For each Adult Program applicant, the following data elements must be collected and documented for federal reporting purposes,1 as outlined below. These elements do not impact program eligibility or priority of service but may impact negotiated and adjusted levels of performance via the statistical adjustment model.
Data Element |
Example Documentation2
NOTE: This list is not intended to be all-inclusive. |
Sex
|
|
Ethnicity: Hispanic/Latino
|
|
Race
|
|
Limited English Language Proficiency
|
|
Limited English Reading Ability
(if Limited English Language Proficient) |
|
Limited English Speaking Ability
(if Limited English Language Proficient) |
|
Primary Language
(if Limited English Language Proficient) |
|
Current Education Status (School Status at Program Entry) |
- Self-Attestation
OR
- Cross-match with Postsecondary Education Database
- Copy of educational institution enrollment record
- Applicable records from educational institution (GED certificate, diploma, attendance record, transcripts, report card, or school documentation)
- Signed WIOA intake application or registration form
- Electronic records
- Verbal Verification
|
Current Highest School Grade Completed |
- Self-Attestation
OR
- Applicable records from education institution (GED certificate, diploma, attendance record, transcripts, drop out letter, school documentation)
- Signed WIOA intake application or registration form
- Electronic Records
|
Single Parent3 |
- Self-Attestation
OR
- TANF/W-2 Single Parent Eligibility Verification
- Needs Assessment
- Signed WIOA intake application or registration form
- Signed Individual Employment Plan
- Case Notes
|
Current Employment Status |
|
Current Unemployment Insurance Programs (UI)4 |
- Self-Attestation, only if customer is not an RESEA or WPRS participant.
OR
- Cross-match to state UI database
- Cross-match to state MIS database (Verification of Re-employment Services and Eligibility Assessment (RESEA)-funded services from the ASSET Manage Services tab)
- Referral transmittal by RESEA or WPRS
|
Pell Grant Recipient
|
- Self-Attestation
OR
- FAFSA/Financial Aid Records
- Award Letter
|
Active Duty Military Spouse |
|
Unemployed Greater Than or Equal to 27 Consecutive Weeks (Long-term unemployed)5 |
- Self-Attestation OR
- Public assistance records
- Refugee assistance records
- Cross-match with public assistance database
- Cross-match to state UI database
|
Actual Dislocation Date6 |
- Self-Attestation OR
- Verification from Employer
- Rapid Response List
- Notice of Layoff (Including a WARN Notice)
- Public Announcement with Follow-Up Cross-Match with UI Database
|
Foster Care (Foster Care Youth Status at Program Entry)7 |
- Self-Attestation OR
- Written Confirmation from Social Services Agency
- Foster Care Agency Referral Transmittal
- Signed WIOA intake application or registration form
- Needs Assessment
- Signed Individual Employment Plan
- Verbal Verification from cognizant agency or official (school counselor, social worker, court, etc.)
- Case Notes
|
Displaced Homemaker8 |
- Self-Attestation
OR
- Signed WIOA intake application or registration form
- Cross-Match with Public Assistance Records
- Copy of Spouse's Layoff Notice
- Copy of Spouse's Death Record
- Copy of Spouse's Permanent Change of Station (PCS) Orders for a military move or assignment)
- Copy of Divorce Records
- Copy of Applicable Court Records
- Copy of Bank Records (showing financial dependence on spouse, no separate individual income support, or no employment income earned)
- Needs Assessment
- Signed Individual Employment Plan
|
Offender or Ex-Offender (Ex-Offender Status at Program Entry)9
NOTE: Does not include speeding tickets or traffic court. |
- Self-Attestation
OR
- Documentation from juvenile or adult criminal justice system (https://wcca.wicourts.gov)
- Written statement or referral document from a court or Probation Officer
- Referral transmittal from a reintegration agency
- Signed WIOA intake application or registration form
- Needs Assessment
- Signed Individual Employment Plan
- Federal Bonding Program Application
- Verbal verification with court or probation representative
- Case Notes
|
Incarcerated at Program Entry
(if Offender or Ex-Offender) |
- Self-Attestation
OR
- Verbal or written verification from justice system
|
Eligible Migrant and Seasonal Farmworker Status10 |
- Self-attestation that participant worked in migrant farm work within last 12-months, seasonally/temporarily, with a recognized employer
OR
- Cross-Match with Public Assistance Records
- NFJP Eligibility Documents
- Cross-Match with State MIS
- Cross-Match with H-1B Records
- Case Notes
|
Exhausting TANF/Wisconsin Works (W-2) within 2 years11 |
- TANF/W-2 Eligibility Verification
- TANF/W-2 Period of Benefit Receipt Verification
- Referral Transmittal from TANF/W-2
- Cross-Match with TANF/W-2 Public Assistance Records
- Verbal verification from appropriate public assistance agency
NOTE: It is not allowable to use screen prints from CARES to document TANF/W-2. |
Cultural Barriers |
|
Individual with a disability12 | - Self-Attestation
OR
- School 504 records provided by student
- Assessment test results
NOTE: Case notes and other documentation related to this element must be maintained in compliance with Section 5.713 of this policy manual.
