Demystifying Applicant File Reviews

1. Demystifying Applicant File Reviews How to Keep Your Files From Being Returned to Your Center!

2. Goals • Clarify how to assess and document whether Job Corps is suitable for an applicant • Decrease the number of files returned to your center

3. Objectives • Describe how federal disability nondiscrimination laws relate to the applicant file review process • List the three current reasons for denial to JC • Identify important pieces of information to review • Articulate the difference between recommendations for denial based on current behavior and instability versus diagnosis and the importance of the applicant interview • Identify appropriate versus inappropriate recommendations for denial

4. What Is the Purpose of the Applicant File Review Process? • Determine if JC is appropriate for applicant • Determine health care needs of applicant and whether JC can serve those needs • Ensure we are considering each applicant’s civil rights • Inflict cruel and unusual punishment on an already busy JC staff • a, b, c

5. Appropriate or Inappropriate Recommendation for Denial? • 16-year-old applicant who reports current treatment for diagnoses of ADHD and Bipolar Mood Disorder on the ETA 6-53 Health Questionnaire • Applicant was psychiatrically hospitalized two years ago for suicide attempt • Recent documentation by treating psychiatrist describes applicant as currently stable • Center recommends denial based on direct threat to self and others given current diagnoses and history of hospitalization

6. Appropriate or InappropriateRecommendation for Denial? • 23-year-old applicant with a diagnosis of Mental Retardation • IEP from 2009 indicates second grade reading level • Applicant received special education services throughout school • Center recommends denial based on being unable to meet his educational and training needs

7. Nondiscrimination and Equal Opportunity are the Law • Federal disability nondiscrimination law prohibits discrimination against people with disabilities • Disability is defined as a physical or mental impairment that substantially limits one or more major life activities • ADA AA broadens definition and makes more inclusive; regulations pending • Must provide reasonable accommodations—changes to the environment or in the way things are customarily done—that give a person with a disability an opportunity to participate in the application process, job, program or activity that is equal to the opportunity given to similarly situated people without disabilities. • See Appendix 605 for details

8. How Do Federal Nondiscrimination Laws Impact Applicant File Reviews? • We can NOT deny applicants admission to JC based on a disability (or diagnosis indicating disability) • We must provide reasonable accommodation

9. We Also Can’t Deny Applicants Based Solely On… • Test scores (e.g., IQ = 68; second grade reading level; low writing achievement test scores) • Test scores in isolation are relatively meaningless

10. How Do We Decide If JC Is Appropriate For Applicant? • Individualized consideration • Current stability • History of stability • Current behaviors • History of behaviors • Medical risks • Failure to comply with an outside provider’s recommendation does not automatically disqualify an applicant admission

11. Important Information to Review • ETA 6-52 (Outreach and Admissions Applicant Information Sheet) • ACAT (Admissions Counselor’s Assessment Tool) • ETA 6-53 (Health Questionnaire) School records including special education assessments (if relevant) • Inpatient psychiatric or medical hospitalizations or Emergency Department visits (if relevant) • Provider completed Information Forms • Reasonable Accommodation Request Form

12. Missing Information? • Determine who can best obtain the information within a reasonable time. Is it Outreach and Admissions Counselor (OA) or Health and Wellness (H&W) staff ? • What type of documentation can be requested? • Which questions on the 6-53 were endorsed? • Ask only for information related to specific event/concern within last two years. No “fishing.”

13. Applicant Interview Is KEY • Interactive in-person or video conferencing interview is best • Ask specific questions regarding any behaviors or information of concern • Document specific behavioral observations from interview if relevant to concerns raised from file review • If center H & W staff (including TEAP) disagrees with the opinion provided by outside professional, try to contact professional to resolve or explain difference of opinion

14. Applicant Interview Is SUPER KEY If: • Center has concerns regarding cognitive ability and adaptive functioning of applicant • Ideal: • Provide in depth tour noting how well applicant functions during time on center • Document specific behaviors that arise indicating applicant might be vulnerable in group setting or have difficulty with vocational training environment

15. There Are Only Three Reasons to Recommend Denial • Direct threat to self or others… • Applicant’s educational and/or training needs cannot be best met through Job Corps… • Applicant cannot be reasonably expected to successfully participate in group situations… ….even with reasonable accommodations

16. What Is Direct Threat? • Concern exists that student is at “significant risk of substantial harm” to self or others, not just a slightly increased, speculative, or remote risk • Recent hospitalization does not automatically make you a direct threat • Office of Civil Rights has ruled that cutting oneself is not an automatic direct threat • Threat must be imminent, based on current signs/symptoms of instability, and not assumed

17. If Student Is Believed To Pose A Direct Threat… • Center must complete an individualized and objective “direct threat assessment” including… • Nature, duration, and severity of the risk • Probability that the potentially threatening injury will actually occur • Whether reasonable modifications of policies, practices, or procedures will sufficiently mitigate the risk • Must include accommodations considered

