IND-GEN - SetupTo begin providing individual-level data for trainees who received BHW-funded financial awards during the reporting period or to provide updates for individuals previously reported on IND-GEN, click "Yes" to the initial setup question. Clicking "Yes" will activate the embedded Excel® form that will allow you to begin data entry. Do not report faculty or preceptors on this form. | Do you have either a) new trainees OR b) updates to provide for trainees from a previous reporting period? | Yes (complete IND-GEN) No (click Save and Validate button to proceed to the next form) |
Figure 1. IND-GEN - Setup Do you have either a) new trainees OR b) updates to provide for trainees from a previous reporting period?:
Warning If you are unable to enter data into the INDGEN form, edit prior records, or see drop-down menus despite the question above being answered ‘Yes’, you likely have a browser compatibility problem. Please refer to the Getting Started-Browser Settings page at the beginning of this manual.
Warning
Prior records cannot be deleted. Note
ANE-SANE trainees should only be reported on one program’s IND-GEN form. If your program shares SANE trainees with other programs, please communicate with each other to identify which program is the “primary training provider.” It is important to avoid reporting one SANE through multiple grant programs because that will impact trainee counts and BHW’s ability to report the total number of new SANEs produced through the ANE-SANE grant program. |
IND-GEN - Excel Upload (optional)Warning Do not modify the format. For example: renaming the columns, deleting columns, or renaming worksheets. Users must download and use the file from EHB. The system will not upload/process a different format.
Warning The ‘Type of Training Program’ (Column 1) and ‘Trainee Unique ID’ are key columns. These columns must be complete for the row to be uploaded and processed into EHB. If one or both of these columns are not complete, then the row of data will not be processed in EHB.
Warning
If you edit your INDGEN data in EHB, you must click the “Generate Template with most recent INDGEN data’ button before downloading the template. If you fail to do so, your Excel template will not reflect the changes you made and may cause issues when you upload/process your data. You can generate and download the Excel template to enter the trainee information on the INDGEN form. Use of the Excel template is optional. If you plan to use it, please read the instructions carefully. - You can generate the Excel template by clicking the ‘Generate Template with most recent INDGEN data’ button.
- You can download the Excel template by clicking the ‘Download Template’ button.
- After downloading the file, save the INDGEN template on your local computer. To save in a particular location, click the arrow next to the Save button and select the Save As option.
- Then you can enter the data in the Excel Template file. After completing the file, click the Browse button to locate your completed INDGEN form on the computer. If applicable, add a description in the textbox field. Click the Upload button to attach the completed INDGEN form.
- Click on the ‘Process Data’ button to view the INDGEN data on your screen.
- You can add or modify the data within EHB once it is uploaded. Note that the system will check for errors and prompt you to fix them before you can save and validate the form.
Types of Data Fields: - Data Entry fields – For these fields, users can copy/paste allowable values and/or enter valid data in the cell or in the formula bar (if required) – e.g., Trainee Unique ID.
- Single-Select dropdown fields – For these fields, users can copy/paste allowable values (note they must match the selection option exactly), select an option from the list of pre-set choices in the dropdown box, and/or enter the valid selection in the cell or in the formula bar – e.g., Select Individual’s Training or Awardee Category.
- Multi-Select dropdown fields – For these fields, users can copy/paste allowable values (note they must match the selection options exactly) and/or select one or more options from the list of pre-set choices in the dropdown box – e.g., Select Individual’s Race. Please do not try to enter data into the cell or the formula bar for this type of field, as it may cause errors.
General Instructions: - Previously reported training programs (i.e., prior records) will be auto-populated and displayed at the top of the page. Gray cells are not editable. If new rows are added in the IND-GEN form, the Record Status, City, and State columns remain non-editable and empty (see below for additional details).
- To enter a new record, users should start on the next blank row, select the ‘Type of Training Program’, and enter the ‘Trainee Unique ID’. While the Record Status will be new, that column is not editable and will remain empty. Once the template is uploaded and processed, the ‘New Record’ status will be displayed in EHB.
