LOCAL EDUCATION AGENCY

APPLICATION PACKET

2016-17 School Year

IDEA, PART B

For sub-grants supported from funds available

under the provisions of the

Individuals with Disabilities Education Act

through the Area Education Agency

For the provision of Special Education and Related ServicesTo Children and Youth with Disabilities

DUE DATE:Application submitted to the AEA by Friday,

September 2, 2016

Revised 6-15-16

Individuals with Disabilities Education Act (I.D.E.A) Part B.

Overview:This is a general overview of the processes related to programs and services that will be described in the application for Part B funding.

The amounts available to each school district can be found on the Iowa Department of Education’s Website. The Excel spreadsheet is located under “Special Education” and under “Fiscal”. The document will be labeled as “LEA Amounts for 2016-17 Part B, IDEA”. Funds are available for only the 2016-17 year. These documents will be distributed to the Area Education Agencies. These funds are available to support activities occurring in 2016-17 and may not be carried forward to subsequent years.

In order to receive IDEA Part B funds for 2016-17 LEA Applicants:

1) Must complete and submit an application to the Area Education Agency no later than Friday, September 2, 2016 4 pm. Submit Sections I & II as a Word document attached to an e-mail to the designated AEA contact. It is necessary to submit, to the AEA, Part III (Statement of Assurances) as a hard copy with an original signature of the applicant district’s authorized representative. If a district is applying to use Part B fund for Coordinated Early Intervening Services (CEIS), Maintenance of Effort Reduction (MOER) or is requesting acquisition of equipment, the e-mail with the attached application must be cc’d to or forwarded by the AEA contact to IDEA.FISCAL@IOWA.GOV.

2) Must submit a mid-year financial expenditure report of Part B funds (July-December) to the AEA; Due date February 13, 2017 (LEA report to the AEA)

3) Must submit a final report of expenditures and narrative of how funds were used in 2016-17 to the AEA; due not later than June 20, 2017. (LEA report to the AEA)

4) Must report in Student Reporting in Iowa those students who benefitted from any CEIS supported by these Part B funds during the project/school year.

Area Education Agencies:

The AEA will distribute the application forms, funding information (also will be on the DE website) and designate a contact(s) at the AEA to receive completed applications for processing and approval. Area Education Agencies are to receive all applications from districts. The AEA contact will forward, to the Department, any applications that contain a planned use for Coordinated Early Intervening Services or acquisition of equipment. If a district is using CEIS or MOER (see below) or the application includes a request to acquire equipment, the AEA may issue a “Conditional Approval” if the Excess Cost portion of the application budget is approvable. Doing so does not constitute approval of the portions of the application for CEIS, MOER or acquisition of equipment, those require Department approval. Once the Department has reviewed and finalized any applications with one or more of these items, the Department will notify the AEA of what has been approved for the district and the AEA will issue a full approval of the application as finalized

Key Dates

o Friday, September 2, 2016, 4 P.M. Application Due. (This allows the AEA to complete the summary report to the Department which will trigger the 1st payment 50% of the total amount available for the year.)

oo Monday, February 13, 2017 Mid-Year (July-Dec) Financial Status Report Due. (Trigger for the 2nd payment for

16-17).o Monday, June 19, 2017: Final Year End Report Due, (Trigger for the final payment for 16-17).

A. Announcement of Subgrant Amounts.

At the earliest possible date estimates of grant amounts will be made available to applicant agencies. This provides planning time for the entire program of services of which the federally supported projects are a part. When the State Education Agency receives a grant award document, a written notification indicating the official amount of grants will be forwarded to Area Education Agencies (AEA) and subsequently to Local Education Agencies along with the appropriate application forms. These will also be made available on the Iowa Department of Education's Website.

B. The Application

There are three parts to the Application.

Part I contains the Applicant Agency Information.

Part II addresses the Utilization of Funds requirement by providing information regarding personnel, services, and Activities to be supported under the project, including a special section (Utilization of Funds, Subpart B) dealing with Coordinated Early Intervening Services (CEIS). The CEIS section of the application provides guidance in the form of a rubric to assist in developing the applicant’s description of Part B supported CEIS. This portion of the application must be reviewed by the Department prior to full approval of the application by the Area Education Agency.

Part III contains the Assurances which are "boiler plate" statements required of the applicant which assure that the program is operated in a manner consistent with the federal and state requirements. This part must be submitted to the AEA contact as a hard copy with an original signature.

NOTE: Department review and approval is required for any application that includes CEIS (Part II, Subpart B) or proposed acquisition of equipment. The completed application which includes one or both of these elements is to be submitted to the Area Education Agency and forwarded to the Department.

Part II, Subpart B) contains the format and instructions for required or voluntary use of Part B funds for Coordinated Early Intervening Services.

The information required includes the applicant’s definition of the population of students in need of additional supports, not on an Individualized Education Plan (IEP) who could benefit from additional academic and/or behavioral supports. Additionally a description of the activities to be supported with Part B funds is required.

C. Review

An application will be reviewed by appropriate staff in the AEA to ensure the proposed use of Part B funds is in accord with the attendant federal and state regulations governing Part B and Special Education. If questions or concerns arise during this review process the applicant will most likely be contacted by telephone for clarification and may be required to submit additional documentation. If warranted, certain issues may require a written inquiry from the AEA, identifying the area(s) of concern and requesting explanations, clarification or modifications. Such written notices and attendant responses are directed at ensuring that the application and district programs, policies and procedures meet federal and state requirements and result in an approvable application.

