oppED-GRANTS-042518-003-cfda84.938-cid84-938C2018-1-instructions.pdf

i

U.S. Department of Education Office of Elementary and Secondary Education

Office of Safe and Healthy Students Washington, D.C. 20202-6450

2018 Application for

Temporary Emergency Impact Aid for Displaced

Students (Emergency Impact Aid) Program

CFDA Number: 84.938C

Closing Date: May 25, 2018

Approved OMB Number: 1810-0735 Expiration Date: 10/31/2018 ii

Paperwork Burden Statement

According to the Paperwork reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is: 1810-0735. Public reporting burden for this collection of information is estimated to average three hours per response, including the time for reviewing instructions, searching existing data resources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is required to obtain a grant Temporary Emergency Impact Aid for Displaced Students (Emergency Impact Aid) Program, authorized under Division B, Subdivision 1, Title VIII of P.L. 115-123, the “Bipartisan Budget Act of 2018.”

If you have comments or concerns regarding the status of your individual submission of this form, write directly to: U.S. Department of Education, Office of Safe and Healthy Students, 400 Maryland Avenue, SW, Room 3E326, Washington D.C. 20202-6450.

Note: Please do not return the completed application to this address.

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Table of Contents Dear Colleague Letter

Program Background Information

Purpose

Eligibility

Funding

Definitions

Technical Assistance Workshops for Prospective Applicants

Application Deadline

Grants.gov Application Instructions

Electronic Application Submission Checklist

SEA Application for Emergency Impact Aid

Sample Template Applications

Sample LEA Application

Sample BIE Application

Sample Certification by Non-Public School

Sample Non-Public School Parent or Guardian Application

Dear Colleague Letter

Dear Applicant:

I am pleased to announce that applications are available for two of the hurricane and disaster relief programs authorized by the Bipartisan Budget Act of 2018: the Temporary Emergency Impact Aid for Displaced Students (Emergency Impact Aid) program and the Assistance for Homeless Children and Youth program. The Emergency Impact Aid program will provide assistance to local educational agencies (LEAs) and non-public schools that have enrolled students displaced during the 2017-18 school year by Hurricanes Harvey, Irma or Maria or the 2017 California wildfires (“a covered disaster or emergency”). The Assistance for Homeless Children and Youth program will provide assistance to LEAs to support the needs of homeless students displaced by a covered disaster or emergency. This letter and the enclosed materials provide the information necessary for State educational agencies (SEAs) to apply for funding under these programs, and SEAs will make awards to LEAs under both programs.

Emergency Impact Aid

Under the Emergency Impact Aid program, the U.S. Department of Education (Department) will award grants to eligible SEAs on the basis of quarterly counts of displaced students. SEAs will then provide payments to eligible LEAs to assist with the cost of educating students who were displaced by a covered disaster or emergency during the 2017-18 school year and who were enrolled in public schools, including charter schools, and non-public schools. States apply for grants based on data that they collect from LEAs and Bureau of Indian Education funded schools that have provided educational services for displaced students. The LEAs and BIE schools must submit applications to SEAs. The parents of non-public school displaced students are to submit applications to the LEAs. We have created sample templates that SEAs may adapt for applications from LEAs, BIE schools, and non-public school parents, as well as a model certification from non-public schools to attest to the enrollment of the students whose parents submitted applications to the LEAs.

In their initial Emergency Impact Aid applications, SEAs will submit enrollment data for all four quarters of the 2017-18 school year, which may include estimated data for the fourth quarter. The Department has identified in the Federal Register Notice of Availability of Funds (Notice) four suggested quarterly count dates for identifying numbers of eligible displaced students: October 1, 2017; December 1, 2017; February 1, 2018; and April 1, 2018. States may use these dates or select count dates that fall within a 21-day range for each of the quarters (i.e., within 10 calendar days before or after these dates). SEAs will subsequently provide any updated enrollment data and any unreported fourth quarter data for the 2017-18 school year by June 29, 2018.

United States Department of Education

OFFICE OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF SAFE AND HEALTHY STUDENTS

We will use the enrollment data that are included in the initial and final SEA applications to make payments under the Emergency Impact Aid program. The statute specifies that the annual per pupil amounts shall be the sum of $9,000 for each displaced student who is an English learner, as that term is defined in section 8101 of the Elementary and Secondary Education Act of 1965;

$10,000 for each displaced student who is reported as a child with a disability; and $8,500 for each student who is not reported as a child with a disability or an English learner. Payments may be ratably reduced if there are not enough funds to pay the full amounts. In addition, the total amount of a payment on behalf of a displaced student enrolled in a non-public school may not exceed the lesser of the above per pupil amounts or the cost of tuition and fees (and transportation expenses, if any) at the nonpublic school for the 2017-18 school year.

If parents have submitted applications on behalf of displaced children who are attending eligible non-public schools, LEAs will make payments to accounts at the non-public schools on behalf of those students. The remainder of the funds LEAs receive will be used to provide educational services for displaced students attending their public schools. Payments received must be used for expenses for the 2017-18 school year only.

