Workforce Investment Act State Compliance Policies. SECTION: 2.1 Eligibility for Youth Services March 2005

Size: px
Start display at page:

Download "Workforce Investment Act State Compliance Policies. SECTION: 2.1 Eligibility for Youth Services March 2005"

Transcription

1 Workforce Investment Act State Compliance Policies SECTION: 2.1 Eligibility for Youth Services March 2005 I. Eligibility Requirements: A. To be eligible for youth services, individuals must [Section 101 (13) and ]: 1. Be age 14 through 21; 2. Comply with Selective Service legislation by providing documents to demonstrate compliance with Selective Service requirements; (WIAL #3-99) 3. Comply with citizenship and eligibility to work requirements by providing documents necessary to validate the same; (WIAL #3-99) 4. Provide documentation of Social Security Number; (State requirement) 5. Be an individual who meets the following income requirements: a. Receives, or is a member of a family that receives, cash payments under a Federal, State, or local income-based public assistance program; b. Received an income, or is a member of a family that received a total family income, for the 6-month period prior to registration for services [exclusive of unemployment compensation, child support payments, payments and old-age and survivors insurance received under Section 202 of the Social Security Act (42 U.S.C. 402)] that, in relation to family size, does not exceed the higher of: (i) (ii) the poverty line*; or 70 percent of the lower living standard income level*; (*State will issue income guidelines annually) c. Is a member of a household that receives (or has been determined within the six month period prior to application for the program involved to be eligible to receive) food stamps pursuant to the Food Stamp Act of 1977 (7 U.S.C et seq.); d. Qualifies as a homeless individual as defined in subsections (a) and (c) of Section 103 of the Stewart B. McKinney Homeless Assistance Act (42 U.S.C ); or e. Is a foster child on behalf of whom State or Local government payments are made; f. Is an individual with a disability whose own income meets the requirements described in Items 1 or 2 above who qualifies as low-income even if the individual family does not meet those requirements ( ); Revised February of 6

2 6. Be within one or more of the following categories: a. Deficient in basic literacy skills according to the following criteria: (i) Computes or solves problems, reads, writes, or speaks English at or below the 8 th grade level; [Note: grade level scores below 9.0 (e.g. 8.9 should be considered as at or below the 8 th grade level reference TEGL Change 1 Attachment E- WIASRD element #131.] (ii) Is unable to compute or solve problems, read, write, or speak English at a level necessary to function on the job, in the individual family or in society; or (iii) Other additional criteria defined by the local board; b. School dropout who is no longer attending school and who has not received a secondary school diploma or recognized equivalent. A youth attending an alternative school is not a dropout. [Section 101(39) and ] c. Homeless, runaway, or foster child; d. Pregnant or parenting; e. Offender; or f. Is an individual (including a youth with a disability) who requires additional assistance to complete an educational program, or to secure and hold employment. B. Up to five percent (5%) of youth participants served by youth programs in a local area may be individuals who do not meet the income criterion for eligible youth, provided that they are within one or more of the following categories [Section 129(c)(5) and (a-h)]: 1. School dropout who is no longer attending any school and who has not received a secondary school diploma or a recognized equivalent. A youth attending an alternative school is not a dropout; [Section 101(39) and ] 2. Is deficient in basic skills according to the following criteria: [Section 101 (4)] a. The individual has English reading, writing, or computing skills at or below the 8 th grade level on a generally accepted standardized test or comparable score on a criterion-referenced test; 3. Is one or more grade level below the grade level appropriate to the individual s age; 4. Is pregnant or parenting; 5. Possesses one or more disabilities, including learning disabilities; 6. Is homeless or a runaway; 7. Is an offender; or 8. Faces serious barriers to employment as identified by the Local Board. C. An out-of-school youth is an individual who: [Section 101(33) and ] Revised February of 6

3 1. Is an eligible youth who is a school dropout; or 2. Is an eligible youth who has either graduated from high school or holds a GED, but is basic skills deficient, unemployed, or underemployed. II. Registration And Acceptable Documentation ( ): A. All youth participants must be registered in order to collect information to support a determination of eligibility. All information required by federal, state, and local reporting requirements must be collected for each youth participant, including documentation of each eligibility requirement for the types of service the individual has received. B. The following chart outlines acceptable forms of documentation for eligibility requirements for youth services: Revised February of 6

4 ELIGIBILITY CRITERIA YOUTH SERVICES ACCEPTABLE DOCUMENTATION A. Citizen/Eligible to Work 1. Birth Certificate 2. Alien Registration Card [Most common forms I-551, and I-94] 3. US Passport 4. I-9 (Immigration Form) 5. Public Assistance Records, etc. submit document ID numbers. B. Social Security No. 1. SS Card 2. Pay Stub, etc. submit Social Security Number. C. Selective Service 1. SS Registration Card 2. Acknowledgment Letter, etc. certify that he meets the requirements of Selective Service (if applicable). D. Birth Date/Age 1. Birth Certificate 2. Driver s License 3. US Passport 4. Work Permit 5. Public Assistance Records 6. School Records, etc. submit birth date. E. Receives, or is a member of a family that receives, cash payments under a Federal, State, or local income-based public assistance program 1. Copy of Public Assistance Records/Check 2. Public Assistance Card showing cash grant status 3. Telephone Confirmation, etc. 4. Food Stamp Card/Receipt 5. Public Assistance Records, etc. Revised February of 6

