Psychoeducational directors' handbook [Aug. 1983]

Psychoeducational Directors' Handbook
Psychoeducational Center Network Program for Exceptional Children Georgia Department of Education
Atlanta, Georgia 30334 Charles McDaniel
State Superintendent of Schools August 1983

The following people made significant contributions in the preparation of this handbook.
Elizabeth LeClair, Director Middle Georgia Psychoed
Meri Cribb, Secretary Middle Georgia Psychoed
Joan A. Jordan, Coordinator Psychoeducational Center Network State Department of Education
Patty O. Higgins, Consultant Psychoeducational Center Network State Department of Education
Sara H. Harris, Secretary Psychoeducational Center Network State Department of Education
Barbara Perkins, Public Information and Publications Specialist State Department of Education

TABLE OF CONTENTS
Foreword. Overview. Program Description Community Relations Administrative Guidelines Program Requirements.
A. 0 through 14 Program B. 15 through 18 Program. C. Instructions for Budgeting D. Reporting Forms. Personnel Data Collection and Documentation References. Appendices.

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Foreword
The Psychoeducational Center Directors Handbook provides guidelines and procedures for the operation of the psychoeducational centers and is the cooperative effort of Psychoed directors and Georgia Department of Education staff. It is the second handbook to be developed and replaces the FY 76 Handbook. As recommended by the performance audit conducted in February, 1981 this handbook has been published as a guide for psychoed directors and their fiscal agents. The handbook includes forms and procedures which are used in the Psychoeducational Center Network. Additional information is provided during directors meetings which are held quarterly. These meetings are conducted by the Georgia Department of Education to provide technical assistance and information regarding specific recommendations. For additional information or assistance contact the Coordinator of the Psychoeducational Center Network, Georgia Department of Education, Program for Exceptional Children, Suite 1966, Twin Towers East, Atlanta 30334, (404) 656-2425.
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Overview of the Network
The Georgia Psychoeducational Center Network is a statewide, comprehensive, educational, treatment program for severely emotionally disturbed, severely behaviorally disordered and autistic children and youth from birth through 18 years old. Serving approximately 10,000 youngsters each year the network consists of 24 nonresidential, community-based programs with numerous satellite facilities.
The network is funded by the Georgia General Assembly through the Georgia Department of Education, Program for Exceptional Children, with local school systems and Cooperative Educational Services Agencies (CESA) serving as fiscal agents for the program. Federal support through Chapter I 89-313 funds supplement state funded programming for infants and preschool children ages birth through four while adolescent services are partially supported by P.L. 94-142 VI-B funds. All services are provided without fees. School systems provide transportation for youngsters to attend psychoeducational classes and work cooperatively with the respective centers to meet housing needs.
The major admission requirement is the presence of an emotional disturbance or behavioral disorder severe enough to require a specialized treatment program. Children with secondary handicapping conditions are accepted if the primary disability is a severe emotional disturbance or severe behavioral disorder. Children who have mild to moderate behavior or discipl ine problems are not eligible.
The network provides comprehensive services which include diagnosis, treatment, periodic evaluation and follow-up. It is a cooperative effort which uses psychologists, psychiatrists, teachers, other educators, social workers, parents and agency personnel. Because it is community-based it reduces the need for residential placement and enables the youth to remain in their homes while receiving treatment. It offers assistance to parents and regular school teachers to encourage a team effort and provide a support system for the child. These unique elements lead to the success of the Georgia Psychoeducational Center Network and assures the provision of quality programming to meet the needs of the severely emotionally disturbed, behaviorally disordered youth in Georgia.
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Program Description
Children and youth who are diagnosed as severely emotionally disturbed, autistic, and/or severely behaviorally disordered, are served through the network. It is projected that one-half of one percent of the birth through 18-year-old population will be identified as psychoed-eligible. (See Rules and Regulations, Appendix D for specific characteristics of this population.)
Psychoeducational Centers are funded to operate 240 days each fiscal year. Center services are available for children ages birth through 14 and 15 through 18 for at least 180 days each year. Summer services are available to the birth through 14 group for a minimum of 30 days.
In an effort to keep severely emotionally disturbed children communitybased, comprehensive services are offered at each center. Basic program components are the same although individual programs may vary from center to center as a result of the population to be served, resources available and needs of each area. Program components are as follows.
Referral and Intake
Referrals with written, informed parental consent are accepted from school systems, parents, child-serving agencies and private psysicians and hospitals. Prior to intake, the referral is screened. The intake process includes vision and hearing evaluation, social history (parental interview), psychological evaluation, psychiatric evaluation (optional), educational evaluation, observation of child in current placement and input from school/agency personnel involved with child. When the intake process is completed, a staffing (placement) committee meeting is scheduled for the purpose of determining the most appropriate placement for the child in the least restrictive environment. All due process procedures must be followed. (See Appendix C.)
Treatment Classes
Therapeutic classes are available from two hours to a full school day for children enrolled in the birth through 14 Program and for children enrolled in the Adolescent Program. The placement committee determines the amount of time each child spends at the Center considering the nature and severity of the child's problem, the treatment program and objectives, the home and neighborhood situation and school conditions as documented by the child's I.E.P. While the child is enrolled in the center treatment program the center staff works to maintain the child's participation in the regular school program.
The treatment approach for children may vary from center to center based on diagnosis and individual needs. Each center outl ines its method of treatment and staffing patterns in the proposal for funding submitted annually to the Georgia Department of Education.
The suggested number of children to be served in psychoeducational center classes is eight in the birth through 14 classes and 10 in the adolescent program.
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Direct Services
Some disturbed childrpn referred to the center can be maintained in the regular school setting through direct services by the center staff. Staff from the center are assigned to work directly with individual children whose behavior does not merit enrollment in treatment classes at the Center.
Children served through direct services are seen on a regular basis, according to individual needs as specified on the I.E.P. In order to maximize results with these children, the staff also works closely with the classroom teacher and parents of the children. Programs utilizing a behavioral approach or other therapeutic methods are used for direct services.
Infant-Preschool Program
The emphasis of the center's Infant-Preschool Program is early identification of children with severe developmental, learning, or emotional problems and thus is preventive in focus. Referral sources may include but are not I imited to parents, pediatricians, nursery and day care personnel, health departments, and other child-serving agencies. Infants three months to three years of age are evaluated according to appropriate developmental instruments. Parents are involved from the initial referral stage and are usually interviewed extensively prior to evaluation of the infant. During the interview, detailed developmental history on the infant is obtained as well as insight into the family dynamics.
Treatment if indicated will focus upon remediation of developmental dalays unless the problem is obviously more complex and requires additional methods of intervention. When developmental lags are attributed primarily to lack of opportunity and/or cultural deprivation, suggestions for providing stimulation to aid the infant's development can be offered and some centers have a toy-lending library that could be used. When the problem is more complex, therapy for the parents in relation to the child1s needs may be appropriate or referral to other child-serving agencies.
Preschoolers three years through five years are evaluated intellectually, socially, emotionallY, and (pre) academically using diagnostic instruments deemed appropriate for the particular child. Parents are given feedback from the evaluation at the placement committee meeting and may be provided with an individualized behavior (home) managment program, be seen in therapy or in a parent group. Some preschoolers may also be enrolled in treatment classes when appropriate.
Infant-Preschool Programs will vary according to the size of the center and services each individual center is able to provide. P.L. 89-313 funds allow centers to provide supplemental services for children ages zero to four.
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Termination Services
When a child is being considered for termination, the center schedules a (termination) I.E.P. review meeting. The decision is a joint decision of the center, LEA and the parents.
The child's present level of emotional and academic functioning is discussed and pertinent testing information is reviewed. Determination of placement in the least restrictive environment is made. Tracking (follow-up) services are provided for a minimum of one year from the date of termination.
Parent Services
Services for parents will be available for the family of each child served at the center. Programs for parents may include.
1. Parent Conferences - sharing of information usually regarding child' I.E.P., program at center, school, and home.
2. Parent AuxilIary - a regular scheduled meeting (generally one a month) of parents for purpose of getting to know other parents with children served by the center. Programs which are educational may be included. The group may also assist the center with projects or help in other ways.
3. Classroom Observation - by observing classes through the one-
way mirror with a staff member, parents may see positive interaction occurring and thus change their own perception of their child. Specific objectives being focused on at the center and ways of working with the child can also be discussed. 4. Training in Treatment Model - parents learn the treatment model through obServation and training. Treatment techniques learned can then be applied with the child at home and other settings in which the child is expected to function.
5. Home Management Training Group - parents real ize that they
~change the behavior of their child in specified directions through careful planning and consistent application of a program based on the basic principles of learning. Behavioral patterns are pinpointed or isolated which the parents desire to change and each parent is assisted in the development and implementation of a home management program using systematic application of reinforcers. The group usually meets on a weekly basis.
6. Parent Therapy Group And/Or Individual Therapy - parents meet
as a group or individually on a weekly basis to share frustrations, to work through guilt feelings, and to grow toward a better understanding of their child and themselves. The treatment deals with stress experienced as a result of having an emotionally disturbed child as a family member and acts as an additional source of strength to the parents.
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Consultation and Training Centers should act as a resource and maintain active involvement
with schools and other child-serving agencies. Cooperative agreements with Mental Health and other appropriate agencies are positive steps in this direction. Centers can assist agencies with
1. Identifying and referring disturbed children. 2. Programming and del ivering services (when requested).
3. Educating and training staff to work more effectively with
disturbed children (in school setting, in-service programs, consultation, etc.)-
4. Working in conjunction with colleges and universities to
plan relevant courses in the field and coordinate intern training programs. In addition to providing consultation and training to other agencies, each center must be responsible for providing an indepth training program for their own staff.
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Community Relation~
In order to provide comprehensive services to the community, close communication with the various agencies within the services areas should be establ ished. Suggestions for working with these agencies are as follows.
I. Develop and distribute center brochures to all childserving agencies including public and private schools, kindergartens, nurseries, training centers, day care programs, superintendents, principals, private psychologists and psychiatrists, physicians, etc. (Listing of agencies can be found in Community Directories generally available through the Chamber of Commerce and mental health agencies).
2. Use available media - talk shows on radio and T.V., newspaper articles, etc.
3. Speak to civic clubs and PTA's and other organizations to
help disseminate information to the publ ic.
4. Become actively involved with such organizations as the Mental Health Association, Council of Service Agencies, etc.
5. Establish a citizens advisory board - may be composed of parents, representatives from child-serving agencies, school board members and other interested citizens.
6. Communicate regularly with schools, training centers,
etc. - work closely with these agencies to exchange information and to share inservice programs, consultation, crisis intervention, etc.
7. Send written communique, i.e., newsletters, monthly summaries, etc. to Advisory Board and Citizens Advisory Board.
8. Contact CIVIC clubs and organizations to establish a
volunteer program for the center.
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Administrative Guidelines
Each Psychoeducational Center employs a full time director to administer and supervise the psychoeducational program. The director is responsible for the following.
1. Preparing and submitting the proposal and budget for the fiscal agent/advisory board and Georgia Department of Education approval
2. Conducting quarterly meetings with fiscal agent/advisory board to review program and to take action regarding personnel matters
3. Preparing and submitting budget and proposal amendments as necessary
4. Maintaining student and center records in order to provide accurate data to LEAs and Georgia Department of Education for P.L. 94-142 and P.L. 89-313 counts and Special Education Monthly Attendance
5. Developing necessary policies and procedures to assure appropriate management which results in program consistency and effectiveness and maintaining a master I ist of students and services to assure accountabil ity
6. Submitting reports as required by Georgia Department of
Education
7. Exercising responsibility for program management, program planning and staff development
8. Being knowledgeable of all Georgia Department of Education
and local rules and regulations, state and federal laws regarding services to children, due process, budgeting and certification/employment of personnel
9. Maintaining cooperative relationship with LEA, school
personnel and other agencies
10. Providing information regarding program and services to the school communities
The responsibil ities of the fiscal agent are outlined in the Georgia Department of Education agreement and Special Education Rules and Regulations. (See Appendices D and E.)
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Program Requirements
The psychoeducational centers must submit annually to the Georgia Department of Education a proposal for funding. The following outlines address the proposal requirements for the birth through 14 and 15 through 18 programs. This is a general outline which is subject to revision. The specific requirements are disseminated each year by the Georgia Department of Education, Program for Exceptional Children.
A. Psychoeducational Center Proposal for birth through 14 Funding Requirements
1. Abstract
2. Cover Page
3. Letter(s) of Support 4. Staffing Pattern 5. Outline of Services 6. Assurances 7. Calendar 8. Center Operational Objectives 9. Budget (Paper Budget and Form DE 0046) and Indirect Cost
Letter if Appropriate
10. Personnel List 11. Due Process Forms
12. Agreement with Georgia Board of Education (See Appendix E)

B. Psychoeducational Center Proposal for 15 through 18 Funding Requirements 1. Abstract (Original) (may be Included in birth through 14) 2 Cover Page
3. Letter(s) of Support (may be included in birth through 14)
4. Staffing Pattern
5. Outline of Services 6. Assurances 7. Calendar 8. Operational Objectives 9. Budget (Paper Budget and Form DE 0046)
10. Personnel List 11. Due Process Forms, if different than birth through 14
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C. Instructions for Budgeting Psychoed Funds on Budget Form DE 0046
The budget should be developed using DE Form 0046 (See Appendix H.) Any items budgeted as other . must be specified on the DE Form 1194 following that budget page. The following instructions indicate the items numbers that should be used in budgeting FY 84 funds. Birth through 14 State Grant Funds should be shown under Column A: All APEG Funds under Column B: Psychoed (15 through 18) adolescent State Funds under Column C; and Federal (15 through 18) under Column D. Federal 15 through 18 FY 83 Carryover Funds should be budgeted under Column E. The grand total should be entered in Column F and will later be transferred to the fiscal agent budget DE 0046 under Column 13 which is designated as Psychoeducational Center.
State Funds - birth through 14 (Column A)
1. State Grant Funds may not be carried over from one fiscal year to the next.
2. Only anticipated receipts for the upcoming fiscal year should be budgeted and shown on Item 1895.
3. Funds may not be budgeted for transportation costs (except
for those centers with buses purchased prior to 1975).
4. Indirect cost if requested by the fiscal agent, must be accompanied by a letter outlining the function provided by the fiscal agent as justification for the indirect cost. Indirect cost may not exceed three percent. The indirect cost should be calculated on the birth through 14 State Grant Grant less the director's salary, using the fiscal agent's approved restricted indirect cost rate or three percent whichever is less.
5. An equipment list must accompany any budget request for
equipment under Item 6192 or 6195. A detailed list describing the equipment, number to be purchased, and cost per item must be shown on DE 1194 and follow Page 14.14 of the DE 0046.
APEG birth through 14 (Column B)
1. Anticipated receipts for the fiscal year should be shown on Item 1815. Any anticipated APEG carryover, sick leave, instructional materials and media must be shown on Item 101, Column B and then budgeted in those areas; other carryover may be budgeted in other areas. Asterisk expenditures of APEG carryover in the budget (DE 0046 and paper budget).
2. The sick leave or substitute funds earned by Section 5
must be budgeted and expended only in 3816 (@125.00 FY 83).
3. The instructional material and media funds earned by each
Section 5 must be budgeted and expended only in 4053. (@450.00 FY 83).
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Budget DE 0046 - (continued)
4. Maintenance and operation (M & 0) funds earned by each Section 5 may be budgeted as needed (@2,lOO FY 83).
5. An equipment list must accompany any budget request for equipment under Item 6192 or 6195. A detailed 1ist describing the equipment, number to be purchased, and cost per item must be shown on the DE 1194 and following page 14.4 of the DE 0046.
State Funds Adolescent 15 through 18 (Column C)
1. State funds may not be carried over from one fiscal year to the next.
2. Anticipated receipts for the fiscal year should be shown on Item 1895.
3. Adolescent Funds may not be budgeted for the following. a) building rental, b) building maintenance, c) transportation.
4. State Adolescent Funds should be budgeted for basIc instructional personnel such as teachers, aides, instructional materials, equipment and may be used for psychologists, clerical personnel or social workers.
5. An equipment list must accompany any budget request for equipment under Item 6192 or 6195. A detailed 1ist describing the equipment, number to be purchased and cost per item must be shown on the DE 1194 and following page 14.4 of the DE 0046.
Federal Funds Adolescent 15 through 18 (Column D)
1. Anticipated receipts should be shown as Item 2295.
2. Personnel such as psychologists, social worker, clerical, etc., may be budgeted under federal funds.
3. An equipment list must accompany any budget request for equipment under Item 6192 or 6195. A detailed 1ist describing the equipment number to be purchased and cost per item must be shown on the DE 1194 and following page 14.4 of the DE 0046.
Federal 15 through 18 FY 83 Carryover (Column E)
1. Adolescent Federal 15 through 18 FY 83 funds which are unexpended may be carried over to FY 84 and must be expended or obligated by June 30,1984.
2. Carryover funds should not be budgeted for personnel.
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Budget DE 0046 - (continued)

3. Federal carryover funds should be shown on Items 101, Column Eon page 4.4A.

4. Federal 15 through 18 carryover funds must be budgeted and agree with the FY 83 VI-B Completion Report.

Totals - Column F

1. Columns A through E should be totaled and entered under Co 1umn F.

2. The totals under Column F should be transferred to the fiscal agentls budget form DE 0046 under Column 13 which is designated as Psychoeducational Center.

INDICATE THE NUMBER OF POSITIONS FOR EACH PERSONNEL ITEM BUDGETED.

General Instructions

1. Each budget series should be totaled. For example, all items in the instruction series should be totaled under 3800.

2. All items ending in 95 which are budgeted in any series must be detailed on the DE 1194.

3. Employee benefits should be computed on all salaried personnel. (Do not include contracted services.) Teacher retirement should be calculated on all personnel salaries except the APEG salaries of the teachers.

The following are tentative figures you may use in estimating employee benefits.

Teacher Retirement

12.67% (FY 83 and FY 84) projected

FICA (Social Security) (On all APEG and Grant) Employee Health Insurance (figures on certified
personnel IS base sa Iary)

6.70% (FY 83 35,700 salary max) FY 84 36,000 salary max)
4.25% or rate per person

4. The 1800 and 2200 series totals (receipts) should equal the grand total credits, 3600 - page 5.4. The 3600 and 100 series should equal total expenditures shown in 9600, page 17.4. The total 1800 and 2200 series total should equal the funds anticipated in FY 84; the 100 series should equal FY 83 APEG and Federal
Adolescent carryover.

5. Each APEG Section 5 unit earns funds for the following: Instructional material and media, $450.00; sick leave, $125.00; maintenance and operation, $2100.00 (FY 83).

6. Please refer to Special Educ~on Regulation6 and P~ocedune6 for
additional information.

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Investment Funds Investment balances should be shown on page 4.4A item 102. Do not include investment funds as a part of the budget in expenditures. Attach a separate paper budget for the investment funds indicating planned use of those funds. (Should only reflect APEG and federal carryover because all state funds must be expended by the end of the fiscal year).
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Budget Amendments Budget amendments are required when a deviation of 15 percent or more occurs between series or when a position has been added or deleted in or between series. If a position is to be added or deleted, a proposal amendment is also required. Any changes in the equipment list for Item 6195 or 6192 as approved must be submitted for prior approval. Approval for budget amendments must be obtained prior to implementation. The approved budget should be amended by striking the original budget figure(s) and inserting the amended figure(s) in red ink. The budget amendment must be dated and signed by the fiscal agent and director. A cover letter briefly explaining the amendment must be submitted.
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FY 84 ITEM NUMBERS

:;'sychoed fJescr i ptors

FY 84 Item #

FY 84 Budget Description

RECEIPTS

Carryover APEG or

Adolescent Federal

VI-B Funds

101

Investment Balance

102

Donations (Identify)

1742

APEG Funds

1815

State Grants

1895

Incoming Transfers (Budget) 2695

Bank Balance Investment Balance
Contributions and Donations
A. P. E. G.
Other Receipts from State Sources Funds Transferred from LEA, Identify Source

EXPENDITURES

Coordinators - Educational

Therapy

3805

Education Therapist

3805

Paraprofessionals

Teacher Aides

3807

Substitute Salary

3816

Evaluator

3818

Education Therapist, Aide/

Paraprofessional,

Evaluator, Psychiatrist -

Travel

3832

Psychiatric Consultation

3895

Diagnostic Dental and

Medical Evaluations

3895

Evaluation and Staff

Development

3895

Education Therapist Materials,

First Aid Kits

4053

Textbooks

4056

Li brary Books

4059

Professional Journals

4062

Audio Visual Supplies

4065

Social Worker

4202

Social Worker - Technicians 4202

Infant Evaluator

4218

School or Clinical Psycho-

logists

4218

Social Worker, Social Worker

Technician, Infant Evaluator 4232

Testing and Evaluation

Materials

4260

Salaries - Systemwide Supervisors Salaries - Classroom Teacher
Salaries - Paraprofessionals Salaries - Substitutes Instructional
Personnel Other Instructional Personnel
Purchased Services - Travel Purchases Services - Others (Psychiatric)
Purchased Services - Other (Psychological, Dental and Medical Diagnosis)
Purchased Services - Other
Teaching Suppl ies Textbouks Library Books Periodicals/Newspapers Audio Visual Supplies Salaries - Attendance and Social Work
Personnel Salaries - Attendance and Social Work
Personnel Salaries - Other Pupil Service Personnel
Salaries - Other Pupil Service Personnel
Purchased Services - Travel
Supplies and Materials

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FY 84 ITEM NUMBERS

Psychoed Descriptors

FY ITEM #

FY 84 Budget Description

EXPENDITURES Secretary Director Director's Travel
Office Suppl ies and Postage Printing
Transportation Services
Custodian Ut iIi ties Telephone Building Maintenance and Operation Building Maintenance Equipment Maintenance and Operation Rent
Insurance Maintenance and Operation Uti I ities Ut iIi ties Ut iIi ties Utilities Equipment
Benefits

4814 4818 4832
4860 4895
5600 (Series)
5702 5740 5744
5750 5770
5775 5785
5790 5795 5835 5836 5838 5895 6192 or 6195

Salaries - Clerical Employees Salaries - Other Administrative Personnel Purchased Services - Travel of General Administrative Services Personnel Suppl ies and Materials Purchased Services - Printing and
Binding, Office Machine Rent Only for those centers who have legitimate
transportation costs (from bus purchased prior to 1975) Salaries - M and 0 Personnel Water Telephone Expense
Suppl ies Repairs and Maintenance of Building
Equipment Maintenance (Service Contracts) Purchased Services - Rental Property, Maintenance Property Insurance Contracted Services Energy - Natural Gas Energy - Tanked Fuel Energy - Electricity Energy - Other
Capital Outlay - Equipment (Itemized List Required on DE 1194)

1. Indirect Cost (State 0-14 only
2. Teacher Retirement 3. Workman1s Compensation *4. Employer1s Portion of
Health Insurance 5. Unemployment Insurance 6. F.I.C.A.

