SELPA Referral Procedures
4.
Timeline for Services
PT services for the student will begin immediately upon receipt of the physical therapy transfer referral packet by the SELPA physical therapist. The SELPA will enter the PT services into the IEP system.
XII. RESIDENTIAL PLACEMENT (RTC)
A.
Initial Referral
1.
Pre-referral
Local Educational Agency (LEA) Responsibility
a) 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. b) Refer the student to the Desert/Mountain Children’s Center (DMCC) for an educationally related residential assessment to determine eligibility for residential placement. c) If the IEP team determines the student does not meet the baseline criteria for residential placement, the referral process ends.
d) If the IEP team determines that the referral is appropriate, the referral process continues.
e) Complete the Residential Placement Assessment Referral form (DM 151) .
f) 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.
2.
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
CAHELP JPA Referral Procedures
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Revised 8/9/2022
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