1 **QUA RTERLY CUMULA**  **TIVE CA SELOA**  **D REPORT (RSA -**  **113) REPORTING INSTRUCTIONS**  **General Purpose** The RSA- 113 provides for the quarterly collection of information on persons with disabilities in their rehabilitation process at State vocational rehabilitation (VR) agencies. Data from t he RSA- 113 are used to track trends of persons applying for VR services, determinations of eligibility made by State VR agencies, identification of persons with significant disabilities, individualized plan for employment (IPE) devel opment, service implementation, and program outcomes. These trends are key program measurements that provide a general assessment of the s tate -f ederal VR program and its accomplishments. Other uses for the RSA- 113 data are to identify technical assistanc e needs of specific State VR agencies, to develop RSA's budget requests, and to provide program information for the Office of Management and Budget, the Department of Education and the United States Congress. The Social Security Administration also uses t hese data in computing reimbursement payments to State VR agencies. Caseload data fr om the RSA- 113 are an integral part of RSA's Annual Report to the President and to the Congress on Federal Activities Related to the Rehabilitation Act of 1973, as Amended

. **Instructions for Completing the RSA** **- 113**  **GENERA L INFORMATION**  State and Agency - Enter the name of the State and check the appropriate box to indicate a general/combined agency or an agency providing services to persons who are blind. Fiscal Year and P eriod Covered - Enter the appropriate fiscal year and check the appropriate period covered by this report. Operated under an order of selection? - Indicate whether the State VR agency operated under order of selection priorities at some time during the r eporting period. **CA SELOA**  **D ITEMS** Data Validation Items - Several data verification items are included in this collection to help verify and validate the accuracy of data reported. These items are identified as such in the instructions below.2

**A. A** **PPLICA**

**TIONS A ND ELIGIBILITY**  Applicants 1 Applicants On Hand, October 1 - Enter the number of persons who applied for VR services in the last fiscal year, and for whom no determination of eligibility was made as of the end of that fiscal year. This figure sta ys constant throughout the current fiscal year. 2 Applicants New This FY - Enter the cumulative number of persons who applied for VR services since the beginning of the current fiscal year. 3 Applicants at End of Period (A1+A2 -A5 -A8 -A12 - D7) - Indicate the number of applicants for whom a determination of eligibility has not yet been made at the end of the period. This is a data verification item. 4 Applicants in Trial Work/EE, On Hand October 1 - Enter the number of persons in Trial Wo rk Experiences a nd/or Extended Evaluation at the end of last fiscal year. This fig ure stays constant throughout the current fiscal year. In the second column enter the number of persons in this category whose disabilities are significant. 5 Applicants in Trial Work/EE , Referred This FY - Enter the cumulative number of applicants who were placed into Trial Wo rk Experiences and/or Extended Evaluation since the beginning of this fiscal year. In the second column enter the number of persons in this category whose disabili ties are significant. 6 Applicants in Trial Work/EE at End of Period (A4+A5 -A9 -A13 - D6) - Indicate the number of individuals who remain in Trial Wo rk Experiences or Extended Evaluation at the end of the period, prior to a determination of eligibility. I n the second column enter the number of persons in this category whose disabilities are significant. This is a data verification item. Eligible Individuals On Order Of Selection (OOS) Waiting List The items in this section apply only to State VR agencie s that were operating under an order of selection at some time during the reporting period. 7 Individuals On OOS W aiting List, On Hand, October 1 - Enter the number of persons who were previously determined eligible for VR services and who continue to wa it on an order of selection waiting list from last fiscal year because the severity of their disabili ties does not correspond with the State VR agency's order of selection categories that are currently being served. In the second column enter the number of those persons whose disabilities are significant. 8 Individuals On OOS W aiting List New This FY From Application - Enter the cumulative number of persons who were determined eligible for VR services this fiscal3