Assistance for Homeless Children and Youth

Under the Assistance for Homeless Children and Youth program, Congress appropriated $25 million for LEAs to address the needs of homeless students displaced by a covered disaster or emergency. The Department will award funds to SEAs, which will then award subgrants to LEAs, on the basis of demonstrated need and the number of homeless children and youth enrolled as a result of displacement by a covered disaster or emergency. LEAs will use the funds awarded under this program to support activities that are allowable under section 723 of the McKinney-Vento Homeless Assistance Act.

In the Assistance for Homeless Children and Youth SEA application, SEAs will submit data on: (1) the total number of displaced students enrolled in public school who are also homeless, as defined in section 725(2) of the McKinney-Vento Homeless Assistance Act, and (2) additional information on demonstrated need for funding, including data on the total number of homeless children and youth, as defined in section 725(2) of the McKinney-Vento Homeless Assistance Act, who were enrolled in public schools in the State during the 2017-18 school year, whose primary nighttime residence changed as a result of the covered disaster or emergency, and who do not meet the definition of displaced student. We will use the data included in the SEA application to determine funding amounts.

Additional Information

Additional information, including the Notice and application materials for each program, are available online at https://www.ed.gov/disasterrelief. These documents contain important information and should be reviewed carefully. The Notice describes the purpose and background of each program, and provides the program authorities and applicable regulations, as well as estimated available funding. Please note that the Notice includes information on how to submit an application with a reference and weblink to the instructions published in the Federal Register on February 12, 2018 (83 FR 6003). Because of the strict statutory obligation deadlines for the Emergency Impact Aid program, the Notice also establishes May 15, 2018 as the deadline for LEAs to submit applications to SEAs under that program. There is no statutory deadline for LEA applications under the Assistance for Homeless Children and Youth program; each SEA that https://www.ed.gov/disasterrelief receives funding will set a reasonable deadline for the submission of LEA applications. The applications describe the specific data and other information that applicants must submit to the Department in order to receive an award. In addition, FAQs for each program will be available in the near future.

The deadline for transmittal of SEA applications under both programs is May 25, 2018.

We know you may have additional questions after reviewing all these materials. For additional information on the Emergency Impact Aid program, please contact Francisco Ramirez by telephone at (202) 260-1541 or by email at K12EmergencyImpactAid@ed.gov. For additional information on the Assistance for Homeless Children and Youth program, please contact Peter Eldridge by telephone at (202) 260- 2514 or by email at HurricaneHomeless@ed.gov.

Sincerely, David Esquith, Director Office of Safe and Healthy Students mailto:K12EmergencyImpactAid@ed.gov mailto:HurricaneHomeless@ed.gov

Program Background Information

Purpose

The Temporary Emergency Impact Aid for Displaced Students (Emergency Impact Aid) program provides funds to assist with the cost of educating public and non-public students displaced by Hurricanes Harvey, Irma, and Maria, or the 2017 California wildfires for which a major disaster or emergency has been declared under sections 401 or 501 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170 and 5190) (covered disaster or emergency). The Emergency Impact Aid program provides these funds, through grants to eligible State Educational Agencies (SEAs), for local educational agencies (LEAs) to assist with the cost of educating students displaced by a covered disaster or emergency, for non-public schools serving displaced students, and for Bureau of Indian Education (BIE)-funded schools serving displaced students.

Eligibility

SEAs in any State, including the District of Columbia, the Commonwealth of Puerto Rico, and each of the outlying areas.

Funding

Congress appropriated a combined amount of approximately $2.5 billion for both the Immediate Aid to Restart School Operations (CFDA number 84.938A) and Emergency Impact Aid for Displaced Students (CFDA number 84.938C) programs. The amounts awarded under each program will be based on demand and on specific data received from eligible applicants.

Definitions

Displaced Students “Displaced students'', that is, the students for whom an SEA may receive payments, are students who:

on the date that is one week prior to the date that the major disaster or emergency was declared for the area, resided in an area for which the Federal Government later declared a major disaster or emergency related to a covered disaster or emergency; and as a result of their displacement by a covered disaster or emergency, are enrolled in an elementary school or secondary school other than the school that the student was enrolled in, or was eligible to be enrolled in, on the date that is one week prior to the date that the major disaster or emergency was declared for the area.

Note that the definition includes students who, on the date a count is taken, are enrolled in a school in their original LEA but, because of the impact of one of the covered disasters or emergencies, are not in their original school.

Eligible Local Educational Agency An LEA is eligible to receive funds if it:

a) enrolls or enrolled at least one displaced student on a date on which a child count is taken under this program; or

b) serves an area in which at least one displaced non-public school child is enrolled on a date on which a count is taken.

Eligible Non-public School The term ‘‘eligible non-public school’’ means a non-public elementary school or secondary school that is accredited or licensed or otherwise operates in accordance with State law, was in existence on February 9, 2018 and serves a displaced student on behalf of whom an application for an account has been made pursuant to subsection (c)(2)(A)(ii).

Eligible BIE-Funded School A school is eligible if it enrolls or enrolled at least one displaced child on the date on which a child count is taken and if it is:

a) operated by the BIE; or

b) operated by a tribe or an organization controlled or sanctioned by an Indian tribal government, for the children of that tribe, under a contract with or grant from the Department of the Interior.

Technical Assistance Workshops for Prospective Applicants

Pre-application webinars or conference calls are planned following the publication of the Notice of Deadline.

