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 revised WIA Participant File Structure Policy for Data Element Validation and Rescind Eastern Carolina Local Area Issuance No. 2004-06 and 2004-06, Change 1. Eastern Carolina Local Area Issuance No. 2004-06, released in December 2004, established file content and structure requirements to comply with the federal data validation mandates. This Issuance replaces Eastern Carolina Local Area Issuances 2004-06 and 2004-06, Change 1. Appendix D to the U.S. Department of Labor s Data Validation Handbook contains the data element validation instructions and documentation requirements. Each WIA data element that is subject to the validation requirements is listed in this appendix, along with the format used in the annual report, definition of the data element, federal sources allowed to validate each element and whether the source must provide information that matches or supports the data element being validated. Each data element listed must have at least on hard copy data source from the allowable list in the participant s file. http://www.doleta.gov/performance/reporting/docs/wia7_0/drvs_wia7 _UsersGuide.pdf Attachment 1 of this Issuance contains the state approved data element validation source documents for use in North Carolina effective October 1, 2007. Service providers may use any of the listed documents for data element validation. Service providers are encouraged to use WorkforcePlus TM Screen printouts that contain source information to support the data elements, where allowed. In some instances, case/activity notes will be required to validate data elements. Each Service Provider must use the established file structure for all WIA participant files, with the file checklist in the front of each file. Supporting documentation within the files must be labeled with the appropriate field code and federal reference number as indicated on the file checklist. 1341 South Glenburnie Road New Bern, North Carolina 28562 (252) 636-6901 voice (252) 638-3569 fax www.ecwdb.org An Equal Opportunity/Affirmative Action Employer
Division of Workforce Development field codes are assigned to each element according to program cohorts and data categories for all data validation elements: Cohorts: A Adults DW Dislocated Workers OY Older Youth YY Younger Youth NEG National Emergency Grant Categories: E Eligibility/Intake/Application A Employment Activities XP Exit and Post-Program Activities Each data element also has a DOL reference number that corresponds to the Federal reporting requirements. Thus, an adult s date of birth would be coded AE2 (where A = adult, E = eligibility/intake/application, and 2 = the U.S. Department of Labor s reference number for date of birth). All data element validation field codes are indicated on the file checklist and must be indicated on the source documents in the files. If the Service Provider places a copy of a birth certificate in the file to support date of birth, the birth certificate should be labeled AE2. The following WorkforcePlus TM screen prints must be in all WIA exiters files: Complete electronic intake/application form printed out after all application data has been entered into WorkforcePlus TM and the applicant certified as WIA eligible, signed and dated by the applicant, intake staff, and parent/guardian if applicable (see note). 1 st Employment Activity Enrollment screen ( I-Case Management for adults, dislocated workers and NEG participants; Y-Comprehensive Guidance and Counseling for youth). Case Profile screen, printed after the individual has exited WIA. Case/activity notes. 1 st, 2 nd, and 3 rd Quarter Supplemental Data screens (if the service provider is using supplemental data for performance calculations and has allowable source documentation in the files to support the supplemental data). Leave Program and Outcomes screens. Employment Plan screen, printed after the individual has exited WIA (if name does not show on printout, it should be written on the printout). NOTE: There are two types of signed application/intake form printouts that are not acceptable sources of documentation for data element validation: Printing out a blank intake/application form, allowing the applicant to complete and sign it in pencil or ink, for the official application. Printing last page of the intake/application form only (the signature lines) and, after having signatures affixed, placing the signature page in the file.
