Appendix A: SELPA Form DM 77
Notice of Procedural Safeguards (Parents’ Rights)
Furthermore, as a public agency, the LEA may access your public benefits or insurance to pay for related services required under Part B of the IDEA for a free appropriate public education. For related services required to provide FAPE to an eligible student, the LEA: • May not require you to sign up for or enroll in public benefits or insurance programs (Medi-Cal) in order for your child to receive FAPE under Part B of the IDEA (34 CFR 300.154(d)(2)(i)) . • May not require you to incur an out-of-pocket expense such as the payment of a deductible or co-pay amount incurred in filing a claim for services and reimbursement through Medi- Cal (34 CFR 300.154(d)(2)(ii)) . • May not use your child’s benefits under Medi -Cal if that use would: ❖ Decrease available lifetime coverage or any other insured benefit; ❖ Result in the family paying for services that would otherwise be covered by the public benefits or insurance program (Medi-Cal) and are required for your child outside of the time your child is in school; ❖ Increase premiums or lead to the discontinuation of public benefits or insurance (Medi-Cal); and/or ❖ Risk loss of eligibility for home and community-based waivers, based on aggregate health related expenditures. Parental Revocation of Consent after Consenting to Initial Provision of Services: You may only revoke your consent in writing and this action cannot be retroactive. Once you revoke consent to the initial provision of services, the LEA will provide prior written notice before ceasing the services. If in the future you seek re-enrollment in special education for your child, the assessment will be treated as an initial evaluation. The LEA may not use the procedures in subpart E of Part 300, 34 C FR (including the mediation procedures under 34 CFR 300.506 or the due process procedures under 34 CFR 300.507 through 300.516 ) to obtain agreement or a ruling that the services may be provided to your child. The LEA will not be in violation of the requirement to make a free appropriate public education available to your child because of the failure to provide the child with further special education and related services. The LEA is not required to convene an IEP team meeting or develop an IEP under 34 CFR 300.320 and 300.324 for your child for further provision of special education and related services. In accordance with 34 CFR 300.9(c)(3) , if you revoke consent in writing for your child’s receipt of special educ ation services after your child is initially provided special education and related services, the LEA is not required to amend your child’s education records to remove any references to your child’s receipt of special education and related services because of the revocation of consent.
Child Participation/Right:
BP 1001 – Procedural Safeguards
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Desert Mountain Special Education Local Plan Area (DMSELPA) (rev. 03/13)
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