4880 7674 7681
7684 7686 7689

Indirect Cost - Federal Programs System Contributions to State Retirement Workman1s Compensation Insurance
Employee Insurance Unemployment Compensation Insurance System Contributions to Social Security

Outgoing Transfers (for Financial Report only)

8675

All State Grant and A. P. E. G.

*This item is available only to those centers where all employees of the fiscal agent are provided this same benefit except for the state health insurance available for certified personnel.

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D. Reporting Forms Data regarding services to children and parents are submitted to
the Georgia Department of Education monthly, quarterly and annually. Objectives for each center are establ ished in the proposal and are
used to document and evaluate center operations quarterly. Financial reports are submitted quarterly and annually. (See
Appendix H.) Demographic data on children served in classes is submitted
annually. (See Appendix F.)
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Personnel Psychoeducational centers shall employ personnel in accordance with Guidelines/Regulations specified by Georgia Board of Education Policies, LEA policies and the project proposals of each psychoeducation center.
Certification Requirements
* All t~Qh~/th~p~~ shall have a valid certificate in behavior
disorders issued by the Georgia Teacher Certification Office.
* All aid~/panap~on~~~o~ shall be licensed by Georgia Teacher
Certification Office.
** All ~ocLal wo~k~/panent wo~k~ shall be certified by the
Georgia Teacher Certification Office or be eligible for appropriate State Merit System rating. All p~!:fQhome.XJrM~/p~!:fQho.e.og~~ shall be certified by the Georgia Teacher Certification Office or meet the requirements
as specified in the P~!:fQho.e.og~Qa.e. S~V~Q~ Handbook.
Noncertified personnel shall meet the requirements as established by the job descriptions in the proposal and approved by the fiscal agent and advisory board.
AcJm<..YL-iAtJw.tive. P~onne..e.
The center director and other administrative personnel shall be certified by the Georgia Teacher Certification Department or hold a degree in a field appropriate to the job description.
* All beginning teachers must pass the teacher criterion test and
an assessment in their field to receive a professional certificate.
** It is strongly recommended that social work personnel pursue
appropriate infield certification.
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Salaries Professional personnel salary schedules shall be determined on the basis of three factors. Experience and level of certification (state salary schedule as issued annually). Local supplement as determined by the fiscal agent/advisory board. Extended day or year contract. Aides/paraprofessional's salary schedules shall be established by the center director with approval of the fiscal agent/ advisory board. Noncertified personnel (secretaries, evaluators, etc.) salary schedules shall be established by the center director with the approval of the fiscal agent/advisory board. Contracts for employment of professional staff are issued annually according to fiscal agent policy and Georgia Department of Education guidel ines.
Travel (See Georgia Financial Accounting Handbook for Local School Systems) Staff Development
Consultants may be used and per diem is I imited to the current state schedule. Staff may attend workshops and in-service training programs with prior approval and in accordance with personnel pol icies and procedures. Expenses incurred may be reimbursed. All psychoeducational centers are to provide staff training programs to update and improve the knowledge and skills of their personnel.
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Benefits The Psychoed Program pays a percentage of teacher retirement, state health insurance, social security, unemployment, and workers' compensation according to the requirements of the fiscal agent and the current state/federal formulas. Sick leave policy for extended contract employees is determined by the fiscal agent/advisory board for each center. Vacation policy for extended contract personnel is determined by the governing agency for each center.
Staff Consultants Consultants, such as a psychologist, psychiatrist, infant evaluator or other professional personnel, may be employed part time. An agreement must be written that outl ines terms of services and reimbursement. Each center should reflect all part-time personnel in the staffing patterns and include job descriptions in the proposal.
Job Descriptions A job description must be written for each position and must include minimum qualifications and specific job responsibilities.
Policy Manuals Each center should develop (adopt) the fiscal agent's personnel policies and provide copies to the staff. Policies specifically regarding children such as staff use of time out, distribution of medication, etc. should be developed.
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Data Collection and Documentation
The Psychoeducational Center Network has an accountability system which provides information to the director, governing agency and Georgia Department of Education regarding services to children, parents and community agencies. Each center also collects data regarding individual children, progress in treatment and demographic data.
A. Monthly Reports: Due each month (See Appendix F.)
Services to children Services to school districts and agencies Services to parents Personnel 1ist for state insurance purposes due in September
B. Quarterly Reports: Due October, January and April
Review of objectives (See Appendix G for complete list of objectives.) Financial report for state, federal and 89-313 funds (See Appendix H for sample of reporting forms.)
C. Annual Report: Due July
Review of objectives for year Demographic data on in-center children (See Appendix F.) Financial report Yearly services report (same as monthly report form) Inventory (See Appendix J.)
D. Annual Proposal: Draft due in 4th Quarter
State and Federal funds Narrative and/or outl ine Center objectives Budget, equipment list, personnel list and paper budget Annual calendar to include 240 operational days each fiscal year, 210 days of classes each fiscal year Assurances
P.L. 89-313 Project (optional) State department provides forms for grant applications
E. Treatment Data: Maintained by each center
Intake/Master List of Total Services (Refer to Appendix K for sample)
Individual Educational Plan/Staffing/Minutes (See Appendix L for sample) Documentation
Monitoring of treatment and progress of child Contacts with parents/schools/agencies Staff development Fire drills Contracts with vendors and the services provided by vendors
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References
The following references may be obtained by writing the designated office at the Georgia Department of Education
Georgia Department of Education Twi n Towers East Atlanta, Georgia 30334
Office of Administrative Services
Geo~gia Financial Aeeounting Handboo~ no~ Loea! Sehool Sy~t~
Travel regulations Accounting procedures Description of codes for the DE 0046
Stann Directory of regional directors
V~ecto~y 0b state and Loea! Sehoo~ and
Georgia telephone director Georgia school board policies
Office of Instructional Services
Directory of regional consultants Chapter I guidel ines
Program for Exceptional Children
P~og!Lam no~ Exeeplionat CMlMen RegulalioVl..6 and P~oeedM~
GLRS directory Directory of local special education directors Directory of district liaisons Resource manuals for each handicapping area BD resource manual
Geo~gia Comp~eheVl..6ive Plan no~ Special Eduealion Geo~gia State P~og~am Plan
Directory of approved private schools
P~vate Sehool StandM~
Forms used by all psychoeducational centers P.L. 94-142 evaluation and assessment instruments Sample due process forms RVI guidel ines
Office of Planning and Development
Competency-based education guidel ines Teacher certification requirements Teacher recruitment information
Geo~gia Sehool P~yehologiea! S~vie~ Handboo~ Publie Sehool StandM~
Office of State Schools and Special Services
Directory of state schools
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Information concerning the following may be obtained by writing to the Georgia Department of Human Resources at Georgia Department of Human Resources
47 Trinity Avenue, S.W.
Atlanta, Georgia 30334 Family and Children Services Division
Child Protective and Placement Services Preventive and Support Services Mental Health and Mental Retardation Division Drug Abuse Services Mental Health Services Directory of Developmental Disabilities Service Center Public Health Division Vocational Rehabilitation Division Youth Services Divisions Interdivisional Troubled Children Committee
-24-

Appendices

Appendix A Appendix B Appendix C Appendix D
Appendix E Appendix F Appendix G Appendix H Appendix Appendix J Appendix K Appendix L Appendix M Appendix N Appendix 0 Appendix P

Center Li s t Psychoeducational Center Directors Organization Due Process Checklist State Rules and Regulations as Applied to Psychoeducational Centers Georgia Board of Education Agreement (Sample) Monthly Report Form and Demographic Data Center Operational Objectives Financial Reporting Forms RFCL Part II - Revised (DSM III) Sample Inventory Form Issues of Performance Audit, Sample Master List and Agreement Georgia Department of Education Sample of Due Process Forms Advocacy Groups and Agencies Interagency Cooperative Agreement Monitoring Documents (Title VI-B and P.L. 89-313) Personnel and Health Insurance List

-25-

Appendix A Li st of Centers

Georgia Department of Education Office of Instructional Services
Division of Special Programs Program for Exceptional Children
Psychoeducational Center Network Centers for Severely Emotionally Disturbed
Suite 1966, Twin Towers East Atlanta, Georgia 30334
(404) 656-2425 - GIST 221-2425

Center
Atlanta City Schools
Larry Weiner, Director North Metro Psychoeducational Center (Whitaker School) 846 Huff Road, N.W. Atlanta, Ga. 30318 (404) 352-3720
Serves Atlanta City, Gwinnett and North Fulton Counties; Buford City
Baldwin County
Joseph Fehlig, Director Oconee Area Psychoeducational Program 180 N. Columbia Mill edgev i I Ie, Ga. 31061 (912) 452-3514
Serves Baldwin, Hancock, Jasper, Johnson, Putnam, Washington and Wilkinson Counties
Bibb County
Elizabeth Bell LeClair, Director Middle Georgia Psychoeducational Center 3769 Ridge Ave. Macon, Ga. 31204 (912) 477-3440
Serves Bibb, Crawford, Houston, Jones, Monroe, Peach and Twiggs Counties

Fiscal Agent
Alonzo A. Crim, Superintendent Atlanta City Schools 224 Central Ave., S.W. Atlanta, Ga. 30335 (404) 659- 3381
William D. Gardner, Superintendent Baldwin County Schools 435 N. Cobb St. Box 649 Milledgeville, Ga. 31061 (912) 452-3516
Thomas E. Hagler, Superintendent Bibb County Schools 2064 Vineville Ave. P.O. Box 6157 Macon, Ga. 31213 (912) 742-8711

A-l

Carroll County
David Craddock, Director Burwell Psychoeducational Center 1905 Burwell Dr. Carrollton, Ga. 30117 (404) 258-7205
Serves Carroll, Coweta, Heard, Meriwether and Troup Counties; Carrollton, Hogansville, LaGrange and West Point Cities
Chatham County
Patricia Hinely, Director Chatham-Effingham Psychoeducational Center 2001 Cynthia St. Savannah, Ga. 31405 (912) 234-8826
Serves Chatham and Effingham Counties
Clarke County
Robert T. Jacob, Director Rutland Psychoeducational Center 125 Mi nor St. Athens, Ga. 30606 (404) 549-3030/GIST 241-5516
Serves Barrow, Clarke, Elbert, Greene, Jackson, Madison, Morgan, Oconee, Oglethorpe and Walton Counties; Commerce Jefferson and Social Circle Cities
Clayton County
Robert Gordon, Director South Metro Psychoeducational Center 180 Poole Creek Road, S.E. Atlanta, Ga. 30354 (404) 762-7900
Serves Clayton and South Fulton Counties; Atlanta City (South), Areas
I, I I

Travis B. Edmondson, Superintendent Carroll County Schools Carrollton, Ga. 30117 (404) 832-3568
Ronald E. Etheridge, Superintendent Chatham County Schools 208 Bull St. Savannah, Ga. 31401 (404) 234-2541, Ext. 108
Carol Purvis, Superintendent Clarke County Schools P.O. Box 1708 Athens, Ga. 30610 (404) 546-7721
Ernest L. Stroud, Superintendent Clayton County Schools 120 Smith Street Jonesboro, Ga. 30236 (404) 478-9991

A-2

Coastal Plains CESA
Harry Hamm, Director Comprehensive Psychoeducational
Services of South Georgia Route #10, Box 322 Valdosta, Ga. 31601 (912) 333-5228/GIST 349-5228
Serves Ben Hill, Berrien, Brooks, Cook, E~hols, Irwin, Lanier, Lowndes, Tift and Turner Counties; Fitzgerald and Valdosta Cities
Cobb County
Sara H. Reale, Director Cobb-Douglas Psychoeducational Center 353 Lemon St. Marietta, Ga. 30060 (404) 422-0833 or 422-9171
Serves Cobb and Douglas Counties; Marietta Ci ty
Crisp County
David Fallin, Director FI int Area Psychoeducational Center P.O. Box 729 Cordele, Ga. 31015 (912) 273-5653
Serves Crisp, Dooly, Macon, Marion, Schley, Sumter, Taylor and Webster Counties; Americus City
Dalton City
George Andros, Director Child Development Psychoeducational Center 820 North Hamilton St. Dalton, Ga. 30720 (404) 272-2140/GIST 234-2140
Serves Cherokee, Fannin, Gilmer, Murray, Pickens, and Whitfield Counties; Dalton City
A-3

Cary Moore, Director Coastal Plains CESA Route HIO, Box 318 Valdosta, Ga. 31601 (912) 333-5224/GIST 349-5224
Thomas S. Tocco, Superintendent Cobb County Schools P.O. Box 1088 Marietta, Ga. 30061 (404) 422-9171
Charles Osborne, Superintendent Crisp County Schools P.O. Box 729 Cordele, Ga. 21015 (912) 273-1611
Robert D. Cox, Superintendent Dalton City Schools P.O. Box 1408 Dalton, Ga. 30720 (404) 278-8766

DeKa 1b County
Glenda Molton, Director DeKalb-Rockdale Psychoeducational Center Robert Shaw Center 385 Glendale Road Scottdale, Ga. 30079 (404) 292-7272, Ext. 38
Serves DeKalb and Rockdale Counties; Decatur City
Dougherty County
Jim N. Bachrach, Director Oak Tree Psychoeducational Center 712 North Jefferson St. Albany, Ga. 31701 (912) 439-4330/GIST 341-4330
Serves Baker, Calhoun, Dougherty, Early, Lee, Miller, Terrell and Worth Counties
First District CESA
Judi Kelley, Acting Director Cedarwood Psychoeducational Center Route #1, Box 8 ColI ins, Ga. 30421 (912) 693-5220
Serves Appling, Bulloch, Candler, Evans, Jeff Davis, Tattnall, Toombs and Wayne Counties; Vidalia City
Glynn County
Kenneth R. Wall in, Director The Community Developmental
Psychoeducational Center No. 2 Ross Road Brunswick, Ga. 31520 (912) 264-8020
Serves Bryan, Camden, Glynn, Liberty, Long and Mcintosh Counties

Robert Freeman, Superintendent DeKalb County Schools 3770 North Decatur Road Decatur, Ga. 30032 (404) 296-1700 or 296-2000
Paul B. Robertson, Superintendent Dougherty County Schools Box 1470 (601 Fl int Ave.) Albanh, Ga. 31703 (912) 885-5800
Inman Davis, Superintendent First District CESA P.O. Box 826 Zetterower Road Statesboro, Ga. 30458 (912) 764-6397
Kermit Keenum, Superintendent Glynn County Box 1677 Brunswick, Ga. 31521 (912) 265-6590

A-4

Jenkins County
Steve Chester, Director Ogeechee Psychoeducational Center P.O. Box 284 Midvi lIe, Ga. 30441 (912) 589-7310
Serves Burke, Emanuel, Glascock, Jenkins, Jefferson and Screven Counties
Laurens County
Martha Hickerson, Director Heart of Georgia Psychoeducational
Center P.O. Box 1031 Dub lin, Ga. 31021 (912) 2]2-9220
Serves Bleckley, Dodge, Laurens, Montgomery, Pulaski, Telfair, Treutlen, Wheeler and Wilcox Counties; Dublin City
Muscogee County
Faires P. Jones, Director Woodall Psychoeducational Center 4312 Harrison Ave. Columbus, Ga. 31904 (404) 323-5683 and 323-6301
Serves Chattahoochee, Clay, Harris, Muscogee, Quitman, Randolph, Stewart and Talbot Counties
Northwest Georgia CESA
Georgia Moore, Director Northwest Psychoeducational Center 200 Reese Street Rome, Ga. 30161 (404) 291-2625/GIST 231-6101
Serves Bremen, Calhoun, Cartersville, Chickamauga, Rome and Trion Cities; Bartow, Catoosa, Chattooga, Dage, Floyd, Gordon, Haralson, Paulding, Polk and Walker Counties

George W. Pope, I II, Superintendent Jenkins County Schools P.O. Box 669 Millen, Ga. 30442 (912) 982-4035
J. M. Warren, Superintendent Laurens County Schools P.O. Box 2128 Dub 1in, Ga. 31021 (912) 272-4767
Braxton A. Nail, Superintendent Muscogee County Schools 1200 Bradley Dr. Columbus, Ga. 31994 (404) 324-5661
Charles L. Florida, Superintendent Northwest Georgia CESA Route #1, Box 255 Cedartown, Ga. 30125 (404) 684-5443

A-5

Okefenokee CESA
Wi 11 iam H. Rivenbark, Jr. Coordinator Harrell Psychoeducational Center 1492 Bailey St. Waycross, Ga. 31501 (912) 285-6191/GIST 368-6191
Serves Atkinson, Bacon, Brantley, Charlton, Clinch, Coffee, Pierce and Ware Counties; Waycross City
Pioneer CESA
Wayne Moffett, Director Alpine Psychoeducational Center P.O. Box 2459 (E.E. Butler High School Building
Athens Highway Gainesvi lIe, Ga. 30501 (404) 532-9981/GIST 245-5260
Serves Banks, Dawson, Franklin, Forsyth, Habersham, Hall, Hart, Lumpkin, Rabun, Stephens, Towns, Union and White Counties; Ga i ne sviII e Cit y
Richmond County
Harry Goodwin, Director Sand Hills Psychoeducational Program 2403 Mount Auburn Ave. Augusta, Ga. 30904 (404) 733-6163
Serves Columbia, Lincoln, McDuffie, Tal iaferro, Richmond Warren and Wi 1kes Count ies
Spalding County
Juanda Ponsell, Director Griffin Area Psychoeducational Center 415 Jefferson Ave. Griffin, Ga. 30223 (404) 228-1290
Serves Butts, Fayette, Henry, Lamar, Newton, Pike, Spalding and Upson Counties; Thomaston City
A-6

A. L. Woodard, Director Okefenokee CESA Route #5, Box 406 Waycross, Ga. 31501 (912) 285-6151/GIST 368-6151
Charles H. Allen, Director Pioneer CESA Route #5, P.O. Box 145 Cleveland, Ga. 30528 (404) 865-2141
John P. Strelec, Superintendent Richmond County Schools 2083 Heck 1e St. Augusta, Ga. 30910 (404) 736-8453
Charles H. Green, Superinendent Spalding County Schools P.O. Drawer N Griffin, Ga. 30223 (404) 227-9478

Thomas County
Jim Hall, Director Southwest Georgia Psychoeducational
Center P.O. Box l10-A Ochlocknee, Ga. 31773 (912) 547-5123/GIST 334-2384
Serves Colquitt, Decatur, Grady, Mitchell, Thomas and Seminole Counties; Pelham and Thomasville Cit ies

Terry Solana, Superintendent Thomas County Schools Thomasville, Ga. 31792 (912) '226-7102

A-7

1. Atlanta City Schools
2. Baldwin County
3. Bibb County 4. Carroll County
5. Chatham County
6. Clarke County 7. Clayton County
8. Coastal Plains C[SA

9. Cobb County 10. Crisp County
11. Dalton City 12. DeKalb County 13. Dougherty County
14. First District C[SA 15. Glynn County 16. Jenkins County
A-8

17. Laurens County
18. Muscogee County
19. Northwest Georgia CESA 20. Okefenokee C[SA 2l. Pioneer C[SA
22. Richmond County 23. Spalding County 24. Thomas County

Appendix B Psychoeducational Center Directors Organization

Psychoed Regional Representatives

Organizational Structure The committee of representatives shall be made up of an elected representative from each of the six regions defined as follows.

Regions

Centers

North

Dalton, Pioneer, Northwest Georgia

Middle

Richmond, Bibb, Jerkins, Laurens, Baldwin

Metro

Atlanta City, Clayton, Cobb, DeKalb

North Central Spalding, Carroll, Clarke

Southwest

Crisp, Thomas, Coastal Plains, Muscogee, Dougherty

Southeast

Glynn, Chatham, Okefenokee, First District

Two chairpersons will be elected from the committee of representatives by the

committee. The committee of representatives will designate the rules and

responsibility of the chairpersons.

Network coordinator will serve as ex-officio member of the representative

committee. All directors will be informed of date, time, and place of meetings,

and meetings will be open to all members of the association.

B-1

Appendix C Due Process Check! ist

Introduction Parents' and children'sl'ights under PL. 94-142 are protected through a procedural due process Structure. The child. the parents and the schools are involved in the specifics of due process.
The following is a chart of due process procedures.

Sc"rin

ReferTal
rIEV P.~Wio.

. Parents refuM

C-...h' 'r ReferTal to other
agenciu!services

Ev ...

if needed

Local Jediation Due prLell hearing



IEP Com

manidttePelaMceeemtienn~t'













Pia' cement. In

pro~am

1 . . . - .

IEP De to d

:

Placement Recvoemp meneda.tIOn.

Need additioNiI

for exceptional children not recommended

information to plan student's program

Permission for Placement

e.





e.

I
Placement in Program for . ., ......., ChUd...

Parents diMgree
II Local mediation

Remain in regular program

I. AnnuaI

ReVICW

f
0

Due procell hearing

1EP,'Placement

I

ThreeYear Reevaluation

C-l

DUE PROCESS CHECKlIST FOR P. l. 94-142

Systl:n Reviewer Date

Student
School Exceptionality

'J1' Record of access sheet(name. date. purpose)

2. Referral date (to Special Education)

3. Parental consent for evaluation a. date sioned I). 1etter inc 1uaes des crl pt1on of DOssible tests. etc.

4. H/V Screening data

a. hearina screenina date &results

b. c.

