Workforce Partnership of Greater Rhode Island 1511 Pontiac Avenue Cranston, Rhode Island (401)

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1 Workforce Partnership of Greater Rhode Island 1511 Pontiac Avenue Cranston, Rhode Island (401) Local Area Workforce Investment Notice: PY15-01 Date: To: From: Re: October 2, 2015 Greater Rhode Island Workforce Investment Area Nancy J. Olson, Executive Director, WPGRI WIOA Title I Eligibility Requirements - Interim Policy Issuance PURPOSE: The purpose of this issuance is to notify the Rhode Island Department of Labor and Training, Workforce Development, networkri One Stop Centers of Title I Eligibility Requirements under the Workforce Innovation and Opportunity Act (WIOA). Please refer to this policy instead of WIN This policy is effective immediately. BACKGROUND: The Workforce Innovation and Opportunity Act (WIOA) was signed into law on July 22, WIOA is designed to help job seekers access employment, education, training and support services to succeed in the labor market and to match employers with the skilled workers they need to compete in the global economy. WIOA supersedes the titles I and II of the Workforce Investment Act of 1998, and amends the Wagner Peyser Act, and the Rehabilitation Act of In general, the Act takes effect on July 1, 2015, the first full program year after enactment. POLICY: All new participant eligibility determinations must be made under the WIOA framework and must follow all WIOA requirements. Participants enrolled on or after July 1, 2015 may only access services allowable under WIOA. ATTACHMENTS: A B C D E F G Program Eligibility Criteria WIOA Access to Services Priority for Services WIOA Definitions Selective Service Registration Requirements Eligibility Documentation Applicant Self Certification REFERENCE: ETA Training and Employment Guidance Letter WIOA No Workforce Innovation and Opportunity Act of 2014; 20 CFR Parts 676, 677, 678 & 680 INQUIRIES: Questions related to this policy may be directed to: Nancy Olson, Executive Director, WPGRI nancy.olson@dlt.ri.gov The Workforce Partnership of Greater Rhode Island se,ves as the Local Workforce Investment Board (LW/8) for thirty~seven or the state's thirty-nine communities (excluding Providence and Cranston). The organization's mission is to provide strategic leadership to meet the current and future human resource needs of Rhode Island's employers and to ensure a well-trained, self-sufficient and adaptable workforce. If you have questions or concerns regarding this poffcy, please contact Nancy Olson, Executive Director, at (401) Page 1 of20

2 TITLE I - ADULTS ATTACHMENT A PROGRAM ELIGIBILITY CRITERIA Title J -Adult participants must meet each of the following criteria: 1. Age 18 years of age or older. 2. A citizen or national of the United States, lawfully admitted permanent resident alien, refugee, asylee, parolee, or other immigrant authorized by the Attorney General to work in the United States. 3. In compliance with the Military Selective Service Act. (This applies to males 18 or older who were born on or after January 1, 1960). TITLE I - DISLOCATED WORKERS Title I -Dislocated Worker participants must meet each of the following criteria: 1. Age 18 years of age or older. 2. A citizen or national of the United States, lawfully admitted permanent resident alien, refugee, asylee, parolee, or other immigrant authorized by the Attorney General to work in the United States. 3. Jn compliance with the Military Selective Service Act. (This applies to males 18 or older who were born on or after January 1, 1960). DISLOCATED WORKER The term "dislocated worker" means an individual who (A) (i) has been terminated or laid off, or who has received a notice of termination or layoff, from employment; (ii) (l) is eligible for or has exhausted entitlement to unemployment compensation; or (II) has been employed for a duration sufficient to demonstrate attachment to the workforce, but is not eligible for unemployment compensation due to insufficient earnings or having performed services for an employer that were not covered under the State of RI unemployment compensation law; and (iii) is unlikely to return to a previous industry or occupation; (B) (i) has been tenninated or laid off, or has received a notice of termination or layoff, from employment as a result of any permanent closure of, or any substantial layoff at a plant, facility, or enterprise; (ii) is employed at a facility at which the employer has made a general announcement that such facility will close within 180 days; or Page 2 of20

