TEGL31-09.pdf

ETA Advisory File Text

ATTACHMENT A SOURCE DOCUMENTATION REQUIREMENTS FOR PROGRAM YEAR PY 2009 WIA DATA ELEMENT VALIDATION A - 1 WORKFORCE INVESTMENT ACT DATA ELEMENT VALIDATION INSTRUCTIONS AND SOURCE DOCUMENTATION Validation Instructions These instructions present the data elements reference numbers formats element definitions Federal sources state grantee sources and validation rules needed to perform data element validation. The Federal sources are the generic federally recommended source documentation. The State Sources column can be used to enter state-specific versions of the federally approved documentation. A. VALIDATION RULES Two types of validation rules exist 1. If the validation instruction says MATCH Enter a checkmark in the box in the pass column if the data on the worksheet match the data in the source documentation. Enter a checkmark in the box in the fail column if the data on the worksheet do not match the data in the source documentation or if no source documentation is found. To match the data on the worksheet must be the same as the data in the source documentation. For example if the worksheet says a participant s date of birth is July 1 1975 then the source documentation must also have July 1 1975 as the birth date. The validator must validate data elements that have checkboxes next to them or are not grayed-out. 2. If the validation instruction says SUPPORT Enter a checkmark in the box in the pass column if the data on the worksheet are supported by the data in the source documentation. Enter a checkmark in the box in the fail column if the data on the worksheet are not supported by the data in the source documentation or if no source documentation is found. To support the data on the worksheet the source documentation must provide evidence that the data on the worksheet is correct. This instruction is used when information must be interpreted or processed before it can be used to assess the accuracy of the data on the participant s records. For example source documentation is used to support youth who needs additional assistance because validators must interpret policy and determine if the documentation supports that policy. A - 2 B. MISSING AND INVALID RECORDS There are four conditions used to describe higher level data problems 1. If a record is missing from the office in which it is supposed to be the validator should check the box at the top of the worksheet that says Missing Record. No other elements should be validated. 2. If the validator cannot determine where a record is supposed to be located the validator should check the box at the top of the worksheet that says Unable to Locate. No other elements should be validated. 3. If a record for a person not registered in WIA has wrongly been included in the extract file the validator should check the box at the top of the worksheet that says Invalid Record. No other elements should be validated. 4. If a record has a wrong Social Security Number SSN the validator should check the Wrong SSN checkbox AND validate all data elements listed on the worksheet. C. TYPES OF SOURCE DOCUMENTATION For most data elements the validation instructions provide multiple forms of acceptable source documentation. Ideally all source documentation should tell the same story regarding the participant services rendered and outcomes. However if the state collects multiple sources for the same data element and the sources conflict the most reliable source should be used to determine if the element passes or fails. For example for School Status at Participation DRVS Field 30 copies of records from an educational institution are a more reliable source than participant self-attestation. For the most part the definition of a particular source is clear. States have however had questions about four sources Cross-Match State Management Information System MIS Self-Attestation and Case Notes. Definitions for these four types of source documentation are 1. Cross-Match A cross-match requires validators to find detailed supporting evidence for the data element. An indicator or presence of an SSN in a non-WIA database is not sufficient evidence. For example Temporary Assistance to Needy Families TANF participation can be determined by a cross-match with the state s public assistance database. It is not sufficient to find that the sampled SSN is present in the public assistance database validators must also find supporting information such as dates of participation and services rendered. A - 3 2. State MIS Unless otherwise noted state MIS refers to specific detailed information that is stored in the state s information system that supports an element. An indicator such as a checkmark on a computer screen is not acceptable source documentation in and of itself. For example state MIS is an acceptable source documentation for date of first training service. To be an acceptable source to validate date of first training service in addition to the date of first training the state MIS should have information about the type of training and the organization that provided the training. This detailed information makes valid source documentation and makes it unnecessary for such states to validate this data element in local offices. 3. Self-Attestation Self-attestation occurs when a participant states his or her status for a particular data element such as pregnant or parenting youth and then signs and dates a form acknowledging this status. The key elements for self-attestation are a the participant identifying his or her status for permitted elements and b signing and dating a form attesting to this self-identification. The form and signature can be on paper or in the state management information system with an online signature. 4. Case Notes Case notes refer to either paper or electronic statements by the case manager that identifies at a minimum the following a participant s status for a specific data element the date on which the information was obtained and the case manager who obtained the information. PLEASE NOTE For DRVS field numbers 3 12 16 21 21 22 and 24 the sources differ for those adults dislocated workers and NEGs where applicable who received intensive and or training services from those who received staff-assisted services only. If a date is in field 68 or 69 the participant received intensive and or training services. Data Elements and Source Documentation Requirements A - 4 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 3 Date of Birth 102 Record the individual s date of birth. YYYYMMDD Yes Yes No Yes Yes Match Adults DW NEG Exiters who received Self-services only Self-attestation Adults DW NEG Exiters who received Staff-assisted core services only Hard or electronic case notes. Should reflect that the client has shown proof of age and should include for example the driver s license number or other uniquely identifiable information of the document. Youth and Adults DW NEG Exiters who received Intensive or Training Services 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 or tribal records Data Elements and Source Documentation Requirements A - 5 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 12 Veteran s Status 111 Record 1 if the individual is a person who served in the active U.S. military naval or air service for a period of less than or equal to 180 days and who was discharged or released from such service under conditions other than dishonorable. Record 2 if the individual served on active duty for a period of more than 180 days and was discharged or released with other than a dishonorable discharge or was discharged or released because of a service connected disability or as a member of a reserve component under an order to active duty pursuant to section 167 a d or g 673 a of Title 10 U.S.C. served on active duty during a period of war or in a campaign or expedition for which a campaign badge is authorized and was discharged or released from such duty with other than a dishonorable discharge. 1 Yes 180 days 2 Yes Eligible Veteran 3 Yes Other Eligible Person 4 No Yes Yes Yes Yes No Support Adults DW NEG Exiters who did not receive Intensive or Training Services State MIS self- attestation case notes Older Youth and Adults DW NEG Exiters who received Intensive or Training Services DD- 214 cross match with veterans data a letter from the Veterans Administration Data Elements and Source Documentation Requirements A - 6 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements Record 3 if the individual is a person who is a the spouse of any person who died on active duty or of a service- connected disability b the spouse of any member of the Armed Forces serving on active duty who at the time of application for assistance under this part is listed pursuant to 38 U.S.C 101 and the regulations issued thereunder by the Secretary concerned in one or more of the following categories and has been so listed for more than 90 days i missing in action ii captured in the line of duty by a hostile force or iii forcibly detained or interned in the line of duty by a foreign government or power or c the spouse of any person who has a total disability permanent in nature resulting from a service-connected disability or the spouse of a veteran who died while a disability so evaluated was in existence. Record 4 if the individual does not meet any one of the conditions described above. Data Elements and Source Documentation Requirements A - 7 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 16 Employment Status at Participation 115 Record 1 if the participant is a person who either a did any work at all as a paid employee b did any work at all in his or her own business profession or farm c worked 15 hours or more as un unpaid worker in an enterprise operated by a member of the family or d is one who was not working but has a job or business from which he or she was temporarily absent because of illness bad weather vacation labor- management dispute or personal reasons whether or not paid by the employer for time-off and whether or not seeking another job. Record 2 if the participant is a person who although employed either a has received a notice of termination of employment or the employer has issued a Worker Adjustment and Retraining Notification WARN or other notice that the facility or enterprise will close or b is a transitioning service member Record 3 if the individual does not meet any one of the conditions described above. 