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R o c h e s t e r P u b l i c S c h o o l s : T o t a l S p e c i a l E d u c a t i o n S y s t e m M a n u a l

CHAPTER 2: REFERRAL STANDARDS T a b l e o f C o n t e n t s

PageChapter 2: Referral Standards

Pre-referral Interventions 2Pre-Referral Intervention / Problem Solving Teams 3Referral Standards: 4 Documentation of Interventions 4 Nonpublic and Interagency Referrals 4Referral Process for Students Birth to Pre-K 5Service Coordination 7Referral Process for Students Ages 5-21 8The Child Study Team 10Guidelines / Forms for Pre-referral of English Language Learners 11Documentation Links: ECSE Referral Form 28 ECSE Parent Contact Log 30 Getting Started Flowchart 31 Consent to Release Private Data 32 Developmental History 33 Pupil Immunization Record 40 Family Thoughts: Family Considerations and Concerns 42 ECSE Observation Form 43 Notice of Procedural Safeguards Brochure 45 Central Referral Team (CRT) Referral Follow-up Letter 55 Head Start Referral Form 56 Referral Procedures for Special Education Evaluation: Public School Students 65 Referral Procedures for Special Education Evaluation: Nonpublic School Students 68 Procedural Safeguards for Nonpublic Special Education Students 70infant and toddler intervention procedural safeguards notice 78Child Study Referral Form 87Child Study Log 89


PRE-REFERRAL INTERVENTIONS

: P RE - R E F E R R A L I N T E R V E N T IO N SKINDERGARTEN THROUGH 12TH GRADE

Pre-referral interventions are the responsibility of general education teachers with the support and consultation of principals, counselors, special education staff, school psychologists, and other specialists.

Pre-referral interventions are planned, systematic efforts by general education staff to resolve apparent learning or behavior problems.

At least TWO pre-referral interventions are required before a special education evaluation may be conducted, according to Minnesota Rule.

Pre-referral interventions may be waived if: the parent requests an evaluation, there is a significant urgency to the student’s situation, or the student’s disability is not conducive to remediation (e.g., deafness, blindness, TBI).

Interventions need to demonstrate that instructional approaches have actually been altered or modified for the student. A pre- and post- date for the intervention period, a description of what was done, and for how long are required for referral.

Pre-referral interventions should involve the parent to the extent that they understand the interventions and why they are being utilized.

Pre-referral interventions may include consultation by related service providers (i.e., occupational therapists, speech therapists).

- Reference: Specific Learning Disabilities (SLD) Manual


PRE-REFERRAL INTERVENTION / PROBLEM SOLVING TEAMS

P R E - R E F E R RA L I N T E R V E N T I O N / P R O B L E M S O L V I N G T E A M S

To assist teachers in developing interventions, building staff may consider the development of a pre-referral/ problem solving team. Several schools already have teams in place. The pre-referral intervention team is the school’s problem-solving team regarding students who are experiencing learning or behavioral problems. Pre-referral intervention teams consist of general education staff who work together with their colleagues to identify concerns, develop appropriate interventions for students, and determine the need for a special education evaluation. Special education staff can serve as a resource to the pre-referral

intervention team; however, the team should not be perceived as a “special education” service.

Questions to consider in addressing a student’s academic/behavior problem during the pre-referral process:

Has the problem been clearly defined?

Is there familiarity with the student’s educational record and background in order to identify those factors which may have a bearing on the presenting problem?

Is the problem of a chronic nature?

Is the identified problem serious enough to affect the educational progress of the student and/or classmates?

Have all of the techniques utilized by the teacher or others to address the student’s problems brought less than desired results?

Have all of the general education interventions been exhausted?


REFERRAL STANDARDSDocumentation of Interventions

Before a student is referred for a special education assessment, the district will conduct and document at least two instructional strategies, alternatives, or interventions while the student is in the regular classroom. The student’s teacher will provide the documentation. A special education team may waive this requirement when they determine the student’s need for the assessment is urgent. A student will not be denied the right to a special education assessment based on this requirement.

Nonpublic and Interagency ReferralsSpecial education instruction and services may be provided to students from birth until July 1 after the child with a disability becomes 21 years old, but will not extend beyond secondary school or its equivalent. Local health, education, and social service agencies must refer children under age five who are known to need or suspected of needing special instruction and services to the school district. A full range of education programs and services will be provided for children with a disability.

Primary referral sources include:

Hospitals, including prenatal and postnatal care facilities; Physicians; Parents; Day Care programs; Local educational agencies; Public Health facilities; Other social service agencies; and Other health care providers.


REFERRAL PROCESS FOR STUDENTS BIRTH TO PRE-K

Districts use the following referral process for students between birth to pre-kindergarten:Referral is the formal, ongoing process for reviewing information related to children who show signs of needing special education services. The referral process includes reviewing screening information and deciding whether or not to conduct an evaluation. A referral may be made by anyone who has a concern.

Birth to 3 Referral Process: The RIT team member assigned to the referral (typically a licensed ECSE

teacher) makes an initial contact with the family to determine specific needs and concerns. The Rochester Public Schools Developmental History form is used to compile relevant information. This information is then shared at the weekly RIT meeting. An additional home visit may be scheduled with the family by another ECSE birth to 3 teacher or a related services provider to observe the child and interview the parents.

Once the team, including the parents, agrees that an evaluation is appropriate, the RIT team member assists the family with completing the documents necessary to register the child with the Rochester Public Schools. An Evaluation Plan is then completed and signed by the parents. The evaluation team has 45 calendar days from the day the referral was received to complete the evaluation. The evaluation team typically conducts the evaluation in the home at a mutually agreed upon time with the family.

If the results of the home visit and observation, combined with information gathered from the parent, indicate no concerns at this time but suggest that it would be appropriate to track the child’s development, the RIT team member will put the child on the RIT follow-up list and will re-connect with the family at an agreed upon time (typically 2-3 months from the time of referral).

Preschool (Ages 3-5) Referral Process:

Referrals are made directly to the ECSE Lead Teacher at 507-328-4523.

The ECSE Lead Teacher contacts the family to determine specific needs and concerns, completes the blue Rochester School District 535 Early Childhood Education Management Team referral form and brings this information to the ECSE Assessment Team.

The membership of the 3-5 Assessment Team includes: ECSE Lead Teacher, ECSE teacher, School Psychologist, Speech/language Pathologist, School Social Worker (as needed), Occupational Therapist (as needed) , EBD teacher (as needed), teacher of the Visually Impaired (as needed) , and teacher of the deaf/hard of hearing (as needed).

The 3-5 Assessment Team receives referrals from various community agencies, as well as parents. The team meets weekly to discuss new referrals and update the members in regards to on-going evaluations.

If the team, including the parents, agree that an evaluation is appropriate, the school team arranges for a mutually convenient time to conduct the evaluation at a school site or in the child’s home. The evaluation team has 30 school days from the time the parent signs permission to evaluate to complete the evaluation.

If the team agrees that no evaluation is needed at this time, but would like to track the child’s development, the child will be put on the 3-5 Assessment Team follow-up list.

S E R V I C E C O O R D I N A T I O NOnce the public agency receives a referral, a service coordinator is appointed to carry out coordination activities on an interagency basis. Service coordination must promote a family’s capacity and competency to identify, obtain, coordinate, monitor, and evaluate resources and services to meet the family’s needs.

Service coordination activities include:

1. coordinating the performance of evaluations and assessments;2. facilitating and participating in the development, review, and evaluation of

individualized family service plans;3. assisting families in identifying available service providers;4. coordinating and monitoring the delivery of available services;5. informing families of the availability of advocacy services;6. coordinating with medical, health, and other service providers;7. facilitating the development of a transition plan at least 90 days before the time the

child is no longer eligible for early intervention services, if appropriate;8. managing the early intervention record and submitting additional information to the

local primary agency at the time of periodic review and annual evaluations; and9. notifying a local primary agency when disputes between agencies impact service

delivery required by an IFSP.


REFERRAL PROCESS FOR STUDENTS AGES 5 - 21 S p e c i a l E d u c a t i o n Re f e r r a l P r o c e s s K - 1 2

Referral process for students in grades K-12 (including non-public or home-schooled students):

Referral is the formal process for requesting a special education evaluation of a student who is experiencing significant difficulties in the school setting.

The Child Study Team (CST) process is a multidisciplinary approach to ensure appropriate education for all learners and is provided in accordance with due process procedures identified by IDEA and Minnesota statute. Parents need to be notified that their child will be brought to the Child Study Team. If appropriate, parents may be invited to the meeting to be a part of the discussion.

A CST will be formed in each building. The CST is the responsibility of general education but does require the support of special education. Team members will include both general and special education teachers. The CST is led by a building administrator who is responsible for maintaining the CST Monitoring Logs. The CST has the following primary responsibilities:

1. PROVIDE TEACHER ASSISTANCE. The CST provides a forum for general education teachers to bring student concerns. Teachers may present information defining current concerns they are experiencing in their classrooms with the individual student. The CST will provide suggestions and identify resources available to help the teacher support the student. The CST provides suggestions for appropriate classroom interventions that may be used prior to referring a student for a special education evaluation.

2. REVIEW PRE-REFERRAL INTERVENTIONS. The CST is responsible to review the documented interventions to ensure that at least two instructional interventions have been carried out over an appropriate timeframe (minimum of three weeks per intervention is the guideline).

The CST must consider the following options for each referral:a. Recommend the classroom teacher continue current interventions for

extended time and/or implement other suggested interventions.b. Recommend services such as 504, Reading Support, After School Academy

(ASA), Rochester After school Program (RAP) or ESOL Services.c. Recommend special education evaluation.d. No further follow-up needed.

3. MAKE DECISIONS TO PROCEED WITH INITIAL SPECIAL EDUCATION EVALUATION. The CST will review the pre-referral interventions, completed CST referral form signed by the parent/guardian, and individual student file information to determine if the Initial Special Education Evaluation is appropriate. The Child Study Team Referral Form should be used for this purpose. For students who are English Language Learners, the following forms should accompany the Child Study Team Referral Form: Student

Information Form, Home and Family Interview Form and the Summary of District Test Information Form.

The forms should be submitted to the Child Study Team Chairperson (building administrator). The principal or the CST committee will review the referral and sign it or return it to the referring teacher if further information is required or the pre-referrals are incomplete.

If the referral proceeds to evaluation, the CST identifies the building School Psychologist as the evaluation manager. The evaluation manager will then consult with other special education staff and with parents to determine areas to be evaluated and develop the Initial Evaluation Plan.

