SCSEP Grantees, State, Local, or Tribal Government

UNITED STATES DEPARTMENT OF LABOR

Division of Adult Services

SCSEPData
CollectionHandbook
The Charter Oak Group, LLC
Rev.6 (4/19/10)

THIS PAGE INTENTIONALLY LEFT BLANK

Introduction to SCSEP Data Collection Handbook
Revision 6
Revision 6 of the Data Collection Handbook is designed to assist grantees and sub-grantees with the changes that have occurred in
SPARQ since the implementation of the changes required by the 2006 amendments to the Older Americans Act and the Interim Final
Rule on July 1, 2007.
This revision of the Handbook contains revised guides to the versions of the four hard copy forms that were effective in January 2010.
The forms are available on the SCSEP site at http://www.charteroakgroup.com/resources/scsep.shtml. Although the forms are considered
draft until they receive final OMB approval, the data elements contained in the four hard copy forms must be reported for all participants
in the specified format regardless of whether a grantee uses the SCSEP Web Data Collection System (WebDCS or WDCS). Following
the format of the hard copy forms, data elements that are optional are shaded in gray. Unshaded fields are required in that they must be
completed if appropriate. The guides, which follow the order of the forms, provide descriptions of the data elements, explanations of
how best to capture and record the required information, and discussions of how the data elements relate to the SCSEP performance
measures. Some of the descriptions and explanations contain additional comments. These comments do not always pertain directly to
completing the data field but will give the user a fuller understanding of the data element. Therefore, all grantees and sub-grantees,
including those that are using their own data collection systems, will need to be familiar with and follow the information in this
Handbook.
The Handbook uses various terms to describe the SCSEP data collection and reporting system:
 “SPARQ” – The overall automated system (data entry application, upload process, national database, management reports, and
QPRs). SPARQ is the acronym for the “SCSEP Performance and Results QPR” system.
 “WebDCS (WDCS)” – The Web-based data entry application in SPARQ. Most grantees use this application to enter their data.
 “Non-Web DCS (Non-WDCS) users” – Grantees that continue to use their own automated systems and submit the required data
through Excel spreadsheets on a specified schedule to SPARQ.
There are “Topics” at various points throughout the guides. These topics provide more extended discussion of important issues for the
data collection and reporting system. Topics generally address broad concepts, such as: what “exit” means, when follow-ups must be
completed, and what services may be provided before assigning an applicant to community service. Data elements or topics that have
been substantively revised or that are new since the fifth revision of the Handbook are so indicated in the first column. Relevant
information that is contained in the postings on the SCSEP Ask the Experts Internet forum through April 8, 2010, has been incorporated
into this revision of the Handbook. However, users should continue to consult the Forum regularly for complete information about an
element or topic. This revision also includes all relevant information from the SCSEP regulations, TEGLs, and other guidance that has
been issued since the last revision.
Rev. 6 (4/19/10)
i

In addition, the Handbook references some of the edits in SPARQ that control how, and in what form, data must be entered. For
complete information on the requirements for the data system, users should see the SPARQ Users’ Guide and other relevant information
on the Mathematica Policy Research Web site, http://SCSEP.Mathematica-MPR.com. For information on the management reports
contained in SPARQ, users should see the revised SPARQ Management Reports Handbook, which will be available on The Charter Oak
Group’s SCSEP Web page, http://charteroakgroup.org/resources/scsep.shtml, in the fall of 2010.
A PDF version of the SCSEP Data Collection Handbook is also available at the SCSEP Web page of The Charter Oak Group. The
Handbook has a revision number and a date on the bottom of each page. The hard copy version of the Handbook that users may have
been given may not contain the most up-to-date version of the guides. However, the version on the Internet will always be the most
recent, and users are encouraged to check the Internet regularly. Additions and clarifications to the Handbook will be posted on the
SCSEP Ask the Experts Internet forum as they occur. The PDF version has a search function in the toolbar at the top of each page that
will allow users to search for key words. The search function will bring you to each instance of the search terms in the Handbook. This
is probably the easiest and quickest way to find information in topics.
The Handbook is designed to be printed in landscape format, back-to-back, “military” style, that is, with the binding along the top. The
Handbook has been organized so that the text for each guide starts on an upper page when the Handbook is opened flat, affording the
reader a view of two full pages. Where possible, breaks were inserted at the end of each bottom page to avoid having material run over
to the next page. To facilitate this full two-page view, extra pages have been inserted where required. These pages are identified as
being intentionally left blank.
All of the resources referenced in this introduction, including the hard copy forms, the Data Collection Handbook, and the SPARQ Users’
Guide, can be accessed through the SCSEP Community of Practice.

Rev. 6 (4/19/10)

ii

Participant Form Guide

Participant Form Guide

Number
Topic 1

Element Name/
Topic
Modifying OMBapproved data
collection forms

Form Heading 1
Form Heading 2
Form Heading 3

Sub-Grantee
Local Site
Case Worker

Topic 2

Ineligible
applicants: When
is an application
required?

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 You are free to modify the forms to add data elements, but if you do so, you must remove all
of the OMB information and the SCSEP form numbers from those modified forms. OMB and
SCSEP have authorized only the collection of the data on the approved forms.
 If you modify the forms, you must retain all of the data elements on the official versions. To
facilitate data entry, you may wish to keep the elements in the same order as the data application.
You could also use the official forms and collect the additional information on a separate form.
 WebDCS will identify grantee and sub-grantee from the log in. The user does not input
either the name or the code.
 You may use the local site if the sub-grantee has multiple sites and the name of the case
worker, if applicable. You may be able to use these two fields and the sub-grantee field as filters
when you generate the management reports.
 WebDCS users can enter local site and case worker in the row above the participant name in
the participant or enrollment screens. These fields are specific to the enrollment.
 Sub-grantees and local projects are required to take an application from any individual who
indicates a desire to apply – even if project staff persons believe that the individual is ineligible.
However, sub-grantees and local projects may provide information about the program and its
eligibility requirements without taking an application if the individual is only making an inquiry
and does not ask to make application.
 If someone calls and inquires about the program, it is entirely appropriate to inform the
individual of the eligibility requirements and to ask if the individual thinks he or she is eligible
and would like to proceed with an application. It is even appropriate to assist the individual with
calculating his or her income to determine whether the individual's income meets the guidelines.
You must, however, be willing to take an application at the individual's request even if your
preliminary discussion suggests that the individual is ineligible.
 In addition to protecting applicants’ rights, taking applications from ineligible applicants
may help to document unmet needs and provide a basis for Congress to expand the program.

Participant Form-1

Participant Form Guide

Number
Topic 3

Topic 4
(Revised)

Rev.6 (4/19/10)

Element Name/
Topic
Entering N/A or
“dummy” data
into the data
system

Data errors in
SPARQ

Element Description/Explanation Plus Additional Comments
 Do not enter anything into the data system except valid data. If you cannot obtain the
information – or even if you think the field should not have any data in it – just leave the field
blank. This is very important to the integrity of the data system and to the ability to extract data.
There are many situations where the national office needs to know if someone has a valid name,
address, Social Security number, etc. If you enter N/A or make up a value, SPARQ will wind up
selecting that record; and it will then be necessary to find some way to manually delete it when
the invalid data are discovered. This happens extensively with the customer satisfaction survey
samples when sub-grantees put N/A or some other invalid value into critical fields like contact
person name or FEIN.
 SPARQ will prevent you from entering invalid values into most fields.
 WebDCS users will be prevented from entering invalid values into most fields, and many
errors in data quality will be flagged before the user leaves the screen on which the errors have
occurred. All other data quality problems for an enrollment will be noted in the Enrollment Data
Quality Problems (EDQP) on the main page of the WebDCS for that participant before you
close the record you are working on.
 Unlike the EDQP, the Data Quality Report (DQR) and the Rejects Report provide a listing of
all data quality problems for a grantee. (DQRs are also available at the sub-grantee level.)
Records are identified by participant last name, the last four digits of the Social Security
number, and participant ID number (PID).
 SPARQ classifies data errors. Records are rejected by the QPR only if they contain serious
errors affecting eligibility or performance. For WebDCS users, most of these rejections will be
flagged at the screen level and will prevent you from leaving the screen without fixing them.
Those that cannot be detected at the screen level will be noted in the Enrollment Data Quality
Problems (EDQP) on the main page and the DQR. For non-WebDCS users, all rejections and
warnings will appear in the DQR.
 All errors other than rejections are designated as warnings. In addition to error messages
identifying the source of the error, the warnings include a priority number based on the
importance of the error:
Participant Form-2

Participant Form Guide

Number

Element Name/
Topic

Topic 5
(Revised)

Missing data
warnings

1

Last name

2

First name

3

Middle initial

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
o Warning Priority 1, like a reject, affects eligibility or performance. In this
instance, although the entire record will not be rejected, credit for one or more
measures is affected.
o Warning Priority 2 affects either a QPR measure other than one of the
performance measures in Section E or F; or a SCSEP program requirement.
o Warning Priority 3 involves data elements that are required but that are not
reported on the QPR.
 Warnings and error messages are not generated for most optional fields.
 If a field is left blank when it could have had data entered, you may receive a Warning
Priority 3 (the lowest level of warning) advising you that the field has no value in it.
 You should never put made-up data or N/A into any field. If you do not have the data and
cannot or do not intend to get them, leave the field blank and ignore the missing data warning.
As long as you do not get a rejection message, you can ignore any data warning where you know
that you have done everything you can to correct or complete the data.
 In a subsequent release of SPARQ, grantee and sub-grantee administrators will have the
ability to turn off many of the missing data warnings on a record-by-record basis.
 A last name (along with a Social Security number and application date) is required to create
a valid record in SPARQ.
 The fields for the applicant’s first and last name will be used to mail letters and the customer
satisfaction survey. Enter them as you want them to appear on a mailing label. If you make an
error in entering a name and need to fix it, contact MPR at SCSEPNJ@mathematica-mpr.com.
 A first name is not required for a valid record. If the applicant only uses one name, list that
name as the last name and leave this field blank.
 Because the applicant’s first and last name will be used for mailing letters and the customer
satisfaction survey, it is essential to enter a first name for all applicants except those who use
only one name.
 You should leave this field blank if the individual does not have a middle initial.

Participant Form-3

Participant Form Guide

Number
4
(Revised)

Element Name/
Topic
Social Security
Number

Topic 6

Dual enrollments

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 Because the Social Security number serves as a unique identifier, it is necessary to record the
Social Security number even if the applicant is determined ineligible. The Social Security
number will also be used to obtain the UI wage records for determining entered employment and
calculating the average wage measure once these records become available for all grantees.
 Records without a Social Security number will be rejected by SPARQ. SPARQ will also
reject records that contain the same Social Security number as that used for a currently active
participant. This will prevent the entry of duplicate participations and incorrect Social Security
numbers. Non-WebDCS users are required to use the participant search function in SPARQ
they can determine whether an applicant is currently enrolled.
 If the applicant does not have a Social Security number, do not make one up. Instead,
contact Mathematica and it will provide a proxy number that you may use.
 If you make an error in entering an SSN and need to fix it, contact MPR at
SCSEPNJ@mathematica-mpr.com.
 All data saved or uploaded to SPARQ are encrypted using Secure Socket Layer (SSL) while
being transmitted over the Internet. The DOL server also stores Personally Identifiable
Information (PII), including name, address and Social Security number, in an encrypted format
to ensure confidentiality. Once entered, the Social Security number is never again displayed in
SPARQ.
 A dual enrollment occurs when the same participant is enrolled with two grantees (or subgrantees) at the same time. Dual enrollments are prohibited because they distort performance,
resulting in some grantees getting credit for enrollments or placements that they do not deserve.
They also create the possibility that participants will receive more hours of community service
than they should, or that grantees will exceed the permissible limits on training dollars.
 Because dual enrollments are not permitted in SCSEP, SPARQ will not permit WebDCS
users to create an enrollment for a participant who is currently active in SPARQ. Non-WebDCS
users are required to use the participant search function in SPARQ before they enter an
enrollment into their own database. If a non-WebDCS user submits a dual enrollment to
Participant Form-4

Participant Form Guide

Number

Element Name/
Topic

5

Home phone
number

6

Mailing address

6(a)

Number and
street; apt. #; PO
Box
County

6(e)

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
SPARQ, it will be rejected. The non-WebDCS user must then use field 6a(iv) of the Exit Form
to exit the participant and end the dual enrollment.
 There may be a situation where you know that a prior enrollment has ended but the
termination of the prior enrollment by a non-WebDCS user has not yet been submitted to
SPARQ. In this case, you may contact Mathematica to have the prior exit entered into SPARQ.
This will permit you to enter the new enrollment.
 If the participant has no home phone, try to obtain a number where a message can be left
with a friend, neighbor, or family member. If none, leave blank. Do not enter N/A or dummy
data into this field.
 If the applicant does not have a residence, try to obtain an address at which the applicant can
receive mail. The mailing address fields will be used to mail letters and the customer service
survey.
 Be sure to enter the complete address exactly as you want it to appear on the envelope.
“County” will not be used for mailing. If you know the last address you have for the participant
is wrong and you are unable to obtain the correct address, delete the street number and street
name only. Leave the last known data in the other address fields. This will prevent surveys
being mailed to the participant.
 If the address has a rural route number or Post Office box rather than a street, use field 6(a)
to record that information. If there are both a street and a Post Office box, record both in field
6(a). In this case, the ZIP code should be that of the P.O. box, not the street address.
 Enter the participant’s county of residence in this field. It is not necessarily the same as the
county in which the authorized position is located. (See field 39a.)
 Use in field 6e only the approved list of counties contained in field 39a. For territories and
the District of Columbia, which do not have counties, the list uses the name of the territory or
the District. For Alaska, the list uses boroughs and census areas.
 Applicants must reside in the state in which they apply unless the state has an approved
cross-border agreement with another grantee, but there is no requirement that applicants reside
in the county in which they apply.
Participant Form-5

Participant Form Guide

Number

6a
6b
7

Topic 7
(Revised)

Rev.6 (4/19/10)

Element Name/
Topic
Participant’s
e-mail address
Emergency
contact
State of residence
if different from
mailing address

Most-in-need
measure:
priorities of
service and
waiver factors

Element Description/Explanation Plus Additional Comments
 County is used for planning, equitable distribution, and persistent unemployment (field 54).
It is not used for mailing.
 This optional field may assist you in contacting the participant.


This optional field may assist you in contacting the participant.

 Residence is defined as an individual’s primary dwelling place or address as demonstrated
by appropriate documentation. No minimum length of residence is required.
 A homeless individual is considered a resident of the state in which he or she is applying.
 Grantees may accept residents of other states if there is an approved multi-state agreement.
 Data validation is required for this element.
 The most-in-need measure reports the average number of barriers to employment per
participant. The regulation allows credit for a total of 13 barriers to employment in two separate
categories.
 The first category is comprised of 8 priorities of service: homeless or at risk of
homelessness; rural; LEP; low literacy skills; veteran (or qualified spouse); disability; failed to
find employment after using WIA Title I; and low-employment prospects. Although age 65 and
over is also a priority of service, it is not included in the most-in-need measure.
 The 8 priorities of service are recorded only at the time of enrollment and may not be
updated. If a participant’s conditions change during enrollment, you can record that fact in the
comments section of the Participant Form, but you may not update any of these 8 fields.
 The second category is comprised of 4 additional barriers to employment that are part of the
waiver factors for the durational limit: severe disability; frail; old enough for SS retirement but
not eligible to receive it; severely limited employment prospects in an area of persistent
unemployment; and age 75 and over.
 LEP and low literacy skills are also waiver factors in addition to being priorities of service.
They are recorded with the priorities of service so that you can provide appropriate services at
the beginning of enrollment. They are only counted once for the most-in-need measure.
Participant Form-6

Participant Form Guide

Number

Element Name/
Topic

8
(Revised)

Homeless

8a
(Revised)

Urban/rural

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 Unlike the priorities of service, the waiver factors may be entered into SPARQ whenever
you become aware of them, and you will receive credit in the most-in-need measure for each
program year in which a waiver factor applies. (See Form Heading 5 and fields 51-57 for an
explanation of the waiver factors.)
 The most-in-need measure is calculated only for participants who enrolled on or after July 1,
2007.
 Homeless means (1) an individual who lacks a fixed, regular, and adequate nighttime
residence; and (2) an individual who has a primary nighttime residence that is: (A) a supervised
publicly or privately operated shelter designed to provide temporary living accommodations
(including welfare hotels, congregate shelters, and transitional housing for the mentally ill); (B)
an institution that provides a temporary residence for individuals intended to be institutionalized;
or (C) a public or private place not designed for, or ordinarily used as, a regular sleeping
accommodation for human beings.
 The most-in-need measure will count participants who are homeless or at risk of
homelessness (field 27). Homeless remains in field 8 in the Participant Information section
because it may be used to establish residence for eligibility.
 Data validation is required for this element.
 Urban/rural is now being captured for the most-in-need measure. It is therefore included in
data validation.
 “Rural” means an area not designated as a metropolitan statistical area by the Census
Bureau; segments within metropolitan counties identified by codes 4 through 10 in the Rural
Urban Commuting Area (RUCA) system; and RUCA codes 2 and 3 for census tracts that are
larger than 400 square miles and have population density of less than 30 people per square mile.
 You may determine rural by using the link from either field 8a of the WebDCS or the
SPARQ home page. This will bring you to a list of counties by ZIP code. Check the
participant’s ZIP code (field 6e) to determine if the participant resides in a rural area.
 The RUCA ZIP code cross-walk will cover most but not all participants. It does not include
RUCA codes 2 and 3 for low-density areas. It may also have some inaccuracies because it uses
Participant Form-7

Participant Form Guide

Number

9
(Revised)
10

Topic 8
(Revised)

Rev.6 (4/19/10)

Element Name/
Topic

Application date
for enrollment or
re-enrollment
Date of birth

Timeframe for
determining age
and other

Element Description/Explanation Plus Additional Comments
ZIP codes as of the year 2000. It does not contain any ZIP codes for Puerto Rico.
 Here are the complete instructions for determining whether an area is rural:
1. You first go to the ZIP code table and check by ZIP code. 2007 ZIP codes are listed at:
http://depts.washington.edu/uwruca/ruca-download.php . Use the 2006 ZIP codes.
RUCA codes 4 and above are rural.
2. If the ZIP code is missing from the table or if the ZIP code table does not seem to be
providing the right answer based on your knowledge of the area, you can look up the
state, county, and census tract codes at this site:
http://www.ffiec.gov/Geocode/default.aspx.
3. Then go to http://www.ers.usda.gov/Briefing/Rurality/RuralUrbanCommutingAreas
and download the 2000 census tract table at the bottom of the page for the state in
question. In the Excel table of census tracts, you can use the "find" function in Excel
(under the edit menu) to find the exact census tract you are looking for, or you can sort
on the tract column heading, or you can just scroll until you find the tract. Again, RUCA
codes 4 and above are rural.
4. If the census tract is larger than 400 square miles and has a population density of less
than 30 people per square mile, RUCA codes 2 and 3 are also rural.
The census tract determination is the final answer.
 Enter the date on which the initial application was filled out. If the information is provided
over several different dates, enter the first date on which information is recorded. SPARQ will
reject any record that does not have an application date.
 Since age is a SCSEP eligibility requirement, this information is required for all applicants.
SPARQ will reject any record where you have determined an applicant under the age of 55 to be
eligible.
 Data validation is required for this element.
 For purposes of the QPR and the performance measures, age and other relevant
characteristics, like poverty level, are determined at the time of enrollment. The statute and
regulations require you to give priority of service to those 65 and over if you have more
Participant Form-8

Participant Form Guide

Number

11
(Revised)

Rev.6 (4/19/10)

Element Name/
Topic
characteristics for
performance
measures

Number in family

Element Description/Explanation Plus Additional Comments
applicants than you have positions. This can only be measured at the time you decide which
eligible applicants to enroll and which to place on the waiting list. Age 65 and over, however,
while still a priority for service, is no longer included in the most-in-need measure.
 The most-in-need measure also considers the waiver of durational limit factors that are listed
in fields 51-57. Unlike priority of service and other participant characteristics, the waiver of
durational limit factors may be updated whenever you become aware of changes. Age 75 and
over (see field 57) is re-calculated for you each time the WebDCS is accessed. You will receive
credit in the most-in-need measure whenever the waiver factors are recorded. They must be
updated at least once each program year to continue receiving credit in the most-in-need
measure.
 Because the performance system determines characteristics at the time of enrollment, you
may not update any fields on the Participant Form, other than contact information and those for
recertification (fields 44-50), in order to reflect changes in the participant’s characteristics.
 TEGL 12-06, which has governed income eligibility since 1/1/07, did not make any change
in the definition of family (although it did make other important changes in how income is
counted and calculated for eligibility purposes.) The rules regarding family contained in the
prior TEGL 13-04 remain in effect under the 2006 amendments to the OAA.
 Enter the number of individuals in the applicant’s family. A “family” is defined in TEGL
12-06 as husband, wife, and dependent children; parent or guardian and dependent children; or
husband and wife. (If the applicant is claimed as a dependant on someone else’s tax return, you
must use the broader Current Population Survey (CPS) definition of family. See Attachment II
of the TEGL and Topics 12-14 below.) Count only current family members living together. Do
not include deceased spouses or separated spouses who are living separately. In addition,
consistent with 20 CFR 641.500, an applicant with a disability may, at the option of the
applicant, be treated as a family of one for income eligibility determination purposes. Familyof-one status does not extend to other members of the applicant’s family. (NOTE: See Topics
54-57 for important information about disability and medical records.)
 Do not use this field for recording family size at recertification. All recertification data are
Participant Form-9

Participant Form Guide

Number

Element Name/
Topic

Topic 9
(New)

Documentation of
family size

Topic 10
(New)

Marriage license
as documentation
of family size

Topic 11

Common law
spouse

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
entered in fields 44-51. Field 11 will always reflect the family size at the time of initial
enrollment. Do not overwrite this field.
 Data validation is required for this element.
 The Data Validation Source Documentation Requirements permit three forms of
documentation for family size: official documents or business records; detailed case notes; or
signed attestation. The signed attestation must be from "a third-party who has knowledge of the
participant’s number in family and reflects the living situation at time of application." Participant
self-attestation is prohibited.
 For documentation of family size, there is no requirement that the signed attestation be from
a person of authority. A friend may sign the attestation. If you are using a detailed case note
reflecting information received from a third-party rather than a signed attestation, you must
document why there is no signed attestation. A person of authority could be a source that would
justify not having a signed statement; a friend would ordinarily not be a sufficiently reliable
source for a case note.
 A marriage license by itself is not sufficient to establish family size of two. The spouse's
income will need to be verified as part of total family income, and that should enable you to
determine that the applicant and spouse reside together. By itself, without the income
verification, the marriage license could only establish that the applicant had been married at
some time, not that the applicant resides with a spouse at the time of application.
 Under the eligibility TEGL, you only count the income of spouses living together. To
determine whether the applicant has a spouse, you follow the law of the state or territory in
which you operate. If state or territory recognizes common law marriage or same sex unions and
the applicant meets the definition, then you count the income of the common law spouse who is
living with the applicant.

Participant Form-10

Participant Form Guide

Number
Topic 12

Topic 13

Topic 14

12

13

Rev.6 (4/19/10)

Element Name/
Topic
Adult child living
with applicant

Element Description/Explanation Plus Additional Comments

 The eligibility TEGL defines a family as a parent and dependent child living together. If the
child is not a minor and is not claimed as a dependant on the applicant's taxes, then the child is
not part of the applicant's family, and the child’s income is not includable. If the child is a
dependant, then the child’s income is includable as part of the family income.
Participant
 In cases where a participant or applicant has been claimed as a dependant on the tax return of
claimed as
another individual, the participant or applicant must be treated as a member of that individual's
dependant by
family for the next year. If the participant or applicant claims that circumstances have changed
another person;
and that he or she is no longer a dependant, the participant or applicant will have to produce a
length of penalty new tax return to document that he or she is no longer a dependant.
Counting family
 According to the eligibility TEGL, if the applicant is claimed as a dependant on someone
members when
else’s tax return, you must include in the applicant’s family all individuals currently residing
the applicant is
with the applicant who are related by blood, marriage or adoption.
claimed as a
 You need not include these family members if the applicant lives independently; pays all of
dependant
his or her own expenses, including rent and utilities; does not share meals; and has separate
living quarters, including a separate entrance. The mere fact that the applicant pays rent and is
financially independent is not sufficient if the applicant does not have separate living quarters.
Receiving public  If the applicant is receiving any form of public assistance, check the appropriate box(es) b-g.
assistance?
If the applicant is receiving some form of public assistance other than those listed in boxes b-g,
check box h and specify the type of assistance. If the applicant is not receiving any form of
public assistance, check box a.
 This data element applies to the applicant only, not the entire family.
Employed prior to  Enter 1 if the participant was employed at the time of participation. An individual employed
participation?
on the date of participation is one who, on the date participation occurs:
o Did any work at all as a paid employee (except the individual is NOT considered
employed if: a) he/she has received a notice of termination of employment or the
employer has issued a Worker Adjustment and Retraining Notification (WARN) or other
notice that the facility or enterprise will close; or b) he/she is currently on active military
Participant Form-11

Participant Form Guide

Number

14
(Revised)

Rev.6 (4/19/10)

Element Name/
Topic

Total includable
family income
(12-month or 6month
annualized)

Element Description/Explanation Plus Additional Comments
duty and has been provided with a firm date of separation from military service);
o Did any work at all in his/her own business, profession, or farm;
o Worked 15 hours or more as un unpaid worker in an enterprise operated by a member of
the family; or
o Was not working, but has a job or business from which he/she was temporarily absent
because of illness, bad weather, vacation, labor-management dispute, or personal
reasons, whether or not paid by the employer for time off, and whether or not seeking
another job.
 Enter 2 if the participant is a person who, although employed, has received notice of
termination of employment.
 Enter 3 if the individual does not meet the definitions listed above, i.e., was not employed on
the date of participation.
 Since SCSEP participants are required to be unemployed at the point of enrollment, only
those for whom you have recorded a 3 are eligible to become participants.
 This field is for the Common Measures and applies to applicants who are assigned to
community service. The point of determination is the date of assignment to community service.
 Data validation is required for this element.
 Under the eligibility TEGL, you use the 12-month period prior to application or the 6-month
period annualized, whichever is more favorable to the applicant.
 Do not use this field for recording income at recertification. All recertification data are
entered in fields 44-51. Field 14 will always reflect the income at the time of initial enrollment.
Do not write over this field.
 Family income is used to establish eligibility. It includes the income of current family
members identified in field 11 above. Sub-grantees may use any income worksheet they wish
for calculating income. Although not part of the database, the worksheet must be retained in the
file for all applicants. You must also retain documentation of all income sources.
 The procedure for validating income is set out in the eligibility TEGL and the Data
Validation Handbook. There are no exceptions. You must calculate the family income for the
Participant Form-12

Participant Form Guide

Number

Topic 15
(Revised)

Rev.6 (4/19/10)

Element Name/
Topic

Date for
determining
income of
applicants

Element Description/Explanation Plus Additional Comments
12-month period prior to application or the 6-month period and annualize it. If the applicant is
ineligible because the income in both look-back periods is not truly typical, the applicant will
have to wait until the atypical income drops out of the look-back period and reapply at that time.
 Data validation is required for this element.
 The statute and regulations state that the look-back period for income eligibility ends on the
date of application. That means that you look back 6 or 12 months from the calendar date of
application to determine the amount of income received. If the application is completed on
October 16, you would include all income received from April 16 to October 16 if you were
using a 6-month look-back period.
 Even if you know that a participant will be receiving income, such as a pension check,
within a few days of the application date and will become over-income, you generally cannot
delay the determination and find the applicant ineligible. The statute is explicit about when the
look-back period ends. The applicant is entitled to the benefit of the look-back period, just as a
taxpayer is entitled to take advantage of any favorable provision in the tax code.
 However, this rule applies only to sources of income that have already been disclosed and
included in the look-back calculation. If there is a new or additional source of income that would
constitute a substantial change in circumstances, you would be required to do a recertification
once the income was received. (See Topic 83.) Therefore, under these limited conditions, you
should delay the determination, count the new income, and find the applicant ineligible.
 On the other hand, an ineligible applicant who has been determined over-income can reapply
and have eligibility re-determined whenever a change in income would make the individual
eligible under either the 12-month or 6-month look-back period. In cases where a fluke in timing
results in the participant receiving more income in the relevant period than that to which he or
she is legally entitled, e.g., a seventh Social Security check within the 6 month period was
received early and you can establish the exact legal entitlement with certainty, you may disregard
the extra check. You must fully document the source and amount of the income and the basis for
your income calculation.

Participant Form-13

Participant Form Guide

Number
Topic 16

Topic 17

Topic 18

Rev.6 (4/19/10)

Element Name/
Topic
Effect of public
assistance on
eligibility

Element Description/Explanation Plus Additional Comments

 Under the eligibility TEGL, public assistance is excluded from income for purposes of
SCSEP eligibility. However, the applicant must still meet the income limit with regard to all
includable family income for the 12 months or annualized 6 months prior to the eligibility
determination. Receipt of public assistance does not make an applicant automatically eligible.
 Furthermore, the determination of a state or local welfare agency to treat an applicant as a
family of one is not determinative of family size for SCSEP purposes. Under the TEGL, if the
applicant has family members who are included for income determination purposes, you will
exclude public assistance benefits received by the applicant and the applicant’s family members,
but you must count the includable income of all other family members.
Exclusion from
 The eligibility TEGL excludes from income all forms of child support, including payments
income: foster
made by the government for the care of children who are not the applicant's own children, such
care and other
as foster care or adoptive grandparent’s subsidies. The exclusion also applies to all Social
types of child
Security payments that an applicant receives for the benefit of a child for whom he or she serves
support payments as legal guardian. All such payments are considered for the benefit of the children, not the
applicant. If the payments are public assistance for the applicant's own children, they are also
excluded. The eligibility TEGL explicitly excludes child support and welfare payments.
 If the payments are excluded, the applicant may still count the children as members of the
applicant's family for purposes of establishing family size and income limits only if the
dependent children are related by blood, marriage, or adoption.
Exclusion from
 The eligibility TEGL excludes from family income any wages or stipends received from any
income: wages or employment and training program by the applicant or the applicant’s family members. This
stipends from
exclusion applies to SCSEP regular program wages and OJE wages (even if paid by the
employment and
employer), as well as to stipends paid by other government programs, such as the VA’s
training
"compensated work therapy."
 This exclusion also applies to Trade Readjustment Allowances (TRA). TRA is provided to
workers who have lost their jobs due to foreign imports. A condition of receiving TRA benefits
is that the claimant be enrolled in training provided by Trade Adjustment Assistance (TAA).
The eligibility TEGL excludes from income for purposes of SCSEP eligibility all stipends from
Participant Form-14

Participant Form Guide

Number

Element Name/
Topic

Topic 19

Exclusion from
income: pay and
educational
benefits received
by active
members of the
Armed Forces;
active service as
employment

Topic 20

Exclusion from
income: Disaster
Assistance
Payments (DUA)
Exclusion from
income: lottery
winnings

Topic 21

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
employment and training programs. Therefore, TRA benefits should be excluded.
 It is highly unlikely, however, that a recipient of TRA benefits would be otherwise eligible
for enrollment in SCSEP. TRA recipients typically have extensive work histories and thus are
likely to be job-ready. To the extent that TRA recipients need retraining to become job-ready,
such training is provided by TAA. Although there may be exceptions, most TRA recipients do
not need and would not benefit from the type of training provided by community service.
 Active service in the Armed Forces, including the National Guard, is considered
employment. Although National Guard service is usually part-time, it meets the SCSEP
definition of employment because it in more than occasional work and results in regular
payment. Therefore, current active members of the Guard are not eligible for enrollment in
SCSEP.
 However, once a member of the Armed Forces, including the National Guard, is no longer
active and has become a veteran, the income from active duty and the amounts received for
educational assistance cannot be included in income when determining eligibility for federallyfunded employment and training programs, including SCSEP. See TEGL 10-09, Attachment A,
Section 1(a).
 DUA is only provided to individuals who do not qualify for regular unemployment
insurance. Like the National Emergency Grant (NEG) benefits that have been provided to
hurricane victims, DUA should be treated as an employment and training stipend and should be
excluded from income for SCSEP eligibility purposes.
 Consistent with the Census and the CPS, the main rule for determining whether to include
certain income for eligibility purposes is based on whether the income is received on a regular
basis. If lottery winnings are collected in a lump sum as a one-time payment, then the winnings
are not considered income for SCSEP eligibility. However, if the winnings are collected from
periodic payments and the applicant receives the income on a regular basis – annually, monthly,
bi-weekly, every two months, etc. – then the winnings are considered income for purposes of
SCSEP eligibility.

Participant Form-15

Participant Form Guide

Number
Topic 22

Topic 23
(New)

Element Name/
Topic
Exclusion for
Railroad
Retirement
Exclusion for
educational
assistance

Topic 24

Early withdrawal
from IRA account

Topic 25
(New)

Jury duty pay

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 It is not permissible to make deductions from Railroad Retirement. The only deduction for
retirement income permitted by the statute and the eligibility TEGL is for Social Security.
 TEGL 12-06 Attachment I, section N, lists "Pell Grants, other government educational
assistance; any scholarships or grants; or financial assistance students receive from employers,
friends, or relatives not residing in the students household" as includable income. In contrast,
free tuition that is provided to everyone who meets certain qualifications is not the kind of cash
educational assistance envisioned by the TEGL as constituting includable income.
 Although income from employment and training programs is excluded, financial assistance
for education is included. Therefore, unless work study payments are provided as part of an
employment and training program, they would be included.
 Regular withdrawals from IRA's are neither interest income nor capital gains. Rather, they
are considered retirement income, which is includable. See Section 5 of TEGL 12-06 and
Section J of Attachment I. However, early withdrawals, for which participants usually pay a
penalty, are not retirement income because a participant is not yet qualified to receive pension
payments. Instead, they are treated like withdrawals from a savings account, which are excluded
from SCSEP income.
 Grantees should check state statutes to determine what their obligations are, if any,
regarding pay to participants on jury duty. Grantees are permitted to pay participants for jury
duty as a fringe benefit. Such payments should not be recorded as paid hours on the Community
Service Assignment form.
 If the participant receives jury duty pay from the state, grantees must subtract this pay from
any SCSEP payment they choose to make. The bottom line is that participants may not “doubledip.” That is, consistent with state law, participants may receive the equivalent of their SCSEP
wages while on jury duty, but no more than that.
 Any amount of jury duty pay participants receive from the state or the grantee is not
includable as income for eligibility purposes during recertification.

Participant Form-16

Participant Form Guide

Number
Topic 26

Topic 27
(New)

Rev.6 (4/19/10)

Element Name/
Topic
Treatment of
Social Security
Benefits Under
TEGL 12-06

Consequences for
disabled
participant when
SSDI converts to
regular SS
retirement

Element Description/Explanation Plus Additional Comments
 TEGL 12-06 addresses three kinds of benefits under the Social Security Act:
1) Supplemental Security Income (SSI) under title XVI is a means-tested benefit that has always
been and remains totally excluded from family income.
2) Social Security Disability Insurance (SSDI) under Title II was not previously excluded for
SCSEP eligibility purposes, but it now is totally excluded under TEGL 12-06 (see first bullet
under Excluded Income on p.3 of the TEGL and Section I of Attachment I), as are all other types
of disability payments. Note that when a beneficiary reaches the age for regular retirement
benefits, SSDI is converted to regular SS retirement benefits. At that point, the benefit loses its
total exclusion and is entitled to only a 25% exclusion as set forth in 3) below.
3) Social Security retirement and survivors’ benefits under Title II have an exclusion for 25% of
the gross amount. There is no deduction for any Medicare premium paid by beneficiaries.
 The exclusions listed above apply to all family income (and not just the income of the
individual applicant) that would otherwise be included when determining income for SCSEP
eligibility purposes. All of these exclusions are effective January 1, 2007.
 Medicare benefits, regardless of the age of the recipient, are not considered income for
SCSEP eligibility purposes.
 All disability payments, regardless of source, are excluded from income for eligibility
purposes. However, when a Social Security disability payment converts to regular Social
Security, the income is treated under the normal rules for Social Security: You exclude 25% of
the payments and include the remainder. (See Topic 26.)
 A disabled applicant or participant is entitled to be treated as a family of one for income
eligibility purposes regardless of the source of income. This treatment is based on status, not
income. In order to claim this special treatment, the participant must document the disability.
 Both disability and severe disability count as separate barriers to employment under the
most-in-need measure. When used for this purpose, they must be documented. In addition,
severe disability is a factor that may entitle a participant to a waiver of the 48-month durational
limit for individual participants. It must be documented if used for this purpose as well.