- Training programs with at least one active Fellowship Program, Major Participating Site/Rotation Site, or Residency Program will be populated in the ‘Type of Training Program’ dropdown list in the IND-GEN. The list is derived from the Training Program – Setup form.
- The City and State columns are not editable and will remain empty even if the user enters the Zip Code. Once the template is uploaded and processed, as long as a valid Zip Code is provided, the City and State will be populated in EHB.
Copying and Pasting Data: - Users can copy and paste data from another source/file into Data Entry, Single-Select Dropdown, and Multi-Select Dropdown fields.
- The values provided for Single-Select or Multi-Select fields must exactly match the values that exist in the system. This includes having the same spelling, spacing, and punctuation (hyphens, etc.). Capitalization does not matter. Values for Multi-Select fields must be separated by a comma and a space.
Multi-Selecting and Unselecting Pre-Set Options: - For the multi-select fields, users can select one or more pre-set options in the dropdown list. Users will have to select the options one at a time. However, the pre-set options will be concatenated in the field.
- To unselect one or more pre-set options, users can click on the pre-set option(s) a second time. This will remove the option from the field.
Validations: - Validations are embedded within the Excel template.
- Validations will fire:
- When a required field is missing,
- When there is a conditional validation on two or more columns,
- When a pre-set selection option cannot be combined with other pre-set options (specifically for multi-select fields), and
- When the value of the cell is changed (i.e., a different selection value is selected, the data is deleted, or the text field does not match the data type).
- When a validation fires, the user can correct the field or leave it as is. Users can still upload the template into EHB and fix any remaining validation errors in EHB as long as data has been selected/entered in Column 1 and Column 2.
Uploading the Excel File in EHB: - Once you have completed the Excel file:
- Log into HRSA EHB,
- Access the Annual Performance Report,
- Navigate to the INDGEN form,
- Click the "Attach File" button,
- Select the completed INDGEN template,
- Upload your Excel file
- Click the ‘Process Data’ button, and
- Confirm that the data transferred successfully, enter missing fields, and fix validation errors.
Note Once the Excel template has been processed in EHBs, the row numbers in EHBs will not match the row numbers in the excel template. |
IND-GEN - Selecting Type of Training Program Figure 2. IND-GEN - Selecting Type of Training Program Type of Training Program: Select each individual's training program by clicking on the drop-down menu and choosing one of the available options.
Note The options available in this dropdown menu will prepopulate with programs entered and saved in the Training Program Setup Form. Note
This column will prepopulate for prior records with data submitted in the previous reporting period. Prior data cannot be altered or deleted. |
IND-GEN - Entering Trainee Unique ID Figure 3. IND-GEN - Entering Trainee Unique ID Trainee Unique ID: Enter a seven (7) character alphanumeric unique identifier for each individual in the textbox in Column 2 (Block 1).
Warning
It is the responsibility of each grantee to generate each unique ID and keep a log of all unique IDs used, as these will be required to provide annual updates and 1-year follow-up data for each individual. Note
This Block will prepopulate for prior records with data submitted in previous reporting periods. |
IND-GEN - Selecting Individual's Training or Awardee Category Figure 4. IND-GEN - Selecting Individual's Training or Awardee Category Select Individual's Training or Awardee Category: Select each individual’s training category by clicking on the drop-down menu in Column 3. Do not report faculty or preceptors on this form. - Enrollee (campus-based only)
- Enrollee (distance learning only)
- Enrollee (hybrid)
Note
This column will prepopulate for prior records with data submitted in the previous reporting period. Prior data cannot be altered or deleted. |
IND-GEN - Selecting Highest Degree Held by Individual Figure 5. IND-GEN - Selecting Highest Degree Held by Individual Select Highest Degree Held by Individual: Select the highest degree held by each individual by clicking the on the drop-down menu in Column 3b and selecting one of the following options: - DDS
- AA/AS
- DMD
- BS
- BSN
- DO
- DNP
- MD
- Doctoral Degree (not otherwise specified)
- Master's Degree (not otherwise specified)
- MHS
- MMSc
- PharmD
- MPAS
- MSN
- PsyD
- PhD
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IND-GEN - Selecting Individual's Enrollment/Employment Status Figure 6. IND-GEN - Selecting Individual's Enrollment/Employment Status Select Individual's Enrollment / Employment Status: Select each individual’s current enrollment or employment status by clicking on the drop-down menu in Column 4 (Block 3) and choosing one of the following options: - Full-time
- Part-time
- On leave of absence
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IND-GEN - Selecting Individuals Gender Figure 7. IND-GEN - Selecting Individuals Gender Select Individual's Gender(s): Select the gender option(s) that apply to each individual by clicking on the drop-down menu under column 5a and choosing all that apply: - Female
- Male
- Transgender or non-binary or another gender
- Not reported
Warning The 'Not Reported' option may not be selected for prior records.
