District Part B 611 Survey

OMB#: XXXX-XXXX

^{Expiration Date: XX/XX/20XX}

The Individuals with Disabilities Education Act (IDEA) State and Local Implementation Study 2019

DISTRICT PART B 611

DRAFT

August 2019

Paperwork Reduction Act of 1995

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. Public reporting burden for this collection of information is estimated to average 60 minutes per response, including time for reviewing instructions, searching existing data sources, 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 or retain benefit (Education Department General Administrative Regulations Section, 34 C.F.R. § 76.591). If you have comments or concerns regarding the status of your individual submission of this survey, please contact the U.S. Department of Education, 400 Maryland Ave., SW, Washington, DC 20202-4537 or email [email protected] directly. [Note: Please do not return the completed survey to this address.]

Notice of Confidentiality

Responses to this data collection will be used only for statistical purposes. The reports prepared for this study will summarize findings across the sample and will not associate responses with a specific individual. All information that would permit identification of the district or individual respondent will be kept confidential (per The Education Sciences Reform Act of 2002), will be used only by persons engaged in and for the purposes of the survey, and will not be disclosed or released to others for any purpose except as required by law. Study reports may present information by state.

PURPOSE OF THE STUDY

This Individuals with Disabilities Education Act (IDEA) State and Local Implementation Study 2019, sponsored by the U.S. Department of Education (ED), is an important study that will develop a national picture of state, district, and school implementation of IDEA. It will provide (1) the Department of Education, Congress, and other stakeholders with knowledge that can inform how special education and related services are provided to children, and (2) states, districts, and schools with an understanding of how others are implementing IDEA.

The IDEA Implementation Study is not a compliance study, nor a study of the results of effectiveness of IDEA.

We are requesting you complete this questionnaire because you and your staff have the most knowledge about special education policies and practices in your district. If there are questions you are not able to answer, please feel free to draw on the expertise and knowledge of others within your district. As grantees under IDEA, local education agencies are expected to participate in this data collection (34 C.F.R. § 76.591). With your contribution, ED and Congress will gain a more accurate and complete understanding of how IDEA is being implemented for preschool- and school-aged students at the district level.

All information that would permit identification of the district or individual respondent will be held in strict confidence, will be used only by persons engaged in and for the purposes of the survey, and will not be disclosed or released to others for any purpose except as required by law.

Thank you for joining us in our effort to understand the current implementation of IDEA. We appreciate your time and cooperation.

Please see the next pages for Instructions for completing this survey, as well as a set of Key Definitions and Frequently Asked Questions (FAQs).

If you have any questions, contact:

Lisbeth Goble, 833-238-7224

email: [email protected]

Before you answer the questions, please carefully read the Instructions, Key Definitions, and Frequently Asked Questions (FAQs):

INSTRUCTIONS

• When completing the survey, please consider ‘school-age children with disabilities’ as students who are in kindergarten or age 6 or older.

• All items request information pertaining to the 2019-2020 school year unless otherwise specified.

• The primary respondent for this survey is intended to be the person most knowledgeable about special education policies and practices in your district. In most cases, the primary respondent will be the Special Education Director.

• Certain questions may require the help of other staff, such as the director of pupil/student services and staff from human resources, finance, and general education. If you need input from other staff, you may either share your unique survey hyperlink, which will give them full access to the survey, or you can print off specific questions for them to answer on paper and fill in the online responses yourself.

• Items on this survey cover the following topics: Agency Role; Identification for Special Education and Related Services; Significant Disproportionality; IEP Development and Quality; Monitoring School-Age Children with Disabilities; Alternate Diplomas; Supports for Transitions; Access to General Education Programs and Supports; Discipline and Safety; Social-Emotional, Behavioral, and Mental Health Supports; Funding Allocation; Staffing; and Evidence from Research

KEY DEFINITIONS

Students with disabilities is used to reflect school-aged students having intellectual disability; hearing impairment, including deafness; speech or language impairment; visual impairment, including blindness; serious emotional disturbance (hereafter referred to as emotional disturbance); orthopedic impairment; autism; traumatic brain injury; developmental delay; other health impairment; specific learning disability; deaf-blindness; or multiple disabilities and who, by reason thereof, receive special education and related services under the Individuals with Disabilities Education Act (IDEA) according to an Individualized Education Program (IEP).

Special education teachers are teachers employed and contracted to work with children with disabilities. For this survey, we would like you to consider teachers who work with students who are in kindergarten through high school graduation or age 21. If your state’s eligibility extends past age 21, please consider the highest age for which teachers serve students with disabilities.

Professional Development includes a range of learning and support activities designed to prepare individuals for work with and on behalf of children and their families, as well as ongoing experiences to enhance this work. Professional development encompasses education, training, and technical assistance.

Training is a learning experience, or series of experiences, specific to an area of inquiry and related set of skills, delivered by a professional(s) with subject matter and adult learning knowledge and skills. This could include seminars, workshops, or courses about specific topics or key concepts.

Technical Assistance (TA) is the provision of targeted and customized supports by a professional(s) with subject matter and adult learning knowledge and skills to develop or strengthen processes, knowledge application, or implementation of services by recipients. This could include coaching, consulting, or other ongoing support.

School levels are defined as follows:

• Elementary schools are schools that can serve students in kindergarten to grades 4-8, depending on state and school district policy.

• Middle schools are schools that can serve students between grades 4 and 9, with most in the grade 6-8 range. Middle schools in the upper grade range (7-9) are sometimes referred to as junior high schools.

• High schools are schools that can serve students between grades 7 and 12, with most in the grade 9-12 range.

• Other schools are all other grade configurations, including schools that are completely ungraded.

FREQUENTLY ASKED QUESTIONS (FAQs)

How do I navigate the survey? You can access the survey by clicking on the unique hyperlink we provided to you via email. Once you have started the survey, you can navigate through it by answering each question and clicking the “NEXT” button at the bottom of the page. To go back to a previous page, click the “BACK” button. Do not use your internet browser back/forward buttons to move through the survey.

Do I have to complete the survey all at one time? No. You can revisit the website as many times as needed to complete the survey. However, if you need to stop before finishing the survey, please be sure to click on the “NEXT” button before closing out so that your responses(s) on that page will be saved. You will resume at the next unanswered question when you return to the survey. Once you have finished and submitted your survey, you will no longer have access to it. Please note that each session will time out after 30 minutes of inactivity.

Can I complete the survey on my tablet or smartphone? Yes. The survey has been optimized to run on desktop computers, tablets, or smart phones. The survey is best viewed in the latest versions of Chrome, Safari, Firefox, or Internet Explorer (IE 11 or Edge).

How long does the survey take? About 60 minutes. You can preview the questions and are not required to complete the survey all at once. The data you provide each time you log in will be securely stored and available when you return to complete the survey.

Do I have to answer all the questions? Please try to answer all questions that are relevant for your district, so the U.S. Department of Education can gain a more accurate and complete understanding of how IDEA is being implemented. You will automatically be skipped past some questions that do not apply to your situation, depending upon your answer to an earlier question. You may choose to skip any question in the survey that you cannot or do not wish to answer. To skip a question, leave the question blank and then click the “NEXT” button to proceed.

Can I have my staff complete some of the questions instead of me? Yes. Certain questions may require the help of other staff. You may either share your unique survey hyperlink with these individuals, which will give them full access to the survey, or you can print off specific questions and fill in the responses yourself at a later time.

Can multiple people work on completing the survey at the same time? No. If multiple people are logged into the same survey at the same time, responses may not be recorded correctly. Only one person on one computer should be completing the survey at any given time.

Can I print individual questions? Yes. You may print an individual page at any time by using your computer’s usual method of printing.

Can I print a copy of the questionnaire when I am finished? Yes. Once you have completed the survey, you will have the option to print a copy of your responses before submitting the survey.

Can I obtain a paper version of the questionnaire? Yes. If you would like to see a paper version for reference purposes, you can download a PDF version by clicking the link at the top of the page that says “Download blank PDF of survey.”

Will my answers be kept confidential? Yes. All information that would permit identification of the district, school, or individual respondent will be kept confidential (per The Education Sciences Reform Act of 2002), will be used only by persons engaged in and for the purposes of the survey, and will not be disclosed or released to others for any purpose except as required by law.

Who should I contact if I have a question? If you have any questions, please contact Lisbeth Goble at 833-238-7224 or at [email protected]. When sending emails, in addition to the question, please be sure to include your name and a phone number where you can be reached.

CONTACT INFORMATION

Please enter the contact information of the primary respondent below in case we need to contact your district to clarify responses to any questions.

First Name:

Last Name:

Title/Position:

Phone: | | | | - | | | | - | | | | |

E-mail Address:

District Name:

Best days and times to reach you (in case of questions):

A. AGENCY ROLE

A1. As the designated special education coordinator for your district, which of the following describes the population(s) of students for which you have responsibility? (Based on Q1, 2009 IDEA-NAIS State 619 Questionnaire; revised for use in District survey)

Select all that apply

 School-age children with disabilities 1

• Preschool-age children with disabilities 2

• School-age children without disabilities 3

• Preschool-age children without disabilities 4

 Other (Please specify) 5

NO RESPONSE M

B. IDENTIFICATION FOR SPECIAL EDUCATION AND RELATED SERVICES

The next questions focus on the identification and eligibility of school-age children for special education services.

B1. How does your district work with other agencies and programs (such as public health, substance abuse treatment, mental health, and social services) to identify or determine eligibility of school-age children who have experienced the following emerging health concerns? (New)

Hyperlink definition of Adverse Childhood Experiences will be provided: Adverse Childhood Experiences (ACEs) is the term used to describe all types of abuse, neglect, and other potentially traumatic experiences that occur to people under the age of 18.

Select all that apply in each row

	Have occasional conversations		Jointly develop or share guidance for personnel	Hold joint professional development for personnel	Share identification and screening data	Establish interagency agreements	Don’t work with other agencies/programs on this condition
a. Adverse childhood experiences (ACES)		1 	2 	3 	4 	5 	6 
c. Fetal alcohol spectrum disorders		1 	2 	3 	4 	5 	6 
d. Lead or other heavy metal poisoning		1 	2	3	4 	5 	6 
e. Neonatal abstinence syndrome		1 	2 	3 	4 	5 	6 
f. Opioid addiction		1 	2	3	4 	5 	6 
g. Prenatal substance use		1 	2 	3 	4 	5 	6 
h. Zika virus		1 	2	3	4 	5 	6 

NO RESPONSE M

B2. Does your district administer a Kindergarten Readiness screener? (New)

Select all that apply

 Yes, a commercial screener 1

 Yes, a district-developed screener 2

 Yes, a state-developed screener 3

 Yes, a state-recommended screener 4

 No, we currently do not 0

NO RESPONSE M

If response to B2=1, 2, 3, or 4, then ask B3

B3. What does your district’s Kindergarten Readiness screener measure? (New)

Select all that apply

 Self-care or self-help skills 1

 Language skills 2

 Cognitive skills, including pre-academic skills 3

 Gross motor skills 4

 Fine motor skills 5

 Social-emotional skills 6

NO RESPONSE M

If response to B2=1, 2, 3, or 4, then ask B4

B4. Does your district use the results of the Kindergarten Readiness screener to inform student evaluation for special education services? (New)

Select all that apply

 Yes, students are referred for evaluation for special education services based on the screener results 1

 Yes, screener results are used to initiate a monitoring process which may then indicate the student should receive special education services 2

 Yes, screener results are used to assign targeted or supplemental supports within the context of a multi-tiered system 3

 No, they are not used to inform further evaluation 0

NO RESPONSE M

B5. Does your district use progress monitoring data from a tiered intervention system to inform any aspect of special education services? (New)

Select all that apply

 Yes, to determine if students are eligible for special education services 1

 Yes, to refer students for evaluation for special education services 2

 Yes, to assign targeted or supplemental supports for students with disabilities 3

 No, we do not use progress monitoring data from a tiered intervention system to inform any aspect of special education services 0

NO RESPONSE M

The next two questions focus on children who are suspected of having dyslexia.