D. Approval

Once the application has been reviewed and is in approvable form, an approval notice will be forwarded to the applicant agency. The Notice will contain information on the approved amount, and any assigned project number/identifier. The federal fund source information is included on the application’s first page of Part I. Periodic financial reporting forms and instructions will accompany the project approval. The availability period for these funds will be twelve months, from July 1 until June 30 th . At the end of twelve-month period, if the district has not been able to expend their dollars, the unused funds cannot be carried forward and will revert to the AEA for further disposition . The personnel services, activities, acquisition of program materials, supplies, instructional or other equipment for special education or any other goods or services for special education must be occur or be received within the July 1st through June 30th time frame for which the Part B allocation is made available. Personnel must possess the appropriate credentials from the State of Iowa to be supported by Part B funds in the delivery of special education and related services.

E. Reports

As previously mentioned, you will receive with the project approval a packet containing a Mid-Year Report of Expenditures and Request for Funds. This form is the same format as the application’s budget page. The local district shall submit that mid-year financial statement to the AEA which reflects the use of the Part B funds for the July through December

period. That Mid-Year Expenditure report is due to the AEA by February 13, 2017.

The final report is due June 19, 2017. The final report will include the cover page used in the application process and be marked as FINAL REPORT. The budget and expenditure page is the second piece and the third section should contain a brief description of how the funds were used in the district's special education instructional program. If the district used Part B funds for CEIS, MOER or were granted permission to acquire equipment there are additional forms to be completed covering those uses.

If a district uses all these funds by the end of December of the school year, they may submit the final report and claim any balance not yet paid. In that situation the district must be able to document expenditures in July through December that would be at least equal to or greater than the amount of the federal funds available.

Please be aware of the Maintenance of Effort Requirement in IDEA, as you monitor the sources into and expenditures for special education. That requires an LEA to expend for special education in the current year in local funds or state and local funds combined, either in total or per capita the same amount or more than in the prior year.

F. Amendments

During the operational period of the Application situations may arise which would necessitate modifications to the approved Application, such as a supplemental federal appropriation, personnel or staff changes, revised priorities regarding utilization of funding, and adjustments in other fund sources. Amendment requests shall be in writing. Such requests will identify the specific part(s) of the Application affected and describe the changes requested. Requests affecting the budget and personnel must include a revised budget. The amended budget can be explained in the request’s cover letter.

Amendment requests depending on the area(s) affected will be processed by the AEA in a manner similar to the approval process. A written response to the request will be forwarded.

G. Payment of Funds

Payments of Part B Basic funds to local districts will be processed through the Area Education Agencies. The schedule calls for up to three payments as indicated previously in these instructions under “Key Dates”.

All Payments will be paid to the AEA upon receipt of a summary report from information provided by the district to the AEA. The first payment will be processed by the DE upon receipt of the LEA Application Summary report from the AEA. The second payment will be processed upon receipt of the Mid-Year expenditure summary from the AEA. The third and final payment will be processed by the DE when the Year-End summary report is received from the AEA. That report summarizes the expenditure data for the entire school year. All of the summary reports and disbursal of funds are dependent upon the timely submission of the application, mid-year expenditure report and final report by the district to the AEA.

H. Options for Use of Funds:

For the 2016-17 there are three options to consider in utilizing Part B funding. Due to the level funded nature for 16-17, only the first two options are available to all districts.

1) Excess Cost of Special Education: This option is to use Part B funds to cover the increase in the excess cost of special education; no change from prior years. This is the primary use of Part B funding. It would include covering any projected deficit for special education programs or the increase in current year’s costs over the prior year’s costs. Increased excess costs, if any, would be those costs of normal and usual operations over and above the previous school year. Such costs might include teacher salary adjustments (salary steps) or cost of living adjustments, increased costs of health insurance or other benefits, adding classroom(s) to meet the needs of identified students, or meeting increased service needs of students. If there is not an increase in the cost of the special education program, Part B funds are to be used first in covering special education program costs.

2) Coordinated Early Intervening Services (CEIS): This provision of IDEA is an amount that may be set aside for CEIS activities. IDEA specifies an amount up to 15% of the award (formula amount) to a recipient may be set aside from Part B to design and implement a system of early intervening services to a defined population that is not special education within the LEA or AEA but would benefit from additional supports which may assist in supporting that population in general education and negate the need for special education. This amount may be combined with other resources available to an LEA or AEA to support the activities. There is a reporting

requirement when Part B funds are used for CEIS. Any child in the defined population must be tracked for a period of two years following services. That reporting is at the LEA level and is done through Project EASIER. An LEA that has been identified as having disproportionate representation must set aside this “15%” to address and remediate the identified problem(s). Additionally such an LEA may not use the Maintenance of Effort Reduction provision of IDEA that is described below.

3) Maintenance of Effort Reduction (MOER): This provision allows a recipient to replace state and local funding in special education with Part B funds. This is a “limited supplanting” of state/local funds. The Department calculates the allowable amounts each year using the prescribed federal formula and provides that information through the Area Education Agency and on the Department’s Website for the year beginning July 1 st. This “Formula Amount” for the coming year is compared to the “Formula Amount” for the prior year. If there is an increase, the amount available for MOER is equal to 50% of the increase in Part B funds (current vs. prior; 16-17 vs. 15-16). If an LEA or AEA exercises the MOER provision the real increase in funds available to supplement the special education program is the amount not used in replacing state and local funds in special education. The freed up state and local funds are to be used in support of any of the activities authorized under ESEA. An LEA identified as having disproportionate representation cannot use the MOER provision. An LEA that has been identified as “not meeting requirements” (of Part B IDEA) cannot use the MOER provision. LEAs will have received written notification from the Department if they fall into either of these circumstances

The Department has calculated amounts for all aspects of the Part B funding going to LEAs. The amount available for the 2016-17 (FORMULA), Non-Public Proportionate Share, CEIS Maximum and any likely MOER. For the 2016-17 school year, there has not been a increase overall in Part B funding available for flowthrough to AEAs and LEAs any changes are a result of shifts in the population and poverty factors used in the distribution formula and where there is an increase it is unlikely a significant enough increase in any district that the amount would make MOER a realistic option..NOTE: LEAs that merged on July 1, 2016 will have the MOER calculations made using the combined awards from the prior and current years to determine any amount available for MOER. Likewise LEAs that are dissolved will have the current year’s award apportioned to the LEAs it is dissolved to for the coming year, calculations are adjusted accordingly.