Warning
'Not Reported' cannot be selected in combination with any other options under column 5a. |
IND-GEN - Entering Year of Birth Figure 8. IND-GEN - Entering Year of Birth Enter Year of Birth: Select each individual’s year of birth in the dropdown menu under Column 6a. - 1933
- 1934
- 1935
- 1936
- 1937
- 1938
- 1939
- 1940
- 1941
- 1942
- 1943
- 1944
- 1945
- 1946
- 1947
- 1948
- 1949
- 1950
- 1951
- 1952
- 1953
- 1954
- 1955
- 1956
- 1957
- 1958
- 1959
- 1960
- 1961
- 1962
- 1963
- 1964
- 1965
- 1966
- 1967
- 1968
- 1969
- 1970
- 1971
- 1972
- 1973
- 1974
- 1975
- 1976
- 1977
- 1978
- 1979
- 1980
- 1981
- 1982
- 1983
- 1984
- 1985
- 1986
- 1987
- 1988
- 1989
- 1990
- 1991
- 1992
- 1993
- 1994
- 1995
- 1996
- 1997
- 1998
- 1999
- 2000
- 2001
- 2002
- 2003
- 2004
- 2005
- 2006
- 2007
- 2008
- 2009
- 2010
- 2011
- 2012
- 2013
- 2014
- 2015
- 2016
- 2017
- Not Reported
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IND-GEN - Selecting Individual's Ethnicity Figure 9. IND-GEN - Selecting Individual's Ethnicity Select Individual's Ethnicity: Select each individual’s ethnicity by clicking on the drop-down menu in Column 7 (Block 6) and choosing one of the following options: - Hispanic/Latino
- Non-Hispanic/Non-Latino
- Not Reported
Warning
The 'Not Reported' option may not be selected for prior records. Note
This column will prepopulate for prior records with data submitted in the previous reporting period. Prior data cannot be altered or deleted. |
IND-GEN - Selecting Individual's Race Figure 10. IND-GEN - Selecting Individual's Race Select Individual's Race: Select each individual’s race by clicking on the drop-down menu in Column 8 (Block 7) and choosing all that apply from the following options. You may select more than one option for individuals of multiple races: - American Indian or Alaska Native
- Asian
- Black or African-American
- Native Hawaiian or Other Pacific Islander
- White
- Not Reported
Warning
You may not select "Not Reported" in combination with any other option.
