Education Stabilization Fund -- Emergency Assistance for Non-Public Schools (EANS) Program Recipient Annual Reporting Data Collection Form

Conducted by: OMB No. XXXX-XXXX Expires XX/XX/20XX

U.S. Department of Education

Education Stabilization Fund - Emergency Assistance to Non-Public Schools

(EANS) Program Recipient Annual Reporting Data Collection Form

Final Version: TBD

Emergency Assistance to Non-Public Schools Annual Reporting Form

State: _____<auto fill from G5>_____________

CRRSAA EANS PR/Award number: ___<auto fill from G5>___________

ARP EANS PR/Award number: ___<auto fill from G5>___________

State Director: _<auto fill from G5>__________

Position: ___<auto fill from G5>___________ (editable)

Office:_ ___<auto fill from G5>___________ (editable)

Telephone:_ ___<auto fill from G5>___________ (editable)

E-mail Address: ___<auto fill from G5>_________

Instructions: States that received Emergency Assistance to Non-Public Schools (EANS) program funds as authorized by the Coronavirus Response and Relief Supplemental Appropriations Act, 2021 (CRRSA Act) and the American Rescue Plan Act of 2021 (ARP Act) shall complete the annual EANS program reporting requirements. Please answer all questions based on the reporting period shown in the Annual Reporting table below.

Definitions

ARP Act - American Rescue Plan Act of 2021

ARP EANS - American Rescue Plan Emergency Assistance to Non-Public Schools

CRRSAA or CRRSA Act - Coronavirus Response and Relief Supplemental Appropriations Act, 2021

EANS - Emergency Assistance to Non-Public Schools

EANS Administrative Reserve - funds to administer the services and assistance provided under the program to non-public schools

ESSER I - Elementary and Secondary School Emergency Relief fund authorized under the Coronavirus Aid Relief, and Economic Security (CARES) Act

ESSER II - Elementary and Secondary School Emergency Relief fund authorized under the Coronavirus

Response and Relief Supplemental Appropriations (CRRSA) Act

GEER I- Governor’s Emergency Education Relief fund authorized under the Coronavirus Aid Relief, and Economic Security (CARES) Act

GEER II- Governor’s Emergency Education Relief fund authorized under the Coronavirus Response and Relief Supplemental Appropriations Act, 2021 (CRRSA Act)

G5 - U.S. Department of Education’s grants management and payment system

SEA - State Educational Agency

Subaward - award made by an SEA to a subrecipient for the subrecipient to carry out part of the EANS program. A subaward may be provided through any form of legal agreement, including an agreement that the SEA considers a contract

Obligation - a binding written commitment to obtain the services, work, or products. For rental or lease of real or personal property, the obligation is made when the property is first used. The regulations at 34 C.F.R. § 76.707 govern when an obligation of Federal funds by an SEA occurs.

Reimbursed - amounts provided as reimbursement to a non-public school for allowable costs incurred by the non-public school.

Annual Reporting: This report should be completed based on activities in the applicable reporting periods for EANS.

Annual Report	Due Date	Applicable Reporting Period
First Annual Report	Early 2022	Award Date- September 30, 2021
Second Annual Report	Early 2023	October 1, 2021- September 30, 2022
Third Annual Report
	Early 2024	October 1, 2022- September 30, 2023

Section I: SEA Grant, Obligation, and Expenditure Amounts by Program

1. Report the total amount of federal funds obligated within the applicable reporting period. This includes obligations of funds for services or assistance provided through a contract.

	CRRSA EANS Program	ARP EANS Program
1a. The total grant amount allocated to the State educational agency (SEA)	<auto fill from G5>	<auto fill from G5>
1b. The total amount obligated by the SEA
1c. The total amount of the grant expended	<auto fill from G5>	<auto fill from G5>

Section II: CRRSA EANS Funds Returned to the Governor

2. Was the SEA required to return any unobligated CRRSA EANS funds to the Governor for authorized uses under the Governor's Emergency Education Relief Fund II (GEER II)? (Yes/No)  If “Yes”, provide the total amount returned  $_________ 

2b. If yes, which types of entities within the State were awarded the returned CRRSA EANS funds?