B6. When determining eligibility for special education, does your district require or recommend a special type of assessment for school-age children who are suspected of having dyslexia? (New)

Select one only

 Yes, we require a special type of assessment 1

 Yes, we recommend a special type of assessment, but do not require it 2

 No, we currently do not 0

NO RESPONSE M

If response to B6=1 or 2, then ask B7

B7. What types of special assessments does your district require or recommend to determine eligibility for special education for school-age children with dyslexia? (New)

Select all that apply

 Auditory processing assessments 1

 Developmental vision assessment, in addition to routine vision screenings 2

 Nonverbal cognitive assessments 3

 Phonological assessments, including measurement of awareness, memory, phones, and decoding 4

 Psychomotor assessments 5

 Rapid automatic naming assessments 6

 Reading fluency assessments 7

 Reading comprehension assessments 8

 Spelling assessments 9

 Verbal cognitive assessments 10

 Visual memory assessments 11

 Visual perception assessments 12

 Vocabulary assessments 13

 Writing assessments 14

 Other (Please specify) 15

NO RESPONSE M

The next two questions focus on children who are suspected of having Autism Spectrum Disorder.

B8. When determining eligibility for special education, does your district require or recommend a special type of assessment for school-age children who are suspected of having Autism Spectrum Disorder? (New)

Select one only

 Yes, we require a specific assessment 1

 Yes, we recommend a specific assessment, but do not require it 2

 No 0

NO RESPONSE M

If response to B8=1 or 2, then ask B9

B9. What types of special assessments does your district require or recommend in determining eligibility for special education for school-age children with Autism Spectrum Disorder? (New)

Select all that apply

 Nonverbal cognitive assessments 1

 Verbal cognitive assessments 2

 Systematic observations of student in the classroom 3

 Teacher ratings of student’s communication, behavior, and functioning in the classroom 4

 Family ratings of student’s communication, behavior, and functioning at home 5

 Collection of information directly from students about their communication, social interactions, and functioning 6

 Collection of pediatrician referrals and/or medical information 7

 Other (Please specify) 8

NO RESPONSE M

The next set of questions focus on children who are English Learners (EL).

B10. When determining eligibility for special education, does your district require or recommend a special type of assessment for school-age children who are English Learners? (New)

 Yes 1

 No 0

NO RESPONSE M

If response to B10=1, then ask B11

B11. What special assessments does your district require or recommend in determining eligibility for special education services for school-age children who are English Learners (EL)? (New)

Select all that apply

 Conduct systematic observations of student in the classroom by a specialist, such as psychologists, occupational therapists, etc. 1

 Use classroom performance assessments and/or observations 2

 Use nonverbal cognitive assessments such as the Leiter, TONI-4, Raven’s Progressive Matrices 3

 Gather information from the family through interviews or forms in the family’s primary language 4

 Gather information from teachers of ELs 5

 Use an English language screener 6

 Use screening instruments that have been translated to EL’s first language 7

 Use assessments that have evidence of validity with students speaking EL’s first language 8

 Use the same assessments used with students whose primary language is English, but with a bilingual assessor or interpreter 9

 Other (Please specify) 10

NO RESPONSE M

B12. Does your district use any of the following policies, procedures, and practices to ensure non-English speaking parents/guardians understand their role in the referral and evaluation processes? (New)

Select all that apply

 Parents/guardians are asked to state their primary language as part of standard procedure at intake. 1

 An interpreter is provided for parents/guardians as needed 2

 Parents/guardians are encouraged to bring someone who can interpret for them 3

 Parents/guardians are provided with translated written resources (including the IEP) 4

 A toll-free phone number staffed by multi-lingual special education staff is provided for non-English-speaking parents/guardians 5

 A toll-free vendor interpreter service is used as needed 6

 Other (Please specify) 7

NO RESPONSE M

B13. What challenges has your district experienced in ensuring that referrals and evaluations are linguistically and culturally competent? (New)

Linguistically and culturally competent practices include understanding and honoring differences in customs, beliefs, values, and language preferences among families from different ethnic, socioeconomic, religious, cultural, or linguistic groups.

Select all that apply

 Addressing family reluctance to engage with schools around special education 1

 Addressing family reluctance to engage with professionals due to concerns about legal status 2

 Having an insufficient number of multilingual professionals 3

 Having an insufficient number of interpreters 4

 Having limited resources for staff training on linguistically and culturally competent processes 5

 Having assessments for evaluation that are not normed for other languages 6

 Difficulty determining if eligibility for services is due to lack of skills in native language, rather than a disability 7

 Other (Please specify) 8

 None of the above 9

NO RESPONSE M

B14. What challenges has your district experienced in ensuring that services are linguistically and culturally competent? (New)

Linguistically and culturally competent practices include understanding and honoring differences in customs, beliefs, values, and language preferences among families from different ethnic, socioeconomic, religious, cultural, or linguistic groups.

Select all that apply

 Addressing family reluctance to engage with schools around special education 1

 Addressing family reluctance to engage with professionals due to concerns about legal status 2

 Having an insufficient number of multilingual professionals 3

 Having an insufficient number of interpreters 4

 Having limited resources for staff training on linguistically and culturally competent processes 5

 Other (Please specify) 6

 None of the above 7

NO RESPONSE M

The next two questions focus on children with specific learning disabilities.

B15. In your district, which of the following kinds of data are part of the process for determining special education eligibility for elementary students with specific learning disabilities? (Q19, 2009 IDEA-NAIS District)

If your district does not serve elementary students, please select not applicable.

Select all that apply

 Data and other information from the Response to Intervention (RtI) process 1

 Data based on cognitive and academic assessments that demonstrate a discrepancy between expected and actual performance (such as an IQ-achievement discrepancy) 2

 Data from other research-based procedures 3

 Not applicable; district does not serve elementary students 4

NO RESPONSE M

B16. In determining eligibility for special education under specific learning disability, which best describes your district’s policy with respect to Response to Intervention (RtI)? (Q11, 2009 IDEA-NAIS State Part B)

Select one only

 The use of an IQ-achievement discrepancy model is prohibited and RtI data are explicitly required in determining eligibility 1

 The use of an IQ-achievement discrepancy model is prohibited and an alternative method (not specifically RtI) is used to determine eligibility 2

 The use of an IQ-achievement discrepancy model is permitted and RtI data are explicitly required in determining eligibility 3

 The use of an IQ-achievement discrepancy model is permitted and RtI data may be used in determining eligibility 4

 The use of an IQ-achievement discrepancy model is permitted and an alternative method (not specifically RtI) may be used to determine eligibility 5

 Other (Please specify) 6

NO RESPONSE M

B17. How many students were newly evaluated for IDEA Part B special education during the 2018-2019 school year, by grade? How many of these students were found eligible for special education services? (Q20, 2009 IDEA-NAIS District)

Please do not include students who transferred into your district already eligible for special education.

Please do include students who received early intervention services under Part C Option and are not being evaluated under Part B.

The intention of this question is to obtain the number of students newly evaluated and those found eligible for special education or related services under all disability categories. We want to count all children who were evaluated for the possibility of receiving an IEP, including those who might end up with a speech-only IEP.

	2018-2019 School Year
	Number of students evaluated	Number of students found eligible
a. Kindergarten	| ___________________________ |	| ___________________________ |
b. 1st grade	| ___________________________ |	| ___________________________ |
c. 2nd grade	| ___________________________ |	| ___________________________ |
d. 3rd grade	| ___________________________ |	| ___________________________ |
e. 4th grade	| ___________________________ |	| ___________________________ |
f. 5th grade	| ___________________________ |	| ___________________________ |
g. 6th grade	| ___________________________ |	| ___________________________ |
h. 7th grade	| ___________________________ |	| ___________________________ |
i. 8th grade	| ___________________________ |	| ___________________________ |
j. 9th grade	| ___________________________ |	| ___________________________ |
k. 10th grade	| ___________________________ |	| ___________________________ |
l. 11th grade	| ___________________________ |	| ___________________________ |
m. 12th grade	| ___________________________ |	| ___________________________ |

B18. During the eligibility determination process, is there anything your district does to help staff apply exclusionary criteria? (New)

The purpose of this exclusionary clause is to help prevent the improper determination of eligibility of children, especially those from distinct cultures who have acquired learning styles, language, or behaviors that are not compatible with academic requirements of schools in the dominant culture.

Select all that apply

 Develop procedures for application of exclusionary criteria 1

 Provide professional development for school staff 2

 Provide written materials to school staff 3

 Provide guidelines for staff to follow before screening children who are English Learners 4

 Other (Please specify) 5

NO RESPONSE M

C. SIGNIFICANT DISPROPORTIONALITY

The next section focuses on significant disproportionality. The first set of questions focuses specifically on significant disproportionality in identification.

C1. In any of the past 5 school years, has the state identified your district as having significant disproportionality in identification of school-age children with disabilities? (New)

Significant disproportionality in identification occurs when districts identify children from any racial or ethnic group at markedly higher or lower rates than their peers. States determine whether significant disproportionality is occurring in a given district.

Select all that apply

 2014-2015 1

 2015-2016 2

 2016-2017 3

 2017-2018 4

 2018-2019 5

 No, our district has not been identified as having significant disproportionality in identification for school-age children in the past 5 school years 6

 Don’t know if our district has been identified as having significant disproportionality in identification for school-age children in the past 5 school years 7

NO RESPONSE M

IF RESPONSE TO C1=1, 2, 3, 4, OR 5, THEN ASK C2

C2. Did your district do any of the following to address or prevent significant disproportionality in identification in the past five school years, and if so, how was it funded? (New)

Coordinated Early Intervening Services (CEIS) are services provided to students in kindergarten through grade 12 who are not currently identified as needing special education or related services, but who need additional academic and behavioral supports to succeed in a general education environment. CEIS can be mandatory (Comprehensive Coordinated Early Intervening Services or CCEIS) or voluntary.

Please include all actions that were used in the district, even if they were not used in all situations.

Select all that apply in each row

	Through CCEIS (mandatory) funds	Through voluntary CEIS funds	Through other funds	District did not do this
a. Reviewed and/or changed assessment/ evaluation instruments	1 	2 	3 	n 
b. Reviewed and/or changed screening procedures	1 	2 	3 	n 
c. Increased monitoring and analysis of school referral or assessment data	1 	2 	3 	n 
d. Hired additional staff, such as reading specialists or mental health specialists	1 	2 	3 	n 
e. Reduced class size	1 	2 	3 	n 
f. Required progress monitoring	1 	2 	3 	n 
g. Reviewed administrative and classroom staff effectiveness	1 	2 	3 	n 
h. Developed a specific plan for school staff to address significant disproportionality in identification	1 	2 	3 	n 
i. Provided targeted supports to all schools	1 	2 	3 	n 
j. Provided targeted supports only to schools with evidence of significant disproportionality, or near significant disproportionality	1 	2 	3 	n 
k. Provided targeted supports for elementary schools	1 	2 	3 	n 
l. Provided targeted supports for middle schools	1 	2 	3 	n 
m. Provided targeted supports for high schools	1 	2 	3 	n 
n. Provided or supported interventions to address issues in literacy	1 	2 	3 	n 
o. Provided or supported interventions to address issues in math	1 	2 	3 	n 
p. Provided or supported interventions to address issues in science	1 	2 	3 	n 
q. Provided or supported behavioral supports	1 	2 	3 	n 
r. Initiated multi-tiered systems of support	1 	2 	3 	n 
s. Initiated other specific interventions (Please specify)	1 	2 	3 	n 
t. Other (Please specify)	1 	2 	3 	n 

IF RESPONSE TO C1=1, 2, 3, 4, OR 5, THEN ASK C3

C3. Did your district provide any of the following types of professional development to address or prevent significant disproportionality in identification in the past five school years, and if so, how was it funded? (New)

Select all that apply in each row

	Through CCEIS (mandatory) funds	Through voluntary CEIS funds	Through other funds	Not provided
a. Training to help general education teachers identify students who should be referred for evaluation	1 	2 	3 	n 
b. Training to help special education teachers identify students who should be referred for evaluation	1 	2 	3 	n 
c. Training to help school administrative staff identify students who should be referred for evaluation	1 	2 	3 	n 
d. Training to help other school staff identify students who should be referred for evaluation	1 	2 	3 	n 
e. Training about instructional strategies for meeting the diverse needs of students in a classroom	1 	2 	3 	n 
f. Technical assistance (specialized advice and customized support) for general education teachers	1 	2 	3 	n 
g. Technical assistance (specialized advice and customized support) for special education teachers	1 	2 	3 	n 
h. Technical assistance (specialized advice and customized support) for school administrative staff	1 	2 	3 	n 
i. Technical assistance (specialized advice and customized support) for other school staff	1 	2 	3 	n 
j. Other (Please specify)	1 	2 	3 	n 

The next set of questions focuses specifically on significant disproportionality in the placement of school-age children in particular educational settings, or Least Restrictive Environment (LRE) placement.