1 Employed 2 Employed but Received Notice of Termination of Employment or Military Separation 3 Not Employed Yes Yes Yes Yes Yes Support Adults DW NEG Exiters who did not receive Intensive or Training Services State MIS self- attestation case notes All Youth and Adults DW NEG Exiters who received Intensive or Training Services Pay stub case notes showing information collected from participant Data Elements and Source Documentation Requirements A - 8 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 20 Low Income 119 Record 1 if the individual is a person who A receives or is a member of a family which receives cash payments under a Federal state or local income- based public assistance program or B received an income or is a member of a family that received a total family income for the six-month period prior to program participation exclusive of unemployment compensation child support payments payments described in subparagraph A 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 i the poverty line for an equivalent period or ii 70 percent of the lower living standard income level for an equivalent period or C is a member of a household that receives or has been determined within the 6-month period prior to program participation Food Stamps under the Food Stamp Act of 1977 7 U.S.C. 2011 et seq. or 1 Yes 2 No Yes No No Yes Yes Support Adults Exiters who did not receive Intensive or Training Services State MIS self-attestation case notes All Youth and Adults Exiters who received Intensive or Training Services 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 public assistance records quarterly estimated tax for self- employed persons Social Security benefits UI documents Data Elements and Source Documentation Requirements A - 9 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 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. 11302 or E is a foster child on behalf of whom State or local government payments are made or F is a person with a disability whose own income meets the income criteria established in WIA section 101 25 A or B but is a member of a family whose income does not meet the established criteria. Record 2 if the individual does not meet the criteria presented above. Data Elements and Source Documentation Requirements A - 10 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 21 TANF Needy Family Status 120 Record 1 if the individual is a person who is listed on the welfare grant or has received cash assistance or other support services from the TANF agency in the last six months prior to participation in the program. Record 2 if the individual does not meet the condition described above. 1 Yes 2 No Yes Yes No Yes Yes Support Adults DW Exiters who did not receive Intensive or Training Services State MIS self-attestation case notes All Youth and Adults DW Exiters who received Intensive or Training Services Cross- match with TANF public assistance records Data Elements and Source Documentation Requirements A - 11 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 22 Other Public Assistance Recipient 121 Record 1 if the individual is a person who is receiving or has received cash assistance or other support services from one of the following sources in the last six months prior to participation in the program General Assistance GA State local government Refugee Cash Assistance RCA Food Stamp Assistance and Supplemental Security Income SSI-SSA Title XVI . Do not include foster child payments. Record 2 if the individual does not meet the above criteria. 1 Yes 2 No Yes Yes No Yes Yes Support Adults DW Exiters who did not receive Intensive or Training Services State MIS self-attestation case notes All Youth and Adults DW Exiters who received Intensive or Training Services Copy of authorization to receive cash public assistance copy of public assistance check medical card showing cash grant status public assistance records refugee assistance records cross- match with public assistance database Data Elements and Source Documentation Requirements A - 12 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 24 Displaced Homemaker 123 Record 1 if the individual is a person who has been providing unpaid services to family members in the home and has been dependent on the income of another family member but is no longer supported by that income and is unemployed or underemployed and is experiencing difficulty in obtaining or upgrading employment. Record 2 if the individual does not meet the conditions described above. 1 Yes 2 No No Yes Yes No No Support DW NEG Exiters who did not receive Intensive or Training Services State MIS self-attestation case notes DW NEG Exiters who received Intensive or Training Services Public assistance records court records divorce papers bank records spouse s layoff notice spouse s death record self - attestation 25 Date of Actual Qualifying Dislocation 124 Record the date of separation or dislocation from employment. This date is the last day of employment at the dislocation job. If there is no dislocation job e.g. displaced homemaker leave blank. YYYYMMDD No Yes Yes No No Match Verification from employer rapid response list notice of layoff public announcement with follow-up cross-match with UI self- attestation Data Elements and Source Documentation Requirements A - 13 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 26 Homeless individual and or runaway youth 125 Record 1 if the individual adult or youth is a person who lacks a fixed regular adequate night time residence. This definition includes any individual who has a primary night time residence that is a publicly or privately operated shelter for temporary accommodation an institution providing temporary residence for individuals intended to be institutionalized or a public or private place not designated for or ordinarily used as a regular sleeping accommodation for human beings or a person under 18 years of age who absents himself or herself from home or place of legal residence without the permission of his or her family i.e. runaway youth . This definition does not include an individual imprisoned or detained under an Act of Congress or State law. An individual who may be sleeping in a temporary accommodation while away from home should not as a result of that alone be recorded as homeless. Record 2 if the individual does not meet the conditions described above. 1 Yes 2 No Yes No No Yes Yes Support Written statements from an individual providing residence shelter or social service agency WIA intake or registration form self- attestation Data Elements and Source Documentation Requirements A - 14 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 27 Offender 126 Record 1 if the individual adult or youth is a person who either a is or has been subject to any stage of the criminal justice process for committing a status offense or delinquent act or b requires assistance in overcoming barriers to employment resulting from a record of arrest or conviction for committing delinquent acts such as crimes against persons crimes against property status offenses or other crimes. Record 2 if the individual does not meet any one of the conditions described above. 1 Yes 2 No Yes No No Yes Yes Support Documentation from juvenile or adult criminal justice system documented phone call with court or probation representatives WIA intake or registration form self-attestation 28 Pregnant or parenting youth 127 Record 1 if the individual is a person who is either under 22 years of age and who is pregnant or an individual male or female who is providing custodial care for one or more dependents under age 18. Record 2 if the individual does not meet the described above. 1 Yes 2 No No No No Yes Yes Support Copy of child s birth certificate baptismal record observation of pregnancy status doctor s note confirming pregnancy self- attestation Data Elements and Source Documentation Requirements A - 15 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 29 Youth who needs additional assistance 128 Record 1 if the individual is a person who is between the ages of 14 and 21 and requires additional assistance to complete an educational program or to secure and hold employment as defined by State or local policy. If the State Board defines a policy the policy must be included in the State Plan. Record 2 if the individual does not meet the conditions described above. 1 Yes 2 No No No No Yes Yes Support See state policy and state plan individual service strategy case notes WIA intake or registration form state MIS self- attestation Data Elements and Source Documentation Requirements A - 16 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 30 School Status at Participation 129 Record 1 if the individual has not received a secondary school diploma or its recognized equivalent and is attending any secondary school including elementary intermediate junior high school whether full or part-time or is between school terms and intends to return to school. Record 2 if the individual has not received a secondary school diploma or its recognized equivalent and is attending an alternative high school or an alternative course of study approved by the local educational agency whether full or part-time. Record 3 if the individual has received a secondary school diploma or its recognized equivalent and is attending a post-secondary school or program whether full or part-time or is between school terms and intends to return to school. Record 4 if the individual is no longer attending any school and has not received a secondary school diploma or its recognized equivalent. Record 5 if the individual is not attending any school and has either graduated from high school or holds a GED. 1 In-school H.S. or less 2 In-school Alternative School 3 In-school Post- H.S. 4 Not attending school H.S. Dropout 5 Not attending school H.S. graduate No No No Yes Yes Support Applicable records from education institution GED certificate diploma attendance record transcripts drop out letter school documentation WIA intake or registration form State MIS self- attestation Data Elements and Source Documentation Requirements A - 17 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 31 Basic literacy skills deficiency as defined in 664.205 130 Record 1 if the participant is a person who computes or solves problems reads writes or speaks English at or below the 8th grade level or is unable to compute or solve problems read write or speak English at a level necessary to function on the job in the individual s family or in society. In addition states and grantees have the option of establishing their own definition which must include the above language. In cases where states or grantees establish such a definition that definition will be used for basic literacy skills determination. Record 2 if the individual does not meet the conditions described above. 1 Yes 2 No No No No Yes Yes Support Standardized assessment test school records case notes 32 Foster Care Youth 131 Record 1 if the individual is a person who is in foster care or has been in the foster care system. Record 2 if the individual does not meet the condition described above. 