Consent Forms

Appendix C.

Informed Consent and Notification Letters

Informed Consent

Purpose

The [contractor], on behalf of the Policy and Program Studies Service (PPSS) of the U.S. Department of Education, is conducting a study of state implementation the Unsafe School Choice Option—Section 8532 of the Elementary and Secondary Act (ESEA) of 1965, as amended by the Every Student Success Act (ESSA). To assist with the study, we are asking state coordinators to participate in telephone interviews. You will be asked about the following topics: how states develop and review USCO policies, what guidance states provide to districts about USCO policies, how states ensure districts are complying with USCO policies, and what challenges states have encountered in implementing USCO policies. Your interview is designed to last approximately 60 minutes.

Risks and Discomfort

We do not know of any risks or discomforts associated with this interview.

Benefits

Your participation in the study will contribute to an understanding of how states implement USCO policies. The Department will use this information to provide better technical assistance to states on USCO implementation.

Participation

Your state’s participation in this study is required, under Section 8304(a)(6)(B) of the ESEA.

Privacy

Responses to this data collection will be used only for research purposes. No part of the study involves evaluation of any individual, agency, or institution. The study report prepared for the study will consolidate the results across all the states in the study. The study report will not disclose the names of individual study participants or their states, except where required by law.

We would like your consent to record the interview. Recordings will be kept in a secure location and will not be accessed by anyone outside of the study team. The audio recordings will be destroyed at the conclusion of the study. You can participate in the interview but decline to have it recorded. Additionally, if you elect to have the interview recorded, you may stop the recording at any time.

More Information

If you would like more information about this study, you may contact the [Project Director information]. For questions regarding your rights as a subject participating in this research, please contact the Institutional Review Board (IRB) at [contact information].

Informed Consent

I have read the above information. I have asked questions and received answers. I consent to participate in the study.

Signature: _______________________________ Date: ________________________

Print Name: ______________________________ Position: _____________________

State: ___________________________________

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB number. The valid OMB control number of this information collection is XXXX-XXXX. The time required to complete this information collection is estimated to average 60 minutes. If you have any comments concerning the accuracy of the time estimates(s) or suggestion for improving this form, please write to: U.S. Department of Education, Washington, 20202-4651. If you have comments or concerns regarding the status of your individual submission of this form, write directly to:

Policy and Program Studies Service, Office of Planning, Evaluation and Policy Development, U.S. Department of Education, 400 Maryland Avenue, SW, Washington, DC 20202.

Notification Letter – State Superintendent

Dear [State Superintendent]:

I am writing to ask for your support for a U.S. Department of Education (Department) study to understand how states are implementing the Unsafe School Choice Option (USCO)—Section 8532 of the Elementary and Secondary Act (ESEA) of 1965, as amended by the Every Student Success Act (ESSA).

As you know, Section 8532 requires that each state receiving funds under the ESEA establish and implement a statewide policy requiring that students attending a persistently dangerous public elementary or secondary school, or students who become victims of a violent criminal offense while in or on the grounds of a public school that they attend, be allowed to attend a safe public school.

The Department is interested in learning how states develop and review USCO policies, what guidance states provide to districts about USCO policies, how states ensure districts are complying with USCO policies, and what challenges states have encountered in implementing USCO policies. To learn how states are implementing USCO policies, the Department will conduct telephone interviews with state coordinators in each state, as well as the District of Columbia and Puerto Rico. The Department will also collect state-level data on the number of students that transferred under USCO policies and the number of schools to and from which students move based on being (1) in a persistently dangerous school and (2) the victim of crime.

The interview will last no more than 60 minutes and the data collection should take no more than 45 minutes. Participation is required of states under Section 8304(a)(6)(B) of the ESEA. I recognize that participation in this study will demand time and effort. However, [state]’s experience in implementing USCO policies will be invaluable to enable the Department to offer improved technical assistance to states around USCO implementation.

The study report will not disclose the names of individual study participants or their states. Rather, the results will be analyzed for trends across states.

I will soon send a letter to your state coordinator about this study and ask for their participation. Should you have any questions, or if you would like to discuss this study further, please feel free to contact Erica Lee at the Department, at 202-260-1463 or [email protected].

We thank you in advance for your support for this important study.

Sincerely,

Gregory Fortelny, Ph.D.

Director, Policy and Program Studies Service

Office of Planning, Evaluation and Policy Development

Notification Letter – State-Level Respondent

Dear [State-level respondent],

Your State Superintendent was recently notified by the U.S. Department of Education’s (Department) Policy and Program Studies Service of a national study of state implementation of the Unsafe School Choice Option (USCO)—Section 8532 of the Elementary and Secondary Act (ESEA) of 1965, as amended by the Every Student Success Act (ESSA).

As you know, Section 8532 requires that each state receiving funds under the ESEA establish and implement a statewide policy requiring that students attending a persistently dangerous public elementary or secondary school, or students who become victims of a violent criminal offense while in or on the grounds of a public school that they attend, be allowed to attend a safe public school.

Because of your role as [role] we are asking for your participation in a telephone interview and your completion of a short data collection form on the number of students that transferred under USCO policies and the number of schools to and from which students move. Participation is required of states under Section 8304(a)(6)(B) of the ESEA. I recognize that participation in this study will demand time and effort. However, [state]’s experience in implementing USCO policies will be invaluable to enable the Department to offer improved technical assistance to states around USCO implementation. The interview will take no more than 60 minutes of your time. We can schedule it at your convenience during [proposed time period]. Completion of the data collection form should take no more than 45 minutes

The study report will not disclose the names of individual study participants or their states. Rather, the results will be analyzed for trends across states.

A representative from the firm conducting this study, [contractor], will contact you soon to find out your availability for an interview and provide you with the data collection form. Should you have any questions, or if you would like to discuss this study further, please feel free to contact Erica Lee at the Department, at 202-260-1463 or [email protected].

We appreciate your cooperation in helping us learn how [state] implements USCO policies. We look forward to learning more about the interesting work that you are doing.

Sincerely,

Gregory Fortelny, Ph.D.

Director, Policy and Program Studies Service

Office of Planning, Evaluation and Policy Development