The exact dates and times of these webinars or conference calls will be posted on the program website at: https://www2.ed.gov/programs/eia/index.html.

Please check the site regularly for updates.

Application Deadline

Applications for grants under this program must be submitted electronically through Grants.Gov by 4:30 p.m., Washington, DC time, on May 25, 2018. The Department will not accept an application for this program after 4:30 p.m., Washington, DC time, on the application deadline date. Please review the instructions in this application package for meeting this deadline.

https://www2.ed.gov/programs/eia/index.html

Grants.gov Application Instructions

For information on how to submit an application please refer to the instructions published in the Federal Register on February 12, 2018 (83 FR 6003) and available at www.gpo.gov/fdsys/pkg/FR- 2018-02-12/pdf/2018-02558.pdf.

Electronic Application Submission Checklist

In order to facilitate review and acceptance of your electronic application, please organize your application in the manner described below. Instructions for all forms are found either on the following pages of the application package or individually for each form on Grants.gov.

Review your electronic application to ensure you have completed the following required forms:

o Application for Federal Assistance (SF 424) o ED SF424 Supplement o Assurances for Non-Construction Programs (SF 424B) o Grants.gov Lobbying Form [V1.1] o Other Attachments Form http://www.gpo.gov/fdsys/pkg/FR-2018-02-12/pdf/2018-02558.pdf http://www.gpo.gov/fdsys/pkg/FR-2018-02-12/pdf/2018-02558.pdf

INSTRUCTIONS FOR THE SF-424

This is a standard form required for use as a cover sheet for submission of pre-applications and applications and related information under discretionary programs. Some of the items are required and some are optional at the discretion of the applicant or the federal agency (agency).

Required fields on the form are identified with an asterisk (*) and are also specified as “Required” in the instructions below. In addition to these instructions, applicants must consult agency instructions to determine other specific requirements.

Item Entry: Item: Entry:

1. Type of Submission: (Required) Select one type of submission in accordance with agency instructions.

• Pre-application

• Application

• Changed/Corrected Application – Check if this submission is to change or correct a previously submitted application. Unless requested by the agency, applicants may not use this form to submit changes after the closing date.

10. Name Of Federal Agency: (Required) Enter the name of the federal agency from which assistance is being requested with this application.

11. Catalog Of Federal Domestic Assistance Number/Title:

Enter the Catalog of Federal Domestic Assistance number and title of the program under which assistance is requested, as found in the program announcement, if applicable.

2. Type of Application: (Required) Select one type of application in accordance with agency instructions.

• New – An application that is being submitted to an agency for the first time.

• Continuation - An extension for an additional funding/budget period for a project with a projected completion date. This can include renewals.

• Revision - Any change in the federal government’s financial obligation or contingent liability from an existing obligation. If a revision, enter the appropriate letter(s). More than one may be selected. If "Other" is selected, please specify in text box provided.

A. Increase Award D. Decrease Duration B. Decrease Award E. Other (specify) C. Increase Duration

12. Funding Opportunity Number/Title: (Required) Enter the Funding Opportunity Number (FON) and title of the opportunity under which assistance is requested, as found in the program announcement.

13. Competition Identification Number/Title: Enter the competition identification number and title of the competition under which assistance is requested, if applicable.

14. Areas Affected By Project: This data element is intended for use only by programs for which the area(s) affected are likely to be different than the place(s) of performance reported on the SF-424 Project/Performance Site Location(s) Form. Add attachment to enter additional areas, if needed.

3. Date Received: Leave this field blank. This date will be assigned by the Federal agency.

15. Descriptive Title of Applicant’s Project: (Required) Enter a brief descriptive title of the project. If appropriate, attach a map showing project location (e.g., construction or real property projects). For pre-applications, attach a summary description of the project.

4. Applicant Identifier: Enter the entity identifier assigned buy the Federal agency, if any, or the applicant’s control number if applicable.

5a. Federal Entity Identifier: Enter the number assigned to your organization by the federal agency, if any.

16. Congressional Districts Of: 16a. (Required) Enter the applicant’s congressional district. 16b. Enter all district(s) affected by the program or project. Enter in the format: 2 characters state abbreviation – 3 characters district number, e.g., CA-005 for California 5th district, CA-012 for California 12 district, NC-103 for North Carolina’s 103 district. If all congressional districts in a state are affected, enter “all” for the district number, e.g., MD-all for all congressional districts in Maryland. If nationwide, i.e. all districts within all states are affected, enter US-all. If the program/project is outside the US, enter 00-000. This optional data element is intended for use only by programs for which the area(s) affected are likely to be different than place(s) of performance reported on the SF-424 Project/Performance Site Location(s) Form. Attach an additional list of program/project congressional districts, if needed.

5b. Federal Award Identifier: For new applications, enter NA. For a continuation or revision to an existing award, enter the previously assigned federal award identifier number. If a changed/corrected application, enter the federal identifier in accordance with agency instructions.

6. Date Received by State: Leave this field blank. This date will be assigned by the state, if applicable.

7. State Application Identifier: Leave this field blank. This identifier will be assigned by the state, if applicable.

8. Applicant Information: Enter the following in accordance with agency instructions:

a. Legal Name: (Required) Enter the legal name of applicant that will undertake the assistance activity. This is the organization that has registered with the Central Contractor Registry (CCR). Information on registering with CCR may be obtained by visiting www.Grants.gov.