1 Yes 2 No No No No No Yes Support Written confirmation from social services agency case notes 34 Date of Program Participation 302 Record the date on which the individual began receiving his her first service funded by the program following a determination of eligibility to participate in the program. YYYYMMDD Yes Yes Yes No No Match State MIS information Data Elements and Source Documentation Requirements A - 18 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 35 Date of Exit 303 Record the date on which the last service funded by the program or a partner program is received by the participant. Once a participant has not received any services funded by the program or a partner program for 90 consecutive calendar days and has no gap in service and is not scheduled for future services the date of exit is applied retroactively to the last day on which the individual received a service funded by the program or a partner program. YYYYMMDD Yes Yes Yes Yes Yes Match WIA status exit forms State MIS data Case notes 38 Date of First Youth Service 306 Record the date on which the individual began receiving his her first service funded by the WIA Youth program following a determination of eligibility to participate in the program. YYYYMMDD No No No Yes Yes Match WIA status exit forms State MIS data case notes 45-47 National Emergency Grant Project Numbers 313a 313b and 313c Record the Project I.D. Number where the individual received services financially assisted under a National Emergency Grant NEG . For example Utah projects may be numbered UT-02 so the WIASRD entry would be UT02 - WIA title ID section 173. Record 0000 or leave blank if the individual did not receive any services funded by a NEG. XXXX No No Yes No No Match Case file data or NEG grant award letter that identifies the project number assigned by the U.S DOL NEG Grant Officer Data Elements and Source Documentation Requirements A - 19 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 61 Other reasons for exit 327 Record 01 if the participant is residing in an institution or facility providing 24-hour support such as a prison or hospital and is expected to remain in that institution for at least 90 days. Record 02 if the participant is receiving medical treatment that precludes entry into unsubsidized employment or continued participation in the program. Does not include temporary conditions expected to last for less than 90 days. Record 03 if the participant was found to be deceased or no longer living. Record 04 if the participant is providing care for a family member with a health medical condition that precludes entry into unsubsidized employment or continued participation in the program. Does not include temporary conditions expected to last for less than 90 days. Record 05 if the participant is a member of the National Guard or other reserve military unit and is called to active duty for at least 90 days. 01 Institutionalized 02 Health Medical 03 Deceased 04 Family Care 05 Reserve Forces Called to Active Duty 06 Relocated to Mandated Residential or Non-Residential Program 98 Retirement 99 Not a Valid SSN Yes Yes Yes Yes Yes Support Information from partner services MIS systems WIA status exit form case notes Information from institution or facility Data Elements and Source Documentation Requirements A - 20 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements Record 06 if the youth participant is in the foster care system or any other mandated residential or non- residential program and has moved from the area as part of such a program or system exclusion for youth participants only . Record 98 if the participant retired from employment. Record 99 if the participant either disclosed an invalid social security number SSN or chose not to disclose a SSN. Record 00 or blank if the participant exited for a reason other than one of the conditions described above. Additional Note Exit Reason 98 Retirement has been added for program management purposes only and individuals who exit the program based on this reason will not be excluded from the calculations of performance measures they will be included. Data Elements and Source Documentation Requirements A - 21 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 66 Date of First Staff Assisted Core Service 332 Record the date on which the individual received his her first staff- assisted core service Note This excludes self-service and informational activities . Leave blank if the individual did not receive staff -assisted core services. YYYYMMDD Yes Yes Yes No No Match State MIS data case notes 68 Date of First Intensive Service 334 Record the date on which the individual received his her first intensive service. Leave blank if the individual did not receive intensive services. YYYYMMDD Yes Yes Yes No No Match State MIS data case notes 69 Date Entered Training 335 Record the date on which the individual s training actually began. If multiple training services were received record the earliest date on which the individual entered training. Leave blank if the individual did not receive training services. YYYYMMDD Yes Yes Yes No No Match Cross-match between dates of service and vendor training information vendor training documentation State MIS case notes 70 Date Completed or Withdrew from Training 336 Record the date on which the participant completed training or withdrew from training. If multiple training services were received record the most recent date on which the individual completed training. Leave blank if the individual did not receive training services. YYYYMMDD Yes Yes Yes No No Match Cross-match between dates of service and vendor training information vendor training documentation State MIS case notes Data Elements and Source Documentation Requirements A - 22 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 74 Type of Training Service 1 340 Use the appropriate code to indicate the type of training being provided to the individual. Record 0 or leave blank if the individual did not receive training services. 1 On-the-Job Training 2 Skill Upgrading Retraining 3 Entrepreneurial Training 4 ABE or ESL in Combination with Training 5 Customized Training 6 Other Occupational Skills Training Yes Yes Yes No No Support Vendor training documentation certificates State MIS case notes 77 Enrolled in Education 343 Record 1 if the individual is enrolled in secondary school post-secondary school an adult education program or any other organized program of study. States may use this coding value if the youth was either already enrolled in education at the time of participation in the program or became enrolled in education at any point while participating in the program. Record 2 if the individual was not enrolled in education. 1 Yes 2 No No No No Yes Yes Support Applicable records from education institution certifying enrollment case notes with verification from education institution or training provider that the individual is enrolled in education Data Elements and Source Documentation Requirements A - 23 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 78 Received Educational Achievement Services 344 Record 1 if the participant received educational achievement services. Educational achievement services include but are not limited to tutoring study skills training and instruction leading to secondary school completion including dropout prevention strategies and alternative secondary school offerings. Record 2 if the individual did not receive any of the services described above. 1 Yes 2 No No No No Yes Yes Support Activity sheets sign-in sheets attendance record vendor contract State MIS case notes WIA status forms noting receipt of educational services and type of services received 79 Received Employment Services 345 Record 1 if the participant received employment services. Employment services include paid and unpaid work experiences including internships and job shadowing and occupational skills training. Record 2 if the individual did not receive any of the services described above. 1 Yes 2 No No No No Yes Yes Support Activity sheets vendor contract attendance record or roster State MIS case notes 80 Received Summer Employment Opportunities 346 Record 1 if the participant received summer employment opportunities directly linked to academic and occupational learning. Record 2 if the individual did not receive any of the services described above. 1 Yes 2 No No No No Yes Yes Support Activity sheets work agreement sign-in sheets attendance record or roster State MIS case notes Data Elements and Source Documentation Requirements A - 24 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 81 Received Additional Support for Youth Services 347 Record 1 if the participant received supports for youth services that include but are not limited to the following a adult mentoring for a duration of at least twelve 12 months that may occur both during and after program participation or b comprehensive guidance and counseling including drug and alcohol abuse counseling as well as referrals to counseling as appropriate to the needs of the individual youth. Record 2 if the individual did not receive any of the services described above. 1 Yes 2 No No No No Yes Yes Support Activity sheets pay stub sign-in sheets attendance record or roster State MIS vendor contract case notes Data Elements and Source Documentation Requirements A - 25 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 82 Received Leadership development opportunities 348 Record 1 if the participant received services that include but are not limited to opportunities that encourage responsibility employability and other positive social behaviors such as a exposure to post-secondary educational opportunities b community and service learning projects c peer- centered activities including peer mentoring and tutoring d organizational and team work training including team leadership training e training in decision making including determining priorities and f citizenship training including life skills training such as parenting work behavior training and budgeting of resources. Record 2 if the individual did not receive any of the services described above. 1 Yes 2 No No No No Yes Yes Support Activity sheets vendor contract attendance record or roster State MIS case notes Data Elements and Source Documentation Requirements A - 26 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 83 Received follow-up services 349 Record 1 if the participant received 12 months of follow-up services. Follow-up services for youth include a regular contact with a youth participant s employer including assistance in addressing work-related problems that arise b assistance in securing better paying jobs career development and further education c work-related peer support groups d adult mentoring and e tracking the progress of youth in employment after training. Record 2 if the individual did not receive 12 months of follow-up services. Record 0 or leave blank if the youth has not exited or has exited and is continuing to receive follow-up services but has not yet received 12 months of follow-up services. Additional Note If a youth reenrolls in WIA within 12 months of exit Record 1 if follow-up services were provided throughout the period from exit to re-enrollment. 