4) Coordinated Early Intervening Services (CEIS)

An LEA may use Part B funds to develop and implement coordinated early intervening services for students, K-12, with particular emphasis on K-3. These are students who are NOT yet identified as needing special education or related services, but need additional academic and behavioral support to succeed in general education. The definition applied to identify the population to benefit from CEIS must be included in Part II, Page 7 that is the CEIS” section.

In that section the applicant must provide a description, guided by the form, for the Coordinated Early Intervening Services to be supported with IDEA, Part B funds for the project period. Title 34, Code of Federal Regulations which apply to the requested or required use of Part B funds is specifically 300.226 “Early Intervening Services”. That section stipulates two allowable uses, both of which must be directed at an identified population of students not on IEPs. The two uses are stated below and the highlighted underlined wording is central to the targeted use of funds for CEIS. After the applicant agency has identified the specific group of students (not identified as eligible for special education services) who need additional academic/behavioral support to be successful in the general education environment, then the applicant agency upon approval can perform the following activities funded with Part B CEIS dollars:

Defining the Population to be served:The definition of the population to be provided services is critical.  The definition of the population “in need of additional supports” to be the targeted beneficiaries of CEIS should be stated in terms of academic and behavioral characteristics and not include descriptors of gender or race ethnicity. It should be specific enough and contain measures and characteristics that make identification for inclusion in CEIS clear. Too broad or an unclear definition poses problems in accounting for the services supported and the reporting requirements attendant to CEIS. For example, it may be desirable to provide professional development on a literacy instruction approach to all elementary teachers in the agency, however while this may improve the ability of all teachers in literacy instruction, it does not ensure that those who will work with the identified group of students have received the targeted professional development they need. A more targeted definition of the student population to benefit from CEIS is essential to ensure accurate and appropriate use of funds and accurate and manageable reporting.

Disproportionate Representation: If your district has been notified as having a condition of disproportionate

representation within your special education population, your district will have received from the Department a notice regarding the disproportionate representation issue(s). Your district must budget the entire 15% amount for coordinated early intervening services to address the disproportionate representation issue. You will need to complete the section entitled “Coordinated Early Intervening Services Action Plan and Budget” in Part IV. An agency that is required to set aside the full 15% to address this situation is NOT allowed to use option 3 (Maintenance of Effort Reduction) described below.

(b) Activities. In implementing coordinated, early intervening services under this section, an applicant may carry out activities that include--

(1) Professional development (which may be provided by entities other than the LEA) for teachers and other school staff to enable such personnel to deliver scientifically based academic and behavioral interventions, including scientifically based literacy instruction, and, where appropriate, instruction on the use of adaptive and instructional software; and

(2) Providing educational and behavioral evaluations, services, and supports , including scientifically based literacy instruction.

In other words, these funds can be used to teach educational staff to deliver the selected scientifically based academic interventions for the identified students. Additionally costs associated with staff providing the interventions directly to the identified students may also be charged to CEIS funds. The amount of time staff spend teaching those who will provide interventions to the specific group of students or the amount of time individuals actually provide interventions to the identified group of students are allowable Part B CEIS expenditures. Such time and effort must be documented to substantiate the costs charged to CEIS supported with Part B funds. The requirements of A-87 related to documentation of “time and effort” are required of the agency from all the staff costs charged to the Part B CEIS funds.

Use of Part B funds to support CEIS obligates the LEA to fulfill the reporting requirements (in Student Reporting in Iowa formerly “Project EASIER”). The regulations for IDEA Part B set a reporting requirement [34 CFR 300.226 (d) (1) & (2)] which states that the number of students served must be reported to the SEA. Furthermore the report must include tracking students for two years following the services to identify those students who went on to receive special education and related services. This reporting is done through Student Reporting in Iowa (SRI) and requires the applicant, if an LEA to enter the data into SRI about individual students served. If the applicant is an AEA then this requires the AEA to work with local districts to report the student data required. At this time AEAs do not have the capability of entering information directly into SRI. There are three major student systems in Iowa’s schools, JMC, Power School and Infinite Campus, all have been adapted to accommodate this reporting requirement. Here are the SRI instructions (in general) with specific instructions for each of the three. The default is to”0” for no CEIS. There may be CEIS provided by the LEA by the AEA or a combination of both. Selecting “1” means that the Part B funds in this LEA application are being used even though the funds flow to the LEA through your AEA. Selecting “2” means that the AEA is using their Part B funds for CEIS and the LEA is benefitting from it. In this circumstance the AEA will work with you to ensure that any students in your district benefitting from Part B supported CEIS are properly identified and reported. Selecting “3” is a combination of “1” and “2”.

The description of Coordinated Early Intervening Services is found in the Data Dictionary:

Use the following guide to appropriately mark a student in your student information system who is the beneficiary of CEIS.

JMCEdit > Student Data > General tab, see Coordinated Early Intervening Services field.

PowerSchool Call up the Student Record

Click on the State – Province – IA link on the left side menu Click on the Programs tab at the top The field is located on that screen about 4 inches down.

It is a drop down with the following choices:0 No1 Yes and funded by the LEA2 Yes and funded by the AEA3 Yes and funded by both the LEA and AEA

Infinite Campus

Enrollment, click on current enrollment, scroll down to State Reporting Fields under Program Indicators, look for Early Intervening Service.