5 ELIGIBILITY CRITERIA F. Received an income, or is a member of a family that received a total family income, for the 6-month period prior to application for intensive or training services (exclusive of unemployment compensation, child support payments, payments and old-age and survivors insurance benefits received under Section 202 of the Social Security Act (42 U.S.C. 402)) that, in relation to family size, does not exceed the higher of-- a. the poverty line; or b. 70 percent of the lower living standard income level G. Is a member of a household that receives (or has been determined within the 6-month period prior to application for the program involved to be eligible to receive) food stamps pursuant to the Food Stamp Act of 1977 (7 U.S.C et seq.) H. Qualifies as a homeless individual as defined in subsections (a) and (c) of Section 103 of the Stewart B. McKinney Homeless Assistance Act (42 U.S.C ) I. Is a foster child on behalf of whom state or local government payments are made ACCEPTABLE DOCUMENTATION 1. Pay stubs 2. Public assistance/social agency records 3. Most recent tax return 4. Birth certificate(s) 5. Telephone verification 1. Food stamp card/receipt 2. Public assistance records, etc. Written statement from social service agency, shelter, individual providing temporary shelter 1. Court documentation 2. Written statement from state/local agency 3. Medical card, etc. J. An individual with a disability 1. School records 2. Social service records/referral 3. Physician s statement Revised February of 6

6 ELIGIBILITY CRITERIA ACCEPTABLE DOCUMENTATION K. Basic skills deficient 1. School Records 2. Assessment from generally accepted standardized test 3. School Report Card L. Pregnant/Parenting 1. School Records 2. Birth Certificate 3. Referrals from official agencies M. School Dropout 1. Drop Out Letter 2. Attendance Records N. Offender 1. Court Documentation 2. Letter of Parole 3. Police Record Revised February of 6

COUNTY OF SAN LUIS OBISPO DEPARTMENT OF SOCIAL SERVICES. EFFECTIVE: December 9, 2009 (revised December 10, 2014)

COUNTY OF SAN LUIS OBISPO DEPARTMENT OF SOCIAL SERVICES. EFFECTIVE: December 9, 2009 (revised December 10, 2014) APPROVAL DATE: 3/23/10 APPROVED BY: Betty Baker, WIB Chair COUNTY OF SAN LUIS OBISPO DEPARTMENT OF SOCIAL SERVICES POLICY NO: 27-08 TO: FROM: Service Providers Department of Social Services EFFECTIVE:

More information

Revision to WIA Eligibility Documentation Guide

Revision to WIA Eligibility Documentation Guide MEMO: AP 00-21 Change 5 DATE: May 22, 2007 TO: FROM: SUBJECT: WIB Directors WIB Chairpersons Grant Recipients Carl Buzzelli WIA Program Manager Revision to WIA Eligibility Documentation Guide Background:

More information

REPUBLIC OF PALAU WORKFORCE INVESTMENT POLICY NO

REPUBLIC OF PALAU WORKFORCE INVESTMENT POLICY NO REPUBLIC OF PALAU WORKFORCE INVESTMENT POLICY NO. 07-003-2000 EFFECTIVE DATE: July 01, 2000 TO : State Workforce Investment Board Members Executive Committee FROM : Ms. Josephine Ulengchong WIA Office

More information

WIOA Eligibility Policy

WIOA Eligibility Policy NWPA WDB POLICY - 212 Rev. Level: A WIOA Eligibility Policy The NWPA Workforce Development Board (WDB) has developed this policy on eligibility and registration to ensure that every Workforce Innovation

More information

ATTACHMENT A SOURCE DOCUMENTATION REQUIREMENTS FOR PROGRAM YEAR (PY) 2008 WIA DATA ELEMENT VALIDATION WORKFORCE INVESTMENT ACT DATA ELEMENT VALIDATION INSTRUCTIONS AND SOURCE DOCUMENTATION Validation Instructions:

More information

Workforce Innovation and Opportunity Act

Workforce Innovation and Opportunity Act Workforce Innovation and Opportunity Act ELIGIBILITY ADULT ELIGIBILITY DISLOCATED WORKER ELIGIBILITY YOUTH ELIGIBILITY SELECTIVE SERVICE SELF-SUFFICIENCY WAGE PRIORITY OF SERVICE FORMS TABLE OF CONTENTS

More information

Workforce Investment Act State Compliance Policies

Workforce Investment Act State Compliance Policies Workforce Investment Act State Compliance Policies SECTION: 1.6 Eligibility for Adult and Dislocated Worker September 2005 Employment and Training Activities I. Core services that are self-service or informational

More information

Workforce Investment Act Title IB Eligibility Policy Guide

Workforce Investment Act Title IB Eligibility Policy Guide Workforce Investment Act Title IB Eligibility Policy Guide Illinois Department of Employment Security Workforce Development Bureau Job Training Division Table of Contents Page Summary of changes to this

More information

Priority of Service. A. Public assistance recipients, other low-income adults; and B. Individuals who are basic skills deficient.

Priority of Service. A. Public assistance recipients, other low-income adults; and B. Individuals who are basic skills deficient. I. Service Priority for Individualized Services and Training Services Priority for adult services must be given to recipients of public assistance or other low-income individuals; with added priorities

More information

Purpose: To provide information regarding eligibility for WIOA funded Dislocated Worker, Adult, and Youth programs

Purpose: To provide information regarding eligibility for WIOA funded Dislocated Worker, Adult, and Youth programs Northern Illinois Workforce Alliance Policy Title: Eligibility Adult / Dislocated Worker / Youth Approved: 06/07/2016 Effective: 06/07/2016 Reference Number 2015-400-01 Status: Active Modifications: Purpose:

More information

Workforce Investment Act State Compliance Policies

Workforce Investment Act State Compliance Policies Workforce Investment Act State Compliance Policies SECTION: 1.6 Eligibility for Adult and Dislocated Worker November 2009 Employment and Training Activities I. Core services that are self-service or informational

