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It Takes A Village

It Takes A Village Using a Team Approach to Create an Effective Applicant File Review Process at the Center Level Presenters: Pat Jackson Humanitas Denise Sudell USDOL Civil Rights Center Debbie Jones Humanitas. Objectives. Health and disability staff will understand

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It Takes A Village

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  1. It Takes A Village Using a Team Approach to Create an Effective Applicant File Review Process at the Center Level Presenters: Pat Jackson Humanitas Denise Sudell USDOL Civil Rights Center Debbie Jones Humanitas

  2. Objectives • Health and disability staff will understand • their roles and responsibilities in the applicant file review process • the components of the applicant file review process • the documentation requirements associated with the applicant file review process

  3. How We Got Here Background and purpose

  4. Existing Admissions Criteria • Under regulations and current PRH – two sets of criteria • “Eligibility criteria” • Factors such as age, income, barriers to education/employment, etc. • “Additional factors” • “Needs can best be met” • “Participate successfully in group situations” • “Not likely to engage in actions . . .” • Covered in ACAT

  5. Why the Changes • Criteria were subjective • Few specifics on how to determine if applicant met these “factors” • Left considerable discretion to ACs • Concerns were raised • National Job Corps workgroup – recommended development of specific criteria • USDOL Civil Rights Center (CRC) – concerned that discretion was excessive, might result in discrimination (intentional or unintentional)

  6. How We Got Here • CRC was invited to partner with Job Corps to ensure that the revised admissions process complies with applicable nondiscrimination requirements and provides equal opportunity for applicants in protected groups (particularly applicants with disabilities) • “Brainstorming team” comprised of Job Corps staff, Job Corps contractor staff, and staff of CRC met from 2006 into 2008 to revise PRH 1 and other related areas

  7. Legal Requirements • Congressional and administrative mandates require Job Corps to: • Enroll and serve applicants who meet the admissions requirements imposed by Congress (as interpreted by USDOL in the Job Corps regulations), regardless of a particular applicant’s disabilities • Provide reasonable accommodations for applicants and students with disabilities

  8. PRH Pending Revisions • The following additions/modifications are anticipated: • Language related to equal opportunity, non- discrimination, and related legal requirements • Clarification of essential admissions requirements • Policy and guidance related to the center review of applicant files

  9. PRH Pending Revisions (cont’d) • Appendices about: • Direct threat • Communicating with persons with disabilities • Transmission, storage, and confidentiality of medical and disability-related records

  10. Policy Applicant File review

  11. Reasonable Accommodation • The reasonable accommodation process is a separate process from applicant file review. With the exception of direct threat, reasonable accommodation will be not be discussed as a part of the applicant file review process. • See Reasonable Accommodation Guidelines

  12. What is Applicant File Review? • Applicant file review is the process by which the center reviews health, medical and disability-related information, and other information about the applicant that was not reasonably available to the Admissions Counselor (AC), to ensure that the applicant meets the essential admissions requirements under applicable statutes, regulations, Executive Orders, and policies • Requires cooperation between ACs, records staff, wellness staff, and possibly other staff

  13. File Review Team • The center must identify those individuals who need to be a part of the file review process. Team composition must include the • Health and Wellness Manager (HWM) • Disability Coordinator (if a student with a disability) and may include the • Mental Health Consultant (CMHC), Physician, TEAP Specialist, and/or Dentist

  14. Policy Requirement • Each center is required to have a written policy (i.e., SOP or COP) 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

  15. Center File Review Policy • All center policies must address the following requirements • All applicant files go to the Records Department • Records tracks the location of each file • 30 day timeframe to complete file review • All applicant files go to Health and Wellness for a health documentation review, initial direct threat review and a clinical care review

  16. Center File Review Policy (cont’d) • All center policies must address the following requirements • Storage and transmission of applicant file information • Notification to applicant of results of file review