Participant Form-17

Participant Form Guide

Number
Topic 28
(New)

Element Name/
Topic
Spouse of
applicant who
receives SSI
benefits

Topic 29
(New)

Survivor of
spouse formerly
on SSDI

Topic 30
(New)

Survivor’s
benefits from VA

Topic 31

Effect of SCSEP
Wages on SSI
and SSDI

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 SSI is a needs-based program for those who are disabled, blind, or over 65. SSI benefits are
excluded from income for SCSEP eligibility purposes whether received by an applicant or the
applicant's spouse.
 Moreover, an applicant who receives SSI by reason of disability may choose to be treated as
a family of one for purposes of SCSEP eligibility. That means that only the applicant's income
is counted; the spouse's income is excluded regardless of the source of that income. On the other
hand, if the applicant does not qualify as a family of one, the spouse's income must be included
unless that income falls under its own exclusion.
 Survivor’s benefits are paid when the deceased spouse was eligible for either Social
Security retirement or Social Security disability. Normally, survivor’s benefits are treated like
Social Security retirement, and only 25% is excluded from income for purposes of SCSEP
eligibility. However, if the surviving spouse is disabled herself and is receiving SSDI based on
the deceased spouse's earnings (regardless of what kind of benefits the deceased spouse
received), then all of the SSDI benefits are excluded.
 A survivor's benefit based on a veteran's disability payment from VA is excluded from
income. The 2006 amendments to the OAA specifically exclude from the definition of income
payments made "to or on behalf of" a veteran by the VA. The specific exclusion in Section G of
Attachment I to TEGL 12-06 for VA payments to veterans or survivors is meant to implement
the OAA provision. Section H of Attachment I, which includes survivors benefits as income, is
not applicable to a surviving spouse's payments from the VA.
 Supplemental Security Income (SSI) is a needs-based program that provides a cash benefit
and Medicaid to recipients. Any earnings reduce SSI benefits dollar-for-dollar after an initial
disregard of the first $30. In most states, the 2007 SSI benefit is $623.00 for an individual and
$934 for a couple. (Some states also use state money to supplement this amount.) SCSEP
wages will always reduce SSI, sometimes to zero. For example, a SCSEP participant working
20 hours per week at $7.59 per hour would lose all SSI benefits while a participant working at
minimum wage would still retain some cash benefit. Many applicants on SSI will probably
choose to forego SCSEP once they know the effect on their federal benefit rate. However, some
Participant Form-18

Participant Form Guide

Number

Element Name/
Topic

Element Description/Explanation Plus Additional Comments
might choose to enroll because as long as a recipient keeps some SSI cash benefit, the recipient
remains eligible for Medicaid.
 All Social Security Disability Insurance (SSDI) beneficiaries under the age of regular
retirement (currently age 65-67, depending on date of birth) are required to report any earnings
to the Social Security Administration (SSA). (In addition, retirement beneficiaries between the
ages of 62 and full retirement age must report their wages because they are subject to an
annualized earnings test on their wages.) Those at or above normal retirement age can work
without any effect on their benefits. For everyone else, the rules can be complicated and the
consequences, especially the loss of health coverage, can be very serious.
 Social Security Disability Insurance is not needs-based. It requires sufficient wage credits
under Social Security to qualify. Beneficiaries of SSDI can jeopardize their benefit eligibility if
they work. However, under the Ticket to Work program, a beneficiary can work for a
significant time and still maintain both cash and medical benefits. The length of time a
beneficiary may work and still receive full benefits varies depending upon his or her situation.
The Ticket to Work can be used with multiple employers over the beneficiary’s lifetime so it
could be used first with SCSEP and then possibly with an unsubsidized employer. However,
both the SCSEP employer and the unsubsidized employer must be recognized by SSA as an
“employment network.” DOL will investigate whether SSA will recognize all SCSEP grantees
and sub-grantees as an employment network, but unless that happens, any sub-grantee enrolling
an SSDI beneficiary has to register individually. Most SSDI beneficiaries have already received
their Ticket to Work. If not, they can get one on demand from SSA by calling 1-800-772-1213.
 SSDI beneficiaries who do not receive the Federal Benefit Rate (FBR) based on their
recorded earnings may also receive SSI to make up the difference. They are called concurrent
beneficiaries. They also receive Medicare (after 24 months) under SSDI and Medicaid under
SSI. Ticket to Work will not protect the SSI portion of their benefit. If SCSEP wages reduce
their SSI to zero, they will also lose Medicaid.
 Information about the effect of work and earnings on both programs is available on the SSA
Web site, www.socialsecurity.gov/work/.

Rev.6 (4/19/10)

Participant Form-19

Participant Form Guide

Number
Topic 32

Topic 33

Element Name/
Topic
Exclusion from
income: reverse
mortgage
payments
Exclusion from
income: medical
insurance
reimbursement

Topic 34
(Revised)

Inclusion of
interest and
dividend income
from IRA’s

Topic 35
(Revised)

Documenting
Social Security
income

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 Payments received by an applicant under a reverse mortgage are considered to be similar to
capital gains and thus are excluded from income for purposes of SCSEP eligibility.
 If an applicant receives reimbursement for medical expenses, including health insurance
premiums, co-payments, and deductibles, as part of an employer-provided pension plan; those
payments are excluded from income for SCSEP eligibility purposes – provided that the applicant
only receives the payment if he or she incurs the expenses. Any payments in excess of expenses
incurred are includable as income, as are the pension payments themselves.
 The eligibility TEGL requires that you include all interest and interest income. However,
there is danger of counting this income twice when IRA’s and other retirement accounts are
involved. DOL has interpreted the eligibility TEGL to avoid double counting: For regular
savings or investment accounts, interest and dividend income are included as income when
credited to the account. For IRA's and other pensions, interest and dividend income are only
included when taken as part of the distribution, i.e., when actually received by the beneficiary.
 This different treatment is required because withdrawals from regular savings and
investment accounts are not otherwise includable as income while all payments from IRA's and
other pensions are includable.
 An applicant can obtain a Social Security or Supplemental Security Income (SSI) benefit
verification letter by using one of the following methods: making the request online at
www.socialsecurity.gov/beve; calling SSA toll-free at 1-800-772-1213, or visiting a local SSA
office. This last method is often the quickest. Since you need total family income, you should
be sure the letter from Social Security addresses all family members counted in field 11.
 If there is a delay in obtaining the verification letter, you may use a properly labeled bank
statement to verify the gross amount of Social Security benefits received by an applicant who is
65 or older. The applicant's bank statement may not suffice to establish whether another family
member is receiving Social Security benefits. It will also not reflect any deductions for
Medicare premiums. If there is any doubt, you should accept the bank statement as provisional
Participant Form-20

Participant Form Guide

Number

Element Name/
Topic

Topic 36

Documenting
income for
farmers and other
self-employed
individuals before
tax returns are
available

Topic 37

Documentation

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
documentation while the applicant works to obtain a statement from the SSA.
 You can use a general letter from SSA to document the amount of the COLA increase for
the year. Thus, the letter from SSA is sufficient to establish that the amount of SSA benefits the
participant is receiving in 2010 is the same as that received in 2009 because there is no COLA
for 2010. Of course, you still have to do the complete determination of income eligibility to
make sure that you have identified and documented all sources of income.
 Farmers and other self-employed applicants may not have official proof of income until
they file their tax returns. You may use signed self-attestation, based on the applicant's own
figures, until the tax documents are available. At that time, you must verify the income
information provided by the applicant. You must inform the applicant that falsification of
eligibility information is cause for immediate termination.
 When accepting self-attestation, you should also require a copy of the prior year’s tax
return. The applicant should be able to satisfactorily explain any substantial changes in expected
income from the prior year.
 Documentation and data validation are required for items that determine eligibility
(residence, family size, income, and employment status), waiver of durational limits, certain
priorities of service characteristics, and veteran’s status. The Data Validation Handbook
indicates where self-attestation or case notes suffice for documentation. If an applicant is
claiming disability for purposes of income eligibility (a disabled applicant is treated as a family
of one), documentation is required. Acceptable documentation would include proof of a
government disability determination. If no such formal determination has been made, you may
accept a doctor's certification. If the applicant is not claiming disability for eligibility purposes,
then disability is an equal opportunity (EO) item, and disclosure is voluntary. In that case,
documentation is not required; however, without documentation, you will not receive credit in
the most-in-need measure. (See field 26 below.) Documentation is required for severe
disability and frail, two of the factors used for waiver of the durational limit.
 If you are unable to make copies when taking an application, the eligibility TEGL permits
you to document the sources that were relied on to establish eligibility. You should create a
Participant Form-21

Participant Form Guide

Number

Element Name/
Topic

Topic 38

Retention of case
files, financial
records and other
documentation

Topic 39
(New)

Special rules
during disasters

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
form to use for documenting income and other eligibility factors. Both the applicant and the
eligibility reviewer must sign the form. Required information includes:
1. Name of reviewer
2. Date of review
3. Title or descriptive name of source documents
4. Other pertinent information
 If an applicant is claiming status as a family of one because of disability, you must retain a
copy of the appropriate medical documentation even if you do not have a copier.
 All required documentation, both fiscal and programmatic, must be retained for three
program years after the end of the program year in which the document was generated. For
participants who enter unsubsidized employment after exiting the program, this means three
program years after the end of the program year in which all follow-up activity is ended.
 If you are required to have a signed IEP or waiver form in the file, you must retain it for the
specified retention period. If you are missing documentation, you must take reasonable steps to
recreate it or you risk audit/monitoring problems. If you do recreate documents, you should also
make case notes to document what you have done.
 If, due to a disaster, applicants have no means of producing supporting documentation of
their income, special rules for income documentation apply. In addition, several forms of
disaster or refugee payments received by natural disaster victims are excludable income:
• For disaster victims who have lost their documentation, grantees may accept selfattestation of age and income in new applications for 90 days while the applicants obtain
new documentation.
• Disaster victims are considered residents of the states in which they apply for SCSEP.
• Current participants may also self-attest to age and income for recertification purposes.
SPARQ records may be used to establish enrollment status and documentation of age and
income.
• Participants whose host agencies are no longer available may be assigned to emergency
relief work with non-profit organizations such as the Red Cross.
Participant Form-22

Participant Form Guide

Number

Element Name/
Topic

Topic 40

Documentation
for ineligible
applicants

Topic 41

Maintaining
participant case
files; access to
files

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
• Evacuees may be enrolled in temporary positions until they can be transitioned to
permanent positions or returned to their home communities.
• Under existing rules, grantees may employ a wide variety of supportive services to assist
hurricane victims.
• Income from any employment and training program is disregarded for purposes of SCSEP
eligibility. The disregard specifically includes employment in NEG temporary jobs and
DUA benefits. Other forms of disaster or relocation assistance will be determined by DOL
on a case-by-case basis.
 In general, you must document eligibility information for all applicants. For ineligible
applicants, documentation is especially important if the applicant is unhappy with the eligibility
determination and may wish to contest it. There are circumstances, however, where an ineligible
applicant readily accepts your determination and merely wishes to take advantage of other
services, such as your assistance in job placement under an MOU.
 If there truly is no doubt about the ineligibility and you are certain that the applicant will not
later decide to challenge your determination, you do not have to document the applicant's age or
income; nor do you have to obtain the applicant's signature on the Participant Form. You
should, however, use the comment field to explain what you have done and why. Because of the
potential for misunderstanding, you should also require that the eligibility determination be
made by the sub-grantee's director rather than a staff person.
 Data validation is not required for ineligible applicants.
 You need not maintain all case notes in hard copy; electronic case notes are acceptable. A
case manager must take detailed notes that include the date and her/his name. You will also
have to retain hard copies of any documents requiring signature and any documents that are not
included in SPARQ.
 It is critical that the case notes contain solid information and be attributable to someone for
accountability. Sub-grantees should clearly understand that they must provide access to this
electronic information to the grantee and to national office monitors. Furthermore, sub-grantees
should be informed in their sub-contract agreements of their legal obligation to turn over their
Participant Form-23

Participant Form Guide

Number

Element Name/
Topic

Topic 42
(New)

Safeguarding
sensitive
information

15

Family income at
or below 100% of
poverty level?

16

Formerly a
participant in any
SCSEP project?

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
complete electronic records to the grantee at the time that they cease to be involved in the
program or when the grantee otherwise requires them.
 The grantee is legally responsible for ensuring complete and accurate data collection and for
the maintenance of all required documentation. As a practical matter, the local site with the
most contact with the client should maintain the primary case file with all the documentation.
This will typically be the sub-grantee or the sub-sub-grantee. However, there should be
agreements in place so that the sub-grantees know these files will be validated and that both the
grantee and DOL have the right to view the information in the files wherever they are
maintained. The procedures for ensuring that information and documentation are properly
collected, stored, and made accessible must be set forth in the grant application.
 The assurances that are part of all grants require grantees to certify that participant records
are securely stored and access is limited to appropriate staff to safeguard personally identifying
information. In addition, grantees must certify that medical records are securely stored separate
from all other participant information and access is limited to authorized staff for authorized
purposes. (See also Topic 56.)
 One way to safeguard sensitive information like case notes about a participant's criminal
background is to treat it the same way as you treat medical records: Put it in the separate
secured file to which access is strictly limited.
 Use the federal poverty level for the applicant’s family size and check the appropriate box.
Use the same income inclusions and exclusions that you use for determining SCSEP eligibility.
 This information is used for reporting purposes only, not for eligibility (which is based on
125% of the poverty level).
 Check “yes” if the applicant reports that he or she was ever enrolled in any SCSEP project.
Re-enrollments are entirely new records. All dates are based on the conditions at the time of reenrollment without regard to anything that occurred during the prior enrollment. The application
date is the date of the application for re-enrollment, and the eligibility determination date is the
date on which eligibility for re-enrollment was determined.
 A new Participant Form is required for each new enrollment. The data system uses Social
Participant Form-24

Participant Form Guide

Number

Topic 43

Rev.6 (4/19/10)

Element Name/
Topic

Re-enrolling a
participant who
quit unsubsidized
employment

Element Description/Explanation Plus Additional Comments
Security number and application date to distinguish multiple enrollments by the same individual.
 Re-enrollment is at the discretion of the sub-grantee. Former participants do not have an
automatic right to re-enroll. You should consider the circumstances of the participants’ prior
exit from SCSEP, e.g., whether they were terminated for cause and whether they are now jobready. Former participants who have had employment since leaving SCSEP may be presumed
to be job-ready and thus ineligible. They should be referred to a One-Stop center.
 See Topic 1 of the Exit Form Guide for a discussion of the right of return and re-enrollment
after placement. (The right of return is limited to participants who exit to enter unsubsidized
employment, work for a total of less than 30 days, and return to the program within 90 days of
exit. Those who do not meet all three criteria for the right of return may seek to re-enroll.)
Either option may be available depending upon how long the participant worked, when the
participant attempts to re-enter the program, why the participant is now unemployed, and
whether the participant is job-ready.
 If the participant quit his or her job, you will obviously want to take that into consideration
in deciding whether to take the participant back into the program. If the participant quit with
good cause – e.g., was unsuited to the work or had a health problem – the participant would be
entitled to exercise the right of return. Alternatively, you would be justified in exercising your
discretion to permit her to re-enroll. Of course, before taking the participant back into the
program, you will want to determine whether another placement would be suitable. For
example, if the participant quit a job for which he or she lacked sufficient skills, but the
participant was otherwise job-ready, you should attempt to find her a job for which the
participant is better suited.
 On the other hand, if the participant quit under conditions that would have amounted to a
failure to comply with the IEP – e.g., the job was suitable but the participant did not really want
to work at any job – you might let the participant exercise the right of return only if he or she
agreed to cooperate in the future and you could treat the quitting as a failure to accept a job
referral under the IEP. You certainly would not have to permit the participant to re-enroll. Reenrollment is discretionary; a participant who has been terminated for cause or has demonstrated
Participant Form-25

Participant Form Guide

Number

Element Name/
Topic

Topic 44

Re-enrolling an
applicant who
previously
withdrew from
the waiting list

Topic 45
(New)

Re-enrollment
when there is no
available slot

Topic 46
(Revised)

Durational limits
and re-enrollment

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
an unwillingness to abide by the program's rules is not entitled to a second enrollment.
 If the participant has worked a sufficient time to demonstrate that she is job-ready, she would
no longer be eligible for re-enrollment. Under most circumstances, a participant who has
worked for 30 days and is laid off for lack of work would be considered job-ready and would not
be eligible for re-enrollment. This would not necessarily be true of a participant who worked a
relatively short time, including one who was in temporary or seasonal work.
 In contrast, a participant who is fired after 29 days in unsubsidized employment for inability
to do the job could very well need additional community service training to be truly job-ready
and would be appropriate for re-enrollment if the participant were financially eligible.
 If you decide to re-enroll a participant who left unsubsidized employment, you count all
income earned in unsubsidized employment in the twelve or six months prior to re-enrollment.
 You must take an application from anyone who wishes to apply. You must apply the
priorities of service in deciding whom to enroll when you do not have sufficient positions
available for all applicants. You do not have to enroll applicants who cannot benefit from the
program or who have failed to cooperate. However, an applicant's withdrawing from the waiting
list and then reapplying would not ordinarily be grounds to refuse to serve an otherwise qualified
applicant, especially if you have an opening or the applicant meets a priority or preference.
 If a former participant is eligible and you decide to re-enroll her but do not have an opening,
you should complete the participant form, determine her eligible, and then place her on the
waiting list until a position is available.
 An individual seeking re-enrollment is subject to the priorities of service like any applicant.
 The 2006 amendments to the OAA impose durational limits for the first time. Grantees are
limited to an average duration of 27 months for all participants. Each spring, as part of the grant
application, grantees may seek an extension of the 27 months average duration to 36 months for
the coming program year. Separate and apart from the average grantee durational limit,
individual participants have a lifetime durational limit of 48 months with any and all projects
and any and all grants, including ARRA, regular SCSEP grants, and additional grant funds.
Grantees may seek a waiver of the 48-month duration for individual participants. Both limits are
Participant Form-26

Participant Form Guide

Number

Topic 47

Rev.6 (4/19/10)

Element Name/
Topic

Entering reenrollments into
the data system

Element Description/Explanation Plus Additional Comments
calculated from July 1, 2007. DOL will provide guidance on the durational limits in the new
regulations implementing the 2006 amendments.
 Regardless of durational limits, a grantee may not enroll job-ready participants. If a
participant has been in another grantee's project for so long that he or she has reached a
durational limit, the participant may be job-ready. In that case, the participant may not be
enrolled by the new grantee but must be referred to the One-Stop center.
 Management reports are being revised in SPARQ to help grantees manage the durational
limits, and the QPR now displays the average project duration for each grantee and sub-grantee.
New reports will be created if necessary.
 Grantees are required to have a durational policy that adopts one of three possible durational
limits for individual participants: 48 months with no possibility of a waiver; 48 months with the
possibility of a waiver; and fewer than 48 months (if the grantee files a special request with its
grant application and the request is approved by DOL). If grantees adopt 48 months with a
waiver, the policy should describe the criteria that the grantee will use to determine which
participants will be entitled to a waiver.
 Participants must be informed of the durational policy (including the possibility of a waiver,
if applicable under the grantee’s policy) at the time of enrollment and annually thereafter.
Participants who are approaching their durational limit and are unlikely to find unsubsidized
employment prior to exit must be provided with transition services. The transition plan must be
reflected in the participant’s IEP.
 Re-enrollment requires the completion of a new Participant Form and the creation of a new
record in the database. SPARQ uses the participant’s Social Security number and application
date to distinguish the original enrollment from the re-enrollment. To create a re-enrollment,
WebDCS users select an existing participant and create a new enrollment for that participant.
 When you create a new enrollment for an individual already in the database, only the basic
participant information (name, date of birth, Social Security number, gender, ethnicity and race)
will be carried over from the prior enrollment. You will enter all other information for this
enrollment and it will be stored in the database separate from the original information.
Participant Form-27

Participant Form Guide

Number
17

Element Name/
Topic
Transferred from
another project?

Topic 48
(Revised)

Repeated transfer
by sub-grantee of
same participant
between grantees

Topic 49

Minimum time of
enrollment before
transfer

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 If the participant was transferred into your project from another project, check “yes” and
enter the name and code of the transferring grantee into the hard copy form.
 If the participant is transferred from another project, the participant will not be included in
the donor grantee’s performance measures until the participant exits from the recipient grantee’s
project. At that time, the participant’s outcomes will be reflected in the performance measures
of both the donor and recipient grantees. The data collection system will automatically track
these outcomes in a future release of SPARQ.
 SPARQ contains a utility for changing entities – either transferring participants from one
grantee to another or changing sub-grantees within a grantee. This utility must be used to
transfer a single participant or multiple participants. When this utility is used for a transfer, it
creates a new enrollment record for the recipient grantee that contains all of the existing
information about the participant’s current enrollment. Field 17 will contain the name and code
of the donor grantee along with the date of transfer. Because field 17 will be system-generated
in the WebDCS, it is grayed out.
 A sub-grantee that works for two different grantees cannot routinely transfer a participant
between the two grants. This is not allowed as a general practice because it distorts the
performance measures. It results in a sub-grantee receiving credit for serving two participants
and two grantees receiving credit for serving the same participant when no additional services
have usually been provided.
 In special circumstances, such as to avoid a premature exit when a grantee has unexpectedly
run out of money at the end of the program year, participants may be moved to another grant.
The movement of a participant from one grant to another is a transfer. It can only be done with
the approval of both grantees, as well as the national office. It cannot be done unilaterally by the
sub-grantee and must be limited to legitimate and unforeseen circumstances.
 There is no minimum time requirement for transfers. The only requirement is that the
transfer be done by agreement of the affected grantees, and that it be approved by the national
office. And, of course, the transfer must be for a legitimate reason. (See Topic 48 above.)

Participant Form-28

Participant Form Guide

Number
Topic 50
(Revised)

Topic 51
(New)

Rev.6 (4/19/10)

Element Name/
Topic
Transfer of
participant vs.
re-enrollment

Transfer of
participant vs.
movement of
positions

Element Description/Explanation Plus Additional Comments
 Transfers of participants between grantees are usually done for the convenience of the
participants or to avoid disruption of service when a grantee has insufficient funds to support all
filled positions. Transfers of participants only (as opposed to the movement of positions)
require the approval of the national office; they do not require the approval of the state grantee
where the positions are located.
 Transfers must be done by agreement of two grantees, not the unilateral action of a
participant. When a participant has been transferred, the participant retains the status that he or
she had at the transferring project. The participant does not have to be recertified (as long as the
last eligibility check was within the last 12 months), nor is the participant subject to priority of
service at the new project. Any participant can terminate from one project and seek to re-enroll
in another project. However, such action requires a new application with an eligibility
determination and is subject to the priorities in effect at the new project.
 Typically, when a participant moves from a service area, the participant terminates from the
first project and seeks to re-enroll in a new project. However, nothing prevents the project that
the participant is leaving from contacting the new project and seeing if a transfer is possible.
The new project is not obligated to accept the transfer. For example, it may not have any
positions available, or it may have higher priority applicants on its waiting list.
 When there has been a transfer of a participant (as opposed to an exit and a re-enrollment),
the first project does not have a true exit and thus does not have an outcome that is reflected in
its performance measures. The true exit occurs when the participant leaves the new project. At
that time, both projects will have the outcome reflected in their QPRs.
 The movement of authorized positions between grantees is done for a variety of purposes;
e.g., to complete a new competitive process for national grantees; to achieve equitable
distribution; to avoid disruption of service; to simplify administration when one host agency has
participants from multiple projects; or to swap positions in the same or different states to
improve efficiency. The movement of positions (as opposed to the transfer of a participant
without the movement of positions) requires the approval of both the state grantee where the
positions are located and the national office.
Participant Form-29

Participant Form Guide

Number
Topic 52

Topic 53

Rev.6 (4/19/10)

Element Name/
Topic
Transfer of
participant vs.
change of subgrantee

“Orphan exiters”:
follow-up for
participants who
exited before a
sub-grantee has
gone out of
business

Element Description/Explanation Plus Additional Comments
 The change of a sub-grantee –for an entire project or for a single participant – is neither a
transfer nor a re-enrollment. A transfer can only occur between grantees. A change of subgrantee occurs within a single grantee. SPARQ contains a utility for changing entities – either
transferring participants from one grantee to another or changing sub-grantees within a grantee.
This utility is used to change the sub-grantee for a single participant or multiple participants.
The grantee enters the codes of the donor and recipient sub-grantees into the utility. SPARQ
then moves the enrollment records from the donor sub-grantee to the recipient sub-grantee.
 The hard copy Exit Form contain a field, 6(a)(ii), for the donor sub-grantee to indicate that it
has lost a participant to the recipient sub-grantee and to record the code of the recipient subgrantee. In the WebDCS, however, this field is grayed out. Field 17a of the Participant Form,
which indicates the code of the donor sub-grantee, is generated by the change of entity utility in
SPARQ. This field is also grayed out in the WebDCS. The date of the change of sub-grantee is
not yet active in SPARQ. You should record that date in field 17a of the hard copy form.
 For changes of sub-grantee during a program year, all QPRs after the date of the change in
sub-grantee will treat participants who have been moved to a new sub-grantee as though they
have always been enrolled with the recipient sub-grantee. Although this may lead to some
inaccuracy in the performance of the new sub-grantee for the balance of the program year; the
QPR for the grantee, which is all that is used for official monitoring of performance, will be
accurate. As long as everyone understands that the QPR for the new sub-grantee includes
performance by the old sub-grantee, the new sub-grantee should not be unfairly evaluated.
 Whenever a total change of sub-grantee occurs, there may be exited participants who are still
in the follow-up period, which can last up to 15 months after the date of exit. Since these
“orphan exiters” are not active participants, the question arises as to which entity will handle
their follow-up once the old sub-grantee goes out of business.
 You cannot transfer participants who exited from a closing sub-grantee. Once an exit has
occurred for any reason, you can no longer enter a transfer into the database.
 You can, however, use the batch change of entity function in SPARQ to have the new subgrantee that is receiving all the active participants from the closing sub-grantee take
Participant Form-30

Participant Form Guide

Number

Element Name/
Topic

17a

Change of subgrantee?

Topic 54

Equal
Opportunity (EO)
information:
required
disclosures

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
responsibility for the orphan exiters as well. The easiest way for this to occur is for the receiving
sub-grantee to receive the entire database of the closing sub-grantee. At that time, the database
of the closing sub-grantee would be deregistered in SPARQ.
 You can use the change of entity function to assign the orphan exiters to one or multiple
recipient sub-grantees.
 Alternatively, the grantee itself may perform the follow-up activities for the orphan exiters.
The grantee has read/write access to the databases of all of its sub-grantees. It could perform the
follow-up and update the records of only the orphan exiters while assigning the active
participants to one or more sub-grantees. The entire database for the old sub-grantee would be
deregistered from SPARQ when the outcomes for the orphan exiters were final.
 If you let the sub-grantee go out of business and do not make arrangements for some other
entity to do the follow-up for the orphan exiters, you will lose any remaining outcome credit for
exited participants. The national office strongly discourages this option because it will
negatively affect performance at the grantee and nationwide levels.
 In the WebDCS, this field is grayed out. If the participant has changed sub-grantee, the
change of entity utility will reassign the affected participant records to the recipient sub-grantee
and will indicate in this field the code of the donor sub-grantee. (See Topic 52 above.)
 You must attempt to collect EO information – gender, ethnicity, race, and disability – from
all applicants. Before doing so, however, you must make the following disclosures:
o the disclosure of the information is voluntary
o the refusal to provide it will have no effect on any decision to provide services except
where disability may be used to establish eligibility or priority of service
o the information will be kept confidential as required by law
o the information will be used only in accordance with the law
o the information will be used for statistical purposes, and disability status will be used
to determine priority of service (and eligibility if applicant is claiming status as family
of one)
 EO information must be requested from all applicants regardless of their eligibility.
Participant Form-31

Participant Form Guide

Number

Element Name/
Topic

Topic 55
(New)

Reasonable
Accommodation

Topic 56

Storage and
confidentiality of
and access to
medical records
and disabilityrelated
information

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 All applicants should also be informed that if they have a physical or mental impairment,
they may request reasonable accommodation for the application process. If any of the host
agencies to which applicants might be assigned has an affirmative action program for persons
with disabilities, or a similar program designed to benefit persons with disabilities, applicants
should also be informed that if they have one or more disabilities and are interested in benefiting
from such programs, they should notify the staff.
 Staff should inform all participants that, if they have one or more disabilities and would like
help deciding whether to disclose their disability status to the host agency, or if they would like
staff to make such a disclosure to the host agency on their behalf; they should notify the staff.
 You can find information about reasonable accommodation at the Job Accommodation
Network web site, http://www.jan.wvu.edu. JAN, a service provided by DOL's Office of
Disability Employment Policy, provides comprehensive information on job accommodation.
 The average cost of accommodation is less than $500 so host agencies may be able and
willing to bear some or all of this cost. Grantees and sub-grantees can pay the cost of reasonable
accommodation at a host agency or an unsubsidized employer as a supportive service. However,
grantee resources for such services are extremely limited and many partners, especially
Vocational Rehabilitation, may also be willing to help.
 Medical- and disability-related records (or records related to a status such as “severely
disabled” or “frail” that might reveal a disability) must be stored separate from other documents.
DOL’s Civil Rights Center interprets this to mean not only that the records must be kept separate
from other information about an applicant or participant, but also that all medical- and disabilityrelated records as a group must be stored separate from all other files regarding applicants or
participants. Access to medical- and disability-related records, and knowledge that a particular
individual is a person with a disability, must be strictly limited, as described below.
 Knowledge of disability status may be provided only to the following individuals and only
when necessary:
o sub-grantee staff who need to know that a participant is entitled to priority of service
or a waiver of the durational limitation; or who need to make a decision about
Participant Form-32

Participant Form Guide

Number

Element Name/
Topic

Element Description/Explanation Plus Additional Comments
financial eligibility based on status as a family of one
o sub-grantee staff who need to know about the accommodation the participant will be
provided
o first aid and safety personnel, if the condition might require emergency treatment or if
the participant may need particular assistance in an emergency evacuation
o grantee staff or federal project officers who are doing monitoring or data validation
o government officials investigating compliance with EO requirements
 The circumstances under which staff may be permitted access to an individual’s underlying
medical- or disability-related documents are even more limited. For example, access to medical
documentation that a participant is entitled to status as a family of one, priority of service, or
waiver of the durational limit should be limited to those grantee or sub-grantee staff who need to
document the basis for such decisions. In addition, first aid personnel may need access to
underlying documentation related to a participant’s medical condition in an emergency.
 As a general rule, staff persons making assignments to a host agency should not have
knowledge of a participant’s disability status unless the participant has requested an
accommodation for the process of assignment, or unless the host agency has an affirmative
action or similar plan intended to benefit individuals with disabilities and the participant has
informed grantee staff that s/he is interested in taking advantage of such programs.
 The case worker may ask all applicants whether they can perform any or all job functions of
an intended host agency assignment, including whether applicants can perform job functions
"with or without reasonable accommodation." Case workers may also ask all applicants if they
can meet the attendance requirements of the community service position.
 Host agencies may not be informed that a participant has a disability unless:
o the applicant has made an independent decision to disclose the disability
o the applicant has directed the sub-grantee staff to make the disclosure on behalf of the
applicant
o the request was initiated by the participant and not by the sub-grantee staff.

Rev.6 (4/19/10)

Participant Form-33

Participant Form Guide

Number
Topic 57

Rev.6 (4/19/10)

Element Name/
Topic
SCSEP disability
status versus EO
nondiscrimination
requirements
applicable to
participants, as
well as to
applicants for
employment and
employees of subgrantees and
grantees

Element Description/Explanation Plus Additional Comments
 As recipients of federal assistance and as mandatory One-Stop partners, grantees and subgrantees are subject to the WIA non-discrimination regulations published at 29 CFR Part 37 in
their employment practices, as well as in their provision of services. Although these matters are
outside of the SCSEP performance system, grantees and sub-grantees are required to comply
with these regulations with regard to applicants for employment and employees.
 The definition of "disability" used in the nondiscrimination context – in both employment
and the provision of service – to determine who is both protected from discrimination and
entitled to positive actions, such as reasonable accommodations, is broader than the Older
Americans Act (OAA) definition of disability that is used by SCSEP for determining eligibility,
priority of service, or waiver of the durational limitation. Both definitions provide that to be
considered as having a "disability," an individual must have a physical or mental impairment
that substantially limits one or more major life activities. However, the list of activities that are
considered "major life activities" is different under each definition.
 The Supreme Court has held that under disability nondiscrimination law, a "major life
activity" is an activity that is “of central importance to daily life." Examples of such activities
include, but are not limited to, caring for one’s self; performing manual tasks; walking; seeing;
hearing; speaking; breathing; and learning.
 The OAA definition, by contrast, provides a specific, restrictive list of "major life
activities." One or more of the particular activities on this list must be "substantially limited" by
a physical or mental impairment in order for a person to be considered as having a disability for
purposes of the SCSEP program. Those activities include self-care; receptive and expressive
language; learning; mobility; self-direction; capacity for independent living; economic selfsufficiency; cognitive functioning; and emotional adjustment. The category of individuals who
qualify as having a "severe disability" under the SCSEP program is even more limited.
 In addition, disability nondiscrimination law prohibits discrimination against two categories
of persons who do not have a "physical or mental impairment that substantially limits one or
more major life activities:" those persons who have a record of having had such a disability, and
those who are regarded as having such a disability by other persons. Under disability
Participant Form-34

Participant Form Guide

Number

Element Name/
Topic

18
19

Gender
Ethnicity

20

Race

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
nondiscrimination laws, people in the "record of" and "regarded as" categories are protected
from exclusion, unlawful segregation, and other adverse actions that are based on their perceived
status as persons with disabilities. However, such laws do not mandate that people in these
categories be provided with positive actions, such as reasonable accommodations, that are
designed to help people with actual, current disabilities compete on an equal basis despite their
substantially limiting impairments.
 See http://www.dol.gov/oasam/programs/crc/WIASection188DisabilityChecklist.htm for
information on the WIA nondiscrimination regulations regarding individuals with disabilities.
See also these CRC sites, http://www.dol.gov/oasam/programs/crc/crcwelcome.htm and
http://www.dol.gov/oasam/programs/crc/dElement5Intro.ppt, for much helpful information.
 Gender, like all other EO information, is voluntary and is self-reported.
 Record “yes” if the individual is a person of Cuban, Mexican, Puerto Rican, South- or
Central-American, or other Spanish culture in origin, regardless of race.
 Applicants must be informed that this information is voluntary and that the refusal to provide
it will have no effect on any decision to provide services to them.
 Previously, ethnicity and race were often combined. This is no longer allowable. The
question about ethnicity must be asked before the question on race.
 Check the appropriate box(es). More than one box may be checked for a single participant:
o American Indian/Alaskan Native
A person having origins in any of the original peoples of North and South America
(including Central America), and who maintains tribal affiliation or community
attachment.
o Asian
A person having origins in any of the original peoples of the Far East, Southeast Asia, or
the Indian Subcontinent (e.g., India, Pakistan, Bangladesh, Sri Lanka, Nepal, Sikkim,
and Bhutan). This area includes, for example, Cambodia, China, Japan, Korea,
Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

Participant Form-35

Participant Form Guide

Number

21

22

Rev.6 (4/19/10)

Element Name/
Topic

Element Description/Explanation Plus Additional Comments

o Black/African American
A person having origins in any of the black racial groups of Africa.
o Native Hawaiian/Pacific Islander
A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other
Pacific Islands.
o White
A person having origins in any of the original peoples of Europe, the Middle East, or
North Africa.
o Did not voluntarily report
Use this field for an applicant who did not select any of the above racial categories.
 Applicants must be informed that this information is voluntary and that the refusal to provide
it will have no effect on any decision to provide services to them.
Education
 Enter the appropriate code that corresponds with the participant’s highest level of education.
Enter only one code for each participant. For those with 1-11 years of school, enter the single
number that corresponds to the highest grade completed. For example, for someone who has
completed the tenth grade, enter 10. The WebDCS has a drop-down menu containing all the
valid values.
 Codes 13 to 15 include college or full-time technical or vocational school. Codes 13 to 15
should not be used for individuals who are not high school graduates or do not have a GED.
Enter the single number that corresponds to the number of years of college completed. For
example, 14 = two years of college completed.
 Note: Individuals who completed 12th grade but did not receive a diploma or equivalent
should be coded A11.
 This field should not be updated once the participant has been enrolled. Grantees must use
other ways, like the IEP, to document the attainment of higher levels of education by the
participant.
Limited English
 Check “yes” if the participant cannot speak or read English well enough to fully participate
Proficiency (LEP) in all aspects of the program.
Participant Form-36

Participant Form Guide

Number

Element Name/
Topic

23

If LEP, please
specify primary
language

Topic 58

Interpreters,
translation, and
other services for
LEP participants

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 There is no substantive change in the definition. An LEP individual is one who does not
speak English as his or her primary language and who has a limited ability to read, speak, write,
or understand English. If you are in doubt, ask the participant.
 Sub-grantees should use this information to provide language assistance to the participant. It
may also be used to send the customer satisfaction survey in the participant’s primary language.
 This priority of service is counted in the most-in-need measure. Data validation is required
for this element.
 If the participant is identified as LEP, it is necessary to specify the participant’s primary
language. This can be determined by asking the participant what language is primarily spoken at
home or what language the participant primarily speaks with friends and family.
 If the participant’s language is not on the list, select “other” and record the language. If the
participant speaks a dialect of a listed language, use the comments field to record the dialect.
 WebDCS will not let you select a language unless you have indicated “yes” in field 22.
Non-WebDCS users should only use this field for participants identified as LEP.
 As recipients of federal grant money, grantees and sub-grantees are subject to Title VI of the
Civil Rights Act. Title VI requires that LEP participants have meaningful access to all federally
funded programs. You are required to identify LEP participants and to have a plan for
communicating with them about the essential features of the program.
 Providing an interpreter is usually the preferred method, but you may also provide written
translations of critical documents. If the need for interpreter services in a particular language is
small, you do not need in-house capacity to communicate with the LEP participants on demand.
However, you should arrange with another community organization or a professional interpreter
service (there are several that operate over the telephone) to provide timely and meaningful
assistance to all LEP participants.
 To address the participant's long-term needs, you should review the participant's IEP and
consider whether the participant would benefit from English as a Second Language (ESL)
classes and a host agency assignment where language skills could be worked on. If part of an
IEP and the grant agreement, ESL classes are an allowable expense, and the participant may be
Participant Form-37

Participant Form Guide

Number

Element Name/
Topic

24
(Revised)

Low literacy
skills?