Entity Type	Returned EANS Funds
Local Educational Agencies (LEAs)	Yes/ No
Institutions of Higher Education (IHEs)	Yes/No
Other Education-Related Entities	Yes/No

<skip logic; if ‘yes’ for ‘LEAs’, then provide responses for question 3>

<skip logic; if yes for ‘IHE’, then provide response for question 4>

<skip logic; if yes for ‘Other Education-Related Entities’, then provide response for question 5>

3. What were the amounts of the State’s returned CRRSA EANS funds awarded to LEAs and expended by LEAs?

	Amount of returned EANS Funds
Total amount of returned CRRSA EANS funds awarded to LEAs
Total amount of returned CRRSA EANS funds expended by LEAs

3b. For what purposes did LEAs use returned CRRSA EANS funds? Select the purposes for which the returned CRRSA EANS funds were expended by the LEAs:

(select Yes or No for each purpose).

1. Purchasing educational technology (including hardware, software, and connectivity), which may include assistive technology or adaptive equipment. (Yes/No)

2. Activities focused specifically to addressing the unique needs of low-income children or students, children with disabilities, English learners, racial and ethnic minorities, students experiencing homelessness, and foster care youth. (Yes/No)

3. Providing mental health services and supports. (Yes/No)

4. Implementing science-based strategies to prevent the spread of COVID-19 consistent with recommendations from the Centers for Disease Control and Prevention (CDC). (Yes/No)

5. . Extended learning time opportunities, including tutoring, summer learning, and supplemental afterschool programs (Yes/No)

6. Other (Yes/No), if yes, please specify:_________________________________

4. What were the amounts of the State’s returned CRRSA EANS funds awarded to IHEs and expended by IHEs?

	Amount of returned EANS Funds
Total amount of returned CRRSA EANS funds awarded to IHEs
Total amount of returned CRRSA EANS funds expended by IHEs

4b. For what purposes did IHEs use returned CRRSA EANS funds? Select the purposes for which the funds were expended by the IHEs (select Yes or No for each purpose)

1. Provide direct financial support of students (e.g., scholarships) (Yes/No)

2. Support distance learning and remote education (Yes/No)

3. Implementing science-based strategies to prevent the spread of COVID-19 consistent with recommendations from the Centers for Disease Control and Prevention (CDC) (Yes/No)Address impact of lost instructional time (Yes/No)

4. Other (Yes/No), if yes, please specify: ___________________________

5. What were the amounts of the State’s returned CRRSA EANS funds awarded to other education-related entities and expended by the entities?

	Amount of returned EANS Funds
Total amount of returned CRRSA EANS funds awarded to other education-related entities
Total amount of returned CRRSA EANS funds expended by other education-related entities

5b. Select the purposes for which the funds were expended by the other education-related entities

1. Support distance learning and remote education (Yes/No)

2. Implementing science-based strategies to prevent the spread of COVID-19 consistent with recommendations from the Centers for Disease Control and Prevention (CDC) (Yes/No)Address impact of lost instructional time (Yes/No)

3. Other services or assistance for early childhood programs (Yes/No)

4. Other services or assistance for public elementary and secondary schools (Yes/No)

5. Other services or assistance for non-public elementary and secondary schools (Yes/No)

6. Other services or assistance for postsecondary education (Yes/No)

7. Other (Yes/No), if yes, please specify: ___________________

Section III: CRRSA SEA EANS Administrative Reserve and SEA determination for services or assistance provided to non-public schools

6. EANS, ESSER I, and ESSER II, as well as GEER I and GEER II if administered by the SEA, are programs under which administrative funds may be consolidated. Did the SEA consolidate its administrative funds under the CRRSA EANS with other programs’ administrative funds? (select one) (Yes/No)

6. What was the total amount of funds reserved by the SEA to administer services and assistance under the EANS program provided through the CRRSA Act ______________ (This amount may not exceed the greater of $200,000 or one-half of 1 percent of the total grant award to administer the services and assistance provided to non-public schools.)

6. What data did the SEA request from non-public schools in the application for schools to apply for services or assistance under the EANS program through the CRRSA Act regarding the number and percentage of students from low-income families enrolled in the non-public school in the 2019–2020 school year? Indicate “yes” or “no” for each data element(s) requested by the SEA.

1. free or reduced-priced lunch data (Yes/No)

2. scholarship or financial assistance data that identifies students whose family income does not

exceed 185 percent of the 2020 Federal poverty guidelines. (Yes/No)

3. E-Rate data (Yes/No)

4. data that the non-public school has provided to the State for purposes of State or local programs that identifies students whose family income does not exceed 185 percent of the 2020 Federal poverty guidelines (Yes/No)

5. other data (Yes/No). If yes, please describe ___________________

6. What factors did the SEA consider in prioritizing non-public schools to receive services or assistance under the EANS program through the CRRSA Act? Please select “yes” or “no” for each factor used.

