Procedure – Category 5000 (Students) AR 5005.4 – SELPA Referral Procedures
9.0
Nonpublic School (NPS)
9.1
Initial Referral Nonpublic Schools (NPS) provide educational settings and services to students who meet the eligibility criteria for special education and are experiencing behavior difficulties that are too significant to be accommodated within a public- school environment. A. Pre-referral LEA Responsibility: 1. Convene an IEP meeting to document the team’s decision to refer the student for a change of placement to an NPS setting. 2. Complete the Nonpublic School Placement Referral form (DM 134) and obtain the signatures of the person making the referral and the director of special education. Specify the team’s preference for a specific NPS, if applicable. 3. Complete the Authorization for Use and/or Disclosure of Information form (DM 63). NOTE: If submitting to more than one NPS, an individual DM 63 must be completed for each school. B. Referral Procedures Forward the following completed documents to the attention of the SELPA school psychologist who coordinates NPS placements: • DM 134 – Nonpublic School Placement Referral • IEP or IEP Addendum dated within one year of the referral for NPS placement (Annual and Triennial IEP needs to be current) • Psycho-educational evaluation dated within three years of the referral for NPS placement. • All current assessment reports, including but not limited to, psycho-educational evaluations, functional behavioral assessment, speech assessments, occupational therapy assessments. • Pertinent medical documentation
AR 5005.4 – SELPA Referral Procedures Desert Mountain Charter Special Education Local Plan Area (DMCS) (rev. 8/9/22)
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