Topic 59
(New)

Lack of computer
skills and low
literacy skills

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
paid wages while attending these classes.
 The label has changed but there is no substantive change in the definition.
 Check “yes” if the participant calculates or solves problems, reads, writes, or speaks English
at or below the 8th grade level or is unable to compute or solve problems, read, write, or speak at
a level necessary to function on the job, in the individual’s family, or in society.
 The field for low literacy skills does not apply to participants who are LEP.
 Asking the participant about literacy is likely to embarrass the participant and is unlikely to
produce accurate information. As part of the IEP, you may wish to test all participants who have
less than some college education. Standard tests include Test of Adult Basic Education (TABE),
Adult Basic Learning Exam (ABLE), and Test of Applied Literacy Skills (TALS). Your local
One-Stop center can administer any of these tests for you. You should not design your own test.
 This priority of service is counted in the most-in-need measure. Data validation is required
for this element.
 The lack of computer skills does not fit within the definition of low literacy skills for the
most-in-need measure. However, it could be a basis for identifying some participants as having
low employment prospects depending on their education, background, skills, and employment
capability/interests.
 It requires a case-by-case determination whether lack of computer skills is a significant
barrier to employment that makes it unlikely the individual will obtain employment without
enrollment in SCSEP or another employment and training program. Not all the jobs participants
desire or secure require computer skills, so lack of computer skills would not constitute low
employment prospects for everyone.

Participant Form-38

Participant Form Guide

Number
25
(Revised)

Rev.6 (4/19/10)

Element Name/
Topic
Veteran (or
eligible spouse of
veteran)?

Element Description/Explanation Plus Additional Comments
 Enter (a) if the individual is a person who served in the active U.S. military, naval, or air
service and who was discharged or released from such service under conditions other than
dishonorable. Active service includes full-time duty in the National Guard or a Reserve
component, other than full-time duty for training purposes.
 Enter (b) if the individual is the spouse of any of the following
o any veteran who died of a service-connected disability
o any member of the Armed Forces serving on active duty who, at the time of
application for the priority, is listed in one or more of the following categories and has
been so listed for a total of more than 90 days: (i) missing in action; (ii) captured in
line of duty by a hostile force; or (iii) forcibly detained or interned in line of duty by a
foreign government or power
o any veteran who has a total disability resulting from a service-connected disability, as
evaluated by the Department of Veterans Affairs; or
o any veteran who died while a disability was in existence
 Enter (c) if neither (a) nor (b) applies
 Documentation is required. Grantees must verify the status of an individual as a veteran or
eligible spouse at the time of eligibility determination and subsequent enrollment in SCSEP.
Eligibility can be verified using a variety of official documents, including, but not limited to:
o a DD 214 (issued following separation from active duty);
o an official notice issued by the VA that establishes entitlement to a disability rating
or award of compensation to a qualified dependent; or
o an official notice issued by a State veterans’ service agency that acknowledges
veterans’ status or spousal rights.
 To mitigate the burden of establishing proof-of-covered-person status, grantees also may
establish other means for verifying status, such as electronic communication with official
databases such as those maintained by State Veterans’ service agencies, or property tax
exemption databases in states that grant exemptions to certain types of veterans or other covered
Participant Form-39

Participant Form Guide

Number

26
(Revised)

Rev.6 (4/19/10)

Element Name/
Topic

Disability?

Element Description/Explanation Plus Additional Comments
persons.
 See TEGL 10-09 and the accompanying guidance, SCSEP and Veterans’ Priority of
Service, for complete information about grantees’ obligations under the Job for Veterans
Act.
 This priority of service is counted in the most-in-need measure. Data validation is required
for this element.
 The regulations define “disability” as: a condition attributable to mental or physical
impairment, or a combination of mental and physical impairments, that results in substantial
functional limitations in one or more of the following areas of major life activity: (A) self-care;
(B) receptive and expressive language; (C) learning; (D) mobility; (E) self-direction; (F)
capacity for independent living; (G) economic self-sufficiency; (H) cognitive functioning; and
(I) emotional adjustment.
 Check “yes” only if the participant actually is impaired at the time of enrollment. We do not
count as disabled an individual who merely has a history of impairment or is regarded as being
impaired. The individual must have the impairment currently.
 Applicants must be informed that this information is voluntary and that the refusal to provide
their disability status or to produce documentation will have no effect on any decision to provide
services to them.
 Documentation is required if the applicant is claiming status as a family of one due to
disability.
 Data validation is also required if this element is used for the most-in need measure.
Because disability is an EO item, a participant may self-report and decline to provide
documentation. In that case, you will check the box for “Yes, self-report,” and you will not
receive most-in-need credit.
 The data validation requirement in no way prevents grantees from recruiting or enrolling
disabled participants. Indeed, the OAA requires grantees to give disabled participants priority of
service. You must still allow participants to self-attest to disability, and you may not require
them to provide documentation. The validation requirement only means that you will not get
Participant Form-40

Participant Form Guide

Number

Element Name/
Topic

27

At risk for
homelessness

28

Displaced
homemaker?

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
credit for the most-in-need measure if you do not obtain documentation.
 For disability to count for the most-in-need measure or to establish status as a family of one,
there must be medical documentation that meets the regulatory definition. If there has not been
an official determination of disability, you may use a doctor's statement that satisfies the criteria:
1) a mental or physical impairment (or combination of impairments); 2) that results in
substantial functional limitation; 3) in one or more of the nine listed areas of major life activity.
The doctor does not have to use the word "disability," but the statement must cover all three
aspects of the definition. Grantees are not allowed to use their own judgment about whether a
medical impairment exists and whether it substantially limits functioning in one of the areas.
 Social Security Disability, where there are objective standards and a formal medical
determination, is sufficient to establish disability. A DMV disability card or parking sticker by
itself would not qualify unless the standard that is applied to issue the card meets the SCSEP
standard. In many states, parking stickers for handicapped parking are provided for reasons that
fall short of the regulatory definition of disability.
 Being at risk for homelessness is considered along with actual homelessness (field 8) as a
single priority for service and a single factor for the most-in-need measure. An individual may
be either at risk for homelessness or homeless, but not both at once.
 At risk for homelessness means an individual is likely to become homeless and the
individual lacks the resources and support networks needed to obtain housing. The risk must be
real and imminent. In some sense, anyone living below the poverty level may be at risk of
homelessness. This field requires a more specific and identifiable risk than just low income.
 Data validation is required for this element.
 A displaced homemaker is an individual who has been providing unpaid services to family
members in the home and who: (1) has been dependent on the income of another family
member but is no longer supported by that income; and (2) is unemployed or underemployed
(involuntarily working fewer hours than the individual desires to work) and is experiencing
difficulty in obtaining or upgrading employment.
 A displaced homemaker will nearly always have low employment history as well.
Participant Form-41

Participant Form Guide

Number
29

Element Name/
Topic
Failed to find
employment after
using WIA Title I

30
(Revised)

Low employment
prospects?

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 Record “yes” if the participant was enrolled in WIA Title I (adult services) prior to enrolling
in SCSEP and was unable to obtain employment before enrolling in SCSEP. If the participant
reports having used the One-Stop system, you must call the WIA provider to determine whether
the participant was actually enrolled in WIA. Mere registration by or use of the One-Stop center
does not constitute registration in WIA.
 This priority of service is counted in the most-in-need measure. Data validation is required
for this element. WIA enrollment may be documented by a case note regarding the call to the
One-Stop center. You may accept signed self-attestation as to the lack of employment.
 Check “yes” if the participant’s employment prospects are low. Low employment prospects
means the likelihood that an individual will not obtain employment without the assistance of
SCSEP or another workforce development program. Persons with low employment prospects
have a significant barrier to employment. Significant barriers to employment may include, but
are not limited to: lacking a substantial employment history, basic skills, and/or Englishlanguage proficiency; lacking a high school diploma or the equivalent; having a disability; being
homeless; or residing in socially and economically isolated rural or urban areas where
employment opportunities are limited.
 A participant with low employment prospects is unlikely to find employment without the
assistance of SCSEP or some other employment and training program. The definition requires
the participant to have at least one significant barrier to employment. The sub-grantee must
identify in a case note which barrier to employment is being relied on and must state how that
barrier renders the participant unlikely to find employment. In some cases, that connection will
be obvious and will require little explanation. In other cases, additional facts may be necessary.
 Lack of a high school degree or its equivalent may be sufficient to establish low employment
prospects, but the determination is not automatic. Lack of a high school degree is listed as a
characteristic that may constitute a significant barrier to employment. Whether it does in any
given case will depend upon several other factors, including the participant's skills and
employment history. For example, if the participant has a work history as a skilled trades
Participant Form-42

Participant Form Guide

Number

Topic 60
(New)

Rev.6 (4/19/10)

Element Name/
Topic

Low employment
prospects due to
"residing in
socially or
economically
isolated rural or
urban area where
employment
opportunities are
limited"

Element Description/Explanation Plus Additional Comments
person, lack of a high school degree by itself would not usually be a significant barrier to
reemployment. On the other hand, if the participant had no marketable skills or a history of only
low-paying, unskilled work, the lack of a high school degree could mean that the participant had
low employment prospects.
 Many barriers, like prior felony convictions, transgender, personal hygiene issues, and
phobias, may support a determination of low employment prospects. Having been a past victim
of age discrimination, however, is not itself a barrier. Nor, given the nature of our program, can
age itself be a barrier for purposes of this measure. Inability to lift weight, which is not unusual
for many older workers, might be a barrier to employment if the participant's only skills and
employment history involved physical labor. However, if the participant were capable of
sedentary work that did not involve lifting, then this restriction would probably not constitute a
significant barrier for purposes of the measure.
 Some, but not all, of these characteristics are captured on the application form. If relevant,
you will have to ask the applicant about other characteristics that might fit the definition of poor
employment history or prospects.
 This priority of service is counted in the most-in-need measure. Data validation is required
for this element.
 There is no definition for this particular barrier to employment. However, the general rules
for low employment prospects apply.
 For social or economic isolation, the case note must contain sufficient facts to establish both
that the area in which the participant resides is socially or economically isolated and that
employment opportunities are limited in that area. Isolation in a rural area should be relatively
easy to document. Isolation in an urban area may turn on whether there is a social infrastructure
in the area (civic organizations, churches, government offices, etc), whether there is
transportation, and whether there is normal commercial and economic activity (stores,
businesses, or industry).
 The area in which the participant resides may depend upon the transportation options
available to the participant and normal commuting patterns. For a city with good public
Participant Form-43

Participant Form Guide

Number

Element Name/
Topic

31

Personal
characteristics
comments

32

Signature of
applicant

33

Date of signing

34

Eligibility
determination

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
transportation, the area could be the city or even surrounding towns. For one with no or very
poor transportation, the area might be much more limited. The unemployment rate for the area
could be used to establish that employment opportunities are limited there compared to less
isolated areas. If there is no official unemployment rate for the area, you will need to determine
whether the number of non-profit, government, and private sector entities in the area is
insufficient to provide jobs for all residents of the area who want employment.
 As with many of the barriers to employment, you will need to develop the facts as best you
can and use your judgment. As long as the case note contains the facts upon which you rely and
you apply the correct factors, there should be no problem.
 Use this field to enter any relevant comments on the application. You will be able to enter as
many as 1000 characters (about 160 words) into the database.
 You may enter into this field additional contact information such as cell phone number,
e-mail address, or an emergency contact person.
 Make sure the applicant reads and understands the certification. Intentional falsification of
eligibility information requires immediate removal from the program. The applicant’s signature
appears on the hard copy form only. It must be retained in the file.
 Under the circumstances described in Topic 40 above, you do not have to obtain a signature
from an ineligible applicant who you are sure will not contest your eligibility determination.
 Enter the date on which the applicant signed the certification of the accuracy of the eligibility
information for the original enrollment or re-enrollment.
 Do not use this field for recording the date of the eligibility determination at recertification.
All recertification data are entered in fields 44-51. Field 33 will always reflect the date on which
the participant signed the original certification. Do not overwrite this field.
 Check the appropriate box to indicate whether the applicant is eligible or ineligible.
 Do not use this field for recording the eligibility determination at recertification. All
recertification data are entered in fields 44-51. Field 34 will always reflect the eligibility
determination at the time of initial enrollment. Do not overwrite this field.
 Sub-grantees are required to take an application from any individual who indicates a desire
Participant Form-44

Participant Form Guide

Number

Topic 61
(New)

Topic 62
(New)

Rev.6 (4/19/10)

Element Name/
Topic

Element Description/Explanation Plus Additional Comments

to apply, even if they believe the individual is ineligible. Sub-grantees need not take
applications from those who merely inquire about the eligibility requirements of the program.
 The regulations provide than an individual who is determined ineligible has the right to
appeal that determination. If the determination is not made formally and documented in an
application, the right of appeal may be meaningless.
Over-enrollment
 Responsible over-enrollment is a routine and expected practice in order to ensure that the
and conditional or normal delays in filling vacancies or participants on approved breaks in participation do not
temporary
cause grantees to under-spend their grants. Since SPARQ was implemented, SCSEP has not had
eligibility
"temporary" positions. All participants are equal, and any durational limit must be applied
equally to all participants in a grant. Therefore, there is no legal authority for treating overenrolled participants as temps who have less right to service than everyone else. When a grantee
over-enrolls, it is expected to know what it is doing and to manage its grant so as to avoid any
dislocation of participants.
 The Recovery Act grant required a disclaimer about termination for lack of funding because
the program was scheduled to end on June 30, 2010, and there was no guarantee of continued
funding. The regular program is different because there is continuing funding each year.
Grantees routinely over-enroll. However, they must do so based on their ability to manage case
flow. They must manage their regular grant to have sufficient exits occurring so that the overenrolled participants are not in danger of being terminated prematurely.
Grantee eligibility  Grantees cannot have eligibility requirements beyond those authorized in the statute. On a
requirements
case-by-case basis, grantees can deny enrollment to someone who refuses to comply with
program requirements. Grantees cannot use past behavior alone as a basis for denial nor can
they impose blanket rules to disqualify applicants without making individualized determinations.
 The Department has previously determined that grantees cannot deny eligibility to someone
who does not have a driver's license and an acceptable level of automobile insurance. It has also
determined that a grantee cannot require a background check of all applicants as a condition of
eligibility. Such issues may determine where participants are assigned, but they cannot be used
to determine eligibility.
Participant Form-45

Participant Form Guide

Number
Topic 63
(New)

Rev.6 (4/19/10)

Element Name/
Topic
Psychological
testing at
enrollment or reenrollment of
participant
believing to be
acting erratically
or disruptively

Element Description/Explanation Plus Additional Comments
 It is neither appropriate nor lawful to request a psychological evaluation of an individual
believed to be acting erratically or disruptively. The same legal limitations on disability-related
inquiries and medical examinations apply to the re-enrollment process as to the original
application process. Therefore, SCSEP may require a psychological evaluation or psychiatric
examination of an applicant or former participant seeking re-enrollment only after he or she has
been extended a conditional offer of (re-)enrollment, and only if all other similarly-situated
participants are subjected to the same evaluation or examination at the same point in the process.
(Note that in the limited circumstances in which an evaluation or examination is permitted, the
program must pay for the evaluation or examination and cannot shift the cost to the former
participant.)
 An applicant’s erratic or disruptive behavior during the application process in and of itself
may provide sufficient basis for declining to enroll her. For those seeking re-enrollment, it is
entirely appropriate to consider past performance as long as you do so uniformly for all those
seeking re-enrollment.
 Re-enrollment is discretionary. Grantees are not required to provide anyone a second
opportunity to participate in SCSEP, especially when there are so many eligible seniors who
have never had the benefit of the program. In deciding whether to exercise their discretion to reenroll any former participant who otherwise satisfies the eligibility criteria (including the
requirement that the individual needs additional time in a community service assignment in
order to become job-ready), grantees should consider whether the individual:
o has taken full advantage of the opportunity afforded by the prior enrollment
o has demonstrated a commitment to the program's objectives
o has violated any conduct standards during the prior enrollment.
 Focusing exclusively on these considerations, which permit the program to take into account
the participant's behavior during the prior enrollment and the circumstances of her leaving the
program, is likely to protect the interests of the SCSEP program without violating either the law
or the participant’s rights. To ensure that these considerations are not used in a discriminatory
fashion, they should be applied in all cases in which a former participant seeks re-enrollment.
Participant Form-46

Participant Form Guide

Number
Topic 64
(New)

Topic 65

Rev.6 (4/19/10)

Element Name/
Topic
Background
checks

Why must
applicants be
unemployed at
time of eligibility
determination?

Element Description/Explanation Plus Additional Comments
 Background checks cannot be used to determine eligibility for SCSEP. Background checks
may be required by state law before you can assign participants to certain jobs. Grantees need to
determine the law in the state in which they are operating. States may also have laws prohibiting
discrimination against individuals based on past criminal behavior so grantees must proceed
carefully.
 If a participant is prohibited from working in a particular job because of a state barrier law,
grantees must attempt to find a community service position for which the participant's criminal
record will not be an issue.
 There is no simple answer about liability. It depends on the circumstances of each case and
on the laws of the state in which the grantee is operating. Grantees should consult an attorney
before taking any action in this area. Grantees may also want to contact organizations that work
with ex-offenders to get a broader understanding of how the issue is dealt with in a particular
state. There are federal and state bonding programs for ex-offenders.
 Although a background check is a permissible grantee expense, some grantees require host
agencies to take full responsibility for any required background checks or refuse to work with
host agencies that require background checks.
 Section 502(a)(1) of the Older Americans Act defines the purpose of SCSEP as:
To foster individual economic self-sufficiency and promote useful opportunities in
community service activities (which shall include community service employment)
for unemployed low-income persons who are age 55 or older, particularly persons
who have poor employment prospects, and to increase the number of persons who
may enjoy the benefits of unsubsidized employment in both the public and private
sectors.
 Employed and recently laid off applicants are presumed to be job-ready and thus ineligible
for SCSEP. SCSEP is solely for those applicants who need community service in order to
become job-ready. Job-ready applicants should be referred to the One-Stop center.

Participant Form-47

Participant Form Guide

Number
Topic 66
(Revised)

Rev.6 (4/19/10)

Element Name/
Topic
What constitutes
employment?

Element Description/Explanation Plus Additional Comments
 The no-employment rule does not apply to casual, non-recurring labor. The 2006
amendments to the OAA did not change the rule regarding unemployment. A participant must
be unemployed at the time of enrollment and must remain unemployed while enrolled.
Regularly working part-time, no matter how little, is not permitted. The amendments codify the
definition of unemployed and make clear that someone who has occasional, irregular work is not
employed for SCSEP eligibility purposes. For example, if a participant occasionally tends to a
neighbor’s garden or occasionally baby-sits for a friend’s child and receives payment, that would
not constitute disqualifying employment unless the participant were regularly engaged in the
business of landscaping or providing child care and received a regular income. Working at the
polls at an election would be occasional employment resulting in non-regular income.
 Furthermore, even for regularly performed labor, such as maintenance of an apartment
complex in exchange for free rent, as long as the applicant receives no cash for the work, the
arrangement does not constitute employment for purposes of SCSEP eligibility. If the applicant
becomes a participant, he or she may continue this arrangement while enrolled, assuming it does
not interfere with the community service or job search activity. In addition, the in-kind payment
received (the value of his rent) is not considered includable income under TEGL 12-06.
 Whenever a participant has done any work within the last year or two of enrolling, whether it
constitutes employment or not, there may be a question whether the applicant is job-ready. A
recent work history creates a presumption that the applicant is job-ready and thus does not need
community service. This presumption may not apply if the participant has had only very limited
work experience or if the applicant’s personal circumstances render him or her no longer jobready. Job-ready applicants should be determined ineligible and referred to a One-Stop center.
 On the other hand, the receipt of a “stipend” from a non-profit organization for performing
regular duties in a social services program is employment, and the “stipend” constitutes wages.
Calling wages a stipend does not change their nature; nor does it matter that the work is
performed for a non-profit or government organization. Regular employment by a social service
program renders an applicant employed and thus ineligible. Active service in the Armed Forces,
Participant Form-48

Participant Form Guide

Number

Topic 67
(New)

Rev.6 (4/19/10)

Element Name/
Topic

Employment vs.
investment
income

Element Description/Explanation Plus Additional Comments
including the National Guard, is also employment (although the pay received is not includable in
income for eligibility purposes.
 Participation in the Foster Grandparent Program (FGP), the Senior Companion Program
(SCP), the Senior Demonstration Programs (SDP), and the Retired and Senior Volunteer
Program (RSVP) is not considered employment. These programs are all funded by the Senior
Corps of the Corporation for National and Community Services. The authorizing legislation, the
Domestic Volunteer Service Act, establishes these programs and VISTA as volunteer service,
not employment, and further provides that the stipend paid to participants in these programs
should not be considered income from employment. Therefore, you do not consider participants
in these programs to be employed; and you do not include any stipend paid by these programs
when determining income for purposes of SCSEP eligibility.
 In situations where the participant is receiving income from leasing commercial or
residential property, the key is deciding whether there is employment at all before determining
whether the income is constant. In many circumstances, the participant may be receiving
payment for the use of his or her property, and any labor the participants performs would be
incidental labor associated with the maintenance of a trivial sideline activity.
 It is often hard to distinguish between active self-employment and passive income from the
lease of an asset. Usually, any leasing requires some degree of administrative labor. For
example, if the participant had an apartment on her property that she leased out, she would have
to clean it between rentals, maintain the books, pay the utilities, arrange for repairs, and maybe
paint it occasionally. That occasional labor would not be considered self-employment, but the
rent for an apartment would be quite regular and frequent.
 However, it can often be a close call. Someone who regularly invested in real estate and
managed her own buildings would be considered self-employed and not just a passive lessor.
Sometimes the degree of activity involved is the deciding factor. These cases really turn on the
particular facts, so it is important to understand the situation fully before you try to apply the
general rule.

Participant Form-49

Participant Form Guide

Number
Topic 68

Topic 69

Topic70

Rev.6 (4/19/10)

Element Name/
Topic
Exiting
participants who
start employment
while enrolled

Element Description/Explanation Plus Additional Comments

 The rules regarding employment of participants are clear: No participant may begin a job
while enrolled in SCSEP. A participant who does so must be exited for unsubsidized
employment. Grantees’ rules and procedures should explicitly spell out this eligibility
requirement, and all participants should be informed in writing at the time of enrollment.
Grantees should also ensure that all host agency agreements include a provision that requires the
host agency to acknowledge this requirement and to inform the grantee of any violations.
 When you are informed that a participant has commenced, or is about to commence,
unsubsidized employment, you should follow your normal procedures to exit the participant.
Normally, the last day in the program would be the day before unsubsidized employment
commences. If you learn of the employment after it has commenced, you must immediately exit
the participant.
 You complete an unsubsidized employment form for the participant regardless of how or
when you learned of the employment. The start work date (field 14 of the UE Form) must be
after the date of exit from the program. (By definition, unsubsidized employment for purposes
of SCSEP placement can only exist after the participant has left the program.) In cases where
you learn of the employment after it has commenced, the start work date must be the day after
exit, not the actual date on which the participant began the employment.
Can participants
 Participants may not work any hours at all in unsubsidized employment (except for
work limited part- occasional and casual employment, such as babysitting a neighbor’s child) while they are
time hours while
enrolled in the program. You may, however, use an OJE to structure a transition to unsubsidized
they move
employment. See Topic 43 of the Community Service Assignment Form.
transition to
employment?
Effect of
 There is a difference between applicants and participants with regard to temporary and ontemporary or on- call work. An applicant must be unemployed at the time of enrollment. An applicant who has
call work on
been listed with a temp agency (or working on-call, e.g., as a substitute teacher) may establish
SCSEP eligibility that he or she is no longer actively seeking work with the agency or employer and thus is no
Participant Form-50

Participant Form Guide

Number

Element Name/
Topic

Topic 71
(New)

Temporary
employment as
Census
enumerator

35

If ineligible,
reason

36

If ineligible,
action taken

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
longer employed. Assuming the applicant meets the other eligibility requirements, the applicant
can be enrolled. However, the amount and type of temp work the applicant has done will be
critical factors in determining whether the applicant is job-ready and thus eligible for enrollment.
A recent work history creates a presumption that the applicant is job-ready and does not need
community service. This presumption may not apply if the participant has had only very limited
work experience or if the applicant’s personal circumstances render him or her no longer jobready. Job-ready applicants should be determined ineligible and referred to a One-Stop center.
See Topic 66, above.
 Once an applicant has been enrolled and is a participant, the individual cannot engage in any
employment. (See Topics 68 and 69 of the Participant Form Guide) Although occasional,
irregular work does not render a participant employed (see Topic 49), registering with a temp
agency or signing up with an employer for on-call work is not compatible with being
unemployed and not job-ready. Therefore, it is not permitted while the participant is enrolled.
 Anyone who becomes employed, even in a temporary position, must be exited from the
program. You cannot re-enroll these participants after their employment ends unless they still
require community service training in order to become job-ready. If they have been employed
more than 30 days, they would generally be presumed to be job-ready and would not be entitled
to re-enrollment. If you determine that they are not job-ready, you should fully document the
reason in their case files.
 If the applicant is ineligible, you must check the appropriate box or boxes to indicate why.
Do not update this field at the time of recertification.
 If the applicant is employed at the time of the eligibility determination, check “other” and
enter “employed.”
 You may also use the comment section in field 41 to enter additional information.
 If the applicant is ineligible, you must check the appropriate box(es) to indicate what, if any,
action was taken on behalf of the applicant. If “other” is checked, specify the action. If no
action was taken, check “none.” Do not update this field at the time of recertification.
 Sub-grantees may not conduct placement activity for ineligible applicants unless the
Participant Form-51

Participant Form Guide

Number

Element Name/
Topic

37

Placed on waiting
list?

Topic 72
(Revised)

Responsibility to
applicants placed
on the waiting list

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
placement is done as a One-Stop partner pursuant to an MOU. They may, however, refer
ineligible applicants to a One-Stop or to other appropriate service provider without limitation.
Such activity on behalf of ineligible applicants may be conducted by permanent sub-grantee staff
or by participants assigned to the sub-grantee’s office.
 If the applicant is eligible but there were no authorized positions available or there were no
suitable community assignments available, you must check “yes.”
 If a community service assignment is available but administrative processing causes a delay
of 14 or fewer days, check “no.”
 Once you have coded your answer to this question, do not change it. When you assign
someone who is on the waiting list to community service, you create an assignment for the
individual just as you would for any other eligible applicant. Do not change the answer to “no.”
If you change the indicator, there will be no way to tell how many participants have been placed
on the waiting list. If you want to see how many applicants are currently on the waiting list, you
can use the Waiting List management report. It will only display those individuals who have not
been assigned to community service as of the date the report is run.
 If an applicant on the waiting list decides not to continue waiting for an assignment, you
close your record by checking box 6a(i) on the Exit Form. Again, you do not change the waiting
list indicator to “no” when the applicant withdraws.
 An applicant may remain on the waiting list as long as he or she is interested in an
assignment and meets the eligibility requirements. However, it is not fair to the applicant or
helpful to the program to let applicants languish on the waiting list for an excessive period. You
should be in touch with waiting list applicants regularly to find out if they are still interested in
the program and to give them an update on when they might be enrolled. If there is no real
prospect of an opening, the participant might decide to withdraw or explore some other program.
The choice remains the applicant’s; you should not force someone off the waiting list.
 The confirmation of the eligibility of applicants on the waiting list should be done informally
and for the benefit of the applicant. An eligibility determination is good for 12 months, barring
a substantial change in circumstance. (See Topic 83.) Furthermore, an applicant who is overParticipant Form-52

Participant Form Guide

Number

Element Name/
Topic

38

Community
service
assignment?

Topic 73

Are participants
employees of the
sub-grantee?

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
income at some point while on the waiting list may not be over-income when an opening is
available. However, if an applicant has become over-income and is approaching 12 months
since the eligibility determination, an applicant is entitled to know that any assignment would be
short-lived and that the first recertification would result in termination from the program. Given
that information, the applicant might decide to withdraw from the waiting list.
 Although you are normally not required to redo or update the Participant Form for eligibility
purposes, you should update the rest of the form, especially the barriers to employment because
you will need that information for making an appropriate assignment,and because the priorities
of service must reflect the participant's situation at the time of enrollment.
 If there has been a change in any of the characteristics that are subject to data validation, you
will need appropriate documentation. Since the Participant Form is filled out by the case
worker, you should not otherwise need the participant to initial or sign anything. If you do want
the participant to update any forms you use, you can have the participant re-date and re-sign the
forms and initial any changes from the original as long as a validator or monitor can easily tell
what has occurred. If there is any ambiguity, it is better to complete a second form and keep
both forms in the file.
 No applicant can receive SCSEP services or wages until assigned to community service.
(The applicant need not actually begin the community service assignment before receiving
services such as training or orientation, but must be assigned to a legitimate position.)
 When the applicant is assigned to community service, you must complete a Community
Service Assignment Form. At that time, the applicant becomes a participant.
 For WebDCS users, it will be necessary to close the Participant Form and add a Community
Service Assignment to start this process.
 Whether participants are considered employees of the sub-grantee or the host agency is a
matter of state law. The regulations provide that participants are not federal employees but do
not take a position on whether they might be considered employees of some other entity.
grantees must consult with the appropriate state authorities, such as the attorney general or the
Department of Labor.
Participant Form-53

Participant Form Guide

Number
Topic 74

Rev.6 (4/19/10)

Element Name/
Topic
Are participants
entitled to
unemployment
compensation
benefits?

Element Description/Explanation Plus Additional Comments
 Section 641.565(b)(4) of the SCSEP regulations provides that grantees may not pay the cost
of unemployment insurance for participants unless required by law. Federal law, Section
3309(b)(5) of FUTA, excludes from mandatory UI coverage any service “as part of an
unemployment work-relief or work-training program assisted or financed in whole or in part by
any Federal agency or an agency of a State or political subdivision thereof, by an individual
receiving such work relief or work training.” SCSEP qualifies for this exemption. However,
states are free to extend coverage to such programs, and a few states do so. If your state is
among them, the regulation permits you to use SCSEP funds to meet your UI tax obligation.
 There are two separate issues regarding UI benefits for participants. Former participants
who are collecting UI benefits may or may not be receiving benefits based upon their
participation in SCSEP. Depending upon when they last worked in covered employment and
when they were enrolled in SCSEP, their UI benefits may be based on their prior employment
and not on their SCSEP participation. Current participants collecting UI are probably collecting
on the basis of prior employment, not current SCSEP enrollment. Federal law provides that a UI
claimant who is otherwise eligible for benefits cannot be denied benefits because he or she is
currently enrolled in an approved job training program.
 You should contact your state UI agency to learn what the law is in your state and which
wage credits were used to establish UI claims for SCSEP participants. If the wage credits came
from prior employment, you have no tax liability. If the wage credits came from SCSEP
participation, then you should discuss with the UI officials whether there is a basis under state
law for exempting participants from coverage because they are trainees under a job training
program and not employees. (You may also wish to confer with other state and national subgrantees in your state. UI determinations are sometimes inconsistent, especially for issues that
seldom occur. Another sub-grantee may have gotten a different result.) You have the right to
appeal any adverse determination made by the UI agency. If you are unsuccessful, you should
discuss with the UI officials the options you have to minimize your tax burden.
 You can use this link to find the UI agency for your state:
http://workforcesecurity.doleta.gov/map.asp.
Participant Form-54

Participant Form Guide

Number

Element Name/
Topic

Topic 75
(New)

How do SCSEP
wages affect
unemployment
compensation
benefits

Topic 76

Are participants
covered by the
Family Medical
leave Act
(FMLA?)

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 There is one final issue. If participants had recent work in an employment relationship prior
to applying for SCSEP, they may well have been job-ready. Job-ready applicants are not
eligible for SCSEP and should be referred to a One-Stop center. If job-ready participants were
enrolled, their IEPs should reflect the goal of unsubsidized employment as soon as possible.
 Many state unemployment laws permit an unemployment compensation recipient to work
part-time and receive a reduced unemployment compensation benefit. Unemployment laws also
permit a participant to be enrolled in an approved training program without jeopardizing his or
her unemployment compensation benefits.
 UI recipients are required to report all earnings to the unemployment compensation
department. Failure to do so may be considered fraud and will certainly result in an
overpayment if state law requires a reduction in UI benefits based on SCSEP wages. All
participants receiving UI benefits should be told to report their SCSEP participation and wages
to the unemployment compensation department at the time of enrollment.
 You need to check with the state unemployment department to see what rules they are
applying and whether they understand that SCSEP participants are trainees and should not be
considered employed.
 Whether participants are covered by the FMLA or any other state or federal workerprotection or labor law depends on whether they are considered employees of either the subgrantee or host agency. The SCSEP statute and regulations state that participants are not federal
employees; however, whether they are state employees depends on state law. See Topic 71. In
most states, participants in an employment and training program are not considered employees,
but in a few states participants are considered employees.
 Grantees have been advised to check with the appropriate state authorities, such as the
Attorney General or state Department of Labor, to determine how SCSEP participants are
treated in their state. This is a matter that can have very serious consequences if the grantee does
not comply with state law.