C4. In any of the past 5 school years, has the state identified your district as having significant disproportionality in the placement of school-age children in particular educational settings, or Least Restrictive Environment (LRE) placement? (New)

Significant disproportionality in LRE placement occurs when districts place in more restrictive settings children from any racial or ethnic group at markedly higher or lower rates than their peers. States determine whether significant disproportionality is occurring in a given district.

Select all that apply

 2014-2015 1

 2015-2016 2

 2016-2017 3

 2017-2018 4

 2018-2019 5

 No, our district has not been identified as having significant disproportionality in LRE placement for school-age children in the past 5 school years 6

 Don’t know if our district has been identified as having significant disproportionality in LRE placement for school-age children in the past 5 school years 7

NO RESPONSE M

IF RESPONSE TO C4=1, 2, 3, 4, OR 5, THEN ASK C5

C5. Did your district do any of the following to address or prevent significant disproportionality in the placement of school-age children in particular educational settings, or LRE placement, in the past five school years, and if so, how was it funded? (Based on Q5, 2009 IDEA-NAIS State Part B Questionnaire)

Please include all actions that were used in the district, even if they were not used in all situations.

Select all that apply in each row

	Through CCEIS (mandatory) funds	Through voluntary CEIS funds	Through other funds	District did not do this
a. Conducted a review of district policies and procedures related to IEPs	1 	2 	3 	n 
b. Reviewed practices used to facilitate parent involvement in LRE placement decisions	1 	2 	3 	n 
c. Provided funding for additional staff, such as reading specialists or mental health specialists	1 	2 	3 	n 
d. Reviewed supplementary aids and services provided to support LRE placements	1 	2 	3 	n 
e. Implemented general education/special education team teaching	1 	2 	3 	n 
f. Increased frequency of analysis of assessment data	1 	2 	3 	n 
g. Required progress monitoring in primary grades	1 	2 	3 	n 
h. Developed a specific plan for school staff to address significant disproportionality in LRE placement	1 	2 	3 	n 
i. Provided targeted supports to all schools	1 	2 	3 	n 
j. Provided targeted supports only to schools with evidence of significant disproportionality, or near significant disproportionality	1 	2 	3 	n 
k. Provided targeted supports for elementary schools	1 	2 	3 	n 
l. Provided targeted supports for middle schools	1 	2 	3 	n 
m. Provided targeted supports for high schools	1 	2 	3 	n 
n. Provided or supported interventions to address issues in literacy	1 	2 	3 	n 
o. Provided or supported interventions to address issues in math	1 	2 	3 	n 
p. Provided or supported interventions to address issues in science	1 	2 	3 	n 
q. Provided or supported behavioral supports	1 	2 	3 	n 
r. Initiated multi-tiered systems of support	1 	2 	3 	n 
s. Initiated other specific interventions (Please specify)	1 	2 	3 	n 
t. Other (Please specify)	1 	2 	3 	n 

IF RESPONSE TO C4=1, 2, 3, 4, OR 5, THEN ASK C6

C6. Did your district provide any of the following types of professional development address or prevent significant disproportionality in the placement of school-age children in particular educational settings, or LRE placement, in the past five school years, and if so, how was it funded? (New)

Select all that apply in each row

	Through CCEIS (mandatory) funds	Through voluntary CEIS funds	Through other funds	Not provided
a. Training about instructional strategies for meeting the diverse needs of students in a classroom	1 	2 	3 	n 
b. Technical assistance (specialized advice and customized support) for general education teachers	1 	2 	3 	n 
c. Technical assistance (specialized advice and customized support) for special education teachers	1 	2 	3 	n 
d. Technical assistance (specialized advice and customized support) for school administrative staff	1 	2 	3 	n 
e. Technical assistance (specialized advice and customized support) for other school staff	1 	2 	3 	n 
f. Other (Please specify)	1 	2 	3 	n 

The next set of questions focuses specifically on significant disproportionality in discipline.

C7. In any of the past 5 school years, has the state identified your district as having significant disproportionality in discipline? (New)

Significant disproportionality in discipline occurs when districts discipline children from any racial or ethnic group at markedly higher or lower rates than their peers. States determine whether significant disproportionality is occurring in a given district.

Select all that apply

 2014-2015 1

 2015-2016 2

 2016-2017 3

 2017-2018 4

 2018-2019 5

 No, our district has not been identified as having significant disproportionality in discipline for school-age children in the past 5 school years 6

 Don’t know if our district has been identified as having significant disproportionality in discipline for school-age children in the past 5 school years 7

NO RESPONSE M

IF RESPONSE TO C7=1, 2, 3, 4, OR 5, THEN ASK C8

C8. Did your district do any of the following to address or prevent significant disproportionality in discipline, in the past five school years, and if so, how was it funded?

Please include all actions that were used in the district, even if they were not used in all situations.

Select all that apply in each row

	Through CCEIS (mandatory) funds	Through voluntary CEIS funds	Through other funds	District did not do this
a. Changed student code of conduct	1 	2 	3 	n 
b. Made environmental changes to schools (for example, cameras in blind hallways; classroom communication systems) to prevent or address problems	1 	2 	3 	n 
c. Increased monitoring of school disciplinary actions	1 	2 	3 	n 
d. Used a support team to review general education student behavioral plans, ensure they have needed support(s), and track progress	1 	2 	3 	n 
e. Used Interdisciplinary Team Teaching or Schools-within-Schools approach	1 	2 	3 	n 
f. Developed a specific plan for school staff to address significant disproportionality in discipline	1 	2 	3 	n 
g. Provided targeted supports to all schools	1 	2 	3 	n 
h. Provided targeted supports only to schools with evidence of significant disproportionality, or near significant disproportionality	1 	2 	3 	n 
i. Provided targeted supports for elementary schools	1 	2 	3 	n 
j. Provided targeted supports for middle schools	1 	2 	3 	n 
k. Provided targeted supports for high schools	1 	2 	3 	n 
l. Provided or supported interventions to address issues in literacy	1 	2 	3 	n 
m. Provided or supported interventions to address issues in math	1 	2 	3 	n 
n. Provided or supported interventions to address issues in science	1 	2 	3 	n 
o. Provided or supported behavioral supports	1 	2 	3 	n 
p. Initiated a tiered system of support for behavior (for example, Positive Behavioral Interventions and Supports (PBIS) / School-Wide PBIS)	1 	2 	3 	n 
q. Used Reconnecting Youth program	1 	2 	3 	n 
r. Used Restorative Justice approach	1 	2 	3 	n 
s. Used Safe and Responsive Schools Guide	1 	2 	3 	n 
t. Provided school resource officers at schools	1 	2 	3 	n 
u. Used social-emotional or character development curriculum	1 	2 	3 	n 
v. Used trauma-informed practices or programs	1 	2 	3 	n 
w. Initiated other specific interventions (Please specify)	1 	2 	3 	n 
x. Developed guidance on office referrals for all staff	1 	2 	3 	n 
y. Other (Please specify)	1 	2 	3 	n 

IF RESPONSE TO C7=1, 2, 3, 4, OR 5, THEN ASK C9

C9. Did your district provide any of the following types of professional development to address or prevent significant disproportionality in discipline, in the past five school years, and if so, how was it funded? (New)

Select all that apply in each row

	Through CCEIS (mandatory) funds	Through voluntary CEIS funds	Through other funds	Not provided
a. Training for school staff on how to manage behavior in the classroom	1 	2 	3 	n 
b. Technical assistance (specialized advice and customized support) for general education teachers	1 	2 	3 	n 
c. Technical assistance (specialized advice and customized support) for special education teachers	1 	2 	3 	n 
d. Technical assistance (specialized advice and customized support) for school administrative staff	1 	2 	3 	n 
e. Technical assistance (specialized advice and customized support) for other school staff	1 	2 	3 	n 
f. Other (Please specify)	1 	2 	3 	n 

IF RESPONSE TO C1, C4, or C7 =1, 2, 3, 4, OR 5, THEN ASK C10

C10. Please provide the total State Part B allocation amount and the amount reserved for voluntary CEIS activities for school-age children with disabilities in your district, for the most recently completed school year (2018-2019). Your best estimates are fine. (New)

a. State Part B allocation (2018-2019)	$ | ___________________________ |
b. Amount reserved for voluntary CEIS (2018-2019)	$ | ___________________________ |

NO RESPONSE M

D. IEP DEVELOPMENT AND QUALITY

This next section focuses on the development and quality of Individualized Education Programs (IEPs).

D1. Does your district provide professional development on any of the following topics to help promote the quality of the IEP process for school-age children with disabilities? (New)

Professional development can occur either in-person or online.

A quality IEP is in compliance with all requirements of state and federal laws and regulations and reflects decisions based on the active and meaningful involvement of all members of the IEP team. The IEP provides a clear statement of expected outcomes and the special education services and supports to be provided to the student.

Hyperlink definition of standards-based IEPs will be provided: Standards-based IEPs are those that align goals for students with disabilities with the content and academic achievement standards that form the basis of each state’s general education curriculum.

Hyperlink definition of appropriately ambitious will be provided: Appropriately ambitious goals are reasonably calculated goals that enable a child to make progress appropriate in light of their circumstances.

Select all that apply

 Developing standards-based IEPs 1

 Developing appropriately ambitious IEP goals 2

 Identifying appropriate services, supports, or accommodations to achieve IEP goals 3

 Engaging families in the IEP process 4

 Engaging school staff (e.g., general educators) in the IEP process 5

 Engaging students in the IEP process 6

 Monitoring progress toward the achievement of IEP goals, including through use of data 7

 Other professional development to promote the quality of IEPs (Please specify) 8

 None of the above 9

NO RESPONSE M

IF RESPONSE TO D1= 1 OR 2, THEN ASK D2

D2. Who was the target audience for professional development on developing standards-based IEPs? (New)

Select all that apply

 Principals 1

 School administrative officials 2

 Special education teachers 3

 General education teachers 4

 Paraprofessionals or instructional learning assistants 5

 Reading specialists 6

 Math specialists 7

 Speech and language therapists/pathologists 8

 School counselors 9

 School psychologists 10

 School or district nurse 11

 Other (Please specify) 12

NO RESPONSE M

D3. Does your district provide written policies or guidelines on any of the following topics to help promote the quality of the IEP process for school-age children with disabilities? (New)

Hyperlink definition of appropriately ambitious will be provided: Appropriately ambitious goals are reasonably calculated goals that enable a child to make progress appropriate in light of their circumstances.

Select all that apply

 Developing standards-based IEPs 1

 Developing appropriately ambitious IEP goals 2

 Identifying appropriate services, supports, or accommodations to achieve IEP goals 3

 Engaging families in the IEP process 4

 Engaging school staff (e.g., general educators) in the IEP process 5

 Engaging students in the IEP process 6

 Monitoring progress toward the achievement of IEP goals, including through use of data 7

 Other topics (Please specify) 8

 None of the above 9

NO RESPONSE M

D4. Does your district provide any of the following resources to help promote the quality of the IEP process for school-age children with disabilities? (New)

Hyperlink definition of appropriately ambitious will be provided: Appropriately ambitious goals are reasonably calculated goals that enable a child to make progress appropriate in light of their circumstances.

