2015–16 Community Impact Application Instructions
for State Special Education Award
Overview:
The 2007 Legislature approved a category of state funded safety net awards for districts that
draw a larger number of families with children in need of special education services. The State
Safety Net Oversight Committee shall consider requests for awards from districts that
convincingly demonstrate extraordinary costs associated with identifiable and quantifiable
community factor(s). Applications should demonstrate the unique combination of extraordinary
demographic, environmental, sociological or other factors that influence a disproportional
representation of students with disabilities and their families within a school district.
Purpose:
The purpose of the application is to allow the applicant district(s) to isolate and quantify those
factors in order to convincingly demonstrate to the State Safety Net Oversight Committee an
adverse documentable fiscal impact upon the district’s Special Education Program.
Award Availability:
State Safety Net awards shall be available to school districts with a convincing demonstration of
need caused by an identified community impact fact. Financial need must exceed available
revenue and not be attributable to district philosophy, service delivery choice, or accounting
practices.
Process:
There are three steps associated with this type of Safety Net Application.
STEP ONE: Identify, in narrative format, the demographic, environmental, sociological or other
factor(s) that supports the district’s assertion that for the 2015–16 school year the district is
adversely financially impacted by the presence of such factor(s). Examples of demographic,
environmental, sociological or other factors include, but are not limited to: state placements,
medical facilities, colleges and universities, military installations, highly mobile populations,
poverty rates, overrepresentation of Medicaid eligible or uninsured student, etc. Data to support
the district’s claims are required in this portion of the application. Cite location of data for
verification. For example, if the district is claiming that the district is impacted disproportionally
by the presence of medical facilities, the district should identify the source of supporting data to
verify the claim. The narrative should be limited to no more than two (2) pages.
STEP TWO: Present student enrollment data (including SSID numbers) from within the district
attributed to the factor identified in Step One. Identified students may not be submitted
additionally for high need individual reimbursement. Provide appropriate comparisons to
surrounding districts or districts of like size throughout the region or state, and statewide data to
demonstrate that the district has a unique situation that is not the result of district philosophy,
service delivery choice or accounting practice. When comparing district IDEA Part B, November
Child Count Report data to statewide Child Count data, use data in the columns titled ‘Total 6—
21’. The district should attempt to rule out factors that may be within their control. Identify the
source of all supporting data presented in this section. Limit this portion of the application to no
more than two (2) pages.
COMMUNITY IMPACT INSTRUCTIONS (Rev. 10/2015)
STEP THREE: Quantify the extent to which the identified factor(s) in Step One creates an
extraordinary documentable fiscal impact upon the district’s Special Education Program. For
example, if the district claims that services provided to eligible special education students cause
a financial burden on the Special Education Program in the district as a result of a defined
community based issue, the district should demonstrate that the number of eligible students in
special education exceed the number of eligible resident students in the district, and then
quantify the adverse fiscal impact. Quantification should include the number of unfunded
students associated with the factor. Limit the fiscal impact description to no more than two (2)
pages including the calculations used to demonstrate the costs identified in Step Two. Total
amount of request should be entered on Form SPI 1381 – Certification.
Application Submission:
To submit the following required items by mail, send to Douglas H. Gill, Ed.D. OSPI, Special
Education State Oversight Committee Manager, PO Box 47200, Olympia, WA 98504-7200 by 5
p.m. Friday, February 12, 2016. Applications for community impact awards will not be
accepted after this date.
Required Items:
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1. Completed Form SPI 1381-CERTIFICATION.
2. Completed Form SPI 1381-WORKSHEET A.
3. Most recent completed monthly detailed expenditure reports for the special
education program showing the budgeted and actual year-to-date expenditures. The
reports must sub-total at three separate levels, 1 – object (i.e. 21-27-5), 2 – activity
(i.e. 21-27) and 3- program level (i.e. 21).
4. Special Education Enrollment Exception Reports for the 2015–16 school year.
5. Completed Form SPI 1381-COMMUNITY IMPACT application including SSID
numbers for students associated with the identified community impact factor(s).
Review Process of Application:
Districts requesting Safety Net awards under the Community Impact category are required to
submit all fiscal components of a Safety Net Application in addition to the Community Impact
application.
Districts will be notified in writing of the decision by the State Oversight Committee.
COMMUNITY IMPACT INSTRUCTIONS (Rev. 10/2015)