Iowa Department of Education
      August 30, 2021
                              Request for Approval (RFAP): 
                             SEBH Universal Screening Tool
      Proposal Overview
      Introduction
      The Iowa Department of Education is seeking universal social-emotional-behavioral health (SEBH) screening tool 
      submissions. Vendors and authors of such tools may submit a request for approval for their SEBH universal screening 
      tool/s to be reviewed and considered for inclusion in a list of approved tools. Screening tools submitted will be reviewed to
      assure each approved measure meets the criteria specified by the Department. Those tools that meet the State’s approval
      criteria will be distributed to Iowa’s schools, area education agencies, and collaborating agencies as approved SEBH 
      screening instruments/processes. Districts, accredited nonpublic schools and area education agencies who contract with 
      licensed mental health providers to engage in screening of SEBH for grades 1 through 12 must select from this list of 
      approved measures. Costs associated with the purchase of universal SEBH screening tools is the responsibility of the 
      district, school, area education agency, or contracted mental health providers administering such assessments. 
      The Iowa Department of Education is seeking information to review universal SEBH screening tools. The Department is 
      not seeking a contract nor to purchase such measures at this time.
      Legislative Authority
      Iowa Code 280A (Behavioral Health Services - School Settings) allows a district, accredited nonpublic school or AEA to 
      contract with a mental health professional or health care organization to provide behavioral health screenings in-person 
      with 1st through 12th grade students in a public/nonpublic accredited school.
      “Behavioral health screening” or “screening” means a screening and assessment performed using a universal behavioral 
      health screening and assessment tool, approved for use by the Department of Education in consultation with the 
      Department of Public Health and the Department of Human Services, to identify factors that place children at higher risk 
      for behavioral health conditions, to determine appropriate treatment or intervention, and to identify the need for referral for 
      appropriate services.
      Approval Process
      The Iowa Department of Education has identified criteria for universal screening assessments that are required as part of 
      this Request for Approval Submission Template. If you are submitting multiple instruments (e.g., Brief Screening Scale 
      and Comprehensive Screening Scale), include a separate submission template for each instrument. Clearly indicate 
      which measures are being submitted, at which ages/grades.
      This template must be used in the format provided when indicated and applicants may adapt the age/grade bands and 
      types of assessments (Teacher, parent, self-rating form) to align to their screening measures. If data is not included in this 
      submission template or if the applicant simply refers reviewers to the technical manual, the proposal may be rejected.
      For consideration for approval, ensure that all items are complete, clear, and accurate. When entering where the 
      supporting evidence exists, be clear by providing exactly where (e.g., document attachment name, specific page 
      number(s), table numbers, section names). The Department prefers you report data by single age/grade (see Sample 
      Item X.1 below) but age/grade spans is allowable (see Sample Item X.2 below). Indicate “NA” if the form/data is not 
      available for the age/grade. Be sure to modify the age/grade column header to clearly show if you are reporting by 
      age/grade. If another type of form is available please add/modify a column header to address your measure/s. 
                                                                                          Page | 1 
       Iowa Department of Education
      When reporting specific technical data for items such as reliability, validity, classification accuracy, report the single most 
      representative estimate. This may be a median of multiple studies or pulled from the most representative study. Vendors 
      may add rows or columns, when necessary. Provide an “NA” if no data is being submitted.
      The following tables are a sample of how Specifications might be reported.
      Sample Item X.1: Sample Curve
             Parent Form  Teacher Form   Student Form  Clear description where evidence exists (page, 
      Age                                              table, and/or section number), or narrative 
                                                       explanation and any/all supporting materials and 
                                                       references.
