CALENDAR - bloomington.k12.mn.us Web viewBL#12 11/04. Other standardized test scores: ... Accuracy of oral word reading on grade level passages ... Adapts to a new motor task

Special Education

Non-Public

Guidebook

TABLE OF CONTENTS

I. SERVICES AVAILABLE PAGE

A. District Responsibility 2B. Goals and Objectives 2C. Program Description 3

II. PROCEDURES FOR INITIATING EVALUATION AND POSSIBLE SERVICE

A. Prereferral 3B. File Search and Review 3C. Initiating Evaluation 4

III. DELIVERY OF SERVICES

A. Procedures for Evaluation and Placement 4B. Transportation 4C. Location of Special Instruction and Services 5

IV. RECORD KEEPING

A. Responsibility of Record Keeping 5B. Location of Records 6C. Transfer of Records 6

APPENDIX A Prereferral Forms 7 - 15APPENDIX B Monthly Student Attendance Form 16

Non Public Guidebook 11/2013 1

I. SERVICES AVAILABLE

A. DISTRICT RESPONSIBILITY

The District is responsible for providing special education programs to children with disabilities. This includes parentally-placed private school children with disabilities who attend private schools located within the boundaries of the District, regardless of where the student resides, and Bloomington students with disabilities who are home-schooled.

PROVIDING SPECIAL EDUCATION TO SHARED-TIME PUPILS

Districts shall identify and make available special education to all students who are disabled regardless of whether they attend a non-public school or are home-schooled. For students who are referred for special education services, the district shall inform parents of their rights to special education services for eligible students. In the evaluation or provision of special education to eligible students, the district may:

1. Evaluate the student at the non-public school, including observing the student in the classroom as part of the formal evaluation;

2. Meet periodically with the non-public staff to review progress of the student in the student’s special education program;

3. Periodically observe the student in the non-public classroom to evaluate the result of the special education provided; and

4. Hold IEP and IFSP meetings at the non-public school.

Special education services provided indirectly or directly to the student may be provided on the premises of the public school, on the premises of the private school or at a neutral site other than a non-public school. (Minnesota Statute 125A.19 Subdivision.4(b)). The district may provide indirect or consultative special education services to the student’s non-public school on the specific skills identified in the student’s IEP by phone or at a meeting. The district shall ensure that equipment or individualized instructional materials placed in a non-public school are used only to implement the student’s IEP for the period needed for that plan. Public school staff shall not become involved with the student’s day-to-day curriculum in the non-public school program. Program funds must not be used to support instruction in a non-public school or otherwise benefit the non-public school, but rather to meet the specific needs of students enrolled in the non-public school.

The district shall, in addition, provide necessary transportation for a student to receive special education from the non-public school to the site where special education is provided on a shared-time basis.

B. GOALS AND OBJECTIVES

The non-public special education program provides special education services to students who attend private schools or are home-schooled in Bloomington as follows:

1. Identify, evaluate and provide appropriate special education services to school-age individuals.

2. Plan and implement special education programs for those individuals according to their respective individual needs, based upon a comprehensive evaluation.


C. PROGRAM DESCRIPTION

The Bloomington Public Schools provide Special Education services in the following areas:

ASD Autism Spectrum DisordersDAPE Developmental Adapted Physical EducationD/HH Deaf/Hard-of-HearingDCD-MM Developmental Cognitive Disability-Mild to ModerateDCD-SP Developmental Cognitive Disability-Severe to ProfoundDD Developmental DelayEBD Emotional or Behavioral DisordersOHD Other Health DisordersOT Occupational TherapyPI Physically ImpairedPSYCH PsychologySLD Specific Learning DisabilitiesSPL Speech-Language PathologySW Social WorkTBI Traumatic Brain InjuryVI Visually Impaired

All students ages birth through 21 (or completion of secondary school) who qualify for Special Education and attend non-public schools in Bloomington or are Bloomington students who are home-schooled may receive Special Education services from public school staff.

II. PROCEDURES FOR INITIATING EVALUATION AND POSSIBLE SERVICE

A. PREREFERRAL

The non-public staff is responsible for the following:

1. Two documented interventions which address the particular concern.The interventions must occur over a period of time (typically 15-20 school days).

2. If the interventions are not effective, complete all prereferral forms. (Appendix A)3. The principal of the non-public school reviews the referral and determines the

appropriateness of the referral.4. If appropriate, the referral should be sent to the Special Education Team Facilitator at the

assigned location. Refer to page 5, section C.