3 (iii) for purposes of eligibility to receive services other than training services, career services, or supportive services, is employed at a facility at which the employer has made a general announcement that such facility will close; (C) (D) (E) was self-employed (including employment as a fanner, a rancher, or a fisherman) but is unemployed as a result of general economic conditions in the community in which the individual resides or because of natural disasters; is a displaced homemaker; or (i) is the spouse of a member of the Armed Forces on active duty who has experienced a loss of employment as a direct result of relocation to accommodate a permanent change in duty station of such member; or (ii) is the spouse ofa member of the Armed Forces on active duty and who meets the criteria described in Displaced Homemaker below. DISPLACED HOMEMAKER The tenn "displaced homemaker" means an individual who has been providing unpaid services to family members in the home and who - (A)(i) has been dependent on the income of another family member but is no longer supported by that income; or (ii) is the dependent spouse of a member of the Armed Forces on active duty and whose family income is significantly reduced because of a deployment, a call or order to active duty, a permanent change of station, or the service-connected death or disability of the member; and (B) is unemployed or underemployed and is experiencing difficulty in obtaining or upgrading employment. Page 3 of20

4 ATTACHMENTB WIOA Access to Services networkri One Stop Centers provide services to customers based on individual needs, including the seamless delivery of multiple services to individual customers. There are no required sequence of services. Career Services Career Services consist of three types: basic career services, individualized career services, and follow-up services. Basic Career Services must be made available and, at a minimum, must include one of the following services, as consistent with allowable program activities and Federal cost principles. J. Determinations of whether the individual is eligible to receive assistance from the adult, dislocated worker, or youth programs; n. Outreach, intake (including worker profiling), and orientation to infonnation and other services available through the one-stop delivery system; 111. Initial assessment of skill levels. For example: literacy, numeracy, and English language proficiency, as well as aptitudes, abilities (including skills gaps), and supportive service needs; 1v. Labor exchange services, including - I. Job search and placement assistance, and, when needed by an individual, career counseling, including - aa. Provision of information on in-demand industry sectors and occupations; and bb. Provision of information on nontraditional employment; and II. Appropriate recruitment and other business services on behalf of employers, including information and refen-als to specialized business services other than those traditionally offered through the one-stop delivery system; v. Provision of referrals to and coordination of activities with other programs and services, including programs and services within the one-stop delivery system and, when appropriate, other workforce development programs; Page 4 of20

5 v1. Provision of workforce and labor market employment statistics information, including the provision of accurate information relating to local, regional, and national labor market areas, inclnding - I. Job vacancy listings in labor market areas; II. III. Information on job skills necessary to obtain the vacant jobs listed; and Information relating to local occupations in demand and the earnings, skill requirements, and opportw1ities for advancement for those jobs; vu. Provision of performance information and program cost information on eligible providers of training services by program and type of providers; v111. Provision of inf01mation, in usable and understandable formats and languages, about how the local area is performing on local performance accountability measures, as well as any additional performance infonnation relating to the area's one-stop delivery system; IX. I. Provision of information, in usable and understandable formats and languages, relating to the availability of supportive services or assistance, and IL appropriate referrals to those services and assistance, including: child care, child support; medical or child health assistance available through the State's Medicaid program and Children's Health Insurance Program; benefits under SNAP; assistance through the earned income tax credit; and assistance under a Slate program for Temporary Assistance for Needy Families, and other supportive services and transportation provided through that program; x. Provision of information and assistance regarding filing claims for unemployment compensation, by which the networkri One Stop Center must provide meaningful assistance to individuals seeking assistance in filing a claim for unemployment compensation. "Meaningful assistance" means: (A) Providing assistance on-site using staff who are well-trained in unemployment compensation claims filing and the rights and responsibilities of claimants; or (B) Providing assistance by phone or via other technology, as long as the assistance is provided by trained and available staff and within a reasonable time. The costs associated in providing this assistance may be paid for by the State's unemployment insurance program, or the WIOA Adult or Dislocated Worker programs, or some combination thereof. x1. Assistance in establishing eligibility for programs of financial aid assistance for training and education programs not provided under WIOA. Page 5 of20