1 Yes 2 No No No No Yes Yes Support Activity sheets attendance record or roster documented receipt of follow-up support services State MIS case notes Data Elements and Source Documentation Requirements A - 27 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 84 Employed in 1 st Quarter after Exit Quarter 601 Record 1 if the participant was employed in the first quarter after the quarter of exit. Record 2 if the participant was not employed in the first quarter after the quarter of exit. Record 3 if information on the participant s employment status in the first quarter after the quarter of exit is not yet available. 1 Yes 2 No 3 Information not yet available Yes Yes Yes Yes Yes Support UI Wage records WRIS supplemental data sources defined by TEGL 17-05 State MIS Data Elements and Source Documentation Requirements A - 28 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 85 Type of Employment Match 1 st Quarter After Exit Quarter 602 Use the appropriate code to identify the method used in determining the individual s employment status in the first quarter following the quarter of exit. Wage records will be the primary data source for tracking employment in the first quarter after the exit quarter. If individuals are not found in the wage records grantees may then use supplemental data sources. If the individual is found in more than once source of employment using wage records record the data source for which the individual s earnings are greatest. Record 0 or leave blank if the individual was not employed in the first quarter after the quarter of exit. Additional Note If the participant is found employed in a wage record source e.g. State local government employment records that cannot be translated into quarterly earnings amounts states should treat these employment matches as supplemental data and use coding value 5 Supplemental through case management participant survey and or verification with the employer. 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 Yes Yes Yes Yes Yes Support UI Wage Records WRIS supplemental data sources defined by TEGL 17-05 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 Data Elements and Source Documentation Requirements A - 29 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 89 Employed in 2 nd Quarter After Exit Quarter 606 Record 1 if the participant was employed in the second quarter after the quarter of exit. Record 2 if the individual was not employed in the second quarter after the quarter of exit. Record 3 if the individual has exited but employment information is not yet available. 1 Yes 2 No 3 Information not yet available Yes Yes Yes No No Support UI wage records WRIS supplemental data sources as defined in TEGL 17-05 State MIS federal wage databases Data Elements and Source Documentation Requirements A - 30 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 90 Type of Employment Match 2 nd Quarter After Exit 607 Use the appropriate code to identify the method used in determining the individual s employment status in the second quarter following the quarter of exit. Wage records will be the primary data source for tracking employment in the second quarter after the exit quarter. If individuals are not found in the wage records grantees may then use supplemental data sources. If the individual is found in more than once source of employment using wage records record the data source for which the individual s earnings are greatest. Record 0 or leave blank if the individual was not employed in the second quarter after the quarter of exit. Additional Note If the participant is found employed in a wage record source e.g. State local government employment records that cannot be translated into quarterly earnings amounts states should treat these employment matches as supplemental data and use coding value 5 Supplemental through case management participant survey and or verification with the employer. 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 Yes Yes Yes No No Support UI wage records WRIS supplemental data sources as defined in TEGL 17-05 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 Data Elements and Source Documentation Requirements A - 31 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 91 Employed in 3 rd Quarter After Exit Quarter 608 Record 1 if the participant was employed in the third quarter after exit. Record 2 if the individual was not employed in the third quarter after exit. Record 3 if the individual has exited but employment information is not yet available. 1 Yes 2 No 3 Information not yet available Yes Yes Yes Yes Yes Support UI wage records WRIS supplemental data sources as defined in TEGL 17-05 State MIS Federal wage databases Data Elements and Source Documentation Requirements A - 32 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 92 Type of Employment Match 3 rd Quarter After Exit 609 Use the appropriate code to identify the method used in determining the individual s employment status in the third quarter following the quarter of exit. Wage records will be the primary data source for tracking employment in the third quarter after the exit quarter. If individuals are not found in the wage records grantees may then use supplemental data sources. If the individual is found in more than once source of employment using wage records record the data source for which the individual s earnings are greatest. Record 0 or leave blank if the individual was not employed in the third quarter after the quarter of exit. Additional Note If the participant is found employed in a wage record source e.g. State local government employment records that cannot be translated into quarterly earnings amounts states should treat these employment matches as supplemental data and use coding value 5 Supplemental through case management participant survey and or verification with the employer. 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 Yes Yes Yes Yes Yes Support UI wage records WRIS supplemental data sources as defined in TEGL 17-05 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 Data Elements and Source Documentation Requirements A - 33 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 95 Wages 3 rd Quarter Prior to Participation Quarter 612 Record total earnings for the third quarter prior to the quarter of participation. Please enter 999999.99 if data are not yet available for this item or data are too far in the past to obtain from the UI wage records or other administrative records. Otherwise leave blank if this data element does not apply. 000000.00 Yes Yes Yes Yes No Match UI wage records WRIS other state wage records Federal wage databases 96 Wages 2 nd Quarter Prior to Participation Quarter 613 Record total earnings for the second quarter prior to the quarter of participation. Please enter 999999.99 if data are not yet available for this item or data are too far in the past to obtain from the UI wage records or other administrative records. Otherwise leave blank if this data element does not apply. 000000.00 Yes Yes Yes Yes No Match UI wage records WRIS other state wage records Federal wage databases 98 Wages 1 st Quarter After Exit Quarter 615 Record total for the first quarter after the quarter of exit. Please enter 999999.99 if data are not yet available for this item. Otherwise leave blank if this data element does not apply. 000000.00 Yes Yes Yes Yes Yes Match UI wage records WRIS other state wage records Federal wage databases Data Elements and Source Documentation Requirements A - 34 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 99 Wages 2 nd Quarter After Exit Quarter 616 Record total earnings for the second quarter after the quarter of exit. Please enter 999999.99 if data are not yet available for this item. Otherwise leave blank if this data element does not apply. 000000.00 Yes Yes Yes Yes No Match UI wage records WRIS other state wage records Federal wage databases 100 Wages 3 rd Quarter After Exit Quarter 617 Record total earnings for the third quarter after the quarter of exit. Please enter 999999.99 if data are not yet available for this item. Otherwise leave blank if this data element does not apply. 000000.00 Yes Yes Yes Yes Yes Match UI wage records WRIS other state wage records Federal wage databases Data Elements and Source Documentation Requirements A - 35 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 102 Type of Recognized Credential 619 Use the appropriate code to record the type of recognized educational or occupational certificate credential diploma or degree attained by the individual who received training services. Record 0 if the individual received training services but did not attain a recognized credential. Credentials must be attained either during participation or by the end of the third quarter after the quarter of exit from services other than follow- up services . 