ACTION: Service Providers must use the formal file structure including the file checklist to be placed in the front of each WIA participant file. All source documents used to support data element validation must have the appropriate Division field code written on them. Service Providers are required to ensure that all data validation elements and supporting documentation are included in all participants files. All new and/or exited files with an application or exit date of October 1, 2007 or later must have the revised checklist in the file. Service Providers will use classification folders with two (2) dividers and set-up participant files using the attached checklist and file section templates as follows: Adult and Dislocated Worker participant files File Checklist Section One Progression through Core-Intensive-Training Services Section Two Intake/Assessment and Documentation to Support Eligibility Section Three Program Participation Information Section Four Training/Support/Exit & Outcome Information Section Five Case/Activity Notes & Supplemental Data Information Older and Younger Youth participant files Follow procedures outlined in issuance 2007-04, WIA Data Validation and Participant File Structure for Older and Younger Youth dated January 15, 2008. EFFECTIVE DATE: October 1, 2007 EXPIRATION DATE: CONTACT: DISTRIBUTION: Indefinite Executive Director All Service Providers Tammy Childers, Executive Director Attachments
DWD Field AE DWE NEGE AE DWE AE DWE NEGE AE DWE NEGE ADULT DISLOCATED WORKER (DW) NATIONAL EMERGENCY GRANT (NEG) Ref # Data Element Federal & State Sources 2 Individual Identifier Social Security Card DD-214, Report of Transfer or Discharge Paper Passport 3 Date Of Birth Baptismal Record Birth Certificate Printout of Birth Certificate From County Register of Deeds Office DD-214, Report of Transfer or Discharge Paper Driver s License Federal, State, or Local Government Identification Card Hospital Record of Birth Passport Public Assistance/Social Service Records School Records/Identification Card (Copy from School) Work Permit Cross-Match with Department of Vital Statistics Tribal Records Department of Motor Vehicles ID Card 12 Eligible Veteran Status 1 = Yes 180 Days 2 = Yes, Eligible Veteran 3 = Yes, Other Eligible Person 4 = No 16 Employment Status At Participation 1 = Employed 2 = Employed, but Received Notice of Termination Of Employment or Military Separation 3 = Not Employed Prison Records Verification DD-214, Report of Transfer or Discharge Paper Cross-Match with Veterans Data Veterans Service Officer Statement/Printout Attachment 1 Case/Activity File Notes Showing Information Collected From Registrant At Registration/Enrollment Pay Stub Self Attestation (Client Statement Notarized) WF+: Printout of Intake/Application Form, Signed and Dated by Applicant (And Parent/Guardian if Applicable) AND WF+: Participation Fields Information Screen, Signed and Dated by Applicant (And Parent/Guardian if Applicable) if employment status changed between application and enrollment (if applicable) 1
DWD Ref # Data Element Federal & State Sources Field AE 20 Low Income AE DWE AE DWE 1 = Yes 2 = No 21 Temporary Assistance to Needy Families (TANF) 1 = Yes 2 = No 22 Other Public Assistance Recipient 1 = Yes 2 = No Alimony Agreement Award Letter from Veterans Administration Bank Statements Compensation Award Letter Court Award Letter Pension Statement Employer Statement/Contact Farm, Family, or Business Financial Records Housing Authority Verification Pay Stubs Public Assistance Records Quarterly Estimated Tax for Self-Employed Persons Social Security Benefits Statements U.I. Documents and/or printout, including U.I. Pay Stub FICA Records Employer Notice of Direct Deposit Written Employer Statement/Contact Scholarship/Financial Aid Records (indicating any cash paid directly to the applicant is counted as income) Self Attestation (Client Statement Notarized) Written Statement by the Applicant of No Income