Reporting Manual For The Case Service Report (RSA 911) Rsa 911 2016
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- I. General Information
- II. Reporting Period Identification Data Elements
- III. Unique Identifier Data Elements
- IV. Data Elements at Application
- A. Date of Application
- B. Date of Birth
- C. Individual Characteristics
- D. Location Information
- E. Source of Referral
- F. Student with a Disability
- G. Support
- 1. Social Security Disability Insurance (SSDI) at Application
- 2. Supplemental Security Income (SSI) for the Aged, Blind, or Disabled at Application
- 3. Temporary Assistance for Needy Families (TANF) at Application
- 4. General Assistance (State or local government) at Application
- 5. Veterans' Disability Benefits at Application
- 6. Workers' Compensation at Application
- 7. Unemployment Insurance at Application
- 8. Primary Source of Support at Application
- H. Medical Insurance Coverage
- 1. Medicaid at Application
- 2. Medicare at Application
- 3. State or Federal Affordable Care Act Exchange at Application
- 4. Public Insurance from Other Sources at Application
- 5. Private Insurance Through Employer at Application
- 6. Not Yet Eligible for Private Insurance Through Employer at Application
- 7. Private Insurance Through Other Means at Application
- V. Eligibility Data Elements
- VI. Order of Selection (OOS) Data Elements
- VII. Disability Data Elements
- VIII. Trial Work Experience Data Elements
- IX. Individualized Plan for Employment (IPE) Data Elements
- A. Date of Most Recent or Amended IPE
- B. Supported Employment Goal on Current IPE
- C. Employment
- D. WIOA Program Involvement
- E. Barriers to Employment
- 1. Long-Term Unemployed
- 2. Exhausting TANF Within Two Years
- 3. Foster Care Youth
- 4. Homeless Individual, Homeless Children and Youths, or Runaway Youth
- 5. Ex-Offender
- 6. Low Income
- 7. English Language Learner
- 8. Basic Skills Deficient/Low Levels of Literacy
- 9. Cultural Barriers
- 10. Single Parent
- 11. Displaced Homemaker
- 12. Migrant and Seasonal Farmworker
- F. Education
- 1. State Definition for Age of Students with Disabilities
- 2. School Status
- 3. Highest Educational Level Completed
- 4. Highest Elementary or Secondary School Grade Completed
- 5. Enrolled in Secondary Education
- 6. Date Received Special Education Certificate of Completion
- 7. Enrolled in a State Adult Secondary School at the High Adult Secondary Education (ASE) Level
- 8. Attained Secondary School Diploma
- 9. Date Attained Secondary School Equivalency (GED)
- 10. Enrolled in Postsecondary Education - Highest Academic Year
- 11. Enrolled in Postsecondary Education
- 12. Date Enrolled During Program Participation in an Education or Training Program Leading to a Recognized Postsecondary Credential or Employment
- 13. Completed Some Postsecondary Education, No Degree or Certificate
- 14. Date Attained Associate’s Degree
- 15. Date Attained Bachelor's Degree
- 16. Date Attained Master’s Degree
- 17. Date Attained Graduate Degree (e.g., Ph.D., Ed.D., J.D., M.D.)
- G. Vocational/Technical Credential, License or Certificate
- 1. Enrolled in a Career or Technical Training Program, Not Leading to a Recognized Postsecondary Credential
- 2. Enrolled in a Career or Technical Training Program, Leading to a Recognized Postsecondary Credential
- 3. Date Attained Vocational/Technical License
- 4. Date Attained Vocational/Technical Certificate
- H. Other Education or Training
- X. Pre-Employment Transition Services Data Elements
- XI. VR and SE Service Data Elements (Applicants and Eligible Individuals)
- XII. Training Services Data Elements
- A. Graduate College or University
- B. Four-Year College or University Training
- C. Junior or Community College Training
- D. Occupational or Vocational Training
- E. On The Job Training
- F. Registered Apprenticeship Training
- G. Basic Academic Remedial or Literacy Training
- H. Job Readiness Training
- I. Disability Related Skills Training
- J. Miscellaneous Training
- K. Randolph-Sheppard Entrepreneurial Training
- L. Customized Training
- XIII. Career Services Data Elements
- A. Assessment
- B. Diagnosis and Treatment of Impairments
- C. Vocational Rehabilitation Counseling and Guidance
- D. Job Search Assistance
- E. Job Placement Assistance
- F. Short Term Job Supports
- G. Supported Employment Services
- H. Information and Referral Services
- I. Benefits Counseling
- J. Customized Employment Services
- K. Extended Services
- XIV. Other Service Data Elements
- A. Transportation
- B. Maintenance
- C. Rehabilitation Technology
- D. Personal Assistance Services
- E. Technical Assistance Services Including Self-Employment
- F. Reader Services
- G. Interpreter Services
- H. Other Services
- XV. Measurable Skill Gain Data Elements (WIOA section 116(b)(2)(A)(i))
- A. Date of Most Recent Measurable Skill Gain: Educational Functioning Level (EFL)
- B. Date of Most Recent Measurable Skill Gain: Secondary
- C. Date of Most Recent Measurable Skill Gain: Postsecondary Transcript/Report Card
- D. Date of Most Recent Measurable Skill Gain: Training Milestone
- E. Date of Most Recent Measurable Skill Gain: Skills Progression
- XVI. Employment Data Elements
- XVII. Exit Data Elements
- A. Date of Exit
- B. Type of Exit
- C. Reason for Exit
- D. Employment at Exit
- E. Support at Exit
- 1. Social Security Disability Insurance (SSDI) at Exit
- 2. Supplemental Security Income (SSI) for the Aged, Blind, or Disabled at Exit
- 3. Temporary Assistance for Needy Families (TANF) at Exit
- 4. General Assistance (State or local government) at Exit
- 5. Veterans' Disability Benefits at Exit
- 6. Workers' Compensation at Exit
- 7. Other Public Support at Exit
- 8. Primary Source of Support at Exit
- F. Medical Insurance Coverage at Exit
- XVIII. Post-Exit Data Elements
- A. Date Enrolled in Post-Exit Education or Training Program Leading to a Recognized Postsecondary Credential
- B. Date of Attainment of Post-Exit Recognized Credential
- C. Type of Recognized Credential Attained Post-Exit
- D. First Quarter After Exit Quarter
- E. Second Quarter After Exit Quarter
- F. Third Quarter After Exit Quarter
- G. Fourth Quarter After Exit Quarter
- XIX. Index of Data Elements