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Applicant File Review (AFR) Regional Process January 15, 2015.

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Presentation on theme: "Applicant File Review (AFR) Regional Process January 15, 2015."— Presentation transcript:

1 Applicant File Review (AFR) Regional Process January 15, 2015

2 Agenda 1 AFR Policy 3 Application Outcomes 4 Forms & Special Considerations 5 Regional Office AFR Process 2 Center Timelines

3 7 New Information/Eligibility 8 Case Studies 9 Regional AFR Data/Center Information 6 Accommodation Recommendation of Denial Agenda

4 4 AFR Policy

5 Applicant File Review Policies Outreach 1.2 Exhibit 1-1 Appendix 103 5 Appendix 108 Center 1.4/6.14 Appendix 107 Appendix 605 Region 1.5 Appendix 108

6 Standard Operating Procedure Each center is required to have a written standard operating procedure (SOP) describing the center’s process for reviewing applicant files. This policy should describe in detail how an applicant file is processed from the time it arrives on center until the applicant is accepted into the program and assigned a start date, or recommended for denial and a final disposition made by the Regional Office. 6

7 Sample SOP JC Community website Disability Frequently Requested Documents Sample Policies 7

8 Center Timelines Processing Applicant Files

9 Timelines The applicant’s file must be processed within 30 calendar days from receipt by center. If the center reasonably can substantiate needing the file longer than 30 days to complete the file review process, then an extension request may be submitted to the respective Regional Office, specifically to the center’s Program Manager. 9

10 10 Application Outcomes

11 Center enrolls the applicant. Applicant withdraws application or is unreachable for the clinical team to complete the clinical review, even with the assistance of the admissions counselor (AC). Applicant poses a direct threat to self or others. Health care needs exceed those of basic health care as per Exhibit 6-4 of the PRH. Applicant is no longer eligible due to new information that the AC could not have reasonably known at the time that eligibility was certified. 11

12 Withdrawal Process during Center File Review – No Application Disposition Recommended Yet There are two occasions when the center may send an applicant file back to Outreach and Admissions (OA) to process as a withdrawal. 1.Applicant requests withdrawal. Document request and return file to the OA if a recommendation of denial has not yet been made. 2.The center is unable to reach the applicant to conduct clinically-related interviews. Document the attempts to contact including collaborations efforts with OA and return the file to OA. 12

13 Withdrawal Process during Center File Review – File is in Regional Review If the file has been returned to the center to complete any portion of the applicant file review process and the center is unable to reach the applicant, even with the AC’s assistance, then the file must be returned to the person/office that sent the center the file and not back to OA. Return it to the address on the memo that came with the file Regional Office Regional Administrative File Review Coordinator 13

14 Forms & Special Considerations Priority Enrollment Candidate?

15 Center Recommendation of Denial Form (CRDF) Two Center Recommendation of Denial Forms: New Information Health Care Needs, Direct Threat & Disability Status Appendix 107 CRDFs function as cover letters. 15

16 Center Recommendation of Denial for New Information Files submitted with the New Information form remain at the Regional Office for review 16

17 Center Recommendation of Denial for Health Care Needs, Direct Threat, or Disability Status Files submitted with this form are forwarded to the Regional Administrative File Review Coordinator 17

18 Triaging Applicant Files Recommended for Denial Technically, the applicant file should arrive with at least 2 sealed envelopes: 1.Labeled “Regional Office” along with the applicant’s ID# and ideally should be the only envelope opened upon receipt Center Recommendation of Denial Form 2.Labeled “Health/Disability” along with the applicant’s ID# and marked CONFIDENTIAL Health Care Needs or Direct Threat Assessment 653 and Supporting Documentation 18

19 Special Considerations Why is there an envelope labeled “Regional Office” designated to hold any cover letters and the Center Recommendation of Denial Form? To allow the applicant file to be triaged for next steps New Information CRDF – file stays at the Regional Office HCNA/DTA or Disability Status CRDF – files is shipped out for health/disability review which includes both an administrative and a clinical review To preserve the integrity of the protected health/disability information until there is true “need to know” 19

20 Special Considerations Do not return the file to the center or hold the file for completion of a CRDF It is for triaging the file initially and it is likely known where the files needs to go next without the unnecessary delay in the process (i.e. assessment is often in the “Regional Office” envelope) Could result in the applicant file potentially be returned to a center 3 times (i.e. by the initial regional office person, the administrative health/disability reviewer, and the regional clinician) which is a scenario to avoid if at all possible TA will be provided and the center file review team advised that they need to submit the form with any future submissions or the file may be sent back the next time 20