More information

WIOA Guidance Notice No. 6-16, Change 2

WIOA Guidance Notice No. 6-16, Change 2 WIOA Guidance Notice No. 6-16, Change 2 TO: FROM: SUBJECT: Workforce Development Boards Angela Fry Assistant Director Workforce Programs Eligibility EFFECTIVE DATE: December 1, 2016 CHANGE 1 EFFECTIVE

More information

Financial Aid Income Guidelines

Financial Aid Income Guidelines Workforce Solutions uses multiple sets of income guidelines when determining eligibility for our income-tested financial aid funds. Income-tested means that a person must have an income at or below a certain

More information

Central Pennsylvania Workforce Development Corporation. Priority of Service Policy and Procedures for Central Region PA CareerLink

Central Pennsylvania Workforce Development Corporation. Priority of Service Policy and Procedures for Central Region PA CareerLink Central Pennsylvania Workforce Development Corporation Priority of Service Policy and Procedures for Central Region PA CareerLink For participants enrolled or dual-enrolled as Title I Adults Developed

More information

Purpose: To provide information regarding eligibility for WIOA funded Dislocated Worker, Adult, and Youth programs

Purpose: To provide information regarding eligibility for WIOA funded Dislocated Worker, Adult, and Youth programs The Workforce Connection, Inc. Policy Title: Eligibility Adult / Dislocated Worker / Youth Approved: 06/07/2016 Effective: 06/07/2016 Reference Number 2015-400-01 Status: Active Modifications: 05-2017

More information

For High School Seniors

For High School Seniors Niagara County Employment & Training Young Adult Employment Program IN-SCHOOL Trott Building, 1001 11 th Street, Niagara Falls, NY 14301 716.278.8238 For High School Seniors Own Your Future Earn Money

More information

Workforce Innovation and Opportunity Act Eligibility

Workforce Innovation and Opportunity Act Eligibility Workforce Innovation and Opportunity Act Eligibility WIOA Low Income Eligibility WIOA Title 1 Authorization Federal: Workforce Investment Opportunity Act of 2014 State of Illinois: Department of Commerce

More information

Workforce Innovation and Opportunity Act NWGRC Eligibility Manual Adult, Dislocated Worker and Youth

Workforce Innovation and Opportunity Act NWGRC Eligibility Manual Adult, Dislocated Worker and Youth Workforce Innovation and Opportunity Act NWGRC Eligibility Manual Adult, Dislocated Worker and Youth Policies and Procedures 2017-2018 Table of Contents I. INTRODUCTION... 1 A. Getting Started... 1 B.

More information

Workforce Investment Act Eligibility Technical Assistance Guide

Workforce Investment Act Eligibility Technical Assistance Guide Workforce Investment Act Eligibility Technical Assistance Guide Prepared by OFFICE OF ECONOM IC AND W ORKFORCE DEVELOPM ENT RHONDA SIMMONS, DIRECTOR OF WORKFORCE DEVELOPMENT Based on a template provided

More information

POLICY ISSUANCE WIOA ADULT AND DISLOCATED WORKER ENROLLMENT AND ELIGIBILITY POLICY

POLICY ISSUANCE WIOA ADULT AND DISLOCATED WORKER ENROLLMENT AND ELIGIBILITY POLICY POLICY ISSUANCE Date: September 21, 2018 Number: 2018-06 WIOA ADULT AND DISLOCATED WORKER ENROLLMENT AND ELIGIBILITY POLICY INTRODUCTION The policy on eligibility ensures that every Workforce Innovation

More information

CANCELLATIONS All previous policies on Title I eligibility requirements remain active for individuals enrolled during that policy s effective date.

CANCELLATIONS All previous policies on Title I eligibility requirements remain active for individuals enrolled during that policy s effective date. POLICY: WIOA ADULT AND DISLOCATED WORKER ELIGIBILITY EFFECTIVE DATE: DECEMBER 8, 2016 POLICY NUMBER: 2016-06 PURPOSE The policy on eligibility ensures that every Workforce Innovation and Opportunity Act

More information

Eligibility Policy Handbook Attachment A

Eligibility Policy Handbook Attachment A Eligibility Policy Handbook Attachment A Eastern Washington Partnership Workforce Development Council Phone: 509 685-6129 Email: tobrien@ruralresources.org Effective Date: July 1, 2015 Introduction:...

More information

Summer U LEAD Program Application

Summer U LEAD Program Application Summer U LEAD Program Application U LEAD is offers a summer job internship program for Ramsey County Suburban youth ages 14 to 24. Youth must complete the summer application and complete work readiness

More information

ETO Policy 2-Documentation of Program Eligibility- Youth Programs

ETO Policy 2-Documentation of Program Eligibility- Youth Programs ETO Policy 2-Documentation of Program Eligibility- Purpose The purpose of this policy is to establish who is eligible for Youth programs funded with WIOA and Blue Collar funds and to provide guidance on

More information

Application Adult & Dislocated Worker Programs

Application Adult & Dislocated Worker Programs Application Adult & Dislocated Worker Programs Workforce Innovation and Opportunity Act (WIOA) FORM WIOA I-B 1.1 For Adult and Dislocated Worker Programs If you are age 18 or older and need help in obtaining

More information

ETO Policy 15-Documentation of Program Eligibility- Adult Blue Collar Programs

ETO Policy 15-Documentation of Program Eligibility- Adult Blue Collar Programs Purpose The purposes of this policy are to establish who is eligible for Blue Collar Adult programs and to provide guidance on how to document the required eligibility. In order to be considered a participant

More information

For Individuals Age and Out of School

For Individuals Age and Out of School Niagara County Employment & Training Young Adult Employment Program OUT-OF-SCHOOL 1001 11 th Street, Niagara Falls, NY 14301 716.278.8238 For Individuals Age 16-24 and Out of School You can be attending