Maintenance of Effort Reduction (MOER):

Example:

The following is an example of how the MOER would work in an LEA that is allowed to use that provision:

West Wonklesburg School District develops a special education budget for the coming year that totals $519,000.

The revenue supporting that budget is $475K state and local funding and $100K is the amount generated by Part B. West Wonklesburg’s current year’s Part B formula amount is $44,000, the increase is then $56K and the MOER maximum is $28K. The two $28K portions (two halves of the increase) work like this: $28K replaces $28K in the $475K of state and local, the second half (also $28K) adds to the available funds for special education programming. The $28K freed up state and local funds from the $475K (state and local) now becomes available for ESEA activities.

Budget for Special Education for Coming Year: $519,000

REVENUE

STATE AID/ LOCAL TAX $475,000PART B BASIC + ARRA $100,000

TOTAL REVENUE $575,000

MAINTENANCE OF EFFORT REDUCTION (MOER) AMOUNT

Coming Year PART B $100,000Current Year PART B $ 44,000CHANGE (Increase) $ 56,000 Maximum Maintenance of Effort Reduction (50% of increase) $ 28,000 MOER AMOUNTThis half of the increase may replace $28,000 in STATE AID/ LOCAL TAX

REPLACEMENT OF STATE AID WITH MOER $

STATE AID/LOCAL $ 475,000MOER federal funds + $ 28,000 To spend on SPED replacing state/local SPED.

State /Local SPED freed up to ESEA - $ 28,000 To general education for ESEA activities.State Aid/Local (with MOER Federal) $ 475,000. Actual amount does not change.

CALCULATION OF ACTUAL SUPPLEMENTAL FUNDS Federal funds $100,000Less MOER amount replacing State/Local - $ 28,000Net Federal Funds Available $ 72,000Amount of Federal Funds needed to meet budget of $519K- $ 44,000 ($475K State aid with MOER $ plus $44K federal = $519K)Actual amount of additional funds available to supplement the $ 28,000Special education program,

Maintenance of Effort Level for 14-15.

There is a tool in the Special Education Supplement “tool kit” that the Department has developed to assist agencies in calculating this amount. In short there are four tests on Maintenance of Effort (MOE) that are set forth in IDEA. An LEA must expend during the operating year in total or per student an amount equal to or greater than the amount from these calculations from the prior year. These can be calculated on local tax revenue expended only or the combination of state aid and local property tax revenue. If an agency meets one of these four tests, the maintenance of effort requirement is met. If in these calculations an agency does not meet the requirement, there are four exceptions that may be used, if applicable, and are in 34 CFR 300.204.In the example above if West Wonklesburg expends from all sources exactly the $519K that was initially budgeted the MOE is lowered by the $28K for the next year. If the agency actually expends more than the $519K that would come from state and local sources, it would negate the MOER that was used, because the agency is expending state/local funds in special education. That increases the required MOE level by the amount above the original budget of $519K in the example above.

I.D.E.A., PART B LEA GRANT 16-17INSTRUCTIONS

TO BE COMPLETED BY APPLICANT AGENCY

PART I. GENERAL INFORMATION

A. Title of Project: Completed

B. Applicant Agency: Enter the legal name and complete address of the applicant agency and the administrator of the applicant agency.

C. Project Contact: Enter the name and other identifying information of the contact person directly responsible for project services.

D. Project Duration: Completed. July 1st through June 30th, which follows the State fiscal and school year.

E. Type of Form: Completed. This will be an application. When using this for an amendment, indicate by check in the appropriate space.

Part II. USE OF FUNDS

Part II, Subpart A Page 1.

Project Budget:

The Budget form provided follows the same structure as that found in the Special Education Supplement to the Certified Annual Report (CAR). Local districts should be familiar with this structure and the Uniform Financial Accounting structure utilized should facilitate proper accounting for and reporting of expenditures of the federal funds available through this program. There are four columns. Column 1 contains the expenditure item; column 2 is utilized for the application process; column 3 shall be used for final reporting of expenditures at the end of the 12-month operational period; column 4 shall reflect any unexpended balance at the end of the 12-month operational period.

Application:

After reviewing the guidance document on use of Part B funds an applicant will develop a plan for use of the funds in one or both expenditure categories. The application budget is entered in column 2. Two additional guidance documents can be found on the Department’s Web site under Special Education Finance, Guiding Practice, “Use of Special Education Funds”.

Use of Funds; General:

These federal funds are available for a twelve-month period to be used for the identified purposes. One is Special Education instructional program costs; the second being the Comprehensive Early Intervening Services. They are available to cover actual events that occur within the July 1st through June 30th school year for which the Part B funding is available. Such costs can be through provision of services directly by a district or under a contractual arrangement with another district or AEA for instructional services. The funds should not be utilized for support and related services normally provided in the cadre of services from the Area Education Agency. These funds cannot be carried forward to the next school year. The third option is the Maintenance of Effort reduction. All of these are described below in more detail.

Options for 2016-17:

For the 2016-17 there are three options (below) for local districts to consider in utilizing Part B funding. Since there is not a growth in the funding available in total going to local districts in 2016-17 the third option (Maintenance of Effort Reduction or MOER) is not a realistic option for 2016-17.

1) Excess Cost of Special Education: (Available to all LEAs), 2.)Coordinated Early Intervening Services (CEIS) and 3.)Maintenance of Effort Reduction (MOER) Option. An agency that has been notified that they do NOT “meet requirements” (of Part B) may NOT use option 3. An agency that has been notified as having disproportionate representation in Special Education may NOT use option 3.

NOTE for 2016-17: The funding levels of Part B for 2016-17 will be not be increasing from the 2015-16 levels and the Maintenance of Effort Reduction provision of Part B will likely not be an option.