year, for whom VR services will be del ayed because the severity of their disabilities does not correspond with the State VR agency's order of selection categories that are currently being served. In the second column enter the number of those persons whose disabilities are significant. 9 In dividuals On OOS W aiting List New This FY from Trial Wo rk/EE - Enter the number of individuals who were determined eligible after trial work experiences or an extended evaluation, but were placed on a waiting list in accordance with the State VR agency's o rder of selection criteria. In the second column enter the number of persons in this category whose disabilities are significant. 10 Individuals On OOS W aiting List at End of Period (A7+A8+A9 -A14 - D5) - Indicate the number of eligible individuals remain ing on a waiting list at the end of the reporting period. In the second column enter the number of persons in this category whose disabilities are significant. This is a data verification item. Individuals Determined Eligible, Before Signed IPE 11 Eli gible Individuals Before Signed IPE, On Hand October 1 - Enter the number of persons who were determined eligible during the last fiscal year, but had not yet developed and signed an IPE at the end of the year. Do not include eligible persons on an order of selection waiting list. In the second column enter the number of persons in this category whose disabilities are significant. 12 Eligible Individuals Before Signed IPE, New This FY From Application - Enter the cumulative number of persons who were de termined eligible this fiscal year and began employment planning after application. Do not include persons who were determined eligible after trial work experiences and/or an extended evaluation (item A- 13), or persons who were determined eligible but are on a waiting list because the severity of their disabilities does not correspond with the State VR agency's order of selection categories that are currently being served (items A- 8 and A- 9). In the second column enter the number of persons in this catego ry whose disabilities are significant. Also, do not include persons who were able to begin employment planning after waiting on an order of selection list since the beginning of this fiscal year (item A- 14). 13 Eligible Individuals Before Signed IPE, New This FY From Trial Work/EE - Enter the cumulative number of persons determined eligible who began employment planning this year after trial work experiences and/or an extended evaluation. In the second column enter the number of persons in this category whose disabilities are significant. 14 Eligible Individuals Before Signed IPE, New This FY from OOS Waiting List - Enter the cumulative number of individuals who began developing an IPE, after waiting on an order of selection list, since the beginning of this fiscal year. In the second column enter the number of persons in this category whose disabilities are significant.4

15 Eligible Individuals Before Signed IPE at End of Period (A11+A12+A13+A14 - B2 - D3) - Enter the total number of persons remaining at the end of the period who are eligible, but have not completed developing an IPE. In the second column enter the number of persons in this category whose disabilities are significant. This is a data verification item. **B. DEVELOPMENT OF INDIVIDUA LIZED P**  **LA N FOR EMPLOYMENT (IPE)**  For purposes of this report, the development of an individualized plan for employment (IPE) is considered to begin on the date of eligibility certification and end on the date that the IPE is signed, possibly on the same day. 1 Individuals Wi th Signed IPE, Before Receiving Services, On Hand October 1 - Enter the cumulative number of eligible persons who developed and signed an IPE, but for whom services under the plan were not yet implemented as of the end of last fiscal year. I n the second column enter the number of persons in this category whose disabilities are significant. 2 Individuals Wi th Signed IPE, Before Receiving Services, This FY - Enter the cumulative number of eligible persons who have developed and signed an IPE since the beginning of this fiscal year. Do not include persons who developed plans for Trial Wo rk Experiences and/or Extended Evaluation. In the second column enter the number of persons in this category whose disabilities are significant. 3 Individua ls Wi th Signed IPE, Before Receiving Services, at End of Period (B1+B2 - C2 - D4) - Enter the total number of persons remaining at the end of the period who have developed and signed an IPE, but for whom services on the IPE have not yet been implemented. In t he second column enter the number of persons in this category whose disabilities are significant. This is a data verification item. **C. SERVICE IMPLEMENTA TION**  1 Individuals Receiving Services, On Hand October 1 - Enter the number of persons who were receiving VR services in accordance with their IPE at the end of the last fi scal year. In the second column enter the number of those persons in this category whose disabilities are significant. 2 Individuals Receiving Services, Beginning This FY - Enter t he cumulative number of persons who started receiving services in accordance with their IPE since the beginning of this fiscal year. In the second column enter the number of those persons in this category whose disabilities are significant. 3 Individual s Receiving Services at End of Period (C1+C2 - D1 - D2) - Enter the total number of individuals remaining at the end of the period who are receiving VR services according to their IPE. In the second column enter the number of persons in this category whose di sabilities are significant. This is a data verification item.5