~Yfol1sTioonw-usocreneninneocedssaatery & r e s u l t s

5. Written notice to parents regarding IEP/Placement meeting a. date sent b. Darticioants or t1tles llsted c. Drojected date of meetlno d. other documentatlon of notif,cat,on

6. IEP (Not applicable to gifted) a. date b. present level of performance

c. annual goals

d. short-term obJectlveS(wrltten same time as annual goals)

apprOp,.late obJectlve crlterla

evaluation procedures

schedules for detemllnlng mastery

e. specific special educatlon and

related services(list)

f. time in reoular educatlon

g. transp~)tatiOn(to the speclal oroaram

h. adaptlve or other speclally

i-:

desianed P.E. lnltlltlon o-r serVlce

j. duratlon of serVlce

. -documentatlon of at least Z

participants(and positions) other

than parents

.

7 Placement mlnutes a. date

I

II. optlons and factors considered. etc. (narratiYt or checklist)

I

1

8 Parental consent for placement

a. date

D. signed1relatlonsh1p to stUdent)

9 Rlghts to parents documented at tlme of I

e. consent for evaluation

!

b. consent for placement

I

I

1O. Annual reYlew(date)

I

I
.I
,~
I

C-2

REQUIRED ELIGIBILITY CRITERIA - SEVERELY EMOTIONALLY DISTURBED
Student 1. Educational Evaluation dates
and significant results
2. Psychological - date and significant results and/or diagnosis
3. Psychiatric as indicated -
date and stated diagnosis
4. Observation - date(s) and significant results
5. Social history - indicate,
if separate report, form or included with other information
C-3

Appendix D State Rules and Regulations
as Applied to Psychoeducational Centers

IDDFd3-21-22 G.crgl. D.p.l1m.nl 01 Educ.lIon 105/17/82 I R.gul.liona and Proef'dur IODFd3-21-22

C. Severely Emotionally Disturbed
I. Definition - Psychoeducational Centers in Georgia serve severely emotionally disturbed chi Idren and youth. (Chi Idren and youth are hereafter referred to as children.) All centers may accept children ages 0 through 18 years. Infants from three months through two years, 11 months may be served by the center staff in well baby clinics, community service centers, in
parent's homes, of may be served in
center classes, or other appropriate settings. Students ages three through 18 can be served by the center staff in classes, direct services or other appropriate settings.
The major admission requirement will be the presence of an emotional disturbance or behavior disorder severe enough to require this special treatment program. Children with secondary handicapping conditions such as, but not limited to, mental retardation, learning disabi 1ity, neurological disability, hearing loss, or developmental delay will be accepted if the primary disability is a severe emotional disturbance or severe behavioral disorder. Children who have mild to moderate behavior or discipline problems are no tel ig i b1e
2. E~igibility and Placement - Based upon educational and psychological evaluation, psychiatric evaluation as indicated, observation, social history, and appropriate center staffing, one or more of the following characteristics exhibited by the children may be regarded as eligibility for placement.
a. Severe emotional disturbance such as, but not limited to, childhood schizophrenia and adjustment reactions.

b. Severe behavioral disorders resulting from, but not limited to, autism, neurological impairment, culturpl deprivation, developmental lag, and family-related problems.

c. Severe school-related problems manifested in, but not limited to, behavior, socialization, communication, and academic ski lIs.

The term Severely Emotionally Disturbed does not include socially maladjusted students unless it is determined that they are also severely emotionally disturbed or severely behaviorally disordered. A student whose values (and/or behavior) are in conflict with the school, home or community or who has been adjudicated through the courts or other involvements with correctional agencies, is not automatically eligible for psychoeducational placement. Ordinary classroom behavior problems and social problems, such as delinquency and drug abuse, do not automatically qual ify a student for psychoeducational placement.

3. Enrollment - The recommended maximum enrollment for severely emotionally disturbed in Psychoeducational Centers is:

Ages 0 through 14 Ages 15 through 18

8

10

D-l

F. Psychoeducational Centers for the Severely Emotionally Disturbed
For definition of children to be served, see VI, Section C.
Operational Regulations and Procedures In compliance with a provision of the budget, Item 624.44, Psychoeducational Centers for Severely Emotionally Disturbed the Georgia Department of Education shall receive funds appropriated by the Georgia Assembly. The Office of Instructional Services, Division of Special Programs, Program for Exceptional Children shall:
a. develop rules, regulations and procedures pertaining to the operation of psychoeducational centers, subject to review and approval of the State Board of Education;
b. review proposals for funding and make recommendations to the State Board of Education.
a. Regulation - A contract shall be awarded to an approved fiscal agent for the operation of a center to serve severely emotionally disturbed or severely emotionally disordered children ages zero through 18.
1. Procedure - The fiscal agent shall:
(a) serve as fiscal agency for the receipt and disbursement of all grant and APEG Section 5 funds;
(b) transfer upon receipt of all grant and APEG Section 5 funds including maintenance and operation, instructional materials and media, and sick leave to restricted center accounts;
(c) maintain appropriate bookkeeping procedures to insure the expenditure of funds as indicated in the approved proposal. (For information on procedures, the Georgia Accounting Handbook for Local School Systems will be used.)
(d) Provide appropriate information as required by the State Department of Education, Office of Instructional Services, Division of Special Programs, Program for Exceptional Children, including:
0-2

(1) Monthly Reports of Services to Children and Parents
(2) Quarterly Documentation of Proposal Objectives
(3) Annual Report of Services to Children and Parents
(4) Annual Documentation of Proposal
Objectives
(5) Quarterly Financial Report
(6) Annual Financial Report*
In July of the following fiscal year, provide the Georgia Department of Education, Fiscal Services Division, Cash Management Section, and the Program for Exceptional Children, Twin Towers East, 19th Floor, Atlanta, Georgia 30334, an Annual Financial Report, a detailed list of encumbered items, a detailed inventory, and a check for the remaining unexpended funds.
2. Two copies of each proposal must be submitted to the Georgia Department of Education, Office of Instructional Services, Program for Exceptional Children, Atlanta, Georgia 30334 for review and approval.
3. Each proposal for funding must con-
tain a letter of support and cooperation from each superintendent. It is recommended that the mental health chief(s) in the c~nter service area provides written support.
4. Upon receipt and approval of a pro-
posal for funding, a contract to operate a psychoeducational center shall be awarded by the State Board of Education to a fiscal agent. This contract will indicate the amount of grant funds plus
the number of APEG Section 5 units
allotted.
b. Regulation
(1) The Advisory Board shall meet at least quarterly.

IDDFd3-33-34 G~rgla Department of Education /05/11/82 / Regulation. and Procedurn IDDFd3-33-34

(2) Responsibilities bf the board shall include, but not be limited to

(a) review and endorsement of the pro-

posal for funding including service

delivery model, staffing pattern

objectives and budget;

,

(b) review of service del ivery model and recommendations for program improvement;

(c) review of services data quarterly.

c. Regulation - Guidel ines for the budget are established to cover all areas of expenditures.

1. Procedure - Budgets will be determined annually according to appropriations and population to be served by centers.

2. Management of center budgets wi 11 be consistent with state fiscal policy.

3. Deviations in the project budget must be approved by the fiscal agent and submitted to the Georgia Department of Education, Program for Exceptional Chi ldren in writing for approval asoutlined in the proposal guidelines.
4. Indirect cost is only allowable on
the 0-14 grant less the director's salary and should be calculated using the state approved restricted percentage or three percent (3%) whichever is smaller. Indirect cost may be negiotiated for providing such services as accounting, data processing and purchasing.

d. Regulation - The procedures outlined below shall be operative in regard to personnel for centers.

1. Procedure - Minimum salary schedules for professionals should be consistent with either the Georgia Department of Education certification requirements or Georgia Merit System rating in the area of job responsibil ity.

2. Personnel salaries should not exceed those being paid local school system personnel with similar training, experience and position.

3. Section 5 APEG units assigned will be utilized for teacher therapist positioqs to operate center classes the equivalent of a minimum four and onehalf days per week.
4. Any positions established which are
not described in the approved proposal must be justified in writing with a complete job description attached and submitted for prior approval to the Georgia Department of Education.
5. Personnel receiving Section 5 APEG
funds must meet the state requirements
for all Section 5 APEG positions. Others
must meet licensing or certification requirements in their own respective professional area; i.e., psychiatrist, psychologist, social worker, or be eligible for an appropriate merit system rating.
e. Regulation - The procedures outlined below shall be operative in regard to costs of operation and equipment.
1. Procedure - Travel expense reimbursement will be based on state travel regulations for local school systems.
2. State funds may not be utilized to buy snacks or rewards for students.
3. Installation of equipment or renovation of a facility on property not legally the property of the fiscal agent is prohibited.
4. Expenditures for purchase or lease
of vehicles or reimbursement for pupil transportation is not an allowable budget item, except in those cases where vehicles were purchased prior to
FY 75.
f. Regulation - The procedures outlined below shall be operative in regard to costs of operation and equipment.
1. Procedure - Insurance coverage may be contracted for center contents.
2. Insurance coverage may be contracted for liability on pupil transportation vehicles unless already covered by pupil transportation grants.

D-3

ICt)Fd3- 34- 35 Georgia Department of EduClitlon / 05/17/82 / Regulations and Procedures

IDDFd3-34-35

3. I nsurance coverage may be contracted for professional liability and/or accident and health when provided to all staff by the fiscal agent.
g. Regulation - The procedure outlined below shall be operative in regard to average daily attendance reporting for chi Idren attending a center.
1. Procedure - Any child served by the center should be counted for average daily attendance by the LEA in which the chi Id spends more than one-half of the school day in regular school programs.
Children also served in LEA/special education classes should be counted on the Special Education Monthly Attendance Report.
Chi Idren served full day by the center are eligible to be reported by the LEA for attendance, administration, and transportation on the Regular Monthly Attendance Report when attendance is verified by center personne 1.
h. Regulation - The procedure outl ined below shall be operative in regard to center operation.
1. Procedure - Each center shall operate eight hours, 240 days each f is ca 1 yea r .
2. Classes in the 0-14 program will operate a minimum of two-hours four and one-half days per week, 210 days each fiscal year and may operate five days per week according to IEP needs.
Classes in the adolescent program will operate six hours per day, five days per week, 180 days each fiscal year.

D-4

Appendix E Georgia Board of Education Agreement

STATE OF GEORGIA COUNTY OF FULTON

AGREEMENT

This agreement is made and entered into this

day of

in

the year 1983 by and between the State Board of Education of the State of

Georgia hereinafter referred to as "State Board" and the

Board of Education hereinafter referred as the "Fiscal Agent".

The Fiscal Agent agrees to operate a psychoeducational center serving identified and eligible severely emotionally disturbed children ages 0 through 14 and 15 through 18 years in the following school systems:

The main center is to be located in

with additional satellite

centers or itinerant programs strategica y ted throughout the service

area. Operation of the center shall be in CV~~II~e with the project

submitted to and approved by the Geor ia epar

of Education Office of

Instructional Services. Program for

i

hildren.

A. The Fiscal

1. Assume responsibility for operation. including se ec

~_~~~~A'sion of center management and pproval of personnel;

2. Operate a psychoeduc fiscal year;

eight hours a day 240 days each

3. Operate psychoedu to include a 30-dB'~fUB~~

at least 210 days per year

4. Specify the

in the proposal for funding;

5. Insure that all Section 5 APEG units assigned to this project are utilized for teacher-therapist positions to operate psychoeducational center classes the equivalent of four and one-half days each week;

6. Promote cooperation and coordination of transportation for the center;

7. Develop a salary schedule for all staff consistent with local school system personnel with similar training experience and position;

8. Provide a list of all staff positions with job descriptions. qualifications and salaries in the project proposal;

9. Develop operational and procedural guidelines consistent with the requirements of this agreement and Regulations and Procedures for Georgia School Systems in IDDFd3-32F for Psychoeducational Centers for the Severely Emotionally Disturbed;

E-l

10. Assign only psychoeducational duties to staff occupying center administrative positions.
B. The Fiscal Agent shall for the 15 through 18 program:
1. Assume responsibility for the supervision of program management and operations t including selection and approval of personnel;
2. Operate a psychoeducational adolescent program eight hours a day, 190 days each fiscal year;
3. Operate adolescent classes at least 180 days per year;
4. Promote cooperation and coordination of transportation and multi-agency services;
5. Develop a salary schedule for all staff, consistent with local system personnel with similar training, experience and position;
6. Provide a list of all staff positions, with job descriptions t qualifications and salaries in the project proposal;
7. Develop operational and procedural guidelines consistent with the requirements of this agreement and Georgia Regulations and Procedures for Georgia School Systems in IDDFd3-32F for Psychoeducational Centers for the Severely Emotionally Disturbed;
C. The Fiscal Agent further agrees to:
1. Negotiate an indirect cost for providing such services as accounting t data processing, purchasing and other administrative support services. Indirect cost is only allowable on the 0-14 grant less the director's salary, per the Regulations and Procedures for Georgia School Systems in IDDFd3-32F for Psychoeducational Centers for the Severely Emotionally Disturbed. For budget purposes, the indirect cost sum budgeted should be calculated using either the approved indirect cost restricted rate approved by the Georgia Department of Education's Accounting Services Section for the period covered by this agreement t or three percent (3~) of the 0-14 grant amount less the director's salarYt whichever is smaller. For expenditure report purposes t the indirect cost rate used for budget purposes is applied to the expenditures incurred for the period covered by this agreement for the 0-14 program t excluding director's salary.
2. Provide information concerning this project t including quarterly financial statements, in such detail and amount as and when required by the Georgia Department of Education t Office of Instructional Services t Program for Exceptional Children;
3. Amend the program budget t if required t in accordance with the Program for Exceptional Children's proposal format for Psychoeducational Centers;
E-2

4. Enter into written agreements for consultant services, utilizing agreement forms provided by the Office of Instructional Services, Program for EIceptional Children;

5. Return to the State Board any State funds which have not been spent, obligated by contract or purchase order by the end of the agreement period. Obligations should be paid SiI months after the end of the agreement period.

It is mutually agreed that teacher allotments, including funds for instructional media, maintenance and operations and sick and personal leave under Section 5 of the Adequate Program for Education in Georgia Act have been assigned to this project for the 0 through 14 program.

The State Board a~rees to provide a grant in the amount of $

0

through 14, $

, 15 through 18, to the Fiscal Agent for the period of

July I, 1983 through June 30, 1984 to serve the aforementioned school

systems.

The Fiscal Agent's and psychoeductional center's employees will not be employees of the State Board while performing this service and will not be entitled to fringe benefits normally accruing for employees of the State Board.

All parties to this agreement certify that the prOV1Slons of Act 56, Georgia Laws, 1956, State Employees and Officials-Trading with State, as amended, have not been violated and will not be violated in any respect.

This agreement will terminate upon payment in full by the State Board for the services stated herein.

STATE BOARD OF EDUCATION

BOARD OF EDUCATION

OF THE STATE OF GEORGIA

By: - - - - - - - - - - - -
Superintendent

FEI Number

Date :

_

By: -C=a-l::A-d-a~m--so-n:-:(-A-u--t h:-o-r:i z-e--d::S-i-g:n-~a-t u--r e ) Associate State Superintendent of Schools, Administrative Services

Date :

_

State Board approved June

Organization COQe

Fund Source

State Class

Cost

(State funds)

Contract Number

, 1983

E-3

Appendix F Monthly Reporting Form
And Demographic Data

Appendix G Center Operational Objectives

Center Operational Objectives (Zero through 14)
Develop objectives and procedures for the following center operations.
1. Number of children to be identified, assessed, and served by the center. (Specify numbers to be served.)
2. Center class operation - Number of classes
a. Number of teachers and teacher assistants b. Number of classes and hours operated c. Number of students to be served in classes
3. Infant program, ages zero through 4. (Number to be served)
4. Parent services (Projected number to be served)
5. Consultation to other agencies
6. Training for other agencies
7. Staff and volunteer training
8. Educational evaluation pre- and post-data
9. Evaluation system
a. Implement a data collection system to document stated center objectives
b. Use a data collection system to document center treatment effectiveness
c. Use a data collection system to document staff and volunteer training
d. Use an evaluation system to record student progress in terms of the curriculum, and to reflect the pre-/posteducational test data
e. Use a data collection system to meet state data collection requirements

Operational Objectives (15 through 18)
Develop objectives and procedures for each of the following program objectives
A. Number of students to be identified, assessed, and served by the program.
B. Program class operation
1. Number of teachers and teacher assistants
2. Number of classes and hours operated
3. Number of students to be served in classes
4. Management of IEP/treatment plan/instructional objectives
5. Curriculum scope - social, emotional, academic (This objective should address specifically the incorporation of curriculum issues regarding all-day placement, least restrictive environment, and mainstreaming in terms of subject areas to be taught and treatment to be used.) Motivational systems or guidelines should be addressed here as well as program design.
6. Evaluation of students to include pre- and post-educational
testing.
C. Parent services
D. Consultation to other agencies
E. Training for other agencies
F. Staff and volunteer training
G. Evaluation system
1. Use a data collection system to document stated program objectives
2. Use a data collection system to document program treatment effectiveness
3. Use a data collection system to document staff and volunteer training
4. Use an evaluation system to record student progress in terms of the curriculum, and to reflect the pre-/posteducational test data.
5. Use a data collection system to meet state data collection requirements
G-2

Appendix H Financial Reporting Forms
And Budget DE 0046

Quarterly StatenEnts of Receipts, Expenditures and Ccmnitnents Directions and I:efinition of Items

Directions

(1) Narre of contracted fiscal agent.

(2) Narre of psychoeducational center (3) Give nonth, date, and year for the reporting Period.
(4) Report FY 84 grant f1.lllds. *

(4A) Report FY 84 89-313 project f1.lllds. Any carry-over FY 83 89-313 f1.lllds must be shawn and designated as such in Section A, line 1 on the first
quarter report. *

(5) Report APEG f1.lllds including salaries, M&O, text books, and instructional materials, etc. Indicate any FY 83 APEG f1.lllds carried over to FY 84 on
Section A, line 1 on the first quarter report. *

(SA) Report FY 84 (15-18) federal adolescent funds. Any carry-over FY 83 federal adolescent funds must be shc:Mn and designated in Section A, line 1 on the
first quarter report. *

(6) This column should be used to report other funding sources, i. e., contributions, other projects, etc. Indicate any FY 83 f1.lllds carried over to FY 84 to Section
A, line 1 on the first quarter report. *

(7) This column should indicate totals for all f1.lllds both across and dawn.

(8) Authorized signature of contractual fiscal agent.

(9) Center director's signature.
* Carry-over funds will be shawn on line 1 in the second and third quarter reports and
on line 1 in the Annual Report. These funds should be shc:Mn as expended in Section B on all reports. FY 83 encumbered funds will not be reflected on the FY 84 reports.

I:efinition of Items

Section A - Cash Received: Report all receipts for all funds individually as indicated.

Section B - Expenditures:
Section c - Catmitrrents:

Report all expenditures for all f1.lllds individually as indicated.
Report the cost for only those services already rendered or outstanding obligations (Le., purchase orders) by fund as indicated.

Section D - cash Reserve Report cash reserve as indicated for all f1.lllds Calculations: and by total.

July 1983

H- 1

STATE OF GEORGIA PROGRAM FOR EXCEPTIONAL CHILDREN PSYCHOEDUCATIONAL CENTERS FOR SEVERELY EMOTIONALLY DISTURBED QUARTERLY STATEMENT OF RECEIPTS, EXPENDITURES, AND COMMITMENTS

(1) Fiscal Agent
(2) Name of Center

For the Quarter Ending.-->;(.3..),-,

, 19

(AGES 0-14 PROGRAM FUNDS ONLY)

SECTION A - CASH RECEIVED

l. Cash received prior to this report period.

2. Cash received this report period



3. Total cash received through this report

(Sum of lines 1 and 2)



SECTION B - EXPENDITURES

GRANT FUNDS ONLY
(4)

APEG FUNDS ONLY
(5)

OTHER
(6)

TOTAL (7)

4. Instructional Payments (Series 3800)
5. Pupil Services Payments (Series 4200).
6. General Administration Services Payments

7. 8. 9. 10. 1l. 12.

(Series 4800). . .
Maintenance and Operation

(Series


5700) .



Capital Outlay Payments (Series 6100).
Employee Benefit Payments (Series 7600). Supporting Services (Series 6400) .



Transportation Services (Series 5600) .

Transfers to other funds (Series 8675)



13.
14.

Energy (Series 5800) Instructional Materials

(Series 4000).



15. Total Expenditures Through This Report

SECTION C - COMMITMENTS

16. Cumulative Commitments this fiscal year
to date of this report

SECTION D - CASH RESERVE CALCULATION

17. 18. 19. 20.

Section A, Line Section B, Line Section C, Line Cash Reserve

3. 15 16

..






































This is to certify that the above information is correct to the best of my knowledge and belief and that the expenditures shown are in accordance with the terms and conditions of the contract and between the Department of Education and the above named Fiscal Agent.

(Date)

(8) (Fiscal Agent)

(Date)

(Center Director)

DE Form 288, October 1982 H-2

STATE OF GEORGIA PROGRAM FOR EXCEPTIONAL CHILDREN
PSYCHOEDUCATIONAL CENTERS FOR SEVERELY EMOTIONALLY DISTURBED QUARTERLY STATEMENT OF RECEIPTS, EXPENDITURES, AND CO~~ITMENTS

-O~)

---:::-;-----:---;--

_

Fiscal Agent

(2)
Name of Center

For the Quarter Ending.~(~3~)

, 19

(SED ADOLESCENT (15/18) PROGRAM FUNDS ONLY)
SECTION A - CASH RECEIVED I. Cash received prior to this report period. 2. Cash received this report period 3. Total cash received through this report
(Sum of lines 1 and 2) .
SECTION B - EXPENDITURES

STATE GRANT FUNDS ONLY
(4)
.

4. Instructional Payments (Series 3800)

5. Pupil Services Payments (Series 4200).

6. General Administration Services Payments

(Series 4800). .

..

7. Maintenance and Operation (Series 5700) .

8. Capital Outlay Payments (Series 6100).

9. Employee Benefit Payments (Series 7600) .

10. Supporting Services (Series 6400) .



1I. Transportation Services (Series 5600) .

12. Transfers to other funds (Series 8675)

13. Energy (Series 5800)



14. Instructional Materials (Series 4000).

15. Total Expenditures Through This Report

FEDERAL/ AGENCY
FUNDS ONLY
(SA)

OTHER
(6)

TOTAL
(7)

SECTION C - CO~~I TMENTS

16. Cumulative Commitments this fiscal year

to date of this report

.