21 Priority/Expedited Enrollment Status Considerations Check to see if the AC has flagged for any priority status; broadly speaking, that could include such individuals as: Veterans (Exhibit 1-6) Spouses of veterans Victims of Disaster (Exhibit 1-8) Homeless (McKinney-Vento) (Appendix 109) Includes those fleeing situations of domestic violence, etc. 21

22 eFolders Program Instruction 13-25, “E-Folders Process for Denials” Print out the complete applicant file when sending the file to the Regional Office for review. This includes: All original admissions paperwork (i.e., AC’s certification of eligibility, court history, data sheet, etc.) All medical/disability documentation and forms Any other documentation that might exist within the applicant’s file 22

23 Regional Office Applicant File Review (AFR)Process

24 Regional AFR Process All applicant files must be sent to the Regional Office initially to be logged in and triaged for type of review needed. 24

25 Regional AFR Process Step 1 25 The “Regional Office File Review Process Form” is initiated by the Regional Office File Review Coordinator and attached to the file for tracking and documenting the disposition of the review.

26 Regional Office Applicant File Review Process Form 26

27 Regional AFR Process Step 2 27 The “Regional Office” envelope is opened to identify the reason for the recommendation of denial checked on the Center Recommendation of Denial Form (CRDF).

28 Regional AFR Process Step 3a 28 If recommendation is for health care needs or direct threat OR disability status (i.e. age or income), then the file is repackaged and sent to the Regional Administrative File Review Coordinator.

29 Regional AFR Process Step 3a 29 If recommendation is for health care needs or direct threat OR disability status (i.e. age or income), then the file is repackaged and sent to the Regional Administrative File Review Coordinator.

30 Storage and Transmission (of Health & Disability Information) 30 Center Recommendation of Denial Form Cover letters Center Tracking Forms Accommodation Recommendation of Denial Form, if applies Health Care Needs Assessment Direct Threat Assessment 6-53 Medical Records Anything health-related IEPs & 504 Plans Any non-medical disability-related information

31 Regional AFR Process Step 4 31 For health care needs and direct threat recommendations of denial, an administrative or process review is completed on the completed denial paperwork.

32 Administrative or Process Review An administrative review is completed in an effort to identify and correct any missing required AFR process components as required by Job Corps policy and applicable legal requirements. Some of the goals of the administrative review are to: Minimize the potential for civil rights complaints or the impact of those complaints Assist with the execution of an equitable and uniform AFR process throughout the JC system Provide TA and support to center staff in completing AFR process Prepare the file for the regional health specialist’s review to minimize the use of their time in dealing with process concerns or issues 32

33 Returning Files to the Center for Process Correction 1.If there is a need to complete a missing part of the AFR or a correction of the process is needed, the Regional Administrative File Review Coordinator returns the applicant file directly to the center and sends a movement notice to the Regional Office. 2.Once the issue has been corrected, the center returns the file directly to the Regional Administrative File Review Coordinator to check the work. 3.An administrative file review checklist is finalized and the file is forwarded to the appropriate regional health specialist for a clinical review. 33

34 Regional AFR Process Step 5 34 Once the administrative or process review is complete, the applicant’s file is forwarded to the appropriate regional health specialist for a clinical review.

35 Clinical Review To review center health care needs and direct threat recommendations of denial to determine whether or not there is a sufficient basis to support the fact that the applicant’s health care needs exceed those of basic care or that the applicant poses a direct threat to self or others To provide TA and support to center clinicians in completing the clinical assessment 35

36 Returning Files to the Center for a Clinical Reason If the regional health specialist needs to return a file to the center for clinical reasons, the file is returned to the center via the Regional Office with a “Request for Additional Clinical Information Memo” attached. The center returns the file to the regional health specialist via the same respective Regional Office. 36

37 37 Request for Additional Clinical Information

38 38 Request for Additional Clinical Information

39 Recommendation to Attend an Alternate Location Center may recommend this when they believe an applicant’s health care needs could potentially be met if they were closer to their home services or closer to a location where needed services were available. Center must demonstrate that the applicant’s health care needs could NOT be met at their location. Having out of state insurance is an insufficient reason to recommend denial with referral to an alternate location 39

40 Referral for Alternate Center Form is completed by the respective Regional Health Specialist. If the RD or designee is in concurrence, then this information is given to the AC to assist in assigning the next center. The second center receives the denial paperwork and recommendations of the first center and proceeds to complete its own clinical review.

