WIOA Title I-A & I-B Policy & Procedure Manual
Ch. 12) File Documentation

12.4 Dislocated Worker Program File Documentation

12.4.3 Required Federal Reporting

Effective date: September 1, 2020

For each Dislocated Worker 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 but may impact negotiated and adjusted levels of performance via the statistical adjustment model.

Consistent with the WIOA Title I Application Process Guidance, WDBs and their service providers must ensure that their WIOA Title I application forms include all the information needed to create an individual's record in ASSET. The WIOA Title I application form is considered an allowable self-attestation for these data elements.

NOTE: The list below is not exhaustive. Allowable forms of documentation for other required federal reporting elements are identified in other areas of this policy.

Income Guidance for included and excluded income types and the time span for calculating income.

Data Element

Example Documentation2


NOTE: This list is not intended to be all-inclusive.
Sex
  • Self-Attestation
Age/Date of Birth3
  • Driver's license
  • Baptismal record
  • Birth Certificate (vital record, do not copy)
  • DD-214
  • Military report of Transfer or Discharge paper
  • Federal, state, or local ID card (Do not copy state ID card)
  • Passport
  • Hospital record of birth
  • Public assistance/social service records
  • School records or ID cards
  • Work permit
  • Family Bible
Ethnicity: Hispanic/Latino
  • Self-Attestation
Race
  • Self-Attestation
Limited English Language Proficiency
  • Self-Attestation
Limited English Reading Ability
(if Limited English Language Proficient)
  • Self-Attestation
Limited English Speaking Ability
(if Limited English Language Proficient)
  • Self-Attestation
Primary Language
(if Limited English Language Proficient)
  • Self-Attestation
Eligible Veteran Status4
  • Form DD-214 showing the military service member's discharge that is anything other than dishonorable
  • Cross-match with Department of Defense records
  • Cross-match with Veterans Service Database
  • Letter from the Veterans Administration
Current Education Status (School Status at Program Entry)5
  • 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)
  • 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 Parent6
  • 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
  • Self-Attestation
Current Unemployment Insurance Programs (UI)7
  • 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
  • Self-Attestation
Foster Care (Foster Care Youth Status at Program Entry)8
  • 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
Family Income at or Below the Current Federal Poverty Level (FPL) or 70% of the Lower Living Standard Income Level (LLSIL)9

Family size must be correctly determined and documented in order to correctly establish a low-income determination.

NOTE: Information used to establish Family size is different from the information used to establish a household composition for the purposes of determining Economic Self-Sufficiency.

NOTE: Family size is determined as of the date of eligibility determination. Family members who may have comprised part of the family during the past six months but no longer meet the definition of family should not be counted.
  • Self-attestation
    OR
  • Award letter from Veterans Administration
  • Bank statements
  • Pay stubs
  • Compensation award letter
  • Court award letter
  • Pension statement
  • Employer statement/contact
  • Family or business financial records
  • Housing authority verification
  • Quarterly estimated tax for self-employed persons
  • Social Security benefits
  • UI claim documents
  • Copy of authorization to receive cash public assistance
  • Copy of public assistance check
  • Public assistance eligibility verification
  • Cross-match with Refugee Assistance records
  • Cross-match with public assistance records
  • Cross-match with UI wage records
  • Local Income Determination Form
NOTE: The career planner must document the participant's income, even if the income was $0 for the past six months.
Unemployed Greater Than or Equal to 27 Consecutive Weeks (Long-term unemployed)10
  • Self-Attestation
    OR
  • Public assistance records
  • Refugee assistance records
  • Cross-match with public assistance database
  • Cross-match to state UI database
FoodShare / (Supplemental Nutrition Assistance Program (SNAP))11
  • FoodShare/SNAP eligibility verification
  • Copy of Authorization to Receive Foodshare/SNAP
  • Receipt of FoodShare/SNAP purchase showing balance from point of sale and date of purchase
  • Referral Transmittal from Foodshare/SNAP
  • Cross-Match with Foodshare/SNAP Public Assistance Record
  • Verbal Verification from appropriate Human Services agency
  • Printout from www.access.wisconsin.gov showing benefits statement
NOTE: The following are not acceptable forms of documentation:
  • A copy of the participant's FoodShare (Quest) card
  • Screen prints from CARES
Temporary Assistance for Needy Families (TANF) / Wisconsin Works (W-2)12
  • 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 Human Services agency
NOTE: It is not allowable to use screen prints from CARES to document TANF/W-2.
Exhausting TANF/Wisconsin Works (W-2) within 2 years13
  • 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 Human Services agency

