2015 Program Agreement KN-CLAIM Forms - KN

Date:
May 14, 2014
To:
Authorized Representative of School Nutrition Programs
From: Cheryl Johnson, MS, RD, LD
Director, Child Nutrition & Wellness
Re:
PROGRAM RENEWAL DOCUMENTS FOR SCHOOL YEAR 2014-2015
Please refer to “2014-2015 Child Nutrition Program Renewal Documents” on the last page of this memo for
instructions. All program renewal forms, instructions and guidance can be downloaded from our website:
www.kn-eat.org, School Nutrition Programs, Administration, Program Renewal. (Program Renewal is in the
drop-down list when you scroll over Administration. If you do not get the drop-down list, change your browser to
Internet Explorer 10 Compatibility or Internet Explorer 9. Click F12 on your keyboard, select Brower Mode then
choose either IE 10 Compatibility or IE 9.)


Program renewal documents are due by Tuesday July 15, 2014.
Reimbursement claims for school year 2014-2015 cannot be processed until all program renewal
documents are approved by KSDE.
2015 Program Agreement
The 2015 Program Agreement contains additions and revisions to the 2012 Program Agreement including the
required Free & Reduced Price Policy and Attestation of Compliance with Meal Pattern Requirements which
must be submitted annually to attest to full compliance with the subsequent year meal pattern requirements. It
is important for you to read the Agreement and make sure that you understand its terms.
Two paper copies of the 2015 Program Agreement must be completed, signed and submitted to Child Nutrition
& Wellness, Kansas State Department of Education (KSDE). Original signatures are required. A signature
stamp is acceptable only if it is registered with the Kansas Secretary of State. When the agreement is
approved, a copy will be returned for the Sponsor’s file.
KN-CLAIM Forms
Update the following forms in the KN-CLAIM system:
 Program Year 2015:
o Sponsor Application
o Site Application
o Food Safety Training Record
 Program Year 2014:
o Monthly/Annual Financial Report
o Wellness Policy Builder
The Sponsor Application, Site Application, Food Safety Training Record and Wellness Policy Builder must be
updated by July 15. The Monthly/Annual Financial Report must be completed by August 15. The KN-CLAIM
Quick Reference for Sponsor & Site Application, Wellness Policy and Monthly/Annual Report are available at
www.kn-eat.org, School Nutrition Programs, Guidance, KN-CLAIM Quick Reference Guides.
Upload Feature: Renewal documents that do not require an original signature can be uploaded to KSDE via
the Sponsor Application in the KN-CLAIM computer system. To use the upload feature, files will need to be in
one of the following formats with the appropriate extension (i.e. the last three characters following the period in
the file’s name):
 Adobe PDF (.pdf)
 Microsoft Excel (.xls) or (.xlxs)
 Microsoft Word (.doc) or (.docx)
 Generic text (.txt)
School Nutrition Program Renewal Documents for SY 2014-2015
Page 2
Browsers that can be used to upload forms on both PCs and MACs:
 Internet Explorer 9
 Firefox
Note: Safari, Google Chrome and Internet Explorer 10 will NOT work for any uploads.
You also have the option to mail completed renewal documents to KSDE. However, we encourage you to
upload them because we will be able to access the files immediately and it will be easier to communicate with
you about them. Instructions for uploading documents are in the KN-CLAIM Quick Reference for the Sponsor
and Site Applications.
Electronic Forms
All forms that require entry of variable information are available on the KSDE website as Microsoft Word
documents. Using these documents will eliminate the need to use a typewriter or re-key the forms. Print all
letters on Sponsor letterhead. Instructions to print on letterhead have been removed from .pdf prototypes for
ease in printing.
Forms/records other than those provided by KSDE, must be reviewed and approved by KSDE prior to use.
Alternate forms may be submitted to KSDE for approval at times other than during the annual program renewal
process.
New Sites
If you need to add a new site that will serve lunch, breakfast, after school snacks or Special Milk, complete a
New Site Application and submit it to KSDE with your renewal packet.
Changes to the Sponsor & Site Applications for SY2014-15
There have been several additions and or changes to the Sponsor and Site Applications for SY2014-15
including: On-line Application for Child Nutrition Program Benefit’s Software information, Independent Review of
Applications Official, Community Eligibility Provision Election and Application, Food Service Management
Company Sponsor Contact, Verification Official Email, Paid Lunch Equity Question Re-order, Civil Rights
Training Reporting, and Enterable Fields for Meal/Snack Times. The Quick Reference for the Sponsor & Site
Application provides information detailing how to complete these new fields on the applications.
Qualifying Students as At-Risk
An optional form is posted on the website for use with students who may be eligible for At-Risk State funds, but
who will not have access to school meals, milk or snacks and for those schools electing the Community
Eligibility Provision. This form was developed so that households are not asked to complete an application for