6 Individualized Career Services must be made available if determined to be appropriate in order for an individual to obtain or retain employment. These services include the following services, as consistent with program requirements and Federal cost principles: I. Comprehensive and specialized assessments of the skill levels and service needs of adults and dislocated workers, which may include - aa. Diagnostic testing and use of other assessment tools; and bb. In-depth interviewing and evalnation to identify employment barriers and appropriate employment goals; Use of Previous Assessments.--' networkri One Stop Centers shall not be required to conduct a new interview, evaluation, or assessment of a participant if it determines that it is appropriate to use a recent interview, evaluation, or assessment of the participant conducted pursuant to another education or training program. II. III. IV. Development of an individual employment plan, to identify the employment goals, appropriate achievement objectives, and appropriate combination of services for the participant to achieve his or her employment goals, including the list of, and information about, the eligible training providers; Group counseling; Individual counseling; V. Career planning; VI. VII. VIII. IX. Short-term pre-vocational services including development of learning skills, communication skills. interviewing skills, punctuality, personal maintenance skills, and professional conduct services to prepare individuals for unsubsidized employment or training; Internships and work experiences that are linked to careers Workforce preparation activities; Financial literacy services X. Out-of-area job search assistance and relocation assistance; and XI. English language acquisition and integrated education and training programs. Page 6 of20

7 Follow-Up Services must be provided, as appropriate, including; counseling, regarding the workplace, for participants in adult or dislocated worker workforce investment activities who are placed in unsubsidized employment, for up to 12 months after the first day of employmeut. Training Services Training services may be made available to adults and dislocated workers: I. Who, after an interview, evaluation, or assessment, and career planning, have been determined by a networkri One-Stop Center to: a. be unlikely or unable to obtain or retain employment, that leads to economic selfsufficiency or wages comparable to or higher than wages from previous employment, through the career services described above; b. be in need of training services to obtain or retain employment that leads to economic self-sufficiency or wages comparable to or higher than wages from previous employment; and c. have the skills and qualifications to successfully participate in the selected program of training services; 11. Who select programs of training services that are directly linked to the employment opportunities in the local area or the planning region, or in another area to which the adults or dislocated workers are willing to commute or relocate; III. IV. Are unable to obtain grant assistance from other sources to pay the cost of such training, including such sources as state-funded training funds, Trade Adjustment Assistance, and Federal Pell Grants established under title IV of the Higher education Act of 1965, or require WIOA assistance in addition to other sources of grant assistance, including ; Federal Pell Grants; and If training services are provided through the adult funding stream, are determined eligible in accordance with the state and local priority system in effect for adults under WIOA (please refer to Attachment C: Priority of Services). Page 7 of20

8 ATTACHMENT C PRIORITY FOR SERVICES WIOA mandates that priority must be given to recipients of public assistance, low income individuals and individuals that are basic skills deficient. VETERANS PRIORITY OF SERVICE Veterans under WIOA receive priority of service in all Department of Labor-funded training programs. A Veteran must still meet each program's eligibility criteria to receive services under the respective employment and training program. ADULT PRIORITY Priority for individualized career services and training services funded with Title J adult funds must be given to recipients of: U public assistance, i:: other low income individuals, and CJ individuals who arc basic skills deficient Local Area Workforce Investment Notice PY15-03 sets forth the definition for low income adults. The priority established does not necessarily mean that these services may only be provided to recipients of public assistance, other low income individuals, and individuals without basic work skills. The WPGRI has defined the term "priority" to mean that 51 % or more of the participants served with WIOA Adult funds must be either low-income, recipients of public assistance or basic skills deficient. Priority of service status is established at the time of eligibility determination and does not change during the period of participation. Priority does not apply to Dislocated Workers. The WIOA Adult funding priority of service does not affect or negate the priority of service provided to veterans and eligible spouses. Veterans and eligible spouses continue to receive priority of service among all eligible individuals; however, they must meet WIOA Adult program eligibility criteria. Thus, for WIOA Adult services, the program's eligibility determination must be made first, then the veteran's priority applied. Veterans and eligible spouses that are not low income, recipients of public assistance or basic skills deficient are not included in the required 51 % priority of service calculation. Page 8 of20

