the INA SYSP, which builds upon and does not duplicate training received under Section 166. [This category excludes those enrolled in Job Corps.]

Section V.  Grantee Performance Outcomes/Performance

This section collects information on outcomes achieved by participants of the SYSP. Grantees are required to submit results for both the current period (Column B) and cumulative period from the beginning of the program year (Column C). Grantees are required to report both the numerator and denominator values for each performance measure contained in this section.

35. Attainment of 2 or More Goals (At least 60% of youth exited in the SYSP who attained at least 2 of the 13 goals listed in Lines 22-34.  Of the participants that exited the program indicated in Section II, Line 2; enter the percentage of youth who attained at least two of the 13 goals listed in Section IV, Lines 22 – 34. Calculate this value by dividing the total number of exiters who attained at least two of the 13 goals listed in Section IV, Lines 22 – 34 by the number of youth that exited the program (Section II, Line 2). Also, provide the numerator and denominator used to calculate this measure.

Numerator:  The number of Exiters who attained at least two of the 13 goals listed in
Section IV, Lines 22 - 34.

Denominator: The number of participants that exited the program. This number should match the number in Section II, Line 2.