SECTION 0 - CASH RESERVE CALCULATION

17. Section A, Line 3. .
18. Section B, Line 15

19. Section C, Line 16



20. Cash Reserve




.

.

..



This is to certify that the above information is correct to the best of my knowledge and belief and that the expenditures shown are in accordance with the terms and conditions of the contract and between the Department of Education and the above named Fiscal Agent.

(Date) (Date)

(8)
(Fiscal Agent)
(9)
(Center Director)

DE Form 288, October 1982 H-3

STATE OF GEORGIA PROGRAM FOR EXCEPTIONAL CHILDREN
PSYCHOEDUCATIONAL CENTERS FOR SEVERELY EMOTIONALLY DISTURBED QUARTERLY STATE~~NT OF RECEIPTS, EXPENDITURES, AND CO~~ITMENTS

(1) Fiscal Agent
(2)
Name of Center
For the Quarter Ending~i~3~)

, 19

(AGES 0-4 89-313 FUNDS ONLY)

SECTION A - CASH RECEIVED

I. Cash received prior to this report period.

2. Cash received this report period

.

3. Total cash received through this report

(Sum of lines 1 and 2)

.

SECTION B - EXPENDITURES

4. Instructional Payments (Series 3800)

.

5. Pupil Services Payments (Series 4200) .

6. General Administration Services Payments

(Series 4800) . .

.

.

"7 Maintenance and Operation (Series 5700) .
. Capital Outlay Payments (Series 6100) .

9. Employee Benefit Payments (Series 7600) .

10. Supporting Services (Series 6400) .

II. Transportation Services (Series 5600) .

12. Transfers to other funds (Series 8675)

13. 14.

Energy (Series 5800) Instructional Materials


(Series

4000).



15. Total Expenditures Through This Report

89-313 FUNDS ONLY
(4A)

SECTION C - COMMITMENTS

16. Cumulative Commitments this fiscal year

to date of this report



SECTION D - CASH RESERVE CALCULATION

17. 18. 19.

. Section A, Line 3.
Section B, Line 15 .
Section C, Line 16





.



20. Cash Reserve





This is to certify that the above information is correct to the best of my knowledge and belief and that the expenditures shown are in accordance with the terms and conditions of the contract and between the Department of Education and the above named Fiscal Agent.

(Date) (Date)

(8)
(Fiscal Agent)
(9)
(Center Director)

DE Form 288, October 1982
H-4

STATE OF GEORGIA PROGRAM FOR EXCEPTIONAL CHILDREN PSYCHOEDUCATIONAL CENTERS FOR SEVERELY EMOTIONALLY DISTURBED QUARTERLY STATEMENT OF RECEIPTS, EXPENDITURES, AND COMMITMENTS

Fiscal Agent

Name of Center

For the Quarter Ending

, 19

(AGES 0-14 PROGRAM FUNDS ONLY)

SECTION A - CASH RECEIVED

I. Cash received prior to this report period.

2. Cash received this report period

..

3. Total cash received through this report

(Sum of lines 1 and 2)

.

SECTION B - EXPENDITURES

4. Instructional Payments (Series 3800)

5. Pupil Services Payments (Series 4200).

6. General Administration Services Payments

7.

(Series 4800). Maintenance and

.
Op

erat

ion

(Series

5700) .

.

.



8. Capital Outlay Payments (Series 6100).

9. Employee Benefit Payments (Series 7600) .

10. Supporting Services (Series 6400) .



1I. Transportation Services (Series 5600) .

12. Transfers to other funds (Series 8675)

13. Energy (Series 5800)





14. Instructional Materials (Series 4000).

15. Total Expenditures Through This Report

GRANT FUNDS ONLY

APEG FUNDS ONLY

OTHER

TOTAL

SECTION C - COMMITMENTS

16. Cumulative Commitments this fiscal year
to date of this report

SECTION D - CASH RESERVE CALCULATION

17. 18. 19. 20.

Section A, Line 3. Section B, Line 15
. Section C, Line 16
Cash Reserve

.















.

.



This is to certify that the above information is correct to the best of my knowledge and belief and that the expenditures shown are in accordance with the terms and conditions of the contract and between the Department of Education and the above named Fiscal Agent.

(Date) (Date)

(Fiscal Agent) (Center Director)

DE Form 288, October 1982
H-5

STATE OF GEORGIA PROGRAM FOR EXCEPTIONAL CHILDREN
PSYCHOEDUCATIONAL CENTERS FOR SEVERELY EMOTIONALLY DISTURBED QUARTERLY STATEMENT OF RECEIPTS, EXPENDITURES, AND COMMITMENTS

Fiscal Agent

Name of Center

For the Quarter Ending~(3~)~

, 19

(SED ADOLESCENT (15/18) PROGRAM FUNDS ONLY)

SECTION A - CASH RECEIVED

I. Cash received prior to this report period.

2. Cash received this report period 3. Total cash received through this report



(Sum of lines 1 and 2) .



SECTION B - EXPENDITURES

4. Instructional Payments (Series 3800)

5. Pupil Services Payments (Series 4200).



. 6. General Administration Services Payments

7.

(Series 4800). Maintenance and

Operation

.
(Series


5700)

.





8. Capital Outlay Payments (Series 6100).

. 9. Employee Benefit Payments (Series 7600) .

10.
II.

Supporting Services (Series 6400) . .
Transportation Services (Series 5600) .



12. Transfers to other funds (Series 8675)

13. Energy (Series 5800)





14. Instructional Materials (Series 4000).

15. Total Expenditures Through This Report

STATE GRANT FUNDS ONLY

FEDERAL/ AGENCY FUNDS ONLY

OTHER

TOTAL

SECTION C - COMMITMENTS

16. Cumulative Commitments this fiscal year

to date of this report





SECTION D - CASH RESERVE CALCULATION

17. 18. 19. 20.

Section A, Line 3.
Section B, Line 15

.



. Section C, Line 16

. Cash Reserve



..





This is to certify that the above information is correct to the best of my knowledge and belief and that the expenditures shown are in accordance with the terms and conditions of the contract and between the Department of Education and the above named Fiscal Agent.

(Date) (Date)

(Fiscal Agent) (Center Director)

DE Form 288, October 1982 H-6

STATE OF GEORGIA PROGRAM FOR EXCEPTIONAL CHILDREN PSYCHOEDUCATIONAL CENTERS FOR SEVERELY EMOTIONALLY DISTURBED QUARTERLY STATEMENT OF RECEIPTS, EXPENDITURES, fu~D CO~~ITMENTS

Fiscal Agent Name of Center For the Quarter Ending,

__ 19

(AGES 0-4 89-313 FUNDS ONLY)

SECTION A - CASH RECEIVED

I. Cash received prior to this report period. 2. Cash received this report period 3. Total cash received through this report
(Sum of lines 1 and 2)
SECTION B - EXPENDITURES

4. Instructional Payments (Series 3800)

5. Pupil Services Payments (Series 4200).

. 6. General Administration Services Payments

7.

(Series 4800). Maintenance and

.Operation

(Series

5700) .

.

.

8. Capital Outlay Payments (Series 6100) . .

9. Employee Benefit Payments (Series 7600) .

10. 1I.

Supporting Services (Series 6400) .
Transportation Services (Series 5600).

.

12. Transfers to other funds (Series 8675)

13. Energy (Series 5800)



14. Instructional Materials (Series 4000).

15. Total Expenditures Through This Report

89-313 FUNDS ONLY

SECTION C - COMMITMENTS

16. Cumulative Commitments this fiscal year
to date of this report .

SECTION D - CASH RESERVE CALCULATION

17. Section A, Line 3.
18. Section B, Line 15

.

.



.

19. Section C, Line 16

.

20. Cash Reserve . .



This is to certify that the above information is correct to the best of my knowledge and belief and that the expenditures shown are in accordance with the terms and conditions of the contract and between the Department of Education and the above named Fiscal Agent.

(Date) (Date)

(Fiscal Agent) (Center Director)

DE Form 288, October 1982
H-7

o BUDGET FOR YEAR ENDING JUNE 30, 1984 o FINANCIAL REPORT FOR YEAR ENDED JUNE 30,1984

1984 FISCAL YEAR BUDGET CERTIFICATION

I swear that this budget has been approved in accordance with proVIsions of applicable laws and State Board policies.

Date
Signed;

,19
_.~-------
Fiscal Agent

Psychoed Director
OE f UHM 004&, J.nu.'lI, 1983

--

Fiscal Agent

[II]I]
(System Code Number) BOARD OF EDUCATION
PAGE 1.1

o BUDGET FOR YEAR ENDING JUNE JO. 1984 o FINANCIAL REPORT FOR YEAR ENDED JUNE JO. 1984

B4 FY BUDGETED (FY 83 c/o)
BEGINNING FUND BALANCES APEG $

B4 FY BUDGETED (State Grant $

REVENUES

0-14 and APEG) $

B4 FY BUDGETED EXPENDITURES

TOTAL $
$

$

0-14
-------

DE FORM 0046, Januarv, 1983

ITIJD
(System Code Number)

Fiscal Agent

BOARD OF EDUCATION

84 FY

(FY 83 C/O)

BEGINNING FUND BALANCES

$

84 FY

State Grantl5_18 $

REVENUES Federal 15-18 S

84 FY EXPENDITURES

TOTAL

$

S

$

FY 83
Federal Acb Iescent

PAGE 1.3

o o=r::ITI BUDGET FOR YEAR ENDING JUNE 30,1984

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _BOARD OF EDUCATION

o FINANCIAL REPORT FOR YEAR ENDED JUNE 30. 1984

DESCRIPTION

COLUMN A

COLUMN B

COLUMN C

COLUMN 0

COLUMN E

COLUMN F

ITEM,

I

I

I

I

I

I

NO.

REVENUES (LOCAL TAXES AND/OR APPROPRIATIONS) ..............................................................................:

PROPERTY TAX

APPROPRIATIONS

1410

LOCAL OPTION SALES TAX
OTHER LOCAL TAXES AND/OR APPROPRIATIONS
TOTAL REVENUE FROM LOCAL TAXES AND/OR APPHOPRIATIONS

1415 1495 1400

SALE OF BONOS
FROM LOCAL BOARDS OF EDUCATION FOR SALES OR SERVICES

1620 1624

FROM CESAs FOR SALES OR SERVICES REVENUE FROM OTHfQ SALES

11634 --f----------::lIIIIIII
1695

TOTAL REVENUE FROM SALES

1600

DE FOHM 0046, JlnlNry, 1983

J.;
'1

PAGE 2.4

Indicate Amount; Do not include in any totals on this or any other page or item. Do not show as expenditures.

o BUDGET FOR YEAR ENDING JUNE 30, 1984 c.:o=IIJ - - - - - - - - - - - - - - - - - - - - - - - -BOARD OF EDUCATION o FINANCIAL REPORT FOR YEAR ENDED JUNE 30, 1984

DESCRIPTION

ITEM

COLUMN A

COLUMN B

COLUMN C

COLUMN 0

e COLUMN

COLUMN F

NO..
Other/Donation

REVENUES IOTHER LOCALI ..I ......

.

_

........

iii

i

REAL ESTATE TRANSFER TAX

1714

TUITION

1718

STUDENT SUPPLY FEES

1720

INTEREST EARNED

1726

RENT DONATIONS LOST AND DAMAGED BOOKS

1734

'k

E1750

FEDERAL PROGRAMS INDIRECT COSTS 11766

REVENUE FROM OTH(R LOCAL SOURCES 11795 TOTAL REVENUE FROM OTHER LOCAL SOURCES
DE FORM 0046, J.nu.ry, 1913

PAGE 3.4

--.-------.-

--,_.-~--

IJ B1JDGn rOil 'II An ENDING JUNE 30. 1984

err IIJ

'

--_.-

__ -- ---._---.....,....... ... ..._.~

.--._~----"

[l fiNANCIAL III "OR r FOR YEAR INDED JUNE 30,1984

' - -....~......_=-~-...:::::=::=.~=~ .--ec.="_~ __-

__

BOARD
--'-~--"--"'-'---'-="""'""''-''-''=~''''-~-''''---'' '-_.-"'"-="-.'--"-_-"'-~

OF

EDUCATION

ITEM

COLUMN A

COLUMN 8

n[~CIIIP Ilf IN

-Sta-te-O--14 -- -11f----
NO.

:=~_~~'~~_~_=': I Grant _ --=J AP~~_

REvtNIJFS (STATII

-=- ~')~ (01 UMdC_

liMN ()

-S-fcife 15-Tff

Federal

Grant -- _. -- ._--

.. -

~-

15-18
--

-------..

Iii

I

L-

(ir.OAGIA FllllCATlnN I\\IIIIORITY

5 .~ls)y"OcInJIolIeIalr,u:>inetc'flIIlo)n';

FU_I ..I~ _ --- 1810

1,I:OIl(jl/\ IIII'T. or III' '('I\TlON rOA

------1------- - -- -.

1\1'1 fj IE )(CLIID1Nlj ~:' :,., '. SI\I I\RYI

1815

COLUMN E

COLUMN F

Federal

Grand

fY . .81_~/O_. __

Total

- : : 7 . - . - : - _ = : - = - = - ~ - : - = - : : - ; ; .

.

I

i

f;1 OIlGII\ DrJ'r. OF I III 'CI\TION FOil
'C", vnCA TIl 'NAL [Ul It, , . .'

11822

(;('OAGl" UFI'T. or I III 'I ,\ nON FOR
BlIlLDINlj rUNUS

11~A_58-+1~~ _

GEORGIA DEPT. or l.OUU\T10N FOR SUPERINTENOENT'S SI\I 1\11"-__.

11874 1

---l~---------- .. I---- - ..- - - - - . - . -

I

1

~

~_

GEORGIA DEPT. OF I ()\ /(1\ TION Fon
-A.D-U.L-T--(.jE-N.-E-R-A-L- f.l.l1JCI-\ li-O.N------~--8- 78 I

GEORGIA DEPT. OF r()IICA TlON rOR

-fC-I-A-------.--- - ... .. .. -----.'sychoed State Grant

1-8--8-2 I

OHlER REVEN11F rROM SIA rF SOURCES 1895

TOTALnEV[NUErrlO.M~;TI\TESOURCESI1ROOI -. ---



-- ----

"C--~ __

:c. -._='.

I I
_=---1
I

- + - - - - - - - - - t - - - - --

- - -.. ----+-~-----

- : .. ==.~-=

= - - ==~- =='C-'; - _ -

I

nEVENUrS(FEDlfl/\I).......................i........L.A..::..........................I..............................I ..............

0,

---..------I~--

I

c- -~ -.--=-, --~ ---~-~=-_.==~.=__~===-~.c=-_

-'-r

--..-L

....

I

rvoLie UWY A14

HI \lENIII IN 1.1111 III TI\)(, $

r1~~~l----.~----

Ilf vrNllf rlH1M IlTIIl1l FY.84 Psych ed

15- 18 Federal " "~I- ll\l SlllJl1l1 r.

----- -.,-- - 21-9-=5-:,.I~-_._--

!

If)II\L nrvi NII I 110M FY 84 Psych ed IL........- ........

'[DEIlAl ;,(lllnCl~ Federal 15-18 2100

or I , 'JIM 00-16, J~n..",v. J 983

PAGE 4.4

- - - - - - - - - - - - - - - - - - - - - - - - . ; ITIJJJ o BUDGET FOR YEAR ENDING JUNE 30, 1984

BOARD OF EDUCATION

o FINANCIAL REPORT FOR YEAR ENDED JUNE 3D, 1984

JUNE 30,1984 BALANCE SHEET BELOW TO BE COMPLETED BY THE LOCAL SCHOOL SYSTEM

DESCRIPTION

ITEM NO.

COLUMN A
State 0-14

I

Grant

ASSETS .. .. ..

APEG & Federal'

at

BANK BALANCES FY 83 Carryover I 101

COLUMN B
APEG

COLUMN C
I State 15-18 Grant

COLUMN D

COLUMN E

I I Federal 15-18lFederal FY 83

Carryover

COLUMN F
Grand Total

..

LA

_.

i

INVESTMENT BALANCES

I 102

ACCOUNTS RECEIVABLE
INVENTORY OF ENTERPRISE SUPPLIES AND MATERIALS TO BE SOLD

I 103
I 104

OTHER ASSETS

I 109

TOTAL JUNE 30.1984 ASSETS

I 100

DE fORM 0046. J4n.,.ry, 1913

See Page 20.4 lor remaender 01 Balance Sheet.

PAGE 4.4A

o DITIJ BUDGET FOR YEAR ENDING JUNE 30. 1984 o FINANCIAL REPORT FOR YEAR ENDED JUNE 30. 1984

BOARD OF EDUCATION

DESCRIPTION

ITEM NO.

COLUMN A
State 0-14 Grant

COLUMN B
APFr.

COLUMNC
State 15-18 Grant

COLUMN D
Federal 111-18

COLUMN E
Federa I FY 83 Carryover

COLUMNF
Grand Total

TOTAL REVENUE

(,800 +2200'

2400

INCOMING TRANSFERS ................................................................................................................................................................................................................

TRANSFERS FROM OTHER FUNDS TRANSFERS FROM OTHER SYSTEMS TOTAL INCOMING TRANSFERS

2675 2695 2600

=- III:

Total of 101

:Total of 102

TOTAL REVENUE AND INCOMING TRANSFERS (2400 + 2600'

3600

DE FORM 0046, J.nu.ry, 19113

PAGE 5.4

Indicate the number of positions as appropriate by each personnel item in columns A-f. All items ending in 95 should be footnoted on DE Form 1194 and follow the page on which the item appears.

ITIIIJ o BUDGET FOR YEAR ENDING JUNE 30, 1984
o FINANCIAL REPORT FOR YEAR ENDED JUNE 30, 1984

BOARD OF EDUCATION

ITEM

COLUMN A

COLUMN B

COLUMN C

COLUMN 0

COLUMN E

COLUMN F

DESCRIPTION

NO. State 0-14

State 15- 18

Federal FY 83

Grand

Grant

APEG

Gran t

Federal 15-18

Carryover

Total

EXPENDITURES (INSTRUCTION) ..................................................................................................................................................................................................

SALARIES-SYSTEMWIDE SUPERVISORS 3803

SALARIES-TEACHERS
SALARIES-TEACHER AIDES AND PARAPROFESSIONALS SALARIES-PROGRAM AND STAFF DEVELOPMENT

3805 3807 3809

SALARIES-STUDENT INSTRUCTION
SALARIES-SUBSTITUTE INSTRUCTIONAL PERSONNEL SALARIES-OTHER INSTRUCTIONAL PERSONNEL

3811 3816 3818

TRAVEL

3832

OTHER EXPENDITUR~
TOTAL EXPENDITURES FOR INSTRUCTION

3895 3800

OE FORM 0046, J.lnUolfY, 19113

PAGE 6.4

Indicate the number of positions as appropriate by each personnel item in columns A-F, All items ending in 95 should be f noted on DE Form 1194 and follow the page on whi the item appears.

o BUDGET FOR YEAR ENDING JUNE 30, 1984 CIIJJ] o FINANCIAL REPORT FOR YEAR ENDED JUNE 30, 1984

BOARD OF EDUCATION

DESCRIPTION

ITEM NO.

COLUMN A
State 0-14 Grant

COLUMN B
APEG

COLUMN C
State 15-18 Grant

COLUMN 0

COLUMNE

Federal FY 83

Federa 1 15-18

Carrvover

COLUMNF
Grand Total

EXPENDITURES (INSTRUCTIONAL MATERIAlSI .. .. ...........................................................................................................~................

TEACHING SUPPLIES

4053

TEXTBOOKS

4056

LIBRARY BOOKS

4059

PERIODICALS AND NEWSPAPERS

4062

AUDIO VISUAL SUPPLIES

4065

OTHER INSTRUCTIONAL MATERIALS

4095

TOTAL EXPENDITURES FOR

INSTRUCTIONAL MATERIALS

4000

EXPENDITURES (PUPil SERViCES) ........ .......... .... .. .... .. ..................................................................................................................................__.

SALARIES-ATTENDANCE AND SOCIAL WORK PERSONNEL

4202

SALAR I ES-GUIDANCE SERVICE PERSONNEL
SALARIES-DTHER PUPIL SERVICE PERSONNEL

4206 4218

TRAVEL

4232

SUPPLIES

4260

OTHER E)(PENDITURE~
TOTAL EXPENDITURES FOR PUPIL SERVICES

4295 4200

DE FORM 0046, Jlnuary, 1913

PAGE 1."

o BUDGET FOR YEAR ENDING JUNE 30. 1984 ccr:=::ITl - - - - - - - - - - - - - - - - - - - - - - -BOARD OF EDUCATION
o FINANCIAL REPORT FOR YEAR ENDED JUNE 30. 1984

DESCRIPTION

ITEM NO.

I COLUMN A
State 0-14

COLUMN B

~rant

APEG

EXPENDITURES (INSTRUCTIONAL STAFF SERVICES)

SALARIES-liBRARIANSI

I

I

,

MEDIA SPECIALISTS

4605

SALARIES-OTHER

14615

TRAVEL

14632

SUPPLIES

14660

OTHER EXPENDITURE,S
TOTAL EXPENDITURES FOR INSTRUCTIONAL STAFF SERVICES

14695 14600

DE FORM 004>. January. 1983

I COLUMNC State 15-18 Grant

COLUMN 0
,

COLUMN E
I Federal FY 831

Federal 15-18

Carryover

,

I

j

:::::::a:: j

COLUMN F
Grand Total
..

PAGE 8.4

Indicate the number of positions as -~oropriate by each personnel item in columns A-F.~
All items ending in 95 should be foe Jted on DE Form 1194 and follow the page on whicff~
the item appears. --

o BUDGET FOR YEAR ENDING JUNE 30, 1984 I T I J I ] o FINANCIAL REPORT FOR YEAR ENDED JUNE 30. 1984

BOARD OF EDUCATION

DESCRIPTION

ITEM NO.

COLUMN A

COLUMN B

COLUMN C

COLUMN D

COLUMN E

COLUMN F

EXPENDITURES tGENERAl ADMINISTRATION SERViCES) .. ...... .. .. .. .. .... .. .. ....................................................................................................