More information

ATTACHMENT 1 PacMtn - ADULT ELIGIBILITY CRITERIA & ACCEPTABLE DOCUMENTATION. Eligibility Criteria Condition Examples of Acceptable Documentation

ATTACHMENT 1 PacMtn - ADULT ELIGIBILITY CRITERIA & ACCEPTABLE DOCUMENTATION. Eligibility Criteria Condition Examples of Acceptable Documentation ATTACHMENT 1 PacMtn - ADULT ELIGIBILITY CRITERIA & ACCEPTABLE DOCUMENTATION Eligibility Criteria Condition Examples of Acceptable Documentation Citizen / Legally Entitled to Work in the U.S. Participants

More information

(REVISED POLICY ) SUBJECT: Determining WIOA Adult and Dislocated Worker Eligibility for WIOA

(REVISED POLICY ) SUBJECT: Determining WIOA Adult and Dislocated Worker Eligibility for WIOA POLICY: WIOA ADULT AND DISLOCATED WORKER ELIGIBILITY POLICY EFFECTIVE DATE: JULY 1, 2016 POLICY NUMBER: 2016-17 (REVISED POLICY 2012-17) SUBJECT: Determining WIOA Adult and Dislocated Worker Eligibility

More information

Workforce Investment Act (WIA) Temporary Assistance for Needy Families (TANF) SUMMER YOUTH PROGRAM GUIDE

Workforce Investment Act (WIA) Temporary Assistance for Needy Families (TANF) SUMMER YOUTH PROGRAM GUIDE Workforce Investment Act (WIA) Temporary Assistance for Needy Families (TANF) SUMMER YOUTH PROGRAM GUIDE DEPARTMENT OF ECONOMIC OPPORTUNITY 107 East Madison Street Caldwell Building TALLAHASSEE, FLORIDA

More information

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

Workforce Partnership of Greater Rhode Island 1511 Pontiac Avenue Cranston, Rhode Island (401) Workforce Partnership of Greater Rhode Island 1511 Pontiac Avenue Cranston, Rhode Island 02920 (401) 462-8730 www.griworkforce.com Local Area Workforce Investment Notice: PY15-01 Date: To: From: Re: October

More information

ELIGIBILITY HANDBOOK

ELIGIBILITY HANDBOOK MINNESOTA DEPARTMENT OF EMPLOYMENT AND ECONOMIC DEVELOPMENT ELIGIBILITY HANDBOOK March 27, 2015 Minnesota Department of Employment and Economic Development Workforce Development Division First National

More information

NORTEC POLICY STATEMENT WIOA ADULT AND DISLOCATED WORKER PROGRAMS

NORTEC POLICY STATEMENT WIOA ADULT AND DISLOCATED WORKER PROGRAMS PURPOSE NORTEC POLICY STATEMENT WIOA ADULT AND DISLOCATED WORKER PROGRAMS Last Update: June 28, 2017 The purpose of this policy is to provide guidelines to the Service Providers (NoRTEC Contractors) regarding

More information

CSBG Scholarship/Trade Training. Please PRINT clearly

CSBG Scholarship/Trade Training. Please PRINT clearly CSBG Scholarship/Trade Training Please PRINT clearly Today s Date: / / Your Name: Your Date of Birth / / Your Social Security Number - - Have you lived in McHenry County for all of the past 90 days? Yes

More information

Workforce Investment Act SOUTHERN NEVADA WORKFORCE INVESTMENT BOARD. SECTION V Glossary April 2007

Workforce Investment Act SOUTHERN NEVADA WORKFORCE INVESTMENT BOARD. SECTION V Glossary April 2007 Workforce Investment Act SOUTHERN NEVADA WORKFORCE INVESTMENT BOARD SECTION V Glossary April 2007 ABUSE OR MISAPPLICATION OF FUNDS [ 667.630 and SNWIB Policy Section 2.2]: Any intentional use of funds,

More information

WORKFORCE INNOVATION AND OPPORTUNITY ACT (WIOA) Eligibility Application

WORKFORCE INNOVATION AND OPPORTUNITY ACT (WIOA) Eligibility Application Local Area/Region: WORKFORCE INNOVATION AND OPPORTUNITY ACT (WIOA) Eligibility Application 7 Chicago Cook Workforce Partnership Office Location of Responsibility: Office Location: Application Date: Start

More information

OTSEGO COUNTY DEPARTMENT OF SOCIAL SERVICES DOCUMENTATION REQUIREMENTS

OTSEGO COUNTY DEPARTMENT OF SOCIAL SERVICES DOCUMENTATION REQUIREMENTS - 1 - OTSEGO COUNTY DEPARTMENT OF SOCIAL SERVICES DOCUMENTATION REQUIREMENTS THIS CHART IS A GUIDE ONLY BE SURE TO PROGRAMS ABBREVIATIONS REVIEW ALL 5 PAGES OF INFORMATION TA=Temporary Assistance X Required

More information

04/04 06/05, 05/10, 12/10, 03/11, 11/11, 03/12, 10/13, 09/14, 08/15, 09/17, 12/17, 09/18, 11/18

04/04 06/05, 05/10, 12/10, 03/11, 11/11, 03/12, 10/13, 09/14, 08/15, 09/17, 12/17, 09/18, 11/18 NMHS CORPORATE POLICIES AND PROCEDURES SUBJECT: FINANCIAL ASSISTANCE APPLICABLE: EFFECTIVE DATE: REVIEWED/REVISED: PURPOSE: Nebraska Methodist Hospital, Methodist Fremont Health, Methodist Jennie Edmundson,

More information

TWIST ID. Selective Service Letter / Registration Letter

TWIST ID. Selective Service Letter / Registration Letter WIOA BASIC ELIGIBILITY Job seekers must meet the following Basic Eligibility requirements and furnish proof of each eligibility criteria with one of the listed Acceptable Documentation source documents.

