New Hampshire Department of Education
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New Hampshire State Department of Education Bureau of Special Education 101 Pleasant Street Concord, New Hampshire 03301-3860 Tel: (603) 271-3741 Fax: (603) 271-1099
INDIVIDUALS WITH DISABILITIES EDUCATION IMPROVEMENT ACT OF 2004 (IDEA) (20 U.S.C. 1400 et seq.)
IDEA RECOVERY FUNDS TEMPLATE
COVER PAGE - IDENTIFYING INFORMATION
IDEA Recovery Funds Part B Section 611 Start Date: ______End Date: 9/30/2011
IDEA Recovery Funds Section 619 Preschool Start Date: ______End Date: 9/30/2011
Agency Responsible for Programmatic and Fiscal Administration:
Agency Name:______Agency Address:______Project Manager: ______Phone No:______Title:______Fax: ______E-mail:______Contact Person(s) (if different):______Phone No: ______Fax:______E-mail:______(see page 3 of the Instructions)
Bureau of Special Education April 15, 2009 Page 1 of 7 PROJECT DESCRIPTION
(see pages 3, 4, 5, 6, 7 and 8 of the Instructions)
PRIORITY TO BE ADDRESSED: Please identify the priority area.
ACTIVITIES: PLEASE TAKE NOTE: When using Object Code Series 100, please reference the position titles, incumbent/vacant, and dollar amounts that FUNCTION/ IDEA-B PRESCHOOL will coincide with the amount listed under Activities. Include all function and OBJECT AMOUNT AMOUNT object codes that are appropriate with this activity.
Totals for each funding source Performance Measurement: Desired Outcome:
PRIORITY TO BE ADDRESSED: Please identify the priority area.
ACTIVITIES: PLEASE TAKE NOTE: When using Object Code Series 100, please reference the position titles, incumbent/vacant, and dollar amounts that will FUNCTION/ IDEA-B PRESCHOOL coincide with the amount listed under Activities. Include all function and object OBJECT AMOUNT AMOUNT codes that are appropriate with this activity.
Totals for each funding source Performance Measurement: Desired Outcome:
PRIORITY TO BE ADDRESSED: Please indentify the priority area.
ACTIVITIES: PLEASE TAKE NOTE: When using Object Code Series 100, please reference the position titles, incumbent/vacant, and dollar amounts that will FUNCTION/ IDEA-B PRESCHOOL coincide with the amount listed under Activities. Include all function and object OBJECT AMOUNT AMOUNT codes that are appropriate with this activity.
Totals for each funding source Performance Measurement: Desired Outcome:
Bureau of Special Education April 15, 2009 Page 2 of 7 PRIORITY TO BE ADDRESSED: Please indentify the priority area.
ACTIVITIES: PLEASE TAKE NOTE: When using Object Code Series 100, please reference the position titles, incumbent/vacant, and dollar amounts that will FUNCTION/ IDEA-B PRESCHOOL coincide with the amount listed under Activities. Include all function and object OBJECT AMOUNT AMOUNT codes that are appropriate with this activity.
Totals for each funding source Performance Measurement: Desired Outcome:
PRIORITY TO BE ADDRESSED: Please indentify the priority area.
ACTIVITIES: PLEASE TAKE NOTE: When using Object Code Series 100, please reference the position titles, incumbent/vacant, and dollar amounts that will FUNCTION/ IDEA-B PRESCHOOL coincide with the amount listed under Activities. Include all function and object OBJECT AMOUNT AMOUNT codes that are appropriate with this activity.
Totals for each funding source Performance Measurement: Desired Outcome:
PRIORITY TO BE ADDRESSED: Please indentify the priority area.
ACTIVITIES: PLEASE TAKE NOTE: When using Object Code Series 100, please reference the position titles, incumbent/vacant, and dollar amounts that will FUNCTION/ IDEA-B PRESCHOOL coincide with the amount listed under Activities. Include all function and object OBJECT AMOUNT AMOUNT codes that are appropriate with this activity.
Totals for each funding source Performance Measurement: Desired Outcome:
Bureau of Special Education April 15, 2009 Page 3 of 7 COORDINATED EARLY INTERVENING SERVICES FOR STUDENTS (K-12) WHO HAVE NOT BEEN IDENTIFIED AS NEEDING SPECIAL EDUCATION SERVICES (OPTIONAL) (see page 8 of the Instructions) Using IDEA Part B and/or IDEA Recovery funds for CEIS may impact the district’s ability to reduce MOE. Guidance from OSEP is expected.