  17. Process Applicant file review

  18. Applicant File Maintenance • All applicant files come from OA and go to the Records Department • Records staff keeps documentation of: • For those files that are on center: where every applicant file is, to whom each file was sent, and how long the file has been (1) on center and (2) with a particular office or staff member • For those files sent to the Regional Office for review,: the date the file was sent, to whom it was sent, and the final disposition

  19. Applicant File Maintenance (cont’d) • Forwards all files to Health and Wellness for initial review, without opening sealed portions of the file • Monitors the 30 day file review time period

  20. Health and Wellness Review • All files must be forwarded to the HWM or his/her designee for a health documentation review and initial direct threat review and a clinical care review

  21. Health and Wellness Review (cont’d) • NOTE: The Disability Coordinator must be involved in any review of the file of an applicant with a disability where concerns arise that: • the applicant may not meet admissions requirements; or • Job Corps cannot meet the applicant’s health care needs; or • the applicant may pose a direct threat

  22. 6-53 Review • The information on ETA Form 6-53 and the medically-related documentation is reviewed to: • determine the health care needs of the applicant; • determine whether Job Corps can meet the health care needs of the applicant; • determine if the applicant presents a direct threat to self or others; and • verify consent for required routine medical assessments and/or consent to receive basic health care services

  23. Direct Threat • In the case of an applicant, a direct threat assessment typically will occur: • after the applicant has received conditional assignment to a Job Corps center and has completed the 6-53 Health Questionnaire, and • if an initial review of the specific information that has been received about that particular applicant (including the 6-53, the medically-related information that has been collected by the AC, and the results of the background check) indicates that he/she may have a medical condition or disability that:

  24. Direct Threat (cont’d) • poses a significant risk of substantial harm to the health or safety of the individual or others, and • if the risk is posed by a disability, that the risk cannot be eliminated or reduced to an acceptable level by reasonable accommodation or modification • If the specific information in the folder appears to meet the standards described above, the HWM will forward the applicant’s information to the appropriately qualified licensed health provider employed by the center for a detailed direct threat assessment

  25. Application Disposition Options

  26. Potential Outcomes • Enrollment • Applicant withdrawal • Found ineligible based on information that was not reasonably available to the AC • Recommendation for denial • Direct threat • Cannot meet basic health care needs

  27. Revisiting Qualification for Admission • Neither the center file review team nor its individual members may revisit the determination that an applicant is qualified for admission unless • there is new information presented that the AC could not have reasonably known at the time the applicant’s qualification for admission was established, and • this new information indicates that the applicant offered enrollment may not meet one of the Essential Admissions Requirements

  28. Recommendation for Denial • If the center recommends denial of enrollment, the center must contact the applicant to explain why it is recommending denial • This contact must be documented and a written explanation of denial must be provided to the applicant

  29. Rejection of Recommendation • If a denial recommendation is rejected by the Regional Office and the applicant’s file returned to the center for enrollment, that applicant must be scheduled for arrival based on the date on which the application first arrived on center, not the date on which it was returned from the region

  30. Transmission and Storage Requirements File Maintenance

  31. Documentation Transmission and Storage • If the applicant withdraws his or her application or chooses not to enroll, all supporting documentation, including all medical, health, and disability-related documentation, must be returned to the AC • Medical, health, and disability-related documentation must be placed in a sealed envelope by a person who is authorized to have access to that information, and must be included with the rest of the supporting documentation about the applicant

  32. Additional Considerations Documentation standard

  33. Consistency in Documentation • If a Center Physician or CMHC disagrees with an opinion provided by an outside professional regarding Job Corps’s ability to provide basic health care needs of the applicant, the Center Physician and/or the CMHC (as appropriate) should contact the outside professional to attempt to resolve the difference in opinion as well or be able to sufficiently document the reasons for it

  34. Documentation Standard to Meet • The final disposition of the application should be well substantiated by the documentation • Can someone not involved in the process pick up this record and clearly understand the final decision re: whether the applicant is qualified?

