| FULL CROSSWALK |
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| DATA ELEMENTS FOR QUARTERLY REPORTS |
DEI Data System |
WP |
WIASRD |
SSA |
| IDENTIFIERS |
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| Today's date |
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| What is the date you stopped receiving services? (Exit Only) |
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| Full Name (First and Last) |
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| What is your date of birth? |
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| What is your telephone number? |
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| Enter your email address |
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| Male/Female |
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| WIA Program Module |
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| Dislocated Worker (WIA) |
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| Incumbent (WIA) |
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| Adult (WIA) |
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| SSA Module |
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| Are you currently receiving Social Security Disability Insurance? |
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| Are you a currently a "Ticket To Work" participant? |
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| Have you ever received Social Security Disability Insurance? |
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| SSI/SSDI impairment type |
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| SSI/SSDI monthly benefit amount |
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| SSI/SSDI benefits suspended/terminated due to work |
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| Time since initial SSI/SSDI eligibility |
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| Time since most recent SSI/SSDI eligibility |
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| Ticket to Work participant ever |
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| Ticket assigned to VR |
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| Ticket assigned to One-Stop |
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| Ticket assigned to other EN |
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| Expanded General Information Module |
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| Do you have a disability? |
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| What type of disability do you have? (Check all that apply) |
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| Physical (Mobility Impairment) |
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| Sensory (Vision, Hearing) |
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| Learning (Cognitive) |
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| Mental |
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| Other (Please specify) |
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| Wages 1st - 3rd Quarter |
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| Employment 1st - 3rd Quarter |
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| Disabled Veteran |
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| Race/Ethnicity |
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| Educational Attainment |
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| School Status |
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| Unemployment Compensation Eligible |
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| What barriers to employment do you have? (Check all that apply)/At Intake and Exit |
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| Limited Education |
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| Limited Work History/Experience |
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| No Child Care |
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| Substance Use |
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| Language Barrier |
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| Ex-Offender |
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| Homeless |
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| Disability |
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| TANF |
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| Other Public Assistance |
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| Homeless or Runaway-Homeless Youth |
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| Offender |
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| What is your current employment status? (Check Only One Response) |
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| Employed Full-Time (40 hours per week) |
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| Working Part-Time (Voluntarily) |
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| Involuntary Part-Time Work (Would like full-time work) |
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| Unemployed and Looking for Work (Not working at all) |
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| Unemployed and Not Looking for Work (Not working at all) |
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| Under-Employed (Over qualified for current job) |
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| IF EMPLOYED FULL-TIME OR PART-TIME |
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| What is your current job title? |
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| What is your current hourly wage? |
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| How long have you been at your current job? |
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| How many hours do you work per week? |
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| What employee benefits do you receive from your current employer? (Check all that apply) |
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| Health |
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| Vacation |
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| Sick leave |
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| Flexible Work Schedule |
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| Telework |
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| Customized Employment |
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| Job Sharing |
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| Other |
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| When did you begin employment at your current job? |
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| Type of Employer/NAIC Code |
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| IF UNEMPLOYED |
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| When is the last time you were employed? |
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| What was your last job title? |
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| What was your hourly wage at your last job? |
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| How long were you employed at your last job? |
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| How many hours per week did you work at this job? |