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42 42

43 Regional AFR Process Step 6 43 The Regional Health Specialist makes a recommendation to the Regional Director (or designee) to either uphold or overturn the center’s recommendation.

44 Regional AFR Process Step 7 44 The Regional Director (or designee) makes the final determination to either uphold or overturn the center’s recommendation.

45 Final Disposition The Regional Office retains final authority in the decision making process. If the Regional Director (or designee) overturns a center’s recommendation, then the center must schedule the applicant for enrollment based upon the initial application date. Files in regional review may not be returned to OA and must be processed through each respective regional office. 45

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47 Notifications The Regional Office must notify the admissions counselor (AC), the applicant and the center of the final disposition of the recommendation. The AC then may provide appropriate referral recommendations if the applicant has been denied admission. 47

48 Processing Over-age Applicants Essential Admission Requirement (EAR) “A”

49 Over-age Applicant Process – EAR “A” Age is processed as an EAR. AC will not determine applicant is a person with a disability. The center clinical staff will do this. The AC does not review health and medical information, only gathers & places it in a sealed envelope with applicant file that is forwarded to center for review. Center reviews documentation of disability and if a person with a disability, the file review process continues. If the center determines that the applicant is not a person with a disability, then the center submits to the Regional Office as a recommendation of denial. 49

50 Which Center Recommendation of Denial Form is used? 50

51 Appendix 107 – Section B 51 Center Recommendation of Denial for Direct Threat, Health Care Needs or Disability Status

52 Appendix 107 – New Information Center Recommendation of Denial 52 Wrong form! No “A” or “D” option.

53 “Behavior” Reviews

54 Separate “behavior” recommendations of denial have not been in existence since the fall of 2011. Recommendations of denial related to behavior must be completed by a licensed clinician using either the health care needs or the direct threat assessment, whichever is appropriate, and they are routed through the typical health/disability review. 54

55 Accommodation Recommendations of Denial

56 Accommodation Recommendations of Denial When an applicant requests an accommodation and the center is recommending denial based upon health care needs or direct threat, the regional office may or may not have to make a ruling on the accommodation request dependent upon the recommendations of the regional health specialists (RHSs) regarding enrollment and the determination of the regional director and his or her designee. How do you know when you do have to make a decision?

57 Reasonableness Review What are the 2 primary reasons that an accommodation might be determined unreasonable? 1.Providing the accommodation would be unduly costly. 2.Providing the accommodation would result in a fundamental alteration to the program. If the accommodation is believed to be unreasonable, then the “Accommodation Recommendation for Denial Form” must be completed and submitted to the Regional Office for review. 57

58 Accommodation Recommendation of Denial

59 Reasonableness Determination – Alternatives Regional Administrative File Review Coordinator flags the regional tracking form by checking the box alerting the regional office staff that there is an accommodation request pending.

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61 Accommodation Determination If the RHS does not believe that accommodations are adequate to sufficiently reduce the barriers to enrollment to allow the applicant to enroll and the regional director concurs, there is no need for the regional office to rule on the accommodation request because the applicant will not be enrolling.

62 Accommodation Determination If the RHS’s and RD’s decision is to overturn the center’s recommendation and allow the applicant to enroll, then the regional office will have to determine whether or not it will provide the accommodation, some alternative or inform the applicant that he or she may choose to enroll without the benefit of the accommodation because the regional office has determined through a cost analysis or review that the accommodation requested is unreasonable.

63 63 Job Corps does not deny applicants solely based upon the need to provide accommodation. The RAC would need to explore: funding options identify equally effective alternatives, if possible offer the opportunity to enroll without the benefit of accommodation.