CNP benefits when meals will not be available to the students or for those schools electing the Community
Eligibility provision. If you choose to use this form, we strongly encourage you to print it on colored paper so
that it is not confused with the regular CNP application. Eligibility determinations for At-Risk Applications must
be handled by someone who is NOT paid from the School Food Service Fund.
Paid Lunch Equity (PLE) Pricing Tool Completion Required by USDA
For school year 2014-15, all sponsors except non-pricing programs and RCCIs are required to complete the
Paid Lunch Equity Pricing (PLE) Tool found at www.kn-eat.org, School Nutrition Programs, Administration,
Program Renewal. The completed PLE Tool must be uploaded to the Sponsor Application in KN-CLAIM as part
of the program renewal process.
USDA’s free reimbursement rate is considered to be the cost to produce a reimbursable meal. If the sponsor’s
average price of paid student lunches is $2.65 or more, it is in compliance. If the sponsor’s average price is less
than $2.65, the tool will calculate required paid lunch price increase or non-Federal source contribution.
If a sponsor decides NOT to raise meal prices and will add non-Federal funds to the food service account, the
required subsidy must be approved by the school board. The board minutes must designate the amount of nonFederal funds transferred to the School Food Service Fund due to a low paid meal price and be uploaded to the
Sponsor Application in KN-CLAIM as a part of the program renewal process.
To apply for an exemption due to strong financial standing, complete the application found at www.kn-eat.org,
School Nutrition Programs, Administration, Program Renewal and send to KSDE for consideration. Policy Memo
SP 28-2014 from USDA details the factors considered in evaluating whether a sponsor is granted an exemption
of the PLE requirements.
School Nutrition Program Renewal Documents for SY 2014-2015
Page 3
Reimbursement & Adult Meal Prices
You will be advised by e-mail when reimbursement rates for July 1, 2014 through June 30, 2015 are posted on
our website. Rates are normally not available from USDA until early July.
The prices charged for adult meals should at least equal the current free rate of reimbursement for those meals,
unless a lower charge is pre-approved by KSDE.
ESTIMATED Free
Reimbursement Rate
$1.61
Recommended Minimum
Adult Meal Charge
$1.65
Severe Need Breakfast Program
$1.94
$1.95
Lunch
$3.36
$3.40
Meal Type
Regular Breakfast Program
IMPORTANT: The estimated reimbursement rates shown above are based upon the average percent of
increase over the last three years.
Note: Maximum charge to students for Paid Special Milk is 15¢, Reduced Price Lunch is 40¢, Reduced Price
Breakfast is 30¢ and Reduced Price Snack is 15¢.
Distributing Applications & Determining Student Eligibility
Sponsors cannot begin accepting and processing applications before the beginning of the federally-defined
school year which is July 1, 2014.
Income Eligibility Guidelines
The Income Eligibility Guidelines (IEG) chart lists the reduced price and free income guidelines by household
size for the period July 1, 2014 through June 30, 2015. This chart is for sponsor use only and should be
provided to each determining official. It should NOT be distributed to school patrons.
Guidance for Determining Officials
The document, Guidelines for Determining Eligibility for Child Nutrition Program Benefits, is available on the
website and should be provided to each determining official. For further information regarding determining
eligibility, refer to Food Service Facts, Chapter 7.
Request to Use Online Application for Child Nutrition Program Benefits
Any sponsor wishing to use an online free and reduced application must complete and submit to KSDE the
Request to Use Online Application for Child Nutrition Program Benefits (available at www.kn-eat.org, School
Nutrition Programs, Food Service Facts, Chapter 7 Related Forms, Form 7F) for approval annually.
Direct Certification
All sponsors are required to use the Direct Certification system to assure that all foster students and students
eligible for Food Assistance or Temporary Assistance to Families (TAF) are approved to receive free school
meals. A complete list of all foster students and students eligible for Food Assistance or TAF will be available
online by the third working day of July. The Direct Certification System displays daily matches for public schools
and all private schools who send student records to KSDE. This year KSDE will send an email notification when
a new student is added to the Sponsor list. The new students added will be displayed at the top with the date
matched. Free meal benefits begin when the sponsor sends letter 7A.
Sponsors can begin directly certifying students as soon as the July list is available. Check the list frequently.
Sponsors must send letter 7A to notify households that students in the household are directly certified for free
meals in a timely manner so that the household does not take the time to submit an income application.
The KN-CLAIM Quick Reference for Direct Certification is available at www.kn-eat.org, School Nutrition
Programs, Guidance, KN-CLAIM Quick Reference Guides.
School Nutrition Program Renewal Documents for SY 2014-2015
Page 4
Important Reminders about USDA Requirements

