Procedure – Category 5000 (Students) AR 5005.4 – SELPA Referral Procedures
The director of special education will reconvene the IEP team to review the report findings and recommendations of the assessment and determine whether behavioral intervention supports/services are warranted. The IEP meeting will be scheduled within the 60-day timeline. If the IEP team agrees that services are not needed, it will be documented in the IEP notes. D. Timeline for Services If the IEP team agrees that services are appropriate, the goals and services will be listed on an Addendum to the IEP including the service Code 535 for behavioral intervention services and/or supervision, the class number for each service, provider code for the NPA (Code 400), projected start date, duration, and frequency. The Addendum should be forwarded to the Program Manager for Resolution Support Services at the SELPA. Within five business days of receipt of the Addendum to the IEP, the Program Manager for Resolution Support Services at the SELPA will develop an ISA and forward it to the appropriate NPA for signature who will then initiate services.
7.0
Nonpublic Agency (NPA) – Behavioral Intervention Supports Only A. Pre-referral LEA Responsibility
1. Convene an IEP meeting to document the team’s decision to refer the student for behavioral intervention supports. 2. Complete the Authorization for Use and/or Disclosure of Information form (DM 63) and obtain the parent/guardian signature. Specify the receiving agency’s name, if known. If not, leave the field blank. B. Referral Procedures Forward the following completed and signed documents to the attention of the Program Manager for Resolution Support Services at the SELPA: • Cover letter requesting the addition of NPA behavioral intervention supports and the name of the selected NPA. • DM 63 – Authorization for Use and/or Disclosure of Information
AR 5005.4 – SELPA Referral Procedures Desert Mountain Charter Special Education Local Plan Area (DMCS) (rev. 8/9/22)
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