1 High School Diploma 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 Certificate Credential Yes Yes No Yes No Support Transcripts certificates diploma surveys case notes Data Elements and Source Documentation Requirements A - 36 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 103-150 Goals Type Date Goal Was Set Attainment of Goal Date Goal Was Attained 620-667 Use the appropriate code to record the type of skill attainment goal. Setting one basic skills goal is required if the youth is basic literacy skills deficient. Record the date on which the goal was set for the youth except that the date of the first goal set must be recorded as the registration date. Record 1 if the goal was attained. Attainment of a goal is to be based on an individual s assessment using widely accepted and recognized measurement assessment techniques. Record 2 if the goal was set but not attained. A goal is not attained when the anniversary date has passed without attainment of the goal. The anniversary date of a goal is the date one year after the date the goal was set. Record 3 if the goal was set but attainment is pending. This code should not be used after exit. When the youth exits this field should be marked with a 1 or 2 for all goals that have been set. 1 Basic Skills 2 Occupational Skills 3 Work Readiness Skills YYYYMMDD 1 Attained 2 Set but not attained 3 Set but attainment is pending No No No No Yes Support for Goal Type and Attainment of Goal Match for Dates Test Records Transcripts School Employer Notification or documentation State MIS Case notes Data Elements and Source Documentation Requirements A - 37 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements Record date on which the goal was attained. This date should be on or before the one-year anniversary of the date the goal was set. However it may be later if the participant had a gap in service during which services were not received but the participant planned to return to the program. YYYYMMDD Data Elements and Source Documentation Requirements A - 38 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 151 Attained Diploma GED or Certificate 668 Record 1 if the individual attained a secondary school high school diploma recognized by the State. Record 2 if the individual attained a GED or high school equivalency diploma recognized by the State. Record 3 if the individual attained a certificate in recognition of an individual s attainment of technical or occupational skills or other post- secondary degree diploma.. Record 4 if the individual did not attain a diploma GED or certificate. SPECIAL NOTE Fields 668 and 669 will be used to calculate both the current WIA Younger Youth Diploma Rate and the common measure Attainment of a Degree or Certificate for all youth 14-21 . To achieve positive outcomes on both measures the state should make sure that coding values 1 or 2 are reported when the youth receives a diploma or equivalent either during participation in the program or by the end of the first quarter after the quarter of exit. If the youth receives another degree or certificate beyond the first quarter after the quarter of exit the state should not update the record. 1 Individual attained a secondary school high school diploma. 2 Individual attained a GED or high school equivalency diploma. 3 Individual attained a certificate or other post- secondary degree diploma. 4 Individual did not attain a diploma GED or certificate No No No Yes Yes Support Transcripts certificates diploma letter or other documentation from school system Data Elements and Source Documentation Requirements A - 39 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements If the youth did not receive a high school diploma or GED by the end of the first quarter after exit but did receive one or more certificates while either participating in the program or by the end of the third quarter after exit the state should record the most recent certificate attained. 152 Date Attained Degree or Certificate 669 Record the date on which the individual attained a diploma GED or certificate. Ideally the date should be the date listed on the diploma GED or certificate. Leave blank if the individual did not attain a diploma GED or certificate. Additional Note For recording multiple degrees or certificates please see the special note under WIASRD Element 668. YYYYMMDD No No No Yes Yes Match Transcripts certificates diploma letter or documentation from school system Data Elements and Source Documentation Requirements A - 40 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 153 School Status at Exit 670 Record 1 if the individual has not received a secondary school diploma or its recognized equivalent and is attending any primary or secondary school including elementary intermediate junior high school whether full or part-time or is between school terms and intends to return to school. Record 2 if the individual has not received a secondary school diploma or its recognized equivalent and is attending an alternative high school or an alternative course of study approved by the local educational agency whether full or part-time. Record 3 if the individual has received a secondary school diploma or its recognized equivalent and is attending a post-secondary school or program whether full or part-time or is between school terms and intends to return to school. Record 4 if the individual is no longer attending any school and has not received a secondary school diploma or its recognized equivalent. Record 5 if the individual is not attending any school and has either graduated from high school or holds a GED. 1 In-school H.S. or less 2 In-school Alternative School 3 In-school Post- H.S. 4 Not attending school H.S. Dropout 5 Not attending school H.S. Graduate No No No Yes Yes Support Transcripts certificates diploma letter or documentation from school system case notes Data Elements and Source Documentation Requirements A - 41 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 154 Youth Placement Information 671 Use the appropriate code to record the primary activity the youth entered in the first quarter following the exit quarter youth may qualify for more than one activity . For example if the youth enters advanced training and has entered a qualified apprenticeship please record 4. Record 0 if the youth did not enter any one of the activities listed in the coding value. 1 Entered post- secondary education 2 Entered advanced training 3 Entered military service 4 Entered a qualified apprenticeship No No No Yes Yes Support Cross-match with other agencies apprenticeship verification documentation of military service advanced training post secondary education transcripts registration forms community college info employer contacts U.I. wage records WRIS Case notes 155 Youth Retention Information 672 Use the appropriate code to record the primary activity the youth entered in the third quarter following the exit quarter youth may qualify for more than one activity . For example if the youth enters advanced training and has entered a qualified apprenticeship please record 4. Record 0 if the youth did not enter any one of the activities listing in the coding value. 1 In post-secondary education 2 In advanced training 3 In military service 4 In a qualified apprenticeship No No No Yes Yes Support Cross match with other agencies apprenticeship verification documentation of military service advanced training post secondary education transcripts registration forms community college info employer contacts U.I. wage records WRIS Case notes Data Elements and Source Documentation Requirements A - 42 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements 156-198 Category of Assessment Type of Assessment Test Functional Area Date Administered Test Educational Functioning Level 701-743 Record 1 if the participant was assessed using approved tests for Adult Basic Education ABE Record 2 if the participant was assessed using approved tests for English-As-A-Second Language ESL Record 0 or leave blank if the individual was not assessed in literacy or numeracy. Use the appropriate code to record the type of assessment test that was administered to the youth participant. 1 ABE 2 ESL 3 Both ABE and ESL 1 TABE 9-10 2 CASAS Life Skills 3 ABLE 4 WorkKeys 5 SPL 6 BEST 7 BEST Plus 8 TABE Class E 9 Wonderlic 10 Other Approved Assessment Tool 1 Reading 2 Writing 3 Language 4 Mathematics 5 Speaking 6 Oral 7 Listening 8 Other Functional Area No No No Yes Yes Support for non- date fields. Match for date fields Test records case notes documenting the necessary details for each element of testing. States should refer to TEGL 17-05 Change 1 Attachment C for the list of approved Educational tests for the Literacy Numeracy measure. Front line staff must keep a copy of the test scoring sheet that shows the date of the test total score and grade levels in the case file. Case notes should also detail the participant s progress. Data Elements and Source Documentation Requirements A - 43 DRVS Field Number Data Element Data Element Definition Code Value Adult DW NEG OY YY Match Support Source Documentation Requirements Record the date on which the pre- assessment test was administered to the youth participant. Leave blank if the individual was not assessed in literacy or numeracy. Record the educational functioning level that is associated with the youth participant s raw scale score. Record 0 or leave blank if the individual was not assessed in literacy or numeracy. YYYYMMDD 1 Beginning ESL Literacy 2 Low Beginning ESL Literacy 3 Beginning ABE Literacy High Beginning ESL Literacy 4 Beginning Basic Education Low Intermediate ESL 5 Low Intermediate Basic Education High Intermediate ESL 6 High Intermediate Basic Education Advanced ESL 7 Low Adult Secondary Education Exit ESL 8 High Adult Secondary Education OMB No. 1205-042 0 Expires 12 31 201 2 State Name Date Submitted A. A discussion of the cost of workforce investment activities relative to the effect of the activities on the performance of participants. B. A description of State evaluations of workforce investment activities including 1. The questions the evaluation will did address 2. A description of the evaluation s methology and 3. Information about the timing of feedback and deliverables. Negotiated Performance Level Actual Performance Level Entered Employment Rate Employment and Credential RateNumerator Denominator Average EarningsNumerator Denominator Reported Information Numerator Denominator Employers Numerator Denominator Table B- Adult Program Results II. Table Section Participants Customer SatisfactionNegotiated Performance LevelActual Performance Level - American Customer Satisfaction IndexNumber of Surveys CompletedNumber of Customers Eligible for the SurveyNumber of Customers Included in the SampleResponse Rate Employment Retention Rate Attachment B I. Narrative Section Workforce Investment Act WIA Annual Report Requirements for States Approved to Report Against the Common Performance Measures Only WIA Title IB Annual Report Form ETA 9091 Table A - Workforce Investment Act Customer Satisfaction Results Table E - Dislocated Worker Program Results Average EarningsNum Num Den DenNum Den Den Employment Retention RateNum Num Den Den Entered Employment RateNum Table D - Other Outcome Information for the Adult Program Reported Information Individuals Who Received Training Services Individuals Who Only Received Core and Intensive ServicesNum Den Den Den DenNum Num Num Den Den Den DenNum Num Average Earnings Num Employment and Credential Rate Num Employment Retention Rate NumNum Num Den Den Den DenNum NumDen Den Reported InformationPublic Assistance Recipients Receiving Intensive or Training ServicesVeterans Individuals With Disabilities NumOlder Individuals Entered Employment Rate NumNum Den Den Reported Information Negotiated Performance Level Actual Performance Level Entered Employment RateNumerator Denominator Table C - Outcomes for Adult Special Populations Employment Retention RateNumerator Denominator Average EarningsNumerator Denominator Employment and Credential RateNumerator Denominator Literacy and Numeracy GainsNumerator Denominator DenominatorNumerator Denominator Num Den Num Table G - Other Outcome Information for the Dislocated Worker Program Average EarningsNum Num Den Employment Retention