FORM 5A –
SERVICES OFFER OF FAPE
Special education and related services are determined at the IEP meeting only after goals and if appropriate objectives /
benchmarks have been finalized. Placement decisions must be
made in conformity with the least
restrictive environment (LRE) provisions. These provisions
direct
that
to the maximum extent
appropriate, students with disabilities be educated with
typically developing peers, and that
special classes, separate schooling or other removal
of students from the general
education environment occurs only if
the
nature or severity of the
disability is such that education in general education classes with the use of supplementary aids and services cannot be achieved satisfactorily. The placement must be made in the school that the student would attend if the student did not have
a disability unless unique
circumstances prevent this placement. Special education and related services and supplementary aids and services,
should be based on peer-reviewed research to the extent practicable.
1. Service Delivery Options Considered: Discuss and document service delivery options
considered. The team must first consider placement in the general
education classroom
with supports prior to recommending a more restrictive setting all
or
part of the day.
Note: ÒIn determining the educational placement of a child with a disability, including a preschool
child with a disability, each public agency must
ensure that É in selecting the LRE, consideration is given to any potential harmful effect on the child or on the quality of services
that he or she needsÓ.
Reference: 34 C.F.R.
Section 300.116(d). Describe the consideration discussed regarding any harmful
effect on the child or on the quality of services he or she needs.
Follow the continuum of
services below as a guide to determining LRE:
¥ General Education Class
¥ General Education Class – Supplemental
aids or services
¥ General Education Class – Some direct instruction by special education staff. Less
than
21% of time out
of
the classroom
for special education services.
¥ General Education Class – 21% to 60% of instructional
day in a separate classroom.
¥ Some/or no instruction in General
Education Class – 60% or
more of
the
instructional
day in a separate classroom
(intensive services).
¥ Special day
school – Separate facility (public or
nonpublic) with no general education
students on campus.
¥ Residential School.
¥ Hospital
Program.
¥ Home Instruction.
2. Supplementary Aids, Services and Other Supports for Student
and/or School Personnel:
Delineate the specific supplementary aids and services and/or supports offered for
the student and offered for school personnel (consultation to teachers, preferential seating, enlarged text,
etc.).
Indicate if the supports are for
the
student or for
school personnel by checking the appropriate box in the grid,
along with the specific start and end dates for
each area.
Team must also document
modifications and/or accommodations that will be needed in order for the student to progress toward annual goals while participating in the general
curriculum. Accommodations
do not
fundamentally alter or
lower expectations or
standards in instructional level, content, or performance criteria (extended time on a
timed task, enlarged text, etc.). Modifications fundamentally alter or lower expectations or standards in instructional level, content, or performance criteria (alternate math
assignment, etc.).
Indicate who will be
responsible for the supplementary aids and services, the start and end date, duration, frequency, and location.
3. Transportation:
Check ÒNoÓ if the IEP team determines that the student does not need special education transportation. Check ÒYesÓ if
the
student will
require special education transportation and specify the type of transportation (e.g. door to door, wheel
chair bus, etc.)
4. Special
Education and Related Services:
The team needs to determine
the special education and
related services that will provide educational benefit and
facilitate progress on the goals for the student (e.g. specialized academic instruction, health and nursing, language and speech, etc.). Identify
the
type of service. Indicate if the service will be individual or group. NOTE: Specialized Academic
Instruction (SAI) is the
core special education service that most students receive.
The duration and frequency
for SAI is
based on the amount of time
the
Special Education Specialist/Full Inclusion Specialist is adapting curriculum and/or working with the student.
SAI is not based on the amount of
time a general education teacher may
spend adapting curriculum for a student. SAI is a service
not
a
location. If
the service is
to support secondary transition, check the secondary transition box.
See CASEMIS
codes below:
SPECIALIZED INSTRUCTION
330 |
Specialized academic instruction |
Adapting, as appropriate to the needs
of the child with a disability
the content,
methodology, or delivery of instruction to ensure access of the child to the general curriculum, so that he or she can meet the educational standards within the jurisdiction of the public agency that
apply to all
children. (RSP- school
based, RSP, SDC inclusion services, SDC-public integrated, SDC-public
segregated, SDC-non-public school.) |
340 |
Intensive individual
instruction |
IEP Team determination that
student requires additional support for all or part
of the day to meet his or
her IEP goals. Such as the
use of an one-on-one instructional
assistant. |
350 |
Individual & small
group instruction |
Instruction delivered one-to-one or in a small
group as specified in an
IEP enabling the individual(s) to participate effectively in the
total
school program.
