Education Stabilization Fund- Governor's Emergency Education Relief Fund (GEER) Recipient Data Collection Form

Conducted by: OMB No. 1810-XXXX Expires XX/XX/XXXX

U.S. Department of Education

Education Stabilization Fund--Governors Emergency Education Relief Fund

(GEER Fund) Recipient Reporting Data Collection Form

Final Version: December 2020

GEER Fund Reporting Form

State: _____<auto fill from G5>_____________

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 and outlying areas that received Governors Emergency Education Relief (GEER) or Education Stabilization Fund (ESF)-Governors funds should fill out this form. References to GEER include ESF-Governors. To fulfill the annual GEER fund reporting requirements, answer all questions based on the reporting period shown in the Annual Reporting table below.

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

Annual Report	Due Date	Applicable Reporting Period
First Annual Report	February 1, 2021	March 13, 2020 - September 30, 2020
Second Annual Report	February 1, 2022	October 1, 2020- September 30, 2021
Third Annual Report	February 1, 2023	October 1, 2021- September 30, 2022

The total grant amount allocated to the State is____<auto fill from G5>______

The total amount of the grant expended is_______<auto fill from G5>_______

1. Which types of entities within the State were awarded Governors Emergency Education Relief (GEER) funds?

• Local Educational Agencies (LEAs) (Y/N).

• Institutions of Higher Education (IHEs) (Y/N).

• Other Education-Related Entities (Y/N).

2. Did the State place any funding conditions or requirements on GEER awards for LEAs to ensure that the funds were spent on specific purposes or activities? (Y/N) If yes,

   1. Were there any changes to the State’s LEA GEER award conditions or requirements since the State’s initial 45-day report to the Department of Education? (Y/N) If yes, please specify the changes. ______________

   2. Did the State place any funding conditions or requirements directing LEAs to use the funds for activities related to distance-learning and remote education? (Y/N).

1. If yes, what were the directed activities?

   • Support access to the technology infrastructure required for distance education (Y/N). If yes,

     • For Internet Access (Y/N).

     • For Devices (Y/N).

   • Training staff/teachers for distance-learning and remote education (Y/N).

   • Providing digital learning content, applications, and tools (Y/N).

   • Other (Y/N). If yes, please specify __________________

2. Did the State place any funding conditions or requirements on GEER awards for IHEs to ensure that the funds were spent on specific purposes or activities? (Y/N). If yes,

   1. Were there any changes to the State’s IHE GEER award conditions or requirements since the State’s initial 45-day report to the Department of Education? (Y/N) If yes, please specify the changes _________________

   2. Did the State place any funding conditions or requirements directing IHEs to use the funds for activities related to distance-learning and remote education? (Y/N).

1. If yes, what were the directed activities?

• Support access to the technology infrastructure required for distance education (Y/N). If yes,

• For Internet Access (Y/N).

• For Devices (Y/N).

• Training staff/faculty for distance-learning and remote education (Y/N).

• Providing digital learning content, applications, and tools (Y/N).

• Other (Y/N). If yes, please specify__________________________

3. Did the State direct any IHEs to use GEER funds for emergency financial aid grants to students? (Y/N).

2. a. In the table below, for each LEA awarded GEER funds from the State, provide the amounts expended and select the purposes for which the funds were expended by the LEA. (If the SEA operates as a unitary system then report for the entire SEA.)

LEA	DUNS #	Total amount awarded to the LEA	Who is the LEA serving with these funds? (select one)	Amount expended by the LEA for Public Schools	Amount expended by the LEA for equitable services for Non-public School students and teachers	Total amount expended by the LEA	Uses of GEER funds (Y/N)
<auto fill from FFATA reporting>	<auto fill from FFATA>	<auto fill from FFATA>	a) Students and teachers in both Title I and Non-Title I Schools; or b) Only students and teachers in Title I Schools			<autofill sum of previous two columns>	1. Purchasing educational technology (including hardware, software, and connectivity), which may include assistive technology or adaptive equipment. <Skip logic: if yes, continue with question 6b; if no, continue> 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 3. Providing mental health services and supports. 4. Sanitization and minimizing the spread of infectious diseases, including cleaning supplies and staff training to address sanitization and minimizing the spread of infectious diseases. 5. Summer learning and supplemental afterschool programs. 6. Other (uses of funds not included above). If yes, please describe:__________
…
LEA award not reported in FFATA because it did not meet the dollar threshold
…

[NOTE to reviewers: in the online data collection instrument, questions 4b and 4c below will be appended to questions 4a above for each LEA.]