Written Statement by the Applicant of Cash Gifts Written Statement by the Applicant of Odd Jobs &/or Self Employment & Income Cross-Match with TANF Database Public Assistance Records DSS TANF Printout (showing appropriate TANF coding) DSS Electronic Interface Printout Written Verification from DSS Attachment 1 Copy of Authorization to Receive Cash Assistance (Must Have Applicant s Name Verified as being on the Grant) Copy of Public Assistance Check Medical Card or Public Assistance ID Card Showing Cash Grant Status Public Assistance records/printout Public Assistance Refugee Assistance Records Cross-Match with Public Assistance Database Written Verification from DSS Written Verification from Awarding Agency Written Documentation/Letter from Social Security Administration SSI Award Letter 2
DWD Field DWE NEGE DWE NEGE AA DWA NEGA AXP DWXP NEGXP Ref # Data Element Federal & State Sources 24 Displace Homemaker 1 = Yes 2 = No Displace Homemaker is an individual who has been providing unpaid services to family members in the home and who: A. Has been dependent on the income of another family member but is no longer supported by that income; AND B. Is unemployed or underemployed and is experiencing difficulty in obtaining or upgrading employment. Public Assistance Records Court Records Divorce Paper Bank Records Spouse s Layoff Notice Spouse s Death Record Self Attestation (Client Statement Notarized) (Applicant Signing/Dating Application is sufficient) Attachment 1 25 Date of Actual Qualifying Dislocation Written Verification from Employer Rapid Response List Notice of Layoff from Employer Public Announcement with Follow-Up Cross Match with U.I. System Self Attestation (Client Statement Notarized) WF+: Printout of Intake/Application Form, Signed and Dated by Applicant (and parent/guardian, if applicable) 34 Date of Program Participation WF+: Printout of 1 st Activity Enrollment Screen Showing Start Date NOTE: If the Case Manager changes the Registration/Participation Date in WF+ for any reason, an explanatory note must be placed in the case file. 35 Date of Exit WF+: After Exit is Keyed into WF+, Printouts of WF+ Case Profile Screen and Case/Activity Notes documenting date of receipt of last service NEGA 45 National Emergency Grant Project Number 1 Case Notes or other file data specifying the particular layoff or emergency that precipitated enrollment must include project number The project number for the grant(s) must be entered into WF+ AND found in/on the case file NEGA 46 National Emergency Grant Project Number 2 Case Notes or other file data specifying the particular layoff or emergency that precipitated enrollment must include project number The project number for the grant(s) must be entered into WF+ AND found in/on the case file NEGA 47 National Emergency Grant Project Number 3 Case Notes or other file data specifying the particular layoff or emergency that precipitated enrollment must include project number The project number for the grant(s) must be entered into WF+ AND found in/on the case file 3
Attachment 1 DWD Field AXP DWXP NEGXP AA DWA NEGA AA DWA NEGA AA DWA NEGA AA DWA NEGA AA DWA NEGA Ref # Data Element Federal & State Sources 61 Other Reasons for Exit (at time of exit or during 3 quarter measurement period following the quarter of exit) 1 = Institutionalized 2 = Health/Medical 3 = Deceased 4 = Family Care 5 = Reservists Called to Active Duty 6 = Relocated to Mandated Residential Program 99 = Invalid SSN Case/Activity Notes Doctor s Records Hospital Records (Written) Contact with the Penal System WF+: After Exit is Keyed into WF+, Printout of Leave Program Screen (exits prior to 7-1-06) or Outcomes Screen (exits 7-1-06 forward) 66 Date of First Staff Assisted Core Service Case/Activity Notes WF+: After Exit is Keyed into WF+, Printout of WF+ Employment Plan Screen 68 Date of First Intensive Service Case/Activity Notes WF+: After Exit is Keyed into WF+, Printout of WF+ Employment Plan Screen 69 Date