4. MONITOR SPECIAL EDUCATION INITIAL EVALUATIONS. The CST will ensure due process procedures are completed within timelines and according to state and federal guidelines. The CST shall monitor all referrals and Initial Evaluations by tracking the dates for each phase of the due process procedures. An Evaluation Team is allowed 30 school days from date of the parent’s signed consent to report completion. There must be a team meeting to determine eligibility and the evaluation report must be completed and delivered to the parents within the 30 day timeline.

N O T E : E F F O R T S M U S T B E M A D E T O I N C L U D E T H E P A R E N T S I N T H E D E C I S I O N - M A K I N G P R O C E S S . I F T H E

P A R E N T D O E S N O T R E S P O N D T O R E P E A T E D A T T E M P T S T O M A K E C O N T A C T ( A T L E A S T T W O D I F F E R E N T M E T H O D S M U S T B E A T T E M P T E D ) O R I F T H E P A R E N T I N D I C A T E S T H A T T H E Y C H O O S E N O T T O A T T E N D , T H E T E A M M A Y

S T I L L M E E T . H O W E V E R , D O C U M E N T A T I O N O F T H E A T T E M P T E D C O N T A C T S A N D / O R T H E P A R E N T S R E Q U E S T

T O P R O C E E D W I T H O U T T H E M M U S T B E N O T E D I N S T U D E N T P L A N S A N D I N T H E S T U D E N T ’ S C U M F I L E .

Parent initiated referral

When a parent requests an evaluation for special education, it is the district’s responsibility to follow-up on the request. It is recommended that the building principal, the school psychologist and the student’s general education teacher, if appropriate, meet with the parent to clearly establish the issue of concern. The parent and school staff should discuss whether to refer to special education or to possibly develop general education interventions that could address the concerns. If the decision is made to conduct a formal evaluation, the process outlined above should be followed. Pre-referral interventions are not required but are suggested for a parent referral.

Note: If a parent requests an initial special education evaluation verbally or in writing , the school district must complete the evaluation.

Referrals from other sources

Referrals may also be received from physicians, private and public programs, and health and human services agencies. Referrals from these sources should be directed to the building’s Child Study Team. Medical reports received about a student must be taken into consideration while completing the evaluation.


THE CHILD STUDY TEAM

The Child Study Team (CST) reviews the pre-referral interventions and decides whether: 1) current interventions should be continued, 2) if the student should be recommended for Title I, a 504 plan, or other in-building programs, or 3) if the student should be evaluated for special education consideration

The CST is chaired by the building administrator, and CST members are comprised of general education staff, the school guidance counselor, and special education licensed staff. The general education staff on the team shall be representative of the grades the school services, and in most buildings, will be the majority of the team members. The special education teachers and licensed staff shall be representative of the services provided in the building. It is important for all members to remember they are representing their colleagues, as well as providing individual expertise.

Responsibilities of the chairperson: receive referrals, create agenda & chair the CST meetings, maintain CST monitoring logs, invite other staff to meeting if referral suggests the need for particular expertise, submit CST monitoring logs to the Director of Student Support Services at the end of each semester.

Responsibilities of team members: review interventions for completeness and appropriateness, provide recommendations for classroom interventions and strategies and resources, represent colleagues, make interventions for each referral (in-building services, 504 plan, special education evaluation).

If an initial special education evaluation is recommended, the school psychologist (except for speech only, DHH, VI and ECSE evaluations) will be assigned as the evaluation manager.

The CST is responsible for coordinating the testing components of the evaluation with special education staff and parents


GUIDELINES FOR PRE-REFERRAL OF ENGLISH LANGUAGE LEARNERS

Prior to referring a student that is a English Language Learner (ELL), the following forms need to be completed and provided to the Child Study Team: 1) Student Information, 2) Home and Family Interview, 3) Teacher Rating Form, 4) Prereferral Intervention Form, and 5) Summary of District Test Information. These forms can be found in the District ELL manual. The ELL Manual can be found in its entirety on the Student Support Services website

STUDENT INFORMATIONTO B E C O M P L E T E D P R I O R T O R E F E R R A L BY C L A SS R O O M &

ESOL T E A C H E R

P L E A S E W O R K W I T H A G U I D A N C E C O U N S E L O R A N D P R O V I D E T H E F O L L O W I N G I N F O R M AT I O N W H E N R E F E R R I N G E L L S T U D E N T S T O T H E C H I L D S T U DY T E A M .

Student Name: Student ID:

Grade: Age:

Language spoken in the home: Grade level:

ESOL level at school: How many years in this school:

Attendance:

How well has the student adjusted to mainstream culture?

How well has the student adjusted to school culture?

What is the student’s previous experience with schooling?

How much time does the student spend interacting with mainstream peers?

What has been the student’s response to previous instruction?

What significant differences have been noted in comparing this student to his/her cultural/linguistic peers?

How does the student compare to other students who have been here the same length of time?

What was the student’s response to ESOL instructions?

N U M B E R O F B E H AV I O R R E F E R R A L S T O T H E P R I N C I PA L ?

Collect samples of the student’s daily work.

Areas of strength for the student:

List the classes the student failed and the reason for failure:C L A S S R E A S O N

ESOL : T E A C H E R

I S T H I S S T U D E N T M A K I N G A C A D E M I C P R O G R E S S ?

F I R S T L A N G U A G E A B I L I T I E S

N O T AT A L L

S O M E F LU E N T

R E A D S I N F I R S T L A N G U A G E

W R I T E S I N F I R S T L A N G U A G E

S P E A K S I N F I R S T L A N G U A G E

C O M P R E H E N D S I N F I R S T L A N G U A G E

HOME AND FAMILY INTERVIEWT O B E C O M P L E T E D B Y PA R E N T S

Dear Family Member,

The purpose of this form is to gather information from parents on your observations about your child and other issues that may affect your child’s school performance. The information you provide must be included as part of the assessment for your child. Your ideas and concerns are important to the assessment process and will be summarized in the Assessment Summary Report (ASR). Use additional paper if more room is needed when answering these questions.

Student’s Name

Date Birth Date

Parent(s)Form completed by Mail Personal interview with: __________________ Phone interview with:

Language(s) spoken in the home:

Percent of time English spoken in home:

Date of entry to U.S.:

Date of entry to Rochester:

How many years in U.S.?

How many years in this school?

How many years education in U.S.:

Attendance:

How many years has student been speaking English?

M E D I C A L /H E A LT H H I S T O RY

Does your child have any medical, physical or psychological conditions? Please check all that apply even if they are not currently present. For items checked, please provide explanation. Indicate medication if applicable.

Fix

CONCERN

MEDICATION EXPLANATION Vision Hearing/Frequent Ear

Infections Over Active Head Injury or Accidents Serious Illness Hospitalized/Operation Physical Movement Asthma Allergies Diabetes Frequent sadness Other

Were there any unusual complications during the pregnancy or birth of this child? yes no If yes, please explain:

Were the developmental stages such as walking, sitting, etc., for this child the same as with your other children?

yes no If yes, please explain:

How do you see this child as compared to his/her brothers and sisters?Give details:

SCHOOL AND B IL INGUAL INFORMATION 1) Did your child go to school in another country/state and/or in another city?

Where, when and for how long?

2) What has been the student’s response to previous instruction?

3) Did your child ever have English as a Second Language (ESL) instruction?

Where, when and for how long?

Their response to instruction:

4) Has your child ever had bilingual instruction? Where, when and for how long:

5) Has your child’s teacher expressed concern about your child’s school work?

Explain:

6) Do you think your child has a problem at school? Student lives with:

1) Who is child’s primary health care provider?:

2) Results of vision screening (see school nurse):

3) Results of hearing screening (see school nurse):

Communication History: (How the child communicates in the native language).

1) How old was your child when he/she spoke their first words?

2) Did he/she start talking sooner, at the same time, or later than your other children?

3) If your child did not talk, did he/she have other ways of communicating with you?

4) What language did your child first hear?

5) What language did your child first use?

6) Can you understand your child? If not, why?

7) What language does your child use with you?

With brothers and sisters? Grandparents?

8) Does your child pronounce sounds correctly in your native language?

What sounds are not said correctly?

9) Does your child often repeat sounds or seem to struggle to get words out?

10)Does your child use correct grammar in your native language?

11)Can he/she express himself/herself in complete sentences?

Example:

12)Does your child ask questions? Example:

13)Can your child follow simple directions?

14) Does your child ever talk about something that doesn’t make sense?

1. Do you think your child has a problem at school? Explain.

When did you first notice it? What do you think caused it?

2. Have you tried anything to help your child at home such as reading aloud, sitting with your child at homework time, etc.?

3. How do you think other people (relatives, neighbors) view your child?

4. In your opinion, what can the school staff do to be most helpful to your child at this time?

5. Share the strengths and special abilities of your child.

6. Describe the way you’ve seen your child learn best. Give an example.

7. Describe something your child has learned easily in the last three months.

8. Describe something your child had difficulty learning in the last three months.

9. What information would you like from this assessment?

10. How many days a week does your child have homework? ______________ (minutes or hours)

How many days a week does your child do homework? ______________ (minutes or hours)How long does he or she spend on homework each day? ______________ (minutes or hours)

Thank you for your input!

TEACHER RATING OF STUDENT SKILLS/ABILITIES(Attach to Child Study Team Referral Form)

Learner Name

ID#

Grade

Completed by

Today’s Date

Approximate Grade Achievement

Rate the areas of concern (1=mild, 2=moderate, 3=severe)

Reading

difficulty with alphabet recognition. poor sound symbol association. has difficulty in sound blending.

confuses visually similar words. reverses words in reading. omits/adds/skips sounds, letters, or words. has difficulty with sight vocabulary.

word guesser.

Comments:

Comprehens ion

difficulty demonstrating word comprehension.

forgets what is read orally. understands what is read to him/her, but not what

he/she reads silently. does not comprehend what he/she reads.

difficulty comprehending particular content area. – name content area difficulty with main idea, supporting details,

context, clues, and drawing conclusions.

Comments:

F luency

loses place when reading.. does not read independently. read words correctly in one context, but not in another. reads word-by-word or sound-by-sound. slow reading rate. difficulty taking tests.

Comments:

SUGGESTED READING INTERVENTIONS

A. change reading group/additional support.

B. peer or cross-age tutoring.C. parent

involvement/reinforcement/follow-up.

D. modify worksheet or workbook.E. use study carrel to improve

environment for conc concentration.

