Colorado Benefits Management System (CBMS) Access and Training Requirements

Transcription

1 Colorado Benefits Management System (CBMS) Access and Training Requirements Health Care and Economic Security - Staff Development Center (SDC) 7800 East Orchard Road, Suite 280 Greenwood Village, CO Page 1 of 27

2 Table of Contents Table of Contents... 2 Introduction - Health Care and Economic Security Staff Development Center... 3 General Training Approach... 3 Background... 4 Definition of a New CBMS User... 4 Existing Eligibility Users Requesting Access To Another CBMS Location... 5 Accessing Training... 6 CBMS Access for County Users Prior to June 1, CBMS Access for County Users Effective June 1, Quick View County User Training Requirements Matrix Details Cheat Sheet for Training Completion/End Date for County Users Completion of training equivalent to SDC Courses Questions and Answers Page 2 of 27

3 Introduction - Health Care and Economic Security Staff Development Center The Health Care and Economic Security Staff Development Center (SDC) was established as a result of House Bill and exists to provide a complete training array to staff working with families accessing Medical, Food and Cash Assistance. The Colorado Benefits Management System (CBMS) is used to determine eligibility for these public assistance programs. The SDC is the training connection between the Colorado Department of Human Services (CDHS), the Colorado Department of Health Care Policy and Financing (HCPF), and the Governor s Office of Information Technology (OIT) to the 64 county Departments of Social/Human Services, and Medical Assistance (MA) sites throughout Colorado. The SDC works to identify essential training needs and to establish, facilitate, and maintain competency-based training curricula, while continually evaluating results. General Training Approach The SDC generally provides a blended and modularized approach to training. This approach allows for immersion in various levels of learning tracks, with the initial level being standardized and compulsory. Blended learning is also most efficient where pre-requisite work can be completed prior to coming to any in-person training, and time spent out of the office is minimized to the extent possible. Blended learning allows for web-based and virtual in-person training to occur without the cost of travel for counties in rural areas of the state. Page 3 of 27

4 Background The Colorado Department of Human Services, Health Care Policy and Financing, and the Governor s Office of Information Technology are responsible for ensuring that comprehensive training is provided for staff, including contract staff, who have access to and/or update the CBMS Production Environment. Due to the sensitivity of information in CBMS and the functionality that allows benefits and services to be issued to Coloradoans, users may need to receive additional training prior to accessing or updating the CBMS Production Environment. All new CBMS users must meet minimum training requirements in order to receive CBMS access and that access should always be requested based on the CBMS user s job duties. For example, an eligibility worker who determines eligibility for Food Assistance and/or Cash benefits must receive training on the rules for these programs in addition to CBMS training. This training must be completed within six months of receiving CBMS access in order meet access requirements. Definition of a New CBMS User A new CBMS user whose job duties require CBMS access must meet the defined requirements. A new CBMS user is defined as: o an individual who has never used CBMS o a returning employee who has not had access to CBMS within 180 days of submitting a request for access If a CBMS user moves to a new position and has not been out of CBMS for more than 180 days, such as County to County, County to State or Medical Assistance Site to County, the user must meet training requirements unless the CBMS Training Request Waiver Form is submitted through ticket submission or the Online Request (OLR) process. A sample of the form is included as the last page of this document. Go to TrainColorado.com under Documents and Resources>Document Library>Training Processes to access the form. Page 4 of 27

5 Existing Eligibility Users Requesting Access To Another CBMS Location Current CBMS users who need access to update cases in another CBMS location must have met training requirements prior to gaining access. The user can provide verification of training requirements by providing a certificate(s) of completion or by accessing training information in one of the following locations: 1. CO.Learn a. Contains courses developed by the SDC and trained by the SDC or a Certified Trainer b. The user can print Certificates of Completion and provide them to the County Security Administrator 2. OIT/CBMS Learning Management System a. The courses provided by the OIT/CBMS Training Team (e.g. Basic Worker 01, 02, 03, 04, 05) b. If a user completed one of these courses, the user or County Security Administrator can locate verification of completion by logging into their account c. If the user has questions about training requirements prior to May 1, 2014, or needs assistance obtaining verification of training completion, please the SDC at soc_staffdevelopment@state.co.us If an Update User is not able to provide verification of meeting training requirements,, the user must meet the training requirements listed in this document prior to gaining access to another CBMS location. If there are special circumstances requiring users to access CBMS in another location, such as providing assistance to a neighboring county that was part of a natural disaster, the State Program Area staff will work with the County and State Access Control to determine the process for access (for example, a waiver form may be created/required). Page 5 of 27