Part II, Subpart A. Page 2

Listing of Contracted Services: Provide a complete listing of contracted services that are to be funded under this project. Include the name of the agency or individual contracted with, a description of the service(s) that are to be provided, and the amount of the contract. Describe how the contract will provide or improve services for children with disabilities.

Part II, Subpart A. Page 3

Justification for Equipment Purchases Building Modification(s): Present a justification on page 4 for any instructional equipment or other equipment with a unit acquisition cost of $5,000.00 or more that you propose to purchase with project funds. Use of these federal funds for this purpose requires Department approval and the application must be routed to the Department for consideration. Be advised that federal funds utilized to acquire equipment also require equipment inventorying and there is a federal interest in that equipment for its usable life. The equipment must be ordered and received within the July 1st through June 30th availability period in order to be charged to this year's allocation. Use of state/local funding in these expenditures does not usually require Department approval. Any equipment purchased with these funds must be properly accounted for in the applicant agency’s inventory system. The applicant agency will be required to provide a report of all equipment acquired in the year-end report.

Part II, Subpart A. Page 4

Proposed Purchases of Equipment: Provide a complete listing of proposed equipment purchases within the project budget. Information required is stipulated on the form. Department approval is required for equipment. Use of state-local resources does not usually require such approval, nor does it carry the federal requirements of inventory and disposition of equipment.

Part II, Subpart A Page 5

Use of Funds Narrative: Provide a detailed description of the activities, programs and services that will be supported under this project and how these will be executed to achieve the project objectives. Include such items as data to support the needs to be addressed, staff assignments, number of children in each activity, facilities to be used, specific resources, methods and procedures to be employed in conducting the activities. In using Part B funds to cover the increased excess costs of providing special education the applicant shall provide a brief description of which category or categories of expenditures will be involved. The narrative can be as simple as a statement to the effect that the district will use the funds available to cover an anticipated deficit; used to cover the increase in personnel costs over the previous year, transportation cost increases, or specialized supplies and material.

Part II, Subpart A, Page 6 Indication of CEIS.

If your district is required or is voluntarily choosing to use Part B funds to support the development and implementation of a system of coordinated early intervening services (CEIS) check “Yes”. Check “No” if your district will not be voluntarily choosing this option. If you check “Yes” then proceed to Part IV, the section entitled “Coordinated Early Intervening Services Action Plan and Budget”. That section provides guidance and a template for the items required when using Part B funds for CEIS

Part II, Subpart B. Page 1

Coordinated Early Intervening Services (CEIS)

These pages request the information related to the definition of the population, staff involved and activities to be conducted during the school year in which these funds are available. It also requests a description of how the project will be evaluation. Part III, Pages 1-4 Annual AssurancesThis contains all of the annual assurances that a subrecipient agency must provide the Area Education Agency. Please review these assurances carefully to ensure that your agency has the proper policies and procedures in place to meet the requirements addressed in these assurances. After you have carefully reviewed these enter the name of your agency

near the top of page 1 of this section and have the appropriate authorized official in your agency sign and date the assurances on the last page of this section.

Final report forms will be made available to the Area Education Agency after January 1st. This report will inform the AEA (and the DE) how the applicant used the project funds during the operational period. The applicant shall complete the final report and submit it to the Area Education Agency. Projects that involved CEIS, MOER or approved acquisition of equipment will be forwarded to the Department for review. If the applicant selected line 9 “Increase in Excess Cost” in the application, the district will need to report on the appropriate line(s) where federal funds were expended. The “Increase in Excess Cost” line is not available on the reporting document. If the applicant exercised the coordinated early intervening services option (CEIS), there are lines for reporting expenditures made on the specific allowable activities under that option. Proper use of the Uniform Financial Accounting structures should facilitate the tracking of project funds from revenue through expenditure. Expenditures will be cross-checked with reporting on the Certified Annual Report, Special Education Supplement. If CEIS is used a check for students benefitting from those expenditures will also be checked by the Department.

Complete and submit only the pages following this page

Part I. Page 1PART B IDEA,

LEA APPLICATION FORFEDERAL FINANCIAL ASSISTANCE FOR THE EDUCATION OF INDIVIDUALS WITH DISABILITIES

UNDER THE INDIVIDUALS WITH DISABILITIES EDUCATION ACTAPPLICATION, AMENDMENT, AND REPORT FORM

PART I: GENERAL INFORMATION

FOR COMPLETION BY APPLICANT AGENCY

A. TITLE OF PROJECT:, Part B FUNDS: Local District Services, 2016-17

B. APPLICANT AGENCY: Department Use Only

1. Name of Administrator :

2. Name of Agency:

3. Street Address:

4. City: State: IOWA Zip Code:

5. Area Code-Number-Ext.

6. Administrator’s E-Mail Address:

C. PROJECT CONTACT

1. Name of Contact:

2.Contact’s Title

3. Number and Street (if different from above)

4. City State IOWA Zip Code (if different from above)

5. Contact’s Telephone Number:

6. Contact’s E-Mail Address:

D. PROJECT DURATIONFROM: 07 / 01 / 2016 TO: 06 / 30 / 2017

TYPE OF FORM CHECK ONE

APPLICATION XXXXX C.F.D.A. # 84.027 IDEA-PART B (Source code: 4720; Project code 4521)

APPLICATIONAMENDMENT

6-15-16

Part II., Subpart A, Page 1Part II. USE OF FUNDS (2016-17)

IDEA, Part B, PROJECT APPLICATION BUDGETAPPLICATION: Give projected expenditure for each applicable line item

NOTE: Column 3: Coordinated Early Intervening Services (CEIS) .     Column 3 reports budget/expenditures of IDEA Part B for this purpose.   There are two breakouts of the total amount.   The first is by the categories shown in lines 1 through 7.   The second breakout is reflected in lines 10 and 11, the two authorized activity categories of expenditures.   The sum of amounts in Column 3, lines 1-7 the itemization is the same as the sum of Column 3, lines 10 and 11.