9 ATTACHMENT D WIOA DEFINITIONS ADULT - an individual who is 18 years or older at the time of application. CONCURRENT ENROLLMENT- eligible individuals who are 18 through 24 years old may participate in adult and youth programs concurrently. Such individuals must be eligible under the youth or adult eligibility criteria applicable for the services received. DISLOCATED WORKER The term "dislocated worker" means an individual who (A) (i) has been terminated or laid off, or who has received a notice of termination or layoff'. from employment; (ii) (I) is eligible for or has exhausted entitlement to unemployment compensation; or (II) has been employed for a duration sufficient to demonstrate attachment to the workforce, but is not eligible for w1employment compensation due to insufficient earnings or having perfonned services for an employer that were not covered under the State of RI unemployment compensation law; and (iii) is unlikely to return to a previous industry or occupation; (B) (i) has been terminated or laid off, or has received a notice of termination or layoff, from employment as a result of any permanent closure of, or any substantial layoff at a plant, facility, or enterprise; (ii) is employed at a facility at which the employer has made a general announcement that such facility will close within 180 days; or (iii) for purposes of eligibility to receive services other than training services, career services, or supportive services, is employed at a facility at which the employer has made a general announcement that such facility will close; (C) (D) (E) was self-employed (including employment as a farmer, a rancher, or a fisherman) but is unemployed as a result of general economic conditions in the community in which the individual resides or because of natural disasters; is a displaced homemaker; or (i) is the spouse ofa member of the Armed Forces on active duty who has experienced a loss of employment as a direct result of relocation to accommodate a permanent change in duty station of such member; or Page 9 of20

10 (ii) is the spouse ofa member of the Armed Forces on active duty and who meets the criteria described in Displaced Homemaker below. DISPLACED HOMEMAKER The term "displaced homemaker" means an individual who has been providing unpaid services to family members in the home and who ~ (A) (i) has been dependent on the income of another family member but is no longer supported by that income; or (ii) is the dependent spouse of a member of the Armed Forces on active duty and whose family income is significantly reduced because of a deployment, a call or order to active duty, a permanent change of station, or the service-connected death or disability of the member; and (B) is unemployed or underemployed and is experiencing difficulty in obtaining or upgrading employment. EEO DAT A - Equal Employment Opportunity information on race and ethnicity, age, sex, and disability required by regulations implementing section 188 of WIOA governing nondiscrimination.. FAMILY - two or more persons related by blood, marriage, or decree of court, who are living in a single residence, and are included in one or more of the following categories: (A) a husband, wife, and dependent children, (B) a parent or gnardian and dependent children, (C) a husband and wife Please Note: Consistent with the policy of the Department of Labor, ET A's policy is to recognize all marriages (including same-sex marriages) that are lawfully entered in the state of celebration. Interpreting "husband" and "wife" should be applied in a gender neutral manner in the definition of "family". Interpretation of "family" includes same sex spouses. HOMELESS - pursuant to the Stewart B. McKinney Homeless Act, an individual who lacks a fixed, regular, and adequate nighttime residence. It also includes persons whose primary nighttime residence is either: (A) a supervised publicly or privately operated shelter designed to provide temporary living accommodations (including welfare hotels, congregate shelters, and transitional housing for the mentally ill), (B) an institution that provides a temporary residence for individuals intended to be institutionalized, or Page 10 of20

11 (C) a public or private place not designed for, or ordinarily used as, a regular sleeping accommodations for human being. INDIVIDUAL -A person not meeting the definition of a member of a family is considered to be an individual ( often referred to as a family of one). The definition of individual may cover a person with a disability or a state custody individual. INDIVIDUAL WITH A BARRIER TO EMPLOYMENT -The term "individual with a barrier to employment" means a member of 1 or more of the following populations: (A) Displaced homemakers. (B) Low-income individuals. (C) Indians, Alaska Natives, and Native Hawaiians, as such terms are defined in section 166. (D) Individuals with disabilities, including youth who are individuals with disabilities. (E) Older individuals. (F) Ex-offenders. (G) Homeless individuals, or homeless children and youths. (H) Youth who are in or have aged out of the foster care system. (I) Individuals who are English language learners, individuals who have low levels of literacy, and individuals facing substantial cultural barriers. (J) Eligible migrant and seasonal farmworkers (K) Individuals within 2 years of exhausting lifetime eligibility under part A of title IV of the Social Security Act. (L) Single parents (including single pregnant women). (M) Long-term unemployed individuals. (N) Such other groups as the Governor determines to have barriers to employment. INDIVIDUAL WITH A DISABILITY-IN GENERAL-The term ''individual with a disability" means an individual with a disability as defined in section 3 of the Americans with Disabilities Act of LOWER LIVING STANDARD INCOME LEVEL - the income level (adjusted for regional, metropolitan, urban, and rural differences and family size) determined annually by the Secretary of Labor based on the most recent lower living family budget issued by the secretary. LOW-INCOME INDIVIDUAL - IN GENERAL-The term "low-income individual'' means an individual who - (i) receives, or in the past 6 months has received, or is a member of a family that is receiving or in the past 6 months has received, assistance through the supplemental nutrition assistance (SNAP) program established under the Food and Nutrition Act of 2008, the program of block grants to States for temporary assistance for needy families (TANF), or the supplemental security income (SSI) program or State or local income-based public assistance; (ii) is in a family with total family income that does not exceed the higher oi: (I) If unemployed: 70% of the (LLSIL) Lower Living Standard Income Level Page 11 of20