Select all that apply

 A mandated standards-based IEP form or template 1

 A suggested standards-based IEP form or template 2

 A rubric or other resource describing features of quality IEPs, including appropriately ambitious IEP goals 3

 Coach, mentor, or IEP facilitator to assist with writing the IEP 4

 List of contact information for Specialized Instructional Support Personnel (SISP) and/or intervention staff 5

 Staff handbook or procedures manual with example IEPs 6

 Other resources to promote the quality of IEPs (Please specify) 7

 None of the above 8

NO RESPONSE M

D5. Does your district provide any of the following types of assistance to enable parents/guardians to participate in IEP meetings (for school-age children with disabilities? (New)

Select all that apply

 Child care assistance 1

 Interpreters 2

 Transportation vouchers 3

 Other (Please specify) 4

 No, we do not provide this type of assistance 5

NO RESPONSE M

D6. Does your district have a process to assess the quality of IEPs? (New)

 Yes 1

 No 0

 Don’t know 2

NO RESPONSE M

IF RESPONSE TO D6=1, THEN ASK D7

D7. What approaches does your district use to assess the quality of IEPs? (New)

Hyperlink definition of quality IEP will be provided: A quality IEP is in compliance with all requirements of state and federal laws and regulations and reflects decisions based on the active and meaningful involvement of all members of the IEP team. The IEP provides a clear statement of expected outcomes and the special education services and supports to be provided to the student.

Hyperlink definition of appropriately ambitious will be provided: Appropriately ambitious goals are reasonably calculated goals that enable a child to make progress appropriate in light of their circumstances.

Select all that apply

 Periodic review of completed IEPs 1

 Interview students about IEP goals and supports 2

 Interview teachers about IEP goals and supports 3

 Interview parents/guardians about IEP goals and supports 4

 Interview administrators about IEP provisions 5

 Monitor the services and supports specified in the IEP 6

 Monitor participation rates of parents/guardians in IEP meetings 7

 Monitor participation rates of students in IEP meetings 8

 Monitor participation rates of district and school staff in IEP meetings 9

 Monitor participation rates of staff from agencies outside the district in IEP meetings 10

 Monitor academic outcomes of students with an IEP 11

 Monitor disciplinary actions of students with an IEP 12

 Monitor the development of appropriately ambitious goals, as documented in an IEP 13

NO RESPONSE M

D8. For the 2019-2020 school year, has your district made available written materials, or offered any workshops, discussions or support groups specifically for parents/guardians of students with IEPs on any of the following topics? (Q21, 2009 IDEA-NAIS District, with two additional response options)

Select all that apply per row

	Provided written materials	Offered workshops, discussions, or support groups	We did not offer materials or supports to parents/guardians on this topic
a. Understanding student accommodations to help them access the general education curriculum	1 	2 	0 
b. Developing and implementing a standards-based IEP	1 	2 	0 
c. Understanding accommodations offered to students when taking state- or district-wide assessments, including the use of alternative assessments	1 	2 	0 
d. Understanding their child’s disability	1 	2 	0 
e. Understanding the law and their legal rights under IDEA	1 	2 	0 
f. Using alternative dispute resolution procedures	1 	2 	0 
g. Understanding any of the five special factors (behavior, limited English proficiency, Braille instruction, language and communication, and assistive technology) as part of the development, review, and revision of IEPs	1 	2 	0 
h. Using interventions for children with behavioral challenges	1 	2 	0 
i. Using strategies for making successful transitions between schools, such as elementary and middle schools	1 	2 	0 
j. Understanding how to file a complaint and where to receive assistance in drafting an effective complaint	1 	2 	0 

E. MONITORING SCHOOL-AGE CHILDREN WITH DISABILITIES

This next section focuses on monitoring and analyzing the outcomes of school-age children with disabilities and related dropout prevention strategies.

E1. Does your district use an early warning system to identify students with disabilities who are at risk of dropping out of school? (New)

An early warning system is based on student data and is used to help identify students who exhibit behavior or academic performance that puts them at risk of dropping out of school.

 Yes 1

 No 0

NO RESPONSE M

IF RESPONSE TO E1=1, THEN ASK E2

E2. Do the indicators used in the early warning system vary depending on the disability category of the student? (New)

 Yes 1

 No 0

NO RESPONSE M

IF RESPONSE TO E1=1, THEN ASK E3

E3. How are the early warning system data used to help students with disabilities? (New)

Select all that apply

• The data are used to identify students for participation in dropout prevention programs 1

 The data are used to provide targeted interventions to children with IEPs 2

 The data are used to monitor progress toward attainment of IEP goals 3

 The data are used to inform professional development for educators about preventing dropout 4

 Other (Please specify) 5

 None of the above 0

NO RESPONSE M

E4. Which of the following strategies are part of your district’s dropout prevention program to help students with and without disabilities who are at-risk of dropping out? (New)

If your district does not have a dropout prevention program, please mark the checkbox below and skip to E5.

 My district does not have a dropout prevention program.

	Select all that apply per row
	Used for students with disabilities	Used for students without disabilities	This is not part of our district’s dropout prevention program
a. Provide mentoring to students	1 	2 	3 
b. Provide tutoring to students	1 	2 	3 
c. Engage students in community service opportunities	1 	2 	3 
d. Provide alternative or non-traditional schooling options, such as alternative times or environments	1 	2 	3 
e. Offer career and technical education courses to students	1 	2 	3 
f. Provide afterschool enhancement programs	1 	2 	3 
g. Provide summer enhancement programs	1 	2 	3 
h. Provide individualized learning to allow students to move through courses at their own pace.	1 	2 	3 
i. Provide personalized learning tailored to the preferences and interests of students	1 	2 	3 
j. Ensure a safe learning environment through the use of a comprehensive discipline plan or violence prevention plan	1 	2 	3 
k. Engage families to help assess student needs and reduce absenteeism and truancy	1 	2 	3 
l. Review attendance and tardiness data to determine any patterns related to poor attendance	1 	2 	3 
m. Other (Please specify)	1 	2 	3 

E5. Does your district use student outcome data to inform any of the following types of targeted assistance your district provides to some or all schools that serve children with IEPs? (New)

Select all that apply

 Provide additional staff to schools 1

 Provide additional professional development to school staff 2

 Provide resources to help schools increase progress monitoring of students with disabilities 3

 Provide resources to help schools make curriculum adaptations 4

 Provide resources to help schools implement programs and interventions 5

NO RESPONSE M

E6. Which of the following components of Multi-Tiered Systems of Support (MTSS) does your district implement and/or have challenges implementing when serving school-age children with disabilities? (New)

Select all that apply on each row

	District implements this component		District has challenges implementing this component	District does not implement this component
a. Universal screening	1 		2 	3 
b. Data-driven decision making	1 		2 	3 
c. Progress monitoring	1 		2 	3 
d. Evidence-based instruction and supplemental support	1 		2 	3 

F. ALTERNATE DIPLOMAS

This next section focuses on alternate diplomas for school-age children with disabilities.

F1. Does your state have a policy to offer an alternate diploma for school-age children with significant cognitive disabilities that is standards-based and aligned with state requirements for the regular high school diploma? (Based on Item 6.1.4, State Supplemental Survey)

 Yes 1

 No 2

NO RESPONSE M

IF RESPONSE TO F1=1 THEN ASK F2

F2. Who decides if a school-age child with disabilities is eligible to be awarded a state-defined alternate diploma? (New)

Select one only

 IEP team 1

 Special education staff, not the full IEP team 2

 Other school staff 3

 District staff 4

 State agency 5

NO RESPONSE M

IF RESPONSE TO F1=1 THEN ASK F3

F3. Who decides if a school-age child with disabilities has met the requirements for and should be awarded a state-defined alternate diploma? (New)

Select one only

 IEP team 1

 Special education staff, not the full IEP team 2

 Other school staff 3

 District staff 4

 State agency 5

NO RESPONSE M

IF RESPONSE TO F1=1 THEN ASK F4

F4. For school-age children with significant cognitive disabilities, do the requirements to earn an alternate diploma in your district exceed the requirements of the state-defined alternate diploma? (New)

 Yes, our district’s requirements to earn an alternate diploma exceed the requirements of the state-defined alternate diploma (Please specify) 1

 No, our district’s requirements to earn an alternate diploma are the same as the requirements of the state-defined alternate diploma 0

NO RESPONSE M

IF RESPONSE TO F1=1 THEN ASK F5

F5. What percentage of students with significant cognitive disabilities have earned a state-defined alternate diploma in your district in the 2018-2019 school year? (New)

| | %

NO RESPONSE M

IF RESPONSE TO F1=1 THEN ASK F6

F6. How does your district provide support for teachers using grade-level content to teach school-age children with significant cognitive disabilities, working toward a state-defined alternate diploma? (Based on EPSEP PreK district coordinator survey)

			Select all that apply per row
	To help teachers adapt curriculum with appropriate complexity and breadth, including incorporation of Universal Design Learning principles	To help teachers provide accommodations		To help teachers manage student behavior	Support not provided through this mechanism
a. Training through a workshop, institute, or online module	1 	2 		3 	4 
b. Ongoing individualized support (such as consultation, coaching, or mentoring)	1 	2 		3 	4 
c. Ongoing group support (in the form of special education department meetings or community of practice/professional learning communities)	1 	2 		3 	4 
d. Release time (including common preparation periods and non-student days) to attend conferences and workshops outside of school	1 	2 		3 	4 
e. Other (Please specify)	1 	2 		3 	4 

G. SUPPORTS FOR TRANSITIONS

The questions in the next section are related to the supports provided to school-age children with disabilities during school transitions, including the post-high school transition.

G1. For school-age children with disabilities who are preparing to transition from high school, how does your district ensure the quality of the transition component of IEPs? (New)

Select all that apply

 Conduct on-site monitoring visits at school districts (for example, stakeholder interviews or observation of IEP meetings) 1

 Identify schools that need to improve transition process 2

 Recommend or require that schools needing improvement implement a quality improvement plan 3

 Provide technical assistance on approaches for developing quality IEP transition components 4

 Review a selection of IEPs for quality 5

 Survey parents/guardians about IEP transition outcomes or supports 6

 Use a transition planning rubric or guidance on best practices that focuses on compliance only 7

 Use a transition planning rubric or guidance on best practices that focuses on compliance and quality indicators 8

 Use a transition procedures manual 9

 Other (Please specify) 10

 None of the above 11

NO RESPONSE M

G2. What programs and supports does your district provide to school-age children with disabilities to prepare them for further education, jobs, and independent living? (New)

Please include programs offered through your district, as well as programs and supports your district makes available through coordination with other partners.

Select all that apply

 Advanced placement or other courses (including dual enrollment programs) that earn college credit 1

 Counseling on federal or state benefits (such as Medicaid or Supplemental Security Income) 2

 Career and technical education courses 3

 Career awareness instruction 4

 Counseling on postsecondary career and technical education and employment training program options 5

 Counseling on postsecondary education, including course guidance 6

 Independent living/self-care skills instruction 7

 Self-advocacy/self-determination instruction 8

 Supported employment in community settings in which students with and without disabilities work 9

 Test-taking strategies and study skills instruction 10

 Work-based learning experiences in community settings in which students with and without disabilities work 11

 Workplace readiness training 12

 None of the above 13

NO RESPONSE M

G3. How does your district obtain data on post-high school transition outcomes? (New)

Select all that apply

 State or district data systems 1

 State or district surveys of providers who support former students after high school 2

 State or district surveys of former students or their families 3

 Summary reports from other agencies 4

 Other (Please specify) 5

 We do not currently obtain data on post-high school transition outcomes 6

NO RESPONSE M

G4. On average, for what percentage of former students are you able to obtain required outcomes for IDEA Part B Indicator 14? (New)

IDEA Part B Indicator 14 includes the post-high school outcomes of enrollment in higher education, enrollment in other postsecondary education or training, competitive employment, and other employment. Your best estimate is fine.