1 2 3 4

Expenditure AccountSpecial Education

InstructionCoordinated Early

Intervening Services (15% Maximum)****

Total Budget forIDEA, Part B Funds

1. Salaries (Instructional)

2. Employee Benefits

3. Employee Travel

4. Supplies & Materials (Consumables)

5. Contracts (Non Tuition) (1)

6. Pupil Transportation

7. Equipment (Instructional) (2)

8 Tuition

9. Increase in Excess Costs (3)

Total Lines 1-9

Coordinated Early Intervening Services (CEIS)10. Early InterveningStaff Development (4)

11. Early InterveningBehavioral Evaluations,Services & Supports.(4)

12. Total

(1)For any expenditure in this category provide a listing of the contracted services obtained in this project.(2)For any expenditure in this category, provide a justification and listing of the equipment or building Modification costs to be charged to this project.(3) A district in applying for Part B funds may make a single entry here of the entire amount or may distribute that amount among the line items 1 through 8. These amount(s) will be used to cover the increase in excess cost of special education services due to normal operational cost increases from last year. For final report purposes line 9 cannot be used(4)Coordinated Early Intervening Services (CEIS) whether required of a district or voluntary on a district’s part can be no more than 15% of the total available formula amount of the award and carries additional data requirements, refer to the instructions for more specific details. A description of the Coordinated Early Intervening Services system in the district and the activities to be supported with IDEA funds must be included as a part of the application. A section of Part II of this application entitled: “Coordinated Early Intervening Services Action Plan and Budget” is to be used when Part B funds for CEIS, whether voluntarily or if the district is required to reserve the maximum of 15% to address identified disproportionate representation.

Part II, Subpart A, Page 2Part II. USE OF FUNDS. (2016-17)

Listing of Contracted Services

Provide a listing of contracted services that are to be supported with project funds (Line 5 of the budget, Contracts: Non-Tuition). Give the name of the agency or individual to be contracted with and the service(s) they are to provide the applicant agency.

Part II, Subpart A, Page 3Part II. USE OF FUNDS: (2016-17)

Justification: Equipment Purchase

Give justification for any capital outlay item(s) included in proposed project budget. (Any proposed acquisition of equipment requires Department approval prior to such acquisition. Additionally, if Department authorization is granted, equipment acquired with project funds must be accounted for and may be used only in the provision of special education and not other purposes in the applicants educational program.)

Part II, Subpart A, Page 4Part II. USE OF FUNDS (2016-17)

Proposed Purchase of EquipmentThis form is to be completed and forwarded with the project application or amendment if the proposal provides for the purchase of any equipment. Justification of these proposed purchases must be presented on page 2, Item B of Part I of the project application form. A complete listing of all items along with the other information requested relative to these items should be presented on this form.

ItemDescription Vendor Quantity

EstimatedItem Cost

TotalCost

Page Total

Part II, Subpart A, Page 5

Part II. USE OF FUNDS NARRATIVE (2016-17)

Part II. Provide a description of how Part B funds will be used to supplement state and local funding (weighted funds) in your district’s special education program.

Part II,Subpart A, Page 6

Part II. USE OF FUNDS NARRATIVE Subpart B, CEIS (2016-17)

If your district will be using IDEA funds on either a voluntary basis to develop and implement a system of coordinated early intervening services (CEIS), (Column 3 of the budget) or if your agency is required to set aside the full 15% to address disproportionate representation in special education, you must provide a detailed description of the system, including your agency’s adopted definition of the population not currently on an IEP, that will be targeted and the specific activities that IDEA funds will support for the operational period of this project.

The next section of the application document entitled: “Coordinated Early Intervening Services Action Plan and Budget” provides a template for the items required in applying for and using Part B funds for CEIS.

CEIS Yes or No (Check one)

NO IF you elect not to do CEIS in 16-17, Check “NO” and skip to Part III Review, Sign and Date the Statement of Assurances. You will not need to complete Part II, Subpart B for CEIS.

If you are not requesting authorization to acquire equipment or conduct CEIS, submit the completed application to the AEA. IF you are proposing to acquire equipment e-mail the application to both your AEA contact and to IDEA.FISCAL@Iowa.Gov

YES Complete Part II, Subpart B for CEIS. Review, sign and date Part III “Statement of Assurances” and submit the entire application as a word document to the AEA contact and the Department. The copy to the Department should be sent to IDEA.FISCAL@Iowa.Gov

Part II, Subpart B. Page 1

IOWA DEPARTMENT OF EDUCATION

Coordinated Early Intervening ServicesAction Plan and Budget

Utilizing funds made available under IDEA, Part B through the Area Education Agency

Part II, Subpart B. Page 3

General Information: Coordinated Early Intervening Services

A district may use no more than 15% of the formula amount for a school year under IDEA, Part B, to develop and implement, coordinated early intervening services as described in Section 613, “Local Education Agency Eligibility” of P.L. 108-446 (Sec 613 (f) Early Intervening Services). Use of this option reduces the amount that would be available for Excess Costs by the amount used for CEIS.