Entered Training Case/Activity Notes Documenting Date Training Actually Started (Note: Case/Activity Notes should support date training actually starts) Vendor Training Documents Showing Training Start Date WF+: After Exit is Keyed into WF+, Printout of WF+ Employment Plan Screen 70 Date Completed or Withdrew From Training Case/Activity Notes Documenting Date Training was Actually Completed or Ended (Note: Case/Activity Notes should support date training actually ended) Cross Match between Dates of Service and Vendor Training Information Vendor Training Documentation WF+: After Exit is Keyed into WF+, Printout of WF+ Employment Plan Screen 74 Type of Training Service #1 1 = On-the-Job Training 2 = Skill Upgrading & Retraining 3 = Entrepreneurial Training 4 = Adult Education & Literacy Activities in Combination with Training 5 = Customized Training 6 = Other Occupational Skills Training In combination with Case/Activity Notes Vendor Training Documentation Identifying Training Received Certificates Case/Activity Notes WF+: After Exit, Printout of WF+ Employment Plan Screen Showing All Employment Activities 4
Attachment 1 DWD Field AXP DWXP DWD Field AXP DWXP NEGXP AXP DWXP NEGXP AXP DWXP NEGXP Ref # Data Element Federal & State Sources 102 Type of Recognized Credential 1 = High School Diploma/Equivalency/GED 2 = AA or AS Diploma/Degree 3 = BA or BS Diploma/Degree 4 = Occupational Skills Licensure 5 = Occupational Skills Certificate or Credential 6 = Other Recognized Educational or Occupational Skills Credential/Certificate 0 = Individual received training, but no recognized credential received Copy of School Transcript indicating requirement for Credential/Certificate completed Copy of Credential/Certificate Copy of Diploma/License/Degree School record/statement NOTE: Master s degree or high, use code 6 ONLY IF USING SUPPLEMENTAL DATA Ref # Data Element Federal & State Sources 84 Employed in 1 st Quarter After Exit Quarter 1 = Yes 2 = No 3 = Information not yet available 85 Type of Employment Match 1 st Quarter After Exit Quarter 1 = UI Wage Records (In-State & WRIS) 2 = Federal Employment Records (OPM, USPS) 3 = Military Employment Records (DOD) 4 = Other Administrative Wage Records 5 = Supplemental through case management, participant survey, and/or verification with the employer 6 = Information not yet available 89 Employed in 2 nd Quarter After Exit Quarter 1 = Yes 2 = No 3 = Information not yet available U.I. Wage Records WRIS (Wage Record Interchange System) Supplemental Data Sources As Defined TEGL 17-05 Employer Statement Check Stub Copy of Notice of Direct Deposit Participant s Business/Tax-Related Records WF+: Printout of 1 st Quarter Supplemental Data Screen Case/Activity Notes Follow-Up Services Record Sharing and/or Automated Record Matching with other Employment and Administrative Databases Other Out of State Wage Records Systems Employer Statement Check Stub Copy of Notice of Direct Deposit Participant s Business/Tax-Related Records WRIS WF+: Printout of 1 st Quarter Supplemental Data Screen plus employer statement and/or check stub/copy U.I. Wage Records WRIS (Wage Record Interchange System) Supplemental Data Sources As Defined TEGL 17-05 Employer Statement Check Stub Copy of Notice of Direct Deposit Participant s Business/Tax-Related Records WF+: Printout of 2 nd Quarter Supplemental Data Screen 5
Attachment 1 DWD Field AXP DWXP NEGXP AXP DWXP NEGXP AXP DWXP NEGXP Ref # Data Element Federal & State Sources 90 Type of Employment Match 2 nd Quarter After Exit Quarter 1 = UI Wage Records (In-State & WRIS) 2 = Federal Employment Records (OPM, USPS) 3 = Military Employment Records (DOD) 4 = Other Administrative Wage Records 5 = Supplemental through case management, participant survey, and/or verification with the employer 6 = Information not yet available 91 Employed in 3 rd Quarter After Exit Quarter 1 = Yes 2 = No 3 = Information not yet available 92 Type of Employment Match 3 rd Quarter After Exit