Participant Form-55

Participant Form Guide

Number
Topic 77

Element Name/
Topic
Garnishment of
SCSEP wages

Topic 78
(Revised)

Effect of SCSEP
wages on
Supplemental
Nutrition
Assistance
Program (SNAP),
federal housing
programs,
Medicaid and
other programs

Topic 79
(Revised)

Permissible
activities prior to
assignment

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 Nothing in the Older Americans Act prevents the garnishment of SCSEP wages. Grantees
will have to look at the law under which a judgment was obtained against the participant (or at
state law generally) to determine the extent to which SCSEP wages can be garnished in a
particular state.
 Section 509 of the Older Americans Act precludes SCSEP wages from affecting eligibility
only for federal housing programs (See TEGL 11-06 and the HUD regs at 24 CFR sections
960.225) and SNAP (formerly Food Stamps). How SCSEP wages are treated for all other state
and federal programs depends upon the rules of the specific programs.
 It does not appear that there is anything in the federal Medicaid rules that would specifically
provide for the exemption of SCSEP wages. Medicaid is a federal-state partnership in which the
states have a fair amount of discretion in setting income and asset limits for different classes of
beneficiaries. To determine what income your state counts for Medicaid eligibility purposes,
you should contact your state social services agency. There are very generous rules for the
"working disabled." There are also programs in many states under which an individual can earn
an amount over the normal limits and “buy-in” to Medicaid for a small amount to maintain their
Medicaid benefits, including personal assistance services for the home and workplace. All
disabled SCSEP participants should be made aware of these Medicaid programs and informed of
what assistance is available in their state.
 Only eligible applicants who have been assigned to an authorized community service
position may receive any SCSEP services. At the point of assignment, the applicant becomes a
participant; may receive services such as orientation, an IEP, and training; and may be paid
wages. The date of participation for the Common Measures is the date of assignment. Note that
the participant is not required to physically commence the assignment with the host agency prior
to receiving SCSEP services. The Community Service Assignment Form has two dates, one for
the date of initial assignment and one for the date on which the participant actually commences
the assignment.
 Obviously, sub-grantees must assess applicants’ work histories, aptitudes, abilities, and
interests in order to make an effective assignment. This determination of suitability for
Participant Form-56

Participant Form Guide

Number

Element Name/
Topic

Element Description/Explanation Plus Additional Comments
assignment is part of the intake and eligibility process and does not conflict with the regulations.
Moreover, in many situations it may be necessary for the sub-grantee, as part of the intake
process, to do a more complete assessment of certain characteristics (such as illiteracy, social
isolation, or other barriers) that determine preferences for service before determining whether to
provide service to an applicant. Sub-grantees are authorized to do as complete an assessment as
necessary to determine preferences for service and make an appropriate assignment. However,
the participant may not be paid for taking part in this assessment, and the process should stop
short of the formal drafting of an IEP. The assessment of suitability and determination of
characteristics may form the foundation for the formal IEP that takes place after the assignment
(and at which time the participant may be paid).
 For many participants, the assessment and assignment process will not be extended or
complicated. In such cases, nothing prohibits a sub-grantee from conducting an assessment,
completing the formal IEP, and assigning a participant to a community service position in one
sitting all on the same day. Since the date of the assignment in the data system and the date on
the assessment instrument and IEP will be the same, there would be no violation of the
regulation. The point of the regulation is that only those individuals who are in need of, and
who actually receive, a community service position are entitled to other SCSEP services.
 It is not permissible to assign an applicant to the sub-grantees’ project office as a placeholder
in order to pay the applicant wages and conduct a formal assessment prior to assigning the
applicant to his or her real community service position. Applicants can be assigned to the
project office only when there is a legitimate community service position available and the
applicant will be performing legitimate work at the project office. On the other hand, as long as
the original assignment was made in good faith, nothing prohibits a sub-grantee from changing a
participant’s initial community service assignment if a more complete assessment or the formal
IEP reveals that the initial assignment was not optimal.
 Although “orientation” is used in several different contexts, it has a specific definition for
SCSEP. Orientation is defined in Section 641.535(a)(1) of the regulations as a mandatory
service that must be provided to participants once they are enrolled. No SCSEP services can be
provided to applicants prior to enrollment. Grantees should, of course, explain program

Rev.6 (4/19/10)

Participant Form-57

Participant Form Guide

Number

Element Name/
Topic

Topic 80
(Revised)

Supportive
services

39

Grantee name

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
requirements and policies to applicants. They do this as part of ascertaining applicants' need for
SCSEP services and their ability and willingness to benefit from those services before deciding
whether to enroll them. This screening and intake function is not a formal “orientation”.
 SCSEP participants are entitled to supportive services as identified in their IEPs to assist
them in successfully participating in the program. Supportive services may be provided while
participants are in community service or in the first six months of unsubsidized employment.
 Supportive services are discretionary, and there is no SCSEP rule dictating what percent of
allowable costs the grantee or sub-grantee should pay. Although you are permitted to pay the
entire cost, you should be careful not to establish a precedent that you may not be able to afford
in the future, or that can give rise to claims of unequal treatment. As with all such matters, it is
best if the grantee has a policy establishing exactly what supportive services it will pay for and
the maximum amount it will pay.
 To the extent practicable, grantees should pay for supportive services with non-SCSEP funds
or assist participants in obtaining supportive services from other community partners. (See Topic
76 for Medicaid services specifically for the working disabled.)
 Enter the name and code of the grantee for the position to which this applicant is being
assigned. This is required even if the sub-grantee only has authorized positions under one grant.
 For WebDCS users, when you log on, your grantee-sub-grantee relationships will be
indicated. If you have more than one, you will have to choose which relationship you are using
before you access a particular participant record. Field 39 will be system-generated based on the
relationship you have chosen when you logged on.
 For non-WebDCS users, this field is required for all records, even if the application is
incomplete or the applicant is ineligible. SPARQ will not accept a data file if the grantee/subgrantee relationship is missing or incorrect.
 If you are a sub-grantee for two grantees, you will have to choose which grantee to “credit”
for an ineligible applicant. You can do this randomly or in proportion to the number of positions
you have for each grantee.

Participant Form-58

Participant Form Guide

Number

Element Name/
Topic

39a

40

Co-enrollments?

Topic 81

WIA and SCSEP

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 The county of authorized position is where the position is assigned. It may often be the same
as the county in which the participant resides or the county in which the host agency is located,
but it could be different. If the sub-grantee serves multiple counties, the sub-grantee will have to
decide which county to assign. The general rule is to assign the participant to the county that
will cause the least disruption to the participant if the position is transferred based on county.
 This field was added to facilitate the transfer of positions that has resulted from the national
grantee competition in 2006. It is a required (as opposed to optional) field for all grantees, but
state grantees will only get a warning if the field is blank. National grantees will get a reject.
 Check the appropriate box(es) to indicate any co-enrollment of the participant. Coenrollment applies to any individual who meets the requirements for SCSEP participation, as
well as the requirements for any other relevant program identified in the Individual Employment
Plan, and is enrolled in both the SCSEP and another relevant program. If “other” is checked,
specify the name of the additional entity or entities with which the participant is enrolled. If
there is no co-enrollment, check “none.”
 Enrollment is as defined by the other program. Registration with a One-Stop does not
always amount to enrollment with either WIA or ES. WIA is fairly restrictive about when an
individual is considered enrolled, while ES generally treats everyone registered with ES as being
enrolled. You will have to contact the One-Stop to determine if enrollment has occurred.
 This field should be updated whenever there is a change in enrollment status. Do not
indicate a co-enrollment until it actually occurs. Do not delete any co-enrollment.
 SCSEP co-enrollments, whether they are with WIA, ES, or any other entity, do not require
documentation. You can accept the participant's self-report, or you can call the One-Stop. It is a
good idea to use the comment field to record the source of the information.
 Co-enrollment with WIA is strongly encouraged. Registration in WIA core or intensive
services should in no way suggest by itself that an applicant is not suitable for SCSEP. Under
the 2006 amendments to the OAA, applicants who have already enrolled in WIA and are unable
to find employment are entitled to priority of service from SCSEP.
 The SCSEP regulations facilitate co-enrollment in a number of ways. For example, Section
Participant Form-59

Participant Form Guide

Number

Topic 82
(New)

Rev.6 (4/19/10)

Element Name/
Topic

SCSEP as
mandatory OneStop partner

Element Description/Explanation Plus Additional Comments
641.220 says that participants assigned to community service can receive wages while
participating in WIA intensive services or training; Section 641.230 says that WIA and SCSEP
IEPs are entitled to reciprocity; and Section 641.240 provides that SCSEP participants may be
deemed automatically eligible for WIA intensive or training services. On the other hand, if an
applicant is job-ready and does not need community service, then the applicant should be
referred to WIA for job search assistance and placement.
 There are a number of resources regarding coordination with WIA in addition to the
regulations cited above. The Older Worker Web site contains the following tools under
Technical Assistance, and then Technical Assistance Guides:
Assessing Workforce Development Systems
Implications and Opportunities in the WIA for the SCSEP
One-Stop Training Curriculum for Older Worker Specialist
Resource Sharing for Workforce Investment Act One Stop Centers
Using the Workforce Investment Act to Serve Mature and Older Workers
Protocol for Serving Older Workers
 The SCSEP regulations state that all grantees are mandatory partners and do not make
distinctions between state and national grantees. Grantees are bound by all applicable WIA
regulations and must provide access to services through the One-Stop. Failure to coordinate
with the One-Stop can result in a finding of ineligibility for a SCSEP grantee.
 The MOU is the vehicle for negotiating the exact roles of the partners. Where there are
multiple grantees in a jurisdiction, it is permissible to negotiate a single MOU that allows for a
division of labor as long as the basic requirements of the regulations are met by all grantees.
One way to do this is for the SCSEP grantees in an area to negotiate their own sub-agreement
governing how they will jointly meet their One-Stop responsibilities and how they will manage
the negotiation of the MOU with the One-Stop. The key is that there must be a negotiation, not
a unilateral decision by the One-Stop or the SCSEP grantee.
 If the One-Stop refuses to negotiate with a grantee in good faith, the issue should be raised
with the grantee’s FPO.
Participant Form-60

Participant Form Guide

Number
40a
40b

40c

Element Name/
Topic
Date of
orientation
Date of last
physical or
waiver
Date of last IEP

Topic 83

Revision to IEP;
failure of
participant to
cooperate

40d

Job interest codes

41

Enrollment
comments

42

Signature

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments


Record the date on which the participant received his or her orientation to SCSEP.

 Enter in this field the date of the last physical the participant received or the date on which
the participant waived the physical.
 If the participant has not yet had a physical, leave this field blank until the physical occurs.
 Enter in this field the date of the participant’s last IEP.
 If the participant has not yet had an IEP, leave this field blank until the IEP occurs.
 An assessment must be conducted and the IEP updated whenever circumstances warrant, but
at least twice in each 12-month period. If there are no changes in the participant’s
circumstances, grantees are free to determine when, within the 12-month period, the two
assessments will be conducted and the IEP updated.
 The IEP is the responsibility of the sub-grantee. Section 641.535(a)(2) and (3) sets forth the
requirement for conducting the assessment of the participant and updating the IEP. The
participant should participate in the drafting of the IEP and agree to it, but you cannot compel
the participant to sign the document.
 If the participant fails to participate in the development or carrying out of the IEP or refuses
to accept provisions that are required by the rules, you may terminate the participant for failure
to cooperate with the IEP process.
 You may use this optional field to record up to three of the pre-defined codes to indicate the
types of jobs and careers the participant is interested in. These codes are also used to indicate
the types of positions that host agencies offer and the specific assignment, training, and
placement the participant has received.
 Enter here any comments regarding the applicant’s status on the waiting list or assignment to
community service. You will be able to enter as many as 1000 characters (about 160 words)
into the database.
 The authorized individual who made the eligibility determination must sign here, and the
signature must be retained in the case file.

Participant Form-61

Participant Form Guide

Number
Topic 84
(New)

43

Form Heading 4
(Revised)

Rev.6 (4/19/10)

Element Name/
Element Description/Explanation Plus Additional Comments
Topic
Staff authorized
 Longstanding SCSEP policy requires that only an authorized sub-grantee representative can
to make eligibility make a final eligibility determination. Well-trained participant staff can conduct the intake, do
determinations
the data collection, and enter the data into SPARQ; however, their recommended decision on
eligibility must be presented to the appropriate sub-grantee official for final action.
 No trainee – whether SCSEP participant or other trainee – can make the determination. In
addition, it is always good practice for a second person to review the application.
Date of eligibility  Enter here the date on which the authorized individual made the eligibility determination.
determination
 Because there is a separate section of the Participant Form for recertification, you should
never update this field. It should always reflect the date of the original eligibility determination
for a given enrollment or re-enrollment.
 Data validation is required for this element.
Recertification
 You must enter all information regarding a recertification in this section of the Participant
Form. Do not write over any prior fields in the form at the time of recertification.
 You must write over the information in fields 44-50 in SPARQ each time you do a new
recertification. SPARQ will only carry information about the latest recertification. You must
retain all hard copies of the recertification section of the Participant Form and the relevant
documentation for each year’s recertification in the case file.
 You may update the participant’s contact information at any time. You do not update any
participant characteristics at the time of a recertification. Elements that affect the most-in-need
measure, such as disability, homelessness, and low employment prospects, remain fixed at the
time of initial application. You do not update them upon recertification or at any other time.
 If the participant has not yet had a recertification, leave the fields in this section blank.
 SCSEP requires that participants be recertified at least every 12 months, not annually.
Programs are free to recertify on the participants' anniversary dates or to recertify all participants
at the same time each year. If your program requires that all participants be recertified at a
specific time, you would have to recertify new participants as well. Otherwise, they would go
more than 12 months between the time of enrollment and their first recertification.
Participant Form-62

Participant Form Guide

Number
Topic 85

Rev.6 (4/19/10)

Element Name/
Topic
Recertification
within 12 months;
substantial
change in
circumstance

Element Description/Explanation Plus Additional Comments
 Grantees are required to recertify participants once every 12 months. They are not supposed
to investigate or make inquiry about income changes between certifications. However, if a
grantee learns of a substantial change in circumstances that is likely to have an effect on
eligibility, such as a new source of income or a substantial increase in an existing source of
income, the grantee must do a recertification as soon as it becomes aware of this information.
 Recertification is required every 12 months, in part, to deal with expected increases in
income due to cost of living increases in Social Security or pensions. COLA's reflect increases
in the cost of living and are not really increases in spendable income. To a large extent, they are
offset by increases in the federal poverty level, upon which eligibility is based. There is no
official definition of "substantial," but an increase in income would have to be more than a
COLA to trigger a recertification.
 The marriage of a SCSEP participant is a substantial change of circumstances that requires a
recertification. However, the part-time employment of a spouse four weeks before the
participant completes a training program or two months before the scheduled recertification date
would generally not constitute a substantial change.
 When you become aware of a change that will make the participant over-income, you should
do a recertification calculation as soon as possible so you can inform the participant when he or
she will become ineligible. For example, if the participant is newly married, the participant's
new spouse adds $1000 per month to the family income starting on November 24, and the
participant's own income remains stable, you would figure out how long it would take before the
extra $1000 per month made the participant over-income for a family of two. Assuming that the
income limit for a family of two is $5000 higher than it was for the participant alone, the
participant would become ineligible in five months – around April 24. If there were no further
changes when that date arrived, you would issue the participant the standard 30-day termination
notice. If circumstances had changed in the interim, you would do a new recertification
calculation.

Participant Form-63

Participant Form Guide

Number
44

Element Name/
Topic
Number in family

45

Total includable
family income
(12-month or 6month,
annualized)

46

Signature of
participant on
recertification

47

Eligibility
determination
If ineligible,
reason

48

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 Enter the number of individuals in the applicant’s family. Use the same instructions as for
field 11.
 A “family” is defined in the eligibility TEGL as husband, wife, and dependent children;
parent or guardian and dependent children; or husband and wife. (If the applicant is claimed as a
dependant on someone else’s tax return, you must use the broader CPS definition of family. See
Topics 12-14 above.) Count only current family members. Do not include deceased or
separated spouses. In addition, consistent with 20 CFR 641.500, a person with a disability may
be treated as a “family of one” for income eligibility determination purposes.
 Data validation is required for this element.
 Enter the 12-month income or the six-month annualized family income, whichever is more
favorable to the participant. Use the same instructions as for field 14.
 Family income establishes eligibility. It includes the income of current family members
identified in field 44 above. Sub-grantees may use any income worksheet they desire for
capturing and calculating income. Although the worksheet is not part of the database, the
worksheet must be retained in the file for all applicants. Documentation of all income is
required.
 Data validation is required for this element.
 Make sure the applicant reads and understands the certification. Intentional falsification of
eligibility information requires immediate removal from the program. The applicant’s signature
appears on the hard copy form only. It must be retained in the file.
 Data validation is required for this element.
 Check the appropriate box to indicate whether the participant remains eligible based upon
the information obtained during the recertification process.
 If the applicant is ineligible, check the appropriate box or boxes to indicate the reason(s).
You must also complete an Exit Form and indicate the appropriate reason for exit in field 6.
 If the participant has moved out of state since the last certification, you are expected to have
a cross-state agreement in effect to permit continued eligibility.
Participant Form-64

Participant Form Guide

Number
49

50

Element Name/
Topic
Signature of
director or
authorized
representative on
recertification
Date of
recertification
determination

Form Heading 5

Waiver of
durational limit
determination

Topic 86
(New)

Updating waiver
factors

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 The authorized individual who made the eligibility determination must sign here, and the
signature must be retained in the case file.
 Data validation is required as part of the validation for element 50.
 Enter here the date on which the authorized individual made the eligibility determination
based upon the information obtained during the recertification process.
 This is the only date that will be used to identify the recertification.
 Data validation is required for this element.
 This section of the Participant Guide is for recording the factors that determine whether a
participant is entitled to a waiver of the 48-month lifetime durational limit. It also enables you
to record these factors so they can be included in the most-in-need measure.
 Priorities of service are recorded at the time of enrollment and are not updated. In contrast,
the waiver factors should be recorded as soon as you become aware of them. Although they are
not needed for waiver purposes until a participant has been in the program for a total of 48
months beginning July 1, 2007, they can be counted at any time as part of the most-in-need
measure. (See Topic 86.)
 Data validation is required for all waiver factors.
 Six of the 7 waiver factors have a field for entering the date on which the factor was last
updated. Once a waiver factor has been entered into SPARQ, the grantee will receive credit for
the most-in-need measure for the entire program year. There will not be any credit in a
subsequent program year, however, unless the existence of the waiver factor is re-documented
and the date entered into SPARQ. A factor need only be updated once in a program year.
 The primary purpose of the waiver factors is to support a waiver of the individual 48-month
participant durational limit. A waiver factor must be in existence and must be updated in
SPARQ in the program year in which the participant reaches the 48-month limit (or in the three
Participant Form-65

Participant Form Guide

Number

Element Name/
Topic

51

Severe disability

51a
(New)

Date of last
update

Topic 87
(New)

Documenting
severe disability
through records
of other agencies

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
months prior to the start of that program year if the 48-month limit falls within the first quarter
of a program year).
 Severe disability means a severe, chronic disability attributable to mental or physical
impairment, or a combination of mental and physical impairments, that (A) is likely to continue
indefinitely, and (B) results in substantial functional limitation in 3 or more of the following
areas of major life activity: (i) self-care, (ii) receptive and expressive language, (iii) learning,
(iv) mobility, (v) self-direction, (vi) capacity for independent living, (vii) economic selfsufficiency.
 Severe disability is to be recorded in addition to disability. Each is counted separately for
the most-in-need measure.
 Severe disability must be documented by a physician. See Topic 56 for restrictions on the
handling of disability-related information and medical documentation.
 Data validation is required for this element.
 SPARQ will automatically enter the date on which the waiver factor was first entered. This
field may be overwritten as necessary. For each program year thereafter, you must enter the date
of updating the factor if you want to receive credit in the most-in-need measure or to use the
factor to support a waiver request for the participant.
 The Data Validation requirements allow the use of official records because an agency may
already have gathered the documentation you need, and its business may require it to make
determinations of this sort. As long as the agency is charged with making such determinations
or otherwise has access to the underlying medical documentation and is competent to make such
determinations, you can rely on the agency for documentation.
 It is permissible to ask the agency to use your form for severe disability as long as the form
fully states the regulatory standard for severe disability and the agency indicates the basis on
which its determination was made; e.g., its own medical staff examined the participant or it has
relied on medical documentation from other sources.

Participant Form-66

Participant Form Guide

Number
Topic 88
(New)

Element Name/
Topic
Documenting
severe disability
through records
of Social Security
Administration

52

Frail

52a
(New)

Date of last
update

53

Old enough for
but not receiving
Social Security
Title II

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 It is unlikely that the Social Security Administration would provide grantees with
documentation of severe disability. The receipt of SSDI is sufficient to document a disability for
SCSEP purposes; but to establish severe disability, you need a medical professional to document
that the applicant's condition meets the definition set out in the SCSEP regulations.
 You could check whether SSA’s medical records are sufficient to constitute this
documentation. However, because the SSDI standard is different from that required by SCSEP
for severe disability, you will probably need to request a statement from the applicant's doctor.
 Frail means that an individual 55 years of age or older is determined to be functionally
impaired because the individual:
(A)(i) is unable to perform at least two activities of daily living without substantial human
assistance, including verbal reminding, physical cueing, or supervision; or (ii) at the option of
the grantee, is unable to perform at least three such activities without such assistance; or
(B) due to a cognitive or other mental impairment, requires substantial supervision because the
individual behaves in a manner that poses a serious health or safety hazard to him- or herself or
to another individual.
 Frailty must be documented by a qualified professional. (See Topic 56 for restrictions on the
handling of disability-related information and medical documentation.)
 Data validation is required for this element.
 SPARQ will automatically enter the date on which the waiver factor was first entered. This
field may be overwritten as necessary. For each program year thereafter, you must enter the date
of updating the factor if you want to receive credit in the most-in-need measure or to use the
factor to support a waiver request for the participant.
 An individual may qualify for SS retirement benefits at age 62. If an individual is 62 or over
but does not have sufficient wage credits to qualify for retirement benefits, check “yes.” This
factor applies only if the participant is not monetarily eligible for Social Security. If the
participant qualifies but chooses to delay receipt to increase the amount of benefits, check “no.”
 Data validation is required for this element.

Participant Form-67

Participant Form Guide

Number
53a
(New)

54

Rev.6 (4/19/10)

Element Name/
Topic
Date of last
update

Severely limited
employment
prospects in area
of persistent
unemployment

Element Description/Explanation Plus Additional Comments
 SPARQ will automatically enter the date on which the waiver factor was first entered. This
field may be overwritten as necessary. For each program year thereafter, you must enter the date
of updating the factor if you want to receive credit in the most-in-need measure or to use the
factor to support a waiver request for the participant.
 This factor has two separate requirements: severely limited employment prospects plus
residence in an area of persistent unemployment. Both must be met for a “yes” answer.
 Severely limited employment prospects means a substantially higher likelihood that an
individual will not obtain employment without the assistance of the SCSEP or another
workforce development program. Persons with severely limited employment prospects have
more than one significant barrier to employment; significant barriers to employment may
include but are not limited to: lacking a substantial employment history, basic skills, and/or
English-language proficiency; lacking a high school diploma or the equivalent; having a
disability; being homeless; or residing in socially and economically isolated rural or urban areas
where employment opportunities are limited.
 The two or more significant barriers to employment must be documented in the case file and
in the comments sections, field 58.
 Persistent unemployment means that the annual average unemployment rate for a county or
city is more than 20 percent higher than the national average for two out of the last three years.
 The link at this field and on the SPARQ home page will bring you to a list of counties by
state. This list, which is updated with the official unemployment rates in April of each year,
indicates whether the county meets the definition of persistent unemployment.
 If the county in which the participant resides does not meet the definition of persistent
unemployment, the grantee may then determine whether the city of residence meets the
definition. You must use official sources, like your state’s Labor Market Information agency,
for this determination and must use the regulatory formula. The data for the past three years and
the source of the data must be documented.
 Data validation is required for this element.

Participant Form-68

Participant Form Guide

Number
54a
(New)

Topic 89
(New)

55

55a
(New)

Rev.6 (4/19/10)

Element Name/
Topic
Date of last
update

Element Description/Explanation Plus Additional Comments

 SPARQ will automatically enter the date on which the waiver factor was first entered. This
field may be overwritten as necessary. For each program year thereafter, you must enter the date
of updating the factor if you want to receive credit in the most-in-need measure or to use the
factor to support a waiver request for the participant.
Which list to use
 The rule defines an area of persistent unemployment as an area with an unemployment rate
for persistent
20% above the national average for any two of the last three calendar years. This requires a new
unemployment
three-year calculation each year. The data to perform the calculation at the county level for the
latest year are not available until April of the following year. Because there are no data
available for the current year until then, there is a blackout period in SPARQ for this field from
January 1 until approximately April 15 of each year when the new table is available.
 Field 54 of the Participant Form is one of the factors used for waiver of the durational limit.
This means that you can enter data into this field whenever you determine that the participant
meets both requirements: has severely limited employment prospects and lives in an area of
persistent unemployment. You use the list that is in effect at the time you make the
determination. Therefore, for any determinations made on or after April 15, 2010, you would
use the list for 2007-2009. The earlier list for 2006-2008 remains in SPARQ so it can be used
for Data Validation for those participants who were coded "Yes" under that earlier list.
Limited English
 This field is system-generated in SPARQ when “yes” is checked in field 22. Only one count
Proficiency (LEP) is given in the most-in-need measure for LEP although it is used as both a priority of service and
a waiver factor.
 Data validation is required for field 22.
Date of last
 SPARQ will automatically enter the date on which the waiver factor was first entered. This
update
field may be overwritten as necessary. For each program year thereafter, you must enter the date
of updating the factor if you want to receive credit in the most-in-need measure or to use the
factor to support a waiver request for the participant.

Participant Form-69

Participant Form Guide

Number
56

Element Name/
Topic
Low literacy
skills

56a
(New)

Date of last
update

57

75 or over

57a
(New)

Date of last
update

58

Recertification/
waiver comments

Rev.6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 This field is system-generated in SPARQ when “yes” is checked in field 24. Only one count
is given in the most-in-need measure for LEP although it is used as both a priority of service and
a waiver factor.
 Data validation is required for field 24.
 SPARQ will automatically enter the date on which the waiver factor was first entered. This
field may be overwritten as necessary. For each program year thereafter, you must enter the date
of updating the factor if you want to receive credit in the most-in-need measure or to use the
factor to support a waiver request for the participant.
 This field is system-generated in SPARQ based on the participant’s date of birth. It is
calculated each time the screen is viewed and is not frozen at the date of enrollment.
 Data validation is required for field 10, date of birth.
 SPARQ will automatically enter the date on which the waiver factor was first entered. For
each program year thereafter, you must enter the date of updating the factor if you want to
receive credit in the most-in-need measure or to use the factor to support a waiver request for the
participant.
 You may use this field for any comments or case notes regarding the recertification or the
waiver factors.

Participant Form-70

THIS PAGE INTENTIONALLY LEFT BLANK

Community Service Assignment Form Guide

Community Service Assignment Form Guide
Number
Form Heading 1

Element Name/
Topic
Community
Service
Assignment Form

Topic 1

Maintenance of
effort; assigning
participants to
host agencies that
have had layoffs

Topic 2
(Revised)

Entering a new
assignment into
WebDCS

3

Grantee

Form Heading 2

Host Agency
Information

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 An applicant does not become a participant and is not eligible to receive any SCSEP
services, including orientation, training or placement activity, until the applicant has been
assigned to community service and this form has been filled out.
 A new form must be filled out for each community service assignment of a participant.
 A participant can have only one community service assignment at a time.
 SCSEP participants cannot be used to replace workers who are on layoff. Section
502(b)(1)(G) of the Older Americans Act specifically provides that each project funded under
the act “will not employ or continue to employ any eligible individual to perform work the
same or substantially the same as that performed by any other person who is on layoff.” The
same requirement is contained in the SCSEP regulations. The statute also provides that
SCSEP funds may “not impair existing contracts or result in the substitution of Federal funds
for other funds in connection with work that would otherwise be performed.” Therefore, you
cannot assign SCSEP participants to a host agency if they will be doing work substantially
similar to that performed by regular employees who have been laid off.
 To enter a new community service assignment, you enter the end date for the old
assignment into field 15 of the Community Service Assignment Form and complete a new
CSA Form for the new assignment.
 You do not delete anything associated with the first host agency assignment. You do have
to enter the end date for the first assignment into the data system. Remember, too, that you
will have to fill in the total paid hours (field 19) and hours of paid training (field 21) at the end
of the quarter even if the first assignment ended before the end of the quarter. You will also
have to enter this information for the new assignment.
 Enter here the name of the grantee that owns the slot the participant is occupying.
 For WebDCS users, the name of the grantee is determined at the time of log on. If the user
works for more than one grantee, the user will have to select the grantee for which it wishes to
access records.
 For users of the WebDCS, elements 4-7b, 8a, and 8b are entered from the Add Host
Agency button in the Organizations function on the main page. You may also add a new host
agency from the first assignment screen.

CSA Form-1

Community Service Assignment Form Guide
Number
4

Topic 3

Rev. 6 (4/19/10)

Element Name/
Topic
Name of host
agency

Rule against
entering duplicate
organizations into
SPARQ database

Element Description/Explanation Plus Additional Comments
 Enter the name of the parent organization at which the participant is assigned. This will
be the entity whose FEIN you enter in field 6. Do not enter the name of a satellite office or
branch unless it has a separate FEIN or one of the exceptions in Topic 7 below applies. The
location at which the participant is assigned will be listed in field 8. The contact person’s
name and address will be entered in fields 9 and 10.
 This field will be used to draw the sample for the host agency customer satisfaction
survey, which will be mailed to the contact person identified in fields 9 and 10.
 There are exceptions to this rule if using the FEIN will result in there being too few host
agencies or using the name of the parent organization makes it difficult to identify the entity to
which the participant is assigned. See Topics 6 and 7 below.
 You should standardize the names of host agencies so that an agency is not entered
multiple times under different names.
 For users of the WebDCS, there is a drop-down menu on the first assignment screen from
which you may select a previously entered host agency. If the host agency you want is listed,
you may select it. If it is not listed, you may add a new host agency from the first assignment
screen without having to open the Organizations function on the main page.
 For Non-WDCS users, there is a similar function on the SPARQ home page. All NonWDCS users must check for the existence of a host agency before entering a new one. If the
organization you want is already listed in SPARQ, you must enter the organization
information into your database exactly as it appears in SPARQ. If you do not, you may wind
up linking to an organization you did not intend to link to.
 You cannot save an assignment in SPARQ without at least a host agency name, a state, and
an assignment date. This means you must, at a minimum, select a host agency on the first
assignment screen and fill out field 13 on the third assignment screen before you can save an
assignment.
 SPARQ will not let you enter an organization into the database if that identical
organization already exists. Organizations are considered identical if: 1) they have the same
FEIN and their mailing addresses are in the same state; or 2) they have the same name and
their mailing addresses are in the same state. WebDCS users will be blocked from entering a
duplicate organization into the database; Non-WebDCS users will have any record with a
duplicate organization rejected.
CSA Form-2

Community Service Assignment Form Guide
Number

Element Name/
Topic

Topic 4

Can two projects
use the same host
agency?

Topic 5

Using an existing
host agency in
SPARQ

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 There are circumstances where using the name and FEIN of the parent organization will
not be feasible. See Topics 6 and 7. In those cases, you may enter multiple organizations with
similar but not identical names in the same state. For example, Goodwill LA North, Goodwill
LA Central, Goodwill LA East, if they are entered without any FEIN, are all considered unique
organizations even though they are all in the state of California. You should only list the FEIN
if you attach it to the parent organization.
 If a WebDCS user attempts to enter an organization that already exists in the database, the
user will be asked whether he or she wants to use the existing organization. If not, the user
will be required to change the name of the organization to one that is unique.
 The first sub-grantee to enter an organization is the “owner” of that organization and is the
only user allowed to change the basic organization information in fields 4-7 and 8a. A nonowner that wishes to change any of this information must contact the owner to do so. The
name of the owner is displayed as part of the organization search function in SPARQ.
 Fields 7a, 7b, and 8b are not unique to the organization and may differ for each subgrantee that uses that organization. Field 8 belongs to a particular assignment and can differ
for each assignment.
 Although the regulations do not prohibit two grantees from using the same host agency, the
national office discourages the practice. The national office prefers that grantees coordinate
the use of host agencies and avoid duplication wherever feasible. Of course, there will be
situations where such duplication may be unavoidable or may be in the best interest of the
participants.
 Coordination among the grantees in the same area will at least ensure that duplication is
not done inadvertently.
 See Element 4 and Topics 3-8 for a full discussion of identifying the parent host agency,
when you may use a host agency name other than the parent name, and how to enter the host
agency information into SPARQ.
 SPARQ is designed to prevent the entry of duplicate organizations (host agencies, training
providers, and employers). If a user attempts to enter an organization for which the same
FEIN has already been entered (or, if there is no FEIN, an organization with the identical name
as an existing organization in the same state), SPARQ will block the duplicate entry and tell
the user that the organization already exists. The user will then have the option of linking to
the existing organization or creating a new organization by deleting the FEIN and changing the
CSA Form-3

Community Service Assignment Form Guide
Number

Element Name/
Topic

Topic 6

Using FEIN to
identify host
agencies (and
employers) for
the customer
satisfaction
surveys

Topic 7

Exception to the
rule about using
FEINs to identify
host agencies

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
organization name. Generally, the user should accept the existing organization and not take
the option of creating a different organization unless one of the exceptions discussed in the
Handbook applies.
 There are three separate pieces of identifying information about the host agency and the
employer: organization name and mailing address; name of site where participant works; and
name (and address) of contact person. The survey will be mailed to the contact person at the
contact person's address if one is listed. The form has a field for the contact person's address if
it is different from the mailing address of the organization. If no contact person address is
listed, the survey will be mailed to the contact person at the organization’s mailing address.
 Determining the identity of the host agency or employer is difficult if the entity has
multiple branches or divisions. The instructions require you to use the FEIN to determine the
main entity. The host agency and employer names are used to draw the samples for the
surveys (and to determine an unduplicated count of host agencies and employers), but the
survey is mailed to the contact person at the contact person's address. Note that the contact
person may or may not be at the site where the participant is working. The site is not required
for the data application. It may be of use for case management purposes, but it is not used in
the selection of respondents or in the mailing of surveys. The form and the data application
only capture the name and location of the site. There are no fields for the address.
 The instructions ensure that the proper person will receive the survey. The only risk is that
the survey will under-sample some government agencies or large organizations. However,
since there are a large number of host agencies, including government agencies, the validity of
results is not threatened.
 Using the FEIN to identify the parent organization may be arbitrary, but it is a clean and
simple rule to follow in most cases. However, the rule does not work well for government
agencies and large organizations that conduct a variety of functions from different locations.
The rule can have an especially unfortunate effect in communities where there are few host
agencies beyond government agencies. We have already recognized an exception for
territorial grantees where the territorial government is the only host agency and all the
government departments to which participants are assigned are under the FEIN of the
territorial government. A similar exception should apply to all grantees and sub-grantees
facing a similar situation.
 While the rule about following the FEIN is still the norm, sub-grantees may depart from
CSA Form-4

Community Service Assignment Form Guide
Number

Element Name/
Topic

Element Description/Explanation Plus Additional Comments
the norm, especially where following the rule will result in a small number of host agencies to
be surveyed. Sub-grantees may treat the local office, department, or division of the parent
organization that owns the FEIN as the host agency for purposes of field 4 of the Community
Service Assignment Form when either of the following conditions applies:
1. The parent organization that owns the FEIN is a national governmental or non-profit
agency, and the participant is assigned to a local office of the parent. Examples include
the Social Security Administration and or a national charitable organization like Goodwill.
OR
2. The parent organization that owns the FEIN is a state, county, or local governmental
agency or large non-profit organization and:
a. The participant is assigned to a local department or division, not the main office;
and
b. The local department or division has a separate administrative structure from the
main office; and
c. The contact person for the participant is located at the local department or division
rather than at the main office.
Although it is not always essential that the local department or division be in a
separate physical location from the main office, the case for treating the local
department or division as a separate host agency will be much stronger if the local
department or division is in a separate location. By main office, we mean the central
location or mailing address of the parent organization that owns the FEIN, e.g., the
Broome County Executive or Comptroller. An example of this exception would be a
county government that runs all services in the county, such as welfare, health,
education, recreation, and public works, and each service is in a separate department
with a separate administrative structure.
 When applying either of the two exceptions described above, the critical concern is that the
same contact person not receive more than one host agency survey in a program year. The fact
that the same person would receive the survey is a strong indicator that you should not apply
the exception. However, the fact that the survey would be going to the same mailing address
(but a different contact person at that address) is not as clear an indicator that the exception
should not apply. In some instances, the parent organization and its divisions will be located
in a single building with a single mailing address. It then becomes even more important to be

Rev. 6 (4/19/10)

CSA Form-5

Community Service Assignment Form Guide
Number

Topic 8
(Revised)

Rev. 6 (4/19/10)

Element Name/
Topic

Warnings in
SPARQ for
duplicate FEIN’s

Element Description/Explanation Plus Additional Comments
sure that the administrative structure is separate and that the contact person is different. If you
are uncertain whether multiple surveys would be sent to the parent organization under either of
these two exceptions, then you should follow the rule and identify the host agency by the
FEIN.
 NOTE: If you apply either exception and list as the host agency (in field 4) a local
department or division that does not have its own FEIN, leave the field for FEIN (#6 on the
Community Service Assignment Form) blank. The FEIN should only be listed for the parent
organization. You may still enter the local site name and location of this local department or
division in field 8 even if this duplicates what you have put in field 4. The data application
does not require that field 8 be filled in.
 An FEIN is supposed to be unique in SPARQ so you get this warning if an organization
with the same FEIN is already being used by any sub-grantee as a host agency, training
provider, or employer. (See Topics 6 and 7.) You can use the Organization search function on
the SPARQ home page to determine which sub-grantee "owns" this organization. If it is
another sub-grantee and you wish to use the same organization, you can link to it and then
substitute it for the organization in your database that is causing the error message. If you are
the owner, the message may be due to your using multiple entries of the same organization as
both an employer and a host agency or to your having entered the same organization multiple
times as a host agency. In that case, you need to pick whichever version of the organization
you want to keep, use that organization for any placement or assignment, and delete the other
versions of the organization.
 If for some reason you do not want to use the organization and FEIN that SPARQ views as
the same as your organization, you can either ignore the warning or delete the FEIN from your
organization. As long as the organization name you use is unique within your state, you will
not get any other warnings. You should not delete the FEIN, however, unless you have
determined that you have a legitimate reason not to use the original organization with its
FEIN.
 Eliminating duplicate organizations can be a tricky and time consuming process.
Mathematica provides technical assistance to SPARQ users and is helping many grantees with
this problem. Users should contact Mathematica if they have questions about how to eliminate
duplicates or need assistance.
 The SPARQ database has many old duplicate organizations that make it nearly impossible
CSA Form-6

Community Service Assignment Form Guide
Number

Element Name/
Topic

Topic 9
(New)

Public source of
FEIN’s

5

Host agency
mailing address

5a

6

Number, street,
suite number; or
PO Box
FEIN

7

Host agency type

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
to get an accurate count of host agencies and employers, and that make it very difficult to
produce good sample lists for the host agency surveys. Because these warnings are alerting
users to a serious problem in SPARQ, there is no way to turn them off other than by
eliminating the duplicate organizations. However, in a subsequent release of SPARQ, grantee
administrators and sub-grantee administrators will be able to turn off this warning on a caseby-case basis.
 There are numerous online search services for FEINs, but they all appear to charge a fee.
(Try searching for “FEIN” with your favorite search engine.) Since many companies consider
their FEIN to be proprietary, you may not be able to obtain the FEIN. This is more likely to be
true of employers. Host agencies, on the other hand, should give you their FEIN as a matter of
course because of your ongoing relationship with them.
 For more information, see http://www.irs.gov/businesses/small/article/0,,id=98350,00.html
 Be sure to enter the information as you want it to appear on the envelope. Do not enter any
extraneous information.
 The mailing address fields will be used to generate letters and mailing labels for the
customer satisfaction survey.
 If the address has a Post Office box rather than a street, use field 5a to record that
information. If there are both a street and a post office box, record both in field 5a.
 You must obtain the host agency’s Federal Employer Identification Number (FEIN).
 The FEIN plus state will be used as a unique identifier for host agencies. The FEIN is used
to search for duplicate host agencies in the database and to ensure that host agencies are only
surveyed once each year.
 If you are unable to obtain the FEIN, leave this field blank. Document your effort to
obtain it in the comments field. Do not put N/A or a dummy value into this or any other field.
 Select only one box. Host agencies must be either Section 501(c)(3) non-profit
organizations or government agencies.
 If the participant is assigned to the grantee or sub-grantee’s project office, select non-profit
in this field and also select value E1, Project Administration, as the community service
assignment code in field 17.

