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{"sheet":"Instructions","index":0,"n_rows":37,"n_cols":2,"rows_kept":37,"cut":false,"hidden":false,"merged":[]}
["HOW TO COMPLETE THE MONTHLY PROVIDER AFFILIATE REPORT"]
["Please enter all of the provider affiliates on the tab- \"Providers List\". Answer all of the questions for each provider affiliate. If you are unsure of how to answer any of the questions, please see definitions below:  "]
["Provider Affiliate Organization Name- ","Enter the full legal name of the provider affiliate."]
["Start Date- ","Enter the date that the provider affiliate began with your EN."]
["End Date- ","If the provider affiliate is no longer working with your EN, enter the date that the provider affiliate stopped working with your EN. If the provider affiliate is still working with your EN, leave the field blank. "]
["Currently an EN?- ","Enter whether the provider affiliate is also an Employment Network. Select \"Yes\" or \"No\" from the dropdown. "]
["Organization Type- ","Enter the organization types that best describe the provider affiliate. Select organization types from the dropdown. The dropdown allows for multiple selections- to make multiple selections from the dropdown, dropdown the options and make a selection, then dropdown the options again and make another selection. "]
["Targets Underserved Populations- ","If the provider affiliate organization's mission is to specifically target one of the underserved populations defined, select the population(s) from the dropdown. The dropdown allows for multiple selections- to make multiple selections from the dropdown, dropdown the options and make a selection, then dropdown the options again and make another selection. If the provider affiliate organization's mission does NOT specifically target one of the underserved populations defined, leave the field blank. For detailed definitions of each underserved population, see below:"]
[null,"Members of religious minorities- Individuals who belong to communities that face discrimination based on their religion. "]
[null,"Members of the LGBTQIA+ community- Individuals who belong to communities that face discrimination based on sex, sexual orientation, and gender identity (including lesbian, gay, bisexual, transgender, queer, gender non-conforming, non-binary, LGBTQ+ persons). "]
[null,"Persons of color- Individuals who belong to communities of color, such as Black and African American, Hispanic and Latino, Native American, Alaska Native and Indigenous, Asian American, Native Hawaiian and Pacific Islander, Middle Eastern, and North African persons. "]
[null,"Persons otherwise adversely affected by persistent poverity- Individuals who have income under the poverty line established by the Director of the Office of Management and Budget and revised by the Secretary."]
[null,"Persons who live in rural areas- Individuals who live in an area other than an area within a metropolitan statistical area or within the outer boundary of any city or town having a population of 20,000 or more."]
[null,"Transition aged youth- Individuals between the ages of 14 and 25. "]
[null,"U.S. Military Veterans- Individuals who have served in the military forces and who was discharged or released under conditions other than dishonorable. "]
["City- ","Enter the city where the provider affiliate is physically located. "]
["State- ","Enter the state where the provider affiliate is physically located. "]
["Change or Addition Since Last Report Submission-","Enter whether there has been a change in the information for the provider affiliate or new provider affiliate since the last report submission. Select \"New Provider Affiliate\", \"Change in Provider Affiliate information\", or \"No change\" from the dropdown. "]
[]
["Please enter all of the staff of the provider affiliates on the tab- \"Provider Employee List\". Answer all of the questions for each employee of the provider affiliates. If you are unsure of how to answer any of the questions, please see definitions below:  "]
["Provider Affiliate Organization Name- ","Enter the full legal name of the provider affiliate."]
["Employee First Name- ","Enter the first name of the employee of the provider affiliate."]
["Employee Last Name- ","Enter the last name of the employee of the provider affiliate."]
["Job Title- ","Enter the job title of the employee of the provider affiliate."]
["Start Date- ","Enter the employment start date of the employee of the provider affiliate."]