SALARIES-PER DIEM OF BOARD MEMBERS

State 0-14

4802

Grant

APEG

State 15-18 Grant

Federal FY 83

Federal 15-18

Carryover

Grand Total

SALARIES-SUPERINTENDENT eSTATE AND LOCALI

4806

SALARIES-AVTS DIRECTOR

4807

SALARIES-CESA DIRECTOR
SALARIES-oTHER DIRECTORS SALARIESADMINISTRATIVE ASSISTANTS
SALARIES-CLERICAL EMPLOYEES SALARIES-OTHER ADMINISTRATIVE PERSONNEL

4808 -
4809 4810 4814 4818

TRAVEL SUPPLIES

4832 4860

INDIRECT COST -FEDERAL PROG~AMS 4880

OTHER EXPENDITURES
TOTAL EXPENDITURES FOR GENERAL ADMINISTRATIVE SERVICES

4895 4800

DE FORM 0046, J~nu~ry. 1983

PAGE 9.4

CITDJ o BUDGET FOR YEAR ENDING JUNE 30, 1984
o FINANCIAL REPORT FOR YEAR ENDED JUNE 30. 1984

BOARD OF EDUCATION

ITEM

COLUMN A

COLUMN B

COLUMN C

COLUMN D

COLUl1N E

COLUMN F

DESCRIPTION

NO. State O-Iq

State 15-18 Federal 15-18 Federal FY 83

Grand

Gra.nt

APEG

Grant

Carrvover

Total

EXPENDITURES ISCHOOl ADMINISTRATION SERViCES)..................................................................................................................

SALARIES-PRINCIPALS AND NON TEACHING ASSISTANT PRINCIPALS

I ~ 5205

~
~ ~

SALARIES-SECRETARIAL AND CLERICAL IN PRINCIPAL'S OFFICE

5210

SALARIES-OTHER SCHOOL ADMINISTRATION SERVICES PERSONNEL 5215

~ ~--...... .......--.-....

~~
~ ............

TRAVEL

5232

~~

SUPPLIES

5260

~~

OTHER EXPENDITU~91'

5295

~~

TOTAL EXPENDITURES FOR SCHOOL ADMINISTRATION SERVICES

-~
5200

~

DE FORM 0046, JAnUAry, 198J

PAGE 10.4

o [ I [ I T ] BUDGET FOR YEAR ENDING JUNE 30,1984 o FINANCIAL REPORT FOR YEAR ENDED JUNE 30,1984

BOARD OF EDUCATION

ITEM

COLUMN A

COLUMN B

COLUMN C

COLUMN D

COLUMN E

COLUMN F

DESCRIPTION

NO. State 0-14
Grant

APEG

State 15-lti
Grant

Federal 15-18

Federal FY 83
CarrYOver

Grand Total

EXPENDITURES (TRANSPORTATION SERViCES) .. .. .............................................................................................................................

SALARIES-SUPERVISORS
SALARIES-PUPIL TRANSPORTATION DRIVERS

5604 5606

SALARIES-GARAGE MECHANICS

5608

SALARIES-SUBSTITUTE BUS DRIVERS 5610

SALARIES-OTHER

5618

TRAVEL

5632

GAS AND OIL

5650

PARTS AND OUTSIDE REPAIRS

5660

OTHER SUPPLIES

5670

PUPIL TRANSPORTATION INSURANCE
TRANSPORT A nON CONTRACTED SERVICES
EXPENDITURES IN LIEU OF TRANSPORTATION

5690 5692 5694

OTHER EXPENDITURES

5695

- .,--

TOTAL EXPENDITURES fOR

TRANSPORTATION SERVICES

5600

DE FD RM 0046, J.nu.,y, 1983

PAGE 11.4

Indicate the number of positions as appropriate by each personnel item in columns A-F.
All items ending in 92- should be footnoted on DE Form 1194 and follow the page in which the item appears.

I T I I ! l o BUDGET FOR YEAR ENDING JUNE 30. 1984
o FINANCIAL REPORT FOR YEAR ENDED JUNE 30. 1984

BOARD OF EDUCATION

ITEM

COLUMN A

COLUMN B

COLUMNC

COLUMN D

COLUMN E

COLUMN F

DESCRIPTION

NO. State 0-14 Grant

APEG

State 15-18 Grant

Federa I 15-18

Federal 15-18 Carrvover

Grand lotal

EXPENDITURES (MAINTENANCE AND OPERATION) .. .. ........................................................................................................................

SALARIES

5702

TRAVEL

5732

WATER TELEPHONE

5740 5744

SUPPLIES

5750

BUILDING MAINTENANCE

5770

EQUIPMENT MAINTENANCE

5775

GROUNDS MAINTENANCE

5780

BUILDING RENTAL

5785

PRDPERTYINSURANCE

5790

OTHER EXPENDitURES
TOTAL EXPENDITURES MAINTENANCE AND OPERATION

5795 5700

DE FORM 0046, J.nu.ry. 1983

PAGE 12.4

Indicate the number of positions as appropriate by each personnel item in columns A-F. All items ending in 95 should be footnoted on DE Form 1194 and follow the page which the item appears.

o BUDGET FOR YEAR ENDING JUNE 30. 1984 DIJJJ
o FINANCIAL REPORT FOR YEAR ENDED JUNE 30. 1984

BOARD OF EDUCATION

ITEM

COLUMNA

COLUMN B

COLUMNC

COLUMN D

COLUMN E

COLUMN F

DESCRIPTION

NO. State 0-15

State 15-18

Federal 15-18 Grand

Grant

APEG

Grant

Federal 15-18 Carryover

Total

EXPENDITURES (ENERGY) ...........................................................................................................................................................................................................

ENERGY-NATURAL GAS

5835

ENERGY-TANKED FUEL

5836

ENERGY-ELECTR ICITY

583B

ENERGY-OTliER-

5B95

TOTAL EXPENDITURES FOR ENERGY

5800

..... EXPENDITURES (SCHOOL FOOD AND NUTRITION) .......................................................................................................................................................................

SALARIES SYSTEM SUPERVISORY

~

AND OFFICE PERSONNEL

5903

SALARIES MANAGERS AND OTHER PERSONNEL

5906

TRAVEL
COMMODITY HAULING IOUTSIDE CONTRACTSI

5932 59B5

OTHER EXPENOITURES
TOTAL EXPENDITURES FOR SCHOOL FOOD AND NUTRITION

5995
5900 III"""""

DE FORM 0046. J.nu.ry. 19.3

PAGE 13.4

Indicate the number of positions as appropriate by each personnel item in columns A-F. All items ending in 95 should be footnoted on DE Form 1194 and follow the page on which
the item appears. --

o CIIJI] BUDGET FOR YEAR ENDING JUNE 30, 1984

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ BOARD OF EDUCATION

o FINANCIAL REPORT FOR YEAR ENDED JUNE 30, 1984

DESCRIPTION

ITEM NO.

EXPENDITURES (CAPITAL OUTLAY)

LAND ACQUISITION AND DEVELOPMENT

6174

COLUMN A
State 0-14 Grant

ARCHITECTURE AND ENGINEERING

6177

BUI LDING ACQUISITION, CONSTRUCTION

AND IMPROVEMENTS

6180

SCHOOL FOOD AND NUTRITION EQUIPMENT

6183

BUSES PURCHASED OUTRIGHT

6186

LEASE-PlJtCHASES FOR BUSES

6189

OTHER EQUIPMENT

6192

OTHER CAPITAL OUTJ.,AY
TOTAL EXPENOITURES FOR CAPITAL OUTLAY

6195 6100

DE FORM 0046, J.nu.rv, 19'3

COLUMN B
APEG

COLUMNC
State 15-18 Grant

COLUMN D

COLUMN E

Federal 15-18 Federal FY 83 Carryover

COLUMNF
Grand Total
.

PAGE 14.4

o CIII!J BUDGET FOR YEAR ENDING JUNE 30, 1984
o FINANCIAL REPORT FOR YEAR ENDED JUNE 30. 1984

BOARD OF EDUCATION

ITEM

COLUMN A

COLUMN B

COLUMNC

COLUMN 0

COLUMN E

COLUMN F

DESCRIPTION

NO. State 0-14 Grant

APEG

State 15-18 Federal 15-18 Federal FY 83

Grant

Carryover

~roatnay

EXPENDITURES (ENTERPRiSES) .. .. ...... .. ....................................................................................................................................................

SALARIES-ALL ENTERPRISE

a......

PERSONNEL

6215

PURCHASES OF SUPPLIES fa MATERIALS

~
~

...

TO BE SOLD THRU ENTERPRISE FUND 6229 DELIVERY AND/OR TRUCK EXPENSES 6240

~...

~........

SHIPPING AND POSTAGE

6242

~e

WAREHOUSE SUPPLIES
OTHER EXPENDITURES
- fOR ENTERPRISES
TOTAL EXPENDITURES fOR ENTERPRISES

6262
6295
6200 ......

DE FORM 0046, Jllnuluy, 1913

-
PAGE 15.4

o o=cIIJ BUDGET FOR YEAR ENDING JUNE 30,1984
o FINANCIAL REPORT FOR YEAR ENDED JUNE 30,1984

BOARD OF EDUCATION

ITEM

COLUMN A

COLUMN B

COLUMNC

COLUMN 0

COLUMN E

COLUMN F

DESCRIPTION

NO. State 0-14 Grant

APEG

State 15-18 I Grant

Federal 15-18

Federal FY 83 Carryover

Grand Total

EXPENDITURES IOTHER SUPPORTING SERVICESI............................................................................................................................

SALARIES-SUPPORTING SERVICES PERSONNEL
TRAVEL
SUPPLIES
EXPENDITURES FOR PRODUCT TESTING LIABILITY INSURANCE AND FIDELITY BOND INSURANCE OTHER COSTS FOR SUPPORTING SERVICES TOTAL EXPENDITURES FOR OTHER SUPPORTING SERViCES

~ 6403

6432

~

6470 6480

' - , ...... ~ """l

6490

V .......
~ ~~ ~

6495 6400

~

~

EXPENDITURES IDEBT SERVICESI .. .. .. .. .. .... .. .. .......... .. .. .. ...... ...... .... .,-:.......................................~................................................................

REDEMPTION OF BOND PRINCIPAL

7273

~

.........~

INTEREST ON BONDS ANDIOR LOANS OTHER DEBT SERVI.CI; EXPENDITURES TOTAL DEBT SERVICE EXPENDITURES

72B1

V .......

7295

.~

~ 7200

~
~ ........

DE FORM 0046, J.nu.ry. 1983

PAGE 16.4

o D I I ! l BUDGET FOR YEAR ENDING JUNE 30, 1984 o FINANCIAL REPORT FOR YEAR ENDED JUNE 30,1984

BOARD OF EDUCATION

DESCRIPTION

ITEM

COLUMN A

NO. State 0-14 Grant

COLUMN B
APEG

COLUMNC
State 15-18 Grant

COLUMN D
Federal 1t;-18

COLUMN E
Federal FY 83 r.r1rrvnver

COLUMN f
Grand Tnt ... !

EXPENDITURES (EMPLOYEE BENEFITS) .. .. .. ........................................................................................................................................

SYSTEM CONTRIBUTIONS TO STATE RETIREMENT SYSTEMS

7674

SYSTEM CONTR IBUTIONS TO OTHER RETIREMENT SYSTEMS

7679

WORKER'S COMPENSATION
INSURANCE (SYSTEM COSTSI

7681

EMPLOYEE INSURANCE (SYSTEM COSTSI
UNEMPLOYMENT COMPENSATION INSURANCE

7684 76B6

SOCIAL SECURITY (SYSTEM COSTSI

7689

OTHER EMPt.QYEE BENEFITS (SYSTEM COSTSI

7695

TOTAL EXPENDITURES FOR EMPLOYEE BENEFITS

7600

TOTAL EXPENDITURES (3800 + 4000 + 4200

4600 + 4800 +5200 +5600 +5700 + 5800 +

5900 +6100 +6200 +6400 + 7200 + 76001

7800

OUTGOING TRANSFERS ..............................................................................................................................................................................................................

TRANSFERS TO OTHER FUNDS
I
TRANSFERS TO OTHER SYSTEMS

8675 8695

TOTAL OUTGOING TRANSFERS

8600

TOTAL EXPENDITURES AND OUT GOING TRANSFERS 11800 + 86001

9600

DE FORM 0046, J.nu.ry. 1983

PAGE 17.4

Appendix I RFCL Part I I - Revised (DSM I I I)

Diagnostic Category Check List RFCL II
Supplementary Section (Revised) (Adapted from DSM II I)
(to be used at time of intake only and completed by at least three diagnostic staff, in consensus at staffing)
CHILD1S IDENTIFICATION NUMBER- - - - - - - - - - - - - - DATE COMPLETED- - - - -/ ---_-:/- - - - -
NAME OF PERSONS COMPLETING THIS SECTION (THREE OF FIVE MUST PART ICIPATE)
PSYCHOLOGIST PSYCHIATRIST __________________________________________________, EDUCATIONAL DIAGNOSTICIAN
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _, SOC IAL WORKER _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _, OTHER, SPECIFY POSITION CHECK ONE:
Presumed Diagnosis
Known Diagnosis (Documented by Psychiatric Report) A child should have only one primary diagnosis check either presumed or known.
Signature of staff person responsible for coordinating Diagnostic services
I-I

ORGANIC BRAIN SYNDROMES

293.00 Delirium

---- 294.10 Dementia

-------
----
--
----

294.00 293.81 293.83 310.10 294.80

Amnestic Syndrome Organic delusional syndrome Organic personality syndrome Organic personality syndrome Atypical or mixed organic brain

syndrome

SUBSTANCE USE DISORDERS

305.0x Alcohol abuse

- - - -

303.9x 305.4x

Alcohol dependence Barbiturate or similarly

acting

sedative

or

- - hypnotic abuse

305.5x Opioid abuse

- - 304.0x Opioid dependence

- - 305.6x Cocaine abuse

- - - -

305.7x

Amphetamine or similarly sympathomimetic abuse

acting

- - 304.4x Amphetamine or similarly acting sympathomimetic dependence

--

305.9x

Phencyclidine (PCP) or similarly acting arlycyclohexylamine abuse

305.3x Hallucinogen abuse

---- 305. 2x Cannab i s abuse

- - 304.3x Cannabis dependence
_ _ 305. Ix Tobacco dependence

-_-_-__-

305.9x 304.9x

Other, mixed or unspecified substance Unspecified substance dependence

abuse

304.7x Dependence on combination of opioid and other

--

non-alcoholic substance

----

304.8x

Dependence on combination of substances, excluding opioids and alcohols.

FACTITIOUS DISORDERS
____ 300.16 Factitious disorder with psychological symptoms
---- 301.51 Chronic factitious disorder with physical symptoms
____ 300.19 Atypical factitious disorder with physical symptoms

1-2

PARANOID DISORDERS

--
-------

297.10 297.30 298.30 297.90

Paranoia Shared paranoid disorder Acute paranoid disorder Atypical paranoid disorder

SOMATOTORM DISORDERS

- - 300.81 Somatization disorder

--- 300. II

Conversion conversion

disorder type)

(or

Hysterical

neurosis,

307.80 Psychogenic pain disorder

---- 300.70 Hypochondriasis (or Hypochondriacal neurosis)

---- 300.71 Atypical somatoform disorder

PSYCHOSEXUAL DISORDERS

-------

302.5 302.60 302.85

Transexualixm Gender identify Atypical gender

disorder identify

of childhood disorder

- - 302.81 Fetishism

-_--_-

302.30 302.10

Transvestism Zoophilia

302.20 Pedophil ia

- - 302.40 Exhibitionism

302.82 Voyeurism

- - 302.83 Sexual masochism

- - 302.84 Sexual sadism
- - 302.90 Atypical paraphilia

PSYCHOLOGICAL FACTORS AFFECTING PHYSICAL CONDITION
--- 316.00 Psychological factors affecting physical condition

PERSONALITY DISORDERS
301.00 Paranoid - - 301.20 Schizoid
301.22 Schizotypal - - 301.50 Histrionic
- - 301.81 Narcissistic
1-3

PERSONALITY DISORDERS (cont.)

--...,..
--
---

301.70 301.83 301.82 301.60 301.40

Antisocial Borderline Avoidant Dependent Compulsive

- - 301.84 Passive-Aggressive

-- -- 301.89 Atypical, mixed or other personality disorder

ADDITIONAL CODES
300.90 Unspecified mental disorder - - V7l.09 No diagnosis or condition on Axis I
- - 799.90 Diagnosis or condition deferred on Axis

SPECIFIC DEVELOPMENTAL DISORDERS

- - - -
----

315.00 315.10 315.31 315.39 315.50

Developmental reading disorder Developmental arithmetic disorder Developmental language disorder Developmental articulation disorder Mixed specific developmental disorder

- - 315.90 Atypical specific developmental disorder

MENTAL RETARDATION

_ _ 317. 0 __ 316.0
318. 1 --318.2
__ 319. 0

Mild mental retardation Moderate Mental retardation Severe mental retardation Profound mental retardation Unspecified mental retardation

ATTENTION DEFICIT DISORDER

_____ 314.01 With hyperactivity

-_--_ --

314.00 314.80

Without hyperactivity Residual type

1-4

CONDUCT DISORDER

312~00 Undersocialized, aggressive

--- 312.10 Undersocialized, nonaggressive

- - - -
-----

312.23 312.21 312.90

Socialized, Socialized, Atypical

aggressive nonaggressive

ANXIETY DISORDERS OF CHILDHOOD OR ADOLESCENCE

- - 309.20 Separation anxiety disorder

--

313.21 313.00

Avoidant disorder of childhood Over anxious disorder

or

adolescence

--

Other

OTHER DISORDERS OF INFANCY, CHILDHOOD, OR ADOLESCENCE
313.89 Reactive attachment disorder of infancy
- - 313.22 Schizoid disorder of childhood or adolescence
- - 313.23 Elective mutism - - _ _ 313.81 Oppositional disorder - - 313.82 Identity disorder

EATING DISORDERS

307.10 Anorexia nervosa

- - 307.51 SuI imia

---
---

307.52 307.53 307.50

Pica Rumination disorder of infancy Atypical eating disorder

STEROTYPED MOVEMENT DISORDERS

307.21 Transient tic disorder

--- 307.22 Chronic motor tic disorder

--- 307.23 Tourette's disorder

-----

307.20 307.30

Atypical Atypical

tic disorder sterotyped movement

disorder

I -5

OTHER DISORDERS WITH PHYSICAL MANIFESTATIONS

---
------

307~OO
307.60 307.70 307.46 307.49

Stuttering Functional enuresis Functional encopresis Sleepwalking disorder Sleep terror disorder

SCHIZOPHRENIC DISORDERS
295. Ix Disorganized - - 295.2x Cataonic
295.3x Paranoid - - 295.9x Undifferentiated
- - 295.6x Residual

PERVASIVE DEVELOPMENTAL DISORDERS

299.0 Infantile autism

- - 299.9 Childhood onset pervasive developmental disorder

- - 299.8

Atypical Other, specify

DISORDERS OF IMPULSE CONTROL NOT ELSEWHERE CLASSIFIED

_ _ 312.31 Pathological gambling

- - 312.32 Kleptomania
____ 312.33 Pyromania

-_ _ -

312.34 312.35

Intermittent explosive disorder Isolated explosive disorder

---- 312.39 Atypical impulse control disorder

ADJUSTMENT DISORDER

--

309.00 309.24

with with

depressed mood anxious mood

- - 309.38 with mixed emotional features

- - 309.30 with disturbance of conduct

-

-

309.40 309.23

with with

mixed disturbance of emotions work (or academic) inhibition

and

conduct

---- 309.83 with withdrawal

__ 309.90 with atypical features

I-6

AFFECTIVE DISORDERS BIPOLAR DISORDER

296.6x Mixed ------296.4x Manic
------296.5x Depressed
Major Depression

296.2x Single episode -------296.3x Recurrent

Other specific affective disorders

_____~301. 13 Cyclothymic disorder 300.40 Dysthymic disorder (or Depressive Neurosis)
----~
Atypical affective disorders

------------229966..8]02

Atypical Atypical

bipolar disorder depression

Physical Problems

-_-_-__-_-_-AVuidsui atol ry

_____Ep i Iepsy

_- _- _- _- _-OOtthheerr

physical physical

handicap problems

Specify:

__

If a child has another diagnosis other than those listed, list them here and document.

(Revised 8-20-81)
1-]

Appendix J Sample Inventory Form

Item Descr i pt ion

No. Serial No.

Sample Format Locat i on

Date Purchased Cost Per Item

Fund Source

'I

Appendix K Issues of Performance Audit Sample Master List and Agreement

Charles McDaniel State Superintendent of Schools

Georgia Department of Education
Office of Instructional Services Twin Towers East
Atlanta, Georgia 30334
October 16, 1981

Lucille G. Jordan Associate State Superintendent

MEMORANDUM

TO: FROM:

Psychoeducational Center Directors

Fiscal Agents

~ t\(Y'

Joan A. Jordan, Coord i nator \.. 1~ {j

Psychoeducational Center Net rk

Program for Exceptional Children

SUBJECT:

Issues and Concerns From the Performance Audit, February 1981

The following items are issues you need to review and/or implement in terms of center operations. These issues were identified during the performance audit.

1. Changes in the program operation such as delivery of service, location of services, staffing patterns, etc., must be submitted to the Department of Education, Program for Exceptional Children for prior approval. Amendments to the proposals must be approved by the fiscal agent and submitted to the Department of Education for approval.

2. All student files should be reviewed to ensure that all due process documentation requirements have been met.

3. Each center will be required to maintain a master list of students
referred and to be served. The master list will include the student's name, service to be provided, person responsible, frequency of contact and monthly status check (see attached sample).

4. Tracking services for provisionally terminated students should
be provided for at least 12 months. The type and frequency of the contacts should be determined by each child's IEP.

5. All teachers and paraprofessionals should hold valid Georgia
certificates or licenses. Copies of certificates and licenses or applications should be maintained at the center.