6 Accessing Training CO.Learn, the SDC Learning Management System (LMS), is accessible by all users and is used to access the Health Care and Economic Security Staff Development Center s web based training modules (WBTs) and to register for Instructor led training. System access (such as having portal or a State or County address) is not required prior to accessing training in CO.Learn. This is an excellent opportunity to ensure users have access to training upon hire. New users go to TrainColorado.com to find out which courses to complete. The following screen shots provide an example of the process to create a CBMS Training Plan. A Training Plan could vary based on the Eligibility Site and user access level needed for CBMS. 1. Go to TrainColorado.com 2. Place your cursor over the Courses tab 3. Select Training Plans Page 6 of 27

7 Select the link that best fits the type of worker Page 7 of 27

8 1. This page provides details regarding the training requirements for each High Level Program Group. 2. If you work multiple programs, combination training plans are available. 3. Select the link for the High Level Program Group you work to view a list of required courses. To register for a training plan select browse for training, this link will take you to CO.Learn. Page 8 of 27

9 Go to TrainColorado to access guides and training to assist you in using CO.Learn. Select Courses>CO.Learn LMS Page 9 of 27

10 CBMS Access for County Users Prior to June 1, 2016 Effective November 10, 2014, County Security Administrators were given access to manage End Dates on a new user s CBMS access. This process included extending the End Date until training was completed (if necessary) and removing the End Date once training requirements are met. The End Date should not have been removed from the user s account without the certificate showing that the user has met the training requirements. CBMS Access for County Users Effective June 1, 2016 The CBMS user should complete their Training Plan based on the HLPGs that training will be provided. The user does not need to receive training for all HLPGs within the first six months. However, when the End Date is removed, the user will only receive access to authorize the HLPGs for which training was received. Access to authorize other HLPGs will not be provided until training requirements for other HLPGs is complete. Example: If the user will initially receive training for Medical Assistance and Food Assistance and will receive Colorado Works training in the future, the Training Plan should be based off of Medical Assistance and Food Assistance. Once the user completes training, the user will have access to a certificate showing the training requirements have been met and the user can authorize the Medical Assistance and Food Assistance programs. The CSA will remove the End Date and only provide access to authorize these programs. When the user is ready to begin Colorado Works training, the user must create a new Training Plan for Colorado Works. Once the user meets all requirements, the user will have access to a certificate showing the training requirements have been met and the user can authorize the Colorado Works program. Page 10 of 27

11 Effective June 1, 2016 Certificates will show the following information: User s name has completed the CBMS Training Requirements to Authorize Medicaid programs. User may now receive CBMS_PRD access or the End Date can be removed from the user s access. User s name has completed the CBMS Training Requirements to Authorize Medicaid and Food Assistance programs. The End Date can be removed from the user s access. User s name has completed the CBMS Training Requirements to Authorize Medicaid and Long Term Care programs. The End Date can be removed from the user s access. User s name has completed the CBMS Training Requirements to Authorize Medicaid, Food Assistance and Colorado Works programs. The End Date can be removed from the user s access. User s name has completed the CBMS Training Requirements to Authorize Medicaid, Food Assistance and Adult Financial programs. The End Date can be removed from the user s access. Effective June 1, 2016, the End Date on user access must not be extended. All training courses and Assessments are now available. Therefore, users must complete all training requirements and Assessments within six months of receiving CBMS access. If the user does not meet the requirements within six months, the CSA should not extend the End Date. A user who has lost CBMS access must complete all training requirements prior to regaining access to CBMS. Page 11 of 27

12 Quick View The following information includes the documentation and training requirements necessary for CBMS access. The new requirements became effective May 1, It is the responsibility of all County Security Administrators, State Security Administrators, supervisors, program and contract managers (where applicable) to ensure the following procedures are adhered to, and to maintain documentation of all current CBMS users and each CBMS user s role. If a user s role changes, the user must complete the necessary training requirements prior to any access changes. These practices are imperative to ensure that audit requirements are met. Page 12 of 27