<Skip logic: If the LEA used GEER funds for the first “use of funds” purpose, then ask>

b. Did this LEA use GEER funds to provide home Internet access for any students?

Did this LEA use GEER funds to provide home Internet access for any students? (Y/N)	If yes, what types of home Internet services were provided by the district using GEER funds? Internet Service type:	Yes/No
	Mobile hotspots with paid data plans
	Internet connected devices with paid data plans
	District pays for the cost of home Internet subscription for student
	District provides home Internet access through a district-managed wireless network
	Other; If yes, please specify:___________

c. Among students enrolled on September 30, 2020, what proportion of students by district had a dedicated LEA-provided device funded by GEER for the following grade bands? For the purposes of this survey, include desktop, laptop, and tablet computers (including Chromebooks and iPads). Do not include smartphone devices. “Elementary” is defined as “a school classified as elementary by state and local practice and composed of any span of grades not above grade 8” and “Secondary” is defined as “a school comprising any span of grades beginning with the next grade following an elementary or middle school (usually 7, 8, or 9) and ending with or below grade 12. Both junior high schools and senior high schools are included.”

Did the LEA use GEER funds to provide dedicated learning devices to any students? (Y/N)	Grade level	Students with dedicated device provided by the LEA (Numerator)	Students enrolled on September 30, 2020 (Denominator)	Proportion of students with an LEA-provided device
	Elementary			<autofill numerator/denominator>
	Secondary			<autofill numerator/denominator>

<Return to 2^nd category of uses of funds in Q4a.>

2. In the table below, for each IHE awarded GEER funds from the State, provide the amount expended and additional information if GEER funds were used by the IHE to provide financial aid to students at the IHE.

IHE name	DUNS #	Amount awarded to the IHE	Amount expended by the IHE	Amount of expended funds used by the IHE to provide student financial aid grants	Number students who received financial aid grants as result of GEER funds
<auto fill from FFATA>	<auto fill from FFATA>	Amount <auto fill from FFATA>
…
IHE award not reported in FFATA because it did not meet the dollar threshold	N/A
…

2. What was the amount awarded and expended by each education-related entity? Which populations of students were or will be served by the entity? Did the funding awarded to the entity support distance-learning and remote education or provide financial support to students?

Other Education-Related Entities	DUNS #	Amount Awarded to Entity	Amount Expended by the Entity	Population Served			Supporting distance-learning and remote education	Direct financial support of students (e.g., scholarships)
				Pre K	K-12	Post-Sec
_<auto fill from FFATA>_	Amount _<auto fill from FFATA>_	Amount _<auto fill from FFATA>_		Y/N	Y/N	Y/N	Y/N	Y/N
…
Entity award not reported in FFATA because it did not meet the dollar threshold				Y/N	Y/N	Y/N	Y/N	Y/N
…

2. Provide the number of full-time equivalent (FTE) positions for the LEA, IHE, or Entity as of the listed reporting dates. (The number of FTE positions includes all staff regardless of whether the position is funded by Federal, State, local, or other funds —including instructional and non-instructional staff and contractors—and equals the sum of the number of full-time positions plus the full-time equivalent of the number of part-time positions.)

[NOTE to reviewers: in the online data collection instrument, these elements will be appended to the questions above for LEAs, IHEs, and Entities.]

LEA Name/IHE/Entity Name	DUNS#	Full-time equivalent (FTE) positions as of September 30, 2018	Full-time equivalent (FTE) positions as of September 30, 2019	Full-time equivalent (FTE) positions as of March 13, 2020	Full-time equivalent (FTE) positions on September 30, 2020
<Pre-populate from data provided in previous tables>	<Pre-populate from data provided in previous tables>
…

2. In the table below, indicate the number of K-12 schools (public and non-public) that received GEER funds or received services paid for with GEER funds:

School Type	K-12 schools
Public Schools
Non-public Schools

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 4.1 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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