Select one only

 0 to 25% of former students 1

 26 to 50% of former students 2

 51 to 75% of former students 3

 76 to 100% of former students 4

NO RESPONSE M

G5. What post-high school outcomes does your district collect, in addition to the required outcomes for IDEA Part B Indicator 14 (enrollment in higher education, enrollment in other postsecondary education or training program, competitive employment, and other employment within one year of leaving high school)? ) (New)

Select all that apply

 Enrollment in higher education more than one year after leaving high school 1

 Enrollment in other postsecondary education or training program more than one year after leaving high school 2

 Completion of higher education, postsecondary education, or training program 3

 Any employment more than one year after leaving high school 4

 Competitive employment more than one year after leaving high school 5

 Independent living arrangements 6

 Supervised living arrangements 7

 Incarceration 8

 Hospitalization 9

 Activities used by schools to prepare students for success after leaving high school 10

 Other (Please specify) 11

 None of the above 12

NO RESPONSE M

G6. For school-age children with disabilities, what does your district share or coordinate with the following programs or entities to support the transition out of high school? (New)

Select all that apply per row

	Share data	Share funding	Share personnel	Coordinate service provision	Share other information (such as IEPs)	No sharing or coordination occurs
a. Post-secondary education and training programs	1 	2 	3 	4 	5 	n 
b. Independent living agencies	1 	2 	3 	4 	5 	n 
c. Health care agencies	1 	2 	3 	4 	5 	n 
d. Mental health agencies	1 	2 	3 	4 	5	n 
e. Social service agencies (for example, Department of Developmental Services)	1 	2 	3 	4 	5 	n 
f. Vocational rehabilitation services (for example, Department of Rehabilitation Services)	1 	2 	3 	4 	5 	n 
g. Employers or potential employers of students	1 	2 	3 	4 	5 	n 
h. Juvenile court or probation officers	1 	2 	3 	4 	5 	n 

NO RESPONSE M

G7. During the current (2019-2020) or preceding two school years (2017-2018 and 2018-2019), what actions has your district taken to change transition policies, procedures, and practices for school-age children with disabilities? (New)

Select all that apply

 Revised or developed MOUs and collaboration agreements with other entities, such as workforce agencies, vocational rehabilitation agencies, or social services 1

 Provided targeted professional development, including materials and funds, to schools with below target outcomes 2

 Updated guidance on transition procedures for families and former students 3

 Revised transition supports offered to families and former students 4

 Added transition supports offered to families and former students (including hiring additional staff) 5

 Revised practices to better support student attendance and participation in the transition meeting. 6

 Analyzed data to identify the relationship between school-based practices and post-high school outcomes to determine areas for improvement and continued implementation 7

 Other (Please specify) 8

 None of the above 9

NO RESPONSE M

H. ACCESS TO GENERAL EDUCATION PROGRAMS AND SUPPORTS

Questions in this section focus on efforts to support school-age children with disabilities and their families in accessing general education programs.

H1. For which of the following groups of students does your district modify its general education curriculum? (New)

Select all that apply

 School age-children with significant cognitive disabilities 1

 School age-children with disabilities, other than significant cognitive disabilities 2

 Other (Please specify) 3

 We do not adapt our curriculum for students with disabilities 0

NO RESPONSE M

IF RESPONSE TO H1=1, 2,or 3, THEN ASK H2

H2. Is the adapted general education curriculum aligned with state standards? (New)

Select one only.

 Yes, alignment has been documented 1

 We are in the process of conducting a check for alignment 2

 There has been no check for alignment 3

NO RESPONSE M

IF RESPONSE TO H2=1 or 2, THEN ASK H3

H3. Which entity or entities conducted (or is conducting) the check for alignment? (New)

Select all that apply.

 State 1

 District 2

 Curriculum developer 3

 Other (Please specify) 4

NO RESPONSE M

H4. How does your district provide support to teachers to help them ensure school-age children with disabilities have access to the general education curriculum? (Based on EPSEP PreK district coordinator survey)?

			Select all that apply per row
	To help teachers adapt curriculum with appropriate complexity and breadth, including incorporation of Universal Design Learning principles	To help teachers provide accommodations		To help teachers manage student behavior	Support not provided through this mechanism
a. Training through a workshop, institute, or online module	1 	2 		3 	4 
b. Ongoing individualized support (such as consultation, coaching, or mentoring)	1 	2 		3 	4 
c. Ongoing group support (in the form of special education department meetings or community of practice/professional learning communities)	1 	2 		3 	4 
d. Release time (including common preparation periods and non-student days) to attend conferences and workshops outside of school	1 	2 		3 	4 
e. Other (Please specify)	1 	2 		3 	4 

H5. Does your district have a policy to support school-age children with disabilities' access to and participation in nonacademic activities? (New)

 Yes 1

 No 0

NO RESPONSE M

IF RESPONSE TO H5=1 THEN ASK H6

H6. Does your district use any of the following methods to support the participation of school-age children with disabilities in the same nonacademic extracurricular activities as children without disabilities? (Based on Item A-30, PEELS Early Childhood Teacher Questionnaire)

Select all that apply

 Provide individualized accommodations to students with disabilities 1

 Provide professional development to personnel supervising nonacademic activities 2

 Offer a specific disability awareness program 3

 Provide assistive technology to help students participate in activities 4

 Assign students without disabilities to be “buddies" to students with disabilities 5

 Prompt and reinforce students without disabilities to initiate and maintain interactions with students with disabilities 6

 Structure activities that require interaction between students with and without disabilities 7

 Provide or assist students in getting the necessary transportation to these activities 8

NO RESPONSE M

This next set of questions is about charter schools in your district.

H7. Which of the following best describes your district and the charter schools that operate as part it? (New)

Select one only

 My district is a traditional public school district that does not include any charter schools 1

 My district is a traditional public school district that does includes charter schools 2

 My district consists of only charter school(s) 3

IF H7 = 2, THEN ASK H8.

H8. Who serves as the authorizer for charter schools that operate as part of your district? (New)

Select one only

 My district authorizes all charter schools that operate as part of the district 1

 Another entity authorizes all charter schools that operate as part of the district. 2

 Some charter schools that operate as part of my district are authorized by my district and some are authorized by another entity. 3

IF H8 = 1 OR 3, THEN ASK H9

H9. For school-age children with disabilities who attend public charter schools that operate as part of your district and are authorized by your district, who has responsibility for the following, either for policy or contractual reasons? (New)

	Select one per row
	Charter schools have primary responsibility	Shared responsibility between the charter schools and your district	District has primary responsibility
a. Identification and evaluation of school-age children suspected of having a disability (for example, Child Find)	1 	2 	3 
b. Coordination of IEPs	1 	2 	3 
c. Development of IEP goals	1 	2 	3 
d. Monitoring progress toward achievement of IEP goals	1 	2 	3 
e. Provision of documents, forms, and resources to promote the quality of IEPs	1 	2 	3 
f. Provision of special education teachers and staff	1 	2 	3 
g. Provision of related services staff	1 	2 	3 
h. Provision of special education supports within the general education class	1 	2 	3 
i. Provision of special education supports within specialized settings (e.g., separate classes, separate schools, or other locations)	1 	2 	3 
j. Transportation for school-age children with disabilities	1 	2 	3 
k. Required qualifications for educators who serve school-age children with disabilities	1 	2 	3 
l. Provision of professional development to school staff on supporting school-age children with disabilities	1 	2 	3 
m. Funding for special education and related services	1 	2 	3 
n. Determining discipline policy or procedures	1 	2 	3 

IF H8 = 2 OR 3, THEN ASK H10

H10. For school-age children with disabilities who attend public charter schools that operate as part of your district but are authorized by another entity, who has responsibility for the following, either for policy or contractual reasons? (New)

	Select one per row
	Charter schools have primary responsibility	Shared responsibility between the charter schools and your district	District has primary responsibility
a. Identification and evaluation of school-age children suspected of having a disability (for example, Child Find)	1 	2 	3 
b. Coordination of IEPs	1 	2 	3 
c. Development of IEP goals	1 	2 	3 
d. Monitoring progress toward achievement of IEP goals	1 	2 	3 
e. Funding for special education and related services	1 	2 	3 
f. Provision of special education teachers and staff	1 	2 	3 
g. Provision of related services staff	1 	2 	3 
h. Provision of special education supports within the general education class	1 	2 	3 
i. Provision of special education supports within specialized settings (e.g., separate classes, separate schools, or other locations)	1 	2 	3 
j. Transportation for school-age children with disabilities	1 	2 	3 
k. Required qualifications for educators who serve school-age children with disabilities	1 	2 	3 
l. Provision of professional development to school staff on supporting school-age children with disabilities	1 	2 	3 
m. Provision of documents, forms, and resources to promote the quality of IEPs	1 	2 	3 
n. Determining discipline policy or procedures	1 	2 	3 

H11. Are there are charter schools within your district’s geographic area that operate independently from your district? (New)

 Yes 1

 No 0

NO RESPONSE M

IF H11 = 1, THEN ASK H12

H12. For school-age children with disabilities who attend public charter schools that operate independently from your district within your district’s geographic area, who has responsibility for the following, either for policy or contractual reasons? (New)

Note: Please focus on charter schools that exist as their own school district within your district’s geographic area.

	Select one per row
	Charter school district has primary responsibility	Shared responsibility between charter school district and your district	Your district has primary responsibility
a. Identification and evaluation of school-age children suspected of having a disability (for example, Child Find)	1 	2 	3 
b. Coordination of IEPs	1 	2 	3 
c. Development of IEP goals	1 	2 	3 
d. Monitoring progress toward achievement of IEP goals	1 	2 	3 
e. Provision of documents, forms, and resources to promote the quality of IEPs	1 	2 	3 
f. Provision of special education teachers and staff	1 	2 	3 
g. Provision of related services staff	1 	2 	3 
h. Provision of special education supports within the general education class	1 	2 	3 
i. Provision of special education supports within specialized settings (e.g., separate classes, separate schools, or other locations)	1 	2 	3 
j. Transportation for school-age children with disabilities	1 	2 	3 
k. Required qualifications for educators who serve school-age children with disabilities	1 	2 	3 
l. Provision of professional development to school staff on supporting school-age children with disabilities	1 	2 	3 
m. Funding for special education and related services	1 	2 	3 
n. Determining discipline policy or procedures	1 	2 	3 

If H7 = 3, THEN ASK H13

H13. For school-age children with disabilities in your district, who has responsibility for the following, either for policy or contractual reasons? (New)

	Select one per row
	Primary responsibility belongs to charter schools or charter district	Shared responsibility between the charter schools/charter district and local school district of residence	Local school district of residence has primary responsibility
a. Identification and evaluation of school-age children suspected of having a disability (for example, Child Find)	1 	2 	3 
b. Coordination of IEPs	1 	2 	3 
c. Development of IEP goals	1 	2 	3 
d. Monitoring progress toward achievement of IEP goals	1 	2 	3 
e. Provision of documents, forms, and resources to promote the quality of IEPs	1 	2 	3 
f. Provision of special education teachers and staff	1 	2 	3 
g. Provision of related services staff	1 	2 	3 
h. Provision of special education supports within the general education class	1 	2 	3 
i. Provision of special education supports within specialized settings (e.g., separate classes, separate schools, or other locations)	1 	2 	3 
j. Transportation for school-age children with disabilities	1 	2 	3 
k. Required qualifications for educators who serve school-age children with disabilities	1 	2 	3 
l. Provision of professional development to school staff on supporting school-age children with disabilities	1 	2 	3 
m. Funding for special education and related services	1 	2 	3 
n. Determining discipline policy or procedures	1 	2 	3 

H14. Are there public virtual schools that operate as part of your district? (New)

 Yes 1

 No 0

NO RESPONSE M

If H14 = 1, THEN ASK H15

H15. For school-age children with disabilities who attend public virtual schools that operate as part of your district, who has responsibility for the following, either for policy or contractual reasons? (New)

	Select one per row
	Virtual schools have primary responsibility	Shared responsibility between the virtual schools and your district	District has primary responsibility
a. Identification and evaluation of school-age children suspected of having a disability (for example, Child Find)	1 	2 	3 
b. Coordination of IEPs	1 	2 	3 
c. Development of IEP goals	1 	2 	3 
d. Monitoring progress toward achievement of IEP goals	1 	2 	3 
e. Provision of documents, forms, and resources to promote the quality of IEPs	1 	2 	3 
f. Provision of special education teachers and staff	1 	2 	3 
g. Provision of related services staff	1 	2 	3 
h. Provision of special education supports within the general education class	1 	2 	3 
i. Required qualifications for educators who serve school-age children with disabilities	1 	2 	3 
j. Provision of professional development to school staff on supporting school-age children with disabilities	1 	2 	3 
k. Funding for special education and related services	1 	2 	3 
l. Determining discipline policy or procedures	1 	2 	3 

The next set of questions focuses on students with disabilities who have been parentally placed in private schools.