17. Proposed Project Start and End Dates: (Required) Enter the proposed start date and end date of the project.

b. Employer/Taxpayer Number (EIN/TIN): (Required) Enter the employer or taxpayer identification number (EIN or TIN) as assigned by the Internal Revenue Service. If your organization is not in the US, enter 44-4444444.

18. Estimated Funding: (Required) Enter the amount requested, or to be contributed during the first funding/budget period by each contributor. Value of in-kind contributions should be included on appropriate lines, as applicable. If the action will result in a dollar change to an existing award, indicate only the amount of the change. For decreases, enclose the amounts in parentheses.

c. Organizational DUNS: (Required) Enter the organization’s DUNS or DUNS+4 number received from Dun and Bradstreet.

Information on obtaining a DUNS number may be obtained by visiting www.Grants.gov.

19. Is Application Subject to Review by State Under Executive Order

12372 Process? (Required) Applicants should contact the State Single Point of Contact (SPOC) for Federal Executive Order 12372 to determine whether the application is subject to the State intergovernmental review process. Select the appropriate box. If “a.” is selected, enter the date the application was submitted to the State.

d. Address: Enter address: Street 1 (Required); city (Required);

County/Parish, State (Required if country is US), Province, Country (Required), 9-digit zip/postal code (Required if country

US).

20. Is the Applicant Delinquent on any Federal Debt?

(Required) Select the appropriate box. This question applies to the applicant organization, not the person who signs as the authorized representative. Categories of federal debt include;

but, may not be limited to: delinquent audit disallowances, loans and taxes. If yes, include an explanation in an attachment.

e. Organizational Unit: Enter the name of the primary organizational unit, department or division that will undertake the assistance activity.

21. Authorized Representative: To be signed and dated by the authorized representative of the applicant organization. Enter the first and last name (Required); prefix, middle name, suffix. Enter title, telephone number, email (Required); and fax number. A copy of the governing body’s authorization for you to sign this application as the official representative must be on file in the applicant’s office. (Certain federal agencies may require that this authorization be submitted as part of the application.)

f. Name and contact information of person to be contacted on matters involving this application: Enter the first and last name

(Required); prefix, middle name, suffix, title. Enter organizational affiliation if affiliated with an organization other than that in 7.a.

Telephone number and email (Required); fax number.

9. Type of Applicant: (Required) Select up to three applicant type(s) in accordance with agency instructions.

A. State Government B. County Government C. City or Township

Government D. Special District

Government E. Regional Organization F. U.S. Territory or

Possession G. Independent School

District H. Public/State Controlled

Institution of Higher Education

I. Indian/Native American Tribal Government (Federally Recognized)

J. Indian/Native American Tribal Government (Other than Federally Recognized)

K. Indian/Native American Tribally Designated Organization

L. Public/Indian Housing Authority

M. Nonprofit N. Private Institution of

Higher Education O. Individual P. For-Profit

Organization (Other than Small Business)

Q. Small Business R. Hispanic-serving

Institution S. Historically Black

Colleges and Universities (HBCUs)

T. Tribally Controlled Colleges and Universities (TCCUs)

U. Alaska Native and Native Hawaiian Serving Institutions

V. Non-US Entity W. Other (specify)

[U.S Department of Education note: As of spring, 2010, the FON discussed in Block 12 of the instructions can be found via the following URL: http://www.grants.gov/applicants/find_grant_opportunities.jsp.] http://www.grants.gov/applicants/find_grant_opportunities.jsp

Form Approved:

– OMB number 1810-0735

– Expiration date: 10/31/2018

SEA Application for Emergency Impact Aid

U.S. Department of Education Office of Elementary and Secondary Education

Office of Safe and Healthy Students Washington, D.C. 20202-6450

ELEMENTARY AND SECONDARY EDUCATION

2018 APPLICATION

FOR TEMPORARY EMERGENCY IMPACT AID FOR DISPLACED STUDENTS

STATE DUNS NUMBER CFDA NUMBER

84.938C

SEA NAME :

STREET/P.O. BOX :

CITY :

COUNTY :

STATE & ZIP :

CONTACT PERSON NAME :

TITLE :

PHONE :

FAX :

E-MAIL :

I certify that the statements and all of the data included in this application are, to the best of my knowledge and belief, true, complete, and correct. I certify that I am authorized to make the representations and commitments in this application, for and on behalf of the applicant, and otherwise to act as the applicant’s authorized representative in submitting this application for funding.

NAME AND TITLE OF AUTHORIZED REPRESENTATIVE SIGNATURE DATE

– Expiration date: 10/31/2018

Information for Setting Quarterly Dates for Submission of Quarterly Numbers of Displaced Students:

The Department has identified four suggested quarterly count dates for identifying numbers of eligible displaced students:

October 1, 2017; December 1, 2017; February 1, 2018; and April 1, 2018. States may use these dates or select count dates that fall within a 21-day range for each of the quarters, that is, within 10 calendar days before or after these dates.

Each State must select four specific dates for the quarterly counts and use those dates consistently for all applicants within the State. Please insert the State’s selected quarter dates, consistent with this guidance, into the charts that follow.

