Access Center Responsibilities in the Applicant File Review Process

Debbie Jones Disability Program Analyst Accommodation Support Contract Humanitas, Inc. 2

What’s New to You? Recommendations of Denial have changed –Certain previous reasons for recommendations of denial primarily rolled up into eligibility criteria No age waiver process –Age/income related to disability status are EARs Health Care Needs Assessment Form and process formalized New process forms (Program Instruction 11-16) PRH Appendices 107 and 108 (PRH Change Notice 11-13) 3

APPLICATION OUTCOMES Center options for applicant file reviews 4

Only Potential Application Outcomes Enrollment Applicant withdrawal Recommendation for denial –Direct threat –Cannot meet basic health care needs Refer to another more appropriate provider Consider admission to another center –New information 5

Applicant Withdrawal Processing a withdrawal of application: Applicant requests withdrawal –Document request and return file to the following: Outreach and admissions if a recommendation of enrollment or denial has not yet been made. 6

Applicant Withdrawal Center is unable to reach applicant –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. –If the center is unable to reach the applicant to conduct clinically-related interviews, then the center would document the attempts to contact and the file would be returned to Outreach & Admissions. –If the application has entered the regional review process, then the region will process the withdrawal, administratively or follow-up (whatever they choose to do). If a file has been returned to a center for completion of the file review process, then it must be returned to the regional office, regardless of inability to contact the applicant. 7

APPLICANT FILE REVIEW AT THE CENTER LEVEL Processing Applications to the Job Corps Program 8

Process Teams 2 Separate Teams –File Review Team (FRT) –Reasonable Accommodation Committee (RAC) May include some of the same individuals on each team Typically fluid in composition Roles and functions are different 9

File Review Team Review relevant parts of the applicant’s file based upon the Health and Wellness Manager’s initial triage of the file. Make recommendations to the center director to accept or recommend denial of an applicant. Does NOT determine accommodation needs of the applicant. 10

Reasonable Accommodation Committee (RAC) RAC’s role within the applicant file review process. –Review and discuss potential accommodations with the applicant as part of the Health Care Needs or Direct Threat assessments. Do not confuse this with the general process of reviewing accommodation requests and developing an accommodation plan for applicants approved for enrollment. –Recommends accommodations and modifications to the FRT. –Does NOT make decisions about enrollment. 11

Applicant File Review Procedures An SOP describing center’s process for reviewing applicant files is required and should describe in detail how applicant file is processed from the time it arrives on center through a final disposition. –See Appendix 107 for specific requirements. 12

Applicant File Review Procedures Step 1: File is received on center by the records staff who: -Records the file in the records log and tracks its movement Step 2: Records forwards the sealed medical, health, or disability-related information unopened to the Health and Wellness Manager (HWM). Step 3: The HWM opens the sealed information and conducts a health documentation review and initial direct threat review of the applicant’s file. 13

Initial Review Step 4: The HWM determines who else may need to review the protected information based upon his or her determination of “need to know.” This is essentially your File Review Team. –Center Mental Health Consultant (CMHC) reviews mental health-related information –Center Physician review medical information –Center Dentist reviews dental information –TEAP Specialist reviews substance-related information –*Academic Manger would review IEPs, 504 plans, educational reports including special education assessment 14

Assessments & Requalification 15 Step 5: The appropriate members of the file review team determine if a health care needs or a direct threat assessment is necessary or if there is a need to revisit the eligibility factors. NOTE: Only complete one assessment, either health care needs or direct threat but not both.