**D. OUTCOMES FOR INDIVIDUA**  **LS EXITING THE PROGRA M**  NOTE: Information provided in this section for the 4th quarter report, end of fiscal year, should be consistent with data provided for the same fiscal year in item #36, “T ype of Closure” on the RSA - 911, Case Service Report OMB number 1820 - 0508. 1 Individuals Exiting With Employ ment Outcomes - Enter the cumulative number of persons who achieved employment outcomes since the beginning of the fis cal year. In the second column enter the number of persons in this category whose disabilities are significant. All persons reported in the item, "Employment Status at Closure," on the RSA- 911, Case Service Report, OMB number 1820 - 0508, would be counted in this category. For a definition of "employment outcome," refer to section 7(11) of the Rehabilitation Act and 34 CFR 361.5(b)(15). For the 4 th quarter report, data in this item should be consistent with data reported as Code 3 under item #36, “Type of Closure” on the RSA - 911, Case Service Report. 2 Individuals Exiting Without Employment, After Receiving Services - Enter the cumulative number of persons whose service records were closed this fiscal year after an IPE was developed and VR services were initiated, but before achieving an employment outcome. In the second column enter the number of persons in this category whose disabilities are significant. For the 4 th quarter report, data in this item should be consistent with data reported as Code 4 under item #36, “T ype of Closure” on the RSA- 911, Case Service Report. 3 Individuals Exiting Without Employment, After Eligibility, Before Signed IPE - Enter the cumula tive number of eligible individuals, not on an order of selection waiting list, who d id not complete developing and signing an IPE, and whose service records were closed before VR services were initiated. In the second column enter the number of persons in this category whose disabili ties are significant. For the 4 th quarter report, dat a in this item should be consistent with the data reported as Code 7 under item #36, “Type of Closure” on the RSA- 911, Case Service Report. 4 Individuals Exiting Without Employment, After Signed IPE, Before Receiving Services - Enter the cumulative numbe r of individuals whose service records were closed after they developed and signed an IPE, but before services were initiated. In the second column enter the number of persons in this category whose disabilities are significant. For the 4 th quarter report, data in this item should be consistent with data reported as Code 5 under item #36, “T ype of Closure” on the RSA - 911, Case Service Report. 5 Individuals Exiting From OOS Wa iting List - Enter the cumulative number of eligible persons whose service reco rds were closed without services, from the order of selection waiting list, since the beginning of the fiscal year. In the second column enter the number of persons in this category whose disabilities are significant. For the 4 th6

quarter report, data in this item should be consistent with data reported as Code 6 under item #36, “Type of Closure” on the RSA - 911, Case Service Report. 6 Individuals Exiting From Trial Wo rk/EE - Enter the cumulative number of persons in Trial Wo rk Experiences and/or Extended Evaluation whose service records were closed without a determination of eligibility for any reason since the beginning of this fi scal year. In the second column enter the number of persons in this category whose disabilities are significant. For the 4 th quarter report, data in this item should be consistent with data reported as Code 2 under item #36, “T ype of Closure” on the RSA- 911, Case Service Report. 7 Individuals Exiting As Applicants - Enter the cumulative number of applicants whose service reco rds were closed before a determination of eligibility was made since the beginning of the fiscal year. Do not include any persons in Trial W ork Experiences and/or Extended Evaluation whose service records were closed without a determination of eligibility (item D - 6). For the 4 th quarter report, data in this item should be consistent with data reported as Code 1 under item #36, “T ype of Closure” on the RSA- 911, Case Service Report. 8 Total Number Of Individuals Exiting The Program (D1+D2+D3+D4+D5+D6+D7)

– Enter the total number of individuals who exited the VR program during this FY, and whose service records were closed. **CONTA CT INFORMATION**  Contact Person - Print or type the name of the person to contact about data presented on the RSA- 113 including th is person's telephone number and e - mail address. Date and Authorized Signature - Enter the date that the report is transmitted and the signature of the Director of the State VR agency, or designee. Any reports submitted electronically should also have a date entered on the form. **Transmittal Of Reporting the RSA** **- 113**  Please send the data for your State VR agency on the RSA- 113 within 30 days after the end of the first, second and third quarters and within 60 days after the end of the fourth quarter of t he Federal fiscal year. The RSA- 113 reports may be sent by mail or electronically using one of the options listed below. **Electronic Mail addresses** Specific instructions and the URL for key entry/on - line and editing of data directly into the RSA MIS: h ttp://rsamis.ed.gov7

The RSA Central Office E - Mail address for the RSA- 113 is: Vernita. Wa shington@ed.gov. US Mail and Facsimile This report may be faxed to the RSA Central Office at 202 - 245 - 7593, or mailed via U.S. mail to: U.S. Department of Educatio n State Monitoring and Program Improvement Division Data Collection and Analysis Unit Attn: Vernita Wa shington 550 12 th Street, S.W

. PCP 5047 Wa shington, DC 20202 - 2800