13 County User Training Requirements Matrix USER TYPE COURSE NAME Inquiry Only Update - AI Only Update (AI and II) Medical Programs Update (AI and II) Food Assistance Update (AI and II) Adult Financial Update (AI and II) Colorado Works Update (AI and II) Long Term Care CBMS Access WBT X X X X X X X County Security Admin Building Foundations WBT X X X X X X Expanding Foundations Medical Assistance Expanding Foundations Food Assistance Expanding Foundations Adult Financial Expanding Foundations Colorado Works Long Term Care X X X X X X X X X X X Security 01 X Page 13 of 27

14 - Details The following information includes the documentation and training requirements necessary for CBMS access. The new requirements became effective May 1, The information below provides step-by-step details for each user type listed in the matrix above. User Type Training Requirements Other Information County or CDHS State Inquiry User Including LEAP Users To request access for a new user, the On Line Request (OLR) or Computer Access Request form must be submitted. If the account is for a State user, the CBMS Waiver and CBMS Template must also be submitted. State Access Control creates the Portal account, pushes the CBMS icon and, when applicable, provisions the account in CBMS. The user goes to TrainColorado.com. Hover over the Courses tab. Select What courses do I need to take? Go to CO.Learn to register for the CBMS Access Training Plan. All new CBMS users must complete the CBMS Access web based training courses. The user provides the certificate of completion to the appropriate Security Administrator (see below). 1. The County Security Administrator (CSA) maintains documentation showing training requirements have been met. 2. If the user is a State User, the On Line Request OLR or Computer Access Request form and certificate of completion are submitted to State Access Control. When marking the Training Requirements Met box on the form, please explain the User Type and the requirements that were met. Attach the certificate of completion. The CSA provides Inquiry Only access to the CBMS Production Environment once the training requirements have been met. CSA saves the certificate of completion for at least 3 years for Audit purposes. The requirements for this user type assumes the user has no other role in CBMS. If the user s job duties change or require update access, the user must meet the requirements defined in this document. Page 14 of 27

15 Work Force Development (WFD) NOTE: Additional training modules are in development for update tasks that Inquiry Users may complete as part of their job. For example, entering Case Comments, completing Address Changes, Starting an RRR, and Case Assignment. Training for specialized positions such as Benefit Recovery users will be developed in the future. Once the training modules are available, the training requirements for Inquiry Users will be modified. This document will be updated and notification will be sent to Eligibility Sites. In the interim, Inquiry access should be provided to these users. The Eligibility Site should provide training on the tasks that require access to a certain profile and keep documentation of the training provided. Once training is completed, the user can be provided access to the profile related to the training received. To request access for a new user, the On Line Request (OLR) or Computer Access Request form must be submitted. If the account is for a State user, the CBMS Waiver and CBMS Template must also be submitted. State Access Control creates the Portal account, pushes the CBMS icon and, when applicable, provisions the account in CBMS. The user goes to TrainColorado.com. Hover over the Courses tab. Select What courses do I need to take? Go to CO.Learn to register for the CBMS Access Training Plan. All new CBMS users must complete the CBMS Access web based training courses. The user provides the certificate of completion to the appropriate Security Administrator (see below). 1. The County Security Administrator (CSA) maintains documentation showing training requirements have been met. 2. If the user is a State User, the On Line Request OLR or Computer Access Request form and certificate of completion are submitted to State Access Control. When marking the Training Requirements Met box on the form, please explain the User Type The requirements for this user type assumes the user has no other role in CBMS. If the user s job duties change or require update access, the user must meet the requirements defined in this document. Page 15 of 27

16 and the requirements that were met. Attach the certificate of completion. The CSA provides the appropriate profile/security access to the CBMS Production Environment once the training requirements have been met. CSA saves the certificate of completion for at least 3 years for Audit purposes. NOTE: Additional training modules are in development for tasks that WFD Users may complete as part of their job. For example, entering Income or Supportive Services. Once the training modules are available, the training requirement for WFD Users will be modified. This document will be updated and notification will be sent to Eligibility Sites. In the interim, Inquiry access should be provided to these users. The Eligibility Site should provide training on the tasks that require access to a certain profile and keep documentation of the training provided. Once training is completed, the user can be provided access to the profile related to the training received. Employment First (EF) To request access for a new user, the On Line Request (OLR) or Computer Access Request form must be submitted. If the account is for a State user the CBMS Waiver and CBMS Template must also be submitted. State Access Control creates the Portal account, pushes the CBMS icon and when applicable provisions the account in CBMS. The user goes to TrainColorado.com. Hover over the Courses tab. Select What courses do I need to take? Go to CO.Learn register for the CBMS Access Training Plan. All new CBMS users must complete the CBMS Access web based training courses. The user provides the certificate of completion to the appropriate Security Administrator (see below). The requirements for this user type assumes the user has no other role in CBMS. If the user s job duties change or require update access, the user must meet the requirements defined in this document. Page 16 of 27