RateDen Num Num Den DenNum Num Den Num Den Den Den Reported Information Individuals Who Received Training Services Individuals Who Only Received Core and Intensive Services Entered Employment RateDenDen Num Den Num Den DenNum Num Reported InformationVeterans Num DenIndividuals With Disabilities Older Individuals NumDisplaced Homemakers DenNum Den Num Table H.1 - Youth 14 - 21 Program Results Reported Information Negotiated Performance Level Actual Performance Level Placement in Employment or Education Attainment of Degree or CertificateNumeratorDen Num Den Den Num Num Den Employment and Credential RateDen Num Num Employment Retention Rate Average Earnings Entered Employment Rate Table F - Outcomes for Dislocated Worker Special Populations Num Den Den Den Num Den Den Reported InformationPublic Assistance Recipients Individuals With Disabilities Num Skill Attainment RateNumNum Den Retention RateNum DenNum Entered Employment Rate Num Num Num Den Den Youth Diploma or Equivalent RateNum DenOut-of-School Youth Reported Information Negotiated Performance Level Actual Performance Level Skill Attainment RateNumerator Six Months Earnings Increase Num Den Den DenNum Employment Retention Rate Denominator Denominator Retention RateNumerator Denominator NumeratorDen Denominator Reported InformationPublic Assistance Recipients Veterans Den Youth Diploma or Equivalent RateDen Num Table J - Younger Youth 14 - 18 Results Numerator Num DenDenominator Credential Rate Table H.2 - Older Youth 19 - 21 Results Individuals With Disabilities NumOut-of-School Youth Num Reported Information Negotiated Performance Level Actual Performance Level Employment Retention RateNumerator Denominator Entered Employment RateNumerator Denominator Six Months Earnings IncreaseNumerator Den Den Den Num Num Table K - Outcomes for Younger Youth Special PopulationsTable I - Outcomes for Older Youth Special Populations NumNum Den Den Den DenNum Num Num Den Credential Rate Num Num Num Num Num Den Den Den Den Num Num Num Num Den Den Den Den Num Num Num Den Den Den In-School Youth WIA Dislocated Workers Older Youth 19 - 21 Out-of-School Youth Younger Youth 14 - 18 Reported Information Total Participants Served Total Exiters WIA Adults Total Adults self-service only Den Table M - Participation Levels Older Youth Total Youth 14 - 21 Total Adult CustomersNum Num Den Den AdultsNum Dislocated Workers Table L - Other Reported Information Reported Information 12 Month Employment Retention Rate12 Months Earnings Increase Adults and Older Youth or 12 Months Earnings Replacement Dislocated Workers Placements in Non-traditional EmploymentWages At Entry Into Employment For Those Individuals Who Entered Unsubsidized EmploymentEntry Into Unsubsidized Employment Related to the Training Received of Those Who Completed Training Services Table N - Cost of Program Activities Program Activity Local Youth Rapid Response up to 25 WIA Section 134 a 2 B Local Adults Local Dislocated Workers Total of All Federal Spending Listed Above Statewide Required Activities Up to 15 WIA Section 134 a 2 B Total Federal Spending Statewide Allowable Activities WIA Section 134 a 3 Program Activity Description Total Exiters Program Participants Employers Adults Dislocated Workers Older Youth Adults Dislocated Workers Older Youth Younger Youth Adults Dislocated Workers Older Youth Adults Dislocated Workers Older Youth Younger Youth Skill Attainment Rate Younger Youth Placement in Employment or Education Youth 14 - 21 Attainment of Degree or Certificate Youth 14 - 21 Literacy and Numeracy Gains Youth 14 - 21 Overall Status of Local Performance ETA Assigned Adults Adults Local Area Name Dislocated Workers Retention Rates Average Earnings Adults DWs Six Months Earnings Increase Older Youth Total Participants ServedDislocated Workers Table O- Local Performance Include this chart for each local area in the state Reported Information Customer Satisfaction Entered Employment Rates Credential Diploma Rates Description of Other State Indicators of Performance WIA Section 136 d 1 - Insert additional rows if there are more than two other state indicators of performance . Exceeded Not Met Met Older Youth 19 - 21 Report Total Youth Older Youth 19 - 21 Report Total Youth Actual Younger Youth 14 - 18 Younger Youth 14 - 18 Negotiated Performance ATTACHMENT C COMMON WORKFORCE INVESTMENT ACT STANDARDIZED RECORD DATA WIASRD REPORTING ERRORS C.1 This attachment includes typical WIA Standardized Record Data WIASRD submission errors that ETA has identified. Please ensure accurate and complete data submission. Not reporting disability status Item 104 for many individuals should be 1 or 2 not 0 or blank for almost everyone. Not reporting Hispanic Item 105 for many individuals. Not reporting Recently Separated Veteran Item 114 for many veterans. Incorrect reporting of high school graduates in Highest Grade Completed Item 119 . High school graduates should be reported using code 87 . Code 12 should be used only for those who completed the 12 th grade but did not graduate. Not including Food Stamps recipients in Other Public Assistance Recipient Item 121 . The definition of this field was changed for PY 2005 to include Food Stamp recipients. Not reporting the Date of Actual Qualifying Dislocation Item 125 for many dislocated workers. Not reporting adult characteristics for all or many individuals. o Homeless Item 125 . o Offender Item 126 . Incorrect reporting of Employment and Training Programs Related to Food Stamps Item 325 . This field is not used for reporting receipt of Food Stamps which is included in Item 121 . Item 325 is to be used only for those who received employment and training services funded by the Food Stamps program. Not reporting new service fields o Core self-service and informational activities Item 331 . o Date of first staff-assisted core service Item 332 . o Workforce information services Item 333 . o Date completed or withdrew from training Item 336 . o Prevocational activities Item 339 . Incorrect reporting of enrolled in education Item 343 . o Should generally be yes if a youth was in school at either participation Item 129 or exit Item 670 . Not reporting wages in the quarter before registration Item 614 . C.2 Not reporting wages before registration Items 612 to 614 for persons who exit after the exit cohort for average earnings or earnings change. Not reporting education status at exit Item 670 for youth. Incorrect reporting of youth activities. Almost all youth should have at least one youth activity reported. Several states report a large number of youth without any youth activities. One state does not report any youth activities at all. Incorrect reporting of NEG participants. o Not providing records for all NEG participants. All participants enrolled in a NEG project must be reported in the WIASRD regardless of whether or not they were coenrolled in Title 1b programs. o Incorrect reporting of the NEG Project ID Items 313a to 313c . A NEG project ID must be entered for each NEG participant. This number is found in the NEG Grant Award package. If the participant is enrolled in more than one NEG all applicable NEG project IDs should be entered in the participant s record. The NEG project ID is the state postal code followed by a two-digit number. For example a valid code for a project in Utah would be UT02. ATTACHMENT D SOURCE DOCUMENTATION REQUIREMENTS FOR FISCAL YEAR FY 2010 TAA DATA ELEMENT VALIDATION FY 2010 Trade Adjustment Assistance Data Element Validation Instructions 1 Trade Adjustment Assistance Data Element Validation Instructions Validation Instruction These instructions present the data elements reference numbers formats element definitions federal sources state grantee sources and validation rules needed to perform data element validation. The federal sources are the generic federally recommended source documentation. The State Grantee Sources column can be used to enter state-specific versions of the federally approved documentation. VALIDATION RULES Two types of validation rules exist 1. If the validation instruction says MATCH Enter a checkmark in the box in the pass column if the data on the worksheet match the data in the source documentation. Enter a checkmark in the box in the fail column if the data on the worksheet do not match the data in the source documentation or if no source documentation is found. To match the data on the worksheet must be the same as the data in the source documentation. For example if the worksheet says a participant s date of exit is July 1 2002 then the source documentation must also have July 1 2002 as the exit date. The validator must validate all data elements that have checkboxes next to them. 2. If the validation instruction says SUPPORT Enter a checkmark in the box in the pass column if the data on the worksheet are supported by the data in the source documentation. Enter a checkmark in the box in the fail column if the data on the worksheet are not supported by the data in the source documentation or if no source documentation is found. To support the data on the source documentation must provide evidence that the data on the worksheet are correct. This instruction is used when information must be interpreted or processed before it can be used to assess the accuracy of the data on the participant records. For example source documentation can support waiver from training requirement. MISSING AND INVALID RECORDS There are four conditions used to describe higher level data problems 1. If a record is missing from the office in which it is supposed to be the validator should check the box at the top of the worksheet that says Missing Record. No other elements should be validated. 2. If the validator cannot determine where a record is supposed to be located the validator should check the box at the top of the worksheet that says Unable to Locate. No other elements should be validated. 3. If a record for a person not registered in TAA has wrongly been included in the extract file the validator should check the box at the top of the worksheet that says Invalid Record. No other elements should be validated. 