More information

SECU Foundation Scholarship Information

SECU Foundation Scholarship Information To be considered, the student MUST: SECU Foundation Scholarship Information Be enrolled in a Continuing Education program at Coastal Carolina Community College that leads to a state-regulated or industry

More information

FINANCIAL ASSISTANCE POLICY

FINANCIAL ASSISTANCE POLICY FINANCIAL ASSISTANCE POLICY I. PURPOSE/OBJECTIVE The mission at DeKalb Medical is to deliver high quality healthcare services that improve the health and well-being of the patients served by DeKalb Medical.

More information

Montana State University MESA Program POTENTIAL PARTICIPANT APPLICATION FORM

Montana State University MESA Program POTENTIAL PARTICIPANT APPLICATION FORM Montana State University MESA Program POTENTIAL PARTICIPANT APPLICATION FORM Date: / / To ensure you qualify for the Matched Education Savings Account (MESA) Program, please read the MESA Frequently Asked

More information

State Proposals for Medicaid Work and Community Engagement Requirements

State Proposals for Medicaid Work and Community Engagement Requirements State Proposals for Medicaid Work and Community Engagement Requirements In January 2018, the Centers for Medicare & Medicaid Services (CMS) issued a new policy allowing states to implement work and community

More information

FAMILY ASSETS FOR INDEPENDENCE IN MINNESOTA (FAIM) FAIM New Participant Application Form AGENCY USE ONLY : Agency Name:

FAMILY ASSETS FOR INDEPENDENCE IN MINNESOTA (FAIM) FAIM New Participant Application Form AGENCY USE ONLY : Agency Name: FAMILY ASSETS FOR INDEPENDENCE IN MINNESOTA (FAIM) AGENCY USE ONLY : FAIM New Participant Application Form Revised 05/23/14 Agency Name: Bank Account Number of 1 st Deposit Asset Grant First Name MI Last

More information

National Verifier Acceptable Documentation Guidelines

National Verifier Acceptable Documentation Guidelines Last Updated: November 15, 2017 Table of Contents Purpose... 1 Proof of Eligibility... 1 Minimal Criteria for Acceptance... 1 New Documentation... 1 Acceptable Documentation... 1 Federal Public Housing

More information

As of October 1, 2008, Supplemental Nutrition Assistance Program (SNAP) is the new name for the federal Food Stamp Program.

As of October 1, 2008, Supplemental Nutrition Assistance Program (SNAP) is the new name for the federal Food Stamp Program. Food Assistance (FA) Supplemental Nutrition Assistance Program (SNAP) As of October 1, 2008, Supplemental Nutrition Assistance Program (SNAP) is the new name for the federal Food Stamp Program. The new

More information

Housing Choice Voucher Program (Section 8) Change Form

Housing Choice Voucher Program (Section 8) Change Form QC Date: LHA Official Proceed to Process by Case Worker Lakeland Housing Authority 430 Hartsell Ave No Action Lakeland FL 33815 Required Tel: 863-687-2911 Housing Choice Voucher Program (Section 8) Change

More information

The St Mary Medical Center Financial Assistance program does not cover the cost from all physician offices.

The St Mary Medical Center Financial Assistance program does not cover the cost from all physician offices. Dear St. Mary Medical Center is committed to providing high quality care to all in our community. We may be able to assist you with your medical bills if you are not able to afford them. Please read the

More information

Unemployed Adults Without Children CalFresh Forum

Unemployed Adults Without Children CalFresh Forum Unemployed Adults Without Children CalFresh Forum February 2017 Ed Bolen Center on Budget and Policy Priorities 107 Agenda The Rule Who is Affected State Challenges 108 Overview: The Rule Benefits are

More information

Tri-County Community Council, Inc PO Box 1210 Bonifay, Florida 32425

Tri-County Community Council, Inc PO Box 1210 Bonifay, Florida 32425 Tri-County Community Council, Inc PO Box 1210 Bonifay, Florida 32425 ***PROOF OF ALL HOUSEHOLD INCOME (LAST 30 DAYS), ELECTRIC OR GAS BILL, CURRENT PICTURE ID ON APPLICANT, AND SOCIAL SECURITY CARDS ON

More information

Providers can verify a consumer s eligibility or initiate a request for Uninsured Eligibility through

Providers can verify a consumer s eligibility or initiate a request for Uninsured Eligibility through CHAPTER 3 UNINSURED ELIGIBLE CONSUMERS Uninsured Eligible consumers are individuals for whom the cost of medically necessary and appropriate mental health services will be subsidized by the Mental Hygiene

More information

II. Policy Scope For purposes of this policy, "financial assistance" requests pertain to the provision of healthcare services by NLH.