Use approved applications from the prior year to establish student eligibility for up to the first 30 operating
days of the current school year. A new eligibility determination in the current school year supersedes the
carry-over eligibility. Households should be notified immediately if benefits are denied or reduced from the
level of the previous year in order to provide adequate time for the family to make appropriate
arrangements for payment to prevent the household from accumulating meal charges. This policy applies
to all students including preschool siblings on applications eligible for reduced price or free Child Nutrition
Program benefits at the end of the prior school year.

If a household reports that all of its income is received with the same frequency, look up the gross
household income on the table for that income frequency. For example, if there are three sources of
monthly income, total the three amounts and look up the total on the monthly guidelines.

Households must report current income. Current income means income received by the household for the
current month, the amount projected for the first month for which the application is filled out or for the
month prior to application. If a household provides only annual income the Sponsor must ensure that this
is an accurate reflection of their current income.

If a household reports income with more than one pay frequency, annualize the amounts and look up the
total on the yearly guidelines. To annualize income, multiply income received weekly by 52, every two
weeks by 26, twice a month by 24, and monthly by 12.

Sponsors that demonstrate high levels of, or a high risk for administrative error associated with certification,
verification and other administrative processes during an administrative review will be required to conduct
an independent review of initial eligibility determinations for free and reduced price school meal
applications for accuracy prior to notifying households of eligibility. Sponsors will be notified by June 30,
2014 if they will be required to complete the second review of applications for SY2014-15.
Excel Application for CNP Benefits
KSDE provides an Excel application that automatically makes eligibility determinations for sponsor use only.
This form will be available on the Application Menu of KN-CLAIM by July 1. Sponsors who have used the Excel
application report that it saves them a substantial amount of time and assures the accuracy of determinations.
Smart Snacks in School Rule - Effective July 1, 2014
Effective July 1, Sponsors must implement the Smart Snacks in School Nutrition Standards for competitive
foods sold on the school campus during the school day and comply with the exempt fundraiser limit set by the
Kansas State Board of Education: “One exempt fundraiser per school organization per semester that does not
meet the Nutrition Standards for All Foods Sold in School during the school day (midnight before to 30 minutes
after the end of the school day) on school grounds will be allowed. An organization is defined as a school group
that is approved by the local board of education. Length of the organization’s exempt fundraiser cannot exceed
2 days.”
Exempted fundraiser foods or beverages may not be sold in competition with school meals in the food serving
area during meal service. There is no frequency or time limit on fundraisers during which food or beverage
items that meet the nutrition standards are sold; nor are there any limits on non-food fundraiser activities.
Proceeds from the sale of all competitive foods must accrue to the food service fund, to the school, or to
approved student organizations.
Wellness Policy Data
Please make certain that the information is current and accurately reflects the sponsor’s status in relation to the
current Kansas School Wellness Policy Model Guidelines. School Wellness Policy data for every school district
in Kansas is available to the public at www.kn-eat.org, School Wellness Policies. The Kansas School Wellness
Policy Model Guidelines are in the process of being updated and revised due to new Nutrition Standards and
the Smart Snacks in School Interim Rule. Additional information and opportunities for training to learn about
changes in Wellness Policy guidance will be provided this fall.
School Nutrition Program Renewal Documents for SY 2014-2015
Page 5
Catalog of Federal Domestic Assistance (CFDA) Numbers
Kansas State Department of Education is required to provide sponsors participating in Child Nutrition Programs
with CFDA numbers for USDA programs that are administered by Kansas State Department of Education. The
following is the list of CFDA numbers and their respective programs:
CFDA
10.555
10.555
10.553
10.556
10.558
10.559
10.582
10.574
10.579
Source Code
4553
4553
4552
4555
4554
4556
4557
4558
4011
Program
National School Lunch Program
After School Care Snack Program
School Breakfast Program
Special Milk Program
Child and Adult Care Food Program
Summer Food Service Program
Fresh Fruit and Vegetable Program
Team Nutrition Grants
Equipment Grant
This information will be useful to auditors when you have an audit. All program participants that expend over
$500,000 in federal financial assistance from all sources are required to have an A-133 audit annually.
Reminders

It is essential that your program renewal documents contain accurate information for next school year, such
as meal prices and the hearing official’s name. Do not submit your program renewal documents until data
for next school year is available.