CSA Form-7

Community Service Assignment Form Guide
Number
Topic 10
(New)

Topic 11
(New)

Topic 12

Topic 13
(New)

7a

Rev. 6 (4/19/10)

Element Name/
Topic
Host agency must
be Section
501(c)(3)
organizations;
churches

Element Description/Explanation Plus Additional Comments

 The regulations require that the host agency itself be a government agency or Section
501(c)(3) organization.
 Section 508 of the Internal Revenue Code states that churches are deemed to be tax-exempt
and do not need to apply for 501(c)(3) status. Therefore, churches are permissible host
agencies even if they have not obtained a Section 501(c)(3) certificate from IRS. However,
grantees can only assign participants to religious organizations if the assignment does not
involve religious activities. (See TEGL 29-07.)
Documentation of  Documentation of tax exempt status has long been a SCSEP program requirement.
Section 501(c)(3) Although this item is not currently subject to Data Validation, it is expected to be added to the
status
sample. Grantees are required to continue to retain documentation as they have always done.
 Acceptable documentation includes the IRS determination letter or the results of a search
on the official IRS Web site for exempt organizations: http://apps.irs.gov/app/pub78. The 990
tax form is not acceptable. Host agencies have the burden of establishing their exemption. If
there is any doubt, they must obtain updated information from the IRS.
Can a host agency  Small nonprofits sometimes use larger organizations as their fiscal agents because it makes
satisfy 501(c)(3)
the funders more secure, but that has no impact on our statute. The statutory requirement is
status through a
not satisfied by using a Section 501(c)(3) organization as the fiscal agent of the host agency
fiscal agent?
unless the host agency itself is also a Section 501(c)(3) organization.
Subordinate
 An IRS Section 501(c)(3) certificate may state that any subordinate entities listed in the
entities of Section organization’s "directory" are also exempt. The critical issue can be whether an organization
501(c)(3)
is itself a separate legal entity or whether it is just an activity of a subordinate entity listed in
organizations
the directory. If the latter, there is no problem. If the former and it is not listed in the directory
itself, then it cannot be a host agency.
 If there is doubt, the potential host agency must get clarification from the IRS. Grantees
are not qualified to determine tax exemption or to guess about how the IRS would handle
complex legal relationships; grantees must act on what the IRS has actually determined.
Date of host
 Indicate the date on which the last host agency agreement was signed. You may use this
agency agreement date as a tickler for the renewal of the host agency agreement.
 This field may be entered by each sub-grantee that uses the organization record and will
display specifically for the sub-grantee that enters the information.

CSA Form-8

Community Service Assignment Form Guide
Number
7b

8

Element Name/
Topic
Date of host
agency
monitoring visit
Host agency site
name and location

8a

Host agency job
codes

8b

Host agency
continued
availability

Form Heading 3

Contact/
Supervisor
Information

9

Name of contact
person

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 Indicate the date on which the last host agency monitoring visit was conducted.
 This field may be entered by each sub-grantee that uses the organization record and will
display specifically for the sub-grantee that enters the information.
 Enter here the site at which the participant is assigned. This field is not required by
SPARQ and is solely for case management purposes.
 Do not enter a full address, just enough information to locate the participant.
 You may record up to three of the pre-defined codes to indicate the types of jobs this host
agency provides. These codes are also used to indicate the types of jobs that the participant is
interested in and the specific assignment, training, and placement the participant has received.
 This field may be entered by the sub-grantee that creates and owns the organization record
and will display for any sub-grantee that uses this organization.
 This field is for administrative use by the sub-grantee. You may indicate if the
organization no longer wishes to serve as a host agency or if the sub-grantee no longer wishes
to continue working with this host agency.
 This field may be entered by each sub-grantee that uses the organization record and will
display specifically for the sub-grantee that enters the information.
 This section is used to record information about the host agency contact person. This is the
individual who will receive the customer satisfaction survey. The contact information is also
designed to facilitate your contacting this person.
 Additional fields have been added to permit the entry of information about the supervisor
if that person is different from the contact person.
 The contact person is the individual who will receive the customer satisfaction survey for
the host agency. There are separate fields for the supervisor if that person is different from the
contact person.
 The contact person is the individual with whom the sub-grantee has had the most contact
regarding the assignment of the participant. It is not necessarily the participant’s supervisor,
nor is it necessarily the same as the main contact person whom you use for administrative
purposes. This is the individual who will receive the customer satisfaction survey in the mail.
 Enter the contact person’s name as you want it to appear on the cover letter and mailing
label for the customer satisfaction survey. Be sure to include the first name unless the contact
person only uses one name. Do not enter any extraneous information into this field.
CSA Form-9

Community Service Assignment Form Guide
Number
10

Element Name/
Topic
Contact person’s
mailing address if
different from
number 5

10a

Organization or
address field 1

11

Contact person’s
title
Contact person’s
salutation

11a

12
12a
12b
Form Heading 4

Rev. 6 (4/19/10)

Contact person’s
phone number
Contact person’s
fax number
Contact person’s
e-mail address
Complete fields
12c-12j if
supervisor is
different from
contact person
(number 9). If
supervisor is the
same as contact
person, skip to
field 12j.

Element Description/Explanation Plus Additional Comments
 Enter a business address for the contact person only if it is different from the host agency’s
main mailing address (field 5). If the contact person’s address is the same as the mailing
address for the host agency in field 5, you do not need to enter anything into field 10.
 This field will be used to generate customized letters and mailing labels for the customer
satisfaction surveys. If you use this field, you must enter a complete mailing address.
 If the contact person has a separate address, enter here the name of the organization at
which the contact person will receive mail. Some surveys addressed to host agency contact
persons without the name of the organization in the address were returned as undeliverable.
 You should enter this information for all host agency contact persons with a separate
address in your database.
 Enter the title by which the contact person is known at the host agency. This may facilitate
your contacting the individual.
 Select either Mr. or Ms. as the salutation for the contact person. The salutation will be
used for the customer satisfaction survey cover letters.
 You should enter this information for all host agency contact persons in your database.
 This field may be used to help you reach the contact person.


This field may be used to help you reach the contact person.



This field may be used to help you reach the contact person.

 Fields 12c-12i are optional. They permit you to record the name and contact information
for the participant’s host agency supervisor if the supervisor is different from the contact
person. The fields for the contact person are not optional since they are used to mail the host
agency survey.
 In SPARQ, contacts are entered into the Organization Contacts utility on the main page
without identifying whether the contact will be used as a contact person or a supervisor. In the
assignment and placement screens, there are two different drop-down menus and displays, one
for the contact person/supervisor and a second for the supervisor if that person is different
from the contact/person supervisor. If the contact person and supervisor are the same person
(or if there is no supervisor), you only select a name from the first drop-down. If you wish to

CSA Form-10

Community Service Assignment Form Guide
Number

12c
12d

12e
12f
12g
12h
12i
12j

13

Rev. 6 (4/19/10)

Element Name/
Topic

Name of
supervisor
Supervisor’s
mailing address if
different from
number 5
Supervisor’s title

Element Description/Explanation Plus Additional Comments
indicate a different person as the supervisor, you can also select a name from the second dropdown. There is a single drop-down menu in the Training Information section to allow you to
select the contact person.
 This optional information may be entered through the Organizations Contacts on the home
page of the WebDCS or directly on the second assignment screen.
 This optional information may be entered through the Organizations Contacts on the home
page of the WebDCS or directly on the second assignment screen.

 This optional information may be entered through the Organizations Contacts on the home
page of the WebDCS or directly on the second assignment screen.
Supervisor’s
 This optional information may be entered through the Organizations Contacts on the home
salutation
page of the WebDCS or directly on the second assignment screen.
Supervisor’s
 This optional information may be entered through the Organizations Contacts on the home
phone number
page of the WebDCS or directly on the second assignment screen.
Supervisor’s
 This optional information may be entered through the Organizations Contacts on the home
Fax number
page of the WebDCS or directly on the second assignment screen.
Supervisor’s e This optional information may be entered through the Organizations Contacts on the home
mail address
page of the WebDCS or directly on the second assignment screen.
Funding source of  This optional field allows you to indicate whether the supervisor (or contact
supervisor or
person/supervisor if one individual has both positions) is federally funded or not federally
contact person/
funded. This information may help you determine the amount of in-kind contribution made by
supervisor
the host agency to your project. For non-federally funded supervisors, you can also indicate
the average number of hours per week spent on supervision of all SCSEP participants and the
supervisor’s average hourly wage. Grantees can use this information to document non-federal
match for SCSEP.
Assignment date
 Enter the date on which the participant was first assigned to the community service
assignment with this host agency regardless of when the participant first started work at the
host agency. For new applicants, it is the date of the first service received by the applicant and
thus the point at which an eligible applicant becomes a participant. It will usually be the date
on which payment of wages begins. For reassigned participants, the date will be the first day

CSA Form-11

Community Service Assignment Form Guide
Number

Topic 14

Topic 15

Rev. 6 (4/19/10)

Element Name/
Topic

What date
determines
enrollment for the
service level
measure?
Permissible
activities prior to
assignment

Element Description/Explanation Plus Additional Comments
of assignment to the new host agency regardless of whether the participant actually starts work
on that day.
 Field 13 is the date the assignment was made regardless of when the participant reported to
the host agency or when the participant first received wages. You may pay wages once the
assignment has been made, but you are not required to do so if the participant is not engaging
in any SCSEP activities, e.g., orientation, assessment, IEP, training, prior to reporting to the
host agency. Field 14 is the date on which the participant first reported to the host agency.
 A participant can only have one assignment at a time and must remain assigned to a host
agency throughout the period of enrollment unless the participant is on an approved break in
participation. The assignment date (field 13) is the date on which the host agency and the
participant agree that the participant will perform community service at that host agency. For
first assignments, this date is straightforward. For subsequent assignments, the participant
cannot be assigned to a new host agency until the assignment at the old host agency has ended.
 The date of assignment to the first community service position will be the date of
participation for the Common Measures.
 When an eligible applicant is assigned to community service (CSA field 13), the applicant
becomes a participant. The numerator for the service level measure is all participants active
(assigned to community service) at any time during the reporting period. A participant with a
community service assignment date of 6/30/07 will be counted in the service level measure for
PY 2006 regardless of when the participant actually started work at the host agency.
 Only eligible applicants who have been assigned to an authorized community service
position may receive any SCSEP services. At the point of assignment, the applicant becomes
a participant; may receive services such as orientation, an IEP, and training; and may be paid
wages. The date of participation for the Common Measures is the date of assignment. Note
that the participant is not required to physically commence the assignment with the host
agency prior to receiving SCSEP services. The Community Service Assignment Form has two
dates, one for the date of assignment and one for the date on which the participant actually
commences the assignment.
 Obviously, sub-grantees must assess applicants’ work histories, aptitudes, abilities, and
interests in order to make an effective assignment. This determination of suitability for
assignment is part of the intake and eligibility process and does not conflict with the
regulations. Moreover, in many situations, it may be necessary for the sub-grantee, as part of
CSA Form-12

Community Service Assignment Form Guide
Number

Topic 16

Rev. 6 (4/19/10)

Element Name/
Topic

Assignment to
project office

Element Description/Explanation Plus Additional Comments
the intake process, to do a more complete assessment of certain characteristics – such as
illiteracy, social isolation, or other social barriers – that determine preferences for service
before determining whether to provide service to an applicant. Sub-grantees are authorized to
do as complete an assessment as necessary to determine preferences for service and make an
appropriate assignment. However, the participant may not be paid for taking part in this
assessment, and the process should stop short of the formal drafting of an IEP. The
assessment of suitability and determination of characteristics may form the foundation for the
formal IEP that takes place after assignment (and at which time the participant may be paid).
 For many participants, the assessment and assignment process will not be extended or
complicated. In such cases, nothing prohibits a sub-grantee from conducting an assessment,
completing the formal IEP, and assigning a participant to a community service position in one
sitting all on the same day. Since the date of the assignment in the data system and the date on
the assessment instrument and IEP will be the same, there would be no violation of the
regulation. The point of the regulation is that only those individuals who are in need of – and
who actually receive – a community service position are entitled to other SCSEP services.
 Except in rare circumstances described in Topic 16, it is not permissible to assign an
applicant to the sub-grantee’s project office as a placeholder in order to pay the applicant
wages and conduct a formal assessment prior to assigning the applicant to his or her real
community service position. Applicants can be assigned to the project office only when there
is a legitimate community service position available and the applicant will be performing
legitimate work at the project office. On the other hand, as long as the original assignment
was made in good faith, nothing prohibits a sub-grantee from changing a participant’s initial
community service assignment if a more complete assessment or the formal IEP reveals that
the initial assignment was not optimal.
 An eligible applicant can be assigned to a grantee’s or sub-grantee’s project office as long
as the grantee or sub-grantee meets the requirements for being a host agency, there is an
authorized position available, the assignment is legitimate, and the assignment is consistent
with the participant’s IEP.
 In extraordinary circumstances where a regular host agency assignment is not available and
placing an applicant on the waiting list for an extended period would create hardship or be
contrary to the intent of the regulations, the applicant may be assigned temporarily to the
grantee’s or sub-grantee’s project office while a more suitable assignment is being developed.
CSA Form-13

Community Service Assignment Form Guide
Number

Topic 17

Rev. 6 (4/19/10)

Element Name/
Topic

Assignment of
participant to
temporary host
agency for
assessment and
other services

Element Description/Explanation Plus Additional Comments
 For example, a veteran over the age of 60 with multiple barriers to employment, including
physical and mental disabilities, requires extensive assessment and observation in a host
agency environment before it is possible to determine what kind of host agency assignment is
appropriate. In this case, the sub-grantee may assign the participant to a position at the subgrantee’s project office and may conduct the assessment while having the participant provide
various services to the sub-grantee. At the end of three weeks of assessment and observation,
the sub-grantee identifies a host agency that is willing and able to work with the participant
and transfers the participant to this host agency.
 This procedure is a very narrow exception to the general rule that an applicant cannot be
paid and cannot receive SCSEP services until the applicant has been assigned to a legitimate
community service position. The general rule does not permit you to pay an applicant while
you are conducting an assessment prior to assignment.
 Furthermore, if there is no suitable host agency assignment available, you are required to
place an eligible applicant on the waiting list and may not assign the applicant to the project
office solely to have a way to pay the applicant wages.
 If a participant is assigned to the project office, you must select value E1, Project
Administration, as the community service assignment code in field 17.
 Any use of this exception must be fully documented and is likely to be audited. For that
reason, you may wish to check with your federal project officer before using this exception.
 Although it is permissible to use temporary assignments in some circumstances, you
should not be assigning participants to temporary host agencies in order to provide additional
services to them before they commence their real host agency assignment.
 Only participants can receive SCSEP services. A participant is an eligible applicant who
has been assigned in good faith to a host agency with the expectation that he or she will
commence work there. Once assigned, the participant may receive additional services before
reporting to the assignment; however, you should not routinely make temporary assignments
in order to provide services before you make the real host agency assignment. You can do as
much assessment as is necessary to make an appropriate host agency assignment, but no more
than that, before assigning an applicant. There are limited exceptions where a participant with
serious barriers to employment may need a trial assignment to community service
 As a rare exception, you may assign the participant to the project office or to a temporary
host agency for purpose of completing the assessment or trial. (See Topics 15 and 16.)
CSA Form-14

Community Service Assignment Form Guide
Number
Topic 18

Topic 19
(New)

Topic 20

Rev. 6 (4/19/10)

Element Name/
Topic
Assignment of
two family
members to same
host agency

Element Description/Explanation Plus Additional Comments

 You may enroll two members of the same family; however, you should usually assign
them to different host agencies in order to prevent family dynamics from affecting the
workplace.
 If there are compelling reasons to allow this – e.g., one participant has a disability and the
other participant is essential for getting the first to the work site – you should try to find them
jobs that minimize their contact. You must ensure that one relative does not supervise the
other and must avoid any issues of nepotism.
 SCSEP wages received by an existing participant are not included in family income when
determining the eligibility of the other family member.
Participant as
 It is a conflict of interest for a participant to serve as a board member or in any decisionboard member
making capacity for a host agency or sub-grantee. Section 641.841(a) of the SCSEP
regulations, the anti-nepotism provision, prohibits assigning a participant to a host agency if a
member of the participant's family (and the definition of family is quite extensive) serves in a
decision-making capacity (whether or not compensated) for the host agency. Since it is a
conflict to have a relative who is on the board of a host agency, it is also a conflict for a
participant himself to be on the board of a host agency. The intent of the regulations is to
prevent a conflict that results in the participant's getting more favorable treatment than other
participants. For the participant himself to be on the board invites exactly that kind of
favoritism or at least the appearance of it.
Advocacy work at  The regulations prohibit enrollees from lobbying or engaging in partisan political
host agency
activities (Hatch Act prohibitions). Moreover, host agencies, which must be non-profits under
Section 501(c)(3) of the IRS code, are not permitted to engage in lobbying. It is often difficult
to tell when advocacy and outreach to members of Congress cross the line into lobbying.
Therefore, the participant may be assigned to a host agency engaged in such actions only if
you have taken adequate steps to ensure that the participant does not engage in activities that
could be considered improper under the regulations.
 The best way to ensure that there are no problems or misunderstandings is to write into the
host agency agreement a provision that the participant may not engage in certain defined
activities, including making phone calls or sending letters to Congress or assisting others in
these activities. You need to make sure that both the host agency and the participant
understand fully the nature of the restriction and the consequences of violating it. You must
also monitor the assignment to make sure that the restrictions are being enforced.
CSA Form-15

Community Service Assignment Form Guide
Number
Topic 21
(New)

Element Name/
Topic
Participants
volunteering at a
host agency

Topic 22
(New)

Participant
discovered to be
working at a host
agency to which
assigned

14

Start assignment
date

15

End date

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 Although there is no specific rule precluding volunteer work in general, volunteer work
should not occur in the host agency where the participant is assigned. In the context of an
assignment, it is often very difficult to determine whether volunteer work is truly voluntary.
Wage and hour laws would require payment of such labor for an employee (that is, an
employer cannot pay an employee for certain hours of work and accept additional hours of
work as volunteered), and the SCSEP regulations require that participants be paid for all
community service work. For these reasons, the participant should be told to volunteer at an
organization other than his or her own host agency if the participant has extra time and energy.
 While you could bring a legal action against the participant, the only practical remedy is to
terminate the participant for failure to comply with program rules. Grantees are required to
inform all participants in writing of the no-employment rule and of the importance of
immediately reporting any employment. If you have properly informed the participant, you
must terminate the participant. (See Topic 68 of the Participant Form Guide.)
 Grantees should also inform all host agencies of the no-employment rule in their host
agency agreements. If the host agency was aware of the rule and was complicit in the
participant's violation, you should end your relationship with the host agency and not place any
other participants there.
 Enter the date on which the participant actually commenced work with the host agency.
 This date may be different from the assignment date if, for example, the participant
attended orientation or training before reporting to the assignment with the host agency.
 Enter the date on which the participant ended the community service assignment with this
host agency. This will usually be either the date of exit or the day before reassignment to a
new host agency.
 An individual must be assigned to community service in order to be a participant. The data
system assumes that a participant without an open community service assignment should have
been exited. Therefore, do not enter an end date for a participant unless: 1) you are assigning
that participant to a new host agency; 2) you are exiting the participant; or 3) you are placing
the participant on an approved leave of absence and the participant is not returning to the
current host agency. (See element 15a below.)
 If the participant exits for unsubsidized employment and exercises the right of return (see
Topic 1 of the Exit Form Guide), when you erase the exit, you must also immediately make a
new community service assignment for the participant even if the participant is returning to the
CSA Form-16

Community Service Assignment Form Guide
Number

Element Name/
Topic

Topic 23

Assignment data
for participants
who do not start
work at a host
agency before
exiting

15a
(Revised)

Approved break
in participation

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
host agency he or she left to enter unsubsidized employment.
 The three host agency dates in fields 13-15 are critically important, and great care should
be taken to enter them accurately. The end date will be used to determine which host agencies
are eligible for participation in the customer service survey each year and to calculate average
duration of assignments.
 There are circumstances where you have made someone a participant – taken an
application, determined the applicant eligible, and assigned the applicant to a community
service position – but the individual changes his or her mind and withdraws from the program
before actually starting the community service assignment. In these cases, you enter the
assignment date in field 13 of the CSA Form; you leave the start date (field 14) and the end
date (field 15) blank. You also complete the Exit Form and identify the reason for the exit in
field 5 or 6. (Do not use field 6a of the Exit Form. Since this individual is a participant, you
use the true exit reasons in fields 5 and 6.)
 You are not permitted to place an applicant directly into unsubsidized employment without
first assigning the individual to community service. If your participants often obtain
unsubsidized employment without starting work at their host agencies, it may appear that you
are circumventing the regulation. This is likely to trigger a monitoring inquiry.
 Enter here the start and end dates of any approved break in participation, such as a leave of
absence without pay.
 You should use this field to record a leave of absence when the participant is returning to
his or her current host agency. In that case, you do not enter an end date for the assignment
while the participant is on leave.
 You should also use this field to record any delay of more than three days in reassignment
when a participant has ended one host agency assignment but has not yet begun another.
 Leaves of absence of four days or more that are properly entered into SPARQ will not be
included in calculating the durational limits for projects or participants. Failure to enter a
leave of absence will work to the disadvantage of a grantee.
 SPARQ permits you to enter multiple breaks in participation for a single assignment.
 Because leaves of absence affect eligibility and performance, the various fields that
establish a valid break in participation are subject to data validation.

CSA Form-17

Community Service Assignment Form Guide
Number
15b

Topic 24
(Revised)

Topic 25
(New)

Rev. 6 (4/19/10)

Element Name/
Topic
Reason for
approved break in
service
Leave of
absence/approved
break in
participation

Federal holidays

Element Description/Explanation Plus Additional Comments
 Indicate the reason for the leave of absence or other approved break in participation.
 You may select only one reason for an approved break in participation. Data validation is
required for this element.
 Grantees are required to have a policy governing approved breaks in participation,
including breaks for necessary sick leave. The policy must be in writing and should clearly
describe the consequences if a participant violates the policy. The policy should also be
referenced in the grant. Violation of the policy would be grounds for termination and should
be subject to the grantee's grievance procedure. See Section 641.580(d) of the regulations.
Participants should acknowledge in writing their receipt of the policy.
 Grantees must provide necessary sick leave to participants. Grantees must decide what
constitutes necessary sick leave and if it is paid or in the form of rescheduled work time.
 Participants are not federal employees and are not subject to the protections afforded to
federal employees. However, before you conclude that participants are not employees under
state law and thus are not covered by federal or state policies providing for leaves of absence
that apply to employees in your state; you might want to check with the relevant state
authorities such as the Labor Department or the Attorney General.
 A participant on an approved break is still a participant. If the participant is returning to
the host agency where last assigned, do not end the current assignment, but use field 15a to
record the dates of a leave of absence. If the participant is not returning to the current host
agency and you have ended the assignment, this field establishes that the participant is still
enrolled in the program while he or she is between host agency assignments.
 If you do not have a suitable host agency assignment for a participant and you do not
expect to have one within a reasonable period, you must terminate the participant using Exit
Form field 6(vi). You cannot place the participant on a leave of absence and leave a
participant in suspension indefinitely. You must make room for other applicants who need and
can take advantage of SCSEP services.
 The 2006 amendments to the OAA provide that grant funds can only be used for specified
fringe benefits, including compensation for scheduled work hours during which a host
agency’s business is closed for a federal holiday.
 Grantees may choose to pay wages for the federal holiday or to allow the participant to
reschedule the lost hours to a day when the host agency is open.
CSA Form-18

Community Service Assignment Form Guide
Number
Topic 26
(New)

Element Name/
Topic
Reinstatement of
participants after
workers’
compensation
leave

Topic 27

End date when reassigning a
participant to a
new host agency

Topic 28
(Revised)

Durational limits

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 Grantees are required by Section 504 of Title V and Section 641.565(b)(1)(iii) of the
SCSEP regulations to provide workers’ compensation coverage for all participants. Legally,
whether the participant is entitled to be restored to his or her host agency position is a matter
of state workers’ compensation law. Under state law, a worker may be entitled to reinstatement
to his or her original job if it is still available. If it is not available, the worker may be entitled
to another suitable and available position. Grantees should check with the relevant state
officials or their own attorney to determine their obligations under state law.
 As a matter of SCSEP policy, grantees should make every effort to return an injured
participant who has been released by his or her doctor to the prior host agency assignment if it
is still available and appropriate to the participant’s needs or to another appropriate assignment
with the same host agency or with a different host agency if the original assignment is no
longer available or appropriate. If the grantee is over-enrolled and cannot accommodate the
participant at the time of the doctor’s return-to-work release, the participant should be placed
on the waiting list.
 Grantees should have a written policy governing breaks in participation that is approved as
part of their grant application. The policy should cover leaves for personal reasons and sick
leave. The policy should also spell out participants’ entitlement to reinstatement following a
workers’ compensation injury. Grantees may not include in their policies any provisions that
would deny injured participants the right to reinstatement.
 The movement of a participant from one host agency to another is a reassignment. In
SPARQ, you have three days after closing a host agency assignment to start a new assignment
for that grantee.
 If you do not think that you can assign the participant to the new host agency within three
days, you have only one effective choice: You should place the participant on an approved
break in participation (see Element 15a and Topic 24 above).
 The 2006 amendments to the OAA impose durational limits for the first time. Grantees are
limited to an average duration of 27 months for all participants. Each spring, as part of the
grant application, grantees may seek an extension of the 27 months average duration to 36
months for the coming program year. Separate and apart from the average grantee durational
limit, individual participants have a lifetime durational limit of 48 months with any and all
projects. Grantees may seek a waiver of the 48-month duration for individual participants.
Both limits are calculated from July 1, 2007. DOL will provide guidance on the durational
CSA Form-19

Community Service Assignment Form Guide
Number

Element Name/
Topic

Topic 29
(New)

Re-enrollment

Topic 30
(New)

Host agency
rotations

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
limits in the new regulations implementing the 2006 amendments.
 Regardless of durational limits, a grantee may not enroll job-ready participants. If a
participant has been in another grantee's project for so long that he or she has reached a
durational limit, the participant may be job ready. In that case, the participant may not be
enrolled by the new grantee but must be referred to the one-stop center.
 Management reports are being revised in SPARQ to help grantees manage the durational
limits, and the QPR now displays the average project duration for each grantee and subgrantee. New reports will be created as necessary.
 Grantees are required to have a durational policy that adopts one of three possible
durational limits for individual participants: 48 months with no possibility of a waiver; 48
months with the possibility of a waiver; and less than 48 months (if the grantee files a special
request with its grant application and the request is approved by DOL). If grantees adopt 48
months with a waiver, the policy should describe the criteria that the grantee will use to
determine which participants will be entitled to a waiver.
 Participants must be informed of the durational policy (including the possibility of a
waiver, if applicable under the grantee’s policy) at the time of enrollment and annually
thereafter. Participants who are approaching their durational limit and are unlikely to find
unsubsidized employment prior to exit must be provided with transition services. The
transition plan must be reflected in the participant’s IEP.
 Grantees should make sure that their policies address the issue of re-enrollment,
specifically under what circumstances a participant may be re-enrolled and what is the effect
of re-enrollment on durational limits for program participation.
 The participant does not have a right to re-enrollment. Re-enrollment is discretionary. If
the participant was terminated for cause, or became job-ready during the prior enrollment, you
should not re-enroll him or her. (See Topic 43 of the Participant Form Guide.)
 Although grantees are permitted to have host agency rotation policies, rotation must be
based on the needs of participants and must be consistent with participants’ IEPs. The IEP
should determine when a participant should be reassigned to another host agency. Although
participant preferences are entitled to consideration, the critical factor in assigning or
reassigning a participant to a host agency is the sub-grantee's determination of where the
participant can best acquire the needed skills to become self-sufficient.
 In the case of a re-enrollment, if the last IEP indicated that the participant acquired the
CSA Form-20

Community Service Assignment Form Guide
Number

Element Name/
Topic

16
(Revised)

CSA wage (per
hour)

Topic 31
(Revised)

Payment of
minimum wage or
higher

Topic 32

Payment of higher
wages to
participants
assigned to project
office

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
expected skills at the prior host agency, then it is time to assign the participant to a new host
agency. If, for some reason, the ex-participant is being re-enrolled because he or she is not
job-ready and needs additional community service, it is hard to see how reassignment to the
original host agency would contribute to a meaningful IEP. If the participant has already spent
significant time with the prior host agency and that was not sufficient to prepare the participant
for unsubsidized employment, then the participant may benefit from the experience of a
different host agency to develop the missing skills.
 This field captures the current wage at the community service assignment. It must be
updated each time the wage changes.
 Grantees are required to increase wages whenever the minimum wage increases, so you
will want to update records for active participants at some point. However, the updating is
most important for new participants enrolled on or after the effective date of the minimum
wage increase and for any participants who receive a wage increase that is due to a reason
other than an increase in the minimum wage.
 Section 641.565(a) of the SCSEP regulations requires that you pay at least the minimum
wage applicable under the Fair Labor Standards Act of 1938; the state or local minimum wage
for the most nearly comparable covered employment; or the prevailing rate of pay for persons
employed in similar public occupations by the same employer, whichever is higher. Grantees
must implement wage changes whenever the applicable minimum wage increases; they cannot
wait until the start of the new quarter or new program year. These wages are floors and apply
to orientation, required training, and community service work.
 You are permitted to pay a wage above any of these rates. However, the national office
discourages projects from paying more than the statutory minimum wage, because raising the
hourly wage reduces the number of participants you can serve.
 There is no rule governing the wages of participants assigned to the project office. The
regulation requires you to pay all participants the higher of the applicable minimum wage or
the prevailing wage. You may pay applicants more than this required amount, but you are
strongly discouraged from doing so. The more you pay participants above the minimum, the
fewer participants you can serve. If you do pay more than the minimum, you should do so
pursuant to a policy so you are not accused of acting arbitrarily or discriminatorily.
 You should be careful about paying higher wages to participants assigned to the project
office. Grantees and sub-grantees often pay participants more than they would receive at other
CSA Form-21

Community Service Assignment Form Guide
Number

Topic 33

Topic 34

Topic 35
(Revised)

Rev. 6 (4/19/10)

Element Name/
Topic

Element Description/Explanation Plus Additional Comments

host agencies in order to keep the participants working for them. This practice may create a
disincentive for the participants to seek unsubsidized employment and thus may be doing the
participants a disservice.
 There are other problems as well. This practice is often seen as unfairly rewarding a small
class of participants and may create morale issues for other participants. In addition,
participants assigned to the project office must be rotated, like all other participants. When
they are, they lose their employment premium. This can have a negative effect on the
participants' morale.
 It is not permissible to put participants directly on the project payroll for a few additional
hours each week as a way to supplement their pay. That constitutes part-time employment,
which is not permitted for participants while they are in community service.
Can SCSEP wages  Nothing in federal law precludes garnishment of Title V wages. It is solely a matter of
be garnished?
state law whether, and to what extent, SCSEP wages can be garnished in a state legal action.
 The IRS has garnished SCSEP wages with DOL’s knowledge, and DOL has not raised
legal objections. The amount of the garnishment may vary depending on state law.
Provision of fringe  Section 502(c)(6)(A)(i) of the 2006 amendments sets forth the required and allowable
benefits
fringe benefits. These benefits include workers’ compensation, unemployment compensation
if required by state law, physical exams, certain federal holidays, and necessary sick leave.
 Grantees may not use grant funds to provide pension benefits, annual leave, accumulated
sick leave, or bonuses.
Physical exam
 Grantees are required to offer all participants an annual physical at the grantee’s expense.
This physical, as a fringe benefit, is solely for the benefit of the participant; it may not be used
for the grantee’s own purposes. If a participant declines the offer of a physical, grantees must
obtain a signed waiver.
 Grantees may not request a copy of the physical. In limited circumstances where grantees
are entitled to require a physical exam, e.g., where one is required of all participants assigned
to a particular host agency position, the grantee must arrange for a separate examination.
 A grantee may impose a cost cap on physical exams as long as the grantee ensured that the
participant can access the physical exam within the constraints of the cost cap. The grantee
should also offer the participant the opportunity to receive the physical exam through the
participant's choice of health providers and be reimbursed up to the amount of the cost cap. In
addition, the grantee must provide for a waiver of the cap if required by extraordinary
CSA Form-22

Community Service Assignment Form Guide
Number

Topic 36

Rev. 6 (4/19/10)

Element Name/
Topic

Are participants
entitled to
unemployment
compensation
benefits?