H15. Are there currently students with disabilities in your district who have been parentally placed in a private school? (New)

Please exclude private schools that only serve students with disabilities, such as residential schools.

Select one only

 Yes 1

 No 0

NO RESPONSE M

H16. In your district, who is currently responsible for identifying students with disabilities who have been parentally placed in private schools? (New)

Please exclude private schools that only serve students with disabilities, such as residential schools.

Select all that apply

 Our district assumes responsibility for identifying these students 1

 Our district contracts with another public agency to identify these students 2

 Our district contracts with a third party other than a public agency to identify these students 3

NO RESPONSE M

H17. Which of the following approaches does your district use to identify students with disabilities who have been parentally placed in private schools? (New)

Please exclude private schools that only serve students with disabilities, such as residential schools.

Select all that apply

 Distribute materials to parents to help in the identification of these students 1

 Work with representatives from private schools to identify these students 2

 Provide staff with guidance specifically designed to support referrals and identification of school-age children in private schools (for example, written guidance or webinars) 3

 Work with the state’s Parent Training and Information Center(s) to ensure materials and processes are appropriate for school-age children in private schools 4

 Other (Please specify) 5

NO RESPONSE M

IF RESPONSE TO H15=1 THEN ASK H18

H18. In the 2018-2019 school year, how many students with disabilities who have been parentally placed in private schools did your district evaluate for special education services? (New)

Please exclude private schools that only serve students with disabilities, such as residential schools.

|_____________________________|

IF RESPONSE TO H15=1 THEN ASK H19

H19. In the 2018-2019 school year, how many students with disabilities who have been parentally placed in private schools were found eligible for special education services? (New)

Please exclude private schools that only serve students with disabilities, such as residential schools.

|_____________________________|

IF RESPONSE TO H19= ANY ENTRY OTHER THAN 0 THEN ASK H20

H20. What services did your district provide in the 2018-2019 school year to support students with disabilities who have been parentally placed in private schools? (New)

Please exclude private schools that only serve students with disabilities, such as residential schools.

Select all that apply

 Individualized tutoring 1

 Speech or language therapy 2

 Training to teachers/staff who work with students with disabilities 3

 Support with diagnostic assessments 4

 Provision of supplementary curricular materials 5

 Provision of assistive technology 6

 Other (Please specify) 7

 No services were provided 8

NO RESPONSE M

IF RESPONSE TO H20= 1-7, THEN ASK H21

H21. Where were these services provided in the 2018-2019 school year? (New)

Select all that apply

 On site at the student’s private school 1

 On site at a public school in the district 2

 At an alternative location (Please specify) 3

NO RESPONSE M

The next set of questions focuses on the access and use of assistive technology (AT) by school-age children with disabilities.

H22. What does your district do to support school use of assistive technology (AT) for school-age children with disabilities? (New)

Select all that apply

 Offer information about AT to families, such as through AT fairs 1

 Provide designated funding to support AT devices and use 2

 Provide a list of AT for students with different challenges to IEP teams for consideration 3

 Require IEP teams to assess the AT needs of individual students 4

 Provide professional development to general education teachers on use of AT 5

 Provide professional development to special education teachers on use of AT 6

 Provide professional development to Specialized Instructional Support Personnel (SISP) on use of AT 7

 Review IEPs to determine the extent of AT use 8

 Monitor use of AT to ensure effective implementation 9

 Hire or contract with AT experts to promote effective implementation strategies 10

 Other (Please specify) 11

NO RESPONSE M

H23. Are school-age children with disabilities allowed to use district- or school-provided AT outside of district buildings and classrooms? (New)

Select one only

 Yes, my district permits all AT devices to be used outside of the district (such as in home or community-based settings) 1

 Yes, my district permits some AT devices to be used outside of the district (such as in home or community-based settings) 2

 No, my district restricts the use of all AT to district buildings and classrooms 0

NO RESPONSE M

H24. Schools and districts provide a variety of services to students with IEPs, either directly or through contracts/arrangements with independent providers. In the past three years, which of the following services were provided or funded by your district for school-age children with disabilities? (Based on items A-21 and A-22, PEELS Early Childhood Program Director Questionnaire Items)

In Column A, please check the services that your district provides directly through staff it employs.

In Column B, please check the services funded by the district, but provided by non-district staff.

In Column C, please check the services that are not currently provided by district or non-district staff.

Select all that apply per row

	A. Services are provided directly by your district staff	B. Services are funded by your district, but provided by non-district staff	C. Services are not provided or funded by your district
a. Assistive Technology	1 	2 	3 
b. Audiology	1 	2 	3 
c. Applied behavior analysis	1 	2 	3 
d. Other behavior management services	1 	2 	3 
e. Orientation and mobility support	1 	2 	3 
f. Mental health counseling	1 	2 	3 
g. Diagnostic services/psychological assessments	1 	2 	3 
h. Training for families, parents, or guardians	1 	2 	3 
i. Social work services	1 	2 	3 
j. Other family services	1 	2 	3 
k. Occupational therapy	1 	2 	3 
l. Physical therapy	1 	2 	3 
m. Speech and language therapy	1 	2 	3 
n. Specialized academic instruction	1 	2 	3 
o. Education in a private institution or school		2 	3 

H19. Which three services for school-age children with disabilities did you spend the most money on during the past three years?

(Respondents will be given a list of the items they selected in column A or B above and asked to the select the three that they spent the most on in the past three years).

I. DISCIPLINE AND SAFETY

The next set of questions focuses on your districts’ discipline policies for school-age children with disabilities.

When answering these questions, please assume manifestation determination review has taken place and it’s been determined that the infraction is not due to the student’s disability or the district’s inability to implement the IEP.

I1. Does your district have a zero-tolerance policy? (New)

 Yes 1

 No 0

NO RESPONSE M

IF RESPONSE TO I1=1 THEN ASK I2

I2. Does your district’s zero-tolerance policy differ based on whether a student has a disability? (New)

 Yes, it always differs for students with and without disabilities 1

 Sometimes, it depends on the infraction 2

 No, the policy is the same for all students 0

I3. Does your district have a policy pertaining to suspensions and expulsions? (New)

 Yes 1

 No 0

NO RESPONSE M

IF RESPONSE TO I3=1 THEN ASK I4

I4. Does your district’s policy pertaining to in-school suspensions differ based on whether a student has a disability? (New)

 Yes, it always differs for students with and without disabilities 1

 Sometimes, it depends on the infraction 2

 No, the policy is the same for all students 0

IF RESPONSE TO I3=1 THEN ASK I5

I5. Does your district’s policy pertaining to out-of-school suspensions differ based on whether a student has a disability? (New)

 Yes, it always differs for students with and without disabilities 1

 Sometimes, it depends on the infraction 2

 No, the policy is the same for all students 0

IF RESPONSE TO I3=1 THEN ASK I6

I6. Does your district’s policy pertaining to expulsions differ based on whether a student has a disability? (New)

 Yes, it always differs for students with and without disabilities 1

 Sometimes, it depends on the infraction 2

 No, the policy is the same for all students 0

NO RESPONSE M

IF RESPONSE TO I3=1 THEN ASK I7

I7. For each of the following groups of students, who has the authority to suspend/expel school-age children? (New)

Select all that apply in each row

	Teacher	Assistant principal	Principal	Superintendent	District does not specify who has the authority
a. Elementary school students with disabilities	1 	2 	3 	4 	5 
b. Elementary school students without disabilities	1 	2 	3 	4 	5 
c. Middle school students with disabilities	1 	2 	3 	4 	5 
d. Middle school students without disabilities	1 	2 	3 	4 	5 
e. High school students with disabilities	1 	2 	3 	4 	5 
f. High school students without disabilities	1 	2 	3 	4 	5 

NO RESPONSE M

I8. Does your district have a policy restricting the use of restraints and seclusion in schools? (New)

 Yes 1

 No 0

NO RESPONSE M

IF RESPONSE TO I8=1 THEN ASK I9

I9. Does your district’s policy restricting the use of restraints and seclusion in schools differ based on whether a student has a disability? (New)

 Yes, it always differs for students with and without disabilities 1

 Sometimes, it depends on the infraction 2

 No, the policy is the same for all students 0

I10. Please enter the web address where we may view your district’s discipline policy. (New)

If this information is not available on a website, please check the box below and scan and email a hardcopy to [email protected].

 Information is not available on a website 0

NO RESPONSE M

J. SOCIAL-EMOTIONAL, BEHAVIORAL, AND MENTAL HEALTH SUPPORTS

The next set of questions focuses on the social-emotional, behavioral, and mental health supports provided to school-age children with disabilities.

J1. Which of the following strategies, programs, or curricula does your district recommend to support the positive behavioral development, social-emotional skills, or mental health concerns of school-age children with disabilities? (New)

Select all that apply

 Mental health specialists to work with children needing individualized support 1

 Early warning indicator systems 2

 Trauma-informed curriculum 3

 Multi-Tiered System of Supports (MTSS) 4

 School-wide Positive Behavioral Intervention and Supports 5

 Applied behavior analysis (ABA), including pivotal response training (PRT) and discrete trials 6

 Functional behavior assessment (FBA) and Behavioral Intervention Plans (BIPS) 7

 Center on the Social and Emotional Foundations for Early Learning (CSEFEL) training modules 8

 Pyramid Model for Supporting Social Emotional Competence 9

 Calm Classroom 10

 First Step to Success 11

 Incredible Years 12

 Lions Quest 13

 Mandt System 14

 Positive Action 15

 Promoting Alternative Thinking Strategies (PATHS) 16

 Second Step 17

 Tools of the Mind 18

 Nonviolent Crisis Intervention Training 19

 Other (Please specify) 20

NO RESPONSE M

IF RESPONSE TO J1=1 through 16 THEN ASK J2

J2. Which of the following types of support does your district provide to teachers who are using positive behavioral development/social-emotional skills curricula with school-age children with disabilities? (EPSEP PreK district coordinator survey)

Select all that apply

 Training to learn new curricula (such as workshops, institutes, or online modules) 1

 Ongoing individualized support to classroom teachers (such as consultation, coaching, or mentoring) for implementing curricula or interventions 2

 Ongoing group support (in the form of special education department meetings or community of practice/professional learning communities) for implementing curricula or interventions 3

 Release time to attend conferences and workshops outside of school 4

 Other types of support for implementing curricula (Please specify) 5

 Not applicable, my district does not provide support for implementing curricula N

NO RESPONSE M

J3. Has your district developed formal agreements with other agencies or entities to provide mental health and/or social-emotional supports for school-age children with disabilities? (New)

 Yes 1

 No 0

NO RESPONSE M

IF RESPONSE TO J3=1 THEN ASK J4

J4. Which agencies or entities has your district developed formal agreements with to provide direct mental health and/or social-emotional supports for school-age children with disabilities? (New)

Select all that apply

 Behavioral/Mental health agency 1

 Court system 2

 Developmental disabilities agency 3

 Health agency 4

 Local or state disability advocacy groups 5

 Private therapists or therapy organizations (e.g., trauma-informed therapists, applied behavior analysis providers) 6

 Social services 7

 Other (Please specify) 8

NO RESPONSE M

K. FUNDING ALLOCATION

Questions in this section focus on the funding of services and supports for school-age children with disabilities.