17 1. The County Security Administrator (CSA) maintains documentation showing training requirements have been met. 2. If the user is a State User or there is not a CSA, the On Line Request OLR or Computer Access Request form and certificate of completion are submitted to State Access Control. When marking the Training Requirements Met box on the form, please explain the User Type and the requirements that were met. Attach the certificate of completion. The CSA provides the appropriate profile/security access to the CBMS Production Environment once training requirements have been met. CSA saves the certificate of completion for at least 3 years for Audit purposes. NOTE: Additional training modules are in development for tasks that EF Users may complete as part of their job. For example, entering Income or Supportive Services. Once the training modules are available, the training requirement for EF Users will be modified. This document will be updated and notification will be sent to Eligibility Sites. In the interim, Inquiry access should be provided to these users. The Eligibility Site should provide training on the tasks that require access to a certain profile and keep documentation of the training provided. Once training is completed, the user can be provided access to the profile related to the training received. County Update Application Initiation Only To request access for a new user, the On Line Request (OLR) or Computer Access Request form must be submitted. If the account is for a State user the CBMS Waiver and CBMS Template must also be submitted. State Access Control creates the Portal account, pushes the CBMS icon and when applicable provisions the account in CBMS. The user goes to TrainColorado.com. Hover over the Courses tab. Select What courses do I need to take? Page 17 of 27

18 NOTE: Application Initiation only is considered an Update Profile when completing the CBMS Training Plan. Go to CO.Learn register for the CBMS Access Training Plan. All new CBMS users must complete the CBMS Access web based training courses. The user provides the certificate of completion to the appropriate Security Administrator (see below). 1. The County Security Administrator (CSA) maintains documentation showing training requirements have been met. 2. If the user is a State User, the OLR or Computer Access Request form and certificate of completion are submitted to State Access Control. When marking the Training Requirements Met box on the form, please explain the User Type and the requirements that were met. Attach the certificate of completion. CSA provides access to the CBMS Production Environment with an End Date 6 months in the future (refer to the Cheat Sheet/Training Completion below). The CSA provides the appropriate profile/security access to the CBMS Production Environment. An AI only user must complete the Building Foundations web based training. The Assessment is taken after completing the web based training modules. The user must pass the Assessment with a score of 85% or better. Once the Assessment is passed, the user will have access to print a certificate that shows the user s name and that the individual has met training requirements for Application Initiation. The user provides the certificate of completion to the CSA. CSA saves the certificate of completion for at least 3 years for Audit purposes. The CSA removes the End Date on the user s access. Page 18 of 27

19 County Update To request access for a new user, the On Line Request (OLR) or Computer Access Request form must be submitted. If the account is for a State user the CBMS Waiver and CBMS Template must also be submitted. State Access Control creates the Portal account, pushes the CBMS icon and, when applicable, provisions the account in CBMS. The user goes to TrainColorado.com. Hover over the Courses tab. Select What courses do I need to take? Go to CO.Learn to register for the CBMS Access Training Plan. All new CBMS users must complete the CBMS Access web based training courses. The user provides the certificate of completion to the appropriate Security Administrator (see below). 1. The County Security Administrator (CSA) maintains documentation showing training requirements have been met. 2. If the user is a State User, the OLR or Computer Access Request form and certificate of completion are submitted to State Access Control. When marking the Training Requirements Met box on the form, please explain the User Type and the requirements that were met. Attach the certificate of completion. CSA provides access to the CBMS Production Environment with an End Date 6 months in the future (refer to the Cheat Sheet/Training Completion below). The CSA provides the appropriate profile/security access to the CBMS Production Environment. The user completes the required courses (based on the CBMS Training Plan) within 6 months of gaining access. Once all training requirements are met, the user must register for and complete a final Assessment. The user registers for the Assessment through the CBMS Training Plan created. Once the Assessment is passed, the user will have access to print a certificate that shows the user s name If the employer s process for new hires includes submitting paperwork for access prior to the employee s start date, the paperwork can still be submitted as it currently is. For example, the employer may want to ensure the employee has a system login and address as soon as possible upon hire. Once the CBMS Training requirement for CBMS access has been met, provide the Computer Access Request Form and verification of the training requirement completion to State Access Control for CBMS access. Average time to receive CBMS Access after necessary paperwork and training requirement is met: 5 business days. Page 19 of 27