12 (Il) If employed: 100% of the (LLSIL) Lower Living Standard Income Level LLSIL (iii) is a homeless individual or a homeless child or youth (iv) receives or is eligihle to receive a free or reduced price lunch under the Richard B. Russell National School Lunch Act (v) is a foster child on behalf of whom State of RI payments are made; or (vi) is an individual with a disahility whose own income meets the income requirement of clause (ii), but who is a member of a family whose income does not meet this requirement. OFFENDER-means an adult or juvenile- (A) who is or has heen subject to any stage of the criminal justice process, and for whom services under this Act may be beneficial; or (B) who requires assistance in overcoming artificial barriers to employment resulting from a record of arrest or conviction. OLDER INDIVIDUAL - an individual age 55 or older. ON THE JOB TRAINING - means training by an employer that is provided to a paid participant while engaged in productive work in a job that- (A) provides knowledge or skills essential to the full and adequate performance of the job; (B) is made available through a program that provides reimbursement to the employer of 50 percent of the hourly wage of the participant, for the extraordinary costs of providing the training and additional supervision related to the training; and (C) is limited in duration as appropriate to the occupation for which the participant is being trained, taking into account the content of the training, the prior work experience of the participant, and the service strategy of the participant, as appropriate. PARTICIPANT - an individual who has been determined to be eligible to participate in and who is receiving services ( except follow-up). Participation shall be deemed to commence on the first day, following determination of eligibility, on which the individual began receiving subsidized employment, training, or other Title I services beyond self- service or infmmational services. POVERTY LINE - as defined by the Office of Management and Budget and revised annually applicable to a family of the size involved. PUBLIC ASSISTANCE - Federal, State or local government cash payments for which eligibility is detennined by a needs or income test. Page 12 of20

13 REGISTRATION (for Title I) - the process of collecting information necessary to make a determination of eligibility for Title I. Adults and dislocated workers who receive services funded under Title I other than self-service or informational activities, and certain staff-assisted core services must be registered for Title I and determined eligible. EEO data must be collected on individuals during the registration process. Please Note The term registration may also be used by different partners to refer to registration in their respective programs. Most jobseekers at networkri One-Stop Career Center will be registered on employri.org. Eligibility determination for Title I may occur at initial registration or at any subsequent point prior to the receipt of Title I participant services. Adults and dislocated workers do not have to be registered and determined eligible for Title I in order to make use of informational and self-service core services that are offered 1miversally to networkri One-Stop Center customers. SUPPORTIVE SERVICES - The term "supportive services" means services such as transportation, child care, dependent care, and housing that are necessary to enable an individual to participate in activities authorized under this Act. SELF-SUFFICIENCY - Employment that pays at least I 00% Lower Living Standard Income Level (LLSIL ). STATE CUSTODY YOUTH - For the purpose of WIOA eligibility, this definition applies to an adolescent between the age of fourteen and eighteen (14 and 18) who is comi ordered into substitute care under the legal responsibility of the State of Rhode Island through its Office of Health and Human Services (OHHS) including the Depaiiments of Human Services (DHS) and the Department of Children, Youth and Families (DCYF) according to the General Laws of the State of Rhode Island. UNEMPLOYED INDIVIDUAL - means an individual who is without a job and who wants and is available for work. The detennination of whether an individual is without a job, for purposes of this paragraph, shall be made in accordance with the criteria used by the Bureau of Labor Statistics of the Department of Labor in defining individuals as unemployed. VETERAN- (A) means a person who served in the active military, naval, or air service, and who was discharged or released therefrom under conditions other than dishonorable according to IOI of title 38, United States Code. (B) RECENTLY SEP ARA TED VETERAN~ The term "recently separated Veterai1" means any Veterai1 who applies for participation under this Act within 48 months after the discharge or release from active military, naval, or air service. Page 13 of20

