Procedure – Category 5000 (Students) AR 5005.4 – SELPA Referral Procedures
services provided. The goal of the DMCC is to assist in developing skills to reach their full protentional. Referrals may be made through the child’s school, parents, physicians, probation, Department of Children and Family Services (CFS), and/or guardians. The DMCC provides School-Age Treatment Services (SATS) medication support and management upon referral from the treating therapist to the DMCC medical doctor. SATS are primarily provided at each child’s school, but are also offered in the home, clinic, and community as needed. For more information, please contact the DMCC or visit their website at www.dmchildrenscenter.org. A. Pre-referral LEA Responsibility: Complete the Referral for Behavioral Health Services form (DMCC 100A) with as much detail as possible and obtain the signatures of the parent/guardian and the school administrator. B. Referral Procedures Forward the completed Referral for Behavioral Health Services form (DMCC 100A) to the attention of the Director of the DMCC. C. Timeline for Assessment Upon receipt of the completed Referral for Behavioral Health Services form (DMCC 100A), the DMCC will contact the parent/guardian by letter (up to three times) to schedule the assessment intake meeting. If no response from the parent/guardian is received by the third letter, the referral will be closed. The DMCC will determine if additional forms ( Authorization for use and/or Disclosure of Information form [DM 63], parental consent [ Assessment Plan form DM 66] are necessary to move forward with an assessment. The assessment must occur within 60 calendar days from the date the assessment plan was received. An intervention specialist or behavioral health counselor will be assigned to conduct the assessment. D. Timeline for Services
• If services are not deemed appropriate, the referral will be closed. • If services are deemed appropriate, a clinician will be assigned, and services will begin.
AR 5005.4 – SELPA Referral Procedures Desert Mountain Charter Special Education Local Plan Area (DMCS) (rev. 8/9/22)
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