Direct Threat A direct threat assessment should be completed whenever center believes that an applicant poses a direct threat to the health or safety of himself or others. –Poses a significant risk of substantial harm to the health or safety of the individual or others; and –Cannot be eliminated or reduced by reasonable accommodation or modification. Assessment done by clinician Must use the appropriate form –See Appendix 609 (forms and guidance) 16

Health Care Needs The Health Care Needs Assessment should be completed if there is a concern that the center cannot meet the basic health care needs of the applicant. Assessment done by clinician Must use the appropriate form –See Appendix 610 (forms and guidance) 17

New Information 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 EARs. 18

Requalification of Eligibility 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. You may not apply additional qualifications. –determine eligibility based upon the responses to the same set of questions asked previously by the AC. 19

Age/Income – Disability Status 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 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 packages up the file and a summary of its findings and submits to the regional office for review. 20

Reasonable Accommodation Step 6: For Direct Threat Assessment: –When completing the direct threat assessment, the reasonable accommodation committee (RAC) must convene to consider reasonable accommodation (RA). In this scenario, the RAC would only be comprised of those staff members with a need to know and would likely consist of the center clinician, the HWM/DC, and must include the applicant. 21

Reasonable Accommodation Step 6 (Cont.): For Health Care Needs Assessment: –When completing the health care needs assessment, the reasonable accommodation committee (RAC) must convene to consider reasonable accommodation (RA) if condition rises to a level of a disability. Appendix 605 for definition of a disability. In this scenario, the RAC would only be comprised of those staff members with a need to know and would likely consist of the center clinician, the HWM/DC, and must include the applicant. 22

RAC Recommendations Step 7: In case of direct threat and health care needs assessments, the RAC will submit its accommodations recommendations to the file review team. -See Appendix

File Review Team Consideration of Reasonable Accommodation Step 8: Review RAC Recommendations Direct Threat –Consider if accommodations and/or modifications would remove the barriers to enrollment by sufficiently reducing the threat to below a level of direct threat or eliminating the direct threat. Health Care Needs –Consider if accommodations and/or modifications would remove the barriers to enrollment and make condition manageable at Job Corps as defined by basic health services in PRH Exhibit

Accommodation Reasonableness Step 9: Complete reasonableness review if the center director believes that the provision of the requested/needed accommodations are unreasonable. -Unduly costly -Result in a fundamental alteration to the program Complete the Accommodation Recommendation for Denial and Justification Analysis Documentation Form (See Program Instruction 11-16). 25

Reasonableness Form 26 Reasonable Accommodation Committee Participants Name: Position: Name: Position: Name: Position: Summarize the applicant’s input: Identify the members of the RAC. Summarize the applicant’s input.

Reasonableness Form 27 Identify the accommodations believed to be unreasonable. Accommodation Applicant Requested? UnreasonablenessAlternative Options ☐ Yes ☐ No ☐ Unduly costly ☐ Fundamental Alteration

Reasonableness Form 28 Show calculated costs for each accommodations being recommended for denial or document why the accommodation requires a fundamental alteration to the program. Cost Analysis or Fundamental Alteration Ensure that the Center Director signs the form.

Important!!!Important!!! 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 –likely offer the opportunity to enroll without the benefit of accommodation 29

When to Use the Reasonableness Form 1.When the center wishes to recommend denial of an accommodation that is deemed unreasonable. The regional office will determine whether or not the center must provide the requested support or not. 2.When there is an assertion of accommodation unreasonableness on either the direct threat or health care needs form. –Do NOT have to fill out with every HCN or DT assessment – only when the accommodations are deemed unreasonable. –Should be needed on a relatively rare basis. 30

Application Recommendation Step 10 Determine recommendation of application Any applicant file recommended for denial for -direct threat -health care needs -new information will be forwarded to the regional office for a final disposition. 31

Reasonable Accommodation - Enrollment Step 11 Whenever the center intends to enroll an applicant, he or she must be engaged in an interactive process to determine reasonable accommodation needs prior to assigning the applicant a start date in cases where an applicant requests reasonable accommodation or information/ documentation in the applicant file indicates accommodation may be necessary. 32

REGIONAL REVIEW OF APPLICANT FILES Preparing your documentation 33

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Center Recommendation of Denial Form If the center is going to recommend denial of the applicant, then it must complete the Center Recommendation of Denial Form. Identify the File Review Team (FRT) participants. 35 File Review Team Participants: Name: Position:

Reason for Recommendation of Denial Identify the reason the center is recommending denial. 36 Reason for Recommendation of Denial: ☐ 1. Applicant poses a direct threat to self or others that cannot be alleviated with reasonable accommodation. If so, the completed direct threat assessment form found in Appendix 609 of the PRH is attached to this document. Skip to Section C. ☐ 2. The health care needs of an applicant is beyond what the Job Corps’ Health and Wellness program can provide as defined as basic health care in PRH Exhibit 6-4: Job Corps Basic Health Care Responsibilities and cannot be eliminated or reduced by reasonable accommodation or modification. If so, the completed health care needs assessment form found in Appendix 610 of the PRH is attached to this document. Skip to Section C. ☐ 3. The applicant is ineligible for Job Corps due to the review of new information that the AC could not have reasonably known. Complete Section B only.

New Information If the center is recommending denial based upon new information, then complete this section of the form. 37 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

38 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. 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.).* Summarize your findings.

Reasonable Accommodation If recommending denial due to direct threat or exceeds basic health care needs, then the question about reasonable accommodation consideration needs to be answered. 39 ☐ Yes ☐ NoThe applicant requested accommodations or there is documentation of a disability present in the file.

Considering Accommodations Is the applicant in agreement with the accommodation decisions and is the accommodation reasonable? 40 Reasonable Accommodation Considerations: AccommodationApplicant AcceptsReasonable* ☐ Yes ☐ No

Remember!Remember! If the center believes that an accommodation requested by the applicant is unreasonable or requires a fundamental alteration to the program, then the center must complete the Accommodation Recommendation for Denial and Justification Analysis/ Documentation Form and attach to this document (i.e. Center Recommendation of Denial Form). 41

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RAC Participation Reasonable Accommodation Team Participants NamePositionDate ☐ Yes ☐ No Did the applicant participate in the RAC meeting? Via what medium did the applicant participate? ☐ Phone ☐ Video conferencing ☐ Face-to-face meeting on center ☐ Other – Describe: 43 Identify the RAC participants and method of applicant contact.

File Review Team Findings Summarize the applicant’s input: 44 ☐ The file review team rationale for recommendation of denial may be found in the attached completed direct threat assessment. ☐ The file review team rationale for recommendation of denial may be found in the attached completed basic health care needs assessment. Finally, certify the reason for recommendation of denial and that the required documentation is attached.

Regional Review Outcomes When files are received at the regional office, there is administrative review to ensure that required processes are followed; then a clinical review to make sure health documentation supports clinician's recommendation and that decision is clinically sound. If denial recommendation is rejected by the Regional Office, applicant must be scheduled for arrival based on the date on which the application first arrived on center. 45

SCENARIOS/REVIEWSCENARIOS/REVIEW Let’s Practice! 46

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 health care need What should happen next? 47

DispositionDisposition Center received new information that the AC could not have known –Revisit eligibility criteria for court history Applicant “may” not be eligible for enrollment 48

Scenario #2 Applicant completes application with the AC and is 26 years of age. The applicant discloses that he is a person with a disability and provides medical documentation. –What happens next? 49

Scenario #2 Discussion Who reviews the medical documentation of disability? Who makes decisions about over age applicants? What happens if the applicant’s documentation does not seem to support that they are a person with a disability? –What would you do? 50

ReviewReview What are the three reasons that a center may recommend denial of enrollment? When must the RAC convene during the applicant file review process? Where should the center staff send an applicant file where the applicant wishes to withdraw and the file has already entered into the regional review process? Who at the center level determines unreasonableness? Who may deny requested accommodations? Who makes the recommendation of denial of enrollment? 51

RESOURCESRESOURCES Job Corps and Partners 52

Appendix

54 Appendix 108

Regional Disability Coordinators Boston Region – Lisa Kosh Atlanta and Philadelphia Regions – Nikki Jackson Dallas Region – Laura Kuhn Chicago and San Francisco Regions – Kim Jones 55

Regional Nurse Specialists Atlanta, Chicago, and San Francisco Regions - Melissa Cusey, RN Boston, Dallas, and Philadelphia Regions – Shannon Bentley, RN 56

Job Corps Disability Web Site 57

Job Accommodation Network (JAN) askjan.org 58