Refugee Health Promotion Data Indicators

Generic Performance Progress Report

RHP Data Indicator Form User Guide

Refugee Health Promotion Data Indicators

OMB: 0970-0490

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User Guide
REFUGEE HEALTH PROMOTION
Program Data Indicators

OVERVIEW
The purpose of these data indicators is to help the Office of Refugee Resettlement (ORR) assess
the progress of the Refugee Health Promotion (RHP) Program’s two main objectives of
promoting health literacy and reducing gaps in health services.
All grantees are required to collect and report aggregate program data for clients served
through the RHP program. If a program has multiple funding sources, only clients served with
RHP funding should be included. Program data include both new and continuing clients.
The Program Data Indicators are reported on an annual basis and are to be submitted on
September 14, along with the semi-annual Performance Progress Report (PPR) and Federal
Financial Report (FFR).
For more information about program reporting requirements, please refer to the PPR reporting
guidance tip sheet and the FOA that aligns with current funding.
Note: Enter “N/A” in sections that list activities that were not included in the original
application submitted to ORR. Enter “0” if the activity was part of the original application plan,
but did not take place.
IDENTIFYING INFORMATION
Federal Grant Number

Reporting Period
Start Date: (MM/DD/YYYY)

End Date: (MM/DD/YYYY)

Definition:
o Reporting Period: Timeframe during which the activities described in this report have
occurred.
I.

DEMOGRAPHICS & LOCALITIES SERVED (Data Points 1-4)

I. DEMOGRAPHICS & LOCALITIES SERVED
Where applicable, provide the number of unduplicated individual clients served for each demographic in the ‘Total’
column. Do not leave any blanks; indicate ‘0’ where applicable.

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OMB Control Number: 0970-0490
Expiration date: 1/31/2020

01: TOTAL NUMBER OF CLIENTS SERVED BY IMMIGRATION STATUS
Data Indicator
1. Number of unduplicated clients served by immigration status

Total

Refugee
Asylee
SIV
Cuban or Haitian Entrant
Trafficking Victim
Amerasian
Total unduplicated number of clients served

Definition:
Total unduplicated number of clients served: Total unduplicated number of clients receiving
service(s) or materials supported by RHP. Clients are defined as refugees and refugee-like
populations. Do not include service providers receiving RHP-funded trainings.
Note: If there are clients receiving multiple services (e.g., case management and health
education), they may be counted more than once in the Services section II below (that is, data
points II.1 through II.3); this will make the total unduplicated number listed above less than the
total sum of the people who received services counted in data points II.1 through II.3.
Definitions:
o Refugee: The client was granted refugee status before entering the United States and was
admitted to the United States as a refugee. This also includes derivative (family member)
refugees who were granted refugee status (Visa 93) as the spouse or unmarried child under
age 21 of a principal refugee.
o Asylee: The client filed for asylum after entering the United States and was granted asylum
by the time of receiving RHP services. This also includes derivatives (family members) who
were granted asylum status (Visa 92) as the spouse or unmarried child under age 21 of a
principal asylee.
o Special Immigrant Visa holder: Individuals who enter to the U.S. through the Special
Immigrant Visa (SIV) program which grants visas to nationals from Iraq and Afghanistan who
have provided faithful and valuable service to the U.S. government, while employed by or
on behalf of the U.S. government, and who have experienced or are experiencing an
ongoing serious threat as a consequence of that employment.
o Cuban or Haitian Entrant: Cuban and Haitian entrants are defined as (a) Any individual
granted parole status (by DHS) as a Cuban/Haitian Entrant (Status Pending) or granted any
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other special status subsequently established under the immigration laws for nationals of
Cuba or Haiti, regardless of the status of the individual at the time assistance or services are
provided and (b) Any other national of Cuba or Haiti (1) Who: (i) was paroled into the
United States and has not acquired any other status under the INA; (ii) is the subject of
exclusion or deportation proceedings under the INA; or (iii) has an application for asylum
pending with (DHS); and (2) With respect to whom a final, non-appealable, and legally
enforceable order of deportation or exclusion has not been entered.
o Victim of Trafficking: Foreign adult victims of human trafficking are eligible for Federal and
State benefits and services to the same extent as refugees upon issuance of a Certification
Letter by HHS; foreign children under the age of 18 who are victims of trafficking do not
need to be certified, but receive an Eligibility Letter to access benefits and services.
o Amerasian: Individuals fathered by a U.S. citizen and born in Vietnam after January 1,
1962, and before January 1, 1976 admitted to the U.S.
Note: Clients who have adjusted their status to Lawful Permanent Resident (green card holder)
should be counted under the immigration status that first entitled them to be eligible for
refugee benefits. The client count by immigration status should be unduplicated (i.e., each
client counted once).
02: TOTAL NUMBER OF CLIENTS SERVED BY COUNTRY OF ORIGIN
2. Number of unduplicated clients served by country of origin List the top 5 countries in descending
order

All other countries (combined)
Total unduplicated number of clients served from all countries

Definition:
Country of Origin: As self-reported by the client. The client’s self-reported country of origin
may be different than the client’s country of birth, or nationality, or country of residence prior
to coming to the U.S. (e.g., a Somali refugee who was born and resided in Kenya who reports
Somalia as his/her country of origin). Please list the countries and corresponding numbers in
descending order.
Note: The client count by country of origin should be unduplicated; that is, if a client received
more than one RHP service, only count that client’s country of origin once for this section. The
total should match the total unduplicated number of clients served from the first data point.
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OMB Control Number: 0970-0490
Expiration date: 1/31/2020

03: LOCALITIES SERVED
3. Number of organization(s) funded and location(s) served
Number of organization(s) funded by RHP
Number of location(s) served

List the number of each organization sub-contracted to receive RHP funds, and provide the
number of locations where RHP services are available (county and/or city).
II.