1. rate of community infection (Yes/No)

2. number of COVID-19-related deaths per capita (Yes/No)

3. loss of tuition revenue due to decrease in enrollment (Yes/No)

4. lack of capacity to provide remote learning due to insufficient technological support (Yes/No)

5. data documenting the extent of learning loss or the social, emotional, or mental health impact attributable to the disruption of instruction caused by COVID-19. (Yes/No)

6. other (Yes/No). If yes, please describe ______________

Section IV: ARP SEA EANS Administrative Reserve and SEA determination for services or assistance provided to non-public schools

If the SEA was awarded ARP EANS funding on or after September 30, 2021, then no responses will be required for ARP EANS sections on this report during this reporting period (e.g., additional questions in Section III, Section IV, Section VI, and ARP fields in Section VII)

10. Did the SEA consolidate its administrative funds under the ARP EANS program with other programs’ administrative funds? (select one response) (Yes/No)

10. What was the total amount of funds reserved by the SEA to administer services and assistance under the EANS program provided through the ARP Act? ______________ (This amount may not exceed the greater of $200,000 or one-half of 1 percent of the total grant award to administer the services and assistance provided to non-public schools.)

Section V: SEA Obligations (including reimbursements) by allowable activity for CRRSA EANS

10. Provide the total amounts of SEA obligated (including reimbursements) by allowable activity for services or assistance to non-public schools under the CRRSA EANS program within the reporting period. SEAs that obligated CRRSA EANS funds to one or more entities are expected to report obligations amounts by allowable activity.

EANS Allowable Activity (CRRSAA)	Total amount obligated for services or assistance to schools for allowable activity
Supplies to sanitize, disinfect, and clean school facilities
Personal protective equipment (PPE)
Improving ventilation systems, including windows or portable air purification systems (Note: reimbursements can only be made for portable air purification systems)
Training and professional development for staff on sanitization, the use of PPE, and minimizing the spread of infectious diseases
Physical barriers to facilitate social distancing
Other materials, supplies, or equipment recommended by the CDC for reopening and operation of school facilities to effectively maintain health and safety
Expanding capacity to administer coronavirus testing to effectively monitor and suppress the virus
Educational technology (including hardware, software, connectivity, assistive technology, and adaptive equipment) to assist students, educators, and other staff with remote or hybrid learning
Redeveloping instructional plans, including curriculum development, for remote or hybrid learning, or to address learning loss
Leasing sites or spaces to ensure safe social distancing
Reasonable transportation costs
Initiating and maintaining education and support services or assistance for remote or hybrid learning or to address learning loss
TOTAL	<Auto-sum>

Section VI: SEA Obligations (including reimbursements) by allowable activity for ARP EANS

10. Provide the total amounts of SEA obligated funds by allowable activity for services or assistance to non-public schools under the ARP EANS program within the reporting period. SEAs that obligated ARP EANS funds to one or more entities are expected to report obligations amounts by allowable activity.

EANS Allowable Activity (ARP)	Total amount obligated for services or assistance to schools for allowable activity
Supplies to sanitize, disinfect, and clean school facilities
Personal protective equipment (PPE)
Improving ventilation systems, including windows or portable air purification systems (Note: reimbursements can only me made for portable air purification systems)
Training and professional development for staff on sanitization, the use of PPE, and minimizing the spread of infectious diseases
Physical barriers to facilitate social distancing
Other materials, supplies, or equipment recommended by the CDC for reopening and operation of school facilities to effectively maintain health and safety
Expanding capacity to administer coronavirus testing to effectively monitor and suppress the virus
Educational technology (including hardware, software, connectivity, assistive technology, and adaptive equipment) to assist students, educators, and other staff with remote or hybrid learning
Redeveloping instructional plans, including curriculum development, for remote or hybrid learning, or to address learning loss
Leasing sites or spaces to ensure safe social distancing
Reasonable transportation costs
Initiating and maintaining education and support services or assistance for remote or hybrid learning or to address learning loss
TOTAL	<Auto-sum>

Section VII. Non-public schools receiving services or assistance under CRRSA EANS

Instructions: Provide the following information for the non-public schools in the State receiving services or assistance under the CRRSA EANS program within the reporting period.