Warning
The 'Not Reported' option may not be selected for prior records. Note
This column will prepopulate for prior records with data submitted in the previous reporting period. Prior data cannot be altered or deleted. |
IND-GEN - Selecting if Individual is from a Rural Residential Background Figure 11. IND-GEN - Selecting if Individual is from a Rural Residential Background Select Whether Individual is from a Rural Residential Background: Select whether each individual is from a rural residential background by clicking on the drop-down menu in Column 9 (Block 8) and choosing one of the following options: Warning
The 'Not Reported' option may not be selected for prior records. Note
This column will prepopulate for prior records with data submitted in the previous reporting period. Prior data cannot be altered or deleted. Reference
Refer to the glossary for a definition of rural setting. |
IND-GEN - Selecting if Individual is from a Disadvantaged Background Figure 12. IND-GEN - Selecting if Individual is from a Disadvantaged Background Select Whether Individual is from a Disadvantaged Background: Select whether each individual is from a disadvantaged background by clicking on the drop-down menu in Column 10 (Block 9) and choosing one of the following options: Warning
The 'Not Reported' option may not be selected for prior records. Note
This column will prepopulate for prior records with data submitted in the previous reporting period. Prior data cannot be altered or deleted. Reference
Refer to the glossary for a definition of disadvantaged background. |
IND-GEN - Selecting Individual's Veteran Status Figure 13. IND-GEN - Selecting Individual's Veteran Status Select Individual's Veteran Status: Select each individual's current veteran status by clicking on the drop-down menu in Column 11 (Block 10) and choosing one of the following options: - Active Duty Military
- Individual is not a Veteran
- National Guard
- Reservist
- Veteran - Prior Service
- Veteran - Retired
- Not Reported
Warning
The 'Not Reported' option may not be selected for prior records. Note
This column will prepopulate for prior records with data submitted in the previous reporting period. Prior data cannot be altered or deleted. Reference
Refer to the glossary for a definition of the various types of veteran statuses. |
IND-GEN - Entering BHW-Funded Financial Award InformationWarning
Multiple steps are required to complete this portion of the subform. Please read instructions carefully. Figure 14. IND-GEN - Entering BHW-Funded Financial Award Information Select Whether Individual Received BHW Financial Award?: Select whether each student received a BHW-funded financial award during the annual reporting period by clicking on the drop-down menu under Block 11 and choosing one of the following options: Enter Individual's Financial Award Amount (BHW funds only): Direct Financial Support:
- If the individual did receive a direct BHW-funded financial award, enter the total amount of BHW dollars provided during the current reporting period in the textbox in Column 20a.
- If the individual did not receive a direct BHW-funded financial award, enter ""0"" in the textbox in Column 20a.
Enter Individual's Financial Award Amount (BHW funds only): Academic Year Total: |
IND-GEN - Entering # of Academic Years the Individual has Received BHW Funding Figure 15. IND-GEN - Entering # of Academic Years the Individual has Received BHW Funding Enter # of Academic Years the Individual has Received BHW Funding: Select the cumulative number of academic years that each student has received a BHW-funded financial award by clicking on the drop-down menu under Column 22 and choosing one of the following options: Note
The number of academic years receiving BHW-funded financial awards does not need to be consecutive; rather, the cumulative total number of years should be reported.
Note
If an individual has received money for a partial academic year, please round up to the nearest whole number. For example, if an individual has received direct financial support for 1 ½ years, please enter 2 in Column 22 (Block 12).
Note
If an individual received a BHW-funded financial award for the first time during the current reporting period, select "1" under Column 22 (Block 12).
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IND-GEN - Selecting Individual's Academic or Training Year Figure 16. IND-GEN - Selecting Individual's Academic or Training Year Select Individual's Academic or Training Year: Select each student's current training year by clicking on the drop-down menu under Block 15 and choosing one of the following options: |
IND-GEN - Selecting Topic Area(s) on which Individual was Trained Figure 17. IND-GEN - Selecting Topic Area(s) on which Individual was Trained Select Topic Area(s) on which Individual was Trained: Use the dropdown menu in Column 26a to select all that apply from the list of topic areas on which the individual was trained. - Clinical Practice Experience
- Clinical Skills Instruction
- Didactic Instruction
- Preceptorship
- Other
Note
These selection values reflect components of the SANE certification eligibility criteria outlined by the International Association of Forensic Nurses (IAFN). Please select the area(s) in which participants received relevant training even if participants do not intend to take the IAFN certification exam. |
