SELPA Referral Procedures
c) Complete the Special Health Care Services Referral form (DM 148) and obtain the signatures of the person making the referral and the director of special education.
2.
Referral Procedures
Forward the following documents to the attention of the Program Manager for Resolution Support Services at the SELPA.
DM 52 – Transfer into LEA
•
• DM 63 – Authorization for Use and/or Disclosure of Information
• DM 148 – Special Health Care Services Referral
• Current Summary of Treatment Plan if available, that specifies the special health care services the student was receiving
• IEP or IEP Addendum dated within one year of the referral for special health care services that lists the special health care services the student was receiving
• Psycho-educational evaluation dated within three years of the referral for special health care services
3.
Timeline for Services
Within five business days of receipt of the completed referral packet, the Program Manager for Resolution Support Services at the SELPA will develop an Individual Service Agreement (ISA) and forward it to the appropriate Nonpublic Agency (NPA) for signature Upon receipt of the signed ISA, the SELPA will forward the transfer referral packet to the appropriate NPA. The agency will contact the person who signed the referral to coordinate and begin services. The SELPA will enter the services into the IEP system.
XIV. DESERT/MOUNTAIN OPERATIONS (DMOPS)
The Desert/Mountain Operations or “County” provides educational settings and services to students severely impacted by their disability and who require specialized academic instruction (SAI). There may be times when a student’s access to the curriculum requires significant accommodations that cannot be met within the local education agency (LEA). The LEA can make a referral into a program operated by County when such a class is not operated by the LEA.
A.
Pre-referral
Local Educational Agency (LEA) Responsibility
CAHELP JPA Referral Procedures
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33
Revised 8/9/2022
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