18. Educational and Training Needs Cannot Best be Met at JC • Applicant only wants to learn a trade and not complete GED program • Applicant unable to comprehend and answer basic questions independently with or without accommodations • Applicant requires complex and specialized environment for learning that changes the scope of the Job Corps program

19. Can’t Successfully Participate in Group Situations/Activities • Behaviors that interfere with the learning of others • Limited adaptive living skills • Unmanaged and problematic symptoms/behaviors from a psychiatric disorder

20. All Applicants with Disabilities • Must have Reasonable Accommodation Team (RAT) meeting • In person or video conferencing is ideal • Team members should be selected based on applicant needs • RAT meeting and applicant interview may be done at the same time (if relevant team members present), but should be distinct processes

21. RAT • RAT must engage applicant in interactive process to determine reasonable accommodation needs • Process must be documented and specific accommodations should be determined • Reasonable accommodation may involve providing an appropriate service or product; modifying or adjusting a job, work/academic environment, policy, program, or procedure; or any other action that removes those barriers for the person with a disability • Applicants can NOT be denied admission based solely on need for accommodations

22. Appropriate or Inappropriate Denial? • 16-year-old applicant • History of significant alcohol and drug use and has been diagnosed as chemically dependent • Recently completed treatment program • Clean and sober for one month at interview • Center recommends denial based on high risk of relapse given stress of JC

23. Appropriate or Inappropriate Denial? • On 6-53 applicant responds affirmatively to the question about braces on teeth. • On the Orthodontic Care Agreement Form, the orthodontist states that the date of the last visit was 7 months ago. The orthodontist stated that the student needs monthly appointments. • The orthodontic office is located in the student’s home community 300 miles from the Job Corps center to which the applicant was accepted. It is the closest Job Corps center to the student's home. • During the interview, the applicant expresses that he has no intention of getting a different orthodontist or having his braces removed.

24. Appropriate or Inappropriate Denial? • On 6-53, applicant acknowledges losing control of anger to the point of hurting herself and others • Treating provider indicates applicant has difficulty with impulse control resulting in two hospitalizations within the past 6 months for suicide attempt and physical aggression with injury towards adult authority figures (punched staff in face) • Applicant stopped treatment, including medications, with provider without warning a month ago • Recent school behavior intervention designed to address outbursts and aggression was not successful (applicant subsequently expelled from school for disruptive behavior) • During interview with applicant, she indicated that she has refused to get additional help for her behavior because “nothing is wrong with me, people just need to leave me alone and stay out of my way”

25. Appropriate or Inappropriate Denial? • 24-year-old applicant has been diagnosed with MR (Mental Retardation) • She received intensive 1:1 services in school due to adaptive impairments including difficulty reading social cues, inability to independently complete ADLs, impulsivity, poor decision making, and vulnerability to peer influence • During in-person tour of JC and RAT meeting applicant appeared confused, was unable to answer simple questions, was highly distractible and off-task, engaged in unusual, repetitive behaviors, and made inappropriate comments to staff and students • Applicant’s mother shared concern applicant is “vulnerable to persuasion by males” and needs close supervision • Center recommends denial based on inability to meet educational needs and concern regarding the difficulty the applicant might have functioning in a group living situation

26. Appropriate or Inappropriate Denial? • 18-year-old applicant with history of arrests and legal involvement due to behavioral problems • Assaulted a teacher two months ago • “Kicked out” of parents’ house last month due to anger problems and aggression • Applicant denied any problems with anger or aggression during IDT meeting and showed no insight into behavior • Applicant became clearly agitated when asked about his legal history during IDT meeting • Direct threat form completed by CMHC

27. Appropriate or Inappropriate Denial? • 21-year-old applicant with a history of chemical dependence • Applicant recently withdrew from CD treatment against provider recommendations • Applicant acknowledges currently smoking marijuana and drinking alcohol regularly • He has a history of becoming physically aggressive when intoxicated and was arrested for assaulting a store clerk while intoxicated two months ago • He denies problems with alcohol or marijuana, explaining previous assaults as “people getting in my way” • Center recommends denial based on danger to others and has completed direct threat assessment identifying specific behaviors of concern

28. Helpful Resources: • Guidelines for Reviewing Applicant Files (Appendix 103of PRH Chapter 1) • Admissions Counselor Guide for Evaluating Applicant Behavior and Court History (Appendix 104 of PRH Chapter 1) • Direct Threat Assessment Guide and Form (attachment H of CMHC DRG) • Sample Accommodations for Students with Mental Health Disabilities (Attachment I of the CMHC DRG) • Mental Health Chronic Care Management Plans (Attachment P of the CMHC DRG) • CMHC File Review Tip Sheet (Attachment J of CMHC DRG) • Job Accommodations Network (JAN) at http://askjan.org • Regional Mental Health Specialists