64 EligibilityRe-certification “New Information” Reviews

65 New Information Review Process (in brief) If the center becomes aware of new information that the AC could not have reasonably known (i.e., health information, interview, etc.) that indicates that the applicant may not be eligible, then the center would revisit the set of questions from Exhibit 1-1 about that particular EAR, and determine eligibility based upon the responses to the same set of questions either asked or conditions reviewed previously by the AC 65

66 FYI Eligibility certification is a legal process and it only should occur rarely. 1.When “new” information is disclosed that the AC could not have reasonably known at the time s/he certified the applicant as eligible, AND 2.The “new” information indicates that the applicant potentially no longer is eligible for enrollment. See Exhibit 1-1 of the PRH. 66

67 New Information Review Tip! The center staff person and the regional reviewer completing the review has to essentially place themselves in the role of the AC. They must recognize that he or she only has the same authority to assess eligibility criteria in exactly the same way as the AC did the first time around. Remember, Improper re-visitation of an EAR may mean that the initial conditional offer of enrollment was not a genuine one. That could be a legal concern. So, ask yourself whether or not the AC would be asking or could be asking or doing what I am doing in revisiting this EAR currently? Am I following the guidance in Exhibit 1-1 or am I following my own interpretation of what the criteria for what each EAR represents? 67

68 Regional Office Review Process for New Information Reviews If the Regional Office finds the applicant to be eligible, then the file would be returned to the center with the instruction to complete the file review process. The center clinical staff may decide that a health care needs or a direct threat assessment is necessary. If not, they will enroll the applicant. If the Regional Office agrees that the applicant is not eligible, then the appropriate notifications will be issued and the file returned to OA. 68

69 Quick Check! Name a few examples of what would not constitute new information. Disclosure of a health condition when 653 was clean. Applicant is determined to be in a treatment facility for mental health reasons during clinical review. Applicant is not compliant with medication. 69

70 Quick Check! Name a few examples of what would constitute new information. Applicant gets arrested after certified eligible and given conditional offer of enrollment. Applicant previously stated to AC that s/he did want to obtain both an academic and a career technical credential but is now telling the clinical review team that s/he only wants to get his or her high school diploma. 70

71 Exhibit 1-1 Essential Admissions Requirements (EAR) 71

72 What Do You Think? True or False: The AC asks the applicant medical and/or disability related questions to determine and certify eligibility. 72

73 Let’s Practice! Applicant File Review Scenarios

74 Regional Office File Review Process Form

75 Applicant Jennifer

76 Jennifer… Please list the specific question from Exhibit 1-1 which the applicant was determined to be ineligible and list the applicant’s specific response to this question. J. Group Participation & Understanding of Rules Identify the new information that the AC could not have reasonably known that was the basis for revisiting eligibility (i.e. document name and where the document was located, applicant stated during a specific interview, etc.).* During interview with AC, the mother informed that Jennifer had past behavioral problems but did not tell the AC that the behavior problems had resurged just before starting the admissions process. Summarize your findings. Mother wonders if daughter is trying to sabotage her own admission. Stated that the defiance had increased at home so much so that she and her husband had to hide in their room. Said that the daughter had decided that she could leave home when she wanted to and do what she wanted to and at school was telling teachers off, skipping classes, etc. Given Jennifer’s history and recent behavioral issues (the latter of which were unknown to the AC), we do not think that applicant is an appropriate candidate for Job Corps.

77 Let’s review What do you do first in considering this information? Go to PRH 1: Exhibit 1-1 and find EAR J

78 Exhibit 1-1 Essential Admissions Requirements (EAR)

79 Is this a New Information Review? Possibly – it depends Read through the AC’s information/notes to ensure that s/he was unaware of the recent behavioral issues. If that was known, then it is not new information and eligibility cannot be revisited. If it was not known, how do you actually re-assess this particular EAR? Go back to EAR J and review the requirements and guidance. Guidance says: “Do you understand that if you are accepted into JC, you will be expected to comply with the rules and regulations of JC? For example, if you live on center, you will have to follow a curfew, there are rules about cell phone use, and you may not be permitted to smoke on center and you may be required to wear a uniform. Knowing this about JC, are you willing to go forward with your application?

80 Is this a New Information Review? If applicant responds to the question with a “yes,” then what? Proceed to the next question. If applicant responds to question with a “no,” then what? Stop the interview. Complete the paperwork for a recommendation of denial based upon new information. If the AC did have knowledge of the recent behavioral concerns, then what are your options? Complete either a health care needs or direct threat assessment, if appropriate. If not appropriate, enroll the applicant.