      Age    NA           NA             NA            NA
      3-7
      8      .72          .68            NA            XYZ Technical Manual, p. 88, Table 5
      9      .63          .74            .71           XYZ Technical Manual, p. 89, Table 5
      10     .89          .84            .65           XYZ Technical Manual, p. 89, Table 5
      11     .85          .82            .62           XYZ Technical Manual, p. 89, Table 5
      12-21  NA           NA             NA            NA
      Sample Item X.2: Sample Curve 
             Parent Form  Teacher Form   Student Form  Clear description where evidence exists (page, 
      Age                                              table, and/or section number), or narrative 
      Span                                             explanation and any/all supporting materials and 
                                                       references.
      ages   NA           NA             NA            NA
      3-5
      6-7    .81          .72            NA            XYZ Technical Manual, p. 88, Table 3
      8-11   .63          .74            .71           XYZ Technical Manual, p. 89, Table 5
      12-17  .89          .84            .65           XYZ Technical Report, p. 12, Table 1 and Table 2
      18-21  .77          .75            .64           XYZ Technical Report, p. 13, Table 3 and Table 4
      Questions, Clarifications, and Suggested Changes
      Applicants may submit questions and request clarifications or suggestions for changes to application process. Such 
      requests must be submitted in writing at Questions: Iowa SEBH Screening RFAP by 5 p.m. CT, September 13, 2021. 
      Questions and Answers will be released by September 27, 2021.
      Evaluation & Approval
      Applicants must submit responses to the required sections of the Submission Template to be considered for approval. 
                                                                                          Page | 2 
          Iowa Department of Education
         The Department will use an evaluation committee to conduct a comprehensive, fair, and impartial evaluation of proposals 
         received in response to this request. The evaluation committee will recommend a list of approved tools to the Department 
         or to such other person or entity that must approve the recommendation. The evaluation committee will fully evaluate and 
         score all requests for approval submitted in accordance with this section.
        Section    Description                                                                          Required/Optional
        1          Contact Information: Provide the contact information for the vendor submitting       Required
                   this screening tool (if applicable) as well as the representative to contact regarding 
                   this application.
        2          Mandatory Specifications: The Department has identified several characteristics      Required
                   that qualify tools as universal SEBH screening tools. Tools must meet criteria on 
                   these Mandatory Specifications to be evaluated on Technical Specifications and be
                   considered for approval.
        3          Technical Specifications: The Department has identified critical technical           Required
                   characteristics for universal screening assessments. Tools must meet minimum 
                   expectations for each component as described to be considered for approval.
        4          Optional Criteria: The Department has identified several screening assessment        Optional
                   characteristics that aid schools in selecting SEBH assessments. Applicants may 
                   provide these at their discretion. Response or failure to respond to these items will 
                   not influence approval.
        5          Authorizations and Agreements:  The Department requires applicants to certify        Required
                   the authenticity of the submission and identify any components of the application 
                   that they request to remain confidential.
         Submitting your Request for Approval
         Proposals must be submitted at RFAP Submission Portal by 5 p.m. CT on Monday, October 11, 2021. Applicants may 
         resubmit a proposal any time before proposals are due. Electronic mail and faxed proposals will not be accepted. If an 
         applicant has technical difficulties submitting a proposal they may contact the Barb Anderson (barb.anderson@iowa.gov; 
         515-664-6732) for assistance. Applicants may withdraw their proposal at any time prior to the due date by emailing the 
         request to barb.anderson@iowa.gov. 
         Submission Checklist
             ❏ Request for Approval Submission Template with Sections 1-3 and 5 completed and submitted. (REQUIRED; 
                 Section 4 is OPTIONAL)
             ❏ Supplemental resources, referenced as evidence within the Request for Approval Submission Template (e.g., user
                 guide, technical manual etc.), are submitted as pdfs with the proposal. (REQUIRED)
             ❏ Each submission is a pdf. (REQUIRED)
             ❏ Each submission is no more than 16MB. (REQUIRED)
             ❏ There are no more than 10 total submissions/attachments per Request for Approval. (REQUIRED)
             ❏ If submitting multiple measures that stand alone (e.g., Brief Screener, Long Screener) each is submitted 
                 separately with a separate Request for Approval Submission Template (REQUIRED when multiple measures). 
                                                                                                                         Page | 3 
       Iowa Department of Education
                                     SEBH Screener: 
                  Request for Approval Submission Template
      Section 1 Contact Information
      Provide the contact information for the vendor submitting this screening tool (if applicable) as well as the representative to 
      contact regarding this application. 
        Vendor Name:
        Address:
        Contact’s Name: 
        Address:
        Telephone number:
        Fax number:
        Email Address:
                                      (Proceed to the next page.)
                                                                                       Page | 4