Raleigh CountySchool District

Making A Difference One Student At A Time

March 2017

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Eligibility

• Eligibility Committee Report
• Individual Evaluation/Reevaluation Request
• Eligibility/IEP Meeting Notice
• Autism Team Report
• Specific Learning Disabilities (SLD) Team Report
• Speech Language Impairment Team Report

IEP

• Invite Agency Representative
• In Lieu of IEP Team Attendance Report
• Additional IEP Team Member Excusal
• Amendment to the IEP without a team meeting
• IEP Consideration for Students Who are Deaf or Hard of Hearing
• IEP Part I Student Information and Part II Documentation of Attendance
• IEP PART III A Extended School Year (ESY) Determination and Part III B Extended School Year Services
• IEP Part IV Consideration of Factors for Annual Reviews
• IEP Part V Assessment Data
• IEP Part VI Transition Planning
• IEP Part VII Present Levels of Academic Achievement and Functional Performance
• IEP Part VII (Continued) Present Levels of Academic Achievement and Functional Performance
• IEP Part VIII Annual Goals Part A
• IEP Part VIII Annual Goals with Short Term Objectives Part B
• IEP Part IX Services
• IEP PART X PLACEMENT Ages 3 to 5
• IEP PART X PLACEMENT Ages 6 to 21
• IEP Part XI Statewide Testing Alternate Assessment
• IEP Part XI Statewide Testing General Summative Assessment
• IEP Part XII Prior Written Notice
• IEP Part XIII Consent

Re-evaluation

• Reevaluation Determination Plan
• Request Additional Evaluation
• Summary of Performance

Medicaid

• Consent to Release Information and Bill Medicaid
• Medicaid Physician Authorization Form
• Medicaid Service Care Plan
• Notice to Parents Parental Consent To Access Public Benefits or Insurance

Discipline

• Disciplinary Action Review Form

Private School Students

• Service Care Plan Part I Student Info Part II Documentation of Attendance
• Service Care Plan Part III Assessment Data
• Service Care Plan Part IV Present Levels
• Service Care Plan Part V Annual Goals
• Service Care Plan Part VI Services
• Service Care Plan Part VII Placement
• Service Care Plan Part VIII Consent

Procedural Safeguards

• Prior Written Notice of District Proposal/Refusal

Out of State

• IEP Fillable Form - All Parts
• Additional Present Levels Page
• Additional Goal A Page
• Additional Goal B Page

IDEA PROCESS FORMS AND INSTRUCTIONS July 2017

Link to school-based Medicaid forms including Medicaid consent and parent notification of rights.

Waiver request form

Monitoring and Compliance Resources

Age of Majority

Director's Resources 2015

Discipline Flowchart

Documentation of Consultation with Private School 2011

Facilitated Individualized Education Program (FIEP)

IEP Form 5/2013

IDEA Process Forms

Procedural Safeguards

Results Driven Accountability Assuring Compliance Improving Results Manual

Results Driven Accountablitiy General Supervision System

Waiver Request Form