TEGL3-03_Ch1_AttachA.pdf

ETA Advisory File Text

1 ATTACHMENT A SOURCE DOCUMENTATION Revised Elements for Data Validation Source Documentation Requirements For WIA Programs This list is intended to provide guidance to states and grantees regarding what types of source documentation are acceptable to validate certain components of eligibility services and outcomes as required on the reports. Please note Only one document listed is required for each element. For example for element 101 Individual Identifier clients only need to present one of the listed documents such as a DD-214 or a passport or a Social Security card. Documentation is only required for clients who receive more than core services. Clients who enroll in training or other intensive services must provide the required source documents for validation purposes. DATA ELEMENT ADULT DISLOCATED WORKER OLDER YOUTH YOUNGER YOUTH Source Documentation Requirements 1 Individual Identifier 101 Yes Yes Yes Yes Social Security Card DD-214 Passport Database Assigned number from the state management information system 2 Date of Birth 102 Yes Yes Yes Yes Copy of I.D. Baptismal record birth certificate DD- 214 Report of Transfer or Discharge paper driver s license Federal state or local identification card passport hospital record of birth public assistance social service records school records or ID cards work permit cross match with Department of Vital Statistics tribal records 2 DATA ELEMENT ADULT DISLOCATED WORKER OLDER YOUTH YOUNGER YOUTH Source Documentation Requirements 3 Individual with a Disability 104 Yes Yes Yes Yes Letter from Drug or Alcohol rehabilitation agency medical records case notes regarding observable conditions physician s statement psychologist s diagnosis rehabilitation evaluation Social Security Administration records school records sheltered workshop certification social service records or referrals disability records Veteran s medical records vocational rehabilitation letter worker s compensation record self attestation 4 Veteran s Status 111 Yes Yes Yes No DD-214 cross match with veterans data 5 Employment Status at Registration 115 Yes No Yes Yes Pay stub case notes showing information collected from registrant 6 U.I. Compensation Programs 118 No Yes No No UI cross-match UI notice of entitlement 7 Low Income 119 Yes No Yes Yes Alimony Agreement applicant statement award letter from veteran s administration bank statements compensation award letter court award letter pension statement employer statement contact family or business financial records housing authority verification pay stubs pension statement social security benefits public assistance records quarterly estimated tax for self- employed persons Social Security benefits UI documents 8 TANF 120 Yes Yes Yes Yes Cross match with TANF public assistance records 3 DATA ELEMENT ADULT DISLOCATED WORKER OLDER YOUTH YOUNGER YOUTH Source Documentation Requirements 9 General Assistance 121 Yes Yes Yes Yes Copy of authorization to receive cash public assistance copy of public assistance check medical card showing cash grant status public assistance refugee assistance records cross match with public assistance database 10 Displaced Homemaker 124 No Yes No No Public assistance records court records divorce papers bank records spouse s layoff notice spouse s death record self attestation 11 Date of Actual Qualifying dislocation 125 No Yes No No Verification from employer rapid response list notice of layoff public announcement with follow-up cross-match with UI self attestation 12 Homeless individual and or runaway youth 126 No No Yes Yes Written statements from an individual providing residence shelter or social service agency WIA registration form self attestation 13 Offender 127 No No Yes Yes Documentation from juvenile or adult criminal justice system documentation phone call with court representatives WIA registration form self attestation 14 Pregnant or parenting youth 128 No No Yes Yes Copy of child s birth certificate baptismal record observation doctor s note confirming pregnancy self attestation 15 Youth who needs additional assistance 129 No No Yes Yes See state policy and state plan individual service strategy case notes WIA registration form state MIS self attestation 16 Education status at time of registration 130 No No Yes Yes Applicable records from education institution GED certificate diploma attendance record transcripts drop out letter school documentation WIA registration form State MIS self attestation 4 DATA ELEMENT ADULT DISLOCATED WORKER OLDER YOUTH YOUNGER YOUTH Source Documentation Requirements 17 Basic literacy skills deficiency as defined in 664.205 131 No No Yes Yes Standardized assessment test school records case notes 18 Date of WIA registration Title 1-B 302 Yes Yes Yes Yes Date of application and signature date signed WIA status form state MIS information 19 Date of WIA Exit 303 Yes Yes Yes Yes WIA status exit forms state MIS data Case notes 20 Supportive Services 330 No No Yes Yes Case notes 21 Date of first intensive service 332 Yes Yes No No Cross match between dates of service and vendor training information vendor training documentation state MIS case notes 22 Date of