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| Which employee benefits did you receive at your last job? (Check all that apply) |
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| Health |
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| Vacation |
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| Sick leave |
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| Flexible Work Schedule |
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| Telework |
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| Customized Employment |
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| Job Sharing |
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| Other |
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| When did you begin your last job? |
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| Expanded Service Utilization Module (At Exit Only) |
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| Which services did you receive from the Career Center? (Check all that apply)/At Exit Only |
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| Employment Counseling |
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| Help with Job Search |
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| Job Readiness Training |
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| Self-Employment Program |
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| Customized Employment Program |
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| Other |
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| Youth Specific |
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| How often do you contact your family or close friends? |
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| Who do you live with? (Check only one response) |
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| Living Independently |
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| Living with Family/Guardian |
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| Did you receive any of the following services (Check all that apply)/At Exit Only |
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| Internship |
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| Job Shadowing Experience |
| Career Guidance from School |
| Benefits-Asset Development Training/Services |
| Employment Counseling |
| Help with Job Search |
| Job Readiness Training |
| Self-Employment Program |
| Customized Employment |
| Other |
| None |
| Did you receive career career guidance from your school/At Exit only |
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| Parenting Youth |
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| Youth who needs additional assistance |
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| Foster Care Youth |
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| WIASRD Youth Services Data |
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| WIASRD Youth Literacy Assessment Data |
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| WIASRD Skill Attainment Data |
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| DEI DATA SYSTEM ONLY |
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| DATA ELEMENTS FOR QUARTERLY REPORTS |
DEI Data System |
| IDENTIFIERS |
|
| Today's date |
√ |
| What is the date you stopped receiving services? (Exit Only) |
√ |
| Full Name (First and Last) |
√ |
| What is your date of birth? |
√ |
| What is your telephone number? |
√ |
| Enter your email address |
√ |
| Male/Female |
√ |
| SSA Module |
|
| Are you currently receiving Social Security Disability Insurance? |
√ |
| Are you a currently a "Ticket To Work" participant? |
√ |
| Have you ever received Social Security Disability Insurance? |
√ |
| Expanded General Information Module |
|
| Do you have a disability? |
√ |
| What type of disability do you have? (Check all that apply) |
√ |
| Physical (Mobility Impairment) |
|
| Sensory (Vision, Hearing) |
|
| Learning (Cognitive) |
|
| Mental |
|
| Other (Please specify) |
|
| What barriers to employment do you have? (Check all that apply)/At Intake and Exit |
√ |
| Limited Education |
|
| Limited Work History/Experience |
|
| No Child Care |
|
| Substance Use |
|
| Language Barrier |
|
| Ex-Offender |
|
| Homeless |
|
| Disability |
|
| What is your current employment status? (Check Only One Response) |
√ |
| Employed Full-Time (40 hours per week) |
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| Working Part-Time (Voluntarily) |
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| Involuntary Part-Time Work (Would like full-time work) |
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| Unemployed and Looking for Work (Not working at all) |
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| Unemployed and Not Looking for Work (Not working at all) |
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| Under-Employed (Over qualified for current job) |
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| IF EMPLOYED FULL-TIME OR PART-TIME |
|
| What is your current job title? |
√ |
| What is your current hourly wage? |
√ |
| How long have you been at your current job? |
√ |
| How many hours do you work per week? |
√ |
| What employee benefits do you receive from your current employer? (Check all that apply) |
√ |
| Health |
|
| Vacation |
|
| Sick leave |
|
| Flexible Work Schedule |
|
| Telework |
|
| Customized Employment |
|
| Job Sharing |
|
| Other |
|
| When did you begin employment at your current job? |
√ |
| IF UNEMPLOYED |
|
| When is the last time you were employed? |
√ |
| What was your last job title? |
√ |
| What was your hourly wage at your last job? |
√ |
| How long were you employed at your last job? |
√ |
| How many hours per week did you work at this job? |
√ |
| Which employee benefits did you receive at your last job? (Check all that apply) |
√ |
| Health |
|
| Vacation |
|
| Sick leave |
|
| Flexible Work Schedule |
|
| Telework |
|
| Customized Employment |
|
| Job Sharing |
|
| Other |
|
| When did you begin your last job? |
√ |
| Expanded Service Utilization Module (At Exit Only) |
|
| Which services did you receive from the Career Center? (Check all that apply)/At Exit Only |
√ |
| Employment Counseling |
|
| Help with Job Search |
|
| Job Readiness Training |
|
| Self-Employment Program |
|
| Customized Employment Program |
|
| Other |
|
| Youth Specific |
|
| How often do you contact your family or close friends? |
√ |
| Who do you live with? (Check only one response) |
√ |
| Living Independently |
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| Living with Family/Guardian |
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| Did you receive any of the following services (Check all that apply)/At Exit Only |
√ |
| Internship |
|
| Job Shadowing Experience |
| Career Guidance from School |
| Benefits-Asset Development Training/Services |
| Employment Counseling |
| Help with Job Search |
| Job Readiness Training |
| Self-Employment Program |
| Customized Employment |
| Other |
| None |
| Did you receive career career guidance from your school/At Exit only |
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