B. FILE SEARCH AND REVIEW

The Special Education Team Facilitator of the assigned school should contact the Special Education District Office to determine if a file exists on the student being referred. If the student was previously enrolled in the Bloomington Public Schools, the registrar may also have file information.


C. INITIATING EVALUATION

Referrals are initiated by either parents or teachers. Parents of students in non-public schools may originate a referral by contacting the non-public school who will then begin the pre-referral process outlined in Section A above. Parents of home-school children may originate a referral by contacting the closest public school.

If the District Non-Public Special Education Team Facilitator receives referrals from a non-public school or a parent of a home-school student, s/he will contact the appropriate public school Team Facilitator for processing. The public school special education team is to treat the referrals the same as “in building” referrals and place them in order of other referrals, following the same procedures for evaluation, reevaluation and/or service delivery.

III. DELIVERY OF SERVICES

A. PROCEDURES FOR EVALUATION AND PLACEMENT

The building Team Facilitator will notify the District Non-Public Team Facilitator when a pre-referral has been received. S/he will register the student with Bloomington Public Schools and obtain a student number. The District Non-Public Team facilitator will keep track of the names of all students referred.

After receiving a referral, the special education team will meet with the parents and classroom teacher to discuss concerns and possibly plan an evaluation. Procedures which must be followed are consistent with procedures followed for public school pupils. Public school staff may observe at the non-public school as a component of the formal evaluation process. Such observation is required by federal rule as part of evaluations in areas such as learning disabilities and emotional/behavioral disorders.

Non-public school staff will participate in the team staffing and the IEP development process. Public school staff may meet periodically with non-public school staff for the purpose of reviewing the progress of the student. Public school staff may also periodically observe the student in his/her regular classroom setting in the on-public school for purposes of evaluating the results of the special education services provided. However, public school staff are not permitted to become involved with the student’s day-to-day curriculum in the non-public school program, including curriculum content, choice of classes, etc.

Note: A Monthly Student Attendance Report must be completed for all evaluations and on-going services. A copy of the report must be sent monthly to the Student Services office at ESC. (Appendix B).

B. TRANSPORTATION

In those cases where services are provided by transporting the student to a public school or neutral site, transportation is provided by the Bloomington Public Schools during school hours. Requests for transportation should be sent to the Student Services Department by the Special Education case manager. When transportation has been arranged, the Student Services secretary will notify the public school personnel, private school personnel and the family regarding the starting date.


C. LOCATION OF SPECIAL INSTRUCTION AND SERVICES

The district determines the location where the services are provided. Screening, evaluation, planning and periodic review conferences may be conducted on the premises of a non-public school. Direct instructional services may be provided on the premises of a public school, on the premises of a non-public school or at a neutral site.

The following are the service locations:

EVALUATION/SERVICE: CONTACT TEAM FACILITATOR AT:Bethany Academy K-5 Olson Elementary 806-8800Bethany Academy 6-8 Olson Middle School 806-8600Bethany Academy 9-12 Jefferson High School 806-7600Bloomington Lutheran preK Southwood Center 806-8900Bloomington Lutheran K-5 Normandale Hills 806-7000Bloomington Lutheran 6-8 Olson Middle School 806-8600International Montessori K-5 Westwood Elementary 806-7200International Montessori 6-7 Olson Middle School 806-8600Life Academy K-5 Oak Grove Elementary 806-6800Life Academy 6-8 Oak Grove Middle School 681-6600Life Academy 9-12 Kennedy High School 681-5000Nativity K-5 Oak Grove Elementary 681-6800Nativity 6-8 Oak Grove Middle School 681-6600Ramalynn Montessori preK Southwood Center 806-8900Ramalynn Montessori K-5 Washburn Elementary 681-5500Ramalynn Montessori 6-8 Oak Grove Middle School 681-6600

IV. RECORD KEEPING

A. RESPONSIBILITY OF RECORD KEEPING

The case manager maintains all originals of the student’s special education records. All files are confidential. Copies of all forms should be sent to the non-public school for their records.

The Bloomington Public Schools does not maintain Permanent Record Files (PRFs) on non-public students. The case manager’s file should contain the due process information and the Special Education folder. It is essential to have these records on each non-public student who receives Special Education services.