14 ATTACHMENT E SELECTIVE SERVICE REGISTRATION REQUIREMENTS To be eligible to pmiicipate in WIOA Title I services, certain Selective Service requirements must be met by networkri One-Stop Center customers: (A)All males born in the United States on or after January 1, 1960 must have registered with the Selective Service System (must be able to document registration with SSS). (B) Males not born in the United States, whose birth date is on or after January 1, 1960 and who entered the U.S. before their 26 th bi1ihday must have registered with the Selective Service System (must be able to document their date of entry and date of birth). Since a foreign born male who enters the U.S. as a student attending school on a full-time basis is not required to register with Selective Service, verification of the individual's Fl Student Visa status when he was between the ages of would be sufficient. (C) Males not born in the United States, whose birth date is on or after January 1, 1960 and who entered the U.S. after their 26 th birthday are not required to register with Selective Service (must document their date of entry and date of birth). (D) Males born on or after January 1, 1960 and who have been discharged from U.S. military service must document their date of discharge on their DD214. (E) Males serving in the military on full time active duty do not have to register. Those attending the service academies do not have to register. If a young man leaves the military before turning 26, he must register. For non-u.s. born customers presentation of either a Certificate of Naturalization form or a valid United States Passport will indicate that an individual has met all Selective Service requirements, as Selective Service compliance is also a requirement of the naturalization process. WIOA Section l 89(h) TEGL Change 2-May 16, U.S.G. Appendix 453- Military SS Act issued June 24, 1948 as amended by P.L 'Online verification is available for men bom on or after 12\31\59. Men between the ages of who have not registered should be referred to SSS for registration prior to enrollment in WIOA Title I. Registration may be completed online at the web site. 'An individual's legal right to work in the United States may be documented using the Social Security Card (unless the card says that it is not valid for employment) ANO Driver's License or other government issued picture ID containing a photograph or information such as name, date of birth. gender, height. eye color and address. The SS Card establishes work authorization and the identification establishes identity (and that the SS Card belongs to the person). Pursuant to the USDOL policy that final decisions for disbursing federally financed domestic benefits, services. rights, or training, rests solely with the provider agencies that disburse them, the local Title I operator is responsible for detennining if an individual seeking services under Title I meets Selective Se,vice requirements. As such, the Title I operator must detennine for any Title I applicant who was required to register with Selective Service and failed to do so, whether that failure was knowing or willful. It is the responsibility of the individual to demonstrate that such failure to register was not knowing or willful. All such determinations must be documented in the participant's case file. OOL TEGL 8-98 issued 11/4198. Page 14 of20

15 ATTACHMENT F ELIGIBILITY DOCUMENTATION ELIGIBILITY CRITERIA SOURCES OF DOCUMENTATION Birth Date/Age U.S. Citizenship or Authorization to Work in the United States if a non U.S. Citizen 1. Baptismal Record 2. Birth Certificate 3. DD-214, Report of Transfer or Discharge Paper 4. Driver's License (with Photo and Date of Birth) 5. Federal, State or Local Government Identification Card that includes a birth date 6. Selective Service Card 7. Hospital Record of Birth 8. Passport (as long as the passport includes the date of birth) 9. Public Assistance\Social Service Records 10. School Recordslldentification Card 11. Letter from State of Rhode Island OHHS Agency (for Foster Child and State Custody Youth, only) 12. Unexpired Alien Registration Card/Documents indicating authorization to work in the Unites States 1-179, 1-197, 1-551, 1-688, l-688a, l-688b, 1-766, Certificate of Naturalization (Form N-565 or N-570) 1-94 Arrival/Departure Form 1. U.S. Baptismal Certificate (if place of birth is shown) 2. U.S. Birth Certificate 3. U.S. Hospital Record of Birth 4. U.S. Passport (either current or expired) 5. Certificate of Naturalization (Form N-565 or N-570) 6. Unexpired Alien Registration Card/Documents indicating authorization to work in the Unites States (INS Forms 1-179, 1-197, 1-327, 1-551, 1-571, 1-688, l-688a, l-688b, 1-766, an unexpired 1-94 Arrival/Departure form that includes an endorsement (stamped) of the individual's status as authorized to work in the United States when accompanied with an unexpired temporary foreign passport that has the same name as the 1-94, an unexpired temporary foreign passport stamped with an Work Authorization stamp 7. Letter from State of Rhode Island EOHHS Agency (for Foster Child and State Custody Youth, only) 8. Native American Tribal document 9. Social Security Card (unless it states not valid for employment) and I.D. 10. One verification source from List A of the 1-9 Form OR one verification source from List BAND one verification source from List C of the 1-9 Form (from list B of the 1-9 Form, Voter Registration Form cannot be used.) Page 15 of20