  35. Scenarios You Decide…

  36. Scenario #1 • AC certifies that applicant meets all admissions criteria and file is forwarded to the center for review • Applicant allegedly commits a crime after he receives a conditional offer of enrollment, and center learns of existing charges when Health and Wellness Manager calls applicant to talk about a healthcare need What should happen next?

  37. Disposition • Center received new information that the AC could not have known • Revisit eligibility criteria for court history • Applicant “may” not be eligible for enrollment

  38. Scenario #2 • AC certifies that applicant meets all admissions criteria and file is forwarded to the center for review • Applicant provides information on the 6-53 that he is HIV positive.  Also provided is information from his attending physician that indicates his present medical status and his ongoing medical needs. What should happen next?

  39. Disposition • The HWM will review the health information to determine if basic health care needs can be met • The HWM will discuss with the applicant how the center intends to provide continuity of care while he/she is on center • An entry date will be set for the applicant

  40. Scenario #3 • AC brings applicant to center to tour • Applicant talks about bringing a knife to center -- context is not clear • Other considerations: • Conditional assignment had been made • Applicant has disclosed a disability What should happen next?

  41. Disposition • More facts are needed about the context of the conversation about the knife. • What salient facts are missing and need to be developed before a disposition can be made?

  42. Disposition • Was the applicant’s comment made in jest or was it serious?  • What type of knife was in issue?  Was it a pocket knife, a knife that the applicant thought would be a useful work tool during training, or a switch blade?  • What did the AC say?  Did the AC explain that there is a rule against bringing any knife to center?

  43. Scenario #4 • Applicant met all eligibility criteria and is conditionally assigned to a center • The applicant discloses an intellectual disability on the 6-53 • IEP indicates a classification of mild MR • IQ score of 69 What should happen next?

  44. Criteria for Consideration • If the applicant has not graduated from high school: • The applicant wants to earn a high school diploma or GED and participate in career technical training (the applicant must indicate a desire to obtain both academic and career technical training); and • After graduation from Job Corps, the applicant intends to: • Obtain employment; or • Enter the military; or • Continue his or her education

  45. Criteria for Consideration (cont’d) • If the applicant is a high school graduate: • The applicant wishes to obtain career technical training; and • The applicant wishes to obtain employment or enter the military after graduation from Job Corps

  46. Criteria for Consideration (cont’d) • Additionally, the applicant is able to complete/answer basic Job Corps application questions (e.g., birth date, address, phone number, last school attended, last grade completed, etc.) with or without reasonable accommodation

  47. Other Considerations • Any considerations at the center level? • If initial review of health and disability material or other protected documentation indicates a possible direct threat to the applicant or others (because his history indicates recent instances in which he did not appear able to make reasonably safe judgments so as to not place himself or others in harm’s way), then the file must be assigned to an appropriately qualified licensed health care provider to conduct a direct threat assessment • Determine if basic health care needs can be met

  48. Disposition • Applicant has already been determined to meet the “program suitability” admissions requirements: • The applicant’s educational and training needs can best be met through the Job Corps program and • Because the applicant met this requirement, he should be able to answer questions about basic personal information, independently or with communication assistance/reasonable accommodation, as appropriate

  49. Scenario #5 • 18 year old male wants to study cement masonry or painting • He was referred to Job Corps by his social worker as both parents are terminally ill and the social worker is seeking a residential placement for him, when his parents are no longer able to care for him • HWM’s initial review of 6-53 and medically-related documentation discloses diagnosis of Disruptive Behavior Disorder secondary to brain abnormality and multiple other anxiety and depressive disorders; partial corpus collosum

  50. Scenario #5 (cont’d) • He is described as having moderate impairment of functioning in most social areas and has obsessive rituals from OCD and conversion symptoms, with frequent anxiety attacks along with aggressive and antisocial behavior

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