SELPA Referral Procedures
• 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
•
• Behavioral intervention plans and behavior data collection
Discipline logs
•
• If the last triennial was completed with a Triennial Assessment Determine form (DM 119), include the last full psycho-educational report.
Any additional information
•
3.
Timeline for Services
Within ten business days of receipt of the completed referral packet, the SELPA school psychologist who coordinates NPS placements will review the packet for completion and forward it to the LEA’s NPS of choice.
The NPS will contact the parent and placement will be made within ten business days.
The NPS will work directly with the LEA to schedule an IEP within 30 days of the student’s placement at the school. The placement should be listed on an IEP or IEP Addendum including the NPS, start date, duration, and frequency. The IEP or IEP Addendum should be forwarded to the SELPA school psychologist who coordinates NPS placements. Within five business days of receipt of the Addendum to the IEP, the SELPA school psychologist will develop a Master Contract with the NPS if one does not currently exist and an Individual Service Agreement (ISA). The ISA will be forwarded to the appropriate NPS for signature. The SELPA will enter the NPS placement into the IEP system.
B.
Transfer Referral
1.
Pre-referral
Local Educational Agency (LEA) Responsibility
CAHELP JPA Referral Procedures
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Revised 8/9/2022
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