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CASBO NewsBreak: CDE releases sample form to determine income eligibility

October 28, 2013
By Jeff Vaca and Sara C. Bachez, Governmental Relations

Last Friday, the Department of Education released five sample forms for provision 2 and 3 schools to use to collect student income eligibility information for the LCFF and federal accountability determination. Provision 2 and 3 schools that are not reassessing their base year this school year under the National School Lunch Program, will need to collect students' information using an alternative form that contains at a minimum:
  • Information to identify the child(ren)

  • Information sufficient to determine that the child or household meets federal poverty income eligibility requirements based on family income and household size, and if so, whether household income is below 130 percent of the federal poverty level (eligible for a free lunch) or between 130-185 percent of the federal poverty level (eligible for a reduced-price lunch). CDE requires this distinction, not for LCFF, but for federal data reporting.

  • Certification that information is true

  • Parent/guardian signature, printed name, and date signed

  • Confidentiality statement


The five sample forms that provision 2 and 3 schools may use to determine students' eligibility for free or reduced-priced meals in order to qualify for the LCFF's supplemental and concentration funds are listed below:

Sample 1
: This form collects information for multiple children in a household. Parents/guardians would calculate their annual income and select among income ranges.

Sample 2:
This form collects information for multiple children in a household. Parents/guardians would list their income sources and amounts. The school would determine whether the income falls within specified ranges.

Sample 3:
This form collects information for multiple children in a household. Parents/guardians would select among income ranges, which are presented for various frequencies of payment (weekly, monthly, yearly, etc).

Sample 4:
This form collects information for one child. Parents/guardians would provide their total income and household size. The school would determine whether the income falls within specified ranges.

Sample 5:
This form collects information for multiple children in a household. Parents/guardians would list their income sources and amounts. The school would determine whether the income falls within specified ranges. The form includes other information that the school may wish to collect, such as eligibility for benefits under various federal programs.

CDE has extended the CalPADS Fall 1 amendment window for LEAs that have one or more schools with provision 2 and 3 status to March 21, 2014. It is important that schools begin the process of distributing and collecting alternative forms as the percentage of unduplicated pupils is based on a three year rolling average from data submitted by LEAs through CalPADS, beginning with the 2013-14 year. Please note that the alternative form process may be an annual responsibility that cannot be funded using cafeteria funds, since CDE is interpreting the LCFF law to require annual certification of all eligible free and reduced-price meal students to determine the unduplicated count for LCFF's supplemental and concentration grants.

CASBO has been working with a coalition of education management organizations to raise this issue to the Legislature and Administration in order to address the fiscal and administrative burden this additional requirement is creating for LEAs with provision 2 and 3 schools.

We will continue to provide updates on this matter as events warrant.

All CASBO NewsBreaks are posted on the CASBO website at www.casbo.org. The legislative status indicated for the bills in this report reflect the location of each of these measures as of the day the report was posted. To get up-to-the-minute status of bills including additional information on bills, bill text, analyses, legislative vote records, and veto messages, log on to the state's Official Legislative Information website at www.leginfo.ca.gov.

For other questions regarding topics covered, you may contact Jeff Vaca, Deputy Executive Director, Governmental Relations, at jvaca@casbo.orgor Sara C. Bachez, Legislative Advocate, Government Relations, at sbachez@casbo.org.