The School Breakfast Program must be offered in all public school buildings used for instruction and be
available to all students (including pre-kindergarten and kindergarten) who attend morning classes except in
those schools granted a waiver from the requirement. Waivers are approved each spring for the following
school year.

Special Milk Program participation is limited to children who do not have access to any other Child
Nutrition Program. Participation in this program is OPTIONAL. If breakfast is served at an attendance
center where morning kindergarten classes are held, only afternoon kindergarten classes without access to
lunch are eligible to participate in the Special Milk Program.

All sponsors planning to purchase meals for the first time from a Food Service Management Company or
another sponsor must contact KSDE for additional instructions.

Sponsors or a school or group of schools within the sponsor electing the Community Eligibility Provision
for SY2014-15, must complete the Community Eligibility Provision Application in KN-CLAIM by June 30,
2014.

Sponsors are required to conduct annual outreach to households about free meals or snacks available from
Summer Food Service Program (SFSP) sites during the summer. The outreach information must be
provided to households prior to the end of each school year, so this information may not be distributed via
the annual school meals application packet. The information may be distributed prior to the end of each
school year by any means normally used to communicate with households, for example email or website.

Sponsors that have one or more sites that offer the School Breakfast Program (SBP) are required by
federal program regulations to inform families about the availability of the breakfast program. This
information must be sent to households prior to or at the beginning of each school year, so it may be
included in the annual school meals application packet. In addition, schools should send reminders
regarding the availability of the SBP multiple times throughout the school year. Schools can provide
reminders to children through their public address systems in schools or through means normally used to
communicate with the households of enrolled children. Other acceptable outreach activities may include
developing or disseminating printed or electronic material to families and school children. For example,
information about the SBP should be posted on the school’s website.

Before mailing completed program renewal documents to KSDE for approval, make copies of all pages for
your file.

Please call our office (785-296-2276) or your area consultant if you have questions or need assistance.
2014-2015 Child Nutrition Program Renewal Documents
Download Program Agreement, forms, instructions and guidance at www.kn-eat.org, School Nutrition
Programs, Administration, Program Renewal.
2015 Program Agreement:
Two copies of the agreement, which includes the Free & Reduced Price Policy
Statement and Attestation of Compliance with Meal Pattern Requirement for SY 2014-2015, must be completed,
signed and submitted to Child Nutrition & Wellness, Kansas State Department of Education (KSDE). Original
signatures are required. (Note: Sponsors that have not been certified as eligible for the 6 cent performance based
reimbursement will complete an Attestation of Compliance with Meal Pattern Requirements for SY2014-2015 when
submitting certification documentation or during the Administrative Review.)
KN-CLAIM Forms: Refer to the KN-CLAIM Quick Reference for Sponsor & Site Applications and to the
KN-CLAIM Quick Reference for the Wellness Policy Builder.
 Sponsor Application
 Site Application(s)
 Wellness Policy Builder
 Monthly/Annual Financial Report (to be completed by August 15, 2014)
 Food Safety Training Record
 Community Eligibility Provision Application, if applicable
Electronic Forms: Refer to the Instructions for Program Renewal Documents.











Form 3B: Household Application Packet without Racial-Ethnic Data
OR
Form 3C: Household Application Packet with Racial-Ethnic Data
Form 3D: Notification of Eligibility Determination
Form 3E: Waiver of Confidentiality
Form 3G: Appointment of New Authorized Representative
Form 3J: For sponsors offering meals AND Special Milk – Information for Households with Pre-K or
Kindergarten Students.
Form 7A: Letter to Household about Direct Certification
Form 8D: Letter to Household about Selection for Verification
Form 8M: Letter to Household about Benefit Decrease
Form 18A: Letter to Household about Community Eligibility Provision
Paid Lunch Equity (PLE) Tool
Guidance:






Guidelines for Determining Eligibility
Income Eligibility Guidelines Chart
Instructions Regarding Confidentiality of Reduced Price/Free Eligibility Information
Foreign Language Materials Information
After School Care Snack and Meal Programs, Questions and Answers
Special Assistance Alternatives (i.e. Provisions 1, 2 and 3 and Community Eligibility Provision)
Keep a copy of all program renewal documents for your files.
Signed documents must contain ORIGINAL signatures.
All program renewal documents are due by July 15, 2014 to:
Child Nutrition & Wellness, Kansas State Department of Education,
Landon State Office Building, 900 SW Jackson St. Suite 251
Topeka, KS 66612-1212.
Questions? Call (785) 296-2276

Download Report