20 and the programs that the user will have access to authorize and the End Date can be removed. User provides the certificate of completion to the CSA. CSA saves the certificate of completion for at least 3 years for Audit purposes. The CSA provides Authorization access to the HLPGs listed on the Certificate. The CSA removes the End Date on the user s access. County Security Administrator (CSA), State CBMS Security Administrator County User: County Security Administrator (CSA) sends an Online Request to State Access Control. State User: A Service Desk ticket must be submitted. Include the Computer Access Request Form. State Access Control provides access to the CBMS Production Environment. The user goes to TrainColorado.com. Hover over the Courses tab. Select What courses do I need to take? Go to CO.Learn to register for your CBMS Access Training Plan. The user completes the required courses within 6 months of gaining access: Security 01 Training this course is offered on a regular basis. If there is a need to have an additional session facilitated, please send your request to SOC_StaffDevelopment@state.co.us. Once all training requirements are met, the user must register for and complete a final Assessment. The user registers for the Assessment through the CBMS Training Plan created. User must pass the Assessment with a score of 80% or better. It is recommended that Security Administrators complete CBMS Training plans for Inquiry Users. Although this is not required for a Security Administrator, the training provides a basic understanding and navigation in CBMS for setting up profiles for new users. Average time to receive CBMS access after necessary paperwork and training requirement is met: 5 business days. Page 20 of 27

21 Once a passing score is received, the user will have access to print a certificate that shows the user s name and that the user has completed the course requirements for County Security Administrators. Medical Assistance Sites Presumptive Eligibility (PE) Cognos Go to TrainColorado.com. Documents and Resources>Document Library>CBMS>MA Site Training Process. Go to TrainColorado.com. Documents and Resources>Document Library>CBMS>MA Site Training Process. County User: To request access for a user, the On Line Request (OLR) or Computer Access Request form must be submitted. The County Security Administrator identifies the type of Cognos access and license being requested. State User: To request access, the On Line Request (OLR) or Computer Access Request form must be submitted identifying the type of Cognos access and license being requested. Tickets are routed to Deloitte to grant access after State Access Control has provided a CBMS user account. It is recommended that the user complete the Cognos training Course regardless of the type of Cognos access the user will be receiving. Page 21 of 27

22 Cheat Sheet for Training Completion/End Date for County Users Month Access is Requested Month of End Date Last Working Day January July February August March September April October May November June December July January August February September March October April November May December June Completion of training equivalent to SDC Courses The training requirements became effective May 1, If a County has a user who received training equivalent to SDC training at the County, the user must also complete the Assessment required by the SDC in order to receive the Certificate showing the End Date can be removed. The process to access the Assessment after attending training equivalent to the SDC training was released March 3, Users who have completed equivalent training must complete and pass the Assessment by May 31, If the user does not meet this requirement, the user will be required to attend an SDC training course (trained by SDC or SDC Certified County Trainer) in order to access the Assessment. Page 22 of 27

23 Questions and Answers Question If a user currently has a future End Date on a CBMS account, what do we do? If I am not a new CBMS user, do I still need to create a new account in the Learning Management System (LMS), CO.Learn? What needs to be done if a user already has a passing score for a required Assessment, but must take the Assessment again? For example, the user left employment for over a year and returned to a position which requires CBMS Access. Will State Access Control verify that I have passed the Assessment? Where can I find course information such as dates, times, locations, modality (in person, web based)? Are there guides available to assist with registering for courses? Do I have to re-take training courses if I completed training at my Eligibility Site while the SDC was developing the Expanding Foundations courses? Answer The user must complete training and pass the Assessment by the End Date on the CBMS account. If training and the Assessment are not complete by the End Date, the End Date must not be extended. The user will lose CBMS access until the training requirements are met. In order to register for any training offered by the Staff Development Center, each user must create an account in the new LMS. The user can manage their own account in the new LMS if updates are needed, such as a name change or contact information change. The user may complete the web based training at any time. If the user must take the Assessment again to provide verification of the Assessment, the user should SOC_StaffDevelopment@state.co.us to request the prior Assessment score be removed so the Assessment can be taken again. State Access Control and or County Security Administrator may verify the information for audit purposes. The process requires the user to provide the certificate of training completion when requesting CBMS Access or requesting an End Date to be removed. Go to TrainColorado.com. Select Training Calendar. Detailed information including course descriptions and locations are listed. This information is also available via CO.Learn. Yes. The guides are located on TrainColorado.com. Select Courses, then CO.Learn LMS. The SDC understands that Eligibility Sites continued to offer training as new employees were hired. Re-training is not required if the user completes the Expanding Foundations Assessment by May 31, The opportunity for the user to complete the necessary Assessment after completing equivalent training is available from March 3, May 31, Page 23 of 27