Quarter 1 = UI Wage Records (In-State & WRIS) 2 = Federal Employment Records (OPM, USPS) 3 = Military Employment Records (DOD) 4 = Other Administrative Wage Records 5 = Supplemental through case management, participant survey, and/or verification with the employer 6 = Information not yet available Case/Activity Notes Follow-Up Services Record Sharing and/or Automated Record Matching with other Employment and Administrative Databases Other Out of State Wage Records Systems Employer Statement Check Stub Copy of Notice of Direct Deposit Participant s Business/Tax-Related Records WRIS WF+: Printout of 2 nd Quarter Supplemental Data Screen plus employer statement and/or check stub/copy U.I. Wage Records WRIS (Wage Record Interchange System) Supplemental Data Sources As Defined TEGL 17-05 Employer Statement Check Stub Copy of Notice of Direct Deposit Participant s Business/Tax-Related Records WF+: Printout of 3 rd Quarter Supplemental Data Screen Case/Activity Notes Follow-Up Services Record Sharing and/or Automated Record Matching with other Employment and Administrative Databases Other Out of State Wage Records Systems Employer Statement Check Stub Copy of Notice of Direct Deposit Participant s Business/Tax-Related Records WRIS WF+: Printout of 3 rd Quarter Supplemental Data Screen plus employer statement and/or check stub/copy 6
EASTERN CAROLINA LOCAL AREA WIA Adult and Dislocated Worker Program FILE CHECKLIST Name: SS#: ADULT DISLOCATED WORKER National Emergency Grant {NEG} DET Code File Section File Documents 1 Core, Intensive, Training Checklist 1 Assessment Tools AE/DWE/NEGE 16 & DWE/NEGE 25 2 Printed WIA WorkforcePlus Intake/Assessment Information (Signed & dated)) AE/DWE/NEGE 16 2 Printed WIA WorkforcePlus Participation Fields Information Screen (signed & dated) if applicable - only if employment status changes after application and before enrollment AE/DWE/NEGE 2 2 Verification of Social Security Number AE/DWE 3 2 Verification of Date of Birth 2 Verification of Citizenship 2 Verification of Residency 2 Verification of Selective Service Registration for Males born on/or after Jan. 1, 1960 AE/DWE/NEGE 12 2 Veteran Status (if applicable) (Discharge Papers DD-214) 2 Individual With A Disability (if applicable) 2 Unemployment Compensation Programs (if applicable) NEGA 45/46/47 2 National Emergency Grant Project Layoff/Emergency documentation (if applicable) 3 Eastern Carolina Workforce Development Board Disclosure/Release Form 3 Equal Opportunity is the Law 3 WIA Services Participation Agreement 3 Individual Employment Plan (IEP) AA/DWA/NEGA 34 3 Printed Copy of WorkforcePlus 1 st Employment Activity {I-Case Management} 3 Printed Copy of WorkforcePlus Job Referral Employment Activity (if applicable) AA/DWA/NEGA 66/68/69/70/74 3 Printed Copy of WIA WorkforcePlus Employment Plan Screen after Exit AXP/DWXP/NEGXP 35 3 Printed Copy of WIA WorkforcePlus Case Profile after Exit AXP/DWXP/NEGXP 61 (prior to 7-1-06) 4 Printed Copy of WIA WorkforcePlus Leave Program 4 Supportive Services {if applicable} 4 Financial Award Analysis {if applicable} 4 Attendance/Timesheets 4 Individual Training Account Vouchers (if applicable) AA/DWA/NEGA 74 4 Adult Education, Basic Skills and/or Literacy Activities (if applicable) 4 On-the-Job Training Contract (if applicable) AA/DWA/NEGA 74 & AXP/DWXP 102 4 Occupational Skills Training (grades, transcripts, certificates, degree, etc.) (if applicable) AXP/DWXP/NEGXP 61 (7-1-06 & forward) 4 Printed Copy of WIA WorkforcePlus Adult Outcomes 4 Printed Copy of WIA WorkforcePlus Exit WIA AXP/DWXP/NEGXP 84/85 5 Printed Copy of WIA WorkforcePlus 1 st Quarter Supplemental Data (if applicable) AXP/DWXP/NEGXP 89/90 5 Printed Copy of WIA WorkforcePlus 2 nd Quarter Supplemental Data (if applicable) AXP/DWXP/NEGXP 91/92 5 Printed Copy of WIA WorkforcePlus 3 rd Quarter Supplemental Data (if applicable) AE/DWE/NEGE 16 & NEGA 45/46/47 & AA/DWA/NEGA 66/68/69/70/74 & AXP/DWXP/NEGXP 35/61 5 Printed Case/Activity Notes {include program participation, program completion or withdrawal, support, exit and follow-up contact information}
