Description
During the ORR Virtual Town Meeting (VTM) on June 3rd, 2024, presenters discussed a newly developed eligibility determination form aimed at assisting Survivor of Torture (SOT) ORR Grant Recipients. This template, created by the National Capacity Building Project (NCB), adheres to the ORR SOT Revised Eligibility Guidelines (2023), included in documents below the recording, and is customizable to suit the specific needs of individual programs. A case study was presented to demonstrate how the NCB sample form can be effectively utilized. The meeting facilitated a discussion and addressed questions regarding the implementation of this sample form, emphasizing that each client’s case file should incorporate this form or a tailored version of it.
As we have received some additional questions since the meeting which we would like to address below.
- The eligibility determination form shared during the VTM is a sample form and is not required to be used by programs. You can continue to utilize your own eligibility form. However, the expectation is that programs will review their eligibility forms to see if there are any changes needed to align with the sample form. You can also simply adopt and customize this form for your eligibility determinations.
- There is no consent required from clients to complete the eligibility determination form. There was a question during the meeting regarding this and I realized I confused the eligibility determination form with the wellness plan. The latter requires consent while the former does not.
- The eligibility determination form should be signed by the staff member completing the form. The client does not need to sign the form.
- Electronic signatures are acceptable for eligibility forms.
Please review and update your current eligibility determination forms during the next month to ensure they align with the sample form and the 2023 Eligibility Guidelines. We do not expect programs to retroactively make changes to clients’ forms that have already been completed. If you have any questions, please feel free to reach out to either Tim or Sabrina at ORR or NCB staff.
Information Required for Documenting Client Eligibility
ORR requires recipients to document an applicant’s eligibility for SOT Program services using an eligibility determination form based on these guidelines. The process of determining eligibility is separate from the intake assessment. To document eligibility, please either use the National Capacity Building Project template or refer to it to create a form for your program. The form must:
- include all eligibility criteria,
- the responses must be well documented, and
- the completed form must be signed by the staff member responsible for making the determination.
General comments on the Eligibility Determination Form (EDF):
- The eligibility form that you choose to use must match the new criteria and the new eligibility determination guidelines.
- The process of determining eligibility is separate from an intake assessment.
- This is the basic set of questions that you need to answer in order to determine whether somebody’s eligible for services.
List of Client Case File Contents
- Intake assessment
- Eligibility determination form
- Enrollment and service agreement
- Informed consent and release information form
- Grievance policy letter
- Goal-centered Individual Self-Sufficiency and Wellness Plan
- Detailed case notes documenting regular client-case worker interaction
- Quarterly assessments
- Survivor Family Self-Sufficiency and Wellness Plan
- Referrals
- Records of any mentoring or volunteering that the client is providing or receiving
- Records of any goods or services donated to the client with client signatures
- Records of client employment training and education
- Case closure letter
Presenters:
- Scott Roehm, JD, MA, Director of Global Policy and Advocacy
- Shruti Dasgupta, PhD, LP, Psychologist and Clinical Advisor for National Capacity Building Project
- Amy Kamel, MA, MSW, LICSW, Psychotherapist, Trainer, and Clinical Advisor for National Capacity Building Project
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