NOTE: It is not allowable to use screen prints from CARES to document TANF/W-2.
Other Income-Based Public Assistance (Other Public Assistance Recipient)14
  • Copy of Authorization to Receive Cash Public Assistance
  • Copy of Public Assistance Check
  • Medical Card Showing Cash Grant Status
  • Public Assistance Eligibility Verification
  • Cross-Match with Refugee Assistance Records
  • Cross-Match with Public Assistance Records
  • Cross-Match with State MIS Database
  • Verbal verification from appropriate social services agency
NOTE: Career planners may not use screen prints from CARES to document public assistance.
Offender or Ex-Offender (Ex-Offender Status at Program Entry)15
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 Status16
  • 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
Individual with a disability17
  • 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 5.718 of this policy manual.
Basic Skills Deficient19
  • Basic Skills Screening Tool (DETW-18156-E)
    OR
  • Assessment test results
  • Applicable records from education institution (transcripts, academic assessments, or other school documentation)
  • Case notes
English Language Learner20
  • Self-Attestation
    OR
  • Basic Skills Screening Tool (DETW-18156-E)
  • Assessment test results
  • Applicable records from education institution (transcripts, or other school documentation)
  • Signed WIOA intake application or registration form
  • Signed Individual Employment Plan
  • Case notes
Cultural Barriers
  • Self-Attestation
Supplemental Security Income (SSI)/Social Security Disability Insurance (SSDI)21
  • SSI/SSDI Receipt of Benefits Verification
  • Referral Transmittal from Social Security Administration (SSA)
  • SSI/SSDI Eligibility Verification
  • Cross-Match with SSA Database
  • Verbal Verification from Social Security Administration
Homeless(Homeless participant, Homeless Children and Youths, or Runaway Youth at Program Entry)22
  • Self-attestation
    OR
  • Signed WIOA intake application or registration form
  • Written Statement or Referral Transmittal from a Shelter or Social Service Agency
  • Needs Assessment
  • Signed Individual Employment Plan
  • A letter from caseworker or support provider
  • Verbal or written verification from social service agency
  • Case Notes
Qualifying Employer Name
  • Self-attestation
    OR
  • Verification from employer
  • Rapid Response list
  • Notice of layoff (Including a WARN Notice)
  • Public announcement of layoff
  • UI documentation
Qualifying Dislocation Date (Actual Dislocation Date)23
  • 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
Rapid Response Participation24
  • Self-attestation
    OR
  • Cross-match to state MIS database
  • Rapid Response list
  • Cross-match to Rapid Response records
  • Case notes




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



FoodShare Wisconsin

Effective date: August 20, 2018

"FoodShare Wisconsin" helps people with limited money buy food they need for good health. FoodShare recipients are people of all ages who work but have low incomes, are living on small or fixed incomes, or have no incomes because they have lost their job, are retired, or are disabled and not able to work. https://www.dhs.wisconsin.gov/foodshare/index.htm



Family (20 CFR § 675.300)

Effective date: October 1, 2017

"Family" means two or more persons related by blood, marriage, or decree of court, who are living in a single residence, and are included in one or more of the following categories:

A "married couple" can either be a man and a woman or same-sex individuals. United States v. Windsor, 133 S.Ct.2675 (2013); 81 FR 56088



Public Assistance

Effective date: August 20, 2018

Revised date: September 1, 2020

"Public Assistance" means federal, state, or local government cash payments where eligibility is determined by a needs or income test.

WIOA Sec. 3(50)

As WIOA does not define "cash payments," DWD-DET used definitions provided by the U.S. Census Bureau and the U.S. Citizenship and Immigration Services to define "cash payments" as cash or a cash equivalent, such as a debit card or check, that can be spent however the recipient choses, and is not restricted to a specific purpose like groceries or childcare.

U.S. Census Bureau (https://www2.census.gov/library/publications/ 2013/acs/acsbr11-12.pdf); U.S. Citizenship and Immigration Services (https://www.uscis.gov/policy-manual/volume-8-part-g-chapter-10)



English Language Learner

Effective date: August 20, 2018

English Language Learner means an individual who has limited ability in reading, writing, speaking, or comprehending the English language because English is not his or her native language OR he or she lives in a family or community environment where a language other than English is the dominant language.

WIOA Sec. 3(21); WIOA Sec. 203(7); TEGL 21-16, p. 3



Supplemental Security Income

Effective date: August 20, 2018

"Supplemental Security Income" (SSI) is a federal income supplement program funded by general tax revenues (not Social Security taxes). It provides cash assistance to aged, blind, and disabled people who have little or no income so they can meet their basic needs for food, clothing, and shelter. https://www.ssa.gov/ssi/



Homeless

Effective date: August 20, 2018

"Homeless" means a person who lacks a fixed, regular, and adequate nighttime residence. This covers the following situations: (1) sharing the housing of other persons due to loss of housing, economic hardship, or similar; (2) living in a motel, hotel, trailer park or campground due to the lack of alternative adequate living accommodations; (3) living in an emergency or transitional shelter; (4) abandoned in a hospital; (5) awaiting foster care placement; (6) using a public or private place for nighttime residence that is not designed for or typically used by human beings for regular sleeping accommodations; (7) a child who has moved in the last 36 months either as a migratory agricultural worker or fisher or with a parent or spouse who is a migratory worker or fisher.

42 U.S.C. 14043e—2(6) ; 42 U.S.C. 11434a(2)



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)