Element Description/Explanation Plus Additional Comments
circumstances, e.g., the nature of the participant's host agency assignment.
 The cost of physical exams may be charged to either the participant wages and fringe
benefits (PWFB) line or the other participant costs (OPC) line. However, it generally makes
sense to use the PWFB line because there is more money there. Because OPC funds can be
used for training, supportive services, etc. while PWFB funds cannot be used for these
purposes, OPC funds should usually be reserved for these more restrictive uses.
 Section 641.565(b)(4) of the SCSEP regulations provides that grantees may not pay the
cost of unemployment insurance for participants unless required by law. Federal law, Section
3309(b)(5) of FUTA, excludes from mandatory UI coverage any service “as part of an
unemployment work-relief or work-training program assisted or financed in whole or in part
by any Federal agency or an agency of a State or political subdivision thereof, by an individual
receiving such work relief or work training.” SCSEP qualifies for this exemption. However,
states are free to extend coverage to such programs, and a few states do so. If your state is
among them, the regulation permits you to use SCSEP funds to meet your UI tax obligation.
 There are two separate issues regarding UI benefits for participants. Former participants
who are collecting UI benefits may or may not be receiving benefits based upon their
participation in SCSEP. Depending upon when they last worked in covered employment and
when they were enrolled in SCSEP, their UI benefits may be based on their prior employment
and not on their SCSEP participation. Current participants collecting UI are probably
collecting on the basis of prior employment, not current SCSEP enrollment. Federal law
provides that a UI claimant who is otherwise eligible for benefits cannot be denied benefits
because he or she is currently enrolled in a job training program.
 Contact your state UI agency to learn what the law is in your state and which wage credits
were used to establish UI claims for SCSEP participants. If the wage credits came from prior
employment, you have no tax liability. If the wage credits came from SCSEP participation,
then you should discuss with the UI officials whether there is a basis under state law for
exempting participants from coverage because they are trainees under a job training program
and not employees. (You might also confer with other state and national sub-grantees in your
state. UI determinations are sometimes inconsistent, especially for issues that seldom occur.
Another sub-grantee may have gotten a different result.) You have the right to appeal any
adverse determination. If you are ultimately unsuccessful, you should discuss with the UI
officials the options you have as a non-profit organization to minimize your tax burden.
CSA Form-23

Community Service Assignment Form Guide
Number

Element Name/
Topic

Topic37
(New)

Effect of SCSEP
wages on
unemployment
compensation
benefits

Topic 38
(New)

Effect of SCSEP
wages on
Supplemental
Nutrition
Assistance
Program (SNAP),
federal housing
programs,
Medicaid, and
other programs

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 You can use this link to find the UI agency for your state:
http://workforcesecurity.doleta.gov/map.asp
 NOTE: If participants had recent work in an employment relationship prior to applying for
SCSEP, they may well have been job-ready. Job-ready applicants are not eligible for SCSEP
and should be referred to the One-Stop center. If job-ready participants were enrolled, their
IEPs should reflect the goal of unsubsidized employment as soon as possible.
 Many state unemployment laws permit an unemployment compensation recipient to work
part-time and receive a reduced unemployment compensation benefit. Unemployment laws
also permit a participant to be enrolled in an approved training program without jeopardizing
their unemployment compensation benefits.
 UI recipients are required to report all earnings to the unemployment compensation
department. Failure to do so may be considered fraud and will certainly result in an
overpayment if state law requires a reduction in UI benefits based on SCSEP wages. All
participants receiving UI benefits should be told to report their SCSEP participation and wages
to the unemployment compensation department at the time of enrollment.
 Check with the state unemployment department to see whether they consider SCSEP
participants to be trainees who should not be treated as employees.
 Section 509 of the Older Americans Act precludes SCSEP wages from affecting eligibility
only for federal housing programs (See TEGL 11-06 and the HUD regs at 24 CFR sections
960.225) and Food Stamps, now known as Supplemental Nutritional Assistance Program
(SNAP) benefits. How SCSEP wages are treated for all other state and federal programs
depends upon the rules of the specific programs.
 It does not appear that there is anything in the federal Medicaid rules that would
specifically provide for the exemption of SCSEP wages. Medicaid is a federal-state
partnership in which the states have a fair amount of discretion in setting income and asset
limits for different classes of beneficiaries. To determine what income your state counts for
Medicaid eligibility purposes, you should contact your state social services agency. There are
very generous rules for the "working disabled." There are also programs in many states under
which an individual can earn an amount over the normal limits and “buy-in” to Medicaid for a
small amount to maintain their Medicaid benefits, including personal assistance services for
the home and workplace. All disabled SCSEP participants should be made aware of these
Medicaid programs and informed of what assistance is available in their state.
CSA Form-24

Community Service Assignment Form Guide
Number
16a

Element Name/
Topic
Number of hours
per week assigned

16b

Participant’s
schedule

16c

Date of safety
consultation with
the participant
Community
service assignment
code

17

18

Rev. 6 (4/19/10)

Community
service assignment
title

Element Description/Explanation Plus Additional Comments
 Enter the average number of hours per week that the participant is assigned to this host
agency. You do not have to update this field with the actual number of hours worked each
week unless the average hours assigned changes. If the average number of hours assigned
does change, you must enter the new average, over-writing the existing number.
 This text field permits you to enter the days of the week and hours of the day when the
participant is expected to be working at the host agency. The field is for your convenience.
 The participant’s schedule is displayed in management reports. For this reason, you may
wish to use simple abbreviations that will be consistent in the report displays, e.g., M-F, 9-12.
 Unlike the date of host agency monitoring visit, which relates to the entire host agency,
this field is specific to the participant. It records the date of the last safety consultation with
this participant on-site at this host agency.
 Enter only one code for the type of community service to which the participant is assigned.
 The codes are divided into two main categories: service to the general community and
service to the elderly community. If the type of assignment you need is not listed, enter the
appropriate code for “other,” either G14 or E14, depending on whether the service is to the
general community or the elderly community.
 The codes reflect the nature of the work the host agency does rather than the participant’s
specific occupation or title. For example, a receptionist working for a visiting nurse
association would be coded G2, while a bus driver for a senior center would be coded E5.
 If the participant is assigned to the grantee’s or sub-grantee’s project office, select value
E1, Project Administration, as the community service assignment code.
 Enter the title of the community service position to which the participant was assigned as
determined by the host agency. This should be a descriptive title, such as receptionist,
nutrition aide, or bus driver. No occupational code is required.
 You do not create a new community service assignment when the participant remains at
the same host agency but the participant's job duties and title change. You can update fields
18 and 19 to reflect the new job title. Field 17, the Community Service Assignment Code,
should not change. The code defines the host agency, not the participant's particular job with
the host agency.

CSA Form-25

Community Service Assignment Form Guide
Number
18a
18b

Topic 39

19
(Revised)

Rev. 6 (4/19/10)

Element Name/
Topic
Participant’s job
code
Participant’s
workers’ comp.
code
Cash handling
assignments for
participants

Total hours paid in
quarter

Element Description/Explanation Plus Additional Comments
 You may enter only one of the pre-defined codes to indicate the particular job assignment
that the participant has at this host agency. If the job changes, you may select a new job code.
 Grantees may designate state-based workers’ compensation codes for use by their subgrantees. There is no nationwide list of codes.
 There is no SCSEP rule that prohibits the assignment of participants to community service
positions involving the handling of cash. It is possible that some grantees have had an
unofficial policy to this effect. If so, they have done so without the approval of the national
office. Such a policy has the appearance of discrimination and would have to be supported by
clear, non-discriminatory justification. A grantee should obtain approval from the national
office before imposing any such restriction.
 If your payroll system tracks hours actually spent in community service, you should use
these hours directly without deriving them from the paychecks. You are permitted to use the
paycheck method described in the next bullet if it is easier for you. However, there are
circumstances where the paycheck method may result in your not receiving full credit for
hours worked in the community service measure.
 For each quarter, enter the total number of hours for which the participant was paid wages
as determined from the sub-grantee’s wage records. To determine hours worked in the quarter,
you may use all paychecks issued in the quarter even if the pay period extends into a different
quarter. Any inaccuracy in reporting that this method causes will be balanced out during the
course of the year. To accommodate the possibility that a pay period may extend into another
quarter, the data system will permit you to enter hours in the quarter after the quarter in which
the participant ended the community service assignment. However, if the participant’s last day
in an assignment is near the end of a quarter and the final paycheck is issued in the subsequent
quarter, QPR field #13 (percent of participants working 18-22 hours per week) may not give
you credit for the final hours represented by that last paycheck.
 Do not make any deduction for fringe benefits paid.
 There is no place on the CSA Form to record paid leave. Grantees have been allowed to
use their payroll records to determine total paid hours in field 19 even if this time includes
some paid time off. However, if you have the time sheets and can determine which hours were
spent in community service, then you may include only those hours in field 19. Do not put
CSA Form-26

Community Service Assignment Form Guide
Number

Element Name/
Topic

Topic 40

Entering total paid
hours when
participant has two
different
assignments in the
same quarter

Topic 41

Required number
of hours in
community service
each week

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
any paid time into field 21 except that spent in paid training provided by the grantee or subgrantee rather than by the host agency.
 Enter this information only at the end of each quarter. WebDCS users may use the
administrative function, CSA Hours, to enter all hours for all participants from a single screen.
Alternatively, they may enter hours for an individual participant directly into field 19.
 The total hours paid in the quarter must at least equal the number of paid training hours in
the quarter (field 21). Training hours are a subset of total hours.
 You may enter time in half-hour increments. Use normal rounding rules: anything .75 or
higher is rounded up; anything less than .25 is rounded down.
 This information will be used to derive the total hours of community service and the
community service measure.
 Data validation is required for this element.
 Each host agency assignment requires a separate Community Service Assignment Form.
In SPARQ, that means a separate assignment record for each host agency. Data on the CSA
Form is specific to that host agency assignment only. It does not include data from any other
assignment. Therefore, you list in field 19 of the CSA Form the hours worked solely at that
host agency during a given quarter. If the participant worked at a second host agency during
the same quarter, you enter the hours worked at the second host agency on the CSA Form for
the second host agency. You do not combine hours and enter them on a single form.
 If a WebDCS user enters hours through the CSA Hours utility, all host agencies at which a
participant worked during a specific quarter will be listed.
 There is no rule governing how many hours a participant must work in community service
each week. There used to be a requirement that you offer all participants at least 20 hours of
community service per week but no more than 25 hours. That requirement no longer applies.
However, the cost per position is based on 21 hours of community service per week, and the
national office strongly recommends that you provide everyone 20 hours per week. The
community service measure uses 21 hours per week in the calculation of the denominator.
 There is no limit on the number of hours a participant can work in community service in a
year. However, the national office considers 1300 hours per year (calculated from the date of
enrollment) to be a good benchmark and encourages grantees to stay within it. Since positions
are allocated to grantees based on 21 hours per week per participant, you cannot exceed the
1300 hour limit without over-spending your grant or leaving some positions unfilled.
CSA Form-27

Community Service Assignment Form Guide
Number

Element Name/
Topic

Topic 42

Limit on number
of hours for
community service
and paid training

20

Types of training
received

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 If you provide more than 20 hours per week, you will not be able to serve the number of
participants required because you won’t have enough money. If you provide fewer hours,
participants may not get the training they need or enough money in wages to support
themselves.
 Field B12 of the QPR lists the percent of active participants who have worked between 18
and 22 hours per week. At this time, this field is for informational purposes only.
 The amount of paid community service and training that a participant can receive each
week is limited. Because the statute defines community service as part-time employment, paid
time must be less than 40 hours each week. (SPARQ requires less than 553 hours per quarter.)
 The national office intends that the limits on OJE training contained in OWB 04-04 apply
to all paid training. Paid training may not exceed 40 hours a week. If the participant is in both
community service and paid training, the total hours paid per week for both may not exceed
40. The SPARQ edits reflect these limits.
 All training must be described and approved in the grant agreement. The details are listed
in the OWB. As a practical matter, because funds for training are so limited, you will need to
set reasonable limits so that your resources are not exhausted by just a few participants.
 Field 20 records all types of training that the participant receives while assigned to this
host agency. A participant can only receive training while assigned to community service,
even if the participant is on a leave of absence from the host agency at the time of training.
 Check as many types of training as apply and update this field as appropriate throughout
the participant’s assignment with this host agency. The data in field 20 are cumulative. You
never delete the information, and you add new training types when they occur.
 If you use the optional Training Information section of the CSA Form and complete field
34, SPARQ will automatically update field 20 with the training type indicated in field 34.
However, you can always update field 20 manually even if you have completed field 34.
 Check the appropriate box(es) to indicate the type(s) of training the participant has
received. If “other” is checked, specify the type(s) of training. If training was not provided,
enter “none.” In this field, include only training that has been designed and provided (directly
or through a training provider) by the sub-grantee, not routine training that is provided by the
host agency as a normal part of the community service assignment. Do not record any host
agency training in field 20.
 The definitions for the types of training listed in field 20 come from OWB 04-04. General
CSA Form-28

Community Service Assignment Form Guide
Number

Element Name/
Topic

Topic 43

Using OJEs to
transition
participants to
unsubsidized
employment

Topic 44

OJEs are not
placements

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
training is defined as that which enhances a participant's basic skills. It is in contrast to
specialized training, which is designed to prepare a participant for a particular job or
occupation. Group meetings could be general training, depending on the content. If you are
doing solely job search or job club without any basic skills component, you should use field
20d, "Other," and list job search in the text field.
 Many participants are unsure of their job skills and are reluctant to leave the program for
unsubsidized employment without some sort of safety net. The new regulations do not permit
participants to work part-time while enrolled, even if the job is designed to transition them to
complete unsubsidized employment. Participants must be unemployed while they are enrolled
in the program. However, the transition to unsubsidized employment can be addressed though
an OJE. OJEs are designed to give both the participant and the employer a trial and to provide
additional training to ensure the success of the unsubsidized employment.
 Under OWB 04-04, the participant may have a combined total of 40 hours per week in
community service and OJE employment for up to 12 weeks. The participant may be enrolled
in the program and receiving wages for community service while working part-time for the
employer. You can also reduce the community service hours as the hours of employment
increase. You must obtain approval for OJEs in your grant before you can create them.
 The transition to unsubsidized employment can also be facilitated by the right of return.
See Topic 1 of the Exit Form Guide. The right of return is designed to encourage participants
to try unsubsidized employment when they may have doubts about their ability to succeed. If
a participant exits the program for unsubsidized employment and does not work for a total of
30 days, you may bring the participant back into the program within 90 days of exit as though
she had never left. If the job does not work out, the participant can come back into the
program and obtain the skills and self-confidence needed to be successful in a new placement.
 An OJE is a type of training, paid for with program funds; it is not a placement. A
participant remains enrolled in the program during an OJE, and does not exit. The
performance measures are not implemented until the OJE ends, the employer has picked up the
participant, and the participant has exited. The start work date on the Unsubsidized
Employment Form should be the first day on the employer's payroll after the OJE has ended
and the participant has exited.
 SPARQ has screens for capturing the details of any paid training provided to a participant,
including an OJE. (See Elements 23-43 below.)
CSA Form-29

Community Service Assignment Form Guide
Number
Topic 45
(New)

Topic 46

Topic 47

Rev. 6 (4/19/10)

Element Name/
Topic
OJE with different
department of
existing host
agency

Element Description/Explanation Plus Additional Comments

 The plain language of the OWB precludes your entering into an OJE contract with an
existing host agency regardless of what department the OJE would be in. The SPARQ rule for
creating multiple host agencies out of a single "parent" host agency was created for a different
purpose and has nothing to do with OJE's. The OWB rule is designed to ensure that there is no
confusion about the role of host agencies and their obligations to participants.
 You should be able to fashion a flexible assignment with the host agency so that the
purpose it wanted to serve through the OJE can be achieved through the assignment.
How long a
 OWB 04-04 requires that participants be assigned to community service before they
participant must be receive any training. The bulletin requires a participant to work at a host agency for at least
in community
two weeks before beginning an OJE but does not provide a specific time in community service
service before
before receiving specialized training. To be safe, you should wait at least two weeks.
receiving
 The key is that the participant be properly enrolled in the program, which means that he or
specialized
she needs and can benefit from community service in order to become job-ready. To enroll
training
individuals, put them directly into training, and then place them violates the requirements of
the program. Note also that you must have approval for specialized training in your grant
agreement or a modification to the agreement. General training, such as an introduction to
computers, can be provided immediately after a participant is assigned to community service.
Participant’s
 A participant must remain assigned to a host agency in order to receive any SCSEP
community service services, including training. If the sub-grantee wishes to provide training to a participant
status when
between host agency assignments, it should reassign the participant to a new host agency
assigned to
before sending the participant to training. If it is unable to make an appropriate assignment
training only or
before the training begins, then it must leave the participant assigned to the first host agency
working reduced
and reassign the participant to a new host agency upon the completion of training.
hours in
 The participant does not have to be actually working at the host agency at the time of the
community service training. You may leave the participant assigned to her original host agency while the
participant is in training even if the host agency is not willing to let the participant work
reduced hours or to hold the position open until the training is concluded. If you do so, you
would end the original host agency assignment on the date the training ends. You would then
need to assign the participant to a new host agency. Alternatively, you can assign the
participant to a new host agency now (ideally one that will let the participant work reduced
hours while in training) and close the original host agency assignment.
 You cannot put the participant in training if the participant is not assigned to a host agency.
CSA Form-30

Community Service Assignment Form Guide
Number
Topic 48

Element Name/
Topic
Paid training and
community service
hours

21

Total hours of paid
training received
in quarter

Topic 49

Payment of wages
for training and
job search activity

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 You may pay participants wages while they are in training regardless of whether WIA
provides the training or the sub-grantee uses its funds for the training. If the training is
considered to be required, e.g., is in the IEP, you must pay wages.
 To receive training, a participant must be assigned to community service; however, there is
no requirement that the participant be working at the host agency for any minimum number of
hours during the training. The maximum number of hours for which the participant can be
paid for training, or for a combination of training and community service, is 40 hours per
week. (See Topics 41 and 42)
 At the end of each quarter, enter the total number of hours of paid training that the subgrantee provided, directly or through a training provider, to the participant. Do not include any
training provided by the host agency.
 WebDCS users may use the administrative function, CSA Hours, to enter all hours for all
participants from a single screen. Alternatively, they may enter hours for an individual
participant directly into field 21.
 The hours in this field will be subtracted from the total number of hours paid in field 19 to
derive the number of hours in community service for the QPR. You do not make this
calculation. The calculation will be done for you at the time the QPR is generated.
 The number of hours of paid training in a quarter can never be more than the total hours
paid in the quarter (field 19).
 You may enter time in half-hour increments. Use normal rounding rules: anything .75 or
higher is rounded up; anything less than .25 is rounded down.
 Data validation is required for this element.
 The regulations provide that you must pay participants the minimum wage for orientation,
grantee-required training, and community service work. Job search activity alone, however, is
not considered training. You may pay participants for engaging in job search activity, such as
participation in a job club, but you are not required to do so unless the job search activity is
provided in conjunction with required training. Of course, you may only provide SCSEP
services, such as training or job search assistance, to participants.
 If you do pay wages for job search activities, you must record these hours in field 21 so the
hours can be deducted from total paid hours to derive the hours of community service. In field
20, you should select "d. Other" and indicate job search assistance.

CSA Form-31

Community Service Assignment Form Guide
Number
Topic 50

Element Name/
Topic
When training is
considered
grantee-required

Topic 51

Effect of paid
training on
performance
measures

Topic 52

Recording paid
OJE hours

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 If you specify in the IEP training that the participant will definitely take, it is considered
grantee-required. (You can always list training that you discussed with the participant and that
the participant may take at some point.) If you do not want to pay for training because you do
not believe that it is essential, you should not list it in the IEP. If the participant nonetheless
decides to take this training on his or her own, you may modify the IEP after the fact to reflect
that, in addition to the required training, the participant also completed other training.
 If job search training is provided as part of other required training, such as general job
readiness, you must pay wages for the training. That does not mean that you have to pay for
the actual job search component. For example, if the grantee requires that participants attend a
training course for 3 hours each week and also spend 3 hours each week seeking employment
with the new skills they are learning or that they contact a minimum of 3 prospective
employers each week; the 3 hours spent in the class would be paid, but the time spent looking
for work would not have to be paid. Note, however, that you may pay for pure job search
activity even though you are not required to.
 You cannot avoid paying wages for required activities by paying the participant for
required training but allowing or compelling the participant to work without pay at the
community service assignment. However, in the negotiation of the IEP, you could agree that
the participant would be on an unpaid leave of absence from the host agency while the
participant attended classes. As long as the participant remains assigned to community
service, even if on an approved break in participation, you can pay for the training.
 Although paid training is subtracted from total paid hours to determine hours in
community service, grantees will not be penalized in the performance measures for providing
paid training. Since the national office is encouraging the appropriate use of training, the
community service measure does not include paid training in the denominator, thus holding
grantees harmless for any training provided.
 OJE wages may be paid by either the sub-grantee or the employer. If paid by the subgrantee using the regular payroll, they must be listed in field 21 so they can be subtracted from
total hours paid. If paid by the employer, they should not be entered in field 21 because they
are not included in field 19 and thus there is no reason to subtract them. When the sub-grantee
reimburses the employer for OJE wages, the sub-grantee must use a form of payment, e.g.,
purchase order, that is outside of the participant payroll system. In that situation as well, the
OJE hours are not included in the total hours paid in field 19. Since the hours in OJE do not
CSA Form-32

Community Service Assignment Form Guide
Number

Element Name/
Topic

Topic 53

Hours of
community
service, how
calculated

22

Community
service assignment
comments
Sub-Grantee
Provided Training
Information

Form Heading 5

Form Heading 6

Training Provider
Information

23

Name of training
provider or OJE
employer
Training provider
or OJE employer
mailing address
Training provider
continued
availability

24

25

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
need to be subtracted from the total hours paid, they should not be listed in field 21.
 Note: Pursuant to OWB 04-04, you will need to track the number of weeks in OJE to make
sure that they are within the durational limit.
 Grantees do not calculate hours of community service. The program that generates the
QPR will do the calculation using the information you provide in fields 19 and 21 of this form.
 If you use the payroll method to determine hours, you do not need to make any adjustment
for fringe benefits received, such as vacation pay. Such benefits may be included in the total
hours paid in the quarter, field 19, in order to simplify your reporting of the data.
 Use this field to record any additional information about the community service
assignment. You may enter up to 1000 characters (about 160 words).
 This optional section of the CSA Form is for recording a single training event that occurs
while the participant is assigned to this host agency. A training event must always be
associated with a specific host agency assignment even if the participant is on an approved
break in participation during the training.
 Complete a new Training Information section for each training event. A participant can
have multiple training events for a single host agency assignment.
 Fields 23-25 are entered in the Organizations utility in SPARQ. An organization can be a
host agency, a training provider, or an employer, or any combination of these three types.
 You select the training provider from the drop-down menu. If training provider is not on
the drop-down menu, you can enter a new one from field 23.
 Enter here the name of the organization that provided the training to the participant. If the
training is OJE, enter the name of the employer providing the OJE even if the participant
continues to receive wages directly from the sub-grantee.
 Enter the address as you want it to appear on an envelope or mailing label.
 You may indicate that the organization no longer wishes to serve as a training provider or
that the sub-grantee has decided it no longer wishes to continue working with this
organization. There are similar fields for host agencies and unsubsidized employers.

CSA Form-33

Community Service Assignment Form Guide
Number
Form Heading 7

26

27

28
29
30
31
32
33

Rev. 6 (4/19/10)

Element Name/
Topic
Contact Person
Information

Name of training
provider or OJE
employer contact
person
Contact person’s
mailing address if
different from
number 24
Contact person’s
title
Contact person’s
salutation
Contact person’s
phone number
Contact person’s
fax number
Contact person’s
e-mail
Types of training
received

Element Description/Explanation Plus Additional Comments
 Fields 26-32 are entered in the Contacts utility in SPARQ 2.
 The information captured by these fields is the same as that for the host agency and
employer contact person. There is no field for training provider supervisor.
 You select the contact person from the drop-down menu. If the contact person is not on
the drop-down menu, you can enter a new one from field 26.
 This optional information may be entered through the Organizations Contacts on the home
page of the WebDCS or directly on the training information screen.
 This optional information may be entered through the Organizations Contacts on the home
page of the WebDCS or directly on the training information screen.
 This optional information may be entered through the Organizations Contacts on the home
page of the WebDCS or directly on the training information screen.
 This optional information may be entered through the Organizations Contacts on the home
page of the WebDCS or directly on the training information screen.
 This optional information may be entered through the Organizations Contacts on the home
page of the WebDCS or directly on the training information screen.
 This optional information may be entered through the Organizations Contacts on the home
page of the WebDCS or directly on the training information screen.
 This optional information may be entered through the Organizations Contacts on the home
page of the WebDCS or directly on the training information screen.
 For each training event, you can only select one value for this field. Unlike field 20 of the
CSA Form, which is cumulative and reflects all training that the participant received while
assigned to this host agency, field 33 captures only the specific training type provided at a
single training event. You must fill out additional Training Information sections of the CSA
Form if you wish to record additional training events.
 SPARQ will automatically add to field 20 any training types indicated in field 33. SPARQ
will not remove training types from field 20. Therefore, if you delete a training type from field
33, you must remember to also delete it from field 20.

CSA Form-34

Community Service Assignment Form Guide
Number

36

Element Name/
Topic
Job code for
which training is
provided, if
relevant
Participant’s
workers’
compensation
code in training
Start training date

37

End training date

38

Average number
of hours per week
of training

39

Average number
of hours of
community
service per week
during training

40

If OJE, wages
paid by
Training wage
(per hour)
Total wages paid
to participant or
reimbursed to
employer

34

35

41
42

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 You may use this field to select one of the pre-defined job codes if the training event
provides training for a specific job or occupation. This field is applicable to specialized
training or OJE, but not to general training.
 Grantees may designate state-based workers’ compensation codes for use by their subgrantees. There is no nationwide list of codes.
 Indicate the date on which the training event began. The participant must remain assigned
to the host agency to which the Training Information section is attached while in training.
 Indicate the date on which the training event ended. This date must be no later than the
end date for the host agency assignment to which the Training Information section is attached.
 Enter the average number of hours per week for which the participant is scheduled to
receive training. You do not have to update this field with the actual number of hours in
training each week. However, you do have to update this field if the number of hours of
training scheduled each week changes.
 Enter the average number of hours per week that the participant is scheduled to work at the
host agency while attending paid training. You do not have to update this field with the actual
hours of work performed each week. However, you do have to update this field if the number
of hours of community service assigned each week changes.
 For OJE, the total of paid training hours (field 38) plus community service hours (field 39)
may not exceed 40 hours per week.
 Indicate whether OJE training wages are paid by the sub-grantee or the employer. If the
wages are paid by the employer, indicate the percent reimbursed by the sub-grantee.
 Indicate the wage paid to the participant while in training. This field must be updated
whenever the wage changes.
 Indicate the total amount of wages paid to the participant during the training event,
whether paid by the sub-grantee, the employer, or both. This amount is not limited to a single
quarter.
 You must continue to fill out field 21 of the CSA Form, which records the total number of

CSA Form-35

Community Service Assignment Form Guide
Number

43

44

Rev. 6 (4/19/10)

Element Name/
Topic

Element Description/Explanation Plus Additional Comments

paid hours of training in a single quarter. Field 21, which is mandatory, is cumulative across
all training events for a participant at a host agency during a specific quarter. Field 42, which
is optional, records the total dollars paid at a single training event regardless of the quarters
involved.
Total amount paid  Indicate the total amount paid to the training provider for the provision of training for this
to training
training event for this participant. Do not include any amount paid to the participant as wages.
provider for
provision of
training (other
than
reimbursement to
employer)
Training
 Enter any comments regarding this training event. You may enter up to 1000 characters
Comments
(about 160 words).

CSA Form-36

THIS PAGE INTENTIONALLY LEFT BLANK

Exit Form Guide

Exit Form Guide
Number

Element Name/
Topic
Form Heading 1 Exit Form

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 This form is used to record when a participant ends his or her last community service
assignment and is no longer being paid wages.
 “Exit” has several different meanings for the data collection and reporting system. For the
performance measures, a recorded exit may not be considered final until a certain amount of time
has passed. For example, if a participant has exited the program to enter unsubsidized
employment, you should code the exit as due to unsubsidized employment, field 5, at the time it
occurs. However, if the unsubsidized employment lasts for fewer than 30 days in the first 90
days after exit, the participant is entitled to a new host agency assignment without having to reenroll, i.e., without completing a new Participant Form. See Right of Return, Topic 1, below. If
the participant elects to return to the program, the “exit” will be reversed and will not be counted
in the performance measures. (See field 5 below.)
 For the Common Measures, an exit does not occur (and the individual is not included in the
performance measures) until the participant has gone 90 days without a service from the
program. Therefore, an individual who exits but receives a SCSEP service (which requires a
new host agency assignment) within 90 days through re-enrollment, i.e., with a new Participant
Form, will be excluded from the Common Measures. In this case, however, the original SCSEP
“exit” will remain and a new record will be created to reflect the re-enrollment. The exercise of
the right of return also means that there has not been an exit for Common Measures purposes.
 Similarly, a participant who exits from one project but is transferred to another project has
not officially exited the program and is not included in the performance measures until the
participant has truly exited the project to which he or she was transferred. The movement of a
participant from one sub-grantee to another sub-grantee within the same grantee is not an exit but
is also recorded on the Exit Form. (See Topic 9 below and field 6a below.)
 Normally, once an individual exits, he or she cannot become a participant again without reenrolling. Re-enrollment requires the completion of a new Participant Form and a new
Community Service Assignment Form. (See field 5 and Topic 1 below for an exception.)
 Do not use the Exit Form to record that a participant is on an approved break in participation,
field 15a of the Community Service Assignment Form. Such an individual is still a participant.
If the participant decides not to return from the leave and to cease participation in the program,
you will record the exit at that point. The date of exit will be the date on which the participant
decides not to return, not the date of the original leave.
Exit Form-1

Exit Form Guide
Number
3

4

5

Rev. 6 (4/19/10)

Element Name/
Topic
Participant
mailing address
(if changed)

Phone number of
participant (if
changed)
Exit due to
unsubsidized
placement?

Element Description/Explanation Plus Additional Comments
 At the time of exit, it is essential to verify and update the participant’s mailing address and
telephone number. If there has been no change, leave this field blank.
 If the applicant does not have a residence, try to obtain an address at which the applicant can
receive mail. The mailing address fields will be used to generate letters and mailing labels for
the customer satisfaction survey. Be sure to enter the information as you want it to appear on the
envelope. “County” will not be used for mailing.
 For WebDCS users, updating of participant information (other than name and Social Security
number) must be done on the Participant Information screen, which you access from the
Enrollments tab on the main page.
 If there has been no change, leave this field blank.
 If no home phone, try to obtain a number where a message can be left with a friend, neighbor
or family member. If none, leave blank. Do not enter N/A or dummy data into this field.
 Check “Yes, regular employment” if the participant exited into a full- or part-time job with
an unsubsidized employer and the participant’s salary is not paid with program funds. There is
no minimum number of hours per week required. An OJE is not considered unsubsidized
employment. A placement does not occur until the OJE has ended, the participant has exited the
program, and the employer has officially hired the participant.
 Check “Yes, self-employment” if the participant exited the program to engage in selfemployment. A self-employed individual includes someone who operates a business or
profession as a sole proprietor, partner in a partnership, independent contractor, or consultant.
An activity qualifies as a business if the primary purpose for engaging in the activity is income or
profit and the participant is involved in the activity with continuity and regularity. A sporadic
activity or a hobby does not qualify as a business. Self-employment may be verified by any
proof that the individual has started a business, such as tax registration, business cards or
invoices, or a state license. The individual does not have to prove income from the business, but
the receipt of income would suffice to establish self-employment.
 Check “No” if the participant exited for some reason other than unsubsidized employment
(field 6) or if you are closing the participant’s record for one of the reasons in field 6a. You must
check “no” in field 5 before you will be allowed to enter a value in either field 6 or field 6a.
SPARQ will not accept an exit from either WebDCS or non-WebDCS users unless field 5 is
completed.
 A placement does not result in entered employment and is not included in the performance
Exit Form-2

Exit Form Guide
Number

Topic 1

Rev. 6 (4/19/10)

Element Name/
Topic

Right of return
and reenrollment:
priorities/
preferences

Element Description/Explanation Plus Additional Comments
measures unless the participant is employed during the first quarter after the quarter of exit.
However, you should record the exit as due to unsubsidized employment at the time it occurs. A
participant whose employment does not last for 30 days is entitled to re-enter the program. If the
participant elects to return to the program, you must delete the exit (and any entered employment
information you may have entered into field 28 of the Unsubsidized Employment Form) and
create a new community service assignment. If you delete the exit, enter a note in the comments
field (field 10). If the participant does not elect to return to the program, the exit remains as
originally coded and no comment is required. (See Topic 1 below.)
 The right of return is designed to afford participants a 30-day trial period in unsubsidized
employment. It is limited to those participants who exit for unsubsidized employment but do not
work for a total of 30 days within the first 90 days of exit. They are allowed to return to the
program within 90 days without being subject to the priorities of service. Their exit is reversed,
and they are treated as though they never left the program. You do not fill out a new Participant
Form for them. You must assign a returning participant to a host agency, either the one the
participant left or a new one. You must create a new host agency assignment even if you
reassign the participant to the old host agency. If there is no slot available at the time the
participant seeks to return, the participant should be placed on an approved break in participation
(field 15a of the Community Service Assignment Form) and given the next available assignment.
 Use field 27 of the Unsubsidized Employment Form to record whether a participant who
worked less than 30 days is electing to return to the program. You delete the exit reason (field 5)
and the exit date (field 7) from the Exit Form, and you must delete the “yes” in field 28 if you
have already recorded entered employment. You also fill out a new Community Service
Assignment Form to document the host agency assignment. Use the comment field on the Exit
Form to explain what you have done. The participant will not be included in the outcome
measures until the participant again exits the program.
 You can choose to re-enroll a participant who exited for any reason provided the participant
is not job ready and meets the other eligibility requirements. Re-enrollment is not limited to 90
days of exit. It does require a new application and a new Participant Form. A participant
seeking to re-enroll is subject to the priorities of service in effect at the time. If there are no
available slots or the re-enrolling participant is lower in priority than other applicants, you can
place the re-enrolling participant on the waiting list. Re-enrollments within 90 days of exit must
be recorded in field 27a of the UE Form.
Exit Form-3

Exit Form Guide
Number
Topic 2

6
(Revised)

Rev. 6 (4/19/10)

Element Name/
Topic
Entered
employment
discovered after
exit

If exit is not due
to unsubsidized
employment,
other reason for
exit

Element Description/Explanation Plus Additional Comments
 The performance system will count any entered employment – i.e., any employment within
the first quarter after the exit quarter – regardless of whether the placement occurred at the time
of exit or subsequent to exit. If you discover the placement after the participant exited, you
should complete an Unsubsidized Employment Form and conduct the three follow-ups.
 You do not change the original exit date and exit reason as entered on the Exit Form. The
system will detect the placement from the Unsubsidized Employment Form.
 It may be worthwhile to stay in touch with some participants (especially those who are most
job-ready) who exit the program for personal reasons to determine whether their circumstances
have changed. They may have obtained employment on their own, or they may be interested in
your assistance in finding employment. If no employment has begun by the last day of the first
quarter after the exit quarter, there is no reason to continue following these participants for
performance measurement purposes. They count as not having achieved entered employment
and will not be subject to any other Common Measures outcome.
 Enter the appropriate code. Only one code may be entered for a participant. Select the
reason that applies at the time of exit. If the participant has truly exited the program, you must
select one of the ten specified exit reasons. If you feel that none of the ten reasons applies
perfectly, pick the reason that is closest and explain the circumstances in the comments field.
 Non-exit reasons for closing your record are recorded in field 6a.
 The first six selections in field 6 are negative outcomes that count against the performance
measures:
i) Moved from area
ii) For cause
Cause may include, but is not limited to the following:
o Refusal to cooperate in recertifying eligibility;
o Inability and/or unwillingness to perform assigned duties;
o Unreasonable refusal to accept a different community service assignment;
o Unreasonable refusal to accept job referrals or cooperate with the IEP;
o Frequent tardiness;
o Falsification by the participant of time sheets or other official records;
o Insubordination;
o Obscene/abusive language or behavior;
o Non-compliance with substance abuse policy; and
Exit Form-4

Exit Form Guide
Number

Element Name/
Topic

Element Description/Explanation Plus Additional Comments
o Failure to cooperate with grantee and/or host agency staff.
iii) Voluntary
Voluntary exit can occur for numerous reasons, including retirement.
iv) Not income-eligible
v) Durational limit
Use this field to indicate an exit due to the participant’s having reached the durational
limit for your project. Policies regarding durational limits must be approved by the
national office.
vi) Administrative reasons
This value has been added to reflect terminations initiated by the sub-grantee for reasons
other than cause or durational limit. For example, the sub-grantee may not have been
able to find a host agency that can meet the participant’s needs.
 The following four reasons for exit cause the participant to be excluded from the
performance measures. The exclusion applies if these reasons exist either at the time of exit or
during the four quarters following the exit quarter. If you discover the exclusion while you are
doing follow-up with an unsubsidized employer, you will record the exclusion in the appropriate
field of the follow-up section of the Unsubsidized Employment Form. You will not change the
original reason for exit that you entered in fields 5 or 6 of the Exit Form.
vii) Deceased
viii) Health/medical
The participant is receiving medical treatment that precludes entry into unsubsidized
employment or continued participation in the program. This does not include temporary
conditions or situations expected to last for less than 90 days.
ix) Family care
The participant is providing care for a family member that precludes entry into
unsubsidized employment or continued participation in the program. This does not
include temporary conditions or situations expected to last for less than 90 days.
x) Institutionalized
The participant is residing in an institution or facility providing 24-hour support, such as
a prison or hospital, and is expected to remain in that institution for at least 90 days. For
purposes of exclusion from the Common Measures, individuals with disabilities (as
defined in 29 CFR 37.4) residing in institutions, nursing homes, or other residential

Rev. 6 (4/19/10)

Exit Form-5

Exit Form Guide
Number

Element Name/
Topic

Topic 3
(New)

Notice of
termination for
misconduct;
removal from
host agency

6a

Non-exit reasons
for closing the
record

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
environments are not considered to be institutionalized.
 An exit for health reasons that does not meet the criteria for an exclusion must be coded as
voluntary, field 6(iii).
 Note that there is no value for “other” in SPARQ. You will have to choose whichever
specified value most closely matches the exit reason. If you believe the exit requires further
explanation, you can enter a comment in field 10.
 Data validation applies to the exclusions, fields 6(vii-x).
 The regulations require that you must always provide written notice of the reason for
termination. You must give the participant 30 days notice and an opportunity to respond before
you terminate. All terminations are subject to the grantee's grievance procedure.
 In some cases, grantees may need to remove a participant from a host agency immediately
upon becoming aware of an alleged violation. However, there is a difference between an alleged
violation and an established violation. Grantees may be justified in temporarily removing a
participant from a host agency pending their investigation and the determination of whether
misconduct has in fact occurred. Depending on the circumstances, grantees might assign the
participant to the project office or have the participant stay home pending the determination. In
any case, a participant is entitled to notice and some opportunity to be heard before the
participant is deprived of the benefits of the program. Therefore, no participant may be
terminated from SCSEP (as opposed to being removed from a host agency) until after the 30
days notice has expired.
 This field is for closing your record when the applicant or participant has left your project but
has not truly exited SCSEP or when you are resolving a dual enrollment.
 Use field 6a(i) for applicants who withdraw from the waiting list or who otherwise withdraw
their applications after being determined eligible but before being assigned to community
service. Once the participant has been assigned to community service, you must use field 6 to
exit the participant. If an applicant withdraws prior to the eligibility determination, use field
35(d) of the Participant Form to determine the applicant ineligible.
 Field 6a(ii) is generated by the batch change of entity function. However, you will still want
to record the name and code of the recipient grantee on the hard copy form so that your case
records are complete.
 Use field 6a(iii) to record the sub-grantee to which the participant has moved when there has
been a change of sub-grantee within the grantee. Because the batch change of entity function
Exit Form-6

Exit Form Guide
Number

Topic 4

Topic 5

Rev. 6 (4/19/10)

Element Name/
Topic

Exiting
participants who
have gone
missing or fail to
return from a
leave of absence
Removing
applicants from
the waiting list
for administrative
reasons

Element Description/Explanation Plus Additional Comments
causes the participant’s record to be reassigned to the recipient sub-grantee, this field is not
active in SPARQ. However, you will still want to record the name and code of the recipient subgrantee on the hard copy form so that your case records are complete.
 Use field 6a(iv) to record a termination by the secondary grantee when a dual enrollment has
been detected. Dual enrollments do not result in credit for the SCSEP performance measures.
 For missing participants, you should use 6(ii), for cause. Participants have an obligation to
keep in touch with you. Their failure to do so justifies your terminating them. Depending on the
reason for the participant's failure to return, you may also use 6(ii), for cause, to record the
participant's exceeding the maximum duration of a leave of absence.
 Applicants on the waiting list are not participants and thus cannot have true exits. However,
there is a field on the Exit Form – 6a(i) – that will allow you to close your record when someone
withdraws an application or withdraws from the waiting list. This is the only field you can use in
these circumstances. You should enter into field 7 of the Exit Form the date on which you
formally removed the applicant from the waiting list. That will generally be the date of data
entry unless you have documented an earlier date on the hard copy Exit Form or some other
document.
 Unless you have a written policy governing removal from the waiting list, removing someone
for administrative reasons may be problematic. An applicant has an absolute right to apply to the
program. The rules require you to place on the waiting list any eligible applicant who is not
assigned to a host agency within two weeks of being determined eligible. Therefore, an
applicant you remove from the list would presumably be able to insist on filing a new application
and being put back on the waiting list. (See Topic 6 below, Responsibility to Applicants on
Waiting List.) You should enter a case note in the comments field of the Exit Form explaining
the reason for removing the applicant from the waiting list, especially if the administrative reason
involves fault on the part of the applicant – e.g., falsifying the eligibility information.
 You should generally provide 30 days written notice before removing someone from the
waiting list on your own initiative. Obviously, no notice is required when the applicant informs
you that he or she is no longer interested in the program.

