Timeline for Assessment An assessment is not required for transfer referrals. Assessments are completed at three-year intervals (from the date that the services originally began) unless there are extenuating circumstances that dictate otherwise. Timeline for Services Within five business days of receipt of the transfer referral packet, the Program Manager for Resolution Support Services at the SELPA will develop an Individual Service Agreement (ISA) for signature and forward it to the occupational therapist or the appropriate Nonpublic Agency (NPA) for signature who will then assign a therapist and determine initiation of services. The SELPA will enter the OT services into the SELPA Management Information System (MIS) database. Section 7: Physical Therapy (PT) Initial Referral School-based physical therapy (PT) supports the student’s ability to gain access to and make progress in the school curriculum. It corrects, facilitates, or adapts to the student’s functional performance in motor control and coordination, posture and balance, functional mobility, accessibility, and the use of assistive devices. PT works on compensation (i.e. modifying the environment, tools, or task) to help the child succeed in school. Pre-Referral Local Education Agency (LEA) Responsibility 1. Convene an Individualized Education Program (IEP) meeting to document the team’s decision to refer the student for a PT assessment. 2. Complete the Physical Therapy Referral form (D/M 120B) and obtain the signatures of the person making the referral and the Director of Special Education. 3. Complete the Authorization for Use and/or Disclosure of Information form (D/M 63) and obtain the parent/guardian signature. Specify the receiving agency as the SELPA. 4. Complete the Assessment Plan form (D/M 66) and obtain the parent/guardian signature. a. The person making the referral should check the box that corresponds to the type of assessment(s) requested. b. The parent/guardian should initial each applicable statement listed under the Parental Authorization section form D/M 66.
Chapter 22 – Supports and Services, Charter SELPA As of 10/17/2019 D/M Charter SELPA Steering Committee Approval
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