1. MONTHLY STUDENT ATTENDANCE REPORT

Each service provider is responsible for completing the attendance report each month, recording the amount and type of service delivered. At the end of each month the form must be sent to the Student Services Department of the Bloomington Public Schools. (Appendix B)

2. REQUEST FOR SPECIAL SERVICES TRANSPORTATION

Complete this form online for all children who require busing to the public school where they are receiving special education services.

3. SCHOOL NUMBER

The school number for all non-public students is 535. The service school number is where the student receives services.

4. EVALUATION MINUTES

Complete the “Student Data Change” form as usual, making sure to document “Assessment Hours”. Complete this form whether or not the student qualified because we need to document assessment minutes. For the “Assessment Hours” section, you can count all minutes except travel time (testing time, report writing, observations, teacher interviews, and meeting time).

B. LOCATION OF RECORDS

While a student is receiving services, records are kept in the school where services are delivered.

C. TRANSFER OF RECORDS

Transfer the Special Education files to the Non-public Team Facilitator in the following situations:

1. If the student is evaluated and does not receive Special Education services

2. If the student moves out of the district3. If special education services are discontinued4. Graduation5. Withdrawn from school

Note: If a child moves to a public school in Bloomington, these files should be transferred to the incoming school.


Name: Date: .Grade: Age: Date of Birth: Male Female School: .Regular Education Teacher: Parent Names: . Home Phone: Work Phone: Cell Phone: .Address: Dates Parents Contacted: Describe Parental Response to Concerns: Native Language spoken at home: Student: Native Language of Parents:

HEALTH INFORMATION: (completed by Health Associate and/or Parent)HEARING SCREENING: Passed: Failed: Date: Vision Screening: Passed: Failed: Health and/or Physical Concerns: If yes, please describe. Yes No Medical Diagnoses (ie. – Depression, Asthma, Diabetes) Yes No Medications Yes No Hospitalization Yes No Seizures Yes No Head Injury Yes No Chronic ear infections Yes No Frequent somatic complaints Yes No Wears Glasses Yes No Wears hearing aids

EDUCATIONAL HISTORYCurrent Year Attendance: Dismissals: Tardies: Absences: .Years at present school: Number of schools attended: . Check all that apply and describe:

Retained (specify grade)Held out of school by parentHome schooled

Indicate any current or past supplemental programs/services (Title 1, Preschool, Reading Recovery, 504, ESL Project Read, etc.):

%ile Rank %ile RankCALT Previous Year: Reading MCA Previous Year: Reading

Math Math CALT Current Year: Reading MCA Current Year: Reading

Math Math Score

BST Reading Math

Writing BL#12 11/04

Non Public Guidebook 11/2013

Bloomington Public Schools1350 West 106th Street

Bloomington, MN 55431-4126

GENERAL EDUCATION INTERVENTION PLAN

APPENDIX A

7

Other standardized test scores: Has the student been assessed previously for Special Education? Yes No

If Yes: Date: Areas Assessed: Qualified: Yes Areas of service: Qualified: No

HOME/CULTURAL INFORMATIONEthnic Background:

African African American Asian European Latino Native American Other

How long has the student been in the USA? If English is a Second Language, attached “Second Language Parent Interview” form(Completed by ESL Teacher or Social Worker)ESL Services:Has the student qualified for ESL services? No YesIf Yes, please complete: In past (Dates: )

Currently receiving servicesDescribe:

Cultural Liaison Services: Name of Liaison contacted: Date: .Services being provided:

Social/Emotional Development: If there are emotional/behavioral concerns, please complete this sectionWhat are the student’s emotional, social, or behavioral strengths?

What are the student’s emotional, social, or behavioral difficulties?

When do behavioral problems occur?

How often do the behavior problems generally occur?


Please describe the classroom strategies you have already tried. Areas of Concern

(Be specific)What have you tried(Include start date)

Result(Include how long you tried strategies.)


1350 West 106th StreetBloomington, MN 55431-4126

SPECIAL EDUCATIONCONSIDERATION

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Name of Student: Date of Birth: Grade: School:

Parent Contact(s): Date By Relationship to student:

Date By Relationship to student:

Referral completed by: Parent contacted about Special Education Referral: Date By Date Referral received by Team Facilitator

ACADEMIC PERFORMANCEWas the student's academic related problems apparent before this year?