PROGRAM SPECIFIC ELIGIBILITY ADULT DET Code DET Code DISLOCATED WORKER/NEG Category Dislocated Worker Eligibility 1 An individual who has been terminated or laid off, or who has received notice of termination or layoff from employment, and is eligible for or has exhausted entitlement to unemployment compensation, and is unlikely to return to a previous industry or occupation. File Section DWE/NEGE 25 2 DET Code Category 2 File Section DWE/NEGE 25 2 DET Code File Section Category 3 File Section DWE/NEGE 25 2 File Documents {circle documentation used to support determination} Termination Letter, Employer Statement AND Employment Security Commission Statement/Printout/Interface AND Intake Officer s Certification Stating Reason unlikely to return to previous industry or occupation. Dislocated Worker Eligibility An individual who has been terminated or laid off, or who has received notice of termination or layoff from employment, and has been employed for a duration sufficient to demonstrate, to the appropriate entity at a one-stop center referred to in section 134, attachment to the workforce, but is not eligible for unemployment compensation due to insufficient earnings or having performed services for an employer that was not covered under a state unemployment compensation law, and is unlikely to return to a previous industry or occupation. File Documents {circle documentation used to support determination} Termination Letter or Employer Statement AND Employment Security Commission Determination of UI Status, Employer Contact by Intake Officer (Non-Monetary Eligibility), Employer Statement, Employment Security Commission Statement AND Intake Officer s Certification Stating Reason unlikely to return to previous industry or occupation. Dislocated Worker Eligibility An individual who has been terminated or laid off, or who 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. File Documents AE 20 2 Low Income {NOT Food Stamps, TANF, GA, RCA, SSI} 2 Number in Family or Family of One Verification AE/DWE 21 2 TANF AE/DWE 22 2 General Assistance (GA), Refugee Cash Assistance (RCA), Supplemental Security Income (SSI Title XVI) 2 Food Stamp Verification File Documents {circle documentation used to support determination} Newspaper Article, Termination Letter, Employer Statement, WARN Notice, ESC Verification
PROGRAM SPECIFIC ELIGIBILITY DET Code DISLOCATED WORKER/NEG continued Category 4 File Section Dislocated Worker Eligibility An individual who is employed at a facility at which the employer has made a general announcement that such facility will close within 180 days. File Documents {circle documentation used to support determination} DWE/NEGE 25 2 Employer Statement, WARN Notice, Newspaper Article DET Code Category 5 File Section DWE/NEGE 25 2 Dislocated Worker Eligibility For purposes of eligibility to receive services other than training, intensive, or supportive services, an individual who is employed at a facility at which the employer has made a general announcement that such facility will close. File Documents {circle documentation used to support determination} Newspaper Article, Termination Letter, Employer Statement, WARN Notice, ESC Verification DET Code Category 6 File Section Dislocated Worker Eligibility An individual who was self-employed (including employment as a farmer, rancher, or fisherman) but is unemployed as a result of general economic conditions in the community in which the individual resides or because of a natural disaster. File Documents {circle documentation used to support determination} Payment of both Employee and employer parts of FICA tax, Wage Records, Copy of W-2 Form, Farm or Business Financial Records, Applicant Statement AND DWE/NEGE 25 2 Newspaper Article, Applicant Statement, General Labor Market Information, Employer Statement, News Media Report, Official