IND-GEN - Selecting any HHS Priority Topic Area on which an Individual Received Training Figure 18. IND-GEN - Selecting any HHS Priority Topic Area on which an Individual Received Training Select any HHS Priority Topic Area on which an Individual Received Training: Use the dropdown menu in Column 26b to select all that apply from the list of topic areas on which the individual was trained. - Individual received provider resilience training
- Individual received training in Health Equity
- Individual received training in medications for opioid use disorder (MOUD)
- Individual received training in substance use treatment
- Individual received training on integrated behavioral health in primary care
- Individual received training related to maternal health
- None of the above
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IND-GEN - Selecting Profession and Discipline/Specialty Figure 19. IND-GEN - Selecting Profession and Discipline/Specialty Select Individual's Profession: Select the individual’s profession by clicking on the drop-down menu in Column 26c and selecting one of the available options.Select Individual's Primary Discipline/Specialty: Select the individual’s discipline/specialty by clicking on the drop-down menu in Column 26d and choosing from one of the available options. Please note that you must select a discipline/specialty that is associated with the profession you selected in Column 26c. The disciplines/specialties are organized by profession in the drop-down; please scroll to find the correct option.- Advanced Practice Nursing
- Clinical Nurse Leader (CNL)
- Clinical Nurse Specialist (CNS)
- Community Health Nursing
- Forensics
- Nurse Administrator
- Nurse Anesthetist
- Nurse Educator
- Nurse Midwife
- Nurse Practitioner (NP)
- Nursing Informatics
- Public Health Nurse
- Registered Nurse (RN)
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IND-GEN - Selecting Training in Interprofessional Education and/or PracticeWarning
Multiple steps are required to complete this portion of the subform. Please read instructions carefully. Figure 20. IND-GEN - Selecting Training in Interprofessional Education and/or Practice Training in Interprofessional Education and/or Practice: Select Whether Individual Received Training: Select whether each individual received experiential training in interprofessional education and/or practice during the annual reporting period by clicking on the drop-down menu under Column 27a and choosing one of the following options: |
IND-GEN - Entering Telehealth Training Information Figure 21. IND-GEN - Entering Telehealth Training Information Training in Telehealth: Select Whether Individual Received Training: Select whether each individual received clinical or experiential training in telehealth during the current reporting period by clicking on the drop-down menu in Column 27d and choosing one of the following options: |
IND-GEN - Entering Training Information in a Primary Care Setting Figure 22. IND-GEN - Entering Training Information in a Primary Care Setting Training in a Primary Care Setting: Select Whether Individual Received Training: Select whether each individual received clinical or experiential training in a primary care setting during the current reporting period by clicking on the drop-down menu in Column 28 (Block 17) and choosing one of the following options: |
IND-GEN - Entering Training Information in a Medically Underserved Community Figure 23. IND-GEN - Entering Training Information in a Medically Underserved Community Training in a Medically Underserved Community: Select Whether Individual Received Training: Select whether each individual received clinical or experiential training in a medically underserved community during the current reporting period by clicking on the drop-down menu in Column 31 and choosing one of the following options: |
IND-GEN - Entering Training Information in a Rural Area Figure 24. IND-GEN - Entering Training Information in a Rural Area Training in a Rural Area: Select Whether Individual Received Training: Select whether each individual received clinical or experiential training in a rural area during the current reporting period by clicking on the drop-down menu in Column 33 (Block 19) and choosing one of the following options: |
IND-GEN - Entering Total # of Patient Encounters Across All Settings Including Inpatients Figure 25. IND-GEN - Entering Total # of Patient Encounters Across All Settings Including Inpatients Enter Total # of Patient Encounters Across All Settings Including Inpatients: For each individual, enter the number of patient encounters across all settings, including inpatients, during the current reporting period in Column 34ab.
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IND-GEN - Entering Total # of Contact Hours Across All Settings Including Inpatients Figure 26. IND-GEN - Entering Total # of Contact Hours Across All Settings Including Inpatients Enter Total # of Contact Hours Across All Settings Including Inpatients: For each individual, enter the number of contact hours across all settings, including inpatients, during the current reporting period in Column 34ac.