U.S. Department of Education Office of Safe and Healthy Students

Washington, D.C. 20202-6450

2018 APPLICATION FOR EMERGENCY IMPACT AID FOR DISPLACED STUDENTS

QUARTERLY NUMBERS OF DISPLACED

STUDENTS

SEA NAME :

Report total numbers of displaced students in the State by category for each applicable quarter. Use whole numbers only.

Do not include any students in more than one category in a single quarter.

For each quarter, provide the total number of displaced students reported to the State for the reporting date for that quarter.

(SEAs must submit enrollment data for all four quarters of the 2017-18 school year, which may include estimated data for the fourth quarter. SEAs must provide as an update to this application any updated enrollment data generally and any unreported fourth quarter data for the 2017-18 school year once that data becomes available but no later than June 29, 2018.)

Quarter 1 on ________, 2017

Quarter 2 on

________, 2017

Quarter 3 on

________, 2018

Quarter 4 on

________, 2018

PUBLIC SCHOOLS: Total number of displaced students in the State, as reported by eligible local educational agencies:

enrolled in public schools in the State who are not receiving special education and related services consistent with IDEA, and who are not English learners

PUBLIC SCHOOLS: Total number of displaced students in the State, as reported by eligible local educational agencies:

enrolled in public schools in the State, and who are receiving special education and related services consistent with

IDEA

displaced students in the State, as reported by eligible local educational agencies:

enrolled in public schools in the State, who are not receiving special education and related services consistent with who are English learners

– Expiration date: 10/31/2018

Washington, D.C. 20202-6450

2018 APPLICATION FOR EMERGENCY IMPACT AID FOR DISPLACED STUDENTS

QUARTERLY NUMBERS OF DISPLACED STUDENTS

SEA NAME :

Report total numbers of displaced students in the State by category for each applicable quarter. Use whole numbers only.

Do not include any students in more than one category in a single quarter.

For each quarter, provide the total number of displaced students reported to the State for the reporting date for that quarter.

(SEAs must submit enrollment data for all four quarters of the 2017-18 school year, which may include estimated data for the fourth quarter. SEAs must provide as an update to this application any updated enrollment data generally and any unreported fourth quarter

________, 2017

Quarter 2 on

________, 2017

Quarter 3 on

________, 2018

Quarter 4 on

________, 2018

NON-PUBLIC SCHOOLS: Total number of displaced students in the State:

enrolled in eligible non-public schools in the State, who are not receiving special education and related services consistent with

NON-PUBLIC SCHOOLS: Total number of displaced students in the State:

enrolled in eligible non-public schools in the State, and who are receiving special education and related services consistent with IDEA

NON-PUBLIC SCHOOLS: Total number of enrolled in eligible non-public schools in the State, who are not receiving special education and related services consistent with IDEA, and

Washington, D.C. 20202-6450

2018 APPLICATION FOR EMERGENCY IMPACT AID FOR DISPLACED STUDENTS

QUARTERLY NUMBERS OF DISPLACED

STUDENTS

SEA NAME :

Report total numbers of displaced students in the State by category for each applicable quarter. Use whole numbers only.

Do not include any students in more than one category in a single quarter.

For each quarter, provide the total number of displaced students reported to the State for the reporting date for that quarter.

(SEAs must submit enrollment data for all four quarters of the 2017-18 school year, which may include estimated data for the fourth quarter. SEAs must provide as an update to this application any updated enrollment data generally and any unreported fourth quarter

________, 2017

Quarter 2 on

________, 2017

Quarter 3 on

________, 2018

Quarter 4 on

________, 2018

BIE SCHOOLS: Total number of displaced students in the State:

enrolled in eligible Bureau of Indian Education (BIE) schools in the State, who are not receiving special education and related services consistent with

BIE SCHOOLS: Total number of enrolled in eligible Bureau of Indian Education (BIE) schools in the State, and who are receiving special education

BIE SCHOOLS: Total number of enrolled in eligible Bureau of Indian Education (BIE) schools in the State, who are not receiving special education and related services consistent with

– Expiration date: 10/31/2018

U.S. Department of Education Office of Safe and Healthy Students

Washington, D.C. 20202-6450

2018 APPLICATION FOR EMERGENCY IMPACT AID FOR DISPLACED STUDENTS

STATE EDUCATIONAL AGENCY NARRATIVE

PARENTAL NOTIFICATION TO LEA

SEA NAME :

Describe the process for the parent or guardian of a displaced student enrolled in a non-public school to indicate to the eligible local educational agency serving the area in which the non-public school is located that the student is enrolled in the non-public school.

Washington, D.C. 20202-6450

2018 APPLICATION FOR EMERGENCY IMPACT AID FOR DISPLACED STUDENTS

STATE EDUCATIONAL AGENCY NARRATIVE

PAYMENTS TO ACCOUNTS

SEA NAME :

Describe the procedure to be used by eligible local educational agencies to provide payments to accounts on behalf of non-public school students.