first training service 333 Yes Yes No No Cross match between dates of service and vendor training information vendor training documentation state MIS case notes 23 Established ITA 334 Yes Yes No No Check ITA account activity Asset database State MIS case notes 24 Adult education basic skills and or literacy activity 335 Yes Yes No No Vendor training documentation certificates state MIS data case notes 25 On-the-job training 336 Yes Yes No No Vendor training documentation OJT master contract state MIS data case notes 26 Occupational skills training or skills upgrading retraining and or workplace training 337 Yes Yes No No Vendor training documentation credentials state MIS documents school records diploma case notes 27 Educational achievement services 340 No No Yes Yes Activity sheets sign-in sheets attendance record vendor contract state MIS case notes 28 Employment services 341 No No Yes Yes Activity sheets vendor contract attendance rosters state MIS case notes 5 DATA ELEMENT ADULT DISLOCATED WORKER OLDER YOUTH YOUNGER YOUTH Source Documentation Requirements 29 Received summer youth employment opportunities 342 No No Yes Yes Activity sheets work agreement sign-in sheets attendance roster state MIS system case notes 30 Additional support for youth services 343 No No Yes Yes Activity sheets pay stub sign-in sheets attendance rosters state MIS vendor contract case notes 31 Leadership development opportunities 344 No No Yes Yes Activity sheets vendor contract attendance roster state MIS case notes 32 Received follow- up services 345 No No Yes Yes Activity sheets attendance rosters receipt for follow-up support services state MIS case notes 33 Post Program Employment 601 Yes Yes Yes No UI Wage records WRIS supplemental data sources defined by TEGL 7-99 State management information system 34 Source of Supplemental Data 602 Yes Yes Yes No Follow up services surveys record sharing and or automated record matching with other employment and administrative databases other out of state wage record systems case notes 35 Entered training related employment 605 Yes Yes No No Employer contacts state MIS WIA exit or status form cross match between occupational training code and occupation code 36 Employed in third quarter after exit 608 Yes Yes Yes No UI wage records WRIS supplemental data sources as defined in TEGL 7-99 37 Source of supplemental data 609 Yes Yes Yes No Follow-up services surveys record sharing and or automated record matching with other employment and administrative databases other out of state wage record systems case notes 38 Third quarter prior to registration 612 Yes Yes Yes No UI wage records WRIS other state wage records federal wage databases 39 Third quarter prior to dislocation 613 No Yes No No UI wage records WRIS other state wage records federal wage databases 6 DATA ELEMENT ADULT DISLOCATED WORKER OLDER YOUTH YOUNGER YOUTH Source Documentation Requirements 40 Second quarter prior to registration 614 Yes Yes Yes No UI wage records WRIS other state wage records federal wage databases 41 Second quarter prior to dislocation 615 No Yes No No UI wage records WRIS other state wage records federal wage databases 42 First quarter following the exit quarter 616 Yes Yes Yes No UI wage records WRIS other state wage records federal wage databases 43 Second quarter following the exit 617 Yes Yes Yes No UI wage records WRIS other state wage records federal wage databases 44 Third quarter following the exit quarter 618 Yes Yes Yes No UI wage records WRIS other state wage records federal wage databases 45 Type of recognized educational occupational certificate creden tial diploma degree attained 621 Yes Yes Yes No Transcripts certificates diploma surveys case notes 46 Other reasons for exit 622 Yes Yes Yes Yes State MIS waiver form doctor s records hospital records contact with the penal system case notes 47 In post- secondary education or advanced training gin quarter after exit 623 No No Yes No Record sharing with state board of governing community colleges state board of governing universities state education associations integrated post secondary education reporting unit higher education planning unit training certificates diploma survey enrollment form case notes 7 DATA ELEMENT ADULT DISLOCATED WORKER OLDER YOUTH YOUNGER YOUTH Source Documentation Requirements 48 In post- secondary education or advanced training in the third quarter after exit 624 No No Yes No Record sharing with state board of governing community colleges state board of governing universities state education associations integrated post secondary education reporting unit higher education planning unit training certificates diploma survey enrollment form case notes 49 Skill attainment goals Elements 625-672 No No No Yes Test Records Transcripts School Employer Notification State MIS Case notes 50 Attained secondary school diploma 673 No No No Yes Transcripts diploma notice from school 51 Date of High School diploma or GED 674 No No No Yes Transcripts diploma notice from school 52 Youth placement and retention information 675 676 No No No Yes Cross match with other agencies apprenticeship verification military service advanced training post secondary education