F. use of reinforcers/behavior modification techniques/contracts.

G. cooperative learning techniques.H. read along with taped readings.I. phrase/sentence strips.J. one-to-one assistance.K. Referral to reading specialist or

reading specialist or reading achievement lab.

L. The Pre-Referral Intervention Manual.

Form 1



Verbal Expression

has difficulty imitating speech sounds. omits, adds, substitutes, rearranges sounds or words when speaking. distorts or mispronounces words or sounds when speaking (not attributed to dialect or accent). does not use appropriate subject-verb agreement when speaking. has limited speaking vocabulary. has difficulty using verb tenses correctly when speaking. speaks dysfluently. does not complete statements or thoughts when speaking. speaks too loud/soft.

W r i t t e n E x p r e s s i o n

performs assignments carelessly. is unable to copy letters, words, sentences, and numbers from a model at a close distance. difficulty using capitalization and punctuation correctly. uses inappropriate spacing between words or sentences. reverses letters and numbers (when written). difficulty writing within a given space. difficulty punctuating correctly when writing. does not use appropriate subject-verb agreement when writing. does not compose complete sentences or express complete thoughts when writing. difficulty organizing writing activities correctly. o mits, adds, or substitutes words when writing. difficulty forming letters correctly when printing or writing. difficulty using verb tenses correctly when writing. uses inappropriate letter size when writing. difficulty writing simple paragraph with topic sentence and supporting details. difficulty beginning writing process (blank sheet syndrome).

d ifficulty with paragraph organization. writes slowly.

Comments:

Spe l l i ng

difficulty using spelling rules. difficulty with phonetic approaches to spelling. omits, substitutes, adds, or rearranges letter or sound units when spelling words. has difficulty spelling words that do not follow the spelling rules. does not use word-endings correctly when spelling or omits them. omits, substitutes, adds, or rearranges letter or sound units when spelling words. spells words correctly in one context, but not in another. requires continued drill and practice in order to learn spelling words.

Comments:

SUGGESTED READING INTERVENTIONS

A. peer and cross-age reading, speaking.B. verbally model what is to be writtenC. grouping or teaming to provide a written product.D. dictation to teacher or another learner and copy result.E. uses story starter.F. uses work banks.G. use of tape recorder.H. shortened assignments.I. model spoken language.J. specific writing forms (pre-printed with paragraph, indentation, spacing, margins).K. reinforcement of skills at home.L. cooperative learning.M. use wider ruled paper.N. use of alphabet strips.O. one-to-one assistance.P. The Pre-Referral Intervention Manual.Q. Other



Behavior toward peers

aggressive withdrawal – isolation poor social skills poor peer relationships attention seeking

Behav ior toward au thor i t y

aggressiveness disregards rules defiance anti-authority

Act iv i ty l eve l

hyperactive difficulty beginning a task difficulty staying on task lacks motivation lacks concentration impulsive perseverates difficulty with changes in routine

Genera l demeanor

daydreams generally depressed/unhappy easily upset tends to develop physical symptoms withdrawn immature overly dependent

Academics

inconsistent unable to do the work refuses to do the work poor quality work skips classes difficulty completing assignments loss or forgets materials/assignments late for class

ALTERNATE DISTRICT PRE-REFERRAL INTERVENTION FORM

Student

Student ID#

Date o f B i r th

Grade

School

Re fer r ing Person

Today ’ s Date

Are Parents/Guardians aware of your concern? Yes No

Define the student’s problem and explain what you would like to do that he/she does not do now. (What, when, where, how)

Description of Intervention I: (three weeks)What w i l l be done?

How will the plan be measured?

Durat ion o f i n te rvent ion? (m in imum of th ree -s i x weeks sugges ted)

What wou ld be acceptab le improvement?

Date In i t i a ted

Results:

Improvement

Main ta in P lan

Ex i t

Date o f Rev iew

Give specific data:

Date Rev iewed

Results:

No Improvement

Fu r ther In te rvent ion

Give specific data:

P R E - R E F E R R A LE N G L I S H L A N G U A G E L E A R N E R S

F O R M 5PRE-REFERRAL INTERVENTION FORM

SAMPLE Student Mary Smither 0505 Grad

e3 Date of

Birth00/00/00Referring

PersonMelloy Schoo

lSansibel Today’s

Date05/05/03

Are Parents/Guardians aware of your concern? Yes No

Define the student’s problem and explain what you would like to do that he/she does not do now. (What, when, where, how)

academic task completion – Does not work well independently (needs 3-5 reminders per hour). Does not follow directions.confuses order when given task involving 3 or more steps. Directions given in large group especially seem to get lost.task completion also a problem. Most assignments only get 2/3 done. Homework rarely is turned in. Talks a lot to peersduring time should be working.

Description of Intervention I: (three weeks)What will be done?

Directions for assignments will be printed in clear steps and a copy will be set on her desk for each

assignment with 3 or more steps. Teacher will check on progress every 15 min. (avg) and reward with a chip each time shehas completed more work. A finished task will be worth 3 chips. Chips will be turned in and tallied at end of each day.Mary will record # of chips earned per day on a graph to be kept at teacher’s desk. Teacher will send home copy of the graph once each week so parents may provide a reward in accord with reward schedule established.

How will the plan be measured?

Graph will have trend line that shows improvement in assignment completion and on

task performance.

Duration of intervention? (minimum of three-six Minimum of three weeks. Goal is six

weeks suggested) weeks.If success is demonstrated, continue for another six weeks.

What would be acceptable improvement?

Trend line shows improvement week by week. Class grades should also

improve with more work being completed.

Date Initiated

02/05/05 Results:

Improvement

Maintain Plan

Exit

Date of Review

02/19/03

Give specific data:

Improvement shown on graph (from baseline of 4 to second week average of 5). Grades for two

week period in math and language arts averaged C.

Date Reviewed

03/02/04 Results:

No Improvement

Further Intervention

Give specific data:

Continued improvement from baseline of 4 to current week average of 6. Grades maintained at C

In math and language arts. Graphs attached. Intervention will be continued.

Summary of District Test Information(Check Student View for Student Test Scores)

School Year:

T E S T S C O R E S : D AT E G I V E N

S C O R ES

D AT E G I V E N

S C O R ES

D AT E G I V E N

S C O R ES

T E A E :

* D I S T R I C T A V E . F O R T E A E :

M C AD I S T R I C T E L L S T U D E N T S A V E . F O R M C A

D R PD I S T R I C T E L L S T U D E N T S A V E . F O R D R P

D I B E L S

E V E RY D AY M AT HD I S T R I C T E L L S T U D E N T S A V E . F O R E V E RY D AY M AT H

S TA N F O R DD I S T R I C T E L L S T U D E N T S A V E F O R S TA N F O R D

* A V E R A G E F O R S T U D E N T S O F T H E S A M E C U LT U R A L G R O U P A N D S T U D E N T S W H O H A V E B E E N I N M I N N E S O T A S C H O O L S T H E S A M E L E N G T H O F T I M E .TEAE: Given to all ELL learners in the Fall (yearly). MCA: 1420 separates level 2 and 3 proficiency.

District-wide in grades 3 through 8 and 10, 11 at grade level (yearly). Scores are reported as Scale Scores and a score of 50 is average.

DRP: The Degrees of Reading Power Test is given in the Fall and Spring to all students in district ESOL program grades 2-12. 15-80 and National Percentile Rank scores of 50 percentile is average.

DIBELS: The Dynamic Indicators of Basic Early Literacy Skills Test is given District-wide to kindergarten and first grade students (three times a year).

Everyday Math: District-wide math test for grades 2-5 (end of the year). Start 04-05. Score percent correct – check for local percentile rank.

Stanford: Given to grades 2, 3, 4, 5, 6 and 9 once a year – composite– Percentile rank given with a score of 50 percentile as average.

NPR = National Percentile RankLPR = Local Percentile Rank

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R o c h e s t e r P u b l i c S c h o o l s : T o t a l S p e c i a l E d u c a t i o n S y s t e m M a n u a l D o c u m e n t a t i o n

ECSE REFERRAL FORM_____ ORIGINAL REFERRAL TO CUM

FOLDER

PLEASE SUBMIT THIS FORM TO THE APPROPRIATE ADDRESS BELOW:

Birth to 3 years of age, send to: Rochester Intake Team (RIT)2746 Superior Drive, NW, Suite 300Rochester, MN 55901(507) 328-4545FAX (507) 288-3993

Age 3 to Kindergarten, send to: Early Childhood Special EducationAttention Coordinator 334 16 St SE Rochester, MN 55904(507) 328-4523 or FAX (507) 328-4535

Kindergarten & above: Please contact your Home School Child Study Team

Gender of Child: _______ Male _______ Female TODAY’S DATE: ______________________________

1. Child's Name: Birth Date: LAST NAME FIRST NAME MIDDLE INITIAL

2. Address:

3. Telephone Number: (H) (W) When Available: ___________________________________

4. Parent(s): E-Mail:

5. Please put an in the specific area/(s) and then write the specific reason(s) and/or situation(s) that led you to make this referral.

_____ COGNITIVE/DEVELOPMENTAL

_____ SOCIAL/EMOTIONAL/BEHAVIORAL

_____ FINE MOTOR

_____ GROSS MOTOR

_____ COMMUNICATION/(SPEECH/LANGUAGE)

_____ HEARING

_____ VISION

_____ OTHER

6. Has your child taken part in any formal early childhood programming, (i.e.) Head Start, Nursery School, etc? NO _____ YES ______

Name of Program:_______________________ How long in program _________________________7. Need for interpreter for child? _____Yes _____No Language? _____________________

REFERRAL FORROCHESTER SCHOOL DISTRICT #535

EARLY CHILDHOOD EDUCATION MANAGEMENT TEAM

Referral Received:

_________________________

Need for interpreter for parents? ______Yes _____No Language? _____________________Need for Interpreter for child? _____Yes _____No Language?

If YES, please answer the following: How long has the child been in the U.S.?

____________________________________________________________________________ How long has the child been in an English speaking education program?