(FOR PRESCHOOL ONLY) |
RELATED
SERVICES
415 |
Language and Speech |
Includes receptive and expressive language, articulation, voice, and fluency. |
425 |
Adapted physical education |
Direct physical
education services provided by an APE. |
435 |
Health & nursing –specialized physical health care services |
Specialized physical health care services means
those health
services prescribed by the childÕs licensed physician and surgeon requiring medically related training of
the individual
who performs the services and which are necessary during the school
day to enable the child to attend school. SPHCS
include but are not
limited to suctioning,
oxygen administration, catheterization,
nebulizer treatments, insulin administration, and glucose testing. |
436 |
Health & nursing –
other services |
This includes
services that are provided to students by qualified personnel pursuant to an IEP
when a student has health problems,
which require nursing intervention beyond basic school
health services. Services include
managing the health problem, consulting with staff, group &
individual counseling, making appropriate referrals and maintaining communication with agencies and health care providers. |
445 |
Assistive technology services |
Any specialized training or technical support for the incorporation of assistive devices, adapted computer
technology or specialized media with the educational programs to improve access for students. |
450 |
Occupational
therapy |
OT includes services to improve studentÕs educational performance, postural stability, self-help abilities, sensory processing and organization, environmental adaptation and use of assistive devices, motor planning and coordination, visual perception and integration, social
play abilities and fine motor. |
460 |
Physical therapy |
Services provided by a register PT pursuant to an IEP
when assessment shows discrepancy between gross motor
performance
and other educational skills. |
510 |
Individual counseling |
One-to-one counseling, provided by a qualified individual pursuant to an IEP. |
515 |
Counseling &
guidance |
Counseling in a group setting,
provided by a qualified individual
pursuant to an IEP. |
520 |
Parent counseling |
Individual or group counseling provided by a qualified individual
pursuant to an IEP to assist
the parent(s) of special education students in better understanding and meeting their childÕs needs. |
525 |
Social work services |
Includes services provided pursuant
to
an IEP by a qualified
individual. |
530 |
Psychological services |
These services provided by a credentialed or licensed
psychologist pursuant
to
an IEP. |
535 |
Behavior intervention services |
A systematic implementation of procedures designed to promote
lasting, positive changes in the studentÕs behavior resulting in
greater access to a variety of community settings, social
contacts, public events, and placement in the LRE. |
540 |
Day treatment services |
Structured education,
training and support services to address the studentÕs mental health needs. |
545 |
Residential
treatment services |
A 24-hour out-of-home placement
that
provides intensive therapeutic services
to support the educational program. |
SCHOOL
TYPE CODES
CASEMIS CODE |
DESCRIPTION |
70 |
Non-public
Day School: A nonpublic, nonsectarian that enrolls the student students with
disabilities pursuant to an IEP and employs at least one special educator and certified by CDE. |
71 |
Non-public Residential School: A nonpublic, nonsectarian school that enrolls students with disabilities pursuant to an IEP
employs at least on special educator and certified by the CDE.
This school provides an education
program at the same location where the student
resides. Located in CA. |
72 |
Non-public Residential School: A nonpublic, nonsectarian school that enrolls students with disabilities pursuant to an IEP
employs at least on special educator and certified by the CDE.
This school provides an education
program at the same location where the student
resides. Located in CA. Located outside of CA |
76 |
Private Residential School (not certified by CDE): A school, sectarian or nonsectarian, which is not administered by a public agency, and
does not provide special education services. The student resides at this school, although private residential school
may
provide a
combination of residential and day programs. The status of a student (whether
day or residential) will depend on where the student resides. Services are through an ISP, in accordance with district policy
for serving students
in private schools. |
CDE Directions on Coding
Residential Placements
Frequency and
Duration
Residential Treatment Services Code (545):
Mark residential services as "Daily" in
"Frequency" and 1,440 minutes under "Duration" as the service is by
its nature provided
24/7.
Any other mental health service received (i.e. counseling, behavioral intervention, etc.), in addition to the residential care service, would reflect the specific frequency
and duration of that service.
Note: Those districts that have historically reported ÒbundledÓ services only and have not listed each separate IEP services (SAI, DIS counseling, etc.) may continue to do so for the June 2012 reporting cycle. Beginning in December 2012, each related service
must
be
identified in the IEP rather than ÒbundledÓ together as
Òday
treatmentÓ or Òresidential
servicesÓ.
