1.B.

8 I

Disclosure of Referral Notification Policy Index:

Policy #: Distribution: Date Policy Initially Developed: Date Policy Revised: Date Policy Effective: Supersedes Policy Dated: Scheduled Review: Policy Tracking #: Applicable Units: Responsible Authority 1.B.8 Public 3-9-2011

4-6-2011 TBD 5 All BWEIP Manager

II

Purpose:
To describe the policy for referral notification for children participating in part C to the State Education Agency (SEA) and the Local Education Agency (LEA) for all potentially eligible children who are enrolled in early intervention (EI) under an Individualized Family Service Plan (IFSP) rd prior to their third (3 ) birthday.

III

Definition(s):
Individualized Family Service Plan (IFSP):
An Individualized Family Service Plan (IFSP) is a working document agreed upon by EI service providers and family members to address the special needs of eligible children from birth to three (3).

State Education Agency (SEA): The State Educational Agency (SEA) is the Utah State
Office of Education.

Local Education Agency (LEA):

A Local Education Agency (LEA) refers to the public school district (Part B Preschool Program) where the family resides.

Early Intervention (EI):

Early Intervention (EI) refers to programs or services which are selected in collaboration with parents, and are designed to meet the developmental needs of a child and the needs of the family to assist in the childs development.

Individualized Family Service Plan (IFSP):

An Individualized Family Service Plan (IFSP) is a working document agreed upon by EI service providers and family members to address the special needs of eligible children from birth to three (3).

Baby and Toddler Online Tracking System (BTOTS):

Baby and Toddler Online Tracking System (BTOTS) is a Utah database application designed to track EI activities and information, assist EI providers in day-to-day activities, encourage compliance with state and federal regulations and simplify compliance monitoring by allowing the BWEIP access to statewide child information.

Revised: 12/20/2012

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IV

Principles and Procedures:

A. Referral Notification:
1. Early intervention (EI) programs shall provide referral notification to special education preschool by providing information to the SEA and the appropriate LEA for all potentially eligible children who are enrolled in EI services with an active IFSP. All children enrolled in EI are considered potentially eligible for special education preschool. Referral information includes: a. b. c. d. Childs name; Date of birth; Primary language; and Parent/guardian contact information: 1) Name; 2) Address; and 3) Telephone number.

2.

3.

EI programs shall inform the parent/guardian of a child during the development or nd review of the IFSP closest to the childs second (2 ) birthday of the required referral notification and provide him/her an opportunity to decline the referral notification (Opt Out). a. The parent/guardian may decline the referral notification by signing the Disclosure of Directory Information Form.

4.

The referral notification shall be sent to the SEA and LEA electronically from BTOTS to TEDI when the child is twenty-seven (27) months of age if the child is enrolled, or at the time of the development of the initial IFSP for children who enter EI after twentyseven (27) months of age. A referral notification will not be sent if the if the parent/guardian declines the referral notification in writing.

5.

Authority:
34 CFR 303.209 (b); Transition to preschool and other programs, Notification to the SEA and appropriate LEA. 34 CFR 303.401 (e): Confidentiality and Opportunity to examine records

VI

Related Directive(s):
None

Revised: 12/20/2012

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VII

Revision Log:
March 2009: New policy. March 2010: No revisions. March 2011: Revised policy format. Added definitions of LEA and IFSP. Added Attachment 1 and hyperlinks to Attachment 1. April 2011: Added definition of IFSP. Added on or in ss (A3) and within Attachment 1. December 2012: Revised policy number. Deleted definition of LEA and Added definitions of SEA, LEA, EI, and BTOTS. Revised Disclosure of Directory Information with Referral Notification through policy. Revised formatting and wording of ss (IV A 1 - 6). Deleted ss (IV B). Added section V. Revised attachment formatting and title.

As per 34 CFR 303.208, this policy awaits public comment. The policy shall be revised as needed after public comment.

0-0-00
Susan Ord, BWEIP Program Manager Date

Revised: 12/20/2012

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Attachment 1:
1.

Disclosure of Referral Notification Form

The Disclosure of Directory Information Form may be accessed on the BWEIP website at www.utahbabywatch.org

Revised: 12/20/2012

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