____________________________________________________

How did you learn about this service?_____________________________________________________________________________________________

Name of Referring Person: ___________________________________________ Agency: _________________________ Phone #: ___________________

E-Mail: ______________________________________________

SIGNATURE OF PARENT: _______________________________________________________________________ DATE: __________________________ (PARENT MUST SIGN)


ECSE PARENT CONTACT LOG

Rochester Public SchoolsECSE Parent Contact Log

School Year: ______to_____Student’s Name: ______________________________ ID: __________________________Parent/Caregiver Name(s): ___________________________________________________________________Phone Number(s): ______________________ ______________________

Type of Contact:Home Visit=HVTelephone=TConference=C

Email=E

Date Contact Persons Type of Contact

Reason Outcomes


GETTING STARTED FLOWCHART

Ch

Child with Suspected Delays

Referral of children under 3 years of age by family, doctor, public health nurse,

social worker, local agencies and programs to Rochester Intake Team (RIT)

328-4545

Contact attempted within 48 hours of referral- Rochester Intake Team:

Olmsted County Community Services 328-6400

Olmsted County Public Health Services 328-7500

Parent Professional 287-2032 Rochester School District 328-4523 Stanley Jones and Associates 288-0064

Register Child At Edison Building

Evaluate child with parent permission

Evaluation results reviewed with family

Qualifies for services based on evaluation

results

Does not qualify for school district services based on evaluation

results

Individual Family Service Plan (IFSP) written

Referral to community resources

Follow-up by RIT as determined by family and RIT


CONSENT TO RELEASE PRIVATE DATA** This is a sample, please complete the actual form in Student Plans


DEVELOPMENTAL HISTORYRochester Public Schools

Developmental History (Birth-Three)Child’s Name: Home Visit or Phone Call (circle)Date of Birth: Date Completed:Parent’s Names: Mother: Father:

Who does child live with?

Any custody agreement?Parent Contact Information: Address:

Phone Number: Other Number: Parent Email:

Siblings: Name Age

Parent Work Contact Information: Mother:

Father:

Daycare Provider Information: Name: Address:

Phone Number: Is this a possible visit location?

What are the best times to contact/visit family:

What is the primary language used in the Home?

Please describe your child in a few words or sentences:

What questions or concerns do you have about your child? (health, developmental, behavior, etc.)

Are any other agencies or services working with you and your child?

If yes, name of agencies or services.

BIRTH HISTORYBiological Birth or Adoption: Length of pregnancy:

Length of labor: Child birth weight:

Apgar scores: How long was child hospitalized:

Complications during delivery: Any breathing or feeding problems:

Illness or complications during pregnancy:

Other information:

MEDICAL HISTORYChild’s primary doctor/pediatrician:

Where:

Last well child exam:

Other doctors/departments your child has seen:

Immunizations up-to-date?

Is your child healthy or frequently sick?

Explain:

Hospitalizations (where/why/duration):

Known allergies: Regular medications:

History of seizures/convulsions: Age of onset: Frequency:

What does your child eat:

How often does your child eat:

Concerns:

When does your child sleep at night: How long:

When does your child nap:

How long:

Frequency:

Concerns:

Other Information:

Vision formally checked? Results:

Hearing formally checked? Results:

Date of last exam:

Concerns:

Date of last exam:

Concerns:

History of ear infections?

Age:

Frequency:

Ear tube placement?

Date:

SENSORY INFORMATION

Child Development ChartCircle item child does regularly—Place a “B” on item child is beginning

SOCIAL SELF-HELP GROSS MOTOR FINE MOTOR LANGUAGE*Quiets when fed and comforted*Makes eye contact

*Alert: interested in sights and sounds

*Wiggles and kicks*Thrusts arms and legs in play

*Looks at objects or faces

*Cries

*Makes small throaty sounds

Social smile. Lifts head and chest when lying on stomach.

Follows moving objects with eyes.

Cries in a special way when hungry.

Recognizes mother. Reacts to sight of bottle or breast.

Holds head steady when held sitting.

Holds objects put in hand.

Makes sounds—ah, eh, ugh.

Recognizes other familiar adults.

Increases activity when shown toy.

Makes crawling movements. Holds up hand and looks at it.

Laughs out loud.Squeals.

Interested in his or her image in mirror; smiles or is playful.

Reaches for objects.

Pivots around when lying on stomach.

Puts toys or other objects in mouth.Shakes rattle.

Ah-goo.

Reacts differently to strangers.

Rolls over from stomach to back. Picks up objects with one hand.

Responds to voices: turns head toward a voice.

Reaches for familiar persons.

Looks for object after it disappears from sight—for example, looks for toy after it falls off tray.

Rolls over from back to stomach. Transfers objects from one hand to the other.

Babbles.

Responds to his/her name; turns and looks.

Gets upset and cries if left alone.

Feeds self cracker or cookie.

Sits alone, steady. Holds two objects, one in each hand, at the same time.Brings two objects together.

Makes sounds like da, ba, ga, ka, ma.

Plays “peek-a-boo” Anticipates being lifted by raising arms.

Moves forward somehow while on stomach.

Uses forefinger to poke, push, or roll small objects.

Makes sounds like ma-ma, da-da, ba-ba.

0/18

Waves “bye-bye”.Gets into things.

Resists having a toy taken away.

Crawls on hands and knees.Pulls self to standing position.

Picks up small objects using thumb and finger grasp.

Imitates sounds that you make.

Plays “patty-cake”. Picks up spoon by handle.

Walks around playpen or furniture while holding on.

Interested in picture books.

Stands alone briefly. Puts small objects in cup or other container.

Understands phrases such as “NoNo” and “All gone”.

Imitates simple acts such as hugging or loving a doll.

Helps a little when being dressed.

Stands alone, steady. Turns pages of books a few at a time.

Says “Mama” or “Dada” for parent.

Plays with other children. Lifts cup to mouth and drinks.

Walks without help. Builds tower of 2 or more blocks.

Shakes head to express “No”.Hands object to you when asked.

Gives kisses. Insists on feeding self.

Climbs up on chairs or other furniture.

Marks with pencil or crayon.

Asks for food or drink with sounds or words.Comes when called.

Greets people with “Hi” or similar.

Feeds self with a spoon.Remembers where things are kept.

Runs. Scribbles with pencil or crayon.

Says 2 words besides Mama or Dada.Makes sounds in sequences that sound like sentences.

Sometimes says “No” when interfered with.

Eats with a fork. Kicks a ball forward.Good balance and coordination.

Builds tower of 4 or more blocks.

Uses 5 or more words as names of things.Follows a few simple instructions.

Early Child Development InventoryPlease circle Yes if statement describes child’s present behavior or No if statement does not describe child’s present behavior. Parents need to have seen their child perform the behavior and should not answer according to what they think he/she may be able to do.

Walks without help Yes No

Unbuttons one or more buttons Yes No

Says two or more words clearly Yes No

Feeds self cracker or cookie Yes No

Washes and dries hands Yes No

Understands the meaning of at least three place words (e.g. in, on beside, under) Yes No

Counts three or more objects Yes No

Refers to self as boy or girl correctly Yes No

Asks questions beginning with “why” or “when” Yes No

Holds two objects at the same time, one in each hand Yes No

Refers to his or her things as “mine” or “my…” Yes No

Uses short sentences to express simple ideas Yes No

Says “hi” Yes No

Helps with little household tasks Yes No

Says when something is heavy Yes No

15/3

Draws or copies circles Yes No

Sits without support Yes No

Says first name when asked “What’s your name?” Yes No

Asks questions beginning with “what” or “where” Yes No

Lifts a cup to his or her mouth and drinks Yes No

Toilet trained for bowel movements Yes No

Insists on feeding self Yes No

Sometimes says “No” when interfered with Yes No

Kicks a ball Yes No

Gets self up to a standing position Yes No

Points to at least three body parts, such as eyes, nose, mouth, hands, feet, etc. when asked to do so Yes No

Uses at least five words Yes No

Turns pages of picture-books on page at a time Yes No

Runs Yes No

Opens doors by turning knob Yes No

Names at least three body parts when asked to do so Yes No

Offers to help others Yes No

Understands the meaning of “up” and “down” Yes No

Identifies at least one color correctly Yes No

Uses at least ten words Yes No

Uses at least one word, such as me, I, he, she, you, it Yes No

Puts two sentences together with the words “and”, “or”, or “but” Yes No

Stands without support Yes No

Follows simple instructions Yes No

Uses the words “fast” and “slow” correctly Yes No

Names a few familiar objects in picture books Yes No

Plays with other children Yes No

Points to or names the bigger of two objects when asked to do so Yes No

Hands a toy to you when asked to Yes No

Claps hands Yes No

Feeds self with a spoon Yes No

Recalls past events: says things like, “Remember when we went…” Yes No

Asks for “more” or “another-one” Yes No

Waves “bye-bye” or “good-bye” Yes No

Tattles or tells on other children Yes No

Uses the words “you” in sentences Yes No

Walks up and down stairs alone Yes No

Builds a tower of two or more blocks Yes No

Eats with a fork Yes No

Sings simple songs Yes No

Responds to simple questions appropriately with “yes” or “no” Yes No

Toilet trained for bladder control Yes No

Puts two or more words together to make a short sentence Yes No

Tells what action is going on in picture, for example, “Kitty is eating” Yes No

Remembers where things are kept in the house Yes No

Do you have any concerns about your toddler’s behavior (aggressive, clingy or extremely shy, fearful, etc.)?

Words/Approximations/Signs/Gestures

Preferred toys/play activities/songs or games

New 3/08 R o c h e s t e r P u b l i c S c h o o l s : T o t a l S p e c i a l E d u c a t i o n S y s t e m M a n u a l D o c u m e n t a t i o n

PUPIL IMMUNIZATION RECORD


FAMILY THOUGHTS: FAMILY CONSIDERATIONS & CONCERNS:

Family Considerations

Do you feel your family has enough connections to be well supported?

Do you know of any families whose children have similar needs?

Are there additional supports that you would like for your family?

What recreational activities is your child interested in?

Do you feel you and your child’s medical needs are being met through your primary care provider?

How do you feel about coordinating your child’s medical appointments and care (PHN support)?

How is your insurance covering your visits (example TEFRA)?

Do you have reliable transportation to and from appointments?

Do you feel you could benefit from assistance from community services?

Do you have people who can help take care of your child so you can have a break?

Would it be helpful for you to get more information about extra resources for your child’s special needs, housing, clothing, ect.?

Do you feel there are other community resources that can help your family?

Would you like more information about community agencies that provide additional therapy and/or services?

Do you know where to go if you need further assistance for childcare?

Do you have opportunities to do fun learning activities with your child?


ECSE OBSERVATION FORMChild ____________________________ Adult_____________________________Setting __________________________ Date ____________________________Child Observations: Who is this child?

Play/Activity

Cognitive

Motor

Social/Behavior

Speech/Language Communication

Summary/Comments:

This form is completed on Initial Intake Visit and again during evaluation.