No Yes. Describe

Please rate the student in the following areas compared to their general education peers:

BASIC READING SKILLSMild Mod. Severe

Superior Average Problem Problem ProblemNaming letters (memory)Letter-sound correspondence (phonological processing)Rhyming, blending, segmenting and manipulation of sounds(phonological processing)Identifying begin and ending sounds (phonological processing)Rate of word retrieval

READING FLUENCYMild Mod. Severe

Superior Average Problem Problem ProblemRate when reading aloud (processing speed)Combining and/or holding sounds in mind until last letter isdecoded (short-term memory/working memory)Accuracy of oral word reading on grade level passages (short-term memory)Reading with expression

READING COMPREHENSION SKILLSMild Mod. Severe

Superior Average Problem Problem ProblemGeneralizing or applying information to new situations (fluid reasoning)Holding detail in memory long enough to get the main idea (working memory)Retelling what was read (short-term/working memory)Applying critical thinking skills when reading (fluid reasoning)


1350 West 106th StreetBloomington, MN 55431-4126

SPECIAL EDUCATIONCONSIDERATION

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REFERRAL FORSPECIAL EDUCATION

CONSIDERATION

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MATH COMPUTATION SKILLSMild Mod. Severe

Superior Average Problem Problem ProblemRemembering basic math facts (working memory)Rate of math calculation compared to peers (processing speed)Number senseRemembering math formulas and procedures (long-termmemory)Problem solving with new and real life situations (fluidreasoning)Generating appropriate strategies (executive functioningNumber sense

WRITTEN EXPRESSION SKILLSMild Mod. Severe

Superior Average Problem Problem ProblemPlanning and/or generating ideas (executive functioning)Spelling (phonological processing)Rate of writing production compared to peers (processing speed)

Knowledge of letter sequences in words or spelling patterns (orthographic processing)

Production of letters/words (motor coordination)

FUNCTIONAL SKILLSPlease rate the student in the following areas compared to their general education peers:

Mild Mod. SevereSuperior Average Problem Problem Problem

Find way around buildingManage stairs in school and on busComplete self-help and dressing manipulations at level ofpeersOpen doors and locker independently Keeps up with peers during passing time or transitionsGoes through lunch line, eats lunch, throws away trashOn time for school and classesFollow a schedule independentlyCompletes assignments in a timely mannerMaintains organized materials, desk, lockerPays attention/stay on taskCompletes and turn in homeworkParticipates in class discussionUse of class timeAsks and answers oral questionsAsks for help when needed


SOCIAL EMOTIONAL/BEHAVIORAL STATUSPlease rate the student in the following areas compared to their general education peers:

Mild Mod.. Severe Superior Average Problem Problem Problem

Ability to self-regulate (calm themselves when agitated)Ability to tolerate frustration or failureAbility to play/ interact appropriately with peers with same age peersAbility to read social cuesAbility to gain positive attentionAbility to develop and maintain friendshipsAbility to interact appropriately with adultsDemonstrates positive self-esteemAbility to initiate or maintain conversations with peers and/oradultsAbility to handle changes in routinePerseveration or obsession with specific objectsVulnerability /awareness in social situations; degree of socialnaitivity

Withdrawn, isolates self from peers Anxious (seems tense, nervous)

Pervasive Sad Disposition or Depression Hallucinating or Delusions of grandeur Overly Perfectionistic Displaying intense fears/school refusal Changes in eating or sleeping patterns, developing physical

symptoms related to stress/worry Distorts reality, inappropriate laughter, crying, language Self-mutilation Sexual Acting out or self-stimulation Overly affectionate behavior towards unfamiliar persons Physically or Verbally abusive behaviors. Describe:

Impulsive. Describe: Violent, destructive or intimidating behavior Other:





CONSIDERATION

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What are the two behaviors of highest concern, Triggers, Frequency #1.

#2.

LANGUAGE/COMMUNICATIONPlease rate the student in the following areas compared to their general education peers:

Articulation Mild Mod.

