NOTE: The LEA is obligated to inform the parent/guardian of their right to obtain an IEE, where they may obtain an IEE, and conditions for obtaining an IEE at public expense. (Refer to SELPA Policy, Chapter 25, Appendices A, B, and C). 3. Complete the Referral for Independent Educational Evaluation form (DMCC 100F) selecting the type evaluation being requested: whether “Occupational Therapy, Psycho- educational, or Speech and Language,” and obtain the signature of the director of special education. By signing the referral, the director of special education acknowledges the LEA is responsible for the cost of the IEE. 4. Complete the Authorization for Use and/or Disclosure of Information form (D/M 63) and obtain the parent/guardian signature. Specify the receiving agency as the Desert/Mountain Children’s Center.
Referral Procedures Checklist: Forward the following documents to the attention of the Director of the DMCC. DMCC 100F Referral for Independent Educational Evaluation form D/M 63 Authorization for Use and/or Disclosure of Information form
Occupational Therapy, Psycho-educational, or Speech and Language prior evaluation report, if available and as applicable to the IEE request, that specifies services the student was receiving and the goals related to the services IEP or IEP Addendum dated within one year of the referral for an IEE to the DMCC to assess in the identified area of need Psycho-educational evaluation dated within three years of the referral for an IEE to the DMCC Any additional supporting information Timeline for Assessment Within five business days of receipt of the completed referral packet, the Director of the DMCC shall: 1. Assign and forward the Referral for Independent Educational Evaluation form (DMCC 100F) to a credentialed, certified and/or licensed DMCC evaluator. 2. Forward a copy of the Referral for Independent Educational Evaluation form (DMCC 100F) to the appropriate support person to document in client file and route to the DMCC Business Office.
Chapter 25 – Guidelines for Independent Educational Evaluation (IEE), Desert/Mountain SELPA
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As of 11/19/2021 Steering Committee Review/Approval
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