1.) Defining the Population (target group) to be served:The definition of the population to be provided services is critical.  The definition of the target population “in need of additional supports” should be stated in terms of academic and behavioral characteristics and not include descriptors of gender or race ethnicity. It should be specific enough and contain measures and characteristics that make identification for inclusion in CEIS clear. Too broad or an unclear definition poses problems in accounting for the services supported and the reporting requirements attendant to CEIS. For example, it may be desirable to provide professional development on a literacy instruction approach to all elementary teachers in the agency, however while this may improve the ability of all teachers in literacy instruction, it does not ensure that those who will work with the defined and identified group of students have received or benefitted from the targeted professional development. A more precise definition of the student population to benefit from CEIS is essential to ensure accurate manageable reporting and appropriate use of funds. In the definition of the population (target group) the “characteristics” or qualifiers for example might include data on assessments that would indicate performance below expected levels on a number of consecutive assessment events (eg. Reading, Math on three consecutive assessments; a grade level below same aged peers). Behavioral characteristics could include number of incidents within a given time period, (eg. Number of office referrals in a one month period).Describe the district’s definition of students “in need of additional support” not currently on an IEP, including the specific criteria to be used in determining students eligible for these services:

2.) Selection of interventions (“scientifically based” academic or behavioral) to be used directly/indirectly with students identified per the above definition. Note: These “selections” are those that CEIS funds could pay for the cost of staff development activities aimed at their proper use with the identified population.Describe the process you will use to determine the interventions selected are evidence-based.

What are the interventions?

Part II, Subpart B. Page 4

DIRECT SERVICES TO THE IDENTIFIED POPULATIONIf you are supporting direct services (those which are allowed in the instructions) to the identified population meeting the criteria in your definition above, describe what those services will be and which staff will be involved with that delivery. Include the staff position and approximate FTE of each. Within your description include a timeline of activities for the direct services.

Part II, Subpart B. Page 5

STAFF DEVELOPMENT TO PERSONNEL DELIVERING THE DIRECT SERVICES:If you are supporting staff development aimed at improving the skills necessary to deliver the chosen interventions, describe the training on those interventions including and who will provide the training. Again provide a timeline of the training to be conducted.

Part II, Subpart B. Page 6

Evaluation:Provide a description of how your agency will evaluate the effectiveness of this project. What data will be gathered to assess the remediation/improvement of the academic achievement or behavioral characteristics of the population defined in this application?

Part III. Page 1 of 4

DUE DATE: SEPTEMBER 2, 2016

PART III, ANNUAL ASSURANCES2016-17

Individuals with Disabilities Education Act

AGENCY:

The above named applicant agency provides the following assurances:

Policies Consistent with Statutes: This applicant agency hereby assures that the activities covered by this application will be administered and implemented in accordance with all applicable statutes, regulations, program plans, and applications, including procedural safeguards as required by this act, State Statutes, Iowa Rules of Special Education, and this State's Eligibility Document. The procedural safeguards in question relate to least restrictive environment, due process, nondiscriminatory testing, and evaluation and are detailed in the Act 34CFR 76.700 34CFR 300.201

Control of Funds: This applicant agency hereby assures that the control of funds provided to this agency under this application and title to property acquired with those funds will be in a public agency and that this public agency will administer those funds and property . 34CFR 76.701

Fiscal Control and Accounting Procedures: This applicant agency hereby assures that appropriate fiscal control and accounting procedures will be used to insure proper disbursement of, and accounting for, federal funds paid to this agency under this application. 34CFR 76.702.

Records, Reports & Information.: This applicant agency hereby assures that it will (i) Make reports to the state educational agency or board and to the Director as may reasonably be necessary to enable the state agency or board and the Director to perform their duties as required under the provisions of IDEA.(ii) Maintain records including records under Section 436 of G.E.P.A. and provide access to those records as the state educational agency or board or the Director decides is necessary to perform their duties. .34CFR 76.722&730: 300.211

Lobbying and disclosure: With respect to the Certification Regarding Lobbying, this applicant agency certifies that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the making or renewal of Federal grants under this program; that this applicant agency shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," when required (34 CFR Part 82, Appendix B); and that this applicant agency shall require the full certification, as set forth in 34 CFR Part 82, Appendix A, in the award documents for all sub-awards at all tiers. 34CFR 82.100

Use of Amounts, Excess Cost and Non-Supplanting.: This applicant agency hereby assures the State Education Agency (SEA) that the expenditure of funds provided to said applicant agency under this Act (i) shall be expended in accordance with the provisions of Part B of the Act, (ii) shall be used to pay only the excess costs directly attributable to the education of children with disabilities, (iii) shall be used to supplement and to the extent practicable, increase the level of state and local funds expended for the education of children with disabilities and in no case to supplant such state and local funds, or other federal funds except as provided under 34 CFR. 34CFR 300.202(a)(1), (2), (3), 203

Maintenance of Effort: This applicant agency assures that funds provided will not be used to reduce the level of expenditures for the education of children with disabilities it makes from local funds below the level of those expenditures for the preceding fiscal year, except as stipulated in 34CFR 300.204 & 205 which address allowable exceptions and adjustments to maintenance of effort. 34CFR 300.203.

Part III, Page 2 of 4 PART III, ANNUAL ASSURANCES

2016-2017Schoolwide programs under Title I of ESEA:

The applicant agency hereby assures that any funding received under IDEA utilized during the fiscal year to carry out school-wide activities under Section 1114 of the ESEA will be in accord with the conditions prescribed for use and calculation of amounts contained in 34CFR 300.206. 34CFR 300.206

Personnel and Personnel Development: The applicant agency hereby assures that all personnel necessary to implement and carry out the provisions of Part B of IDEA are appropriately and adequately prepared in accord with 34 CFR 300.156 and section 2122 of ESEA and to be paid from these federal funds said personnel are appropriately credentialed for the provision of special education and related services . 34CFR 300.207

Treatment of charter schools and their students: The applicant agency hereby assures that in carrying out the provisions of Part B and the attendant regulations for IDEA with respect to charter schools, if any, it will provide services and support in the same manner as such services and support is provided to other public schools and children within the applicant agency’s service area. Such provision of services and support shall be in a manner consistent with the requirements assigned in state law. 34CFR 300.209

