Desert Mountain Charter SELPA Policies and Procedures

Procedure – Category 5000 (Students) AR 5005.4 – SELPA Referral Procedures

1. Convene an IEP meeting to confirm the student is eligible for special education services and determine a need for a referral for mental health evaluation. Include SELPA school psychologist who coordinates residential placements. 2. Refer the student to the Desert Mountain Children’s Center (DMCC) for an educationally related residential assessment to determine eligibility for residential placement. 3. If the IEP team determines the student does not meet the baseline criteria for residential placement, the referral process ends. 4. If the IEP team determines that the referral is appropriate, the referral process continues. 5. Complete the Residential Placement Assessment Referral form (DM 151). 6. Complete the Authorization for Use and/or Disclosure of Information form (DM 63) and obtain the parent/guardian signature. Specify the receiving agency as the DMCC. B. Referral Procedures Forward the following completed documents to the attention of the SELPA school psychologist and designated support staff who coordinates the RTC placements. • DM 63 – Authorization for Use and/or Disclosure of Information • DM 151 – Residential Placement Assessment Referral • IEP or IEP Addendum dated within one year referring the student for an assessment for residential eligibility. • Most current complete annual or triennial IEP. • Psycho-educational evaluation dated within three years from the time the student was identified as eligible for special education and related services. • All current assessment reports, including but not limited to, psycho-educational evaluations, functional behavioral assessment, speech assessments, occupational therapy assessments.

AR 5005.4 – SELPA Referral Procedures Desert Mountain Charter Special Education Local Plan Area (DMCS) (rev. 8/9/22)

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