Coding for Residential Placements
When students are placed in residential placements by the IEP team it is critical that the
IEP reflect this type of placement.
If a student is placed in a residential placement by an expanded IEP team, which includes county mental health, the following coding on the IEP should correspond.
CASEMIS FIELD |
CODE |
DESCRIPTION |
Residential Status |
50 |
Residential Facility |
Federal School Setting |
460 |
Residential Facility |
Service |
330 |
Specialized Academic Instruction |
|
540 |
Day Treatment Services or other Mental Health Services |
|
545 |
Residential Treatment Services |
|
865 |
Case Management |
|
|
Other Related Services as appropriate |
Provider |
300 |
Department of Mental Health |
Service Location |
360 |
Residential Facility (or) |
|
550 |
Public Residential School |
LOW INCIDENCE
SERVICES
610 |
Specialized services
for low incidence disabilities |
Low incidence
services are defined as those provided to the student population of orthopedic impairment
(OI),
visual impairment
(VI),
deaf, hard of hearing (HH), or deaf-blind (DB). Typically, services are provided in education settings by an itinerant teacher or the itinerant teacher/specialist.
Consultation is provided to the teacher,
staff and parents as needed. |
710 |
Specialized deaf and hard of hearing services |
These services include speech therapy, speech
reading, auditory training, and/or
instruction in the student's mode of communication. Rehabilitative and educational services; adapting curricula,
methods, and the learning environment; and
special consultation to students, parents,
teachers, and other school
personnel may also be included. |
715 |
Interpreter services |
Sign language interpretation of spoken language to individuals,
whose communication is normally sign language, by a qualified
sign language interpreter. |
720 |
Audiological services |
These services include measurements of acuity, monitoring amplification,
and Frequency
Modulation system use. |
725 |
Specialized vision services |
This is a broad category of services provided
to students with
visual
impairments. It includes
assessment of
functional
vision; curriculum
modifications necessary to meet
the student's educational needs -- including Braille, large type, aural
media; instruction in areas of need; concept
development and academic
skills;
communication skills
(including alternative modes of
reading and writing); social, emotional, career, vocational, and
independent living skills.
It may include coordination of other
personnel providing services to the students (such as transcribers, readers,
counselors, orientation &
mobility specialists, career/vocational
staff, and
others) and collaboration
with the student's classroom
teacher. |
730 |
Orientation and mobility |
Students with identified visual
impairments are trained in body
awareness and to understand how to move.
Students are trained
to
develop skills
to enable them
to
travel safely and independently
around the school
and in the community. It
may include consultation services
to parents regarding their children requiring such
services according to an IEP. |
735 |
Braille transcription |
Any transcription services
to convert
materials from print to
Braille. It may include
textbooks, tests, worksheets, or anything necessary for instruction. The transcriber
should be qualified in English Braille as well
as Nemeth Code (mathematics) and be certified by appropriate agency. |
740 |
Specialized orthopedic services |
Specially designed instruction related to the unique needs
of students with orthopedic disabilities, including specialized materials and equipment. |
745 |
Reading Services |
|
750 |
Note taking services |
Any specialized assistance given to the student
for the purpose of
taking notes when
the student is unable to do so independently. This may include, but is not limited to, copies of notes taken by another
student, transcription of tape-recorded information from a |
|
|
class, or aide designated to take notes. |
755 |
Transcription Services |
Any transcription service to convert materials from print
to
a mode of communication suitable for
the student. This may also include
dictation services as it may pertain to textbooks,
tests, worksheets, or anything necessary for instruction. |
760 |
Recreation Services |
Therapeutic recreation and specialized instructional
programs
designed to assist pupils to become as independent as possible
in leisure activities, and when possible and appropriate, facilitate
the pupilÕs integration into general education programs. |
TRANSITION SERVICES
820 |
College Awareness |
|
830 |
Vocational assessment,
counseling, guidance,
and career assessment |
Organized educational programs that
are directly related to the
preparation of individuals for paid or unpaid employment and may
include provision for work experience, job coaching, development and/or
placement, and
situational assessment. This includes career counseling to assist student in assessing his/her aptitudes, abilities, and interests in order
to
make realistic career
decisions. |
840 |
Career awareness |
Transition services include a provision for in self-advocacy, career planning, and career guidance. |
850 |
Work experience education |
Work experience education means organized educational programs that are directly related to the preparation of individuals for
paid or unpaid employment, or for
additional preparation for a
career requiring other
than a baccalaureate or advanced
degree. |
855 |
Job Coaching |
Job coaching is a service that provides assistance and guidance
to
an employee who may be experiencing difficulty with one or
more aspects of the daily job tasks and functions.