16 Social Security Number 11 Social Security Card/Notice of Social Security Number Assignment 12. W-2 Assignment of pseudo SSN is '3. U.C. Records (if name and social security number is shown) forbidden by IRS regulations 4. DD-214, Report of Transfer or Discharge (if SSN is shown) 5. Employment Records 3. IRS Form Letter from Social Service Agency 8. Pay Stub 9. Social Security Benefit Documents Selective Service Registrant 1. DD-214, Report of Transfer or Discharge 2. Selective Service Advisory Opinion Letter (not used after Jan., 1995) 3. Selective Service Online Verification at (printout) 4. Selective Service Registration Acknowledgement Card 5. Selective Service Status Information Letter 6. Selective Service Registration Record (Form 3A) 7. Stamped Post Office Receipt of Registration 8. Certificate of Naturalization (indicates compliance with all Selective Service requirements) (Cannot be copied must verify using the Document Inspection Form - see Attachment G) 9. U.S. Passport (for non-u.s. born customers, only) ECONOMIC ELIGIBILITY Cash Public Assistance NOTE: The listed items of documentation are acceptable for any individual listed on arant. Individual/Family Income If applicant is low income based on meeting the definition of TANF, SNAP benefits, SS!, homeless, or foster child this must be verified. Family income does not need to be verified or recorded., 1. Copy of Authorization to Receive Cash Public Assistance 2. Public Assistance Identification Card showing Cash Grant Status 3. Public Assistance Records/Printout/Master File 1. Alimony Agreement 2. Award letter from Veterans Administration 3. Bank Statements (Direct Deposits) 4. Compensation Award Letter 5. Court Award Letter 6. Employer Statement/Contact 7. Business Financial Records 8. Housing Authority Verification 9. Pay Stubs 10. Pension Statement 11. Quarterly Estimated Tax for Self-Employed Persons 12. Social Security Benefits 13. Unemployment Insurance Documents 14. Written statement from other Federal, State or Local agency 15. Applicant Statement (Self Certification) if no other forms of documentation available Page 16 of20

17 Individual Status/Family Size 1. Birth Certificate 2. Decree of Court 3. Disabled (See "Individuals with Disabilities" below) 4. Divorce Decree 5. Lease or Landlord Statement 6. Marriage Certificate 8. Medical Card 9. Public Assistance/Social Service/Public Housing Agency Records 10. Letter from State of Rhode Island OHHS Agency (for Foster Child and State Custody Youth, only) 11. Applicant Statement (Self Certification) if no other forms of documentation available SNAP 1. Current Authorization to obtain SNAP 2. Current SNAP receipt ff applicant is low income based 3. SNAP Card with Current Date on meeting the definition of SNAP 4. Postmarked SNAP letter with Applicable Name and Address benefits, this must be vetified. 5. Public Assistance Records/Printout Family income does not need to be verified or recorded. Homeless 1. Written Statement from an Individual Providing Temporary /Income verification not Residence required) 2. Written Statement from Shelter/Social Service Agency 3. Letter from State of Rhode Island OHHS Agency (for Foster Individual and State Custody Individual, only) 4. Applicant Statement (Self Certification) if no other forms of documentation available Supported Foster Individual - 1. Court Contact uptoage18 2. Court Documentation (Income verification not 3. Medical Card required) 4. Verification of Payments made on Behalf of the Child 5. Written Statement from State\Local Agency 6. Letter from State of Rhode Island OHHS Agency Individual with Disabilities 1. Letter from Drug or Alcohol Rehabilitation Agency ( Customer's own income 2. Letter from Child Study Team Stating Specific Eligibility must be considered) 3. Medical Records 4. Observable Condition 5. Physician Statement 6. Psychiatrist's/Psychologist's Diagnosis 7. Rehabilitation Evaluation 8. School Records 9. Sheltered Workshop Certification 10. Social Service Records\Referral 11. Social Security Administration Disability or Veterans Adm in. Records 12. Vocational Rehabilitation Letter 13. Workers Compensation Record State Custody Individual - 1. Court Contact Up to age Court Documentation (Customer's own income 3. Medical Card must be considered) 4. Verification of Payments made on Behalf of the Child 5. Written Statement from State\Local Agency 6. Letter from State of Rhode Island OHHS Page 17 of20