Exit Form-7

Exit Form Guide
Number
Topic 6
(Revised)

Topic 7

Rev. 6 (4/19/10)

Element Name/
Topic
Responsibility to
applicants on
waiting list

Element Description/Explanation Plus Additional Comments

 An applicant is entitled to remain on the waiting list as long as he or she is still interested in
an assignment and meets the eligibility requirements. However, it is not fair to the applicant or
helpful to the program to let applicants languish on the waiting list for an excessive period. You
should generally be in touch with waiting list applicants every three months to find out if they are
still interested in the program and are still eligible, and to give them an update on when they
might be enrolled. If there is no reasonable prospect of an opening, the participant might decide
to withdraw or explore some other program. The choice remains with the applicant. No matter
how unlikely the prospect of enrollment, you cannot force someone off the waiting list.
 The confirmation of the eligibility of applicants on the waiting list should be done informally
and for the benefit of the applicant. An eligibility determination is good for 12 months, barring a
substantial change in circumstance. (See Topic 15 of the Participant Form Guide, Date for
Determining Eligibility of Applicant.) Furthermore, an applicant who is over-income at some
point while on the waiting list may not be over-income when an opening is available. However,
if an applicant has become over-income and is approaching 12 months since the eligibility
determination, an applicant is entitled to know that any assignment would be short-lived and that
the first recertification would result in termination from the program. Given that information, the
applicant might decide to withdraw from the waiting list.
 Although you are normally not required to redo or update the Participant Form for eligibility
purposes, you should update the rest of the form, especially the barriers to employment because
you will need that information for making an appropriate assignment and because the priorities
of service must reflect the participant's situation at the time of enrollment.
 If there has been a change in any of the characteristics that are subject to data validation, you
will need appropriate documentation. Since the Participant Form is filled out by the case worker,
you should not need the participant to initial or sign anything. If you do want the participant to
update any forms you use, you can have the participant re-date and re-sign the forms and initial
any changes from the original as long as a validator or monitor can easily tell what has occurred.
If there is any ambiguity, it is better to complete a second form and keep both forms in the file.
Closing the
 Applicants who were not determined eligible include both those determined ineligible and
record of inthose who changed their mind in the middle of the application process. In either case, you
eligible applicants complete fields 34-36, 42, and 43 of the Participant Form. You do not enter any information into
the Exit Form.
Exit Form-8

Exit Form Guide
Number
Topic 8

Topic 9

Rev. 6 (4/19/10)

Element Name/
Topic
Transfer of
participant vs.
re-enrollment

Transfer of
participant vs.
change of subgrantee

Element Description/Explanation Plus Additional Comments
 Transfers between grantees are done for a variety of purposes: to reflect the results of a new
competitive process for national grantees; to achieve equitable distribution; to avoid disruption of
service; to simplify administration when the same host agency has participants assigned from
multiple projects; and to allow national grantees to swap authorized positions in the same or
different states in order to make their operations more efficient. Transfers require the approval
of the state grantee where the slots are located and the national office.
 Transfers must be done by agreement of two grantees, not the unilateral action of a
participant. When a participant has been transferred, the participant retains the status that he or
she had at the transferring project. The participant does not have to be recertified (as long as the
last eligibility check was within the last 12 months), nor is the participant subject to priority of
service at the new project. A participant can always terminate from one project and seek to reenroll in another project. However, such unilateral action requires a new application with an
eligibility determination and is subject to the priorities in effect at the new project at the time of
application.
 Typically, when a participant moves from the area, the participant terminates from the first
project and seeks to re-enroll in the new project. However, nothing prevents the project that the
participant is leaving from contacting the new project and seeing if a transfer is possible. The
new project will not be able to accept the transfer if it does not have any positions available.
Furthermore, it is not obligated to accept the transfer, and it may not be willing to accept the
transfer if it has higher priority applicants on its waiting list.
 When there has been a transfer (as opposed to an exit and a re-enrollment), the first project
does not have a true exit and thus does not have an outcome that is reflected in its performance
measures. The true exit occurs when the participant leaves the new project. At that time, both
projects will have the outcome reflected in their QPRs.
 The change of a sub-grantee – whether for an entire project or for a single participant – is
neither a transfer nor a re-enrollment. A transfer can only occur between grantees. A change of
sub-grantee occurs within a single grantee. SPARQ contains a utility for changing entities –
either transferring participants from one grantee to another or changing sub-grantees within a
grantee. This utility is used to change the sub-grantee for a single participant or multiple
participants. The grantee administrator enters the codes of the donor and recipient sub-grantees
into the utility. SPARQ then moves the affected enrollment records from the donor sub-grantee
to the recipient sub-grantee.
Exit Form-9

Exit Form Guide
Number

7

Element Name/
Topic

Exit date

Form Heading 2 Waiver of
Confidentiality

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 The hard copy Exit Form contain a field (6(a)(ii)) for the donor sub-grantee to indicate that it
has lost a participant to the recipient sub-grantee and to record the code of the recipient subgrantee. In the WebDCS, however, this field is grayed out. Field 17a of the Participant Form,
which indicates the code of the donor sub-grantee, is generated by the change of entity utility in
SPARQ. This field is also grayed out in the WebDCS. The date of the change of sub-grantee is
not yet active in SPARQ. You should record that date in field 17a of the hard copy form.
 For changes of sub-grantee during a program year, all QPRs after the date of the change in
sub-grantee will treat participants who have been moved to a new sub-grantee as though they
have always been enrolled with the recipient sub-grantee. Although this may lead to some
inaccuracy in the performance of the new sub-grantee for the balance of the program year, the
QPR for the grantee, which is all that is used for official monitoring of performance, will be
accurate. As long as everyone understands that the QPR for the new sub-grantee includes
performance by the old sub-grantee, the new sub-grantee should not be unfairly evaluated.
 Enter the date on which you exited the participant. SPARQ will not accept any exit date
prior to 7/1/04, the date on which SPARQ was first implemented.
 If you transfer the participant or do a change of sub-grantee for the participant, do not enter
an exit date. The change of entity utility will enter an exit date for any transfer. This date will
always be the day before the effective date of the transfer. For change of sub-grantee, you
should record the date on the hard copy form, but it will not appear in SPARQ.
 Data validation is required for this element.
 The waiver of confidentiality is only applicable to participants who are placed into
unsubsidized employment. The waiver may make it easier for you to obtain the follow-up
information from the employer. The participant should be encouraged to sign the waiver but
cannot be required to do so. The participant’s failure to sign does not relieve you of the
obligation to conduct follow-up activity with the employer.
 Before having the participant sign the waiver, write the participant’s name in the first blank,
the employer’s name in the second blank, and the name of the sub-grantee in the third blank.
 You may use any form of the waiver that you wish. If you prefer, you can have the
participant sign a general waiver at the time of enrollment. In that case, you would need to
modify the language to refer to employers generally and to indicate that the waiver is effective
for 15 months from the date of exit rather than the date of signing.

Exit Form-10

Exit Form Guide
Number
8

Element Name/
Topic
Signature of
participant

9

Date of signing

9a

Exclusion
discovered after
exit (only for
exiters not in
unsubsidized
employment)
Date exclusion
occurred
Exit comments

9b
10

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 A signature is only applicable to the waiver of confidentiality. If the participant exited for a
reason other than unsubsidized employment or if the participant refuses to sign the waiver, do
not obtain a signature on this form. If the applicant does not wish to sign the waiver, leave this
field blank.
 If the participant exited for a reason other than unsubsidized employment or if the participant
refused to sign the waiver of confidentiality, leave this field blank.
 If you discover that the participant qualifies for one of the exclusions discussed in field 6 of
the Exit Form Guide (deceased, medical condition, family care, or institutionalized), enter the
appropriate code. The participant will then be excluded from the relevant measures and will not
count against your performance.
 Data validation is required for this element.


If exclusion discovered after exit is entered, the date the exclusion occurred must be entered.

 Use this field to record any additional information about the exit, including information about
any exit that has been reversed. You may enter up to 1000 characters (about 160 words).

Exit Form-11

Unsubsidized Employment Form Guide

Unsubsidized Employment Form Guide

Number
Form Heading 1
(Revised)

Form Headings
2, 3 and 4

Rev. 6 (4/19/10)

Element Name/
Element Description/Explanation Plus Additional Comments
Topic
Unsubsidized
 An Unsubsidized Employment Form must be started when a participant enters unsubsidized
Employment
employment, including self-employment, either at the time of exit or within the first quarter after the
Form
quarter of exit. (You do not need to complete the form for anyone who first begins unsubsidized
employment after the end of the first quarter after the quarter of exit because it will be too late for
the participant to achieve any Common Measures employment outcomes.) You must continue to fill
out the form for up to 15 months after the participant begins employment.
 The form is used to capture basic information about:
o the employer and the placement
o contact information to facilitate the customer service survey
o information about the survey instrument(s) provided to the employer
o the employment and earnings information required for the performance measures
 A new Unsubsidized Employment Form must be started for each unsubsidized employment that
the participant has during the 15-month follow-up period.
 A participant may have two simultaneous part-time jobs after exit. Only one job is needed to
establish entered employment and retention, but the income from both jobs will be counted for
average earnings. As long as these are two separate employer entities, you enter both into SPARQ
and conduct all required follow-ups with both. (See Topics 25 and 26 for a discussion of which
follow-ups are required with which employers.) You can check "yes" with regard to entered
employment and retention for both jobs, but SPARQ will only give you credit once. You must enter
into SPARQ separate wages for the second and third quarters after the exit quarter for both jobs so
that SPARQ gives you complete credit for all wages earned in those quarters.
Employer
 Most of the information for these sections will be obtained from the participant at the time of the
Information,
exit interview (or subsequently) or from the sub-grantee’s own records. If the participant is unable
Contact/
to provide certain information, it may be obtained from the employer before the date for the first
Supervisor
follow-up. Information obtained from the participant may need to be verified once the sub-grantee
Information,
has made contact with the employer.
and Placement
 For WebDCS users, elements 3-6 and 9b-13i are entered from the Add Employer button in the
Information
Organizations function on the main page. They may also be entered from the first two placement
screens.

UE Form-1

Unsubsidized Employment Form Guide
Number
3

Topic 1

Rev. 6 (4/19/10)

Element Name/
Element Description/Explanation Plus Additional Comments
Topic
Name of
 Enter the name of the parent organization at which the participant is placed. This will be the
employer
entity whose FEIN you enter in field 5. Do not enter the name of a satellite office or branch unless
it has a separate FEIN or it is not feasible to treat the parent organization as a single employer. See
Topic 1 below and Topics 6 and 7 of the Community Service Assignment Form Guide. The
location at which the participant is placed will be listed in field 9. The contact person’s name and
address will be entered in fields 10 and 11.
 You should standardize the names of employers so that an employer is not entered multiple
times under different names.
 If a participant is self-employed and working for a client, you enter the participant's name into
field 3, not the name of the client for which the participant is working. By definition, this client is
not the participant’s employer.
 For WebDCS users, there is a drop-down menu from which you can select a previously entered
employer. (For Non-WDCS users, there is a similar function on the SPARQ home page. All nonWDCS users must check for the existence of an employer before entering a new one.) If the
employer you want is listed, select it. If it is not listed, you may add a new one from this field.
 You cannot save a placement in SPARQ without at least an employer name, a state, and a start
employment date.
Rule against
 SPARQ will not permit users to enter an organization into the database if that identical
entering
organization already exists. Organizations are considered identical if: (1) they have the same FEIN
duplicate
and state; or (2) they have the same name and their mailing addresses are in the same state.
organizations
WebDCS users will be blocked from entering a duplicate organization into the database; noninto SPARQ
WebDCS users will have any record with a duplicate organization rejected.
database
 There are circumstances where using the name and FEIN of the parent organization will not be
feasible. (See Topics 6 and 7 of the Community Service Assignment Form Guide.) In those cases,
you may enter multiple organizations with similar but not identical names in the same state. For
example, Goodwill LA North, Goodwill LA Central, Goodwill LA East, if they are entered without
any FEIN, are all considered unique organizations even though they are all in the state of California.
You should only list the FEIN if you attach it to the parent organization.
 If a WebDCS user attempts to enter an organization that already exists in the database, the user
will be asked whether he or she wants to use the existing organization. If not, the user will be
required to change the name of the organization to one that is unique.
 The first sub-grantee that enters an organization is considered the “owner” of that organization
UE Form-2

Unsubsidized Employment Form Guide
Number

Topic 2

4
4a

5

Topic 3
(New)

Rev. 6 (4/19/10)

Element Name/
Topic

Element Description/Explanation Plus Additional Comments

and is the only user allowed to change the basic organization information in fields 4-6. A nonowner that wishes to change any of this information must contact the owner to do so. The name of
the owner is displayed as part of the organization search function in SPARQ.
 Field 9b is not unique to the employer and may be different for each grantee using that
employer. Fields 7, 8, and 9 belong to a particular placement and thus can be different for each
placement. In future releases of the WebDCS, field 7 may be system-generated and will be unique
to the employer.
Using stored
 WebDCS users can designate an existing host agency as an employer without having to re-enter
host agency
basic organization information. By selecting the edit button after selecting an existing organization
information in
from the Organizations function on the main page, the user can designate the existing organization
the WebDCS
in any additional capacity. For example, an existing host agency can also be designated as a training
when a host
provider and an employer.
agency becomes  When you give an existing organization a new capacity, you will only have to add the fields that
an employer
are specific to the new capacity. For an employer, the only additional field is 9b.
Employer
 The mailing address fields will be used to generate letters and mailing labels for the customer
mailing address satisfaction survey. Be sure to enter the information as you want it to appear on the envelope.
Number, street,  If the address has a Post Office box rather than a street, use field 4a to record that information.
suite number;
If there are both a street and a Post Office box, record both in field 4a.
and/or PO Box
FEIN
 Every effort must be made to obtain the employer’s Federal Employer Identification Number
(FEIN). If an employer refuses to provide the FEIN, it should be informed that its refusal will not
affect the decision to provide services to the employer. If you cannot obtain the FEIN, leave it
blank. Do not enter N/A or dummy data.
 For self-employed participants, leave this field blank.
 The FEIN is used as a unique identifier for employers. The FEIN is also used to ensure that
employers are only surveyed once each year.
Obtaining
 There are numerous online search services for FEINs, but they all appear to charge a fee. (Try a
employer
Google search for FEIN.) Since many companies consider their FEIN to be proprietary, you may not
FEINs
be able to obtain the FEIN. This is more likely to be true of employers. Host agencies, on the other
hand, should give you their FEIN as a matter of course because of your ongoing relationship with
them. For more information, see http://www.irs.gov/businesses/small/article/0,,id=98350,00.html.
 There is no good answer to the problem of obtaining employer FEINs except to be actively
UE Form-3

Unsubsidized Employment Form Guide
Number

Element Name/
Topic

6

Employer type

6d

Selfemployment

Topic 4

Determining
whether the
participant is
self-employed
or an employee

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
involved in as many placements as possible and to develop a relationship with the employer as soon
as possible after a participant does a self-placement. Employers are usually more willing to give
you an FEIN and to provide the follow-up information if they have a relationship with you and
recognize the benefits they receive or can receive from SCSEP.
 Check the appropriate box to indicate whether the employer is a not-for-profit, for-profit, or
government entity. Check 6d if the participant is engaged in self-employment.
 Self-employment may be verified by any proof that the individual has started a business, such as
tax registration, business cards or invoices, or a state license. The individual does not have to prove
income from the business, but the receipt of income would suffice to establish self-employment. If
the participant is working completely under the table and does not want to provide you with any
documentation of his self-employment venture, such as licensing, invoices, or advertising, you may
not be able to claim the placement. You must document self-employment just like you must
document employment. You cannot merely take the participant's word for it.
 If the participant is self-employed, you will only need to capture minimal information on these
sections of the Unsubsidized Employment Form: Fields 1-3, 6, 14, 15, 18, and 20.
 A self-employed participant will not receive the employer survey (although the individual may
be selected for the participant survey) but will be included in two of the Common Measures (entered
employment and retention). Self-employed participants will not be included in the average earnings
measure. All three follow-ups are required.
 There is no simple way to determine whether a former participant is truly self-employed or is
being forced to work as an independent contractor by an entity that should be considered the
participant’s employer. It is a question of state law whether former participants are employees or
independent contractors (self-employed). In many states, participants are considered employees
unless they hold themselves out to the public as being engaged in their occupation and are free from
direction and control in the performance of their duties. For unskilled, unlicensed work, this is a
very hard standard to meet.
 If you believe that the participant is being forced to work under the table and is being deprived
of rights under state or federal law – e.g., to Social Security, unemployment compensation, workers’
compensation – you should inform the participant that the arrangement may be illegal, that the
participant is entitled to all of the protections of state and federal employment laws, and that you can
assist the participant in filing a complaint with the appropriate authorities. You should also inform
the participant that you are required to contact the employer to confirm the employment and to
UE Form-4

Unsubsidized Employment Form Guide
Number

Element Name/
Topic

7

Is employer a
host agency?

8

Did employer
provide an OJE
training site for
this participant?
Employer site
name and
location

9

9a

Rev. 6 (4/19/10)

Employer
received
customer
satisfaction
survey in PY__

Element Description/Explanation Plus Additional Comments
obtain wage information. Your involvement may be sufficient to persuade the employer to comply
with the law. Any retaliation against the participant by the employer would expose the employer to
serious liability. On the other hand, if the participant is fully aware of his or her rights and is
comfortable with being paid as an independent contractor, you may not wish to interfere.
 For SCSEP purposes, there is not a significant difference in the way you treat an individual who
is self-employed versus an individual working as an employee for an employer. For self-employed
participants, you will do somewhat less follow-up and you will not be delivering the employer
survey. The follow-up issue for self-employed participants is addressed in Topic 14 below.
 Self-employment should not be confused with temporary or on-call employment, such as
substitute teaching or working for a temporary employment agency. The distinction can be
especially difficult when dealing with home aides, who may be both self-employed when they are
caring for private clients directly and employed by an agency when placed in a client’s home.
Again, state labor law officials are your best resource for making this determination.
 Unsubsidized employers that have served as a host agency for this participant or any other
participant (under any state or national grant) in the last 12 months will not be included in the
customer service survey of employers. They will be in the pool for the host agency survey.
 Check “yes” if the employer provided an on-the-job experience (OJE) for this participant.
 OJE placements are a subset of regular program placements in field 10b of the QPR.
 Enter here the site at which the participant is placed. This field is not required by SPARQ and is
solely for case management purposes.
 You need not enter a full address. Merely provide enough information so that you can locate the
participant at the employer’s facility.
 This field will be generated by SPARQ whenever an employer has received a customer
satisfaction survey. It is designed to prevent the inadvertent delivery of a survey to an employer
twice in a program year.
 Because this field is part of the Organizations utility, it will display on all placements, not just
the placement that resulted in the delivery of the original customer satisfaction survey.

UE Form-5

Unsubsidized Employment Form Guide
Number
9b

Form Heading 5

10
(Revised)

11
(Revised)

11a

Rev. 6 (4/19/10)

Element Name/
Topic
Employer
continued
availability
Contact/
Supervisor
Information

Element Description/Explanation Plus Additional Comments

 This optional field is for administrative use by the sub-grantee only to indicate that the employer
no longer wishes to participate in SCSEP or that the sub-grantee no longer wishes to continue
working with this employer. There are similar fields for host agencies and training providers.
 This section is used to record information about the employer contact person. This is the
individual who will receive the customer satisfaction survey.
 The contact information is also designed to facilitate your contacting this person by phone, by
mail, by fax, by e-mail, or in person if necessary.
 Additional fields have been added to permit the entry of information about the supervisor if that
person is different from the contact person.
 For WebDCS users, elements 10-13i are entered from the Organizations utility on the main
page. They may also be entered from the second screen in the placement section.
Name of contact  The contact person is the individual who will receive the customer satisfaction survey for the
person
employer. There are separate fields for the supervisor if that person is different from the supervisor.
 The contact person is the individual with whom the sub-grantee has had the most contact
regarding the placement of the participant. It is not necessarily the participant’s supervisor. This is
the individual who will receive the customer satisfaction survey.
 Enter the contact person’s name exactly as you want it to appear on the cover letter and mailing
label for the customer satisfaction survey. Be sure to enter a first name unless the individual only
uses one name. Do not enter any extraneous information.
 Although the first survey should be hand-delivered to the employer contact, the second survey
may be mailed.
Contact
 Enter a business address for the contact person only if it is different from the host agency’s main
person’s
mailing address (field 4). If the contact person’s address is the same as the mailing address for the
mailing address host agency in field 4, you do not need to enter anything into field 11.
if different from  This field will be used for letters and mailing labels for the customer satisfaction surveys. If you
number 4
use this field, you must enter a complete mailing address.
Organization or  If the supervisor has a separate address, enter here the name of the organization at which the
address field 1
contact person will receive mail. Some surveys addressed to employer contact persons without the
name of the organization in the address were returned as undeliverable.
 Enter this information for all employer contact persons with a separate address in your database.
UE Form-6

Unsubsidized Employment Form Guide
Number
12
12a

13

13a

13b

Form Heading 6

13c
13d

Rev. 6 (4/19/10)

Element Name/
Topic
Contact
person’s title
Contact
person’s
salutation
Contact
person’s phone
number
Contact
person’s fax
number
Contact
person’s e-mail
address
Complete fields
13c-13i if
supervisor is
different from
contact person
(number 10). If
supervisor is the
same as contact
person, skip to
field 14.
Name of
supervisor
Supervisor’s
mailing address
if different from
number 4

Element Description/Explanation Plus Additional Comments
 Enter the title by which the contact person is known at the employer’s facility. This may
facilitate your contacting the individual.
 Select either Mr. or Ms. as the salutation for the contact person. The salutation will be used for
the customer satisfaction survey cover letters.
 You should enter this information for all employer contact persons in your database.
 This field may be used to help you reach the contact person.


This field may be used to help you reach the contact person.



This field may be used to help you reach the contact person.

 New fields 13c-13i are optional. They permit you to record the name and contact information
for the participant’s unsubsidized employment supervisor if the supervisor is different from the
contact person. The fields for the contact person are not optional since they are used to deliver the
employer survey.
 In SPARQ, there are two different drop-down menus and displays, one for the contact
person/supervisor and a second for the supervisor if that person is different from the contact/person
supervisor. If the contact person and supervisor are the same person (or if there is no supervisor),
you only select a name from the first drop-down. If you wish to indicate a different person as the
supervisor, you can also select a name from the second drop-down.
 There is no field for the funding source of the unsubsidized employment supervisor.
 This optional information may be entered through the Organizations Contacts on the home page
of the WebDCS or directly on the second placement screen.
 This optional information may be entered through the Organizations Contacts on the home page
of the WebDCS or directly on the second placement screen.

UE Form-7

Unsubsidized Employment Form Guide
Number
13e
13f
13g
13h
13i
14

Element Name/
Topic
Supervisor’s
title
Supervisor’s
salutation
Supervisor’s
phone number
Supervisor’s fax
number
Supervisor’s email address
Start date

15
(Revised)

End date

16

Starting wage
per hour

17

Benefits

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
 This optional information may be entered through the Organizations Contacts on the home page
of the WebDCS or directly on the second placement screen.
 This optional information may be entered through the Organizations Contacts on the home page
of the WebDCS or directly on the second placement screen.
 This optional information may be entered through the Organizations Contacts on the home page
of the WebDCS or directly on the second placement screen.
 This optional information may be entered through the Organizations Contacts on the home page
of the WebDCS or directly on the second placement screen.
 This optional information may be entered through the Organizations Contacts on the home page
of the WebDCS or directly on the second placement screen.
 Enter the date on which the participant began work with this employer. This will be the date of
placement for measurement purposes.
 The exit date on the Exit Form (field 7) must also be filled out. The exit date will usually be the
day before the start date.
 Enter the date on which the unsubsidized employment with this employer ended. If there is
additional unsubsidized employment within four quarters after the quarter of exit from SCSEP, all
unsubsidized employment may be included in the performance measures.
 The end date will determine when follow-up activity for each employer may be terminated.
 No end date is required for a placement that continues for more than four quarters after the
quarter of exit. You will not have to obtain follow-up information after the fourth quarter after exit.
 Enter the wage rate that the participant received at the beginning of employment with this
employer. Do not update this field. This information is for management and analysis purposes
only. It is not used for the performance measures. However, starting wage is important information
about the quality of the jobs into which SCSEP participants are placed. If you update this field,
valuable information will be jeopardized.
 Check all benefits that the participant received (or was promised) at the time of employment. If
“other,” specify the additional benefit or benefits that the participant received. If the participant did
not receive any benefits, check “none.”
 This information is for management and analysis purposes only. It is not used for the
performance measures.
UE Form-8

Unsubsidized Employment Form Guide
Number
18
(Revised)

19
19a
19b
20

21

Rev. 6 (4/19/10)

Element Name/
Topic
At time of
placement, is
employment
expected to be
full- or parttime

Element Description/Explanation Plus Additional Comments

 Check the appropriate box to indicate whether the employment was expected to be full-time or
part-time at the time of hire.
 If part-time, specify the number of hours per week that the participant was expected to work.
Full-time work means work of at least 40 hours per week, or such lesser amount as determined by
the employer to constitute full-time work.
 Under the Common Measures all part-time placements may be counted. There is no
requirement that the job provide at least 20 hours of work per week or that it be more favorable than
the prior SCSEP assignment. If the participant received any income greater than zero from
unsubsidized employment (or was self-employed) in the first quarter after the exit quarter, the
placement will count as entered employment.
 The average number of hours per week in employment for all participants is now reported in
Section B of the QPR. This information, along with average starting wage, will help you monitor
likely performance on the Common Measures average earnings.
Job title
 Enter the participant’s job title as determined by the employer. This should be a descriptive title,
such as receptionist, nutrition aide, or bus driver. No occupational code is required.
Participant’s job  You may enter one pre-defined code that reflects the particular job that the participant is
code
performing.
High growth
 Use this field to indicate whether the placement is in one of the 12 high growth industries
placement
included in the President’s initiative. You must select one of the 12 listed industries or “none.”
Training-related  Check “yes” if the participant is performing work related to the assignment that the participant
placement?
had with the host agency or to any training provided by the sub-grantee.
 Information about the current job will usually be obtained from the participant, but it may be
necessary to obtain additional information from the employer. Information about the host agency
assignment and other training should be available from the sub-grantee’s records.
Was placement  All placements are, to some extent, the result of the SCSEP program. Without the training
the result of a
provided by the community service assignment, participants would not have the skills and selfsubstantial
confidence needed to obtain employment. However, this question is designed solely to determine
service
whether the employer perceives the sub-grantee as having actively facilitated the placement.
provided to the  Check “yes” only if the sub-grantee provided a substantial service to the employer as part of the
employer by the placement process and the employer was aware of the efforts of the sub-grantee; e.g., the subsub-grantee?
UE Form-9

Unsubsidized Employment Form Guide
Number

22

Form Heading 7

Topic 5

Rev. 6 (4/19/10)

Element Name/
Topic

Unsubsidized
employment
comments
Customer
Service Survey
Information

Employer
survey when
sub-grantee
works for two
grantees

Element Description/Explanation Plus Additional Comments
grantee referred the applicant to the employer and the employer was aware of the referral.
 If the participant found his or her own job or if the sub-grantee only provided assistance directly
to the participant without the employer’s knowledge, check “no.”
 This information will be used to determine which employers will receive the customer service
survey. It is not relevant to employers that are host agencies because they are excluded from the
employer survey.
 Use this field to record any additional information about the unsubsidized employment. You
may enter up to 1000 characters (about 160 words).
 This section is used to record the pre-printed number on the survey instrument delivered to the
employer and the date on which the instrument was delivered. To obtain the required response rate
(70%), sub-grantees will have to deliver a second survey to those employers that do not complete the
first survey.
 The information for this section must be provided by the sub-grantee when the customer service
survey is administered to an employer. The information is only provided for those employers
selected for the survey.
 An employer is only selected for the survey once each year at the time of Follow-up 1 for a new
placement that meets the selection criteria. Employers that are host agencies will not receive the
employer survey. Employers that did not have substantial contact with the sub-grantee at the time
of placement will not receive a survey. Self-employed individuals will not receive the employer
survey. Employers will be surveyed even if the participant did not achieve entered employment
with that employer.
 If an employer hires two participants, one from each grantee for which the sub-grantee works,
the employer should only be surveyed for the first placement. If the two placements happened
simultaneously, you should flip a coin to determine which grantee’s survey you use.
 For sub-grantees that work for two grantees, it is no longer necessary to maintain different
survey number sequences for each grantee. Credit for surveys is now determined solely by the entry
of a survey number and delivery date into field 23 (and 24 for second surveys) of the unsubsidized
Employment Form for a particular placement. If the sub-grantee works for two different grantees, it
will have to indicate which grantee owns the enrollment when the record is first entered into
SPARQ. The ownership of the enrollment and the entry of the survey number into field 23 will
determine which grantee receives credit for the survey.
UE Form-10

Unsubsidized Employment Form Guide
Number
Topic 6

Topic 7
(New)

Rev. 6 (4/19/10)

Element Name/
Topic
Which
employers
receive surveys
and when
should they
receive them?