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IND-GEN - Selecting Student Services Information Figure 27. IND-GEN - Selecting Student Services Information Student Services: Select Social Support services used by Trainee: Select whether each trainee used social support services by clicking on the drop-down menu under Column 34a and choosing all that apply from the following options: - Faculty or staff led counseling sessions
- Other social support services
- Peer support advisors
- Peer support groups
- Service learning opportunities
- None of the above
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IND-GEN - Selecting Individual's Field Placement Setting Figure 28. IND-GEN - Selecting Individual's Field Placement Setting Select Individual's Field Placement Setting: Select the type of setting where each student was placed during the annual reporting period by choosing one of the following options: - Academic institution
- Acute Care for the Elderly (ACE) Units
- Acute care services
- Aerospace operations setting
- Ambulatory practice sites
- Assisted Living Community
- Certified Community Behavioral Health Center (CCBHC)
- Community - based care programs for elderly mentally challenged individuals
- Community Behavioral Health Center
- Community care programs for elderly mentally challenged individuals
- Community Health Center (CHC)
- Community Mental Health Center
- Community-based organization
- Day and home care programs (e.g.Home Health)
- Dental Services
- Dentist Office
- Emergency Room
- Extended care facilities
- Federal and State Bureau of Prisons
- Federal Government Office or Agency
- FQHC or look-alike
- Geriatric ambulatory care and comprehensive units
- Geriatric Behavioral or Mental Health Units
- Geriatric consultation services
- Hospice
- Hospital
- Independent Living Facility
- Indian Health Service (IHS) site
- International nonprofit/nongovernmental organization
- Local Government Office or Agency
- Local health department
- Long-term Care Facility
- Mobile Clinic/Site
- National health association or affiliate
- Nurse Managed Health Clinics
- Nursing Home
- Other
- Other community health center (e.g.free clinic)
- Other Oral Health Facility
- Physician Office
- Program of All Inclusive Care for the Elderly
- Residential Living Facility
- School-based clinic
- State Government Office or Agency
- State Health Department
- Surgery Clinic
- Tribal Health Department
- Tribal Organization
- Veterans Affairs Hospital or clinic
- N/A
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IND-GEN - Selecting Whether Individual Left the Program Before Completion Figure 29. IND-GEN - Selecting Whether Individual Left the Program Before Completion Select Whether Individual Left the Program Before Completion: Select whether each individual permanently left their training program before completion during the current reporting period by clicking on the drop-down menu in Column 36 (Block 21) and choosing one of the following options: |
IND-GEN - Selecting Reason for Attrition or Inactive Status Figure 30. IND-GEN - Selecting Reason for Attrition or Inactive Status Select Reason for Attrition or Inactive Status: Select the primary reason each individual discontinued participation by clicking on the drop-down menu under Column 36a and choosing one of the following options: - Academic withdrawal
- Administrative Error
- Change in major
- Discontinuous year in training program
- Emotional/physical/mental exhaustion (burnout)
- Family obligations
- Financial obligations
- Medical leave of absence
- Military/Active duty
- Transfer to another institution
- Transportation difficulties
- Other
- None of the Above
- N/A
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IND-GEN - Entering Graduation/Completion InformationWarning
Multiple steps are required to complete this portion of the subform. Please read instructions carefully. Figure 31. IND-GEN - Entering Graduation/Completion Information Select Whether Individual Graduated/Completed the Program: Select whether each individual completed from their training program during the current reporting period by clicking on the drop-down menu in Column 37 (Block 22) and choosing one of the following options: Select Degree Earned: - Post-Masters Certificate
- SANE
- SANE-A
- SANE-A/P
- SANE-P
- State Certification
- N/A
- Yes, passed on first attempt
- Yes, passed after two or more attempts
- No, did not pass
- N/A
- Individual intends to apply for NHSC Loan Repayment
- Individual intends to become a preceptor
- Individual intends to become employed or pursue further training in a medically underserved community
- Individual intends to become employed or pursue further training in a primary care setting
- Individual intends to become employed or pursue further training in a rural setting
- Individual intends to pursue further education
- None of the above
- N/A
Warning
None of the above, Not reported, and N/A cannot be selected in combination with any other option. To Complete the Form: Click on the “Save and Validate” button located on the bottom right corner of your screen. If no errors are found, the BPMH system will automatically route you to the next required subform. |
IND-GEN - Entering Individual's Employment DataWarning
Multiple steps are required to complete this portion of the subform. Please read instructions carefully. Figure 32. IND-GEN - Entering Individual's Employment Data Select whether Employment Data is available?: Select whether employment data are available by clicking on the drop-down menu in Column 56 and choosing one of the following options: - Yes
- Yes (outside U.S.)