24 Accessing the Assessment If the user has a Training Plan created in the Learning Management System (LMS) and has completed SDC developed and/or delivered training classes, the user will access the Assessment as part of their Training Plan. If the user has a Training Plan created in the LMS and has completed equivalent training classes at the County (meaning the class was not posted in the LMS for registration), the user must do the following: o Go to > Courses > Equivalent Training. o Find and complete the form titled Test Out Request. o Within 3 business days, the user will receive an from the CO.Learn LMS stating the user has been registered for the appropriate Training Plan. o These training plans all start with the words Test out option-. o o Users will receive an from SOC_StaffDevelopment@state.co.us containing account information if an account was set up in the LMS. User will access and complete the Assessment. If the user does not pass the Assessment by May 31, 2016, the user will be required to receive re-training in order to take the Assessment. Page 24 of 27

25 What are the training requirements if I am moving to a new position, such as County to County, County to State or Medical Assistance Site to County? If a CBMS user moves to a new position, such as County to County, County to State or Medical Assistance Site to County, the user must meet training requirements unless the CBMS Training Request Waiver Form is submitted to State Access Control. The form is included as the last page of this document. The form is also available on TrainColorado.com under Documents and Resources>Document Library>Training Processes. What is the process to re-gain access if I lose it due to non-use? CBMS users should make sure to log in to CBMS at least every 30 days to make sure access is not revoked. The Security Administrator also receives reports identifying users who may lose access for non-use. The Security Administrator should work with the employee to help prevent the user from losing access for non-use. If a CBMS user loses access within the last 180 days, the user must meet training requirements unless the CBMS Training Request Waiver Form is submitted to State Access Control. The form is included as the last page of this document. The form is also available on TrainColorado.com under Documents and Resources>Document Library>Training Processes. What is the process if the user has an End Date on their CBMS account, but the user was a transfer from another CBMS site? If there is an End Date on the user s ID, the user must meet the training requirements regardless of the site. The users transcript will show training completed and HLPGs the user has access to Authorize. Page 25 of 27

26 SAMPLE ONLY GO TO TrainColorado.com TO ACCESS THE FORM CBMS Training Waiver Request Form This waiver certifies that suitable judgments have been made on the part of the requestor to grant CBMS access to the requested party specified below without having to attend Staff DevelopmentCenter mandated training sessions. The requestor and the requestor s organization assume all CBMS risk and liability issues that may potentially arise from an individual who does not attend mandated Staff Development Center training sessions usually required for CBMS access and use. This form shall be submitted in conjunction with the standard departmental (Colorado Department of Human Services or Health Care Policy and Financing) CBMS access request form. Complete all required fields on this form (Indicated by the *red fields). Submit the completed form to the CBMS Security Contact. REQUESTOR INFORMATION (Complete all fields in the following section with current information). *Last Name: *First Name: MI: Phone Number *Organization: * Address: Requesting CBMS Access For (first and last name of individual for whom you are requesting CBMS access): Page 26 of 27

27 *Last Name: *First Name: MI: Phone Number *Organization * Address Reason for Waiver Request (please check all that apply): Individual is transferring to my organization with no break in CBMS access from previously held position. Individual has had CBMS access within 180 days of the date of this waiver request. Individual has same level of responsibility in new position as previously held position. Other (please specify): I hereby attest that (list individual s first and last name) has the requisite skills and training necessary to be granted CBMS access, and that this individual does not need to attend the required training sessions offered at the Staff Development Center related to CBMS access. I understand that by filling out this form, my organization and I assume all risk and liability issues associated with this individual s potential inappropriate uses of CBMS. Requestor Signature: Date: Approved by CBMS Security Contact CBMS Security Contact Signature: Date: Page 27 of 27