81 81 Ineligibility Determination: Check the EAR from PRH 1, Exhibit 1-1 for which the applicant was found to be ineligible for the program. ☐ A.Age ☐ H.Child Care ☐ B.Selective Service Registration ☒ I.Program Suitability ☐ C.Legal U.S. Resident ☐ J. Group Participation and Understanding of Rules ☐ D.Low Income ☐ K. Interference with Other Students’ Participation ☐ E.Education/Training/Family Needs ☐ L.Community Relations ☐ F. Authorization for Use and Disclosure of Health Information ☐ M. Court Involvement and/or Agency Supervision ☐ G.Parental Consent ☐ N.Maintenance of Sound Discipline Applicant Juan

82 82 Juan… Please list the specific question from Exhibit 1-1 which the applicant was determined to be ineligible and list the applicant’s specific response to this question. I – The applicant wants to earn a high school diploma or GED and participate in Career Technical Training. Identify the new information that the AC could not have reasonably known that was the basis for revisiting eligibility (i.e. document name and where the document was located, applicant stated during a specific interview, etc.).* After IEP review and in person meetings, it has been determined that the applicant does not have the cognitive abilities to complete a trade or obtain a HSD/GED. Summarize your findings. While the applicant presents well verbally, cognitive assessments indicate an intellectual disability. After review of our least academically challenging medical TAR, a request to modify this TAR to the applicant’s ability level was denied by the Regional Office. Without a modified TAR, this applicant is not suitable for the program.

83 83 Applicant Malcolm Ineligibility Determination: Check the EAR from PRH 1, Exhibit 1-1 for which the applicant was found to be ineligible for the program. ☐ A.Age ☐ H.Child Care ☐ B.Selective Service Registration ☐ I.Program Suitability ☐ C.Legal U.S. Resident ☒ J. Group Participation and Understanding of Rules ☐ D.Low Income ☒ K. Interference with Other Students’ Participation ☐ E.Education/Training/Family Needs ☐ L.Community Relations ☐ F. Authorization for Use and Disclosure of Health Information ☐ M. Court Involvement and/or Agency Supervision ☐ G.Parental Consent ☒ N.Maintenance of Sound Discipline

84 84 Malcolm… Please list the specific question from Exhibit 1-1 which the applicant was determined to be ineligible and list the applicant’s specific response to this question. In telephone conversation, he responded that he could go by the rules, participate in groups, and not interfere with other student’s participation in the program. Identify the new information that the AC could not have reasonably known that was the basis for revisiting eligibility (i.e. document name and where the document was located, applicant stated during a specific interview, etc.).* The applicant has checked that he had a LD on the 6-53 but did not request accommodations. Nothing else was checked suggesting the applicant was not endorsing any other mental or emotional problem. At home, the applicant gets angry, hits things, threw his video game out the window, argues with his mother, etc. Summarize your findings. Although the applicant was 17 years 5 months old when the above occurred, and the applicant did not disclose this information concerning adjustment problems, mental health diagnosis, treatment or involvement with the juvenile justice system.

85 85 Red Flags

86 Applicant files are returned to OA for additional medical documentation or insufficient medical documentation but information is not received and file never retrieved by the center and processed to a final disposition. If the center has requested additional documentation about an applicant and it does not receive that information, the center must make a decision on the information that is available to it. The applicant file cannot be returned to OA to process as a withdrawal. Lack of dates and details included in the disposition column of the Applicant File Review Tracking Log. Failure to include dates, names of individuals involved and their titles, details of the situation or conversation and to maintain copies of any supporting documentation (e.g., emails received, sent, etc.) leads to additional review and time spent on identifying dispositions of files. 86

87 Red Flags Lack of applicant file recommendation of denial submissions to the respective Regional Office. The center has not submitted any files or a very limited number of applicant files to the Regional Office for review over an extended period of time. 87

88 Why is the Returning to OA a Concern? Bypasses the Regional Review process Violation of JC policy Deprives applicant right to have a final disposition of their application Potential legal issues Possible discrimination concerns 88

89 89

90 As of December 2014 Improvements Charleston has submitted 1 file since July 1. Woodland has submitted several files so much improved! No submissions still from: Red Rock (RED) Wilmington Frenchburg Carl D. Perkins (Yellow) Harper’s Muhlenberg Keystone 90

91 Resources 91

92 National Office Health & Disability Carol Abnathy, National Office of Job Corps (202) 693-3283 abnathy.carol@dol.gov Johnetta Davis, National Office of Job Corps (202) 693-8010 davis.johnetta@dol.gov 92

93 Questions? 93


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