II. Policy Scope For purposes of this policy, financial assistance requests pertain to the provision of healthcare services by NLH. I. Purpose of Policy To establish a policy for the administration of New London Hospital s (NLH) financial assistance for healthcare services program. This policy outlines the: eligibility criteria for

More information

Rx for Oklahoma P.O. Box 603 Jay, OK Phone: ext 34 or 29 Fax:

Rx for Oklahoma P.O. Box 603 Jay, OK Phone: ext 34 or 29 Fax: Rx for Oklahoma P.O. Box 603 Jay, OK 74346 Phone: 918-253-4683 ext 34 or 29 Fax: 918-253-6059 Email: lindaely@neocaa.org Email: lrutherford@neocaa.org Serving Craig, Delaware and Ottawa Counties Thank

More information

Scholarship Application

Scholarship Application Giving all Galveston children the opportunity to soar Scholarship Application The Moody Early Childhood Center is a private nonprofit 501 (c) (3) and does not discriminate on the basis of sex, race, color,

More information

Eligibility Checklist

Eligibility Checklist Eligibility Checklist Patient s Name: of Service: /_/ Medical Record #: _ Account Number: _ You are encouraged to apply one week prior to any appointments with proof of appointment and/or referral. In

More information

Workforce Innovation and Opportunity Act

Workforce Innovation and Opportunity Act Workforce Innovation and Opportunity Act Eligibility Technical Assistance Guide Program Year 2016-2017 Page 1 of 26 Rev 11/28/2016 INTRODUCTION The Workforce Innovation and Opportunity Act (WIOA) offers

More information

MAYOR BYRON W. BROWN S SUMMER YOUTH INTERNSHIP PROGRAM APPLICATION

MAYOR BYRON W. BROWN S SUMMER YOUTH INTERNSHIP PROGRAM APPLICATION MAYOR BYRON W. BROWN S SUMMER YOUTH INTERNSHIP PROGRAM February 1, 2018 Dear Applicant: Thank you for your interest in applying for my 2018 Summer Youth Internship Program. This is truly a wonderful opportunity

More information

RAWLINS FIRE DEPARTMENT PO BOX 953 RAWLINS, WY FAX Website:

RAWLINS FIRE DEPARTMENT PO BOX 953 RAWLINS, WY FAX Website: PERSONAL HISTORY STATEMENT The following information is requested of you for verification and contact purposes: (Please Print or Type) 1. Your Name Last Name: First Name: Middle: Other Names (including

More information

Finance Division Revenue Cycle Operational Policy Page 1 of 6. Financial Assistance Program

Finance Division Revenue Cycle Operational Policy Page 1 of 6. Financial Assistance Program Finance Division Revenue Cycle Operational Policy Page 1 of 6 Financial Assistance Program I. POLICY STATEMENT Origination Date: Revision Date: 2/4/09 4/15/09, 8/3/09, 2/15/11, 3/14, 1/16, 11/16 Grady

More information

Community Services Block Grant Q&A on... Client Eligibility

Community Services Block Grant Q&A on... Client Eligibility Community Services Block Grant Q&A on... August 2013 Introduction The federal Community Services Block Grant (CSBG) funds local Community Action Agencies and other eligible entities to carry out a variety

More information

National Verifier Acceptable Documentation Guidelines

National Verifier Acceptable Documentation Guidelines Last Updated: January 24, 2018 Table of Contents Purpose... 1 Criteria for Acceptance... 1 Minimal Criteria for Acceptance... 1 New Documentation... 1 Acceptable Forms of Submission... 1 Acceptable Documentation...

More information

January 14, WIA Data Element Validation and Participant File Structure for Adult & Dislocated Worker Programs

January 14, WIA Data Element Validation and Participant File Structure for Adult & Dislocated Worker Programs January 14, 2008 EASTERN CAROLINA LOCAL AREA ISSUANCE NO. 2007-03 SUBJECT: PURPOSE: BACKGROUND: WIA Data Element Validation and Participant File Structure for Adult & Dislocated Worker Programs To release

More information

Questions and Answers for Service Providers. (March 28, 2019)

Questions and Answers for Service Providers. (March 28, 2019) New Reporting Requirements for Labour Market Transfer Agreement-funded Employment Ontario Programs/ Employing Young Talent Incentive and Youth Job Link Update Questions and Answers for Service Providers

More information

The Housing Authority of the City Of New Albany 300 Erni Avenue New Albany IN 47150

The Housing Authority of the City Of New Albany 300 Erni Avenue New Albany IN 47150 The Housing Authority of the City Of New Albany 300 Erni Avenue New Albany IN 47150 Public Housing: GENERAL INFORMATION We do not have emergency housing. Emergency housing is available only through a shelter.

More information

Children s Specialized Hospital Benefit Fund Policy - Plain Language Summary

Children s Specialized Hospital Benefit Fund Policy - Plain Language Summary Children s Specialized Hospital Benefit Fund Policy - Plain Language Summary How to Apply CSH Benefit Fund and related application forms may be obtained/completed/submitted as follows: In person at any

More information

Moffitt Cancer. Policy: Charity Care/Financial Assistance. Policy Statement. Purpose. Scope. Procedures. Effective: 04/2018 Page 1 of 10

Moffitt Cancer. Policy: Charity Care/Financial Assistance. Policy Statement. Purpose. Scope. Procedures. Effective: 04/2018 Page 1 of 10 Responsible Office: Business Office Category: Finance Authorized: Vice President, Revenue Cycle Policy Number: ADM-C032 Management Review Frequency: 3 years Effective: 04/2018 Policy Statement This Policy

More information

Board NGHS Board X NGMC Barrow Board THC Board NGMC Barrow Medical Staff. Health Partners Board

Board NGHS Board X NGMC Barrow Board THC Board NGMC Barrow Medical Staff. Health Partners Board Title Financial Assistance, NGMC Primary Reviewer System Director, Patient Receivables Reviewer(s) VP, Revenue Cycle and Chief Financial Officer 1. Applicability- Select all Entities that are covered by

More information

Instructions. 1. Your Name 2. Your Case Number 3. Your Daytime Telephone Number For a change in employment you must also provide:

Instructions. 1. Your Name 2. Your Case Number 3. Your Daytime Telephone Number For a change in employment you must also provide: Instructions Please complete this form when reporting any change in circumstances including but not limited to: employment, income, address, household composition. You must always provide the following