K-l

Psychoeducational Center Directors Fiscal Agents Page 2
6. Letters of agreement should be maintained by the center and
fiscal agent for contracted consultant services used throughout the fiscal year (see attached sample). Documentation of dates, names of students seen, and number of hours should be maintained by the center and number of hours and dates specified on the invoice.
7. The LEA is responsible for securing certificates of occupancy
for buildings used to house educational programs. A copy of the certificate of occupancy should be maintained in each building. Each center should develop policies in accordance with fire and safety codes, conduct fire drills as required, and maintain records and documentation of those procedures.
8. A budget amendment is required for any five percent or more
deviation of costs for items wihin a series or between series. Amendments should be approved by the fiscal agent, signed by the fiscal agent and director and submitted to the Department of Education, Program for Exceptional Children for approval.
9. Separate accounts should be established for psychoeducational
funds and records maintained regarding receipts and expenditures by fund source. 10. The State Department of Education must consider holding payment of funds if reports are not forwarded as specified in the agreement between the State Department of Education and fiscal agent for the center according to the FY 82 calendar. JAJ: 1rt Attachments cc: Dr. Ellouise ColI ins Dr. Arthur E. Bilyeu
K-2

Sample Haster List of All Psychoed Students

Student's Name

Service to Date Referred Date Enrolled be provided

IEP
Staff Person Frequency Responsible of Contact

JUL. AUG. SEPT. OCT. NOV. DEC. JAN. FEB . MAR. APR. HAY JUN.

0

~\\ \~
.. <A\\) )\\~t/ ~\\\ I\.. V
~\~ I\~ \\>V

;;0:: I

( ~\~ ~\)V-

W

~}\) ".

"'--/

Indicate the number of contacts each month, status initials of staff person responsible. Status

R .. Referral (A) C .. Class (B) C .. Direct Service (C)

T .. Tracking (D)
PT .. Provisional Termination
crw .. Circumstantial Termination
Withdrawn

RR = Re-referral
DR .. Dropped In Referral PS = Parent Service Only

AGREEMENT

SAMPLE

STATE OF GEORGIA
COUNTY OF----------

This agreement is made and entered into this - - - - - -day of- - - - - -in the year of 1981 by and between the - - - - - -Board of Education- - - - - -
Georgia, fiscal agent for the

- - - - - - - - - - - - Psychoeducational Center, hereinafter referred to as

and

of- - - - - - - - - - - - - - - - - -

to confirm verbal authorization for

------::~---------------

to perform as a consultant for the

during July 1, 1981 and June 30, 1982.

The Board agrees to accordance with the travel but not to exceed $200 per
consul tation or
wi 11 provide a consultation.

expenses in

'>oL-

- "p e r

while per-

-------'per day for a
this agreement. The consultant

r. reports for each student evaluation or

-----------------is not an employee of - the ---------
- - - - - - - - - -Psychoeducational Center while performing this service
and will not be entitled to fringe benefits normally accruing for employees

of the

Board.

All parties to this agreement certify that the provisions of Act 56, Georgia Laws, 1956, State Employees and Officials Trading with State, as amended, have not been violated in any respect.

This agreement will terminate upon payment in full by the Board for the services stated herein.

- - - - - - - - - - - - - - - - - -Board of Education
- - - - - - - - - - - - - - - - -(.enter

BY--------------- BY

SSN.

_

Date- - - - - - - - -

DATE,

K-4

(Authorized Signature) _

SAMPLE OBSERVATION FORM

Scheduled Visit- - - - -

Unscheduled Visit- - - - -

Class/Location-

-

-

-

-

-

-

-

-

_

-N:aDmeateo-f--

.

,

.

.

,

-N-a-m-e-

Length :of

of

Observation- - - - - -

Level/Subject~

~AM/PM Lead

Support _

Name and Position of Observer - - - - - - - - - - - - - - - - - - - - - - . Students- - - - - - - - -

Observed Satisfactory

1. Planning

A. Instruction

* 1. Lesson Plans(Available in

* 2.

Objectives

-

Observ. appro-

area)

--

priate for group

3. Materials-

available, undis-

tracting

4. Content for lessons

are appropriate

II. Classroom Management

A. Techniques Used

1. Redirection - physical and/or Verbal
2. Humor 3. Body contact/touch 4. Follow-through
with consequences
* 5. Dialog between
Lead/Su ppo rt
* 6. Structure of room
7. Reflection 8. Interpretation 9. Life Space Interview 10. Confrontation 11. Quiet Chair/Square 12. Appropriate Body
Language
13. Other B. Time Out
* 1. Number of students
in time out during observation

Observed

Not

Improvement Observed, But Not

Needed

Needed Applicable

K-5

Observed Satisfactory * 2. Length of time students in time out (Record of time out maintained) 3. LSI following time out 4. Teachers welcome child: return to group III. Classroom Routine A. Use instructional media and equipment with lesson plans B. Organizes learning activities in logical sequence *C. Gives clear directions, explanations and special help when needed D. Elicits students participation E. Uses variety of teaching methods to conduct classes F. Demonstrates ability to work with individuals, small groups and large groups *G. Follows posted schedule of activities H. Maintains orderly classroom procedures in order to facilitate instruction * I. Makes modification in lessons as needed * J. Manage disruptive behavior among students in dignified, fair and positive manner K. Classroom Atmosphere
* These items must be observed and recorded.
K-6

Observed

Not

Improvement Observed, But Not

Needed

Needed Applicable

Recommendations for next observation:
l.
2. 3. 4. 5.

Comments regarding observation (List at least three positive aspects/comments about the class).

Top; c/Act; vity

D;scussion

Alternatives

THIS OBSERVATION FORM WILL BE USED DURING FY 83 AND WILL BE REVISED AT LEAST IN APRIL, 1983 FOR FINALIZING THE FORMAT TO BE USED IN FY 84. PLEASE KEEP NOTES.
K-7

Appendix L Georgia Department of Education
Sample Due Process Forms

GEORGIA DEPARTMENT OF EDUCATION Office of Instructional Services
Division of Special Programs Program for Exceptional Children Revised Sample Forms for Special Education The Georgia Department of Education has revised the attached sample forms for use by a public agency providing programs for handicapped children. LEAs are not required to use these forms as they are printed and may revise them to meed individual system needs. The forms contain the minimum information and rights guaranteed by P.L. 94-142 and the Family Education Rights and Privacy Act. LEAs are required to provide all the information and rights contained in the state's sample forms meeting these minimum requirements.
Revised 10/82
L-l

SAMPLE FORM PARENTAL RIGHTS IN SPECIAL EDUCATION

As a parent of a child~ho is receiving special education benefits, you have certain rights which are protected by state or
federal law. We want you to know about these rights.

Your rights are listed below in outline form under eight headings. If you would like a further explanation of any of these rights, you may contact your local superintendent or the Georgia Department of Education, Program for Exceptional Children, Suite 1970 Twin Towers East, 205 Butler Street, S.E., Atlanta, Georgia 30334, (404) 656-2425.
RECORDS:
1) Right to inspect and review" records; 2) Right to have a representative appointed by you review the records; 3) Right to make copies of records; 4) Right to be informed of all types and locations of records being collected, maintained or used by the agency; 5) Right to ask for an explanation of any item in the records; 6) Right to ask for an amendment of any record if it is inaccurate, misleading or violates privacy rights; 7) Right to a hearing if the agency refuses to make the requested amendment.
CONFIDENTIALITY OF INFORMATION:
1) Right to restrict access to your child's records by withholding consent to disclose records; 2) Right to be notified and receive copies before information in your child's file is destroyed; 3) Right to be told to whom information has been disclosed; 4) Right to review and receive copies of all information sent to another agency where your child seeks or is eligible to enroll.
INDEPENDENT EVALUATION:
1) Right to obtain an independent evaluation by an approved examiner; 2) Right to have the independent evaluation considered in either meetings where placement or program decisions are made or in a hearing to challenge the identification, evaluation, or placement of your child; 3) Right to be told where an independent evaluation may be obtained at no expense or low expense; 4) Right to an independent evaluation at public expense if you disagree with the agency's evaluation; 5) Right to an independent evaluation at public expense when the evaluation is requested by a hearing officer during a hearing.
NOT! CE:
1) Ri9ht to be notified and present at all meetings before the agency initiates or changes (or refuses to initiate or change) the identification, evaluation or placement of your child; 2) Right to have that notice in writing, in your native language, or other principal mode of "communication, at a level understandable to the general public; 3) Right to have the notice describe the proposed action, explain why it is proposed, describe the options considered and explain why those other options were rejected; 4) Right to be notified of each evaluation procedure, test, record or report the agency has used as a basis for any proposed action; 5) Right to a description of any other factors which are relevant to the agency's proposed action; 6) Right to be present at all IEP meetings.
CONSENT:
1) Right to give consent before a ~replacement evaluation is conducted; 2) Right to give consent before initial placement can be made in special education; 3) Right to a description of the activity for which consent is requested including a list of records (if any) which will be released and to whom; 4) Right to revoke consent at any time; 5) Right of the agency to proceed in the absence of consent to a hearing to determine if your child should be evaluated or initially placed.
HEARINGS:
1) Right to request local mediation and/or an impartial due process hearing to question the agency's identification, evaluation, or placement of your child or to question the agency's provision of a free appropriate public education; 2) Right to be told of any free or low-cost legal and other relevant services available (e.g., an expert on handicapping conditions that may be a witness at the hearing); 3) Right to have the hearing chaired by a regional hearing officer who is not employed by a public agency involved in the education of your child or otherwise personally or professionally interested in the hearing; 4) Right to be advised and accompanied at the hearing by counsel and to be accompanied by individuals with special knowledge or training in problems of the handicapped; 5) Right to have your child present; 6) Right to have the hearing open to the public; 7) Right to present evidence and confront, cross-examine and compel the attendance of witnesses; 8) Right to prohibit the introduction of any evidence at the hearing that has not been disclosed at least five days before the hearing; 9) Right to have a written or electronic verbatim record of the hearing; 10) Right to obtain written findings of fact and a written decision within 45 days after the local education agency received the initial request for the hearing; 11) Right to appeal the decision of the regional hearing officer to the state hearing officer for the Georgia Board of Education and receive a decision within 30 days of the filing of an appeal; 12) Right to have a hearing and an appeal set at a time reasonably convenient to you; 13) Right to appeal the decision of the state hearing officer for the Georgia Board of Education to Civil Court; 14) Right to have your child remain in his or her present educational placement until completion of all hearing and appeal proceedings, unless you and agency agree otherwise.
EVALUATION PROCEDURES:
1) Right to have a full and individual evaluation of your child's education needs; 2) Right to have the evaluation made by a multi-disciplinary team including at least one specialist with knowledge in the area of the suspected disability; 3) Right to have your child assessed in all areas related to the suspected disability; 4) Right to have appropriate tests administered by qualified evaluators; 5) Right to have more than one criterion used in determining the appropriate educational program for your child; 6) Right to have the evaluation made in your child's native language or mode of communication; 7) Right to have a re-evaluation every three years; 8) Right to have a re-evaluation in less than three years if you or your child's teacher requests it.
LEAST RESTRICTIVE ENVIRONMENT:
1) Right to have your child educated with non-handicapped children to the maximum extent appropriate; 2) Right to have your child remain in a regular education environment, unless a special class or separate school is needed (Removing a child from a regular class environment may be done only when the nature or severity of the handicap is such that education in the regular class with the use of supplementary aids and services cannot be achieved satisfactorily.); 3) Right to have a continuum of alternative placements so that removal from the regular educational program can be the least restrictive situation; 4) Right to have supplementary services such as resource room or itinerant instruction to make it possible for your child, to remain in a regular class placement; 5) Right to have placement in the school your child would attend if non-handicapped and right to participate in non-academic and extracurricular services and activities such as meals, recess, counseling, athletics and special interest groups.

As parents of handicapped children, you have many rights; and with these rights, there are certain responsibilities. The
school system is responsible for safeguarding your rights. You, in turn, should attempt to keep the school system informed of things that affect your child's education. You also are urged to assist the school by attending IEP conferences and by keeping the lines of communication open at all times. When you are unhappy with your child's education, it is important to
tell your school principal or coordinator of special education. If you need further assistance in talking to people in the school system, there are parent groups from whom you may obtain help. Also, you may contact the Georgia Department of Education (see address above). First and foremost, however, you should talk to your child's teacher, principal or other school administrators. Schools exist to help children grow and develop into capable adults but schools need the help and cooperation of parents to accomplish their goals.

Revised

10/82

L-2

SAMPLE FORM NOTIFICATION OF LOCAL HEARING REVIEW

Dea r

Date _

Due to a request by (Name of Parent or Public Agency) ,a hearing has been scheduled with a

regional hearing officer for the purpose of evaluating the appropriateness of the decision of

the (Name of System)

Special Education Placement Committee concerning

--;--;-.,....:.(_S=-tu::-d_e'-n_t~)'-'--'s':_-~-_:,._..,_--_,_-'p ropo sed educational program. As the hearing must occur

within 20 calendar days of the receipt of the written request, the hearing will be conducted on

- - - . : . . : :(.D. ;a:t .e.): . . : : . : : . . - _ - - - - - "a t

(Address

and begin at_~(~T~i~m~e~)

_

As the copies

parent of all

orefc-o-r~d-s-p-e-rt~a-;-in-'~ln-g"-t~0-y-o-u-r-c7h~i~1~d~d-,e-vyeo-luopembdyay

inspect, the school

at reasonable system or by

times, its

agents or employees, including all tests or reports upon which the proposed placement

action was based.

The regional hearing officer will consider independent medical, psychological or educational evaluations by a certified or licensed examiner which may be presented as evidence.

In addition, you may be represented, at you own expense, by counselor other individuals at any stage of the hearing process.

The above hearing will be closed to the public unless you request to the regional hearing officer that the hearing be open to the public. However, in such an instance. the school system's attorney, appropriate staff members of the local board of education and other persons requested by either the school system or you and approved by the regional hearing officer may be present.

Both parties may present testimony or evidence to the regional hearing officer and both parties will have the opportunity to question witnesses. Either party may lawfully subpoena or compel the attendance of witnesses during the due process hearing. All proceedings will be recorded on tape or by other appropriate means. The regional hearing officer has the authority to confirm or reject the decision of all concerned parties.

Within 25 calendar days following the conclusion of the hearing, the written decision of the regional hearing officer will be submitted to you and the local board of education. The regional hearing officer may grant specific extensions of these timelines at the request of either party.

The written decision of the regional hearing officer shall be based solely upon the evidence presented at the hearing and shall include a summary of the hearing and written recommendations of fact supporting the reasons for the decision.

Either party has the right to appeal the decision to the state hearing officer for the Georgia Board of Education for review. The decision of the regional hearing officer
is binding on all parties unless appealed within 30 calendar days to the state hearing
officer for the Georgia Board of Education.

The written findi~gs or decision of the regional hearing officer are to be transmitted to the State Advisory Panel for Special Education after deleting any personally identifiable information.
Sincerely,

Revised 10/82

(S ignature) (Title)
L-3

SAMPLE FORM Parental Consent for Evaluation

Date
Dear- - - - - - - -
Your child, ______________has been referred for evaluation by

Name

Position

Name

Position

Name

Position

We believe that an evaluation of your child is needed for educational planning. The evaluator{s} who work with your child will use tests in the following areas:

- - - - -Vision

- - - - -Motor

- - - - -Behavioral

- - - - -Hear i ng
- - - - -Achievement

- - - - -Psychological - - - - -Speech/Language

- - - - -Oetxhperlan{Saetieon
below}

Should you have any questions about the reasons for the referral or the nature

of the evaluation, contact

{Name}

{Position}

at {Phone}

Attached is a statement of parent rights.

Within 30 school days following the evaluation, you will be given the opportunity to discuss the results with someone knowledgeable about the evaluation. If no response is received from you within 15 days, an appropriate school official will visit your home to determine the reason for lack of response. If you refuse to grant permission for this evaluation, either you or the school may request local mediation or an impartial hearing within 15 days of your signed response or lack of response.

You may agree or disagree to have your child evaluated, but your decision must be clearly indicated on the attached form and signed by you. Please return the attached form to your child's principal as soon as possible.

Sincerely,

Name

Title
L-4

Page I

SAMPLE FORM
Individual ized Education Program (I.E.P.) Total Service Plan

Date

Type of Staffing:
RIneviiteiwa-l ---------

Student:

Birth Date:

School:

Pa ren ts -o-r--::-G-ua-rd-:-::-ia-n-s-:------

-------Phone: ----------

Committee Members Present:

Name

Title

1.
2.
3.

Name
4. 5. 6.

Ti tIe

I. PRESENT LEVEL OF PERFORMANCE: (Include, where appropriate, intellectual and achievement, teacher observation, physical/medical, behavior, communication, adaptive behavior, vocational/career, and perceptual-motor)

I I. ANNUAL GOAL(S): See attached page(s) for short term objectives.

II I.RECOMMENDED SPECIAL EDUCATION AND/OR RELATED SERVICES: (Include, where appropriate transportation, reqular and adaptive physical education.)

Service/Program

Implementation Date (Projected) Hours/Week

Anticipated Duration

IV. SPECIAL CONSIDERATIONS WHILE IN REGULAR CLASS:
L-S

Page 2 Student

SAMPLE FORM
Individual ized Education Program (I.E.P.) Total Service Plan
Short Term Objectives
Person to Provide Services-------------------

Annual Goal Number

Short Term Instructional Objectives

r
I
'"

Criteria for Mastery

Date

Method of

Reviewed Evaluation

Mastery

Yes

No

Documentation of Attempts to Involve Parent/Guardian

Date

Comment

This is to certify that I was invited to participate in the writing of the I.E.P. and that I understand its contents.
As the parent/legal guardian of the above named child, I have had explained to me the due process rights and procedures and I have been provided a copy of these rights. I understand that a copy of this I.E.P. will be given to me upon request.

Parent/Legal Guardian

Date

b

SAMPLE FORM

Parental Consent for Evaluation

Please sign and return this form indicating whether you agree or disagree to have your child evaluated.

I have read or have had read to me the attached letter requesting permission
to evaluate my child-----------------------

Should you desire the specific time, place and date of your child's evaluation

please contact

-at ---------------

Check one below:

_

_

_

_

____1 agree System

-- for the
to evaluate

-m-y

-c-h;il-d-.

:

-

:-

-

-

;

-

-

--

-

-

-

-

--

-

-

-

-

- -School

------------- --------I do not agree for the following reasons:

Parent or Legal Guardian Date

L-7

SAMPLE FORM Notice of I.E.P. and Placement Committee Meeting

Date

Dear- - - - - - - - - - - - - - - - - - -

There will be a meeting of the Special Education Committee at

(School)

_ _~-~~~----~o.n

at

The purpose of this

meeting will be to review all relevant information and to determine an appropriate

and least restrictive educational program for your child. If your child is eligible

for special education, an Individualized Educational Program (I.E.P.) will be developed.

Placement recommendations for special education and/or related services will be based

on the I.E.P.

The following people have been asked to attend this meeting:

Name

Title

You are invited and urged to participate in this committee meeting. You may be

accompanied to this meeting by a third party if you wish. If you would like more

information about this meeting or would like the meeting date and/or time changed,

please call your child's school at this number:

A statement

of parent rights is attached.

A copy of the recommendations made by the committee is available upon your request if you are unable to attend the meeting.

Sincerely,

Name RETURN THIS SECTION TO YOUR CHILD'S PRINCIPAL

Title

Student's Name
will attend the meeting.
would like to attend the meeting but cannot at this date or time. will contact the school regarding a different date or time.
will not be attending the meeting and understand that I may request a copy of the committee recommendations.

Parent or Legal Guardian

Date

L-8

SAMPLE FORM SPECIAL EDUCATION COMMITTEE MINUTES

Date

- Student - - - - - - - - - - - - - -Birth Date---- - -School - - - - - - - -

Committee Members Present

NAME

TITLE

NAME

TITLE

1.

_ _ _ _ _ _ _ 4.

_

2.

________ 5.

_

3.

________ 6.

_

FACTORS CONSIDERED BY THE COMMITTEE

Information related to present levels of performance were reviewed and are included in the IEP Total Service Plan. (Including, where appropriate, intellectual and achievement level, teacher observation, adaptive behavior, communication, behavior, vocational/career and perceptual information).

I. OPTIONS CONSIDERED

I I. OPTIONS REJECTED AND REASONS

I I I. FINAL RECOMMENDATIONS
L-9

SAMPLE FORM Authorization to Release Information
I hereby - authorize -----------------------------

- - - - - - - - - - - - - - - - to release the records listed below on my child

to

_

It is understood that the party to whom this information is released will not release it to a third party. These records are needed for the following reasons.

Records to be released------------------------------

I understand and agree to the above statement Parent or Legal Guardian Date
(Authorization to be kept on file.)

L-10

SAMPLE FORMS Notification of Local Mediation

Date

Dear

The

School System requests a mediation conference

with--y-o-u--o-n--~(~d-a-t-e~)----a-t---(time) to discuss the special education

services proposed for

(name)

The purpose of

this conference is to provide the opportunity to meet informally to re-

solve our differences regarding these proposed services. You are not re-

quired to participate in mediation and may bypass this process and request

a hearing. Mediation will not interfere with required timelines for the

hearing process.

You may be accompanied to the mediation conference by a third party. Minutes will be kept at the conference and a copy of the minutes will be available to you.

We look forward to this opportunity to meet with you to hear your concerns and evidence regarding your child's educational needs.

If you have any questions prior to this meeting, please let me know.