– Expiration date: 10/31/2018

U.S. Department of Education Office of Safe and Healthy Students

Washington, D.C. 20202-6450

2018 APPLICATION FOR EMERGENCY IMPACT AID FOR DISPLACED STUDENTS

STATE EDUCATIONAL AGENCY NARRATIVE

ATTESTATIONS

SEA NAME :

Describe the process to be used by eligible local educational agencies in the State to obtain:

(1) Attestations of attendance of eligible displaced students from eligible non-public schools, and

(2) Attestations from eligible non-public schools that accounts established for non-public students will be used only for allowable purposes.

– Expiration date: 10/31/2018

U.S. Department of Education Office of Safe and Healthy Students

Washington, D.C. 20202-6450

2018 APPLICATION FOR EMERGENCY IMPACT AID FOR DISPLACED STUDENTS

STATE EDUCATIONAL AGENCY NARRATIVE

ASSISTANCE CRITERIA

SEA NAME :

Describe the criteria, including family income, to be used to determine the eligibility for and the amount of assistance under this section provided on behalf of a displaced student attending an eligible non-public school.

The Authorized Representative assures that the State will comply with all of the requirements that apply to Emergency Impact Aid for Displaced Students including the following:

1. The State will comply with reporting requirements (see 2 CFR 200.333-200.337), including additional reporting required by the Improper Payments Information Act of 2002 (31 U.S.C. 3321 note).

2. The State will cooperate with any Inspector General examination of records under the program.

3. Any LEA receiving funding under this program will have on file with the State a set of assurances that meets the requirements of section 442 of the General Education Provisions Act (GEPA) (20 U.S.C.

1232e).

4. To the extent applicable, an LEA will include in its local application a description of how the LEA will comply with the requirements of section 427 of GEPA (20 U.S.C. 1228a).

5. The State and other entities will comply with the provisions of all applicable acts, regulations and assurances; the following provisions of Education Department General Administrative Regulations (EDGAR) 34 CFR parts 76, 77, 81, 82, 84, 97, 98, and 99; The OMB Guidelines to Agencies on Governmentwide Debarment and Suspension (Nonprocurement) in 2 CFR part 180, as adopted and amended as regulations of the Department in 2 CFR part 3485; and The Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards in 2 CFR part 200, as adopted and amended as regulations of the Department in 2 CFR part 3474.

Washington, D.C. 20202-6450

2018 APPLICATION FOR EMERGENCY IMPACT AID FOR DISPLACED STUDENTS

ADDITIONAL CERTIFICATIONS & ASSURANCES

– Expiration date: 10/31/2018

Appendix: Definition of Displaced Student

Displaced student

The term "displaced student'' means a student who enrolled in an elementary school or secondary school (other than the school that the student was enrolled in, or was eligible to be enrolled in, on the date that is one week prior to the date that the major disaster or emergency was declared for the area) because such student resides or resided on the date that is one week prior to the date that the major disaster or emergency was declared for the area, in an area for which a major disaster or emergency declared by the President in accordance with section 401 or 501, respectively, of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170), related to a covered disaster or emergency.

Section 107(b)(1) of Title IV of Division B of Public Law 109-148, as modified by Division B, Subdivision 1, Title VIII of P.L. 115-123, the “Bipartisan Budget Act of 2018.”

– Expiration date: 10/31/2018

Sample Template Applications

The Department has provided sample template applications on the following pages for use by the

SEA.

Please note that SEAs should adapt the Department sample template applications from LEAs, BIE schools, and non-public school parents, as well as a sample certification from non-public schools to describe the specific SEA’s processes and procedures described in paragraphs b-e above.

An SEA should consider how to adapt templates to include all of the relevant information needed to complete its application.

– Expiration date: 10/31/2018

Sample LEA Application

ELEMENTARY AND SECONDARY EDUCATION

2018 APPLICATION

BY LOCAL EDUCATIONAL AGENCIES

FOR TEMPORARY EMERGENCY IMPACT AID FOR DISPLACED STUDENTS

LEA NAME :

STREET/P.O. BOX :

CITY :

COUNTY :

STATE & ZIP :

CONTACT PERSON NAME :

TITLE :

PHONE :

FAX :

E-MAIL :

I certify that the school district has contacted all non-public schools within the district’s boundaries to notify them of the availability of funding under this program and that the district has reviewed documentation to verify the eligibility of any non-public school students included in counts in this application as meeting the definition of displaced students, as defined in Section 107(b)(1) of Title IV of Division B of Public Law 109-148, as modified by Division B, Subdivision 1, Title VIII of P.L. 115-123, the “Bipartisan Budget Act of 2018.”

I certify that the school district will make payments to Individual Emergency Impact Aid Accounts for students enrolled in non-public schools who are counted on this application within 14 calendar days of the school district’s receipt of funds provided for this application.

I certify that public school student counts included in this application meet the definition of displaced students.

I certify that the statements and all of the data included in this application are, to the best of my knowledge and belief, true, complete, and correct. I certify that I am authorized to make the representations and commitments in this application, for and on behalf of the applicant, and otherwise to act as the applicant’s authorized representative in submitting this application for funding.

State __________________________

2018 APPLICATION

BY LOCAL EDUCATIONAL AGENCIES

FOR EMERGENCY IMPACT AID FOR DISPLACED STUDENTS

QUARTERLY NUMBERS OF DISPLACED STUDENTS

LEA NAME :

Report total numbers of displaced students in the school district by category for each applicable quarter. Use whole numbers only.

Do not include any students in more than one category in a single quarter.