10. List the non-public schools that received services or assistance under the CRRSA EANS program within the State.

Name of the non-public school

…

10. How many non-public schools received services or assistance under the CRRSA EANS program within the State? __________

10. What was the total number of non-public schools that served elementary school students and received services or assistance under the CRRSA EANS program? ___________

10. What was the total number of non-public schools that served secondary school students and received services or assistance under the CRRSA EANS program? ___________

10. What was the total student enrollment within all the non-public schools that received services or assistance under the CRRSA EANS program? _____________

10. What was the total number of students from low-income families (total low-income student enrollment) enrolled in all the non-public schools that received services or assistance under the CRRSA EANS program? ___________

10. Provide the following information regarding the population of students from low-income families served within non-public schools that received services or assistance under the CRRSA EANS program:

Percentage of students from low-income families within a non-public school	Number of non-public schools that received services or assistance under the CRRSA EANS program
0%-10%
11%-20%
21%-30%
31%-40%
41%-50%
51%-60%
61%-70%
71%-80%
81%-90%
91%-100%

Section VIII. Non-public schools receiving services or assistance under ARP EANS

Instructions: Provide the following information for the non-public schools in the State receiving services or assistance under the ARP EANS program within the reporting period.

10. List the non-public schools that received services or assistance under the ARP EANS program within the State.

Name of the non-public school

…

10. How many non-public schools received services or assistance under the ARP EANS program within the State? ___________

10. What was the total number of non-public schools that served elementary school students and received services or assistance under the ARP EANS program? ___________

10. What was the total number of non-public schools that served secondary school students and received services or assistance under the ARP EANS program? ___________

10. What was the total student enrollment within the non-public schools that received services or assistance under the ARP EANS program? _____________

10. What was the total number of students from low-income families (total low-income student enrollment) enrolled in the non-public schools that received services or assistance under the ARP EANS program? ___________

10. Provide the following information regarding the population of students from low-income families served within non-public schools that received services or assistance under the ARP EANS program:

Percentage of students from low-income families within a non-public school	Number of non-public schools that received services or assistance under the ARP EANS program
0%-10%
11%-20%
21%-30%
31%-40%
41%-50%
51%-60%
61%-70%
71%-80%
81%-90%
91%-100%

Section IX. Subawards/Subcontracts

28. Instructions: Provide the following information for each entity that received a subaward or subcontract to provide services or assistance to participating non-public schools in the State under the CRRSA and ARP EANS program provided by the SEA.

Sub-awardee/Subcontract Entity Name	DUNS #	SAM #	Total amount award/contract ed from CRRSA EANS funding	Total amount obligated from CRRSA EANS funding	Number of non-public schools served with CRRSA funding through subaward	Total amount awarded from ARP EANS funding	Total amount obligated from ARP EANS funding	Number of non-public schools served with ARP EANS funding through subaward ng	What services or assistance were or will be provided by the entity to non-public schools? Select corresponding letters from the categories below *

a. Supplies to sanitize, disinfect, and clean school facilities

b. Supplying personal protective equipment (PPE)

c. Improving ventilation systems, including windows or portable air purification systems

d. Training and professional development for staff on sanitization, the use of PPE, and minimizing the spread of infectious diseases

e. Providing physical barriers to facilitate social distancing

f. Providing other materials, supplies, or equipment to implement public health protocols, including guidelines and recommendations from the Centers for Disease Control and Prevention for the reopening and operation of school facilities to effectively maintain the health and safety of students, educators, and other staff during the qualifying

emergency

g. Expanding capacity to administer coronavirus testing to effectively monitor and suppress coronavirus, to conduct surveillance and contact tracing activities, and to support other activities related to coronavirus testing for students, teachers, and staff at the non-public school;

h. Providing educational technology (including hardware, software, connectivity, assistive technology, and adaptive equipment) to assist students, educators, and other staff with remote or hybrid learning

i. Redeveloping instructional plans, including curriculum development, for remote or hybrid learning, or to address learning loss

j. Leasing of sites or spaces to ensure safe social distancing to implement public health protocols, including guidelines and recommendations from the Centers for Disease Control and Prevention;

k. Reasonable transportation costs

l. Initiating and maintaining education and support services or assistance for remote or hybrid learning or to address learning loss

m. Administration of the EANS program (e.g., reviewing applications, processing awards, etc.)

Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 1810-XXXX. Public reporting burden for this collection of information is estimated to average 4 hours 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. Under the PRA, participants are required to respond to this collection to obtain or retain a benefit. If you have any comments concerning the accuracy of the time estimate, suggestions for improving this individual collection, or if you have comments or concerns regarding the status of your individual form, please contact Joanne Bogart, US. Department of Education, 400 Maryland Avenue, SW, Washington, DC 20202.

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