Government Declaration DET Code Category 7 File Section DWE/NEGE 24 2 Dislocated Worker Eligibility An individual who is a displaced homemaker. The term displaced homemaker means an individual 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 (B) is unemployed or underemployed and is experiencing difficulty in obtaining or upgrading employment [WIA 101(10)]. File Documents {circle documentation used to support determination} Death Certificate, Decree of Court, Disabled, Written Landlord Statement, Written Statement fro a Domestic Violence Shelter, Marriage Certificate, Most Recent Tax Return support by IRS documents, Public Assistance/Social service Agency Records, Public Housing Authority (if resident of or on waiting list), Written Statement from a Publicly Supported 24 Hour Care Facility or Institution (e.g. Mental, Prison) Banks Statement (Direct Deposit), Written Employer Statement/Contact, Pay Stubs, Pension Statement, Public Assistance Records and/or Printouts, Social Security benefits and/or Printouts, Social Security Benefits and/or Printouts, Unemployment Insurance Documents and/or Printout, Intake Officer s Statement dealing with under employment
Core-Intensive-Training Checklist Assessment Tools
WF+ Printed Intake/Assessment Form signed & dated (AE/DWE/NEGE 16 & DWE/NEGE 25) WF+ Printed Participation Fields Information Screen signed & dated (AE/DWE/NEGE 16) if applicable - only if employment status changes after application and before enrollment Verification of Social Security Number (AE/DWE/NEGE 2) Verification of Date of Birth (AE/DWE/NEGE 3) Verification of Citizenship Verification of Residency/Address Selective Service Verification Verification of Veteran Status - DD 214 (AE/DWE/NEGE 12) Individual with Disability Documentation Verification of Unemployment Compensation Income Verification (AE 20) Family Size Verification TANF - this is not food stamps (AE/DWE 21) Public Assistance {GA, RCA, SSI} Verification - this is not food stamps (AE/DWE 22) Food Stamps Verification Displaced Homemaker Verification (DWE/NEGE 24) Dislocation Status Verification (DWE/NEGE 25) National Emergency Grant - Layoff/Emergency Documentation (NEGA 45/46/47)
Disclosure/Release EEO Notice/Grievance WIA Service Participant Agreement Individual Employment Plan (IEP) Printed WF+ I-Case Management Activity (AA/DWA/NEGA 34) Printed WF+ Job Referral Employment Activity Printed WF+ Employment Plan Screen after Exit (AA/DWA/NEGA 66/68/69/70/74) Printed WF+ Case Profile Screen (AXP/DWXP/NEGXP 35) Agency Created Forms
Printed WF+ Leave Program Screen (AXP/DWXP/NEGXP 61) Printed WF+ Adult Outcomes Screen & Documentation (AXP/DWXP/NEGXP 61) Printed WF+ Exit WIA Screen ITEMS LISTED BELOW MAY BE GROUPED BY SEMESTER WITH THE MOST CURRENT ON TOP Supportive Services Documentation Financial Award Analysis (FAA) Attendance/Timesheets Individual Training Account Vouchers (ITA) (AA/DWA/NEGA 74) Adult Ed, Basic Skills &/or Literacy Activities Documentation (AA/DWA/NEGA 74) On-the-Job Training Contract & Training Outline (AA/DWA/NEGA 74) Occupational Skills Training (grades, transcripts, etc.) (AA/DWA/NEGA 74 & AXP/DWXP 102)
Printed WF+ Case/Activity Notes (notes should include program entry, participation activities, completion or withdrawal from activities, supportive services, exit & follow-up information) (AE/DWE/NEGE 16 & NEGA 45/46/47 & AA/DWA/NEGA 66/68/69/70/74 & AXP/DWXP/NEGXP 35/61) Printed WF+ 1 st Quarter Supplemental Data Screen & Verification Source (AXP/DWXP/NEGXP 84/85) Printed WF+ 2 nd Quarter Supplemental Data Screen & Verification Source (AXP/DWXP/NEGXP 89/90) Printed WF+ 3 rd Quarter Supplemental Data Screen & Verification Source (AXP/DWXP/NEGXP 91/92) Case/Activity notes should be updated at least every 30 days. If no WIA or partner services are provided for over a 90 day period, the participant should be exited as of the date the last service was provided. Follow-up contact should also be documented in case/activity notes.