The service is provided by a job coach who is highly successful, skilled and trained on the job that
can determine how the employee that is
experiencing difficulty learns best and formulate a training plan to improve job performance. |
860 |
Mentoring |
Mentoring is a sustained coaching relationship between a student
and teacher through on-going involvement and offers support, guidance, encouragement and assistance as the learner encounters challenges with respect
to
a particular
area such as acquisition of
job skills.
Mentoring can be either formal as
in planned, structured instruction of informal that occurs naturally through friendship, counseling and collegiality in a casual, unplanned way. |
865 |
Agency linkages (referral and placement) |
Service coordination and case management that facilitates the
linkage of individualized education programs. |
870 |
Travel Training (includes
mobility training) |
|
890 |
Other transition services |
These services
may include program
coordination, case management and meetings, and crafting linkages between schools
and between schools and post-secondary agencies. (Note:
This code should be used with caution and only when appropriate) |
900 |
Other Special Education/Related Services |
Any other specialized service required for a student with a
disability to receive educational benefit. |
3. Start
and End Date:
This will
often be the same start/end dates for the primary service on
the IEP.
4. Provider: Note the title of the provider of
the
service (do not put the personÕs name).
5. Frequency: Indicate the frequency of the service being provided, such as daily, weekly, monthly, yearly, or any other frequency.
6. Duration: Indicate number of
times per frequency (see CASEMIS
for examples).
7. Location: Select the location of where the service is provided to the student from the
following:
210 Home instruction based on IEP team determination (not
medical)
220 Hospital
310 Head Start center
320 Child development or childcare facility
330 Public preschool
340 Private preschool
350 Extended day care
360 Residential facility
510 Regular classroom/public day school
Includes students who are fully included in general
education classrooms. Also
includes students who are seen under a Òpush inÓ model
in
the general
education classroom
and students who receive DIS services in the general
education
classroom. Additionally,
students who receive services in a setting that includes other
students with special
needs are included here if there are general
education students who are Òreverse mainstreamÓ students in that
class for that
portion of
the
day.
520 Separate class in public integrated facility
Includes students receiving special education ÒpulloutÓ services, including RSP
and DIS,
or in a Òspecial day classÓ model,Ó etc.
530 State Special School
540 Separate school
or special education center or facility
550 Public residential
school
560 Other public school
or facility
570 Charter
school operated by a LEA/district
580 Charter
school operated as a LEA/district
610 Continuation school
620 Alternative work education center/work study facility
630 Juvenile court school
640 Community school
650 Correctional
institution or facility
710 Community college
720 Adult education facility
810 Nonpublic day school
820 Nonpublic residential
school-in California
830 Nonpublic residential
school-outside California
840 Private day school (not certified by CDE Special Education Division)
850 Private residential school (not certified by CDE Special Education Division)
860 Parochial school
890 Service provider location
This would include CMH Outpatient Services provided at a clinic or
other outside
medical/therapeutic setting.
900 Any other location or
setting
8. Extended School
Year (ESY): Discuss
if the student needs ESY to receive FAPE. Check yes or no. If yes, specify in the grid the services the student will receive, the start and
end date, provider, frequency, duration, and location.
Note: ESY shall be provided to a student with a disability who the IEP deems requires
special education and related services in excess of the regular academic year. Such
students shall have
disabilities which are likely to continue indefinitely or
for
a prolonged period of time,
and interruption of the studentÕs educational programming may cause
regression, when coupled with limited recoupment capacity, rendering it impossible or
unlikely that the student
will
attain the level
of self-sufficiency and independence that
would otherwise be expected in view
of his or her disability. (5 CCR
3043)
Educational Benefit Reminder
- Was the determination of the appropriate supplementary aids and services,
and special education and related services completed after
the
goals were finalized?
- Are the appropriate services identified to support progress toward all goals including: progress in the general curriculum, participation in extracurricular activities,
and other nonacademic activities?
- Are the special education,
related services, and supplementary aids and services
based on peer-reviewed research to the extent practicable?
- Are the start/end dates, provider, frequency, duration, and location specified for supplementary aids and services as well
as special education and related services?
[Excerpted from the State SELPA IEP Manual, July, 2013]