More information

Adult General Education Data Collection and Reporting Changes

Adult General Education Data Collection and Reporting Changes 2016 17 Adult General Education Data Collection and Reporting Changes Division of Career and Adult Education Florida College System Webinar Wednesday, March 9, 2016 Revised March 10, 2016 1 Workforce Innovation

More information

18 to 21 year olds and housing costs

18 to 21 year olds and housing costs 18 to 21 year olds and housing costs First published: 04 April 2017 (version 1) Contents Housing costs not payable Claimants not in all work related requirements Claimants temporarily exempted from all

More information

Life below the poverty line - examining the deep and concentrated need of those in the Bronx community

Life below the poverty line - examining the deep and concentrated need of those in the Bronx community Life below the poverty line - examining the deep and concentrated need of those in the Bronx community POTS Breakfast Forum June 15, 2016 Deep and Concentrated Poverty in our Community Concentrated Poverty

More information

REQUEST FOR PROPOSALS FOR YOUTH SERVICES UNDER THE WORKFORCE INNOVATION AND OPPORTUNITY ACT (WIOA)

REQUEST FOR PROPOSALS FOR YOUTH SERVICES UNDER THE WORKFORCE INNOVATION AND OPPORTUNITY ACT (WIOA) REQUEST FOR PROPOSALS FOR YOUTH SERVICES UNDER THE WORKFORCE INNOVATION AND OPPORTUNITY ACT (WIOA) RFP Page 1 RFP SC08-17R Issued by Southwest Ohio Region Workforce Investment Board Area 13 In Partnership

More information

Rental Application. First Priority: Persons 62 years or older get first choice at apartments. The approximate waiting period is days.

Rental Application. First Priority: Persons 62 years or older get first choice at apartments. The approximate waiting period is days. 105 E. Walnut Street, Kalamazoo, MI 49007 269-388-3011 TTY: 1-800-649-3777 Office Hours: M-F 10 am-12 pm, 1 pm-5 pm Rental Application Thank you for your interest in Skyrise Apartments! Since 1987, Skyrise

More information

TITLE: Financial Assistance/Community Benefit Policy for Northeast Georgia Physicians Group

TITLE: Financial Assistance/Community Benefit Policy for Northeast Georgia Physicians Group TITLE: Financial Assistance/Community Benefit Policy for Northeast Georgia Physicians Group TYPE: NGPG PRIMARY REVIEWER: System Director, Patient Receivables FINAL APPROVER: CFO COLLABORATORS/DEPARTMENTS:

More information

Charity, Financial Assistance. Definitions The following definitions are applicable to all sections of this policy.

Charity, Financial Assistance. Definitions The following definitions are applicable to all sections of this policy. Title: Effective Date: 02/01/13 Distribution: Attachments: Formulated By: Keywords: Patient Business Services None Patient Business Services Charity, Financial Assistance I. Purpose: The purpose of the

More information

Policy Number: Approval Date: March 2018 Page 1 of 7

Policy Number: Approval Date: March 2018 Page 1 of 7 Page 1 of 7 TITLE: PURPOSE: POLICY: Financial Assistance Program To ensure that UF Health Jacksonville meets its community obligations to provide financial assistance in a fair, consistent and objective

More information

Online: Mail or in person: The Heat and Warmth Fund, 535 Griswold, Suite 200, Detroit, MI 48226

Online:  Mail or in person: The Heat and Warmth Fund, 535 Griswold, Suite 200, Detroit, MI 48226 Dear Friend, The Heat and Warmth Fund (THAW), a leading provider of utility assistance, wants to make it easier for you to get the help you need. If you are a Detroit resident living in the following Zip

More information

III. Dislocated Worker Eligibility

III. Dislocated Worker Eligibility III. Dislocated Worker Eligibility Rev. 10/2013 WIA Dislocated Worker The Workforce Investment Act (WIA) serves dislocated workers. WIA dislocated worker programs are designed to meet employer needs by

More information

KERR COUNTY INDIGENT HEALTH CARE POLICY

KERR COUNTY INDIGENT HEALTH CARE POLICY KERR COUNTY INDIGENT HEALTH CARE POLICY (This revised policy, adopted by Kerr County Commissioners Court at the regular meeting on June 9, 2014, shall become effective June 15, 2014.) The Kerr County Indigent

More information

MONROE COUNTY CENTRAL POINT OF COORDINATION (CPC) Application Form

MONROE COUNTY CENTRAL POINT OF COORDINATION (CPC) Application Form MONROE COUNTY CENTRAL POINT OF COORDINATION (CPC) Application Form Application : Received by CPC Office: If agency referral, name of agency/contact person and contact information: Last Name: First Name:

More information

The Federal Supplemental Nutrition Assistance Program (SNAP) Introduction. Filing FS Application

The Federal Supplemental Nutrition Assistance Program (SNAP) Introduction. Filing FS Application The Federal Supplemental Nutrition Assistance Program (SNAP) Barbara Weiner Empire Justice Center 119 Washington Ave. Albany, New York 12210 bweiner@empirejustice.org (518) 462-6831 Introduction FSP renamed

More information

*Remember to attach a copy of your state issued ID and credit report*

*Remember to attach a copy of your state issued ID and credit report* INDIVIDUAL DEVELOPMENT ACCOUNT (IDA) APPLICATION CONTACT INFORMATION Date of Application Regional Communty Action Agency Last Name First Name M.I. SS # DOB Home and Cell Phone # (include area code) Street

More information

Children s National Financial Assistance Application

Children s National Financial Assistance Application Children s National Financial Assistance Application Children s National will offer financial assistance to patients who are unable to pay their hospital and/or clinic bills due to difficult financial

More information

UNC Pharmacy Assistance Program (PAP)

UNC Pharmacy Assistance Program (PAP) (PAP) INSTRUCTIONS Requirements and Documents for Application If you have questions about the PAP application or the 14 day Temporary PAP Benefit, please call (919) 966-7690, option 1. A counselor is available

