SELPA Referral Procedures
forward residential placement packets to potential residential treatment centers (RTCs). Upon receipt of responses from the residential facilities, the results will be shared with the student’s parent/guardian and a facility will be selected. The student will be enrolled at the selected RTC as soon as possible. Transportation of the student to the RTC is based on the LEA of residence’s re imbursement policy. After the student is placed at the RTC, SELPA and the LEA of residence will coordinate a transfer IEP meeting within 30 days to document the new placement. The placement should be listed on an IEP document, including the NPS, residential placement, start date, duration, and frequency of each service to be provided. Within five business days of receipt of the Addendum to the IEP, the SELPA school psychologist at the SELPA will develop an Individual Service Agreement (ISA) with the NPS and RTC. If a Master Contract does not exist, one will be developed and an ISA. The SELPA will enter the NPS and RTC placement into the IEP system.
B.
Transfer Referral
The LEA that placed the student at the beginning of the fiscal year is responsible for funding the residential placement for the remainder of the school year, including extended school year (ESY). (Education Code § 56325(c))
1.
Pre-referral
Local Educational Agency (LEA) Responsibility
a) Complete the Transfer into LEA form (DM 52) and obtain the parent/guardian signature.
b) Complete the Interim Placement form (DM 68IP)
c) Confirm the student’s current residential placement and educational services through a review of current IEP.
d) Complete the Authorization for Use and/or Disclosure form (DM 63) and obtain the parent/guardian signature. Specify the receiving agency as the DMCC.
2.
Referral Procedures
Upon confirmation of prior placement, forward the following completed documents to the attention of the SELPA school psychologist who coordinates RTC placements.
DM 52 – Transfer into LEA
•
• DM 63 – Authorization for Use and/or Disclosure of Information
CAHELP JPA Referral Procedures
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Revised 8/9/2022
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