For each quarter, report the number of displaced students as of the reporting date for that quarter.

(LEAs must submit enrollment data for all four quarters of the 2017-18 school year, which may include estimated data for the fourth quarter. LEAs must provide as an update to this application any updated enrollment data generally and any unreported fourth quarter data for the 2017-18 school year once that data becomes available but no later than the deadline set by the SEA.)

__________, 2017

Quarter 2 on

__________, 2017

Quarter 3 on

__________, 2018

Quarter 4 on

__________, 2018

PUBLIC SCHOOLS: Total number of displaced students:

enrolled in the elementary and secondary schools (including charter schools) of the school district, and who are not receiving special education and related services consistent with IDEA displaced students:

enrolled in the elementary and secondary schools (including charter schools) of the school district, and who are receiving special education displaced students:

enrolled in the elementary and secondary schools (including charter schools) of the school district, who are not receiving special education and related services

State __________________________

2018 APPLICATION

BY LOCAL EDUCATIONAL AGENCIES

FOR EMERGENCY IMPACT AID FOR DISPLACED STUDENTS

QUARTERLY NUMBERS OF DISPLACED STUDENTS

LEA NAME :

Report total numbers of displaced students in the school district by category for each applicable quarter. Use whole numbers only.

Do not include any students in more than one category in a single quarter.

For each quarter, report the number of displaced students as of the reporting date for that quarter.

(LEAs must submit enrollment data for all four quarters of the 2017-18 school year, which may include estimated data for the fourth quarter. LEAs must provide as an update to this application any updated enrollment data generally and any unreported fourth quarter data for the 2017-18 school year once that data becomes available but no later than the deadline set by the SEA.)

______, 2017

Quarter 2 on

______, 2017

Quarter 3 on

______, 2018

Quarter 4 on

______, 2018

NON-PUBLIC SCHOOLS: Total number of displaced students:

for whom the school district expects to provide payments to Individual Emergency Impact Aid Accounts, and who are not receiving special education and related services consistent with IDEA

NON-PUBLIC SCHOOLS: Total number of displaced students:

for whom the school district expects to provide payments to Individual Emergency Impact Aid Accounts, and who are receiving special education

NON-PUBLIC SCHOOLS: Total number of displaced students:

for whom the school district expects to provide payments to Individual Emergency Impact Aid Accounts, who are not receiving special education and related services

– Expiration date: 10/31/2018

Additional Requirements for LEAs

In addition to the information provided above, LEAs must ensure to comply with:

the procedures, as established by the SEA, that the LEA will use to receive applications for assistance from the parents or guardians of non-public school students;

the procedures, as established by the SEA, that the LEA will use to make payments to accounts for non-public school students;

the procedures, as established by the SEA, that the LEA will use to obtain:

o Certifications of attendance from non-public schools for displaced students; and o Certifications from non-public schools that payments for displaced non-public school students will be used only for allowable purposes.

Appendix: Definition of Displaced Student

Displaced student

The term "displaced student'' means a student who enrolled in an elementary school or secondary school (other than the school that the student was enrolled in, or was eligible to be enrolled in, on the date that is one week prior to the date that the major disaster or emergency was declared for the area) because such student resides or resided on the date that is one week prior to the date that the major disaster or emergency was declared for the area, in an area for which a major disaster or emergency declared by the President in accordance with section 401 or 501, respectively, of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170), related to a covered disaster or emergency.

Section 107(b)(1) of Title IV of Division B of Public Law 109-148, as modified by Division B, Subdivision 1, Title

– Expiration date: 10/31/2018

Sample BIE Application

ELEMENTARY AND SECONDARY EDUCATION

2018 APPLICATION

BY BUREAU OF INDIAN EDUCATION-FUNDED SCHOOLS

FOR TEMPORARY EMERGENCY IMPACT AID FOR DISPLACED STUDENTS

BIE SCHOOL NAME :

STREET/P.O. BOX :

CITY :

COUNTY :

STATE & ZIP :

CONTACT PERSON NAME :

TITLE :

PHONE :

FAX :

E-MAIL :

Report total numbers of displaced students in the Bureau of Indian Education (BIE) school by category for each applicable quarter. Use whole numbers only.

Do not include any students in more than one category in a single quarter.

For each quarter, report the number of displaced students as of the reporting date for that quarter.

(BIE schools must submit enrollment data for all four quarters of the 2017-18 school year, which may include estimated data for the fourth quarter. BIE schools must provide as an update to this application any updated enrollment data generally and any unreported fourth quarter data for the 2017-18 school year once that data becomes available but no later than the deadline set by the SEA.)

Quarter 1 on

__________, 2017 Quarter 2 on

__________, 2017 Quarter 3 on

__________, 2018 Quarter 4 on

__________, 2018

BIE SCHOOLS: Total number of displaced students:

enrolled in the BIE school, and who are not receiving special education and related services consistent with

BIE SCHOOLS: Total number of displaced students:

enrolled in the BIE school, and who are receiving special education and related services consistent with IDEA

BIE SCHOOLS: Total number of displaced students:

enrolled in the BIE school, who are not receiving special education and related services consistent with

– Expiration date: 10/31/2018

2018 APPLICATION

BY BUREAU OF INDIAN EDUCATION-FUNDED SCHOOLS

FOR EMERGENCY IMPACT AID FOR DISPLACED STUDENTS

I certify that the statements and all of the data included in this application are, to the best of my knowledge and belief, true, complete, and correct. I certify that I am authorized to make the representations and commitments in this application, for and on behalf of the applicant, and otherwise to act as the applicant’s authorized representative in submitting this application for funding.