K1. What funding sources support services for school-age children with disabilities, as required by their IEPs? (Q20, 2009 IDEA-NAIS State Part C Questionnaire; includes additional response options)

In Column A, please select any funding sources that support school-age children with disabilities.

In Column B, please write in the space provided a “1” for the source that provides the largest sharing of funding, a “2” for the source that provides the next largest share of funding, and a “3” for the third largest funding source.

	A. Used to support school-age children with disabilities Select all that apply	B. Rank 1, 2, and 3 by share of funding. Use each number only once.
a. IDEA, Part B	1 □	| |
b. General education funds	2 □	| |
c. State education funds	3 □	| |
d. Local municipality or county funds	4 □	| |
e. Children with Special Health Care Needs/Title V	5 □	| |
f. Medicaid/Title XIX	6 □	| |
g. Private insurance	7 □	| |
h. State Children’s Health Insurance Program (SCHIP)	8 □	| |
i.    Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)	9 □	| |
j.      Temporary Assistance for Needy Families (TANF)	10 □	| |
k.     TRICARE (formerly CHAMPUS, Civilian Health and Medical Program of the Uniformed Services)	11 □	| |
l. Other federal funding sources (Please specify)	12 □	| |
m. Other state funding sources (Please specify)	13 □	| |
n. Other local funding sources (Please specify)	14 □	| |

K2. What funding sources do you blend with Part B IDEA funds to support CCEIS or CEIS, for school-age children not yet identified with disabilities? (New)

Coordinated Early Intervening Services (CEIS) are services provided to students in kindergarten through grade 12 who are not currently identified as needing special education or related services, but who need additional academic and behavioral supports to succeed in a general education environment. CEIS can be mandatory (Comprehensive Coordinated Early Intervening Services or CCEIS) or voluntary.

Select all that apply per row

	A.	B.	C.
	Blended with Part B IDEA funds to support CCEIS	Blended with Part B IDEA funds to support voluntary CEIS	Not used to support CCEIS or voluntary CEIS
a. General education funds	1 □	2 □	3 
b. State education funds	1 □	2 □	3 
c. Local municipality or county funds	1 □	2 □	3 
d. Children with Special Health Care Needs/Title V	1 □	2 □	3 
e. Medicaid/Title XIX	1 □	2 □	3 
f. Private insurance	1 □	2 □	3 
g. State Children’s Health Insurance Program (SCHIP)	1 □	2 □	3 
h.    Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)	1 □	2 □	3 
i.      Temporary Assistance for Needy Families (TANF)	1 □	2 □	3 
j.     TRICARE (formerly CHAMPUS, Civilian Health and Medical Program of the Uniformed Services)	1 □	2 □	3 
k. Other federal funding sources (Please specify)	1 □	2 □	3 
_______________________________________
l. Other state funding sources (Please specify)	1 □	2 □	3 
_______________________________________
m. Other local funding sources (Please specify)	1 □	2 □	3 

K3. In your district, how are training and implementation of Multi-Tier Systems of Support (MTSS) including RtI, currently being funded? (Q12 and Q13, 2009 IDEA-NAIS District Questionnaire; format revised and response options updated with current language)

In Column A, please select any funding sources that support training and implementation of MTSS.

In Column B, please write in the space provided a “1” for the source that provides the largest sharing of funding, a “2” for the source that provides the next largest share of funding, and a “3” for the third largest funding source.

	A.	B.
	Used to fund training and implementation of MTSS or RtI Select all that apply	Rank 1, 2, and 3 by share of funding. Use each number only once.
a. Title I-A School-wide or Targeted Assistance funds	1 □	| |
b. Title I-B Reading First funds	2 □	| |
c. Title II-A funds	3 □	| |
d. Title III funds	4 □	| |
e. Title V grants for innovation	5 □	| |
f. IDEA Early Intervening Services (EIS) funds	6 □	| |
g. IDEA Part B flow-through funds, other than funds used for EIS	7 □	| |
h. IDEA district discretionary funds, other than funds used for EIS	8 □	| |
i. IDEA state discretionary funds	9 □	| |
j. District General funds	10 □	| |
k. Other federal funding source(s) (Please specify)	11 □	| |

K4. For school-age children with IEPs, what are Medicaid funds used to support? (New)

Select all that apply

 Disability screening and diagnosis 1

 Case management and referrals to services 2

 Outreach and facilitating eligibility determinations for Medicaid 3

 Equipment and assistive technologies 4

 Transportation services 5

 Mental and behavioral health services 6

 Occupational therapy 7

 Personal aide services 8

 Physical therapy 9

 Speech therapy 10

 Other (Please specify) 11

NO RESPONSE M

K5. For school-age children with IEPs, what are general education funds used to support? (New)

Select all that apply

 Disability screening and diagnosis 1

 Case management and referrals to services 2

 Outreach and facilitating eligibility determinations for Medicaid 3

 Equipment and assistive technologies 4

 Transportation services 5

 Mental and behavioral health services 6

 Occupational therapy 7

 Personal aide services 8

 Physical therapy 9

 Speech therapy 10

 Professional development for administrators 11

 Professional development for guidance counselors 12

 Professional development for paid teacher aides/instructional assistants 13

 Professional development for nursing/medical personnel 14

 Professional development for reading specialists 15

 Professional development for school psychologists or other diagnostic personnel 16

 Professional development for special education resource room teachers 17

 Professional development for speech/communication therapists 18

 Professional development for other related services personnel (such as occupational or physical therapists) 19

 Other (Please specify) 20

 Other (Please specify) 21

 Other (Please specify) 22

NO RESPONSE M

K6. For school-age children with IEPs, what are special education funds used to support?

In Column A, please select any activities that are supported with special education funds.

In Column B, please write in the space provided a “1” for the activity that requires the largest sharing of funding, a “2” for the activity that requires the next largest share of funding, and a “3” for the activity that requires the third largest share of funding.

	A.	B.
	Supported with special education funds Select all that apply	Rank 1, 2, and 3 by share of funding required. Use each number only once.
a. Disability screening and diagnosis	1 □	| |
b. Case management and referrals to services	2 □	| |
c. Outreach and facilitating eligibility determinations for Medicaid	3 □	| |
d. Equipment and assistive technologies	4 □	| |
e. Transportation services	5 □	| |
f. Mental and behavioral health services	6 □	| |
g. Occupational therapy	7 □	| |
h. Personal aide services	8 □	| |
i. Physical therapy	9 □	| |
j. Speech therapy	10 □	| |
k. Professional development for administrators	11 □	| |
l. Professional development for guidance counselors	12 □	| |
m. Professional development for paid teacher aides/instructional assistants	13 □	| |
n. Professional development for nursing/medical personnel	14 □	| |
o. Professional development for reading specialists	15 □	| |
p. Professional development for school psychologists or other diagnostic personnel	16 □	| |
q. Professional development for special education resource room teachers	17 □	| |
r. Professional development for speech/communication therapists	18 □	| |
s. Professional development for other related services personnel (such as occupational or physical therapists)	19 □	| |
t. Other local funding source(s) (Please specify)	20 □	| |
u. Other local funding source(s) (Please specify)	21 □	| |
v. Other local funding source(s) (Please specify)	22 □	| |

K7. Which funding sources are used to support IEP-specified residential placements for school-age children with disabilities? (New)

Select all that apply

 Children with Special Health Care Needs/Title V 1

 General education funds 2

 Local municipality or county funds 3

 IDEA, Part B 4

 Private insurance 5

 Medicaid/Title XIX 6

 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) 7

 State Children’s Health Insurance Program (SCHIP) 8

 State education funds 9

 Temporary Assistance for Needy Families (TANF) 10

 TRICARE (formerly CHAMPUS, Civilian Health and Medical Program of the Uniformed Services) 11

 Other (Please specify) 12

 Other (Please specify) 13

 Other (Please specify) 14

NO RESPONSE M

K8. Which funding sources are used to fund IEP-specified placements of school-age children with disabilities in separate non-public day schools? (New)

Select all that apply

 Children with Special Health Care Needs/Title V 1

 General education funds 2

 Local municipality or county funds 3

 IDEA, Part B 4

 Private insurance 5

 Medicaid/Title XIX 6

 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) 7

 State Children’s Health Insurance Program (SCHIP) 8

 State education funds 9

 Temporary Assistance for Needy Families (TANF) 10

 TRICARE (formerly CHAMPUS, Civilian Health and Medical Program of the Uniformed Services) 11

 Other (Please specify) 12

 Other (Please specify) 13

 Other (Please specify) 14

NO RESPONSE M

K9. What percentage of special education funding for school-age children with disabilities is provided by the following? (New)

	Percentage of special education funding provided
a. Federal Funding Sources	|____|%
b. State Funding Sources	|____|%
c. Local District Funding Sources	|____|%

NO RESPONSE M

K10. In the past three years, has there been a change in the proportion of the district budget provided by state special education funding? (New)

 Yes 1

 No 0

NO RESPONSE M

IF RESPONSE TO K10=1 THEN ASK K11

K11. In the past three years, has the proportion of state funding for special education increased or decreased? (New)

Select one only

 Increased 1

 Decreased 2

NO RESPONSE M

IF RESPONSE TO K10=1, THEN ASK K12

K12. In the past 3 years, what has your district done to reduce the costs of providing special education services for school-age children? (New, some features from Q8-Q9, 2017 IDEA Infant and Toddler Coordinators Association Tipping Points Survey)

Select all that apply

 Changed educational placement or least restrictive environment (LRE) options 1

 Changed processes to reduce administrative costs 2

 Changed use of data management, communication systems, or other technologies to reduce costs 3

 Changed level of contracted services 4

 Changed local municipality, county, or school district funding 5

 Changed policy related to State Children’s Health Insurance Program (SCHIP) billing 6

 Changed use of general state funds 7

 Changed level of administrative staffing 8

 Changed level of general education aide or paraprofessional staffing 9

 Changed level of special education aide or paraprofessional staffing 10

 Changed level of general education teacher staffing 11

 Changed level of special education teacher staffing 12

 Changed level of Specialized Instructional Support Personnel (SISP) staffing 13

 Changed class size 14

 Renegotiated provider reimbursements 15

 Changed the amount of professional development activities 16

 Changed the amount of spending on materials, buildings, or grounds 17

 Other (Please specify) 18

 Other (Please specify) 19

 Other (Please specify) 20

K13. Which of the following methods are used to determine how all special education funding (including federal, state, and local) is allocated to schools that serve children in your district? (New, some features from the National Center for Special Education in Charter Schools report)

Do not include high-cost funds.

Hyperlink definition of high-cost funds will be provided: High-cost funds help offset the financial impact on Local Education Agencies (LEAs) that provide educational services to high-need children with disabilities.