Each LEA that develops and maintains CEIS must report to the state on the number of children who received CEIS and the number of those who subsequently received special education and related services under Part B of IDEA in the two- year period after receiving CEIS. The NHDOE and LEAs must maintain these records for audit and monitoring purposes. The NHDOE will notify you at a later date regarding reporting actual numbers and tracking information on students who receive CEIS. (OSEP memo 08-09: http://www.ed.gov/policy/speced/guid/idea/ceis.html)
PRIORITY TO BE ADDRESSED : To develop and implement coordinated, early intervening services, which may include interagency financing structures, for students in kindergarten through grade 12 (with a particular emphasis on students in kindergarten through grade 3) who have not been identified as needing special education or related services but who need additional academic and behavioral support to succeed in a general education environment.
ACTIVITIES: PLEASE TAKE NOTE: When using Object Code Series 100, please reference the position titles, incumbent/vacant, and dollar amounts that will coincide FUNCTION/OBJEC IDEA-B with the amount listed under Activities. Include all function and object codes that are T AMOUNT appropriate with this activity.
Total for funding source Performance Measurement: Desired Outcome: PRIORITY TO BE ADDRESSED : To develop and implement coordinated, early intervening services, which may include interagency financing structures, for students in kindergarten through grade 12 (with a particular emphasis on students in kindergarten through grade 3) who have not been identified as needing special education or related services but who need additional academic and behavioral support to succeed in a general education environment.
ACTIVITIES: PLEASE TAKE NOTE: When using Object Code Series 100, please reference the position titles, incumbent/vacant, and dollar amounts that will coincide FUNCTION/OBJEC IDEA-B with the amount listed under Activities. Include all function and object codes that are T AMOUNT appropriate with this activity.
Total for funding source Performance Measurement: Desired Outcome:
Bureau of Special Education April 15, 2009 Page 4 of 7 CHILDREN WITH DISABILITIES ENROLLED BY THEIR PARENTS IN PRIVATE SCHOOLS ACTIVITY DESCRIPTION
(see page 9 of the Instructions)
PRIORITY TO BE ADDRESSED: Each LEA must spend the proportionate share of the LEA’s FY 2010 IDEA Part B entitlement funds to provide special education and related services (including direct services) to parentally placed private school children with disabilities. For FY 2010, the LEA must also include the district’s total allocation of IDEA Recovery Funds Part B (only) when determining the proportional share.
ACTIVITIES: PLEASE TAKE NOTE: When using Object Code Series 100, please reference the position titles, incumbent/vacant, and dollar amounts that will coincide FUNCTION/OBJEC IDEA-B with the amount listed under Activities. Include all function and object codes that are T AMOUNT appropriate with this activity.
Total for funding source Performance Measurement: Desired Outcome:
PRIORITY TO BE ADDRESSED: Each LEA must spend the proportionate share of the LEA’s FY 2010 IDEA Part B entitlement funds to provide special education and related services (including direct services) to parentally placed private school children with disabilities. For FY 2010, the LEA must also include the district’s total allocation of IDEA Recovery Funds Part B (only) when determining the proportional share.
ACTIVITIES: PLEASE TAKE NOTE: When using Object Code Series 100, please reference the position titles, incumbent/vacant, and dollar amounts that will coincide FUNCTION/OBJEC IDEA-B with the amount listed under Activities. Include all function and object codes that are T AMOUNT appropriate with this activity.
Total for funding source Performance Measurement: Desired Outcome:
Bureau of Special Education April 15, 2009 Page 5 of 7
CONSOLIDATED AGREEMENT
(see page 9 of the Instructions)
This agreement must be completed when the application includes federal Section 611/Section 619 IDEA Recovery Funds from more than one LEA.
For Fiscal Year 2010, the LEAs listed below have agreed to the following:
1. will serve as the ADMINISTRATIVE AGENCY for the consolidated application for the following federal funds: Check each source of funds for which there is a SEPARATE Form 1 included with this application.
2. will serve as the PROJECT MANAGER for the consolidated application for the federal funds indicated in item #1 above.
3. For Section 611/Section 619 IDEA Recovery Funds, the services and other items specified in the consolidated application will be delivered to each participating district in a manner consistent with the amount of funds allocated to this project by each district.
4. VERIFICATION of the delivery of the services described in this consolidated application will be reported to the State Department of Education as required in an End of the Year Report of Federal Funds Expended and to each of the participating districts at the conclusion of the project.
Date of School IDEA Preschool Board Amount Amount Original Signature of Date of Approval Allocated By Allocated By Superintendent or Signature LEA LEA LEA Other Authorized Personnel
Bureau of Special Education April 15, 2009 Page 6 of 7 IDEA-B SECTION 611 ASSURANCES Certification of Superintendent
All policies, procedures, documents and descriptions of activities, which are referred to in Sections I of this Request for Federal Special Education Funds as described in the American Recovery and Reinvestment Act of 2009 and Individuals with Disabilities Education Act of 2004, Section 611 are currently operational within each LEA listed below:
LEA Original Signature of Superintendent or Date Other Authorized Personnel
Bureau of Special Education April 15, 2009 Page 7 of 7