- No
- N/A
Enter the zip code for the individual’s Employment Location. Enter City: Employment City (Column 58) will auto-populate based on Employment Location Zip Code (Column 57). Enter State: Employment State (Column 59) will auto-populate based on Employment Location Zip Code (Column 57). Select Type of Employment: - If ‘Yes’ was selected in Column 56, identify the individual’s type of employment by clicking on the drop-down menu and selecting the best option among those listed below.
- If ‘No’ or ‘Yes (outside U.S.)' was selected, select 'N/A' in Column 60.
- Academic Institution
- Academic Medical Center
- Area Health Education Center
- Certified Community Behavioral Health Clinic (CCBHC)
- Community Behavioral Health/Mental Health Center
- Community Health Center (CHC)
- Critical Access Hospital
- Federal Government
- FQHC or Look-Alike
- Health Department (local/state/tribal)
- Hospital (non-academic)
- Indian Health Service (IHS)/Tribal/Urban Indian Health Center
- Nursing Home
- Other Clinical Health Setting
- Other Community-Based Organization
- Other Long-term Care Facility
- Other Specialty Clinic
- Private Industry
- Private Practice
- Residential Living Facility (including independent and assisted living)
- Rural Health Clinic
- School-based Clinic
- State or Local Government
- US Armed Forces
- Veterans Affairs Healthcare (e.g. VA hospital or clinic)
- Pursuing Additional Education or Training
- Not Currently Employed
- N/A
Warning
For Column 60, None of the above, not reported, and N/A cannot be selected in combination with any other option. NoteIf an individual has completed the program but is not currently employed, please select “Yes” for Column 56 (Select whether employment data is available). Leave the zip code, city, and state blank and select "N/A" for whether you or a partner organization hired the individual (Columns 56a and 56b). Then, select “Not Currently Employed” for Column 60 and N/A for Column 61.
Note You must also select “N/A” if you indicated that the person is “Not Currently Employed” in Column 60.
Note
Leave the zip code blank if you indicated that the person is “Not Currently Employed” in Column 60. |
IND-GEN - Selecting Individual's Employment Location Settings Figure 33. IND-GEN - Selecting Individual's Employment Location Settings Select Individual's Employment Location Settings: For each individual, use the drop-down menu in Column 61 to select all that apply from the list of employment location settings. - Medically Underserved Community
- National Health Service Corps (NHSC)-Approved Site
- Primary Care Setting
- Rural Area
- None of the Above
- N/A
To Complete the Form: Click on the "Save and Validate" button located on the bottom right corner of your screen. If no errors are found, the BPMH system will automatically route you to the next required subform. |
IND-GEN - Selecting Individual's Role(s) at Employment Setting Figure 34. IND-GEN - Selecting Individual's Role(s) at Employment Setting Select Individual’s Primary Role at Employment Setting: Indicate the individual’s primary role at their employment setting by selecting the best option from the list under column 62. If employment data are not available for the individual, or if the individual dropped out, or if the individual is still actively enrolled in the training program, select “N/A.” - SANE Nursing Role
- Non-SANE Nursing Role
- N/A
Indicate roles other than the role selected under column 62 that the individual fulfills at their employment setting by clicking on the drop-down menu under column 63 and selecting all that apply. If employment data are not available for the individual, if the individual dropped out, or if the individual is still actively enrolled in the training program, or if the individual did not serve in other roles, select “N/A.” No other options can be selected in combination with “N/A.” - SANE Nursing Role
- Non-SANE Nursing Role
- N/A
Note For primary role, select one. For other roles, select all that apply. Note
You must also select “N/A” if you indicated that the person is “Not Currently Employed” in Column 60. |
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