SELPA Referral Procedures
3.
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.
4.
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 IEP system.
XI.
PHYSICAL THERAPY (PT)
A.
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 function al 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 student succeed in school.
1.
Pre-referral
Local Educational Agency (LEA) Responsibility
a) Convene an IEP meeting to document the team’s decision to refer the student for a PT assessment.
b) Complete the Physical Therapy Referral form (DM 120B) and obtain the signatures of the person making the referral and the director of special education. c) 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 SELPA.
d) Complete the Assessment Plan form (DM 66) and obtain the parent/guardian signature.
The person making the referral should check the box that corresponds to the type of assessment(s) requested.
CAHELP JPA Referral Procedures
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Revised 8/9/2022
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