SevereSuperior Average Problem Problem Problem

Please describe sound errors:

Expressive LanguageMild Mod. Severe

Superior Average Problem Problem ProblemUses proper grammar

Uses age-appropriate vocabulary Retrieves words quicklyVerbally responds to questions quicklyAsks questions appropriatelyAnswers questions appropriatelyExpresses and organizes ideasRetells stories and a sequence of events

Receptive LanguageMild Mod. Severe

Superior Average Problem Problem ProblemFollows oral directions/discussionsUnderstands oral information

Remembers auditory informationDiscriminates between similar sounding words

Fluency/Voice Dysfluent (stutters) Unusual Voice quality, pitch or volume

Comments:





CONSIDERATION

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Bloomington, MN 55431-4126 CONSIDERATION

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MOTOR SKILLSFine MotorPlease rate the student in the following areas compared to their general education peers:

Mild Mod.Severe

Superior Average Problem Problem Problem Ability to: Copy from whteboard/far point Copy from desktopWrite with good pressureUse correct pencil graspWrite letter and numbers without reversals (after grade 2)Use keyboard and/or mouse at same rate as peersAttach a handwriting or work sample if appropriate.Write within space provided.

Comments:

Sensory MotorPlease rate the student in the following areas compared to their general education peers:

Mild Mod.Severe

Superior Average Problem Problem Problem Remains seated during an activity without excessive

movementEnergy level comparable to peers (High or Low)Adapts to a new motor taskOver/under reaction to touch/tactile, noises, tastes, smellsvisual stimuliUnusual body movements (rocking, hand flapping, fingerflicking, spinning)

Gross Motor (Completed by the Physical Education Teacher) Initials Please rate the student in the following areas compared to their general education peers:

Mild Mod.Severe

Superior Average Problem Problem ProblemStrengthSpeedEnduranceBalanceCoordination/accuracyObject Control SkillsStay on taskLocomotor SkillsParticipation effort and cooperationAbility to follow directionsAbility to work with othersSportsmanship

Comments:


Bloomington, MN 55431-4126 CONSIDERATION

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MEDICAL INFORMATION (nurse, parent, or records)

Yes No Are there any medical records/informationIf yes please describe:

Yes No Takes medication(s) Home School

ASSISTIVE TECHNOLOGYAn Assistive Technology/Device is any item, piece of equipment, or product system that is used to increase, maintain, orimprove functioning of individuals.

Does the student currently use any Assistive Technology devices in any environment? Yes NoIf yes, check all that apply.

slant boardsseating/posture adaptationsalternate pencils, pens, crayons, etc.adapted paperpaper stabilizers (clip boards, dicey)adapted scissorshighlighters

TRANSITION (for Secondary Students Only)Has a vocational assessment been completed?

Yes. When No------------------------------------------------------------------------------------------------------------------------------------------------------------

S.W.I.M. PROCESSDate Decision Evaluate

Return to General Education for continued supportAreas to consider

Cognitive Gross MotorAcademics SensoryFunctional Skills Assistive TechnologyEmotional/Behavioral Status TransitionLanguage/Communication FBAFine Motor

Evaluation Case Manager: Date:

Parent contacted (Within 5 days of S.W.I.M. meeting): Team:

Facilitator Signature:


ECSE (0-3) ECSE (3-6) Special “K” Non Public

Student’s Name: Birthdate: Grade:

Public School Providing Services: Non Public School of Attendance:

Area(s) of Disability:

Starting Date if new student : Ending Date if services discontinued:

Instructional Days Per Week (indicated on IEP):

Minutes Per Session, Sessions Per Week Per IEP and Days of Wk for ECSE

On calendar dates below, place a slash (/) through each SCHEDULED instructional day (ON IEP). Place and (X) through each day student was IN ATTENDANCE. If a student is receiving more than one service, it is necessary to have an attendance report for each service unless the service is provided in a classroom setting and that time is already reported.

If minutes of service vary from day to day, note times of service scheduled and times of services received next to the / or X on the calendar.

CALENDARDate / or + Time

if needed

Date / or + Time if needed



1 9 17 25

2 10 18 26

3 11 19 27

4 12 20 28

5 13 21 29

6 14 22 30

7 15 23 31

8 16 24

TOTAL ASSESSMENT HOURS ARE NOW REPORTED ON INPUT FORM.

REPORT FOR MONTH OF 20__

DAYS SCHEDULED DAYS ATTENDED


Student Services DepartmentBloomington Public Schools MONTHLY 1350 W. 106th Street ATTENDANCE REPORT Bloomington, MN 55431 APPENDIX B

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HOMEBOUND HRS SCHEDULED HOMEBOUND HRS PROVIDED

SIGNATURE OF TEACHER


Documents

CALENDAR - bloomington.k12.mn.us Web viewBL#12 11/04. Other standardized test scores: ... Accuracy of oral word reading on grade level passages ... Adapts to a new motor task