Grantees that
wish to
administer their
own surveys in
addition to the
official SCSEP
surveys

Element Description/Explanation Plus Additional Comments
 You should deliver the employer survey in person to the employer contact person when you do
Follow-up 1. Although for the Entered Employment measure you can do Follow-up 1 as early as
the first day of the first quarter after the quarter of exit, you will want to schedule the follow-up at a
time that will yield the best results for the employer survey. This means a date within the first
quarter after the exit quarter that is between 10 and 90 days after the participant started work with
the employer. Before 10 days, the employer has not had time to assess the placement. After 90
days, the employer's recollection of the circumstances surrounding the placement may be unreliable.
 You must deliver a survey to a qualified employer even if the placement fails. In such cases,
you should deliver the survey as soon as you learn that the participant has left the employer.
 You are not required to deliver surveys to any employers with which the participant starts
employment after the end of the first quarter after the exit quarter; however, you are free to survey
all qualifying employers during the entire 15-month follow-up period if you wish. You must be
certain, however, that you follow the same rules of administration that are required for surveys at the
first follow-up: only survey employers that qualify; do not survey host agencies; do not survey
employers more than once in a program year; and survey all qualifying employers – whether or not
the participant stays employed with the employer – between 10 and 90 days after the employment
starts. You cannot choose to survey only successful placements. If you survey placements after the
end of the first quarter after exit, you must still survey both successful and unsuccessful placements.
 Do not forget to enter the survey number and date of delivery into field 23 of the Unsubsidized
Employment Form (and field 24 if you deliver a second survey to the same employer) whenever you
survey an employer.
 From time to time, grantees may wish to deliver their own surveys to their customers. Although
nothing prohibits grantees from doing so, care must be taken not to cause confusion among
customers who may then receive two surveys in the same program year. To minimize any such
confusion and avoid jeopardizing both surveys, grantees must confer with the national office and the
consultants overseeing the SCSEP surveys regarding the timing of such individual grantee surveys
and the language used to explain the difference between the individual survey and the official
SCSEP survey.
 As an alternative to using their own survey, grantees may arrange to add grantee-specific
questions to the official SCSEP survey or to increase the sample size of their customers selected for
the official survey. Such changes will be at the expense of the grantee.
UE Form-11

Unsubsidized Employment Form Guide
Number
23

24

25

Form Heading 8

Topic 8

Rev. 6 (4/19/10)

Element Name/
Element Description/Explanation Plus Additional Comments
Topic
CS Survey #1;
 Enter in this field the survey number and date for the first survey delivered to a qualified
date
employer. Each survey number is unique and can only be entered once. If a qualified employer has
subsequent placements in the same program year, the employer is not re-surveyed and this field is
left blank for the subsequent placements.
 The survey number and date are essential for computing the response rate and for assigning
credit for the survey to the correct grantee.
 The survey number is unique to the placement of a single participant and must not be entered in
the placement record of any other participant.
 If no survey is delivered, leave this field blank.
CS Survey #2;
 A second survey should be delivered to the employer if the first survey is not returned within
date
three weeks. You use a new survey with a new survey number.
 Enter the second survey number and date in this field. If a second survey is not delivered, leave
this field blank.
CS Survey #3;
 This field is for the number and date of the third survey delivered to a qualified employer for the
date
same placement. At this time, sub-grantees are not required to deliver a third survey.
 If a third survey is not delivered, leave this field blank.
Follow-up
 Follow-ups are required in order to obtain information needed for the performance measures, to
Information
provide case management to the newly placed participant, to establish or maintain contact with the
employer, and to deliver the customer service survey to the employer. The system has been
designed to require the minimum possible number of follow-ups.
 If efforts to obtain the information from the employer are unsuccessful, the sub-grantee may
obtain the information from the participant.
 Failure to conduct required follow-ups may be considered a violation of the administrative
requirements of the grant.
 If you are unable to obtain the follow-up information, you can so indicate for each of the followups. However, incomplete follow-up information, regardless of the reason for the incompleteness,
will have a negative effect on performance measures.
Documenting
 When you conduct the three required follow-ups, it is important that you document the
follow-up
information you receive regarding employment and wage information. This documentation is
information
required for the Common Measures and for data validation as well.
 If you rely on documents, you should copy the documents for the file. If you use the phone or
UE Form-12

Unsubsidized Employment Form Guide
Number

Element Name/
Topic

Topic 9

Follow-up
information,
how to obtain
from employer

Topic 10

Follow-up
information,
inability to
obtain

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
an in-person interview, you should use the comment field on the Unsubsidized Employment Form to
record the individual spoken to, the date, the information conveyed, and the case worker who
obtained the information. For example, “Follow-up 2: Spoke to bookkeeper Roger Johnson by
phone on 1/25/05. He reported that participant was still employed and received wages in the quarter
October 1 - December 31. BP”
 For self-employment, you should also copy and file any documents that you used to determine
that the participant was engaged in a legitimate business.
 The follow-up information is best obtained from the employer. Participants may not work
consistent hours and may not keep accurate records of their pay for the quarter. You must make
reasonable efforts to obtain the information from the employer before you seek it from the
participant. The participant is not required to sign the waiver of confidentiality. However, even if
the participant does not sign the waiver or wish you to contact the employer, you are still required to
obtain the information from the employer.
 Although some participants may be reluctant to have their employers know about their
participation in SCSEP, it is important that employers become aware of the program. Doing the
follow-up activity with the employer is an opportunity for you to establish a relationship with the
employer that may lead to additional placements. You should attempt to assure participants that
their involvement with SCSEP will be seen as a positive factor by employers and will not in any
way jeopardize their employment. You should discuss this issue at orientation so participants
understand how important employer contact is to the program and are not surprised at exit to
discover that you will be contacting their employers.
 All exiters (with a few limited exceptions) are included in the performance measures. If the subgrantee does not record the required employment or wage information into the SCSEP data
collection system by the specified deadlines, the absence of data is treated as though the exiter had
no employment or wages. Entered employment, retention, average earnings, or retention at 1 year
could be affected, depending on which information is missing.
 The national office recognizes that some employers may be reluctant to provide the required
information. For that reason, it has recommended that the sub-grantee obtain a waiver of
confidentiality from the participant at the time of exit and that the sub-grantee conduct the first
follow-up in person. This first follow-up will provide an opportunity for the sub-grantee to establish
a relationship with the employer and to explain the importance of the follow-up information before
the sub-grantee has to ask the employer for wage information. Furthermore, if the employer is
UE Form-13

Unsubsidized Employment Form Guide
Number

Element Name/
Topic

Topic 11
(Revised)

Follow-ups for
participants
working under
the table and
unwilling to
reveal their
employers

Topic 12

Quarter,
definition of

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
unwilling to provide the information, the sub-grantee may obtain it from the participant. There may
be cases where the participant can no longer be located, but these should be fairly uncommon.
 For those rare instances where the sub-grantee cannot obtain the information from either the
employer or the participant, there is a code in fields 28, 29, and 30 of the follow-up section of this
form for the sub-grantee to indicate that it could not obtain the information. Although entering this
code will not prevent the exiter from being counted negatively in the performance measures, it will
give the sub-grantee a way to track and document the extent of the problem. This issue will be
eliminated once DOL obtains access to the UI wage records for all of the national programs.
 If the participant refuses to provide any information about the employer, you will not receive
any credit at all in the performance measures.
 If the participant is working under the table, you should inform the participant that the
arrangement is illegal, that the participant is entitled to all of the protections of state and federal
wage and hours laws, and that you can assist the participant in filing a complaint with the
appropriate authorities. You should also inform the participant that you are required to contact the
employer to confirm the employment and to obtain wage information. Your involvement should be
sufficient to persuade the employer to comply with the law. Any retaliation against the participant
by the employer would expose the employer to serious liability.
 If the participant is willing to identify the employer and the participant is employed during the
first quarter after the exit quarter, the entered employment will count toward your goal regardless of
the employer's method of paying the participant. Workers are sometimes compelled to accept illegal
working conditions. Neither you nor the participant should be penalized for the employer's actions.
 For purposes of the data collection system and the performance measures, a quarter always
means a calendar quarter: July 1-September 30; October 1-December 31; January 1-March 31; and
April 1-June 30. The Common Measures refer to the quarter after the quarter in which the
participant exited.
 For example, Common Measures entered employment requires that the participant have wages
in the first quarter after the quarter of exit. Therefore, if the participant exited and started
unsubsidized employment on July 5, you would need to determine whether there were any wages for
the period October 1-December 31, the first quarter after the quarter in which the exit occurred.
You would not be concerned with whether there were wages from July 5-September 30, which is the
quarter of exit.
 Similarly, the Common Measures average earnings measure requires the total amount of the
UE Form-14

Unsubsidized Employment Form Guide
Number

Topic 13
(Revised)

Rev. 6 (4/19/10)

Element Name/
Topic

Follow-ups,
scheduled dates
for completing

Element Description/Explanation Plus Additional Comments
participant's earnings in both the second and third quarters after the quarter of exit. In the example
above, the second quarter after the exit quarter would be January 1 - March 31, and the third quarter
after the exit quarter would be April 1 to June 30.
 The timing rules for the Common Measures follow-ups are simplified in SPARQ. Each measure
has an activity period (the quarter or quarters in which the outcome being measured occurs) and a
reporting period (the quarter in which the measure will be reflected in the QPR). The QPR will not
reflect either successes or failures for a measure until the first day after the reporting period closes.
The scheduled date (the earliest date on which the follow-up can be conducted) varies for each
measure.
 Follow-up 1 captures Common Measures entered employment. Both the activity period and the
reporting period are the first quarter after the exit quarter. The scheduled date is the first day of the
first quarter after the exit quarter. Although you can complete the follow-up during this quarter and
enter the data into SPARQ, the measure will not be reported for the first quarter after the exit quarter
until the end of the activity period, in this case, the first day of the second quarter after the quarter of
exit.
 Follow-up 2 captures both Common Measures retention and average earnings. Because we need
complete earnings in both the second and third quarters after the exit quarter, the activity period is
the second and third quarter after the exit quarter, and the reporting period is the fourth quarter after
the exit quarter. Thus, you may complete Follow-up 2 at any time during the fourth quarter after the
exit quarter, but the results for the second and third quarters will not be reported until the first day of
the fifth quarter after the exit quarter.
 Follow-up 3 captures the measure for retention at 1 year. Like entered employment, both the
activity period and the reporting period are the same, the fourth quarter after the exit quarter.
Although you can complete the follow-up during this quarter and enter the data into SPARQ, the
measure will not be reported in the QPR for the fourth quarter after the exit quarter until the end of
the activity period, in this case, the first day of the fifth quarter after the quarter of exit.
 The following tables illustrate when follow-ups may be conducted and when the measures will
be reported.

UE Form-15

Unsubsidized Employment Form Guide
Number

Element Name/
Topic

Element Description/Explanation Plus Additional Comments

Follow-up 1 completed dates and QPR credit “as of” dates for PY2010 Exiters
Exit in this quarter

When follow-up can be conducted

7/1/2010 ─ 9/30/2010

10/1/2010 ─ 9/30/2011

10/1/2010 ─ 12/31/2010

1/1/2011 ─ 9/30/2011

1/1/2011 ─ 3/31/2011

4/1/2011 ─ 9/30/2011

4/1/2011 ─ 6/30/2011

7/1/2011 ─ 9/30/2012

Credit reported for Entered
Employment in
Q2 PY2010 QPR
(first calculated on 1/1/2011)
Q3 PY2010 QPR
(first calculated on 4/1/2011)
Q4 PY2010 QPR
(first calculated on 7/1/2011)
Q1 PY2011 QPR
(first calculated on 10/1/2011)

Follow-ups 2 and 3 completed dates and QPR credit “as of” dates for PY2006 Exiters
Exit in this quarter

When follow-up can be conducted

7/1/2009 ─ 9/30/2009

7/1/2010 ─ 9/30/2011

10/1/2009 ─ 12/31/2009

10/1/2010 ─ 9/30/2011

1/1/2010 ─ 3/31/2010

1/1/2011 ─ 9/30/2011

4/1/2010 ─ 6/30/2010

4/1/2011 ─ 9/30/2011

Credit reported for Retention,
Average Earnings, and
Retention at 1 Year in
Q1 PY2010 QPR
(first calculated on 10/1/2010)
Q2 PY2010 QPR
(first calculated on 1/1/2011)
Q3 PY2010 QPR
(first calculated on 4/1/2011)
Q4 PY2010 QPR
(first calculated on 7/1/2011)

 Each follow-up must be completed in the program year in which the reporting quarter falls.
Thus, for Follow-up 1, follow-ups for all exits in the first three quarters of the program year must be
completed by September 30 following the close of the program year. For exits occurring during the
fourth quarter of the program year, the reporting period is the subsequent program year; so you have
until that September 30 to complete Follow-up 1.
 For Follow-up 2, all exits occurring in any quarter of the program year have their reporting
period in the following program year so you have until September 30 after the close of that
following program year.
Rev. 6 (4/19/10)

UE Form-16

Unsubsidized Employment Form Guide
Number

Element Name/
Topic

Element Description/Explanation Plus Additional Comments
 For Follow-up 3, the same rule applies as for Follow-up 2: All exits occurring in any quarter of
the program year have their reporting period in the following program year so you have until
September 30 after the close of that following program year to complete this follow-up.
 The following table illustrates the last date for completing each of the follow-ups.
Last Follow-up dates for QPR performance credit in PY2010

Topic 14
(Revised)

SPARQ followup reports and
scheduled dates

Follow-up(s)

Exit on or between these dates

Last date for completing the Follow-up

1

4/1/2010 ─ 3/31/2011

9/30/2011

2 and 3

7/1/2009 ─ 6/30/2010

9/30/2011

 SPARQ contains management reports for pending follow-ups and overdue follow-ups (those
pending more that 20 days after the scheduled date), as well as follow-ups by month. The scheduled
dates in the management reports are the same as those used in the WebDCS for fields 28a, 29a, and
30a.
 For Follow-up 1, the scheduled date is the first day of the first quarter after the exit quarter.
 For Follow-up 2, the scheduled date is the first day of the fourth quarter after the exit quarter.
 For Follow-up 3, the scheduled date is the first day of the fourth quarter after the exit quarter.
Follow-up scheduled dates based on exit quarter in P7 2010-2012
Exit Date Between
Exit Quarter
Follow-up 1
Follow-ups 2 and 3
Scheduled Date
Scheduled Date
4/1/10 and 6/30/10
Q4 PY 2009
7/1/10
4/1/11
7/1/10 and 9/30/10
Q1 PY 2010
10/1/10
7/1/11
10/1/10 and 12/31/10
Q2 PY 2010
1/1/11
10/1/11
1/1/11 and 3/31/11
Q3 PY 2010
4/1/11
1/1/12
4/1/11 and 6/30/11
Q4 PY 2010
7/1/11
4/1/12
7/1/11 and 9/30/11
Q1 PY 2011
10/1/11
7/1/12
10/1/11 and 12/31/11
Q2 PY 2011
1/1/12
10/1/12
1/1/12 and 3/31/12
Q3 PY 2011
4/1/12
1/1/13
4/1/12 and 6/30/12
Q4 PY 2011
7/1/12
4/1/13


Rev. 6 (4/19/10)

The follow-up reports will continue to list undone follow-ups until September 30 following the
UE Form-17

Unsubsidized Employment Form Guide
Number

Topic 15

Topic 16
(Revised)

Rev. 6 (4/19/10)

Element Name/
Topic

Element Description/Explanation Plus Additional Comments

program year in which you can last receive credit for a given follow-up. Once it is no longer
possible to receive credit, the follow-up will no longer appear on the report.
 For management purposes, the report for follow-ups pending by month may be the most useful;
it enables grantees and sub-grantees to quickly see how many undone follow-ups of each kind it has
for each quarter in the program year. Since you have until September 30 following the close of the
program year to get credit for undone follow-ups, it is a fairly simple matter to ensure that no credit
is lost because of undone follow-ups.
 The report for follow-ups by month will also enable you to determine how many placements are
truly failing because the participant does not last in the job long enough to achieve entered
employment or retention. Field B10f of the QPR tells you the total number of placements that did
not result in entered employment. By subtracting from this number the number of undone Followup 1’s in the relevant reporting period, you will know the count of placements that truly failed.
Follow-ups for
 Self-employment is counted for SCSEP the Common Measures entered employment, retention,
self-employed
and 1 year retention measures. That requires you to do all three follow-ups. Self-employed
participants
individuals are excluded from the Common Measures average earnings measure.
 You must document that the participant is engaged in a legitimate business, but you do not
obtain any information about income or earnings. Self-employment may be verified by any proof
that the individual is engaged in a business, such as tax registration, business cards or invoices, or a
state license. The individual does not have to prove income from the business, but the receipt of
income would suffice to establish self-employment.
 Although a self-employed participant has no reported wages, you use fields 28c(vi), 29c(vi),
29e(vi), and 30e(vi) of the UE form to record that the participant is still self-employed during the
first, second, third, and fourth quarters after the quarter of exit. This will provide you with credit for
Common Measures entered employment and retention, and retention at 1 year. For Follow-ups 1
and 3, you capture all listed information.
Follow-ups only  You need to fill out an Unsubsidized Employment Form for each employer that a participant has
for exited
during the follow-up period, generally the first 15 months after exit. If you know that the participant
participants
has failed to achieve a measure with an employer, you can indicate "no" in the appropriate field
who have
along with the date of the follow-up. If you do not complete the fields for a follow-up, the measure
employment
will be treated as a failure.
and no
 If a participant is excluded at the time of exit, you do not need to do any follow-up with that
exclusion
participant even if the participant subsequently becomes employed. If the participant becomes
UE Form-18

Unsubsidized Employment Form Guide
Number

Topic 17

Rev. 6 (4/19/10)

Element Name/
Topic

“Orphan
exiters”:
follow-up for
participants
who exited
before a subgrantee has
gone out of
business

Element Description/Explanation Plus Additional Comments
excluded at Follow-up 1 or Follow-up 2, you do not have to conduct subsequent follow-ups.
 Fields 27 and 27a of the Unsubsidized Employment Form are used to record whether there is a
Common Measures exit. If the participant exercises the right of return or re-enrolls within 90 days
of the date of exit, the Common Measures do not apply. Therefore, you would not need to do any
follow-ups.
 Whenever a total change of sub-grantee occurs, there may be exited participants who are still in
the follow-up period, typically 15 months after the date of exit. Since these “orphan exiters” are not
active participants, the question arises as to which entity will handle their follow-up once the old
sub-grantee goes out of business.
 You cannot transfer participants who exited from a closing sub-grantee. Once an exit has
occurred for any reason, you can no longer enter a transfer into the database.
 You can, however, use the batch change of entity function in SPARQ to have the new subgrantee that is receiving all the active participants from the closing sub-grantee take responsibility
for the orphan exiters as well. The easiest way for this to occur is for the receiving sub-grantee to
receive the entire database of the closing sub-grantee. At that time, the database of the closing subgrantee would be marked as “retired” in SPARQ.
 If more than one sub-grantee is receiving the active participants from the sub-grantee that is
closing, you can still use the change of entity function to assign the orphan exiters to one or more of
these recipient sub-grantees.
 Alternatively, the grantee itself may perform the follow-up activities for the orphan exiters. The
grantee has read/write access to the databases of all of its sub-grantees. It could perform the followup and update the records of only the orphan exiters while assigning the active participants to one or
more sub-grantees. The entire database for the old sub-grantee would be marked as “retired” in
SPARQ when the outcomes for the orphan exiters were final.
 If you let the sub-grantee go out of business and do not make arrangements for some other entity
to do the follow-up for the orphan exiters, you will lose any remaining outcome credit for exited
participants. The national office strongly discourages this option because it will negatively affect
performance at the grantee and nationwide levels.

UE Form-19

Unsubsidized Employment Form Guide
Number
26

Element Name/
Element Description/Explanation Plus Additional Comments
Topic
90-day date
 In order for the participant to exit for purposes of the Common Measures, the participant must
not have received any program services (other than the specifically defined follow-up activities or
services listed in field 27a) for 90 days. (See Form Heading 1 of the Exit Form Guide.) For
SCSEP, additional program services would require returning to the program or re-enrolling in the
program.
 At the time of starting this form, enter the 90-day date so you will know when to check to see if
the participant has received additional services. WebDCS will automatically provide this date.

27

Has the
participant
returned to
program within
the first 90 days
of exit

27a

Has the
participant reenrolled in
SCSEP within
the first 90 days
after exit?

Rev. 6 (4/19/10)

 This field is used to indicate whether the participant has exercised the right of return. If so, there
is no exit for purposes of the Common Measures, and the participant is not included in the
performance outcome measures.
 If the participant exits for unsubsidized employment and the employment does not last for 30
days within the first 90 days after exit, the participant is entitled to return to the program (within 90
days of exit) without having to re-enroll. Although the participant has this right, you should make
every effort to place the participant in a new unsubsidized job before re-assigning the participant to
community service. If the participant accepts a new job, you fill out a new Unsubsidized
Employment Form and conduct the follow-ups with the new employer. The new employment will
be combined with the original employment for determining the Common Measures.
 Use field 27 to record that a participant whose employment lasted for less than 30 days is
electing to return to the program. (If you have checked “yes” in field 28c to indicate entered
employment, you must also delete that check mark.) You then delete the exit reason (field 5, 6, or
6a) and the exit date (field 7) from the Exit Form. You also fill out a new Community Service
Assignment Form to document the host agency assignment. Use the comment field on the Exit
Form to explain what you have done. The participant will not be included in the outcome measures
until the participant again exits the program.
 If “yes,” an exit has not occurred for purposes of the Common Measures, and the participant is
excluded from the Common Measures. Follow-ups are not required.
 Additional services for purposes of the Common Measures do not include specifically defined
follow-up activities or services. If the participant has received any of the following within 90 days
after exit but has not re-enrolled, check “no”:
o the payment of reasonable costs of transportation
o health care and medical services

UE Form-20

Unsubsidized Employment Form Guide
Number

Element Name/
Topic

Topic 18
(New)

Performance
measures credit:
transfer vs. reenrollment

28

Follow-up 1

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
o special job-related or personal counseling
o incidentals (such as work shoes, badges, uniforms, eyeglasses, and tools)
o child and adult care
o temporary shelter
 These follow-up activities are specifically authorized in the regulations in order to help a
participant in unsubsidized employment achieve entered employment and retention.
 In the case of a transfer, both donor and recipient grantee will be credited with the employment
outcomes when there is a true exit from the recipient grantee. Those outcomes can be either positive
or negative. The mechanism for recording the dual credit in SPARQ will be implemented in a
subsequent release of SPARQ.
 In the case of an exit from one grantee and subsequent re-enrollment with another grantee, each
grantee gets its own credit. If the participant exited from one grantee for personal reasons and did
not start a placement, the original grantee would have a negative outcome on the entered
employment rate. If the participant subsequently re-enrolled with a different grantee, only the new
grantee would receive credit for the employment outcomes when the participant left the second
program.
 Follow-up 1 is designed for case management purposes and for delivering the customer
satisfaction survey to the employer, as well as for establishing entered employment. Therefore, it
should be completed as close to the beginning of the first quarter after the exit quarter as is
compatible with delivering the customer satisfaction survey, i.e., between 10 and 90 days after the
employment started. See Topic 6 above. The follow-up will not be reported as a success or failure
until the first quarter after the exit quarter has ended. On the first day of the second quarter after the
exit quarter, the QPR for the prior quarter will reflect everyone who could have achieved entered
employment.
 You have until 90 days after the end of the program year in which the reporting quarter falls to
complete Follow-up 1 and get credit for entered employment.
 The first follow-up should be conducted in person if at all possible. If it is not feasible to
conduct the follow-up in person, it may be conducted by phone, and the customer satisfaction
survey may be mailed to the contact person.

UE Form-21

Unsubsidized Employment Form Guide
Number

Element Name/
Topic

Element Description/Explanation Plus Additional Comments
 You will conduct this follow-up with self-employed individuals solely to determine whether
they have been self-employed during the first quarter after the exit quarter. You will not give them
the employer customer satisfaction survey.
 If the participant has multiple employers, you conduct Follow-up 1 with the current employer to
determine whether there was employment in the first quarter after the exit quarter and work
backwards until you find a success. If the participant achieves an entered employment with one
employer and then has subsequent employment with another employer, you do not conduct Followup 1 with the subsequent employer. You might have to do Follow-up 2 with both the first and
second employers depending upon when the first employment ended.
 The follow-up with the participant is part of case management. It is an opportunity to see if the
placement is going well and to determine whether the participant needs supportive service,
counseling, or other assistance to be successful in the placement. If the placement is not working
out, the follow-up may be the time to suggest another placement for the participant.
 The follow-up is also an opportunity to establish a relationship with the employer if one has not
already been established. This may be especially important if the participant obtained the job
without assistance from the sub-grantee and the employer is not aware of the connection with the
program. This contact allows the sub-grantee to explain SCSEP to the employer, learn about the
employer’s needs, and begin a relationship that may yield additional placements.
 Sub-grantees should use this first follow-up to prepare the employer for the next follow-up, at
which time the employer will need to provide employment and wage information. Explaining the
need for this information during an in-person conversation may make the employer more willing to
cooperate later.
Note: A follow-up does not itself constitute a substantial service that would render the employer
subject to the customer satisfaction survey. All employers will receive the first follow-up. Only
those employers that have received a substantial service in connection with the placement of the
participant will receive the customer satisfaction survey during the first follow-up.

28a

Rev. 6 (4/19/10)

Scheduled date

 This date is the first day of the first quarter after the exit quarter.
 You should enter the scheduled date into this field when the form is first filled out so you will
know when to conduct the first follow-up. The WebDCS will automatically provide this date.

UE Form-22

Unsubsidized Employment Form Guide
Number
28b

28c
(Revised)

Topic 19

Topic 20

Rev. 6 (4/19/10)

Element Name/
Element Description/Explanation Plus Additional Comments
Topic
Completed date  Enter the date on which the follow-up is conducted by the sub-grantee.
 This date is critical for the performance measures. SPARQ will not let you submit a follow-up
record without this date or with an improper date in this field.
 SPARQ contains case management reports that will help you keep track of follow-ups that are
pending or overdue.
 You may record the completed follow-up as early as the first day of the first quarter after the exit
quarter, but the results will not be reflected in the QPR for that quarter until the first day of the
second quarter.
Any wages for
 This field indicates if the participant entered employment for the Common Measures.
first quarter
 Indicate whether the participant received any wages in the quarter after the quarter of exit. Do
after exit
not consider the quarter in which the participant first exited.
quarter? Please  If the participant had wages, you will check box vi.
also indicate
 Check box vii to indicate if you were unable to obtain information about employment or wages
method of
from either the employer or the participant.
verification
 If you discover that the participant qualifies for one of the exclusions discussed in field 6 of the
Exit Form Guide (deceased, medical condition, family care, or institutionalized), check box viii.
The participant will then be excluded from the relevant performance measures and will not count
against your performance. You will not need to conduct Follow-up 2 or 3 with this employer.
 Complete this field for self-employed individuals.
 If you were unable to obtain the information, the exit will not be counted as an entered
employment under the Common Measures, and the retention and earnings gain measures will not
apply. You will not need to conduct Follow-up 2 or 3.
 Data validation is required for this element.
Temporary or
 Entered employment does not consider the type or duration of employment. Any employment
on-call
whatsoever, including temporary or on-call employment for as little as an hour during the first
employment
quarter after the exit quarter, suffices to establish entered employment.
and entered
employment
OJE’s and
 OJE is a type of training. Because it is subsidized at least in part by the program, it does not
entered
qualify as unsubsidized employment even if the employer directly pays the participant’s wages
employment
during the OJE. Furthermore, a participant must remain enrolled in the program during an OJE.

UE Form-23

Unsubsidized Employment Form Guide
Number

Topic 21

Topic 22

Topic 23

Rev. 6 (4/19/10)

Element Name/
Topic

Element Description/Explanation Plus Additional Comments

Therefore, the participant does not exit and is not included in the Common Measures performance
measures until the OJE ends and the employer has hired the participant. The start work date on the
Unsubsidized Employment Form should be the first day on the employer's payroll after the OJE
ended and the participant was exited from the program.
Placement
 You can create an Unsubsidized Employment Form for an exited participant who never started
credit for
work at his or her host agency assignment and receive credit. However, since you are only supposed
participants
to enroll those who need and can benefit from community service, the number of cases where
who do not start someone obtains a job before starting a community service assignment should be extremely limited.
community
An applicant who got a job so quickly after enrolling was probably job-ready. Although you will
service
receive credit for entered employment, a monitor could find that the enrollment was improper.
 Job-ready applicants should be referred to the One-Stop center. If your MOU so provides, you
may conduct job search and placement activity for job-ready applicants. You should determine
them ineligible and indicate in field 36 of the Participant Form the action you took to assist them.
Right of return  If the participant exits for unsubsidized employment and works for a total of less than 30 days
within the first 90 days after exit, the participant is entitled to return to the program (within 90 days
of exit) without having to re-enroll. Although the participant has this right, you should make every
effort to place the participant in a new unsubsidized job before re-assigning the participant to
community service. If the participant accepts a new job, you fill out a new Unsubsidized
Employment Form and conduct the follow-ups with the new employer. The new employment will
be combined with the original employment for purposes of the performance measures.
 If the participant exercises the right of return, you must check “yes” in field 27.
Credit for
 The reason for exit on the Exit Form does not determine whether you receive credit for a
entered
placement. If the participant exited for some other reason but subsequently started unsubsidized
employment
employment, you leave the Exit Form as it was. The Exit Form records the reason for exit at the
where exit was
time of exit. You create an unsubsidized employment form and fill it out as you would for any other
for reason other placement. A "yes" in field 28c will provide you credit for entered employment.
than
unsubsidized
employment

UE Form-24

Unsubsidized Employment Form Guide
Number
Topic 24

Topic 25
(New)

Rev. 6 (4/19/10)

Element Name/
Topic
Re-enrolling
participants
who quit their
jobs

Element Description/Explanation Plus Additional Comments

 If the participant quit a job, you should consider that in deciding whether to take the participant
back into the program. If the participant quit with good cause, e.g., was unsuited for the work or
had a health problem, and came back to you for services within 90 days of exit, the participant
would be entitled to exercise the right of return. Alternatively, you would be justified in exercising
your discretion re-enroll an applicant who sought to return after 90 days. Of course, before taking
the participant back into the program, you will want to determine whether another placement would
be suitable. If the participant quit a job for which he or she lacked sufficient skill but was otherwise
job-ready, you should attempt to find another job for which he or she is better suited.
 On the other hand, if the participant quit under conditions that would have amounted to a failure
to comply with the IEP, e.g., the job was suitable but the participant really did not want to work in
any job, you might not let him or her exercise the right of return, or you could take the participant
back only if he or she agreed to cooperate in the future and you could treat the quit as a failure to
accept a job referral under the IEP. You do not have to permit the participant to re-enroll.
Remember, re-enrollment is discretionary, and a participant who has been terminated for cause or
has otherwise demonstrated an unwillingness to abide by the program's rules may not be entitled to a
second enrollment.
 Furthermore, if the participant has worked a sufficient time to demonstrate that he or she is jobready, the participant would no longer be eligible for re-enrollment. Job-ready applicants, including
former participants, should be referred to the One-Stop center.
Follow-up for
 How re-enrollment affects follow-up and grantee credit for employment outcomes depends on
participants
when the re-enrollment occurs. Re-enrollment (or right of return) that occurs within 90 days of exit
who re-enroll
means that there is no true exit for the Common Measures. Therefore, there is no possibility of
after having had outcome credit in SPARQ and no need to do any follow-up. See Elements 26-27a. On the other
a placement
hand, if the individual re-enrolls more than 90 days after exit (there can be no right of return after 90
days), the exit counts and the first grantee will be credited – positively or negatively – for all
relevant outcome measures. The original grantee should continue doing follow-up until the
participant re-enrolls and it is clear that further employment credit is no longer possible. (An edit in
SPARQ will alert you if the participant has re-enrolled with another grantee.)
 How much follow-up the original grantee does will be determined by when the re-enrollment
occurs. If the re-enrollment does not occur until 6 months after exit, the grantee should have already
done Follow-up 1 and gotten credit for entered employment. In that case, the participant will be in
UE Form-25

Unsubsidized Employment Form Guide
Number

Element Name/
Topic

Topic 26

Follow-ups for
participants
with multiple
employers

29

Follow-up 2

Rev. 6 (4/19/10)

Element Description/Explanation Plus Additional Comments
the pool for retention. Retention requires employment in the first, second, and third quarters after
exit. Re-enrollment before 6 months of employment almost certainly means that the original
grantee will not be able to complete Follow-up 2, and that retention will not be achieved.
 You must create a new Unsubsidized Employment Form for each job that a participant has
during the follow-up period, generally the first 15 months after exit. No matter how many jobs the
participant has, either concurrently or consecutively, you will only get credit for one entered
employment and one retention per enrollment. In SPARQ, you can enter "no" many times for these
measures, but you can only enter one "yes," even if the participant has multiple employers.
 When there are multiple employers, start the follow-up with the current employer. If that
employer can provide definitive information about all the measures that you are trying to capture in
that follow-up, you do not have to contact previous employers. If the current employer cannot give
you a definitive answer, then you contact the next most recent employer and keep moving back in
time until you have gotten a definitive answer or have run out of employers.
 In the WebDCS, you only need to fill in the follow-up information that is required for each
employer. You can leave the other fields blank and ignore the missing data messages you get, or
you can enter "no" and avoid the missing data messages. The QPR treats blank measurement fields
as "no" once the time for doing the follow-up has passed.
 Follow-up 2, which captures the Common Measures retention and average earnings measures, is
scheduled for the first day of the fourth quarter after the exit quarter .Because you must wait for the
second and third quarter to end to have complete wages for those quarters, you will wind up doing
the second follow-up at least a week or two after the close of the third quarter – i.e., sometime in the
fourth quarter after the quarter of exit – and you should complete it any time during that quarter.
 This follow-up may be conducted in person, by mail, or by telephone.
 Because you need complete wages for both the second and third quarters after the exit quarter, it
is essential that you conduct this follow-up with all employers with which the participant was
employed at any time during these quarters.
 You do conduct this follow-up for self-employed individuals to determine if they had any wages
in the second and third quarters after the quarter of exit (for retention), but you do not record the
amount of earnings in the second or third quarters.
 This follow-up is not required for any participant who returned to program or re-enrolled within
90 days of starting employment. Nor is it required if you were unable to obtain employment
information from this employer during the first follow-up.
UE Form-26

Unsubsidized Employment Form Guide
Number
29a

29b

29c
(Revised)

Rev. 6 (4/19/10)

Element Name/
Element Description/Explanation Plus Additional Comments
Topic
Scheduled date  This date is after the end of the third quarter after the quarter in which the participant exited –
i.e., the first day of the fourth quarter after the quarter of exit. For example, if the participant exited
the program and entered employment on July 24, the third quarter after the quarter of exit would be
April 1-June 30. The follow-up would be scheduled for July 1.
 You should enter the date into this field when the form is first filled out so you will know when
to conduct the third follow-up. WebDCS will automatically provide this date.
Completed date  Enter the date on which the follow-up is conducted by the grantee. This information is required
for the Common Measures. SPARQ will reject any follow-up record that is missing the completed
date or has an improper completed date.
 You will usually need to wait until a week or so after the close of the third quarter after the
quarter of exit in order to obtain full wages for the second and third quarters after the exit quarter.
 SPARQ contains case management reports that will help you keep track of follow-ups that are
pending and that are overdue.
 You may record the completed follow-up as early as the first day of the fourth quarter after the
exit quarter; but the results will not be reflected in the QPR for that quarter until the first day of the
fifth quarter.
Any wages for  You must indicate whether there were wages in both the second and third quarters after exit for
second quarter
all participants who entered employment for Common Measures retention. For the average earnings
after exit
measure (fields 29d and 29f), however, you only collect the amount of earnings in these quarters for
quarter?
participants who enrolled on or after July 1, 2005.
 If the participant had wages in the second quarter after the exit quarter, you will check box vi.
 Check box vii to indicate if you were unable to obtain information about employment or wages
from either the employer or the participant.
 If you discover that the participant qualifies for an exclusion discussed in field 6 of the Exit
Form Guide (deceased, medical condition, family care, or institutionalized), check box viii. The
participant will be excluded from the performance measures from this point forward.
 Complete this field for self-employed individuals.
 Data validation is required for this element.

UE Form-27

Unsubsidized Employment Form Guide
Number
29d

29e
(Revised)

Rev. 6 (4/19/10)

Element Name/
Topic
If yes, earnings
for second
quarter after
exit quarter

Any wages for
third quarter
after exit
quarter? Please
also indicate
method of
verification

Element Description/Explanation Plus Additional Comments
 Effective July 1, 2006, you began capturing actual earnings for the second quarter after the
quarter of exit for participants who enrolled on or after July 1, 2005. Although these wages are
available earlier than the fourth quarter, you obtain them during the fourth quarter after the quarter
of exit, when you are also obtaining the wages for the third quarter after the quarter of exit. This
means that you will obtain all wages from unsubsidized employment in a single follow-up.
 You do not capture this information for any participants who enrolled prior to July 1, 2005.
 Do not use this field for self-employed participants.
 Data validation is required for this element.
 For new applicants who enrolled on or after July 1, 2005, and who entered employment, you
began collecting the amount of earnings in the third quarter after the quarter of exit for the new
average earnings measure on July 1, 2006. However, for all participants who entered employment,
regardless of when they enrolled, you have always been required to record whether there are any
wages in the second and third quarters for Common Measures retention.
 Indicate whether the participant received any wages in the third quarter after the quarter of exit.
This will determine retention for purposes of the Common Measures.
 If the participant had wages, you will check box vi.
 Check box vii to indicate if you were unable to obtain information about employment or wages
from either the employer or the participant.
 If you discover that the participant qualifies for one of the exclusions discussed in field 6 of the
Exit Form Guide (deceased, medical condition, family care, or institutionalized), check box viii.
The participant will then be excluded from the relevant performance measures and will not count
against your performance.
 If you were unable to obtain the information, the exit will be counted as having failed the
retention measure under the Common Measures, and the earnings for the second and third quarters
will be counted as zero.
 Complete this field for self-employed participants.
 Data validation is required for this element.

UE Form-28

Unsubsidized Employment Form Guide
Number
29f

Topic 27

30
(Revised)

30a

30b

Rev. 6 (4/19/10)

Element Name/
Topic
If yes, earnings
for third quarter
after exit
quarter
Temporary or
on-call
employment,
effect on
retention
Follow-up 3

Element Description/Explanation Plus Additional Comments
 Effective July 1, 2006, you began capturing actual earnings for the third quarter after the quarter
of exit for participants who enrolled on or after July 1, 2005.
 You do not capture this information for any participants who enrolled prior to July 1, 2005.
 Do not complete this field for self-employed participants.
 Data validation is required for this element.
 Retention does not consider the type or duration of a particular placement. Any employment
whatsoever, including temporary or on-call employment for as little as an hour during the second
and third quarters after the exit quarter, suffices to establish retention.

 This follow-up captures retention at 1 year, defined as employment in the fourth quarter after the
quarter of exit for all participants who had wages in the first quarter after the quarter of exit. This
follow-up effectively extends the follow-up period to 15 months.
 Retention at 1 year applies to all participants who achieved entered employment, regardless of
whether they also achieved employment retention at 6 months (Follow-up 2).
 As with Follow-up 1, you record only the fact of employment, not the amount of wages earned
in this quarter.
 Both the activity and reporting periods are the fourth quarter after the exit quarter.
Scheduled date  This date is the first day of the fourth quarter after the exit quarter.
 You should enter the scheduled date into this field when the form is first filled out so you will
know when to conduct the first follow-up. The WebDCS will automatically provide this date.
Completed date  Enter the date on which the follow-up is conducted by the sub-grantee.
 This date is critical for the performance measures. SPARQ will not let you submit a follow-up
record without this date or with an improper date in this field.
 SPARQ contains case management reports that will help you keep track of follow-ups that are
pending or overdue.
 You may record the completed follow-up as early as the first day of the fourth quarter after the
exit quarter, but the results will not be reflected in the QPR for that quarter until the first day of the
fifth quarter.

UE Form-29

Unsubsidized Employment Form Guide
Number
30c
(Revised)

Rev. 6 (4/19/10)

Element Name/
Topic
Any wages for
fourth quarter
after exit
quarter? Please
also indicate
method of
verification

Element Description/Explanation Plus Additional Comments
 This field determines if the participant achieved retention for 1 year.
 Indicate whether the participant received any wages in the fourth quarter after the quarter of exit.
 For these purposes, do not consider the quarter in which the participant first exited. For
example, if the participant exited and entered employment on July 24, 2007, the fourth quarter after
the quarter of exit would be July 1-September 30, 2008.
 If the participant had wages, you will check box vi.
 Check box vii to indicate if you were unable to obtain information about employment or wages
from either the employer or the participant.
 If you discover that the participant qualifies for one of the exclusions discussed in field 6 of the
Exit Form Guide (deceased, medical condition, family care, or institutionalized), check box viii.
The participant will then be excluded from this performance measure and will not count against
your performance.
 Complete this field for self-employed individuals.
 Data validation is required for this element.

UE Form-30