SERVICES (Data points 1-8)

II. SERVICES
Provide the total number of recipients for each service in the ‘Total’ column and a description for each service in the
space provided. Do not leave any blanks; indicate ‘0’ and ‘N/A’ where applicable.
*For Pro Bono Services and interpretation services, provide the number of hours instead of the number of clients.

01: CASE MANAGEMENT
Data Indicator
Total
1. Case management Includes medical and mental health case management and coordination of resources for the provision of health care
services.

Number of clients who received medical case management services
Number of clients who received mental health case management services
Total unduplicated number of clients receiving case management services

Definitions:
o Medical Case Management: Any case management service that involves facilitation of
medical care beyond the initial health screening.
o Mental Health Case Management: Any facilitation of referrals to mental health specialists,
or action that otherwise addresses mental health needs of clients.
Note: If a client received both medical and mental health case management, count the client in
both sections for each service received. For the total unduplicated number of clients, first
count those who either received medical case management or mental health case
management, plus the number of those who received both. Those who received both medical
and mental health case management services should only be counted once.
02: ADJUSTMENT OR SUPPORT GROUPS
2. Adjustment or support groups Includes community adjustment groups, support groups, or other similar activities.
Number of clients who attended adjustment or support groups

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OMB Control Number: 0970-0490
Expiration date: 1/31/2020

Definitions:
Adjustment or support groups: Any group activity designed to reduce isolation or share coping
strategies and experiences.
Note: The client count should be unduplicated; that is, if a client attended more than one
group, only count that client once.
03: HEALTH ORIENTATION AND EDUCATION
3. Health orientation and education Includes U.S. healthcare orientation workshops and other health education classes.
Number of clients who received initial health orientation services
Number of clients who received additional health education services
Number of clients who received mental health education/training

Definitions:
o Initial health orientation services: General health orientation received by all new arrivals.
o Additional health education services: Health education services provided beyond initial
health orientation; could be focused on a specific topic. Additional health education
services could include classes, trainings or workshops that may focus on various topics
related to wellness.
o Mental health education/training: Any mental health education/training that is offered in a
group setting.
Note: The client count should be unduplicated for each row; that is, if a client received more
than one of the above services, count the client once in each section for each service received.
Service providers receiving RHP services should not be counted in this section.
04: SERVICE PROVIDER TRAINING
4. Service provider training Includes education on refugee health, mental health training, and National Standards for Culturally and
Linguistically Appropriate Services (CLAS) in Health and Health Care.

Number of service providers that received training

Definition:
Service providers could include medical and mental health providers, legal and social workers,
administrators, case managers, volunteers, or any community member serving or potentially
assisting refugees. Training topics may include basics of the refugee program for healthcare
providers, refugee health or mental health needs, CLAS standards, etc.
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Note: The service provider count should be unduplicated; that is, if a service provider attended
more than one training, only count the service provider once.
05: INTERPRETATION SERVICES
5. Interpretation services
Number of hours of interpretation services provided

Definition:
Interpretation Services: Telephonic or face-to-face live interpretation services.
Note: Only count hours of interpretation funded by the RHP grant.
06: TRANSLATION SERVICES
6. Translation services
Number of clients who received translated materials

Definition:
Translated Materials: Written materials translated for distribution to clients.
Note: Clients who receive translated materials may have also received other RHP services, and
should be counted once for each service received in the appropriate sections of the form.
Translation services funded by RHP should only be related to the objectives of the RHP grant.
07. PRO BONO AND VOLUNTEER SERVICES
7. Pro Bono Services For each service area, indicate the total number of pro-bono hours contributed by providers and other volunteers
during the reporting period.

Interpreters/translators
Medical
Mental health
Social
General volunteer hours
Other
Total hours contributed

Definitions: Number of hours contributed pro bono (i.e., free) by service providers during the
reporting period.

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OMB Control Number: 0970-0490
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o Interpreters/translators: Trained and certified individuals or volunteers who convert spoken
or written material from one language (the source language) into a different language (the
target language).
o Medical: All services provided by nurses (with the exception of psychiatric nurses), physical
therapists, massage therapists, medical doctors (with the exception of psychiatrists),
dentists, or other medical service providers that specifically address medical or physical
issues.
o Mental health: All services provided by psychologists, psychiatrists, licensed clinical social
workers (providing explicit mental health treatment), psychiatric nurses, or other qualified
mental health professionals that address specific mental health, psychiatric, or
psychological issues.
o Social: All services provided by social workers (with the exception of licensed clinical social
workers or equivalent who provide explicit mental health treatment) or other social service
providers or services that address housing, clothing, employment, transportation, case
management, or other specific social service issues.
o General volunteer hours: Services may include administrative or coordination activities,
facilitating groups or teaching classes by interns, students, community members, or
transportation.
o Other: All services that do not fit into any of the preceding categories.
08: GRANT ACTIVITIES BY PERCENTAGE
8. Please provide a breakdown by percentage of RHP grant activities:
Medical Case Management
Mental Health Case Management
Interpretation/Translation
Health Orientation/Education
Adjustment or Support Groups
Administrative
Other Activities
Total

Note: The percentages provided here should indicate the percentage of RHP funds used for
each activity. The total of these percentages should equal 100%. Enter whole numbers to
indicate the percentage.

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September 2017
OMB Control Number: 0970-0490
Expiration date: 1/31/2020


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