4. If a record has a wrong Social Security Number SSN the validator should check the Wrong SSN checkbox AND validate all data elements listed on the worksheet. FY 2010 Trade Adjustment Assistance Data Element Validation Instructions 2 TYPES OF SOURCE DOCUMENTATION For most data elements the validation instructions provide multiple forms of acceptable source documentation. If the state collects multiple sources for the same data element and the sources conflict the most reliable source should be used to determine if the element passes or fails. For example for Employed in first full quarter after exit Ref 11 UI wage records are more reliable than supplemental data sources. Validators should use their best judgment when deciding the most reliable source to validate an element. For the most part definition of a particular source is clear. States have however had questions about three sources -- Cross-Match State Management Information System MIS and Case Notes. Definitions for these elements are 1. Cross-Match A cross-match requires validators to find detailed supporting evidence for the data element. An indicator or presence of an SSN in a non-TAA database is not sufficient evidence. For example veteran status can be determined by a cross-match with the veteran s database. It is not sufficient to find that the sampled SSN is present in this database validators must also find dates of service separation and discharge information. 2. State MIS Unless otherwise noted state MIS refers to specific detailed information that is stored in the state information system that supports an element. An indicator such as a checkmark on a computer screen alone is not acceptable source documentation. For example state MIS is acceptable source documentation for date entered training. To be an acceptable source to validate this date in addition to the date of first training the state MIS should have detailed information about the type of training and the organization that provided the training. This detailed information makes valid source documentation and makes it unnecessary for such states to validate this data element in local offices. 3. Case Notes Case notes refer to either paper or online statements by the case manager that identify a participant s status for a specific data element the date on which the information was obtained and the case manager who obtained the information. FY 2010 Trade Adjustment Assistance Data Element Validation Instructions 3 Data Element Number Ref Format Definition Federal Sources State Grantee Instructions Veteran status 301 1 Numeric 1 Yes 180 days 2 Yes eligible veteran 3 Yes other eligible person 0 No Record the code that indicates whether the individual served in the active U.S. military naval or air service for a period less than or equal to 180 days and who was discharged or released from such service under conditions other than dishonorable or whether the individual met the conditions above for more than 180 days. DD-214 Cross-match with Veterans Data Cross-match with Wagner- Peyser State MIS Support Most recent qualifying separation 707 2 Date YYYYMMDD Record the most recent date of separation from trade-impacted employment that qualifies the individual to receive benefits and or services under the Trade Act. Use the YYYYMMDD format. Layoff lists or rapid response list Determination of eligibility form Notice of termination Letter from employer Match Date of application 20 3 Date YYYYMMDD Record the date using YYYYMMDD format on which the individual first applied for Trade Act services benefits under the applicable certification. Application in case file State MIS WIA registration form Designation of Eligibility form Match Petition number 920 4 Numeric Record the petition number of the certification which applies to the individual s worker group. If there is more than one petition number for example certifications under both the TAA and NAFTA-TAA programs record the petition number of the program from which the training is paid unless a waiver was issued. Do NOT include any alphabetic suffix record the petition number only. Worker group certification in case file State MIS UI records DOLETA Website Determination of Eligibility form Match Date entered training 1208 5 Date YYYYMMDD Record the date using YYYYMMDD format when the participant s approved training began. NOTE Trade Act-approved training which begins under the WIA dislocated worker program may have a date entered training that is earlier than the participant s application date. Vendor training documentation in case file Case notes WIA Status Form State MIS Attendance lists UI records Match Date completed or withdrew from training 1211 1216 or 1221 6 Date YYYYMMDD Record the date using YYYYMMDD format when the participant completed training or withdrew permanently from training. Vendor training documentation in case file WIA Status Form Training plan Match FY 2010 Trade Adjustment Assistance Data Element Validation Instructions 4 Training completed 1210 1215 or 1220 7 Numeric 1 Yes completed approved training course 0 No did not complete withdrew Record the appropriate code Vendor training documentation in case file WIA Status Form State MIS Case Notes about communications with program Applicant Statement UI Records Support Date Received First Basic TRA Payment Allowance TRA 1420 8 Date YYYYMMDD Record the first date upon which the participant received Basic Trade Readjustment Allowances TRA . State UI records of TRA checks issued Request for allowance State MIS Support Waiver from training requirement 1225 9 Numeric 1 Recall 2 Marketable 3 Retirement 4 Health 5 Enrollment unavailable 6 Training Not Available Record the code that indicates the reason the participant received a waiver from the training requirement. Case file documentation that includes initial approval and renewals at 30 day intervals State UI records of TRA checks Form from employment counselor Support Date of exit 901 10 Date YYYYMMDD Record the last date on which the participant received TAA or partner funded services after 90 days without a service. See TEGL 17-05 for more information Documentation in case file State MIS WIA exit form Match Employed in first full quarter after exit 1500 11 Numeric 1 Yes 0 No Record whether the participant was employed in the first full quarter after exit. UI Wage Records WRIS State MIS Supplemental Data Sources as defined in TEGL 7-99 Support Validate blank Employed in third full quarter after exit 1509 12 Numeric 1 Yes 0 No Record whether the participant was employed in the third full quarter after exit. UI Wage Records WRIS Supplemental Data Sources as defined in TEGL 7-99 State MIS Support Validate blank Three quarters prior to participation quarter 1600 13 Numeric 00000.00 Earnings in the third full quarter prior to the quarter of participation. UI Wage Records WRIS Other state wage records Federal Wage Databases Match Validate blank fields FY 2010 Trade Adjustment Assistance Data Element Validation Instructions 5 Two quarters prior to participation quarter 1601 14 Numeric 00000.00 Earnings in the second full quarter prior to the quarter of participation. UI Wage Records WRIS Other state wage records Federal Wage Databases Match Validate blank fields Wages first quarter after exit quarter 1603 15 Numeric 00000.00 Earnings in the first full quarter after the participant has exited. UI Wage Records WRIS Other state wage records Federal Wage Databases Match Validate blank fields Wages second quarter after exit quarter 1604 16 Numeric 00000.00 Earnings in the second full quarter after the participant has exited. UI Wage Records WRIS Other state wage records Federal Wage Databases Match Validate blank fields Wages third quarter after exit quarter 1605 17 Numeric 00000.00 Earnings in the third full quarter after the participant has exited. UI Wage Records WRIS Other state wage records Federal Wage Databases Match Validate blank fields ATTACHMENT E SOURCE DOCUMENTATION REQUIREMENTS FOR PROGRAM YEAR PY 2009 NFJP DATA ELEMENT VALIDATION 1 This appendix presents the data elements to be validated with their associated WIASPR number element definitions valid values federal validation sources state grantee sources and validation instructions needed to perform data element validation. The federal sources are the generic federally recommended source documentation. The State Grantee Sources column can be used to enter grantee- specific versions of the federally approved documentation. Two types of validation rules exist 1. If the validation instruction cell says MATCH Enter a checkmark in the box in the pass column if the data on the validation worksheet match the data in the source documentation. Enter a checkmark in the box in the fail column if the data on the worksheet do not match the data in the source documentation or if no source documentation is found. To match the data on the worksheet must be the same as the data in the source documentation. For example if the worksheet says a participant s date of birth is July 1 1975 then the source documentation must also have July 1 1975 as the birth date. 2. If the validation instruction says SUPPORT Enter a checkmark in the box in the pass column if the data on the validation worksheet are supported by the data in the source documentation. Enter a checkmark in the box in the fail column if the data on the worksheet are not supported by the data in the source documentation or if no source documentation is found. To support the data on the worksheet must be similar to the data in the source documentation. This instruction is used when information must be interpreted or processed before it can be applied to the participant s records. For example source documentation can support farmworker status in different ways by a code or narrative or other information. For the most part the definition of a particular source is clear. Grantees may however have questions about three sources Grantee Management Information System MIS Self-Attestation and Case Notes. Definitions for these three types of source documentation are 2 1. MIS Unless otherwise noted MIS refers to specific detailed information which supports an element that is stored in the grantee s information system. An indicator alone such as a checkmark on a computer screen is not acceptable source documentation. For example a grantee s MIS is acceptable source documentation for date of exit if it identifies the last service received in addition to the date on which that service was received. 2. Self-Attestation Self-attestation occurs when a participant states his or her status for a particular data element and then signs and dates a form acknowledging this status. The key elements for self-attestation are a the participant identifying his or her status for permitted elements and b the signing and dating of a form attesting to this self-identification. The form and signature can be on paper or in the state management information system with an online signature. 3. Case Notes Case notes refer to either paper or electronic statements by the case manager that identifies at a minimum the following a participant s status for a specific data element the date on which the information was obtained and the case manager who obtained the information. 