transcripts registration forms comm.college info employer contacts U.I. wage records WRIS Case notes Revised Elements for NFJP Data Validation Source Documentation Requirements DATA ELEMENT Source Documentation Requirements 1 Date of Enrollment 004 IEP Certification self attestation case manager counselor intake application with signature 2 Date of Birth 005 Copy of I.D. Baptismal record birth certificate driver s license Federal state or local identification card passport hospital record of birth public assistance social service records school records or ID cards work permit cross match with Department of Vital Statistics tribal records 3 Qualifies for Sec. 167 Program as a Farmworker or dependent or spouse of a Farmworker 009 Pay stubs W-2 forms IRS 1040 forms case manager counselor intake notes self attestation 8 DATA ELEMENT Source Documentation Requirements 4 Farmworker Status 011 Pay stubs W-2 forms IRS 1040 forms case manager counselor intake notes self attestation 5 Number of individuals in the Family 013 b Birth certificate family bible IRS 1040 forms 6 Total Preprogram earnings during the 12-Month eligibility determination period 017 Pay stubs W-2 forms employer payroll records IRS 1040 forms Administrative wage records 7 Long-term Agricultural employment 020 f IRS 1040 forms pay stubs intake application case manager counselor progress notes self-attestation 8 Date of First Intensive Services 024 Case manager counselor progress notes with signature IEP assessment and diagnostic testing 9 Date of First Training Service 025 Case manager counselor certification signature employer signed document attendance records from institution or instructor 10 Enrolled in a program or activity leading to an educational or occupational credential or license 028 Case manager counselor progress notes with signature employer signed document attendance records from institution or instructor intake application 11 Date of Exit 035 Case manager counselor termination notice case manager counselor progress tracking report 12 Category of Exit 036 Grantee Administrative Records 13 Other reasons for Exit 037 Grantee Administrative Records 14 Date Entered Unsubsidized Employment 038 Case manager counselor progress notes letter from employer 15 Attainment of state recognized educational or occupational certificate credential diploma or degree 042 Copy of diploma degree record from Department of Education school sign-in sheet and certification completed by instructor 16 Total earnings during 6 months since placement 044 a Pay stubs employer payroll records IRS tax forms administrative UI wage records case manager counselor progress notes with signature 17 Has participant been employed at any time during the 4 th 5 th or 6 th months after placement 044 b Pay stubs employer payroll records IRS 1040 forms case manager counselor progress notes self attestation Revised Elements for Trade Data Validation Source Documentation Requirements DATA ELEMENT Source Documentation Requirements 1 Veteran Status I.8 DD-214 cross match with Veterans Data cross match with Wagner-Peyser State MIS 2 Most Recent Qualifying Separation I.13 Layoff or rapid response list determination of eligibility notice of termination letter from employer 3 Date of Application I.15 Application in case file State MIS WIA registration form Designation of Eligibility form 9 DATA ELEMENT Source Documentation Requirements 4 Petition Number I.16 Worker group certification in case file State MIS UI records DOLETA website Determination of Eligibility form 5 Date Entered Training II.1a Vendor training documentation in case file case notes State MIS attendance lists UI records WIA status forms 6 Date completed or withdrew from training II.1b Vendor training documentation in case file WIA status form training plan 7 Training Completed II.1c Vendor training documentation in case file WIA status form state MIS case notes about communications with program applicant statement UI records 8 Trade Readjustment Allowance TAA II.2 State UI records of TRA checks issued request for allowance state MIS 9 Waiver from training requirement II.3 Case file documentation that includes initial approval and renewals at 30 day intervals State UI records of TRA checks issued form from employment counselor 10 Date of Exit III.1 Documentation in case file State MIS WIA exit form 11 Employed in first full quarter after exit III.2 UI Wage records WRIS supplemental data sources as defined in TEGL 7-99 state MIS 12 Employed in third full quarter after exit III.5 UI Wage records WRIS supplemental data sources as defined in TEGL 7-99 state MIS 13 Three quarters prior to most recent qualifying separation III.6 UI Wage records WRIS other state wage records Federal Wages Database 14 Two quarters prior to most recent qualifying separation III.7 UI Wage records WRIS other state wage records Federal Wages Database 15 First quarter following exit III.8 UI Wage records WRIS other state wage records Federal Wages Database 16 Second quarter following exit III.9 UI Wage records WRIS other state wage records Federal Wages Database 17 Third quarter following exit III.10 UI Wage records WRIS other state wage records Federal Wages Database