Sincerely,

L-ll

SAMPLE FORM Parental Consent for Placement

Date

Dear

On

, the Special Education Committee of your child's school

met. As a result of this meeting, the following recommendations were made

regarding

The Special Education Committee recommended that your child participate in

the following special education program(s) located in

(school)

This recommendation is in consideration of the service needs identified in your child's Individual Education Program (IEP). Attached is a copy of the Special Education Committee minutes. Also attached is a statement of parent rights. If there should be a question about this placement, you may request a conference.
You may accept or reject this placement recommendation, but your decision must be clearly indicated on this form and signed by you. We will attempt to contact you again if we do not have your response within the next fifteen days. NO CHANGE WILL BE MADE IN YOUR CHILD'S PLACEMENT UNTIL WE RECEIVE YOUR SIGNED PERMISSION FOR PLACEMENT.
If you refuse to grant permission for services, either you or the school may request local mediation or an impartial hearing within fifteen days of your signed response or lack of response.
The attached form should be completed and returned to your child's principal as soon as possible. If you have questions or concerns about your child's program we hope you will feel free to contact us at any time.
Sincerely,
Name
Title
Telephone Number
L-l2

SAMPLE FORM Parental Consent for Placement

I have read, or have had read to me, the following statement:

This is to certify that I have been informed of the recommendation that

participate in the following special

educa t ion prog ram (s) at

-..l.:(s;,.;c:;.;h.;.:o:...:o:...;l~)

_

I understand that this recommendation includes all the service needs identified in my child's Individual Education Plan. __________________ Yes, I do agree with this placement. ________________ No, I do not agree with this placement.
Reasons for non-agreement -------------------------------------
I would like a conference concerning my child's placement. Parent or Legal Guardian Date

L-13

Appendix M Advocacy Groups and Agencies

Advocacy Groups and Agencies

American Academy of Child Psychiatry (AACP) 1424 16th St., N.E. Suite 201-A Washington, D. C. 20036
American Association for the Education of the Severely/Profoundly Handicapped
Box 15287 Seattle, WA.
American Association of Colleges for Teacher Education (ASCTE) One DuPont Cr.
Washington, D. C. 20036
American Association of Psychiatric Services for Children (AAPSC) 1725 K St., N.W.
Washington, D. C. 20006
American Association of School Administrators (AASA) 1801 N. Moore St. Arlington, VA. 22209
American Personnel and Guidance Association (APGA) 1607 New Hampshire Ave., N.W. Washington, D. C. 20009
American Psychological Association (APA) 1200 17th St., N.W. Washington, D. C. 20036
Association for Children with Learning Disabil ities 4156 Library Rd. Pittsburg, PA. 15234
Autistic Group Training Home Clayton MH/MR Center 15 S.W. Upper Riverdale Rd. Riverdale, GA. 30274
Child and Maternal Health Unit Department of Human Resources Room 346-S, 47 Trinity Ave. Atlanta, GA. 30334

Closer Look Box 1492 Washington, D. C. 20013
Council for Children with Behavioral Disorders (CCBD) 1920 Association Dr. Reston, VA. 22091
Council for Administrators of Special Education (CASE)
6807 Park Heights Ave. Baltimore, MD. 21215
Crippled Children's Unit Georgia Department of Human Resources 618 Ponce de Leon Ave. Atlanta, GA. 30308
Department of Education 400 Maryland Ave., S.W. Donohoe Building, Room 4000 Washington, D. C. 20202-4714
Developmental Disabilities 4th and C Streets, N.W. Washington, D. C. 20202
Georgia Advocacy Office 1447 Peachtree St., N.E. Suite 811 Atlanta, GA. 30309
Georgia Association for Retarded Citizens 1575 Phoenix Blvd., Suite 8 Atlanta, GA. 30349
Georgia Center for the Miltihandicapped 1815 Ponce de Leon Ave., N.E. Atlanta, GA. 30307
Georgia Department of Human Resources Division of Vocational Resources 610 State Office Building Atlanta, GA. 30334
Georgia Rehabilitation Center Warm Springs, GA. 31830

Child Welfare League of America (CWLA) 67 Irving Pl. New York, N. Y. 10003

Georgia Society for Autistic Children Chapter of the National Society for
Autistic Children 2001 Fisher Trail, N.E. Atlanta, GA. 30345

M-l

National Association of Social Workers (NASW) 1425 H St., N.W. Suite 600 Washington, D. C. 20005
National Association of State Boards of Education
444 N. Capitol St., N.W. Suite 526 Washington, D. C. 20001
National Association of State Directors of Special Education (NASDSE) 1201 16th St., N.W. Suite 404E Washington, D. C. 20036
National Center for Law and the Handicapped 1235 North Eddy St. South Bend, IN.
National Center on Educational Media and Materials for the Handicapped Ohio State University 220 W. 12th St. Columbus, OH. 43210
National Committee for Prevention of Child Abuse (NCPCA) 111 E. Wacker Suite 510 Ch i cago, IL. 60601
National Consortium for Child Mental Health Service (NCCMHS) 1424 16th St., N.W. Suite 201-A Washington, D. C. 20036
National Easter Seal Society for Crippled Children and Adults Executive Director 2023 W. Ogden Ave. Chicago, IL. 60612
National Education Association (NEA) 1201 16th St., N.W. Washington, D. C. 20036
National Information Center for the Handicapped P.O. Box 1492 Washington, D. C. 20013
National Institute of Education (NIE) 1200 19th St., N.W. Washington, D. C. 20208

National Institute of Mental Health 5600 Fisher La. Parklawn Building Rockville, MO. 20800
President's Committee on Employment of the Handicapped Washington, D. C. 20210
Rehabilitation Services Administration Office for Handicapped Individuals S. Par t i a I Bu i 1ding Washington, D. C. 20201
Scottish Rite Hospital 1001 Johnson's Ferry Rd., N.E. Atlanta, GA. 30342
The Association for the Severely Handicapped
Garden View Suite 1600 West Armory Way Sea ttl e, WA. 98119
TIE LINE Information and Referral System
Office of Consumer Affairs 618 Ponce de Leon Ave., N.E. Atlanta, GA. 30308
U. S. House Subcommittee on Select Education
Annex 1, 300 New Hersey Ave., S.E. Room 617 Washington, D. C. 20515
U. S. Senate Subcommittee on Handicapped 4230 Dirksen Senate Office Building Washington, D. C. 20510

M-2

APPROVED SPECIAL EDUCATION PROGRAMS CURRENTLY OFFERED BY GEORGIA COLLEGES AND UNIVERSITIES MAY 1983

ALBANY STATE COLLEGE
Dr. Edward Chang, Chairman Department of Psychology 504 College Drive Albany, Georgia 31705 (912) 439-4033
Undergraduate Level (T-4)
Mental Retardation
Graduate Level (T-5)
Interrelated
ARMSTRONG STATE COLLEGE
Dr. John Hansen, Chairman Department of Education 11935 Abercorn Street Savannah, Georgia 31406 (912) 927-5280
Undergraduate Level (T-4)
Speech and Language Programs
Graduate Level (T-5)
Behavior Disorders Learning Disabilities Speech and Language Programs
ATLANTA UNIVERSITY
Dr. Brenda Rogers, Chairperson Special Education Department 223 Chestnut Street Atlanta, Georgia 30314 (404) 525-5098
Graduate Level (T-5)
~ental Retardation Interrelated Behavior Disorders Learning Disabilities Gifted (Certification)
Post Master Level (T-6)
Interrelated Mental Retardation Learning Disabilities

AUGUSTA COLLEGE
Dr. Frank McMillan, Coordinator School of Education Special Education Department 2500 Walker Way Augusta, Georgia 30910 (404) 828-3054 or 828-3601
Undergraduate Level (T-4) Mental Retardation Learning Disabilities
Graduate Level (T-5) Hospital/Homebound (Certification) Gifted (Certification) Interrelated Mental Retardation Learning Disabilities
Post Masters Level (T-6) Learning Disabilities Mental Retardation Interrelated
BERRY COLLEGE
Dr. Daniel McBrayer, Chairperson Department of Education Mt. Berry, Georgia 30149
Graduate Level (T-5) Learning Disabilities
BRENAU COLLEGE
Dr. William Ware, Chairman
Division of Education &Graduate Study
Gainesville, Georgia 30501 (404) 534-6299
Undergraduate Level (T-4) Mental Retardation
Graduate Level (T-5) Learning Disabilities Interrelated

M-3

COLUMBUS COLLEGE
Dr. Joseph Johnson, Dean College of Education Columbus, Georgia 31907 (404) 251-2251
Undergraduate Level (T-4)
Mental Retardation Speech and Language Programs
Graduate Level (T-5)
Mental Retardation Learning Disabilities Behavior Disorders Gifted (Certification) Hospital/Homebound (Certification) Speech and Language Programs
EMORY UNIVERSITY
Dr. James R. Graham, Program Director Graduate Program of Communicative
Disorders P. O. Drawer WW Atlanta, Georgia 30322 (404) 329-6468 or 329-7790
Graduate Level (T-5)
Learning Disabilities Audiology Hearing Impaired
GEORGIA COLLEGE
Dr. Michael Hickman, Chairman Department of Special Education Milledgeville, Georgia 31061 (912) 453-4577 or 453-5187
Undergraduate Level (T-4)
Mental Retardation
Graduate Level (T-5)
Interrelated ~ental Retardation Specific Learning Disabilities Behavior Disorders Gifted (Certification)

GEORGIA SOUTHERN COLLEGE
Dr. Robert Freeman, Head Elementary Education with Special Education Statesboro, Georgia 30459 (912) 681-5121 or gist 364-5121
Undergraduate Level (T-4) Mental Retardation
Graduate Level (T-5) Mental Retardation Learning Disabilities Behavior Disorders Interrelated
Post Masters Level (T-6)
Interrelated Mental Retardation
GEORGIA SOUTHWESTERN COLLEGE
Dr. Marjorie Ramsey Department of Education Americus, Georgia 31709 (912) 928-1283 or gist 345-1283
Undergraduate Level (T-4) Learning Disabilities Mental Retardation
Graduate Level (T-5) Learning Disabilities Mental Retardation Behavior Disorders
GEORGIA STATE UNIVERSITY
Dr. Oliver Leon Hurley, Chairman Department of Special Education University Plaza Atlanta, Georgia 30303 (404) 658-2310
Undergraduate Level (T-4) Mental Retardation Vision Impaired

M-4

GEORGIA STATE UNIVERSITY (cont'd)

MORRIS BROWN COLLEGE

Graduate Level (T-5)
Mental Retardation Behavior Disorders Interrelated Learning Disabilities Visual Impairment Speech Pathology Hospital/Homebound (Certification) Gifted Education (Certification) Hearing Impaired Physically Handicapped

Dr. Chloe Mitchell, Chairperson Department of Education and Psychology Box 302 643 Martin Luther King, Jr. Drive, S.W. Atlanta, Georgia 30314 (404) 525-7831, ext. 38
Undergraduate Level (T-4)
Mental Retardation
NORTH GEORGIA COLLEGE

Post Master Level - Ed.S. (T-6) Education Specialist in:
Mental Retardation Behavior Disorders Learning Disabilities Hearing Impaired
Doctora 1 Level Mental Retardation Behavior Disorders Learning Disabilities
LAGRANGE COLLEGE
Dr. Maynard L. Reid, Chairperson Department of Education LaGrange, Georgia 30240 (404) 882-2911
Undergraduate Level (T-4) Learning Disabilities
Graduate Level (T-5) Learning Disabilities
MERCER UNIVERSITY
Dr. Janet Busboom, Acting Chairperson Department of Education Maco~ Georgia 31207 (912) 744-2700
Undergraduate Level (T-4) Mental Retardation (Macon)
Learning Disabilities (Atlanta &Macon)
Graduate Level (T-5) Interrelated (Macon)

Dr. Jewel Wade, Coordinator Special Education Department Dahlonega, Georgia 30533 (404) 864-3391
Undergraduate Level (T-4)
Mental Retardation
Graduate Level (T-5)
Mental Retardation Learning Disabilities Behavior Disorders Interrelated Hospital/Homebound (Endorsement) Gifted Education (Endorsement)
TIFT COLLEGE
Dr. Wayne C. Hall, Chairperson Department of Education Forsyth, Georgia 31029 (912) 994-6739
Undergraduate Level (T-4)
Mental Retardation
UNIVERSITY OF GEORGIA
Dr. Bill Swan, Chairman Division of Exceptional Children 570 Aderhold Hall Athens, Georgia 30602 (404) 542-1151 or gist 241-3030 or 2165
Undergraduate Level (T-4) Mental Retardation

M-5

UNIVERSITY OF GEORGIA (Cont'd)

VALDOSTA STATE COLLEGE (cont'd)

Graduate Level (T-5)

Doctoral Level

Interrelated

(Cooperative Program with University of

Mental Retardation

Georgia)

Speech Pathology

Mental Retardation

Multi-handicapped/Physically Handicapped

Interrelated

Behavior Disorders

Learning Disabilities

WEST GEORGIA COLLEGE

Gifted (Certification)

Hospital/Homebound (Certification)

Dr. William Moeny, Chairman

Hearing Impaired

Department of Special Education

Audiology

Carrollton, Georgia 30117

(404) 834-1332 or gist 232-1332

Post Master Level (T-6)

Behavior Disorders

Undergraduate Level (T-4)

Mental Retardation

Mental Retardation

Learning Disabilities

Multi-handicapped

Graduate Level (T-5)

Speech and Language Program

Mental Retardation

Learning Disabilities

Doctoral Level

Behavior Disorders Interrelated

Behavior Disorders

Speech and Language Program

Mental Retardation

Hospital/Homebound (Certification)

. Learning Disabilities

Orthopedically Handicapped

Post Master Level (T-6)

Speech and Language Program

Behavior Disorders

VALDOSTA STATE COLLEGE

Learning Disabilities Mental Retardation

Dr. A. Carol Hartman, Chairman

Interrelated

Special Education Department

Valdosta, Georgia 31601

(912) 247-3270 or gist 343-3270

Undergraduate Level (T-4) Mental Retardation

Graduate Level (T-5)
Physically Handicapped Mental Retardation Behavior Disorders 1earning Disabilities Hearing Impaired Hospital/Homebound (Certification) Gifted (Certification)

Post Master Level (T-6)
Behavior Disorders Hearing Impaired Learning Disabilities Mental Retardation Physically Handicapped Interrelated

M-6

Appendix N Interagency Cooperative Agreement

COOPERATIVE AGREEMENT BETWEEN
THE GEORGIA DEPARTMENT OF EDUCATION} DIVISION OF SPECIAL PROGRAMS AND THE OFFICE OF VOCATIONAL EDUCATION AND
THE GEORGIA DEPARTMENT OF HUMAN RESOURCES} DIVISION OF MENTAL HEALTH AND MENTAL RETARDATION}
DIVISION OF REHABILITATION SERVICES} AND DIVISION OF YOUTH SERVICES
1983
N-]

TABLE OF CONTENTS

I. Purpose

1

II. Compl i ance Requi rements

l

III. Departmental Responsibi I ities ............................ 3

A. Department of Human Resources

3

B. Department of Educat i on

3

IV. Procedures

5

A. Evaluation and Assessment.

5

1. Mental Retardation Service Centers

5

2. Local Rehabilitation Services

5

3. Youth Development Centers

5

B. Referral and Admission

6

1. Mental Retardation Service Centers

6

2. Vocational Education

6

3. Institutions/Hospitals

6

4. Local Mental Health Programs

7

5. Local Rehabilitation Services

7

C. Appea I Procedu re

7

D. 'iindividual ized Plan 8 l'

1.lnstitutions/Hospitals ........................... 8

2. Youth Development Centers , .. ,

8

3. Mental Retardation Service Centers

8

4. Vocational Education and Rehabilitation Services .. 9

E. Release of Information/Confidentiality

9

1. Insti tutions/Hospitals

9

2. Youth Development Centers

10

3. Mental Retardation Service Centers

10

4. Rehabi litation Services

10

F. Release or Termination

10

G. Local Cooperative Agreements

10

V. Glossary

G-l

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STATE COOPERATIVE AGREEMENT BETWEEN THE GEORGIA DEPARTMENT OF EDUCATION, DIVISION OF SPECIAL PROGRAMS,
AND THE OFFICE OF VOCATIONAL EDUCATION, AND THE GEORGIA DEPARTMENT OF HUMAN RESOURCES, DIVISION OF
MENTAL HEALTH AND MENTAL RETARDATION, DIVISION OF REHABILITATION SERVICES, AND DIVISION OF YOUTH SERVICES.
I. PURPOSE
The purpose of this agreement is to promote the development and maintenance of educational and related services programs for school-age (5 through 18) handicapped individuals who are residing in state institutions or confined to Youth Development Centers (YDCs) or placed in local Mental Retardation (MR) Service Centers administered by the Department of Human Resources, and to commit on behalf of the state agencies to provide comprehensive vocational services for handicapped individuals. The agreement is designed to more effectively implement the intent of the Adequate Program for Education in Georgia Act (APEG) and the Education for All Handicapped Children Act of 1975 (P. L. 94-142). Each agency shall abide by all state and federal laws governing the programs for its services. The provision of services shall adhere to the state and federal regulations which govern the Department of Education and the Department of Human Resources.
I I. COMPLIANCE REQUIREMENTS
A. Section 300.600, P. L. 94-142
1. P. L. 94-142 includes the following language relative to educational programs for handicapped children administered by other agencies:
The state educational agency is responsible for insuring:
a. That the requirements of this part are carried out; and
b. That each educational program for handicapped children administered within the state, including each program administered by any other public agency:
(1) Is under the general supervision of the persons responsible for educational programs for handicapped children in the state educational agency; and
(2) Meets education standards of the state educational agency.
2. The following procedures shall be implemented to assure compl iance with Section 300.600 of P. L. 94-142.
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a. The Georgia Department of Education (DOE) and Human Resources (DHR) agree that planning related to educational standards for programs for handicapped individuals shall be coordinated between the Georgia Department of Education, Division of Special Programs and/or Office of Vocational Education, and the Georgia Department of Human Resources, Division of Mental Health and Mental Retardation, Division of Rehabilitation Services, and/or Division of Youth Services, as appropriate.
b. Agencies and programs shall share personnel and services when feasible.
c. Procedural safeguards as outlined in the current DOE Program for Exceptional Children Regulations and Procedures shall apply.
d. Age requirements to be used in determining eligibility for services are specified in the current DOE Program for Exceptional Children Regulations and Procedures.
e. Eligibility for educational services by handicapping areas shall be determined through util ization of the current DOE Program for Exceptional Children Regulations and Procedures and shall include the Division of Mental Health and Mental Retardation definition of severely and profoundly retarded.
f. A representative from each state agency shall be responsible for coordinating the development of the interagency program and for providing technical assistance to local education agencies (LEAs) and rehabilitation agencies in developing more specific working agreements at the local level.
g. A cooperative plan for sharing statewide data will be implemented to determine the degree of success of these comprehensive services.
h. Cooperative in-service and staff development activities shall be initiated by state, regional, and local personnel in the areas of program organization, operation and current developments. Local and regional agency staff will cooperatively participate in staff development designed for locally assessed needs.
i. This agreement shall become effective on March 1, 1983 and shall terminate one year thereafter. It shall be subject to renewal at the time of termination upon written agreement of the parties.
j. It is agreed that DOE and DHR state staff may jointly visit selected LEAs and selected DHR agencies and institutions to evaluate efforts to provide appropriate placement and services for handicapped students.
B. Confidentiality
1. DOE and DHR recognize that sharing of information is essential in order to provide needed services to handicapped individuals of school age. Both Departments further recognize that information and records must be shared in accordance with any appl icable state or federal laws or rules and regulations. Authorizations for releasing information
N-4