– Expiration date: 10/31/2018

Appendix: Definition of Displaced Student

Displaced student

The term "displaced student'' means a student who enrolled in an elementary school or secondary school (other than the school that the student was enrolled in, or was eligible to be enrolled in, on the date that is one week prior to the date that the major disaster or emergency was declared for the area) because such student resides or resided on the date that is one week prior to the date that the major disaster or emergency was declared for the area, in an area for which a major disaster or emergency declared by the President in accordance with section 401 or 501, respectively, of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170), related to a covered disaster or emergency.

Section 107(b)(1) of Title IV of Division B of Public Law 109-148, as modified by Division B, Subdivision 1, Title

Sample Certification by Non-Public School

ELEMENTARY AND SECONDARY EDUCATION

CERTIFICATION BY NON-PUBLIC SCHOOLS

FOR 2018 TEMPORARY EMERGENCY IMPACT AID FOR DISPLACED STUDENTS

NAME OF SCHOOL :

STREET/P.O. BOX :

CITY :

COUNTY :

STATE & ZIP :

CONTACT PERSON NAME :

TITLE :

PHONE :

FAX :

E-MAIL :

Name of the local educational agency within whose boundaries this non-public school is located:

I certify that this school is a non-public school that meets the requirements of paragraph (b)(3) of the law governing Emergency Impact Aid .

I certify that the displaced students included in the count on the attached list were enrolled in this school on the designated count date.

I certify that payments to Emergency Impact Aid Accounts received from the local educational agency will be used by this school only for purposes described in sub-paragraph (e)(2)(A) of the law governing Emergency Impact Aid.

I certify that I have received and read copies of paragraph (b)(3) and sub-paragraph (e)(2)(A) of the law governing Emergency Impact Aid.

I certify that I am authorized to make the representations and commitments in this certification, for and on behalf of this school, and otherwise to act as this school’s authorized representative in submitting this certification.

NAME AND TITLE OF AUTHORIZED REPRESENTATIVE SIGNATURE

DATE

– Expiration date: 10/31/2018

Appendix: Definition of Displaced Student

Displaced student

The term "displaced student'' means a student who enrolled in an elementary school or secondary school (other than the school that the student was enrolled in, or was eligible to be enrolled in, on the date that is one week prior to the date that the major disaster or emergency was declared for the area) because such student resides or resided on the date that is one week prior to the date that the major disaster or emergency was declared for the area, in an area for which a major disaster or emergency declared by the President in accordance with section 401 or 501, respectively, of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170), related to a covered disaster or emergency.

Section 107(b)(1) of Title IV of Division B of Public Law 109-148, as modified by Division B, Subdivision 1, Title

– Expiration date: 10/31/2018

Sample Non-Public School Parent or Guardian Application

ELEMENTARY AND SECONDARY EDUCATION

2018 APPLICATION BY PARENT OR GUARDIAN FOR TEMPORARY EMERGENCY IMPACT AID ON

BEHALF OF STUDENTS DISPLACED BY HURRICANES HARVEY, IRMA, AND MARIA, OR THE 2017

CALIFORNIA WILDFIRES AND WHO ARE ATTENDING A NON-PUBLIC SCHOOL

NAME OF PARENT OR GUARDIAN :

STREET/P.O. BOX :

CITY :

COUNTY :

STATE & ZIP :

PHONE :

EMAIL :

NAME OF NON-PUBLIC SCHOOL :

STREET/P.O. BOX :

CITY :

COUNTY :

STATE & ZIP :

Names of children enrolled in this non-public school prior to 2/9/2018:

Name of the local educational agency (local school district) within whose boundaries this non-public school is located:

I request that the local educational agency named above make payments to Emergency Impact Aid Accounts on behalf of each of my children named above.

I certify that I enrolled my children named above in this non-public school prior to February 9, 2018 (the date of enactment of the law authorizing Emergency Impact Aid for Displaced Students).

I certify that my children named above, to the best of my knowledge and belief, were enrolled or were eligible to be enrolled in a school in an area for which the Federal Government later declared a major disaster or emergency related to Hurricanes Harvey, Irma, and Maria, or 2017 California wildfires and, as a result, are displaced students.

NAME OF PARENT SIGNATURE DATE

– Expiration date: 10/31/2018

Appendix: Definition of Displaced Student

Displaced student

The term "displaced student'' means a student who enrolled in an elementary school or secondary school (other than the school that the student was enrolled in, or was eligible to be enrolled in, on the date that is one week prior to the date that the major disaster or emergency was declared for the area) because such student resides or resided on the date that is one week prior to the date that the major disaster or emergency was declared for the area, in an area for which a major disaster or emergency declared by the President in accordance with section 401 or 501, respectively, of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170), related to a covered disaster or emergency.

Section 107(b)(1) of Title IV of Division B of Public Law 109-148, as modified by Division B, Subdivision 1, Title