NOTICE OF PROCEDURAL SAFEGUARDS BROCHURE PROCEDURAL SAFEGUARDS NOTICE

PARENTAL RIGHTS FOR PUBLIC SCHOOL SPECIAL EDUCATION STUDENTS

INTRODUCTION

This notice provides an overview of parental special education rights, sometimes called procedural safeguards. This notice must be provided in your own language or any other mode of communication you may be using, unless such provision is clearly not feasible for the district. These same procedural safeguards are applicable for students with disabilities who have reached the age of 18. You must be provided a copy of this notice at least one time per year and:

1. The first time the student is referred for a special education evaluation, upon evaluation, or reevaluation;

2. The first time you or the district requests a due process hearing or you file a special education complaint with the Minnesota Department of Education; or

3. At your request.

PRIOR WRITTEN NOTICE

When a district proposes or refuses to initiate or change the identification, evaluation, or educational placement of a student or the provision of a free appropriate public education to the student, the district must serve prior written notice on the parent. The district must serve this notice on the parent within a reasonable time, and in no case less than 14 calendar days before the proposed effective date of the change or evaluation. If the notice only includes a refusal of a request, the notice must be served on the parent within 14 calendar days of the date the request was made.

A prior written notice must include the following statements:

1. A description of what the district proposes or refuses to do;2. An explanation of why the district proposes or refuses to take the

action;3. A description of any other options the district considered and the

reasons those options were rejected;4. A description of each evaluation procedure, assessment, record, or

report the district used as a basis for its proposal or refusal;5. A description of any other factors affecting and relevant to the

district’s proposal or refusal;6. A statement that you are protected by procedural safeguards and how

you can obtain a description of the procedural safeguards;

7. Sources you may contact for help in understanding these procedural safeguards.

8. A statement that the district will not proceed with the initial placement without your consent;

9. A statement informing you that except for the initial placement and provision of services, the district will proceed with the

proposed placement and provision of services unless you object in writing within 14 calendar days after the receipt of the notice; and

10. A statement indicating that you may request a conciliation conference if:

a. you refuse to provide written consent for an initial evaluation or initial placement;b. object in writing to any proposal; or c. the district refuses to initiate or change the identification,

evaluation, educational placement, or a free appropriate public education.

PARENTAL CONSENT

1. Giving your informed consent means that you have been fully informed of the information relevant to the activity for which your written consent is sought. Your consent is voluntary and may be revoked at anytime. However, the revocation of your consent does not negate any action that has occurred after your consent was given but before your consent was revoked. Revocation of your consent for a behavior intervention plan requires the district to immediately stop using the plan.

2. The district must obtain your consent before conducting an initial evaluation of the student. Your consent for an initial evaluation does not authorize the district to begin providing the student with special education and related services.

3. Your consent is required before the district begins to provide special education and related services to the student. If you refuse to consent to the initial provision of services to the student, the district may not override your refusal, and the district will not be considered in violation of the law for a failure to provide the student with special education and related services for which the district requested your consent.

4. Your consent is required before a district conducts a reevaluation of the student. The reevaluation may occur without your consent if the district has taken reasonable steps to get your consent and you have failed to respond.

5. You have a right to object in writing to any action the district proposes.

6. Generally, your consent is required before a district may disclose personally identifiably information regarding the student or the student’s educational

records, but this information may be disclosed to individuals within the district who have a legitimate educational interest in the information or are providing services to the

student under the IDEA. This information may also be disclosed in accordance with the Family Educational Rights and Privacy Act (“FERPA”), the Minnesota Government Data Practices Act, the Individuals with Disabilities Education Act (“IDEA”), or other law.

7. The law mandates that a district must seek reimbursement from health care insurers for the cost of health-related services the district provides whenever the provided services are covered by the student’s health insurance policy. The district will request your consent to disclose student records for the purpose of obtaining reimbursement from the student’s health insurance coverage. Your refusal to consent does not release the district from its obligation to provide a free appropriate public education to the student. You may withdraw your consent for disclosure of the student’s records at any time without consequence.

MEDICAL ASSISTANCE OR MINNESOTACARE

If the student is enrolled in medical assistance or MinnesotaCare, the District will attempt to seek reimbursement for health-related services provided under the student’s individual education plan (“IEP”). The district can request, though not require, you to provide information about the student’s health coverage. If you refuse to provide the district with information regarding the health coverage or refuse to allow the district to share information with the health care coverer, the district still must provide all services necessary for a free appropriate public education to the student.

ACCESS TO STUDENT’S EDUCATION RECORDS

If you want to review the student’s education records, the district must give you access to the records. The district must allow you to review the records without unnecessary delay, and before any meeting regarding an IEP or any due process hearing about the student.

Your right to inspect and review education records includes the right to:

1. An explanation or interpretation of the student’s records from the district upon reasonable request;

2. Have your representative inspect and review the records on your behalf; and

3. Request the district provide copies of the student’s education records to you.

The district may not charge a fee to search or retrieve the student’s education records. However, if you request copies, the district may charge a reasonable fee for the copies, unless charging that fee would prevent you from exercising your

right to inspect and review the education records. If you request 100 or fewer copies of black and white, letter or legal size paper copies, the district may not charge more than $.25 per copy.

The district must keep a record of persons accessing the student’s special education records. This record must include the persons, except the parents and district employees, who are given access to the student’s education records. This record of access must include the name of the person who accessed the records, the date of access, and the purpose of the person’s access to the student’s education records. You may specifically request a copy of all records concerning IEP health-related services disclosed by the district to a third party.

INDEPENDENT EDUCATIONAL EVALUATIONS

An independent educational evaluation (“IEE”) is an evaluation by a qualified person who is not an employee of your district. You may ask for an IEE at school district expense once the district evaluates the student and you disagree with the district’s evaluation. A hearing officer may also order an independent evaluation of the student at school district expense during the pendency of a due process hearing.

Upon your request for an IEE, the district must provide you with information about where an IEE may be obtained and the applicable district criteria for an IEE. When you request an IEE, the district must, without delay, ensure that either the IEE is provided at public expense or request a hearing to determine the appropriateness of the district’s evaluation. If the district requests a hearing and the hearing officer determines the district’s evaluation is appropriate, you still have the right to an independent evaluation, but not at public expense. If you obtain an IEE at your own expense, the results of the evaluation must be considered by the district and may be presented as evidence at a due process hearing regarding the student.

MEDIATION

Mediation is a voluntary process to help resolve disputes. Mediation uses a neutral third party trained in dispute resolution techniques. Mediation may not be used to deny or delay your right to a due process hearing or other procedural safeguards. If both you and the district agree to try mediation, a mediator will be assigned. The state will pay for the costs of mediation, but not for attorneys brought by either you or the district. The mediation will be scheduled in a timely manner and a location convenient to you and the district. All discussions during the mediation are confidential and cannot be brought forth later as evidence in a due process hearing. At any time during the mediation, you or the district may end the mediation. If a resolution arises from the mediation, the parties must execute a legally binding agreement stating the resolution and the confidentiality of the discussions that occurred during the mediation. The agreement must be signed by both you and the district. You or the district may request mediation from the

Minnesota Special Education Mediation Service (MNSEMS) at 651-582-8222 or 1-866-466-7367.

WRITTEN COMPLAINTS

Any parent, district, or organization may file a complaint with the Minnesota Department of Education (“MDE”). This complaint must be with respect to the identification, evaluation, educational placement, or provision of a free appropriate education of the student. A complaint sent to MDE must:

1. Be in writing and be signed by the individual or organization filing the complaint;

2. Allege violations of special education law or rules that have occurred within two years of the date the complainant

knew or should have known about the alleged action that forms the basis of the complaint.

3. State the facts upon which the allegation is based; and4. Include the name, address, and telephone number of the complainant.

The complaint must be sent to:

Minnesota Department Education Division of Compliance and Assistance Due Process Supervisor1500 West Highway 36 Roseville, MN 55113-4266 (T) 651-582-8689 (F) 651-582-8725

MDE will issue a written decision within 60 days. The final complaint decision may be appealed to the Minnesota Court of Appeals within 60 days of the date the decision is issued.

IMPARTIAL DUE PROCESS HEARING

Both you and the district have a right to request in writing an impartial due process hearing within two years of the date you or the district knew or should have known about the alleged action that forms the basis of the complaint. A request for a hearing must be sent to MDE and to the other party. A due process hearing may address any matter related to the identification, evaluation, educational placement, manifestation determination, or provision of a free appropriate public education of the student. The MDE will appoint an impartial hearing officer to conduct the due process hearing. If the MDE is the provider of services to the student, the MDE will request the Office of Administrative Hearings to appoint a qualified hearing officer.

Request for Due Process Hearing

The request for a due process hearing must include:

1. The name of the student;2. The address of the student;3. The name of the school the student is attending;4. A description of the nature of the problem(s) of the student causing

you to request the hearing, including facts relating to such problem(s); and

5. A proposed resolution of the problem to the extent known to you.

The requesting party may not have a due process hearing until the requesting party submits a request that complies with these requirements.

Resolution Session

When you request a hearing, the district must arrange for a resolution session to occur within 15 days after receiving the hearing request. The resolution session is an opportunity for you to discuss your complaint with the district and gives the district an opportunity to resolve the complaint. The resolution session must include you and relevant members of the IEP team. If an agreement is reached during the resolution session, you and the district must execute a legally binding agreement stating the resolution. Either party may void the agreement within three business days of signing the agreement.

The requirement for this resolution session may only be waived if (1) both you and the district agree to mediation; or (2) both you and the district agree to waive the resolution session requirement in writing. If you do not attend a resolution meeting or mediation, you are not entitled to a hearing.

Disclosure of Additional Evidence Before a Hearing

At least five business days before a hearing, you and the district must disclose to each other any evidence that you intend to use at the hearing, including, but not limited to, all evaluations of the student completed by that date as well as any recommendations based on those evaluations. A hearing officer may refuse to allow you to introduce any undisclosed evidence at the hearing unless the other party consents. All evidence must be limited to the specific issues described in the request for a due process hearing.

Your Rights During Hearing

Both you and the district have the right to:

1. Be accompanied and advised by an attorney and by individuals with special knowledge or training with respect to the problems of students with disabilities;

2. Present evidence;3. Confront, cross-examine, and compel the attendance of witnesses;

4. Prohibit the introduction of any evidence at the hearing that has not been disclosed at least five business days before the hearing, including, but not limited to, evaluation data and recommendations based on that data;

5. Receive a written copy of the hearing transcript, or at your discretion, an electronic, verbatim record of the hearing; and

6. Receive a written copy of the hearing officer’s findings of fact and decision, or at your discretion, an electronic version

of the findings of fact and decision.

