Employment and Retention Contract and Forms

ESS-C-141 — Career Exploration Report

Form Number: 

ESS-C-141

Prior to implementing the Plan of Exploration, the contractor will be email the plan to the DRS Counselor. If the DRS Counselor does not respond within 5 working days, the Contractor may proceed with the planned career exploration activities. The Contractor must be onsite in order to assess the individuals work skills, interests and behaviors. Career exploration activities may include but are not limited to: job shadowing, work-site tours, trial work experiences, volunteer experiences, and/or other activities approved by DRS Counselor. In some cases, less than three (3) different exploration activities may be needed to complete the Career Exploration service. Contractors must provide written documentation to justify their request to use less than the three (3) different activities to complete this service, and obtain written approval from the DRS Counselor. At the completion of this service, the individual will move to the next appropriate service or milestone that best meets their needs.

File Origination or Revision Date: 

02/11/2020

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ESS-C-145n — DRS Counselor Response to Plan of Exploration

Form Number: 

ESS-C-145n

Instructions for ESS-C-145n (DRS Counselor Response to Plan of Exploration)

(In contracts: CEC, ERC, SEC)

Prior to implementing the Plan of Exploration, the Contractor will email the plan to the DRS Counselor. The DRS Counselor e-mail response must be maintained in the individual's case file. If the DRS Counselor does not respond to the e-mail within five (5) working days, the Contractor may proceed with the planned career exploration activities. The e-mail to the DRS Counselor with Plan of Exploration must also be maintained in the individual’s Case Documentation file.

File Origination or Revision Date: 

02/25/2020

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ESS-C-149n — Contractor's Written Justification for completing less than three (3) different activities

Form Number: 

ESS-C-149n

Instructions for ESS-C-149n (Contractor's Written Justification for completing less than three (3) different activities)

(In contracts: CEC, ERC, SEC)

In some cases, less than three (3) different exploration activities may be needed to complete the Career Exploration service. Contractors must provide written documentation to justify their request to use less than the three (3) different activities to complete this service, and obtain written approval from the DRS Counselor. The written justification requesting DRS Counselor approval for completing less than three (3) different career exploration activities must be maintained in the individual’s Case Documentation file.

File Origination or Revision Date: 

02/25/2020

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ESS-C-153n — DRS Counselor Written Approval for completing less than three (3) different activities (if applicable)

Form Number: 

ESS-C-153n

Instructions for ESS-C-153n (DRS Counselor Written Approval for completing less than three (3) different activities (if applicable))

(In contracts: CEC, ERC, SEC)

In some cases, less than three (3) different exploration activities may be needed to complete the Career Exploration service. Contractors must provide written documentation to justify their request to use less than the three (3) different activities to complete this service, and obtain written approval from the DRS Counselor. Written approval from the DRS Counselor must be maintained in the individual’s Case Documentation file.

File Origination or Revision Date: 

02/25/2020

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ESS-C-197n — Internship Agreement Documentation

Form Number: 

ESS-C-197n

Instructions for ESS-C-197n (Internship Agreement Documentation)

An internship agreement is a document that defines the nature of the internship or placement. It is normally issued by the current or former university or the educational/training institution and serves to prove that the internship would be a part of individual’s studies and related to their education/training. If the internship is not sponsored by a school, the contractor must develop an Internship Agreement. A copy must be emailed to the DRS Counselor and maintained in the individual’s Case Documentation file.

File Origination or Revision Date: 

02/25/2020

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ESS-C-213n — O-NET median hourly wage documentation

Form Number: 

ESS-C-213n

Instructions for ESS-C-213n (O*NET median hourly wage documentation)

(In contracts: CEC, ERC, JPC, JOBSC, SEC)

When the individual is hired by the Contractor, prior to the first (1st) day of work, the O*NET median hourly wage documentation for the respective region or city must be e-mailed to the DRS Counselor and ESS TA along with the Pre-Placement Information Form.
The breakdown of the hourly wage and hourly health and/or wellness benefit(s) when applicable, must be documented in the comments box of the Pre-Placement Information Form.

A copy must be emailed to the DRS Counselor and maintained in the individual’s Case Documentation file.

File Origination or Revision Date: 

02/25/2020

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ESS-C-237n — Current Pay Stub or Earnings Statement

Form Number: 

ESS-C-237n

Instructions for ESS-C-237n (Current Pay Stub/Earnings Statement)

(In contracts: CEC, ERC, JPC, SEC)

A pay stub is part of a paycheck that lists details about the employee’s pay. It itemizes the wages earned for the pay period and year-to-date payroll. The pay stub also shows taxes and other deductions taken out of an employee’s gross earnings. And, the pay stub shows the amount the employee actually receives (net pay).

or

This may be an earnings statement downloaded from the employee’s payroll account web page, but must contain all of the information.
All documentation must be emailed to the DRS Counselor for payment and be maintained in the Case Documentation.

File Origination or Revision Date: 

02/25/2020

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ESS-C-277 - ER Plan for Assessment

Form Number: 

ESS-C-277

The Contractor will schedule a Team Meeting to review the Plan for Assessment with the DRS Counselor, individual and any other relevant team members. During the Team Meeting, the Plan for Assessment will be approved, or amended and approved if needed. The results of the Team Meeting will be documented on the Team Meeting Narrative and submitted for payment along with the approved or amended Plan for Assessment.

File Origination or Revision Date: 

02/12/2020

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ESS-C-281n — DRS Counselor Response to Plan for Assessment

Form Number: 

ESS-C-281n

Instructions for ESS-C-281n (DRS Counselor Response to Plan for Assessment)

(In contract: ERC)

Prior to completing the assessments, The Contractor will schedule a Team Meeting to review the Plan for Assessment with the DRS Counselor, individual and any other relevant team members.

During the Team Meeting, the Plan for Assessment will be approved, or amended and approved if needed.

The results of the Team Meeting will be documented on the Team Meeting Narrative and submitted for payment along with the approved or amended Plan for Assessment, and also be maintained in Case Documentation.

File Origination or Revision Date: 

02/25/2020

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ESS-C-285n — Electronic Résumé

Form Number: 

ESS-C-285n

Instructions for ESS-C285n (Electronic Résumé)

(In contracts: ERC, JPC, JOBSC, SEC)

An electronic resume is a résumé that is submitted to a potential employer electronically. The purpose of an electronic résumé is to apply for jobs online.
Copies of the electronic résumé are to be provided to the individual and by email to the DRS Counselor.
Copy of the email to DRS Counselor is to be maintained in individual’s Case Documentation file.

File Origination or Revision Date: 

02/25/2020

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ESS-C-297 — Compatibility Analysis

Form Number: 

ESS-C-297

he Job Analysis and Situational Assessment Report will be used to complete the Compatibility Analysis. The Contractor may choose to complete a situational assessment in their facility if it is based on an actual job which matches the individual’s vocational goal on the IPE. When an in-house situational assessment is completed, a copy of the job description must be submitted with the required documentation for payment of the milestone. The ER AS Milestone Report will be completed in collaboration with the individual to summarize intake and assessment information.

File Origination or Revision Date: 

02/12/2020

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