["End Date- ","If the employee is no longer working at the provider affiliate, enter the employment end date. If the employee is still employed, leave the field blank. "]
["Suitability Status- ","Enter the suitability status of the employee of the provider affiliate. Select the suitability status from the dropdown. For detailed definitions of each suitability status, see below:"]
[null,"Rollover sent- Individual has submitted the required forms and Contractor Personnel Rollover Request Form, which is used when contractor personnel already working on an SSA contract need to move to another SSA contract.  "]
[null,"Pending- Individual has submitted the required forms and applicant listing and the Suitability office has activated the e-QIP process."]
[null,"Pre-Pending- Individual has not begun the suitability application process. "]
[null,"Suitable- Individual has a suitability letter issued with a favorable determination under the Administrative EN award number. "]
[null,"Pre-screen denied- Individual has a suitability letter issued with a pre-screen denial determination under the Administrative EN award number. Pre-screen denials are issued when the Suitability office needs additional documentation and/or corrections."]
[null,"Not Suitable- Individual has a suitability letter issued with an unfavorable determination under the Administrative EN award number. "]
[null,"Not Active- Individual received a favorable suitability determination, but is now no longer an employee of the provider affiliate."]
[null,"Cancelled- Individual had begun the suitability application process, but had not yet received a decision and is now no longer an employee of the provider affiliate."]
["Determination Date- ","Enter the suitability determination date if the employee of the provider affiliate's suitability status is either \"suitable\", \"pre-screen denied\", or \"not suitable\". For any other suitability status, leave the field blank. "]
["Change or Addition Since Last Report Submission-","Enter whether there has been a change in the information for the employee of the provider affiliate or new employee of the provider affiliate since the last report submission. Select \"New Provider Affiliate employee\", \"Change in employee information\", or \"No change\" from the dropdown. "]

{"sheet":"Providers List","index":1,"n_rows":1002,"n_cols":11,"rows_kept":1002,"cut":false,"hidden":false,"merged":[]}
["ADMINISTRATIVE EN PID:",null,null,"ADMINISTRATIVE EN NAME: "]
["Provider Affiliate Organization Name","Start Date","End Date","Currently an EN?","Organization Type (Select all that apply)","Organization Targets Underserved Populations (Select all that apply)","City","State","Change or Addition Since Last Report Submission?","EN Name","EN PID"]
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{"sheet":"Provider Employee List","index":2,"n_rows":1002,"n_cols":11,"rows_kept":1002,"cut":false,"hidden":false,"merged":[]}
[]
["Provider Affiliate Organization Name","Employee First Name","Employee Last Name","Job Title","Start Date","End Date","Suitability Status","Determination Date","Change or Addition Since Last Report Submission?","EN Name","EN PID"]
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{"sheet":"Sheet1","index":3,"n_rows":17,"n_cols":3,"rows_kept":17,"cut":false,"hidden":true,"merged":[]}
["AbilityOne Program",null,"Members of religious minorities"]
["American Indian Vocational Rehabilitation Agency (AIVR) or Another Organization Serving Indigenous Peoples",null,"Members of the LGBTQIA+ community"]
["Center for Independent Living (CIL)",null,"Persons of color"]
["Disability Services Representative Organization",null,"Persons otherwise adversely affected by persistent poverty"]
["Easterseals Industries Organization",null,"Persons who live in rural areas"]
["Educational Institution",null,"Transition aged youth"]
["For-Profit Organization",null,"U.S. Military Veterans"]
["Goodwill Industries Organization"]
["Mental Health Care Provider or Other Healthcare Provider"]
["Non-Profit Organization"]
["Project SEARCH Program"]
["State or Local Government Agency (non-SVRA)"]
["State Vocational Rehabilitation Agency (SVRA) Vendor"]
["State Workforce Agency (SWA)/ American Job Center (AJC)/ Local Workforce Development Board (LWDB)"]
["The Arc Chapter"]
["United Cerebral Palsy (UCP) Affiliate"]
["Veterans Affairs (VA) or Veterans Services"]