Purchase of Instructional Materials for Visually Impaired: If the applicant agency chooses to not coordinate with the National Instructional Materials Access Center the acquisition and provision of instructional materials for visually impaired children and youth, the applicant agency hereby assures that it will provide such instructional materials to visually impaired children and youth in a timely manner. 34CFR 300.210, Section 613 (a)(6)(B)

Information for the State Education Agency (SEA).: This applicant agency hereby assures that it will provide the State Education Agency such information as may be required for the SEA to carry out its duties under Part B of the Act. Specifically the applicant agency assures that it will comply with and provide information related to, the performance of children with disabilities participating in programs carried out under Part B of the Act. The information required addresses the requirements in the Act, Performance Goals and Objectives and Participation in general State and district–wide assessments. Additionally, if the applicant supports with Part B funds a system of early intervening services as described in Section 613 (f), all information required under that component of the Act will be collected and reported to the SEA. 34CFR 300.211

Public Information: The applicant agency hereby assures that it will make available to parents of children with disabilities and the general public all documents relating to the eligibility of the agency under Part B of the Act. 34CFR 300.212

Records regarding migratory children with disabilities: The applicant agency hereby assures that it will cooperate with the efforts of the U.S. Department of Education’s under section 1308 of the ESEA to ensure the linkage of records pertaining to migratory children with disabilities for the purpose of electronically exchanging, among the States health and educational information regarding such children. 34CFR 300.213

Federal Statutes and Regulations on Nondiscrimination : This applicant agency hereby assures the state education agency that it will comply with the following statutes and regulations.

Subject Statute Regulation

Discrimination on the basis of race, color, or national origin.

Title VI of the Civil Rights Act of 1964 (45 U.S.C. 2000d through

2000d-4).

34 CFR Part 100

Discrimination on the basis of sex. Title IX of the Education Amendments of 1972 (20 U.S.C.

1681-1683).

34 CFR Part 106

Discrimination on the basis of disability.

Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794) as amended

by the Rehabilitation Act Amendments of 1992.

34 CFR Part 104

Discrimination on the basis of age. The Age Discrimination Act (42 U.S.C. 6101 at seq.).

45 CFR Part 90

Part III, Page 3 of 4 PART III, ANNUAL ASSURANCES

2016-17

Cooperation with Audits: This applicant agency hereby assures the State and Area Education Agencies that it will cooperate with the U.S. Secretary of Education and the Comptroller General of the United States or any of their authorized representatives in the conduct of audits authorized by federal law. This would include access without unreasonable restrictions to records and personnel for the purpose of obtaining relevant information. 34CFR 76.910

Planning and Participation: This applicant agency hereby assures that it will provide reasonable opportunities for participation by teachers, parents, and other interested agencies, organizations, and individuals in the planning for and operation of this program. .(USC 20, Sec. 1232e (b)).

Availability of Application, Plans, Reports: This applicant agency hereby assures that this application, evaluation, and any periodic project plan or report relating to this project will be readily available to parents and other members of the general public. . 34CFR 76.304 1232e (b)(6

Acquisition, Dissemination of Information: This applicant agency hereby assures that it has established effective procedures for (i) Acquiring and disseminating to teachers and administrators participating in this program, significant information from education research, demonstrations, and similar projects, and (ii) Adopting promising educational practices developed in this project. . (USC 20, Sec.1232e (b)).

Use of Funds (General): This applicant agency hereby assures that none of the funds expended under any applicable program will be used to acquire equipment (including computer software) in any instance in which such acquisition results in a direct financial benefit to any organization representing the interests of the purchasing entity or its employees or any affiliate of such an organization. . (USC 20, Sec.1232e (b)).

CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY, AND VOLUNTARY EXCLUSION;

LOWER TIER COVERED TRANSACTIONS

(1) By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below.(2) The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered

into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

(3) The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted. If at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

(4) The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," " person," "primary covered transaction," "principal," "proposal," and "voluntary excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations.

(5) The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated.

(6) The prospective lower tier participant further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion--Lower Tier Covered Transaction," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.

(7) A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to check the nonprocurement list.

(8) Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

(9) Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntary excluded from participation in this transaction, in addition to other remedies available to the federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

Part III, Page 4 of 4 PART IV, ANNUAL ASSURANCES

2016-2017

This certification is required by the regulation implementing Executive Order 12549, Debarment and Suspension, 34 CFR Part 85, Subpart C, Participants' Responsibilities. (1) The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency. (2) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal.

CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTSA. The grantee certifies that it will or will continue to provide a drug-free workplace by:

(a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition.(b) Establishing an ongoing drug-free awareness program to inform employees about--(1) The dangers of drug abuse in the workplace;(2) The grantee's policy of maintaining a drug-free workplace;(3) Any available drug counseling, rehabilitation, and employee assistance programs; and(4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace;(c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (a);(d) Notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the grant, the employee will--(1) Abide by the terms of the statement; and(2) Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction;(e) Notifying the agency in writing, within ten calendar days after receiving notice under paragraph (d)(2) from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to every grant officer or other designee on whose grant activity the convicted employee was working, unless the Federal agency has designated a central point for the receipt of such notices. Notice shall include the identification number(s) of each affected grant; (f) Taking one of the following actions, within 30 calendar days of receiving notice under paragraph (d)(2), with respect to any employee who is so convicted--(1) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or(2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency;(g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e), and (f).

CERTIFICATION AND ASSURANCE

I CERTIFY that to the best of my knowledge, the information contained in this application is correct and complete and that the applicant agency named in Part I has authorized me, as its representative, to give the above assurances and to file this application.

Signature of Agency’s Authorized Official for Applicant Agency DATE

Typed Name of Authorized Official Title Applicant Agency