As a parent, you have the right to:

1. Have the student who is the subject of the hearing present; 2. Open the hearing to the public; and 3. Notice of the time, date, and place of the hearing from the hearing

officer at least ten calendar days in advance of the hearing.

Hearing Process

The hearing must be held at a location within the district responsible for ensuring a free appropriate public education is provided to the student.

The burden of proof at the hearing is on the district to demonstrate, by a preponderance of the evidence, that it is complying with the law and offered or provided a free appropriate public education to the student in the least restrictive environment. If the district has not offered or provided a free appropriate public education in the least restrictive environment and you want the district to pay for a private placement, the burden of proof is on you to demonstrate, by a preponderance of the evidence, that the private placement is appropriate.

With the exception of an expedited hearing for which a decision must be rendered within ten days of the completion of the hearing, the hearing officer will make a written decision based only on evidence received and introduced in the record at the hearing not more than 45 calendar days from the expiration of the resolution period. Extensions may be available under some circumstances if the requesting party can show good cause. The proposed action or refusal will be upheld only upon a showing by the district by a preponderance of the evidence.

You have the burden of proving, by a preponderance of the evidence, that services for which you are paying or have paid, and for which you are seeking public funds, are appropriate for the student. In order for you to prevail, the hearing officer must have found that the district has failed to provide a free appropriate public education in the least restrictive environment.

Attorneys’ Fees for Hearings

You may be able to recover your attorneys’ fees if you prevail in a due process hearing or further civil action. A petition for fees must be filed in a court of

competent jurisdiction. A judge may make an award of attorneys’ fees based on prevailing rates in your community. The court may reduce an award of attorneys’ fees if it finds that you unreasonably delayed the settlement or decision in the case.

If the district prevails and a court agrees that your request for a hearing was for any improper purpose, such as to harass the district, you may be required to pay the district’s attorneys’ fees.

EXPEDITED HEARINGS

An expedited due process hearing may occur in the following situations:

1. Whenever you request a hearing to dispute a determination that the student’s behavior was not a direct result or caused by the

student’s disability;2. Whenever you request a hearing to dispute a 45-day interim

alternative education placement order by the district; or3. When a district requests an expedited hearing to establish that it is

dangerous for the student to remain in the current placement.

An expedited hearing must be held within 20 school days of the request for hearing. The hearing officer must issue the determination within 10 school days of the hearing. If you requested the expedited hearing, you and the district must comply with the resolution session requirement, mentioned in detail above. A hearing officer may decide to move the student to an interim alternative educational setting for up to 45 school days if the hearing officer determines that the student is substantially likely to injure self or others if he or she remains in the current placement.

CIVIL ACTION

The independent hearing officer’s decision is final unless you or the district files a civil action. If you or the district disagrees with the findings or decisions made by a hearing officer, either party may file a court action. The action may be brought in a federal district court or the Minnesota Court of Appeals. Different standards of review apply in each court. An appeal to the state Court of Appeals must be made within 60 days of the date of the decision. An appeal to a federal district court must be made within 90 days of the date of the decision.

STUDENT PLACEMENT DURING A HEARING OR CIVIL ACTION

During a hearing or court action, unless you and the district agree otherwise, the student will not be denied initial admission to school and the student will remain in the education placement where the student is currently placed. This is commonly referred to as the “stay-put” rule.

Three exceptions to the “stay-put” rule exist:

1. A student may be removed from his or her educational setting for not more than 45 days to an interim alternative educational placement for certain weapon, drug, or serious bodily injury violations; and

2. A decision by the hearing officer confirming your proposed student placement is the appropriate stay-put placement for the

student.3. If you and the district agree to a different placement pending the

completion of the proceeding.

INTERIM ALTERNATIVE EDUCATIONAL PLACEMENT

The district may unilaterally change the student’s educational placement for up to 45 school days if the student:

1. Possesses a dangerous weapon at school, on school premises, or at a school function;

2. Carries a dangerous weapon to school, on school premises, or at a school function;

3. Knowingly possesses or uses illegal drugs at school, on school premises, or at a school function;

4. Sells or solicits the sale of a controlled substance while at school, on school premises, or at a school function;

5. Has inflicted serious bodily injury upon another person while at school, on school premises, or at a school function.

The IEP team determines the interim alternative educational setting at which the student will be placed. Even though this is a temporary change, the setting must allow the student:

1. To continue to progress in the general curriculum, although in a different setting;

2. To continue to receive those services and modifications, including those described in the student’s IEP, that will help the student meet his or her IEP goals; and

3. Include services and modifications designed to prevent the behavior from recurring.

If the student is placed in an interim alternative educational setting, an IEP team meeting must be convened within ten school days of the decision. At this meeting, the team must discuss the behavior and its relationship to the student’s disability, review evaluation information regarding the behavior, consider teacher observations, your input, and determine the appropriateness of the student’s IEP and any behavior plan.

PRIVATE SCHOOL PLACEMENT

If your district has failed to or is unable to provide the student a free appropriate public education, you may be able to recover costs from a placement at an appropriate private school. You may be able to recover tuition expenses for a private school placement if you inform the district of your intent to enroll the student in a private school at public expense. This must be done at the most recent IEP team meeting prior to the removal of the student from public school or by written notice to the district at least 10 business days prior to removal of the student from public school. Your written notice must state why you disagree with the district’s proposed IEP or placement.

Your failure to tell the school of your intent to enroll the student in a private school at public expense, your failure to make the student available for evaluation, or other unreasonable delay on your part could result in a reduction or denial of reimbursement for the private school placement. If the district prevented you from providing notice, you are illiterate, or you cannot write in English, the hearing officer may not reduce the reimbursement.

FOR MORE INFORMATION

If you need help in understanding this notice or anything about the student’s education, please contact the administration at the student’s school, the district’s special education director, or the person or the agencies listed below. As indicated above, this notice is a general overview of parental special education rights as of November 2005, and is not intended to address a parent’s specific rights in a particular factual situation.

If you have any questions or would like further information, please contact:Name _____________________________ Phone _____________________________

For additional assistance, you may contact any of the groups listed below:

ARC Minnesota Minnesota Disabilities Law Centerwww.arcminnesota.com http://www.mndlc.org/(651) 523-0823 (612) 332-1441 (800) 582-5256 (800) 292-4150

(612) 332-4668 (TTY)

PACER Minnesota Department of Educationhttp://www.pacer.org/ http://www.education.state.mn.us(952) 838-9000 (651) 582-8689 (800) 537- 2237 (651) 582-8201 (TTY)(952) 838-0190 (TTY)RRM: 84289/nlt

http://www.pacer.org/


ROCHESTER INTERVENTION TEAM REFERRAL FOLLOW-UP LETTER

Month/Day/Year:__________________

Dear_________________________,

You referred (Name of Child):_______________________________on (Month/Day/Year):___________to (Name of Team Member):_____________________ (a member of the Rochester Public Schools Interagency Central Referral Team), through (Name of Agency):___________________.

We would like to inform you that (Name of Child):______________________ was visited by: Public Health Nurse:Education:and ( ):

Based on this team's screening/assessment information, this child/family will:

Comments:

If you have any questions or concerns regarding this child/family, please contact me. Thank you for referring this child/family to us.

Service Coordinator:Parents:Address:Phone:


HEAD START REFERRAL FORM

Parent shares concernsTeacher gathers information and takes concerns to CST or Problem Solving Team

Concern is identified

Teacher conducts and documents prereferral interventions

CST reviews prereferral information

Evaluation plan writtenAlternative options will be recommended

Referral is not appropriateIf referral is appropriate, an Evaluation Determination meeting is held


REFERRAL PROCEDURES FOR SPECIAL EDUCATION EVALUATIONS

Since 1975, public schools have been responsible for providing special education services to children with disabilities. Part of that obligation is the identification of students with disabilities who are in need of special education and related services. An educational evaluation is conducted to determine if a child meets the state mandated eligibility criteria for disabilities and if the child is in need of special education and related services. The disability areas include: Autism Spectrum Disorders (ASD) Deaf-Blind (DB) Deaf and Hard of Hearing (DHH) Developmental Cognitive Disability:

Mild to Moderate or Moderate-Severe (DCD-MM, DCD-MS)

Early Childhood Special Education (ECSE)

Emotional or Behavioral Disorders (EBD)

Other Health Disabilities (OHD) Physically Impaired (PI) Severely Multiply Impaired (SMI) Specific Learning Disability (SLD) Speech or Language Impairments

(S/LI) Traumatic Brain Injury (TBI) Visually Impaired (VI)

The purpose of this brochure is

to outline the

initial referral process used if a parent or teacher suspects that a student between the ages of 5 and 21 may have a disability and needs special education and related services.

Child Find Process

Rochester Public Schools: Special

Education Department

If concerns persist teacher submits prereferral intervention documents to building Child Study Team

(CST)

Referral Process

Parent or teacher identifies a concern with the student’s academic performance, communication, health/physical status, social/emotional or behavioral skills, motor skills, or functional skills.

Parent and teacher discuss concern.

Teacher gathers information on student performance and presents it to the building Child Study Team / Problem Solving Team

Teacher conducts and documents prereferral interventions.

If concerns persist and performance is discrepant from classmates/norms, teacher submits prereferral interventions and information to the special education Child Study Team (CST)

The school Child Study Team (CST) reviews prereferral information and interventions and will contact parent, teacher and/or principal for additional information or consultation.

The CST determines whether prereferral information is adequate. If not, the information is returned to the referring party for completion.

The CST then determines if an evaluation is needed.

If evaluation is needed, an Evaluation Determination meeting is held

and an evaluation plan is completed. The plan is shared with parents for their written consent.

If the referral is inappropriate, alternative options for action will be recommended.