|
- 1 WIOA Reporting Advisories
- 2 Unless otherwise noted, information on documentation sources is from OMB Control No. 1205-0521 and TEGL 23-19, Attachment II.
- 3 Per TEGL 23-19, Attachment II, Data Element 806 Data Element Validation is required.
- 4 Per TEGL 23-19, Attachment II, Data Element 401 Data Element Validation is required.
- 5 Per TEGL 23-19, Attachment II, Data Element 402 Data Element Validation is required.
- 6 Per TEGL 23-19, Attachment II, Data Element 410 Data Element Validation is required.
- 7 Per TEGL 23-19, Attachment II, Data Element 704 Data Element Validation is required.
- 8 Per TEGL 23-19, Attachment II, Data Element 807 Data Element Validation is required.
- 9 Per TEGL 23-19, Attachment II, Data Element 801 Data Element Validation is required.
- 10 Per TEGL 23-19, Attachment II, Data Element 808 Data Element Validation is required.
- 11 Per TEGL 23-19, Attachment II, Data Element 601 Data Element Validation is required.
- 12 Per TEGL 23-19, Attachment II, Data Element 202 Data Element Validation is required.
- 13 29 CFR § 38.41 requires that any medical or disability-related information about a particular individual, including information that could lead to the disclosure of a disability, must be collected on separate forms. All such information, whether in hard copy, electronic, or both, must be maintained in one or more separate files, apart from other information about the individual, and treated as confidential.
Offender/Ex-offender
Effective date: November 7, 2019
"Offender" or "ex-offender" means an adult or juvenile who is or has been subject to any stage of the criminal justice process.
WIOA Sec. 3(38)
Eligible Migrant Farmworker
Effective date: November 7, 2019
"Eligible migrant farmworker" means a seasonal farmworker whose agricultural labor requires travel to a job site such that the farmworker is unable to return to a permanent place of residence within the same day. The term also includes the farmworker's dependents.
WIOA Sec. 167(i)(2)
Eligible Seasonal Farmworker
Effective date: November 7, 2019
"Eligible seasonal farmworker" means a low-income individual who: 1) for 12 consecutive months out of the 24 months prior to application for the program involved, has been primarily employed in agricultural or fish farming labor that is characterized by chronic unemployment or underemployment; and 2) faces multiple barriers to economic self-sufficiency. The term also includes the farmworker's dependents.
WIOA Sec. 167(i)(3)
Wisconsin Works
Effective date: August 20, 2018
"Wisconsin Works" (W-2) is a limited-time program that provides temporary cash assistance and case management services to low-income parents and pregnant women who engage in work activities.
https://dcf.wisconsin.gov/w2/parents/w2
Disability (WIOA Sec. 3(25))
Effective date: August 20, 2018
"Disability" means:
- a physical or mental impairment that substantially limits one or more major life activities such as caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, working, and the operation of major bodily functions
- a record of such impairment
OR
- is regarded as having such impairment (which means the individual can establish that s/he has been the subject of a discriminatory action under the American with Disabilities Act because of an actual or perceived impairment whether or not the impairment actually limits a major life activity).
WIOA Sec. 3(25); 42 U.S.C. 12102 (1)-(3)