18 (A) (i) terminated, laid-off or received notice and (ii) (I) is eligible for, or has exhausted entitlement to, UI benefits; or (II) has been employed but is not eligible for UI due to insufficient earnings or were not covered under UI, and (iii) is unlikely to return to a previous industry or occupation (B) (i) is terminated, laid-off or received notice as a result of permanent closure or substantial layoff (ii) is employed at a facility that has announced plans to close within in 180 days; or (iii) for purposes of receiving core services, is employed at a facility that has announced plans to close (C) was self-employed but is unemployed due to general economic conditions or because of natural disaster (D) is a displaced homemaker who has been providing unpaid services to family members in the home and who has been dependent on the income of another family member but is no longer supported by that income, and is unemployed or under employed and is experiencing difficulty in obtaining or upgrading employment. (E) Spouse of member of armed services 1. Unemployment Insurance (UI) records 2. Referral from Rapid Response 3. Notice of Ineligibility for Unemployment Insurance 4. Profiled Customer/Referral Form 5. Documentation from former employer of employment and layoff status 1. Letter from company (must list customer name and date of layoff if only form of documentation presented) 2. WARN Notice with recent pay stub 3. Newspaper article with recent pay stub 4. Documentation from employer, including telephone verification or employment and layoff status. 5. Unemployment Insurance (UI) records 6. Profiled Customer/Referral Form 7. Referral from Rapid Response 1. Document indicating business closure 2. Business Tax documents or returns 3. Federal or State Declaration of Disaster 1. Tax returns 2. Social Security documents 3. Death notice and/or certificate (with applicant statement and/or other proof of income status such as 1, 2, 4, 5 or 6) 4. Divorce decree (with applicant statement and/or other proof of income status such as 1, 2, or 5) 5. Public assistance records/ui records 6. Documentation of divorce filing (with applicant statement and/or other proof of income status such as 1, 2, or 5) 1. DO214 if dislocation is based on discharge from the military 2. Spouse's military orders if the dislocation is based onjhe SellliCe rnernbe[ oerm;ane,nt ~h~nno of mifibrn Page 18 of20

19 ATTACHMENT G APPLICANT STATEMENTS (SELF CERTIFICATION) Applicant statements may be used, in a limited way. after all practicable attempts to secure recommended documentation is exhausted, to document those items that, in some cases, are not verifiable or may cause undue hardship for individuals to obtain. An applicant statement may be used as the sole source document only for determining family income, residence and family size or in determining whether a customer is to be considered "hard to serve" because of barriers of pregnancy/parenting or his/her status as "homeless", an "offender" or a school "dropout", and may not be used as the sole source document for any other eligibility criteria. Example: Use of the sample APPLICANT STATEMENT FORM (SELF CERTIFICATION) (Attachment G) is as follows: If an applicant states that he/she is unable to provide evidence that no income was received during the past six months, and that he/she was unemployed for that period, the blank spaces following the words "/ certify, under penalty of perjury, that I have received no income from any source during the past six months, that I have been unemployed during that time, and have been supported by donations/contributions from relatives and friends." Page 19 of20

20 ATTACHMENT G WORKFORCE PARTNERSHIP OF GREATER RHODE ISLAND SELF-CERTIFICATION Applicant's Nam.,. _ Last First Ml Addres~ Social Security Number A lication Date: I HEREBY CERTIFY UNDER PENAL TY OF PERJURY, THAT THE FOLLOWING INFORMATION IS TRUE: I ATTEST THAT THE INFORMATION STATED ABOVE IS TRUE AND ACCURATE, AND UNDERSTAND THAT THE ABOVE INFORMATION, IF MISREPRESENTED, OR INCOMPLETE, MAY BE GROUNDS FOR IMMEDIATE TERMINATION AND/OR PENAL TIES AS SPECIFIED BY LAW. APPLICANT'S SIGNATURE and DATE APPLICANT'S PHONE NUMBER APPLICANT'S ADDRESS SIGNATURE OF PARENT OR GUARDIAN (as needed) The above Self-Certification is being utilized for verification of the following eligibility criteria: CERTIFICATION I certify that the information recorded on this form was provided by the individual whose signature appears above. Counselor's Signature: Date: Page 20 of20