For additional information:Rochester Public Schools Student

Support ServicesEdison Building 615 7th St. SW

Rochester, MN 55902Phone: (507) 328-4310

Parent and nonpublic school teacher discuss concern

Nonpublic school teacher gathers information and contacts Public School Child Study Team

If concerns persist teacher submits prereferral intervention documents to public school Child Study Team leader(CSTleader

Concern is identified

Public school Child Study Team reviews prereferral information

Evaluation plan written

Alternative options will be recommended

Nonpublic school teacher conducts and documents prereferral interventions

Referral is not appropriateIf referral is appropriate, an

Evaluation Determination Meeting is held

8/08 R o c h e s t e r P u b l i c S c h o o l s : T o t a l S p e c i a l E d u c a t i o n S y s t e m M a n u a l D o c u m e n t a t i o n

REFERRAL PROCEDURES FOR NONPUBLIC SPECIAL EDUCATION EVALUATIONS

Since 1975, public schools have been responsible for providing special education services to children with disabilities. Part of that obligation is the identification of students with disabilities who are in need of special education and related services. An educational evaluation is conducted to determine if a child meets the state mandated eligibility criteria for disabilities and if the child is in need of special education and related services. The disability areas include:

Autism Spectrum Disorders (ASD) Deaf-Blind (DB) Deaf and Hard of Hearing (DHH) Developmental Cognitive Disability:

Mild to Moderate or Severe-Profound(DCD-MM, DCD-SP)

Early Childhood Special Education (ECSE)

Emotional or Behavioral Disorders (EBD)

Other Health Disabilities (OHD) Physically Impaired (PI) Severely Multiply Impaired (SMI) Specific Learning Disability (SLD) Speech or Language Impairments

(S/L) Traumatic Brain Injury (TBI) Visually Impaired (VI)

The purpose of this brochure is to outline the initial referral

process used if a parent orteacher suspects that a student between the ages of 5 and 21 may have a disability and needs special education and related services.

Child Find Process

Rochester Public Schools

Special Education Department

Referral Process Parent or nonpublic school teacher identifies a concern with the student’s academic performance, communication,

health/physical status, social/emotional or behavioral skills, motor skills, or functional skills.

Parent and nonpublic school teacher discuss concern.

Nonpublic school teacher gathers information on student performance.

Nonpublic school teacher conducts and documents prereferral interventions.

If concerns persist and performance is discrepant from classmates/norms, teacher submits prereferral interventions and information to the Public School Child Study Team leader where the nonpublic school is aligned.

The public school Child Study Team (CST) reviews prereferral information and interventions and will contact parent, teacher and/or principal for additional information or consultation.

The CST determines whether prereferral information is adequate. If not, the information is returned to the referring party for completion. The SST determines if an evaluation is needed.

If evaluation is needed, an evaluation determination meeting is held and an evaluation plan is completed. The plan is shared with parents for their written consent.

If the referral is inappropriate, alternative options for action will be recommended.

For additional information:Rochester Public Schools Special Education Department

Edison Building615 7th Street SW

Rochester, MN 55902Phone: 507-328-4310

8 R o c h e s t e r P u b l i c S c h o o l s : T o t a l S p e c i a l E d u c a t i o n S y s t e m M a n u a l D o c u m e n t a t i o n

PROCEDURAL SAFEGUARDS NOTICE FOR NONPUBLIC SPECIAL EDUCATION STUDENTS

NOTICE OF PROCEDURAL SAFEGUARDS FOR PARENTS

WHO HAVE UNILATERALLY ENROLLED A CHILD WITH A DISABILITY AT A NONPUBLIC SCHOOL

INTRODUCTION

This document is intended to provide an overview of the special education rights, called procedural safeguards, which are available to parents who have unilaterally enrolled a child with a disability in a nonpublic school, including a private school or a home school. These same procedural safeguards are also available for students with disabilities who have reached the age of 18, who remain eligible for special education, and who have enrolled themselves in a nonpublic school. This document will be provided in your native language or through another mode of communication when necessary.

PARENTAL CONSENT

1. Consent means that you have been fully informed of the information relevant to the activity for which your written consent is sought. Your consent is voluntary and may be revoked at anytime. However, the revocation of your consent does not negate any action that has occurred after your consent was given but before your consent was revoked, except for the revocation of consent for a behavior intervention plan, which requires the school district to immediately stop using the plan.

2. The school district must obtain your consent before conducting an initial evaluation of your child. Your consent for an initial evaluation does not authorize the school district to begin providing your child with special education and related services.

3. Your consent is required before the school district conducts a reevaluation of your child. The reevaluation may occur without your consent if the school district has taken reasonable steps to get your consent and you have failed to respond.

4. Your consent is not required for the district to review existing data on your child or to administer a test or other evaluation that is given to all children, unless consent is required from parents of all children.

5. Your consent is required before the school district begins to provide special education and related services to your child. If you refuse to consent to the initial provision of services to your child, the school district may not override your refusal, and the school district will not be considered in violation of the law for a failure to provide your child with special education and related services for which the school district requested your consent.

6. You have a right to object in writing to any action the school district proposes. However, the manner in which a parent of a unilaterally placed non-public school student challenges a

school district’s decision or proposal varies according to the nature of the decision or proposal.

7. Generally, your consent is required before the school district may disclose personally identifiably information regarding your child or your child’s educational records, but this information may be disclosed to individuals within the district who have a legitimate educational interest in the information or are providing services to your child under the IDEA. This information may also be disclosed in accordance with the Family Educational Rights and Privacy Act (“FERPA”), the Minnesota Government Data Practices Act, the Individuals with Disabilities Education Act (“IDEA”), and other laws.

ACCESS TO EDUCATION RECORDS

Your Access to Records

Subject to any applicable limitations under the Minnesota Government Data Practices Act, you have the right to review your child’s education records. The school district must allow you to review the records without unnecessary delay, and before any meeting regarding a services plan or any due process hearing about the student. The school district generally must comply with your request to review your child’s education records within ten business days.

Your right to inspect and review education records includes the right to:

1. An explanation or interpretation of your child’s records from the district upon request;2. Have your representative inspect and review the records on your behalf; 3. Review your child’s records as often as you wish; and4. Ask the school district to provide copies of your child’s education records to you,

subject to any costs that are permitted under the law.

Record of Access by Others

The school district must keep a record of persons accessing your child’s special education records. This record must include the persons, except parents and authorized school district employees, who are given access to your child’s education records. This record of access must include the name of the person who accessed the records, the date of access, and the purpose of the person’s access to your child’s education records.

Consent to Release Records

Parental consent is required before personally identifiable information is released to unauthorized individuals or agencies. The consent must be in writing and must specify the individuals or agencies authorized to receive the information; the nature of the information to be disclosed; the purpose for which the information may be used; and a reasonable expiration date for the authorization to release information. Upon request, the district must provide you with a copy of records it discloses after you have given this consent. The district may not disclose information contained in your child’s services plan (such as diagnosis and treatment information) to a health plan company without your signed consent.

If your child is enrolled or is going to be enrolled in a nonpublic school that is not located in the school district of your residence, your consent must be obtained before any personally identifiable information about your child is released between officials of the school district where the private school is located and officials of the school district where you reside.

Fees for Searching, Retrieving, and Copying Records

The school district may not charge a fee to search or retrieve your child’s education records. However, if you request copies, the district may charge a reasonable fee for the copies, unless charging that fee would prevent you from exercising your right to inspect and review the education records because you cannot afford to pay it. If you request 100 or fewer copies of black and white, letter or legal size paper copies, the district may not charge more than $0.25 per copy.

Amendment of Records at Parent’s Request

If you believe that information in your child’s records is inaccurate, misleading, incomplete or in violation of your child’s privacy or other rights, you may request in writing that the school district amend or remove the information. The school district must decide within a reasonable time whether it will amend the records. If the school district decides not to amend the records, it must inform you that you have the right to a hearing to challenge the school district’s decision. If, as a result of that hearing, the school district decides that the information is not inaccurate, misleading, incomplete or in violation of your child’s privacy right, it must inform you that you have the right to include a statement of your comments and disagreements alongside the challenged information in your child’s education records.

Destruction of Records

The school district will inform you when personally identifiable information is no longer needed in order to provide educational services to your child. That information must be destroyed at your request. However, the school district may retain a permanent record of your child’s name, address, phone number, grades, attendance records, classes attended, grade level completed and year completed. The school district may not destroy any education records if there is an outstanding request to review those records.

CHILD FIND

Under the Individuals with Disabilities Education Act (IDEA), public schools are obligated to locate, evaluate, and identify all children with disabilities, including those students voluntarily enrolled in and attending nonpublic schools.

SPECIAL INSTRUCTION AND SERVICES

Under federal law, no parentally placed nonpublic school child with a disability has an individual right to receive some or all of the special education and related services that the child would receive if enrolled in a public school. However, under Minnesota law, no resident of a school district who is eligible for special instruction and services may be denied instruction and service on a shared time basis because of attending a nonpublic school. A shared time student is one who attends public school programs for part of the regular school day and who otherwise fulfills the requirements of the compulsory attendance law by attending a nonpublic school. For those children with a disability who attend nonpublic school at their parents’ choice, a school district may provide special instruction and services at the public school, the nonpublic school, or a neutral site. The school district must determine the location where it will provide services on a student-by-student basis, consistent with federal law.

SERVICES PLAN

A “services plan” describes the special education and related services that the school district will provide to a child with a disability who attends a nonpublic school for all or part of the school day. The special education and related services described in a services plan must be provided by personnel meeting the same standards as personnel providing services at the public school

district. A services plan must be developed, reviewed, and revised consistent with the requirements for developing, reviewing, and revising an individual education program (IEP). On a student-by-student basis, the school district may offer to provide the services specified in a services plan at a public school, a neutral site, or a nonpublic school, including a religious school to the extent consistent with law.

INDEPENDENT EDUCATIONAL EVALUATIONS

An independent educational evaluation (“IEE”) is an evaluation by a qualified person who is not an employee of your district. You may ask for an IEE at school district expense each time the district evaluates the student and you disagree with the district’s evaluation. A hearing officer may also order an independent evaluation of the student at school district expense during the pendency of a due process hearing.

Upon your request for an IEE, the district must provide you with information about where an IEE may be obtained and the applicable district criteria for an IEE. When you request an IEE, the district must, without delay, ensure that either the IEE is provided at public expense or request a hearing to determine the appropriateness of the district’s evaluation. If the district requests a hearing and the hearing officer determines the district’s evaluation is appropriate, you still have the right to an independent evaluation, but not at public expense. If you obtain an IEE at your own expense, the results of the evaluation must be considered by the district and may be presented as evidence at a due process hearing regarding the district’s obligation to locate, evaluate, or identify the student.