More information

HOUSING CHOICE VOUCHER (SECTION 8) INCOME ADJUSTMENT

HOUSING CHOICE VOUCHER (SECTION 8) INCOME ADJUSTMENT HOUSING CHOICE VOUCHER (SECTION 8) INCOME ADJUSTMENT INSTRUCTON FOR INCOME ADJUSTMENT: Complete attached Income Adjustment Packet & Release of Information form. Attach verification of ALL household income

More information

Special Enrollment Period and Documentation for Health Plans Purchased Off the Health Insurance Marketplace

Special Enrollment Period and Documentation for Health Plans Purchased Off the Health Insurance Marketplace Special Enrollment Period and Documentation for Health Plans Purchased Off the Health Insurance Marketplace Individuals requesting enrollment during a Special Enrollment Period must provide the following:

More information

APPLICANT PLEASE DO NOT WRITE ON THIS SHEET FOR OFFICE USE ONLY

APPLICANT PLEASE DO NOT WRITE ON THIS SHEET FOR OFFICE USE ONLY Date received: Staff initials: Dear Applicant, Thank you for considering Coburn Place Safe Haven s transitional housing program for your new beginning! Coburn Place Safe Haven is a two year transitional

More information

Chapter 811. Job Opportunities and Basic Skills

Chapter 811. Job Opportunities and Basic Skills Chapter 811. Job Opportunities and Basic Skills The Texas Workforce Commission proposes the repeal of 811.1-811.5, 811.10-811.23, and 811.60 relating to the Job Opportunities and Basic Skills and new 811.1,

More information

Dear Parent/Guardian:

Dear Parent/Guardian: Dear Parent/Guardian: Children need healthy meals to learn. Community School Corporation of Southern Hancock offers healthy meals every school day. Breakfast costs $1.80; lunch costs $2.80 (Elementary)

More information

COMMUNITY REPORT CARD Monroe County

COMMUNITY REPORT CARD Monroe County LEARN CONNECT ACT COMMUNITY REPORT CARD Monroe COMMUNITY INDICATORS Arts, Culture and Leisure Children and Youth Community Engagement NY STATE COMPARISON LONG TERM TREND 2017 ACT Rochester s purpose is

More information

RESIDENCY QUESTIONNAIRE

RESIDENCY QUESTIONNAIRE ADMISSIONS & RECORDS OFFICE 1900 Pico Blvd. Santa Monica, CA 90405 Phone: 310-434-4380 Fax: 310-434-3645 RESIDENCY QUESTIONNAIRE Received by: Date: The information requested is deemed relevant and necessary

More information

Alabama s Ryan White Part B Program Eligibility Standard

Alabama s Ryan White Part B Program Eligibility Standard PURPOSE This document establishes guidelines to determine eligibility of persons seeking services through Ryan White Part B and the State s AIDS Drug Assistance Program (ADAP). This policy is binding to

More information

Northwest Workforce Council

Northwest Workforce Council Northwest Workforce Council EFFECTIVE DATE: October 15, 2001 POLICY AND PROCEDURE DIRECTIVE SUBJECT: Eligibility Verification and Priority Selection for Title I B Dislocated Worker REFERENCE #: WIA 01

More information

Verification. For all students: Only funds for which the student is eligible are from the unsubsidized student financial

Verification. For all students: Only funds for which the student is eligible are from the unsubsidized student financial is the process required by the Department of Education to verify the accuracy of the information submitted by or on behalf of a student for the purpose of applying for financial aid. The purpose is to

More information

Rent determination plan changes since the last submission Public Housing/Housing Choice Voucher

Rent determination plan changes since the last submission Public Housing/Housing Choice Voucher Rent determination plan changes since the last submission Public Housing/Housing Choice Voucher Housing Choice Voucher Program and Public Housing: CHAPTER 6 Income and Subsidy Determinations Revised the

More information

APPLICATION COVER SHEET

APPLICATION COVER SHEET APPLICATION COVER SHEET Date of Application: Name of Applicant: Date of Birth Email Address: Additional Applicant(s): 1) Date of Birth Email Address: 2) Date of Birth Email Address: 3) Date of Birth Email

More information

APPLICATION FOR STERN CENTER/CONGREGATE TRUMBULL HOUSING AUTHORITY 210 Hedgehog Circle Daisy Torres

APPLICATION FOR STERN CENTER/CONGREGATE TRUMBULL HOUSING AUTHORITY 210 Hedgehog Circle Daisy Torres CONGREGATE LIVING Updated August 15, 2017 About the Congregate: THE CONGREGATE IS A SMOKE-FREE BUILDING By definition, the Congregate is a non-institutional, independent group living environment that integrates

More information

MEMORIAL HERMANN HEALTH SYSTEM POLICY

MEMORIAL HERMANN HEALTH SYSTEM POLICY Page 1 of 17 MEMORIAL HERMANN HEALTH SYSTEM POLICY POLICY TITLE: Financial Assistance Policy ("FAP") PUBLICATION DATE: 05/10/2016 VERSION: 3 POLICY PURPOSE: The purpose of this Financial Assistance Policy

More information

Lyon County Human Services

Lyon County Human Services Lyon County Human Services 620 Lake Avenue, Silver Springs, NV 89429 (775) 577-5009 / (775) 577-5093 fax Appointment Date: Time: Advocate: Important: Please provide the office with all required documentation

More information

Verification Worksheet Dependent Student- Tracking Group V5

Verification Worksheet Dependent Student- Tracking Group V5 2014 2015 Verification Worksheet Dependent Student- Tracking Group V5 Your 2014 2015 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law says

More information