Select all that apply

 A fixed amount per student enrolled, with or without a disability 1

 A fixed amount per student with disabilities enrolled, regardless of disability type 2

 Pre-determined amounts per student with disabilities enrolled, depending on disability category 3

 Pre-determined amounts per student with disabilities enrolled, depending on type of student placement 4

 Pre-determined amounts per student with disabilities enrolled, depending on specific services required 5

 Pre-determined amounts per teacher, supportive services staff position, or other resource required given the number of students with disabilities 6

 A formula based on the amount of specific allowable special education expenses actually incurred (e.g. full reimbursement or percentage reimbursements) 7

 Other (Please specify) 8

 None of the above, funding to support special education is not separated out from the general education funding formula 9

 None of the above, only one school in the district serves school-age children with disabilities 10

 None of the above, no funds go directly to the school 11

NO RESPONSE M

K14. How are Part B special education program funds used to support direct service personnel (such as special education teachers, paraprofessionals, and related services providers) who serve school-age children with disabilities within your district? (New)

Select all that apply

 To fund their salaries 1

 To fund their benefits 2

 To provide professional development 3

 Other (Please specify) 4

 None of the above 5

K15. How are Part B special education program funds used to support administrators and administrative support staff (including clerical, data, accounting, and Medicaid billing personnel) who serve school-age children with disabilities in your district? (New)

Select all that apply

 To fund their salaries 1

 To fund their benefits 2

 To provide professional development 3

 Other (Please specify) 4

 None of the above 5

K16. Are Part B special education program funds used to support the salaries, benefits, or contracts of any of the following personnel who serve school-age children with disabilities in your district? (New)

Select all that apply

 Guidance counselors 1

 Nursing/medical personnel 2

 Paraprofessionals, such as teacher aides/instructional assistants, occupational therapy assistants, personal aides, or health aides 3

 Reading specialists 4

 School psychologists or other diagnostic personnel 5

 Special education teachers, including itinerant teachers or coaches 6

 Speech/communication therapists or pathologists 7

 Other related services personnel (e.g., occupational or physical therapists) 8

 Other (Please specify) 9

 None of the above 10

K17. Are Part B special education program funds used to provide any of the following direct services for school-age children with disabilities in your district? (New)

Select all that apply

 Special education or related services provided directly by the district 1

 Special education or related services provided through contracted services 2

 Contracted student placements outside of the school district 3

 Other (Please specify) 4

 None of the above 0

K18. Are Part B special education program funds used for any of the following supplies, equipment, or facilities modifications for school-age children with disabilities in your district? (New)

Select all that apply

 Provide assistive technology or specialized equipment 1

 Maintain, repair, manage, and upgrade assistive technology or specialized equipment 2

 Make modifications to facilities to meet the unique needs of school-age children with disabilities 3

 Provide instructional materials, specialized curriculum, or instructional software 4

 Provide non-instructional software, supplies, and equipment 5

 Other (Please specify) 6

 None of the above 0

L. STAFFING

Questions in this section focus on the hiring and retention of special education teachers and other personnel.

L1. What do you consider when assigning specialized instructional support personnel (SISP), or non-teaching staff, to schools to work with students with disabilities? (New)

Select all that apply

 Level of effort required based on IEPs of students in the school 1

 Number of students in the school needing service 2

 Distance from another school 3

 Prior experience with the school staff 4

 Tenure 5

 Other (Please specify) 6

NO RESPONSE M

L2. School districts may employ a variety of personnel who work with school-age children with disabilities, either directly or through contracts with independent providers. (Based on item A-23, PEELS Early Childhood Program Director Questionnaire)

In Column A, please indicate which personnel who work with school-age children with disabilities are employed directly by your district.

In Column B, please indicate which personnel who work with school-age children with disabilities are employed through contracts with outside providers.

Select all that apply per row

	A. Personnel employed directly by district	B. Personnel employed through contracts with outside providers
a. Audiologists	1 	2 
b. Behavioral analysts or experts	1 	2 
c. Family therapists	1 	2 
d. Nurses	1 	2 
e. Pediatricians and other physicians	1 	2 
f. Physical therapists	1 	2 
g. Psychologists	1 	2 
h. Occupational therapists	1 	2 
i. Orientation/mobility specialists	1 	2 
j. Registered dieticians	1 	2 
k. Service coordinators	1 	2 
l. Speech/language therapists/pathologists	1 	2 
m. Social workers	1 	2 
n. Teacher aides, paraprofessionals, or personal care assistants	1 	2 
o. Transition specialists	1 	2 
p. Vision specialists, including ophthalmologists and optometrists	1 	2 
q. Sign language interpreters	1 	2 
r. Other (Please specify)	1 	2 

L3. Please indicate the types of effective special education personnel who work with school-age children that your district has had difficulty finding and retaining during the current (2019-2020) or preceding two school years (2017-2018 and 2018-2019). (Q26, 2009 IDEA-NAIS District Questionnaire, with response options added for related services personnel [based on Q44, 2009 IDEA-NAIS State Part C Questionnaire], bilingual staff, and a column added to gather data about staff retention)

Select all that apply per row

		Difficulty finding personnel	Difficulty retaining personnel	No difficulty finding or retaining personnel
a. Special education teachers who serve children in:
	1. Elementary school	1 	2 	0 
	2. Middle school	1 	2 	0 
	3. High school	1 	2 	0 
	4. Vocational or alternative school	1 	2 	0 
b. Special education teachers who primarily serve children with:
	1. Developmental delays	1 	2 	0 
	2. Specific learning disabilities	1 	2 	0 
	3. Emotional disturbance/behavior disorders	1 	2 	0 
	4. Intellectual disability	1 	2 	0 
	5. Autism	1 	2 	0 
	6. Speech or language impairment	1 	2 	0 
	7. Traumatic brain injury	1 	2 	0 
	8. Sensory impairments (hearing/vision)	1 	2 	0 
	9. Other low-incidence disabilities (e.g., other health impairments, orthopedic impairments, or multiple disabilities)	1 	2 	0 
	10. Other disability (Please specify) ________________________	1 	2 	0 
c. Secondary school special education teachers of:
	1. English/Language Arts	1 	2 	0 
	2. Mathematics	1 	2 	0 
	3. Science	1 	2 	0 
	4. Social Studies (including history, civics, geography and economics)	1 	2 	0 
	5. Other subjects (Please specify) ________________________	1 	2 	0 
d. Specialized instructional support personnel (SISP):
	1. Audiologists	1 	2 	0 
	2. Behavioral analysts or experts	1 	2 	0 
	3. Family therapists/mental health providers	1 	2 	0 
	4. Nurses	1 	2 	0 
	5. Pediatricians and other physicians	1 	2 	0 
	6. Physical therapists	1 	2 	0 
	7. Psychologists	1 	2 	0 
	8. Occupational therapists	1 	2 	0 
	9. Orientation/mobility specialists	1 	2 	0 
	10. Registered dieticians	1 	2 	0 
	11. Service coordinators	1 	2 	0 
	12. Speech/language therapists/pathologists	1 	2 	0 
	13. Social workers	1 	2 	0 
	14. Teacher aides, paraprofessionals, or personal care assistants	1 	2 	0 
	15. Transition specialists	1 	2 	0 
	16. Vision specialists, including ophthalmologists and optometrists	1 	2 	0 
	17. Sign language interpreters	1 	2 	0 
e. Bilingual staff		1 	2 	0 
f. Other staff (Please specify)		1 	2 	0 

NO RESPONSE M

L4. During the current (2019-2020) or preceding two school years (2017-2018 and 2018-2019), what strategies has your district used to increase the number of effective special education teachers? (Based on Q30, 2009 IDEA-NAIS State Part B 619 Questionnaire and Q33, 2009 IDEA-NAIS District Questionnaire)

Select all that apply

 Collaborated with universities to develop programs and curricula to prepare teachers in specific shortage areas 1

 Paid fees for tests/licensure exams 2

 Paid for tutoring to prepare teachers for certification tests/licensure exams 3

 Provided free or subsidized training for secondary school teachers to obtain special education credentials 4

 Provided free or subsidized training for special education teachers to obtain content area credentials 5

 Provided time or funding for teachers to participate in professional development opportunities (for example, institute of higher education tuition, workshop fees) 6

 Supported participation in dual certification preparation programs 7

 Other (Please specify) 8

 None of the above 9

 Not applicable N

NO RESPONSE M

L5. Which supports or incentives did your district use to recruit new special education teachers for the 2019-2020 school year? (Q27, 2009 IDEA-NAIS District Questionnaire)

Select all that apply

 A signing bonus 1

 A bonus supplement to regular compensation 2

 A permanent salary augmentation or adjustment to normal base salary 3

 Placement of a teacher on a higher step of the salary schedule 4

 Relocation assistance 5

 Payoff of student loans 6

 Finder’s fee to existing staff for new teacher referrals 7

 Mentoring or induction programs 8

 Other (Please specify) 9

 None of the above 10

NO RESPONSE M

IF RESPONSE TO ANY ROW IN L3=2, THEN ASK L6

L6. During the current (2019-2020) or preceding two school years (2017-2018 and 2018-2019), what initiatives or incentives has your district used to retain effective educators? (New)

Hyperlink definition of pay back will be provided: For every year of tuition, educators owe the district a year of service.

Select all that apply

 Cover continuing education costs to get a higher degree 1

 Cover continuing education costs to maintain certification 2

 Provide mentoring or induction programs 3

 Offer full time teaching positions 4

 Offer part time teaching positions 5

 Provide additional planning or release time 6

 Provide smaller caseloads 7

 Provide smaller class sizes 8

 Offer student loan forgiveness 9

 Offer tuition “pay back” or partial reimbursement 10

 Other (Please specify) 11

 None of the above 12

NO RESPONSE M

M. EVIDENCE FROM RESEARCH

This final section focuses on the use of evidence from research.

M1. Does your district provide guidance on acceptable evidence-based policies, procedures, and practices that schools should use to provide services to students with disabilities? (New)

 Yes 1

 No 0

NO RESPONSE M

IF RESPONSE TO M1=1 THEN ASK M2

M2. How does your district help ensure that schools use evidence-based special education programs and services? (New)

Hyperlink definition of Tier 1 to Tier 4 will be provided: Tier 1 – Strong Evidence: supported by one or more well-designed and well-implemented randomized control experimental studies. Tier 2 – Moderate Evidence: supported by one or more well-designed and well-implemented quasi-experimental studies. Tier 3 – Promising Evidence: supported by one or more well-designed and well-implemented correlational studies (with statistical controls for selection bias). Tier 4 – Demonstrates a Rationale: practices that have a well-defined logic model or theory of action, are supported by research, and have some effort underway by an SEA, LEA, or outside research organization to determine their effectiveness

Select all that apply

 We provide a curated list of suggested evidence-based policies, procedures, and practices 1

 We require that schools only purchase materials and programs from a curated list of suggested evidence-based policies, procedures, and practices 2

 We conduct a formal review of the materials and programs used by schools to make sure they are evidence-based 3

 We recommend materials based on the level of evidence of their effectiveness (Tier 1 to Tier 4, under ESSA), specifically for children with disabilities 4

 Other (Please specify) 5

NO RESPONSE M

M3. How often does your district draw on the following sources of information when selecting special education policies and practices? (Based on Title 1/II Implementation Surveys)

Select one only per row

		Never or Not Applicable	Rarely	Sometimes	Often		Don’t know
a. Guidance or advice from the state education department or a technical assistance center funded by the state		1 	2 	3 	4 		5 
b. A list of vendors approved by the state		1 	2 	3 	4 		5 
c. Information provided by the intervention’s developer or vendor		1 	2 	3 	4 		5 
d. Recommendations from colleagues in my own or other school districts		1 	2 	3 	4 		5 
e. Information from a federally-funded technical assistance center		1 	2 	3 	4 		5 
f. Information from a U.S. Department of Education Comprehensive Center		1 	2 	3 	4 		5 
g. Information from a U.S. Department of Education Regional Educational Laboratory (REL)		1 	2 	3 	4 		5 
h. Information from the U.S. Department of Education’s What Works Clearinghouse		1 	2 	3 	4 		5 
i. Information from the district’s research/evaluation office		1 	2 	3 	4 		5 
j. Information from professional associations		1 	2 	3 	4 		5 
k. Information from a college/university researcher		1 	2 	3 	4 		5 
l. Information from a research journal		1 	2 	3 	4 		5 
m. Social media (Twitter, Facebook, Pinterest, other)		1 	2 	3 	4 		5 
n. Other (Please specify)		1 	2 	3 	4 		5 

NO RESPONSE M

Thank you for taking the time to complete this survey.

If other staff provided answers to questions in this survey, please indicate their names and positions below, and the relevant survey sections.

Name/Position/Sections

Name/Position/Sections

Name/Position/Sections