3 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 4. Date of Participation Record the date on which the individual begins receiving his her first service funded by the program following a determination of eligibility to participate in the program. YYYYMMDD Grantee Administrative Records Match 5. Date of Birth Record the individual s date of birth. YYYYMMDD Family bible birth certificate passport driver s license baptismal record I-9 form Match 9. Qualifies for Sec. 167 Program as a Record appropriate status of the participant. SPECIAL NOTE If a participant qualifies as eligible under both categories use Code 1 Farmworker. 1 Farmworker 2 Dependent or Spouse of a Farmworker Pay stubs W-2 forms IRS 1040 forms case manager counselor intake notes self attestation Support 11. Farmworker Status Use the appropriate code to record the status of the participant at the time of eligibility determination. SPECIAL NOTE Where participant is a dependent of a farmworker record the status of the eligible farmworker. 1 Migrant Farmworker 2 Seasonal Farmworker Pay stubs W-2 forms IRS 1040 forms case manager counselor intake notes self attestation Support 13b. Number of Individuals in the Family Record the total number of individuals in the family including the participant. 00 Birth certificate family bible IRS 1040 forms Match 4 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 16. Employment Status at Participation Record 1 if the participant is a person who either a did any work at all as a paid employee b did any work at all in his or her own business profession or farm c worked 15 hours or more as an unpaid worker in an enterprise operated by a member of the family or d is one who was not working but has a job or business from which he or she was temporarily absent because of illness bad weather vacation labor-management dispute or personal reasons whether or not paid by the employer for time off and whether or not seeking another job. Record 2 if the participant is a person who although employed either a has received a notice of termination of employment or the employer has issued a Worker Adjustment and Retraining Notification WARN or other notice that the facility or enterprise will close or b is currently on active military duty and has been provided with a date of separation from military service. Record 3 if the participant does not meet any one of the conditions described above. 1 Employed 2 Employed but Received Notice of Termination of Employment or Military Separation 3 Not Employed Pay stub case notes showing information collected from participant Support 5 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 17. Six Month Pre-Program Earnings Record the total pre-program earnings of the participant for the 6-month period prior to the date of application in the program. Earnings include salaries or wages and also include any bonuses tips gratuities and commissions or overtime pay earned. Record 00000 if there were no earnings during this period. 00000 Pay stubs W-2 forms employer payroll records IRS 1040 forms administrative UI wage records self attestation detailed case management notes Match 21e. Long-term Agricultural Employment Record 1 if the participant is a person who has engaged in agricultural work as the primary source of income for a minimum of four 4 years prior to intake eligibility determination. Record 2 if the participant does not meet the conditions described above. 1 Yes 2 No IRS 1040 forms pay stub intake application case manager counselor progress notes self- attestation Support 24. Date of First Intensive Service Record the date on which the participant first received intensive services. Intensive services include specialized assessments of skill levels work experience diagnostic testing adult basic education or English as a Second Language ESL training development of an individual employment plan group or individual counseling case management for participants seeking training services short-term prevocational services and remedial reading writing or communication skills training. Otherwise leave blank if the participant did not receive intensive services. YYYYMMDD Case manager counselor progress notes with signature IEP assessment and diagnostic testing Match 6 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 25. Date of First Training Service Record the date on which the participant first received training services. Training services include but are not limited to occupational skills training OJT skill upgrading entrepreneurial training and job readiness training. Otherwise leave blank if the participant did not receive training services. YYYYMMDD Case manager counselor certification signature employer signed document attendance records from institution or instructor Match 33. Date of Exit Record the date on which the last service funded by the program or a partner program is received by the participant. Once a participant has not received any services funded by the program or a partner program for 90 consecutive calendar days and has no gap in service and is not scheduled for future services the date of exit is applied retroactively to the last day on which the individual received a service funded by the program or a partner program. YYYYMMDD Case manager counselor termination notice case manager counselor progress tracking report grantee MIS Match 7 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 34. Category of Exit Record 1 if the participant received and or completed any job-related core beyond core informational or self-services and eligibility determination intensive or training services. Record 2 if the participant received non-job related services without having received job-related core intensive or training services. Record 3 if the participant did not complete the program and exited for other reasons as specified in Item 35 below. SPECIAL NOTE Individuals who receive training-related services AND intensive or training services should be coded 1. 1 Employment and Training Exiter 2 Related Assistance Services ONLY Exiter 3 Other Reasons for Exit Grantee administrative records Support 8 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 35. Other Reasons for Exit at time of exit or during 3- quarter measurement period following the quarter of exit Record 1 if the participant is residing in an institution or facility providing 24-hour support such as a prison or hospital and is expected to remain in that institution for at least 90 days. Record 2 if the participant is receiving medical treatment that precludes entry into unsubsidized employment or continued participation in the 167 program. Does not include temporary conditions expected to last for less than 90 days. Record 3 if the participant was found to be deceased or no longer living. Record 4 if the participant entered advanced training. Advanced training includes an occupational skills employment training program not funded under Title I of WIA which does not duplicate training received under Title I. This category includes only training outside of the 167 program One- Stop WIA and partner system. Record 5 if the participant entered post- secondary education. Post-secondary education includes a program at an accredited degree-granting institution that leads to an academic degree e.g. AA AS BA BS . This does not include entry into post-secondary education programs offered by degree-granting institutions that do not lead to an academic degree. 1 Institutionalized 2 Health Medical 3 Deceased 4 Entered Advanced Training 5 Entered Post- Secondary Education 6 Moved Cannot Locate Voluntary Separation 7 Family Care 8 Reserve Forces Called to Active Duty 9 Not a Valid SSN Grantee administrative records Support 9 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 35. Other Reasons for Exit continued Record 6 if the participant cannot be located or has moved to an area that prevents them from completing their program or has voluntarily left the program. Record 7 if the participant is providing care for a family member with a health medical condition that precludes entry into unsubsidized employment or continued participation in the program. Does not include temporary conditions expected to last for less than 90 days. Record 8 if the participant is a member of the National Guard or other reserve military unit and is called to active duty for at least 90 days. Record 9 if the social security number of the participant is not valid. Record 0 or leave blank if the participant exited for a reason other than one of the conditions described above. 36. Date Placed in Unsubsidized Employment Record the date on which the participant was placed into unsubsidized employment. Leave this field blank if the participant did not enter unsubsidized employment. YYYYMMDD Case manager counselor progress notes Match 41. Employed in the 1 st Quarter After Exit Quarter Record 1 if the participant was employed in the first quarter after the quarter of exit. Record 2 if the participant was not employed in the first quarter after the quarter of exit. Record 3 if information on the participant s employment status in the first quarter after the quarter of exit is not yet available. 1 Yes 2 No 3 Information Not Yet Available Pay stubs employer payroll records IRS 1040 forms case manager counselor progress notes self- attestation Support 10 WIASPR Item Name and Number Data Element Definition Valid Values Federal Sources State Grantee Sources Instructions 42. Employed in the 2 nd Quarter After Exit Quarter Record 1 if the participant was employed in the second quarter after the quarter of exit. Record 2 if the participant was not employed in the second quarter after the quarter of exit. Record 3 if information on the participant s employment status in the second quarter after the quarter of exit is not yet available. 1 Yes 2 No 3 Information Not Yet Available Pay stubs employer payroll records IRS 1040 forms case manager counselor progress notes self- attestation Support 43. Employed in the 3 rd Quarter After Exit Quarter Record 1 if the participant was employed in the third quarter after the quarter of exit. Record 2 if the participant was not employed in the third quarter after the quarter of exit. Record 3 if information on the participant s employment status in the third quarter after the quarter of exit is not yet available. 1 Yes 2 No 3 Information Not Yet Available Pay stubs employer payroll records IRS 1040 forms case manager counselor progress notes self- attestation Support 44. Wages 2 nd 3rd Quarters After Exit Quarter Record the total earnings earned by the participant in the second and third calendar quarters after the quarter of exit. Total earnings include any bonuses tips gratuities commissions and overtime pay earned. Note Enter whole dollar amounts 00000 . Enter 99999 if data are not yet available for this item. Otherwise leave blank if this data element does not apply. 00000 Pay stubs employer payroll records IRS tax forms administrative UI wage records case manager counselor progress notes with signature Match