PRIOR WRITTEN NOTICE

The district must provide you with prior written notice each time it proposes to initiate or change, or refuses to initiate or change the identification, evaluation or educational placement of your child, or to modify a services plan for your child. This written notice must include:

1. A description of the action proposed or refused;2. An explanation of why the district proposes or refuses to take the action;3. A description of any other options the district considered and the reasons why those

options were rejected;4. A description of each evaluation procedure, test, record or report the district used as

a basis for its proposal or refusal;5. A description of any other factors relevant to the district’s proposal or refusal;6. A statement that your child has protection under these procedural safeguards and

information about how you can get a copy of the brochure; and7. Sources for you to contact to obtain assistance in understanding these procedural

safeguards.

WRITTEN COMPLAINTS

You may file a complaint with the Minnesota Department of Education (“MDE”) to challenge any aspect of the school district’s provision of special education and related services to your child. A complaint sent to MDE must:

1. Be in writing and be signed by the individual or organization filing the complaint; 2. Allege violations of federal and/or state special education law or rules that have

occurred not more than one (1) year prior to the date the complaint is received by MDE;

3. State the facts upon which the allegation is based and include a proposed resolution for your complaint;

4. Include the name, address and telephone number of the person or organization filing the complaint, the name and address of the nonpublic school attended by the child; and the school district in which the nonpublic school is located or against which the complaint is being raised;

5. Provide a copy of the complaint to the school district at the same time the complaint is filed with MDE.

The complaint must be sent to:

Minnesota Department of Education Division of Compliance and Assistance Due Process Supervisor1500 West Highway 36 Roseville, MN 55113-4266 (T) 651-582-8689 (F) 651-582-8725

MDE will investigate the complaint and issue a written decision within 60 days. The final complaint decision may be appealed to the Minnesota Court of Appeals within 60 days of receiving the final decision.

MEDIATION AND IMPARTIAL DUE PROCESS HEARINGS

The parents of children with disabilities who are unilaterally attending a nonpublic school have limited access to due process hearings and other dispute resolution proceedings. The parents of children with disabilities who are unilaterally attending a nonpublic school may only request mediation and/or a due process hearing to resolve a dispute over the district’s responsibility to locate, evaluate, and identify a child with a disability.

Mediation

Mediation is a voluntary process to help resolve disputes. You or the school district may request mediation from the Minnesota Special Education Mediation Service (MNSEMS) at 651-582-8222 or 1-866-466-7367. Mediation uses a neutral third party trained in facilitative dispute resolution techniques. Mediation may not be used to deny or delay your right to a due process hearing regarding the school district’s obligation to locate, evaluate, or identify your child. Both you and district staff must agree to engage in mediation before a mediator can be assigned. At any time during the mediation, you or the school district may end the mediation.

Procedures for Initiating a Due Process Hearing

Impartial due process hearings must be requested in writing within two (2) years of the date you knew or should have known about the alleged action that forms the basis of your request for a hearing. A request for a hearing must be sent to MDE and to the responsible school district. You may only request a due process hearing to resolve a dispute over the district’s responsibility to locate, evaluate, or identify a child with a disability.

The request for a due process hearing must include:

1. The name of your child;2. The address of your child;3. The name of the school your child is attending; 4. A description of the problem(s), including your view of the facts relating to such

problem(s); and5. A proposed resolution of the problem to the extent known to you.

The MDE will appoint an impartial hearing officer to conduct the due process hearing.

Resolution Session

When you request a hearing regarding the location, identification, or evaluation of your child, the school district must arrange for a resolution session to occur within fifteen days after receiving the hearing request. The resolution session is an opportunity for you to discuss your complaint with the school district and gives the district an opportunity to resolve the complaint. The resolution session must include you and the relevant individuals involved with the child find process for your child. If an agreement is reached during the resolution session, you and the school district must execute a legally binding agreement stating the resolution. Either party may void the agreement within three business days of signing the agreement. If the matter is not resolved to your satisfaction within 30 days of your hearing request, the hearing timelines begin.

The requirement for this resolution session may only be waived if both you and the school district agree to mediation, or both you and the school district agree to waive the resolution session requirement in writing. If you do not attend a resolution meeting or mediation, and the school district does not agree to waive the meeting in writing, you are not entitled to a hearing.

Your Rights During Hearing

Both you and the school district have the right to:

1. Be accompanied and advised by an attorney and by individuals with special knowledge or training with respect to the problems of students with disabilities;

2. Present evidence;3. Confront, cross-examine, and compel the attendance of witnesses;4. Prohibit the introduction of any evidence at the hearing that has not been disclosed at

least five business days before the hearing, including, but not limited to, evaluation data and recommendations based on that data;

5. Receive a written copy of the hearing transcript, or at your discretion, an electronic, verbatim record of the hearing; and

6. Receive a written copy of the hearing officer’s findings of fact and decision, or at your discretion, an electronic version of the findings of fact and decision.

As a parent, you have the right to:

1. Have your child who is the subject of the hearing present; 2. Open the hearing to the public; and 3. Notice of the time, date, and place of the hearing from the hearing officer at least ten

calendar days in advance of the hearing.

Disclosure of Additional Evidence Before a Hearing

At least five business days before a hearing, you and the school district must disclose to each other any evidence that you intend to use at the hearing, including, but not limited to, all evaluations of the student completed by that date as well as any recommendations based on those evaluations. A hearing officer may refuse to allow you to introduce any undisclosed evidence at the hearing unless the other party consents. All evidence must be limited to the specific issues described in the request for a due process hearing.

Hearing Process

The hearing must be held at a location within the school district. The party who requests the hearing has the burden of proving its case by a preponderance of the evidence. If you request a

hearing, you would have the burden of proving, by a preponderance of the evidence, that the district did not comply with its responsibility to locate, evaluate, or identify your child.

The hearing officer will make a written decision based only on evidence received into the record at the hearing. The hearing officer will make his or her written decision not more than 45 calendar days from the expiration of the resolution period. Extensions may be available under some circumstances if the requesting party can show good cause. The hearing officer’s decision is final unless you or the school district appeals from the decision by commencing a civil action.

Attorneys’ Fees

You may be able to recover your attorneys’ fees if you prevail in a due process hearing or further civil action. A petition for fees must be filed in a court of competent jurisdiction. A judge may make an award of attorneys’ fees based on prevailing rates in your community. The court may reduce an award of attorneys’ fees if it finds that you unreasonably delayed the settlement or decision in the case or that you prevailed in a limited portion of your case. If the school district prevails and a court agrees that your request for a hearing was for an improper purpose, such as to harass the school district, you may be required to pay the school district’s attorneys’ fees.

Civil Action

If either party disagrees with the findings or decisions made by a hearing officer, the party may appeal by commencing an action in federal district court or the Minnesota Court of Appeals. Different standards of review apply in each court. An appeal to the Minnesota Court of Appeals must be made within 60 days of your receipt of the hearing officer’s decision. An appeal to a federal district court must be made in accordance with federal and state law.

FOR MORE INFORMATION

If you need help understanding this notice or anything about your child’s education, please contact the administration at the student’s school, the district’s director of student support services, or the person or the agencies listed below. This notice is a general overview of procedural safeguards for parents of children with disabilities who are unilaterally enrolled at a nonpublic school. This notice is not intended to address a parent’s specific rights in a particular factual situation.

If you have any questions or would like further information, please contact:

Name _____________________________

Phone _____________________________

For additional assistance, you may contact any of the groups listed below:

ARC Minnesota (advocacy for persons withdevelopmental disabilities)www.arcminnesota.com 651-523-08231-800-582-5256

Children Home Society (CHS) and Family Service Incwww.chsfs.org651-255-24481-800-982-2303

MN Association for Children’s Mental Healthwww.macmh.org 651-644-73331-800-528-4511

Brain Injury Association of Minnesotawww.braininjurymn.org 612-378-27421-800-444-6443

http://www.braininjurymn.org/

http://www.macmh.org/

http://www.chsfs.org/

http://www.arcminnesota.com/

MN Disability Law Centerwww.mndlc.org 612-332-14411-800-292-4150612-332-4668 (TTY)

PACER (Parent Advocacy Coalition for Educational Rights)www.pacer.org 952-838-90001-800-537-2237952-838-0190 (TTY)

You may also contact:

Minnesota Department of Educationwww.education.state.mn.us651-582-8689651-582-8201 (TTY)

RRM: 113046

http://www.education.state.mn.us/

http://www.pacer.org/

http://www.mndlc.org/

I N F A N T A N D T O D D L E R I N T E R V E N T I O N P R O C E D U R A L S A F E G U A R D S N O T I C E


CHILD STUDY REFERRAL FORM

Building: Date:

STUDENT INFORMATIONID Number: Name: Birthdate: Age: Grade: Address:

Parent(s) or Legal Guardian: Phone Numbers: Address (if different from child):

Referring Person Name: Referring Person Title:

REASON FOR REFERRAL (Be specific)For English Language Learner Referrals, please see the Working Together to Meet the Needs of the ENGLISH Language Learner Manual on the ISD 535 website.

PARENT CONTACT REGARDING REFERRAL BY REFERRING PERSONDates Information

PRE-REFERRAL INTERVENTIONS (Attach Pre-Referral Intervention Documentation)Intervention CST Review Response (this section completed by CST)1. 2. 3.

LEARNER FILE INFORMATION Previous referral or services(Note What, When, Where)

Current Supporting Services

Attendance

Achievement Data Testing ScoresReport Card

Behavioral Data

Health (include vision & hearing if concerns)

Other

DISPOSITIONTO BE COMPLETED BY CHILD STUDY TEAM

CHAIRPERSON

Options include: Return to teacher for further intervention

Recommend pursuit of other service: 504, School Guidance, Title I,

In-building support group, Other In-building programsRecommend Initial Special Education EvaluationNo further consideration needed

Dates Action Person identified to move next step

_____ Copy of this form is to be placed in Student Cumulative File_____ Copy of this form is to be maintained with CST records

CHILD STUDY LOG

Child Study Team Monitoring LogReferrals and Initial Special Education EvaluationsSchool: __________________ Chairperson____________ School Year: 20011-2012Submit copy to Director of Student Support Services at end of each semesterChild Study Team Leader records on this form all referral and Initial Evaluation Data.*Initial Referrals includes students new to special education in Minnesota and students changing from ECSE to specific disabilityDISTRICT CST INFORMATION FOR 2011-2012

School Name

Last Name, First Name

M o

r F

Grad

e

Ethn

icity

Refe

rred

by:

Date

Qua

lified

?

Pri.

Disa

bilit

y

Sec.

Disa

bilit

y

Documents

Chapter 2: TSES - rochester.k12.mn.us Web viewmodify worksheet or workbook. ... does not use word-endings correctly when spelling or omits them. ... uses story starter. uses work banks