must be obtained when required by law. No information will be provided to any party to this agreement or to any other party/agency without following the provisions for the release of information contained in the Georgia Laws covering the treatment of the mentally ill (O.C. GA Section 37-3-166), habilitation of the mentally retarded (O.C. GA Section 37-4-125) and the treatment of substance abusers (O.C. GA Section 37-7-166).
2. It is agreed that education data, including psychological testing and social histories, shall be exchanged between DHR and DOE when required for legitimate educational purposes and when applicable confidentiality requirements are to be followed.
I I I. DEPARTMENTAL RESPONSIBILITIES
A. The Department of Human Resources shall:
1. Provide for institutional/hospital clients, facilities, staff, equipment and materials needed to operate programs for meeting special education needs of handicapped individuals.
2. Provide vocational rehabilitation services as specified under the Division of Rehabilitation Services Client Services Policy and Procedure Manual, Georgia's State Program Plan for Rehabilitation Services, and appl icable federal and state rules and regulations.
3. Develop, implement and evaluate, in cooperation with DOE, joint standards for educational services for handicapped individuals.
4. Provide access to facilities, staff and educational records to appropriate
DOE staff for the purpose of monitoring programs and services for handicapped individuals. Any applicable confidentiality requirements will be followed.
5. Assure that the local MR Service Center refer to the LEA school-age
(5 through 18) handicapped students who are in a program of the Service Center or who apply for admission to a program of the center.
6. Cooperate with DOE in the appointment of surrogate parents as necessary in meeting the requirements for appointment set forth by the U. S. Department of Education.
B. The Department of Education shall:
1. Assure that the LEA provide a special education placement committee which will determine the most appropriate educational placement. If the parents disagree with the placement decision, they may follow the appeal procedure as outlined in Georgia's State Program Plan (for exceptional children) and DOE's Program for Exceptional Children Regulations and Procedures to insure due process or seek a private educational setting at their own expense.
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2. Assure that local education agencies invite appropriate MR Service Center staff to participate in the development of the "Individualized Plan"~'< for severely handicapped students enrolled or for whom enrollment in the local MR Service Center is being considered.
3. Assure that special education and related services as specified in the
"Individual ized Plan" are provided at no cost to the parent. These may include, but are not limited to, instruction from certified personnel, occupational therapy, physical therapy, speech and language therapy, and transportation.
4. Assure that educational programs within public schools are available
for severely handicapped students ages 5 through 18. In order to provide maximum opportunity for interaction with nonhandicapped peers, the program should be housed within the regular school building with students of similar chronological age.
5. Assure that the primary responsibi lity for developing an "Individualized
Plan" for a child who has been placed by the Division of Mental Health and Mental Retardation in a residential program located in a county other than the county of residence of the parent or guardian rests with the LEA of the county in which the parent resides. Further, assure than the LEA of the county of the parents' residence meet with the LEA serving the county of the cl ient's residence and develop agreements regarding delivery of education services and payments for those services.
6. Provide technical assistance to LEAs to assure that:
a. handicapped students have been offered personal adjustment and pre-vocational skill training prior to being referred to Vocational Education;
b. placement of handicapped students in Vocational Education Programs is based on "Individual ized Plan" as specified in the current DOE's Program for Exceptional Children Regulations and Procedures and requirements and conditions reflected in the state plan.
7. Assure that LEAs are aware of services available from the Division of
Rehabil itation Services and the requirement for eligibility for such services.
8. In accordance with P. L. 94-142, DOE and DHR personnel shall conduct
joint monitoring visits at least once every three years to DHR operated institutions/hospitals.
9. Recruit and train surrogate parents as necessary in meeting the require-
ment for appointments as set forth by the U. S. Department of Education.
~~"Individualized Plan" refers to Individualized Education Program (IEP), Individualized Program Plan (IPP), Individualized Treatment Plan (ITP), and/or Individualized Written Rehabilitation Plan (IWRP).
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IV. PROCEDURES
A. Evaluation and Assessment
1. Mental Retardation Service Centers (MR Service Centers)
It is agreed that, in order to make appropriate placement decisions for severely handicapped students, current assessment data must be available at the IEP/placement committee or annual review meeting. A release of information will be obtained when required by law. Assessment should provide information in the following areas: daily living skills, communicative skills, motor skills, social skills, cognitive skills, and vocational skills. In assessing the severely handicapped student, particular attention should be given to the student's response to environmental stimuli and the potential for learning a method of comminicating his/her wants and needs.
In making placement decisions, the following criteria should not be used to exclude a student from a public school program.
not toilet trained nonverbal nonambulatory unable to feed self requires extended day requires medication behavior disordered requires special transportation
2. Local Rehabilitation Services (RS)
RS will accept primary responsibil ity for assessment of eligibility and provision of rehabilitation services to handicapped students in Georgia. RS will provide timely screening of all school referrals to determine el igibility for rehabilitation services.
3. Youth Development Center (YDC)
The YDC shal I provide initial diagnostic screening consisting of, but not limited to
group intelligence test academic achievement test vocational potential test medical profile review of records forwarded to Department of
Human Resources, Division of Youth Services, from local education agency or other referring agency. individual psychological evaluation
The YDC shall refer severely multi-handicapped offenders to the Department of Education, Division of Special Programs, for evaluation and services beyond the capabilities of the Department of Human Resources, Division of Youth Services.
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B. Referral and Admission
1. Mental Retardation Service Centers (MR Service Centers)
In making placement decisions, the following guide will be used by local MR Service Centers:
a. Upon reaching school-age, cl ients of the local MR Service Center shall be referred to the LEA. If, through the "Individual ized Plan" process, the client is recommended for placement in the local MR Service Center and no break in service has occurred, the client shall remain in the local MR Service Center.
b. Former clients of MR Service Centers who have been accepted into an LEA and later referred back to an MR Service Center shall be admitted to a center in accordance with the DHR criteria for admission as specified in the current Minimum Requirements for Mental Retardation Service Centers.
c. School-age individuals referred to MR Service Centers by LEAs who have not been formerly served by MR Service Centers shall be admitted to those centers in accordance with the DHR criteria for admission as specified in the current Minimum Requirements for Mental Retardation Service Centers.
2. Vocational Education (VE)
VE shall accept for vocational training those students/clients referred by Rehabilitation Services and Special Education as funding and space I imitations will al low and comply with requirements and conditions as set forth in the Vocational Education State Plan. VE shal I determine and report those identified due-processed handicapped students participating in regular vocational education programs and include these in the Management Information System (MIS) data collection.
3. MH/MR Institutions/Hospitals
Local area mental health (MH) personnel will evaluate and make recommendations for admission to the appropriate institution or regional hospital psychiatric unit.
Local MR personnel will notify LEA personnel in writing within 24 hours of a school-age cl ients's admission to a mental retardation facility. The institution/hospital personnel wil I notify in writing LEA personnel* within 24 hours of the admission of a school-age client with a copy sent to the local area mental health program.
If local education services are considered during the hospitalization period, all appropriate agency personnel, including the LEA of legal residence, the LEA serving the geographic area where the institution is located, institution personnel and the parent/legal guardian must meet and develop agreements regarding delivery of education services and payment for those services. Notification must be done within appl icable confidentiality requirements.
*LEA personnel refers to the special education coordinator or contact person and includes the psychoeducational center director if the cl ient was/is enrolled in the psychoeducational center program.
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4. Local Mental Health Programs
Referrals to area mental health programs can be made by school personnel without the LEA being responsible for payment unless the service/referral is specified in the student's "Individualized Plan". The parends) or legal guardian of a student referred for services when the services are not part of the student1s "Individual ized Plan" will be charged for the services in accordance with the policies of the particular area mental health program. This should be explained to the parent(s) or legal guardian at the time a referral is made. LEAs and Community Mental Health Programs are encouraged to develop agreements regarding the type and the delivery of any mental health services that are described in a student's "Individualized Plan".
The mechanism to address payment of fees for those services included in the "Individual ized Plan" is as follows:
a. Medicaid el igible students will be billed through Medicaid. (According to Medicaid regulations, if Medicaid is billed for any cl ient, all cl ients of the agency must be billed.)
b. The LEA may be billed at the regular or discounted rate for other cl ients or contractual arrangements can be made.
c. Private insurance companies may be bil led for those students whose parent/legal guardian holds appropriate insurance pol icies.
5. Local Rehabil itation Services (RS)
RS will accept from Vocational Education and/or Special Education all referrals of handicapped students who are at the 10th grade level and receive some portion of their daily classroom instruction within special education classes. (RS may accept referral of special education students who are below the 10th grade level but have obtained 16 years of age.) RS will accept referrals at the 12 grade level from Vocational Education, Special Education, or other school staff of other handicapped students. RS will accept referrals from Vocational Education of handicapped students at the post secondary level.
c. Appeal Procedures
If a parent requests a public agency, other than the local education agency, to provide special education and/or related services as defined by P. L. 94-142 for their school-age child (5 through 18 years of age), that public agency must inform the local education agency of the referral. It then becomes the LEA's responsibil ity to insure that the child receives a free appropriate public education. For a severely handicapped child, as with all handicapped children, the LEA will provide a special education placement committee which will determine the most appropriate education placement. If the parents disagree with the placement decision, they may follow the appeal procedure as cutl ined in Georgia's current State Pro9ram Plan (for exceptional children) and DOE's Program for Exceptional Children Regulations and Procedures to insure due process or seek a private educational setting at their own expense.
N-9

C. '1lndividual ized Planll
1. Institutions/Hospitals
Upon admission, it is the responsibil ity of the institution/hospital to develop and implement an '1lndividual ized Plan" which contains all the components specified by education regulations and state and federal law.
A preliminary "Individual ized Plan" will be developed during the preadmission process to mental retardation facilities and will be finalized within 30 days of admission. The LEA will be apprised by the local mental retardation personnel of the date of the 30-day update staffing.
The "Individual ized Plan" {prel iminary or final} shall be developed within the time period specified in DHR rules and regulations (290.4.7) relating to the admission and treatment of minors. The LEA personnel will be approsed in writing of the meeting, with a copy sent to the local area mental health program and invited to attend and participate in the development of the "Individualized Plan".
2. Youth Development Centers (YDC)
YDCs are responsible for developing an "Individual ized Plan" for those youth identified as handicapped which will:
a. state the individual IS present levels of educational performance;
b. state the need for special education and related services;
c. state education objectives (annual goals and short-term instructional objectives);
d. identify specific special education programs and related services to be provided;
e. state projected dates for initiation of services and anticipated duration of services;
f. be reviewed at least every six months or upon release.
3. MR Service Centers
MR service centers shall participate in the initial development and annual review of an "individualized Plan" for each handicapped student enrolled or for whom enrollment in the local MR service center is being considered. If the decision is made to serve the handicapped student in a local MR service center, an "Individualized Planll will be developed by the local MR service center in compliance with the current Minimum Requirements for Mental Retardation Service Centers.
N-IO

4. Vocational Education and Rehabilitation Services
VE and RS shall recommend that LEAs involve VE and RS staff in the writing of the Illndividual ized Plan" for handicapped secondary students. VE and RS shall participate in the development of an 'iindividualized Plan" for each jointly served handicapped student/client in accordance with guidel ines established by cooperating agencies. VE and RS shall identify additional entry and exit points in regular vocational programs and make curriculum modifications to meet individual student needs.
E. Release of Information/Confidentiality
1. Genera 1
When applicable laws require an authorization for the release of records of information, the releases are normally obtained from either parent or an individual appointed as the legal guardian of a minor. In situations where the parents are divorced or separated, the release must be obtained from the parent who has legal custody. The need for the release should be explained, any questions answered and the authorized person asked to give consent in writing. In the event the release cannot be obtained, administrative staff at the local or state level should be contacted for assistance.
2. Institutions/Hospitals
At the time of referral/admission, a release of information form will be secured to obtain information from the LEA and the psychoeducational center if appropriate. Intake procedures for mental health/mental retardation facil ities will include a signed parental consent for notifying the LEA of admission and a request for records of previous educational services. Ongoing contact between the MH/MR personnel and the LEA (and psychoeducational personnel) will take place through telephone contact and/or correspondence.
The LEA special education coordinator will be responsible for facilitating the release of LEA records. Release of records should not be circumvented for any reason. The release will specify the records being requested. All records should be released and forwarded within 10 working days of the request unless the agency receiving the request notified the requesting agency of the delay.
a. The following MR facility records shall be released with parental consent, when an LEA requests educational records.
1. The Illndividual ized Plan"
2. The most current assessments
b. Prior to the discharge 'iindividual ized Plan" staffing for mental health cl ients, the parents or guardians will be requested to sign release for the following information to be sent to the LEA and/or psychoeducational center:
N-ll

1. summary of hospitalization
2. IIlndividual ized Planll
3. additional information such as psychological or psychiatric
report as requested by the LEA and/or psychoeducational center and for which consent for release has been obtained.
3. Youth Development Centers
Within limitations of state and departmental regulations of confidentiality, the Division of Youth Services will make educational records of handicapped juvenile offenders available to any recognized educational agency upon request.
4. MR Service Centers
The exchange of confidential student information between LEAs and local service centers requires parental consent prior to release of information.
5. Rehabil itation Services
The exchange of confidential student information between local education agency and Rehabilitation Services requires parental notification of the information being transferred.
F. Release or Termination
MH/MR institution/hospital personnel will contact the LEA when community Placement has been recommended, apprise the LEA of the client's status regarding discharge, and review community placement options. Prior to discharge and community placement, the LEA shall assure development of an 'iindividual ized Plan. 1I
MH/MR institution/hospital personnel will notify the LEA personnel in writing, with a copy to the local mental health program, at least 10 working days prior to the anticipated release of a client. This notice shall include a meeting date to develop the discharge "Individual Plan" and follow-up plan for identified handicapped students. At the time of discharge, the LEA must assure implementation of the "Individualized Planll according to state and federal guidel ines.
G. Local Cooperative Agreements
It is strongly recommended that a cooperative agreement be implemented at the local level between the LEA and the following agencies:
1. Area Mental Health Programs
2. Mental Retardation Service Centers
3. Vocational Education and Rehabil itation Services Programs
N-12

The local cooperative agreement shall:
1. Establ ish specific guidel ines for dealing with release of information requests, including names of individuals within each agency responsible for transmission of information.
2. Identify responsibilities in delivery of services to mutual clients.
3. Develop written agreements and guidelines regarding referrals (Section IV)
and LEA services.
The local cooperative agreement shall also include a mechanism for establishing at least quarterly meetings with staff from the above-referenced agencies. These quarterly meetings shall:
1. Provide a medium for dialogue about agency pol icies and procedures.
2. Discuss sharing of agency personnel and services currently available and proposed.
3. Discuss criteria for crisis intervention and hospitalization of clients.
4. Generate minutes to be shared with agency representatives.

Charles McDaniel Date

James Ledbetter Date

Authority:
1. 37-2-1 Mental Health and Mental Retardation Services 2. 37- 5- 3 Community Services Act for the Mentally Retarded 3. 37-4-2 Habil itation of Mentally Retarded Persons
4. 15-11 Juvenile Proceedings Code 5. 49-5 Program for Children and Youth
N-13

V. GLOSSARY
1. FAPE - Free Appropriate Publ ic Education - Special education and related services as specified in the IEP which: (a) are provided at public expense, are under public supervision, may include private school placement, and are without charge; (b) meet the standards of the Georgia Department of Education, including the requirements of P. L. 94-142; (c) include children five through eighteen years of age (In Georgia services to children birth through four and nineteen through twenty-one years of age are permissive. Students enrolled in an ongoing program may continue until completion of that program or through age twenty-one.); (d) are provided in conformity with an individual education program which meets the requirements of P. L. 94-142.
2. l'lndividualized Plan" - refers to Individualized Education Program (IEP), Individualized Program Plan (IPP), Individual ized Treatment Plan (ITP), and/or Individualized Written Rehabilitation Program (IWRP).
3. IEP - Individualized Education Program - A written statement developed by the local placement committee, translating the child's evaluation and evaluation and educational assessment into a practical plan for instruction and del ivery of services. The context of the IEP shall include:
1. present levels of education performance, 2. annual goals and short-term objectives,
3. specific educational services to be provided,
4. extent to which child will participate in regular classroom,
5. projected date for initiation and duration of services, 6. objective criteria and evaluation procedures, and 7. schedule and procedures for review.
4. IPP - Individual ized Program Plan - A process that includes an interdiscipl inary team staffing report, a quarterly plan/progress report, a training/contact schedule, and an individual training/contact record; contents of the plan determined by the interdisciplinary team.
5. IWRP - Individualized Work Rehabil itation Plan - An individualized written
plan for services which includes intermediate short-range objectives related to an individual IS vocational preparation and those services to accomplish these objectives within definite time frames. It may also contain related resources provided through other agencies.
6. Institution/Hospital - Any state-owned or state-operated institution
utilized 24-hours a day for the habil itation and residence of persons who are mentally ill or mentally retarded, any facil ity operated or utilized for such purpose by the U. S. Veterans Administration or other Federal agency, and any other facil ity within the State of Georgia approved for such purpose by the Department.
7. Mental Retardation Service Center - The composition of several programs;
a center includes facility-based (training program, work activity program, extended day program) and outreach programs for children and adults.
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8. Severely Handicapped - Refers to severely mentally, emotionally or physically handicapped. Severely mentally handicapped include those students whose p~rformance on an individually administered psychological examination lies more than four standard deviations below the mean of the test utilized and who show significant deficits in adaptive behavior. Severely emotionally distrubed include children who exhibit childhood schizophrenia and severe behavioral disorders resulting from autism, neurological impairment, cultural deprivation, developmental lag and family related problems, as well as severe school-related problems manifested in behavior, social ization, communication, and academic skills. Severely physically handicapped includes deaf, b1 ind, deaf-blind, and severely orthopedically handicapped.
9. Youth Development Centers - Institutions for the placement and rehabilitation
of del inquent youth committed by juvenile courts to the custody of the Division of Youth Services, Department of Human Resources. 10. Management Information System - A data collection process whereby vocational program managers can assess on a self-initiated and continuous basis, the effectiveness of DOE vocational educational programming.
N-15

Appendix 0 Monitoring Documents Title VI-B And P. L. 89-313

LLU~GIA 0(' lM[NT OF CDUCATION OI",'.SION m ~P(CIAL PROGRA'~S
PUl~!;I(/\M rem (Xc/PT lUNAL CII.lOR[N
MONITORING DOCUMENT, PSYCHOEOUCATIONAL CENTE~ PROGRAMS P.L. 89-313 (Chapter I)

- - - LtNltK
nATE

---------------;lI~ai

REQUIREMENTS

Y N NA

-----
COMPLIANCE INDICATORS

COMMENTS

I. ELIGIBILITY OF CHILDREN TO BE COUNTED
1. Was each handicapped child counted on the October 1 Child Count on the membership roll of the Stateoperated school
Sec. 116b.41 Sec. 116b.44

1. Obtain a list of all handicapped children counted on October 1 and randomly select children's names.
2. Obtain case records, membership list, or other documentation to determine if students counted were enrolled October 1.

2. Were all ~i19:ble transfer students
? reported to the SEA? (Eligible
~transfer students are those who meet the following criteria; (1) P. l. 89-313 Child Count in the 1971-72 or subsequent school year, (2) will leave or have left the State-operated facility and (3) were enrolled for . one school year or mor~ (minimum of 180 school days).
Sec. 116b. 25 Sec. 116b 41

1. From the list of ~ildren on form DE Form 0922 randomly select student names and ask for documentat ion thatthose children were enrolled for one school year (not less than 180 school days) to determine if children were
eligible as transfer students.

3. Was each chi ld counted under age 5?

1. Use sample of children from item 1.

~llll\U 11\ LJ' '/II'ILIH UF [LJUCI,T1 ON 01 VISION Or 51'(( IAL prWGRAr1S
PWlGRAM fOR E~Cr~TIONAl CHILDREN MONITORING DOCUMENT, PSYCHOEDUCATIONAL CFNTF:R PROGRA~1S P.L. 89-313 (Chapter I)

REQUIREMENTS

Y N NA

CENT~R
OATE
CO-M-P-LI-A-NCE
INDICATORS

----------:.'---
COMMENTS

2. Obtain case records or other documentdtior, to determine if
students were un '~r age 21 (SED, age 5) on Letober 1.

4. Is each handicapped child counted being provided with an educational program designed to meet the child's special educational needs?
0
I N
Sec. 116b. 50(2)
I I. PROJECT PARTICIPANTS
5. Are the types and numbers of handicapped children participating the same as those specified in the approved project application
Sec. 116b. 21 (2)

1. Use sample of children from item
1.
2. Obtain case records to detenmine if IEP's are developed for each identified child.
1. Compare page DOE 4 of the project application to those participating at the date of the on-site. (Additional children may be served on a space available basis if: (a)all children counted are receiving benefits from project funds and (b) all children counted are receiving an appropriately designed education commensurate with their needs.)

6. Do all staff employed with project funds meet State Education Agency Certification standards?
Sec. 116b. 51

1. Obtain a list of certification and area teaching responsibility of all personnel paid fully or in part with project funds.

Gtol{GIA OLr'ARTI~[NT OF EDUCATION DIVlSIO~! OF SPECIAL PROGRAMS
P~OGkAM tOR EXCEPTIONAL CHILDREN MONITORING DOCUMENT, PSYCHOEDUCATIONAL r.FNTFR PROGRAMS P.L. 89-313 (Chaoter I)

CENTER nATE

REQUIREMENTS
7. Do all staff employed under Section 5 funds meet State,Education Agency standards?

Y N NA

COMPLIANCE INDICATORS

1. Obtain a list of all Section 5 teachers, their certification and area of teaching responsibility.

8. Are the responsibliities of personnel funded through project funds the same as described in the approved project?
Sec. 116b. 2l( 7)
a J.,
I II. PARENT PARTICIPATION 9. Have the parental participation activities specified on page DOE 12 of the approved project been implemented?
Sec. 116b.22

1. Canpare infonmation obtained through interviews with the approved project.
1. Vertify throuqh interviews and written documentation.

IV. ACTIVITIES 10. Are the activities being carried out
as specified in the approved project (page DOE 7)? Sec.116b.21(7)

1. Verify through interview and review of randomly selected student records.

COMMENTS

GEORGIA 0 .RTM[NT OF [DUCAT ION DIVISION OF SPECIAL PROGRAMS
PU()GRAM fOH EXCEPTIONAL CHILDREN MONITORING DOCUMENT, PSYCHOEDUCATIONPL CE"'Tr::~ PROGRAMS
P.L. 89-313 (Chaotp.r I)

REQUIREMENTS

Y N NA

1

CENTER
nATE

---- -

-..
COMPLIANCE INDICATORS

~

o I ~
Sec. 116b. 2l( 7) 12. If equipment has been disposed of,
has the agency followed the procedures outlined in General Provisions Regulations and has approval from the SEA been obtained? Sec. lOOb.215

etc . for a specific piece of equipment as long as the total amount is not in excess of 10% upward). 2. Obtain documentation throu~h interviews or review of records that all staff budgeted have been employed. 3. Obtain documentation throu9h interviews and record review that contracted services. travel, and other expenses are the same as in the approved project budget.
1. Review copies of correspondence with the SEA requesting approval to dispose of equipment and a copy of the approval letter sent to the agency.

;~Y_------
COMMENTS

tlO~GIA O. .~TM[NT OF EDUCATION OIVISION OF SPECIAL PUOGRAMS
P"OGRAM FOR EXCePTIONAL CHILDREN MONITORING DOCUMENT, PSYCHOEDUCATIONAL CENTER PROr,RAMS P.L. 89-313 (Chapter I)

CENTER OATE

---------------~-----

REQUIREMENTS

y N NA

COMPLIANCE INDICATORS

13. Is a P. L. 89-313 inventory on file and kept up to date by the agency?
Sec. 100b.215(d)(1)
0
I V1

1. Review copy of the current equipment inventory.
2. Determine that property records provide for (1) list of equipment including serial number and model if appropriate, (2) date our purchase, (3) quantity or number received, (4) cost per unit, (5) location. and (6) disposal date and method of disposal, if appropriate.
3. Review procedures which assure that all equ i pment purchased throuqh project funds can be identified (e.g., labeling of equipment, coding, tracking list/ inventory, etc.)

COMMENTS

14. Are the materials and. equipment
purchased being used as described '1n the approved project? Sec. 116b 54

1. Interview appropriate staff members to determine how materials and equipment are being utilized.
~. Interview staff to determine if they are knowledgeable in the use of operation of the equipment

15. Are project funds being utilized to provide special education and re-
Sec. 116b. 61

Review the responsibilities of all personnel paid through project, (all such personnel are identified in .the ~udge~ section of the

RGIA DEPARTMENT OF EDUCATION ISION OF ~PECIAL PROGRAMS GRAM fOR EXCEPTIONAL CHILDREN JITORING DOCUMENT, PSYCHOEDUCATIONAL CENTFq . 89-313 (Chaotp.r I)

CENTER OATE

REQUIREMENTS
C) I 0'

Y N NA

COMPLIANCE INDICATORS

2. Verify that all teachers and teachers aides/paraprofession~ls are directly involved in the special education program for eligible students. Attention should be paid to working hours, supervision, and assigned duties.
3. Review all project funded administrative and clerical personnel. for these individuals obtain a job description or other evidence of the employee's duties. If considered necessary to determine extent of special education assignment, interview the employee personally.
From the information obtained. determine if the administrative and clerical staff were necessary to carry out the project and the requirements of P. L. 89-313.
From the information obtained during the on-site visit and from interviews with the project staff, determine if the administrative responsibilities. in your professional judqmpnt. warrant the administrative staff funded in the approved project.

COMMENTS

~LOJ(Cl" lJl' ",TMllH OF EDUCATION
.)1 V1~ IlJN 0, .,I'C CI/\L rIWG[O\I~S ill(IJltla\M I (Jl( LXCIYflOl'4I\L CllJLO~(N
MONITORING DOCUMENT, PSYCHOEDUCATIONAL CPITER PROGRAMS
P.L. 89-313 (Chaoter I)

CENTER
nl\TE

- - - - - t \ 1 .-

REQUIREMENTS
0
I -..J

Y N NA

COMPLIANCE INDICATORS

4. For contracted services for occupational therapy. physical therapy. and speech therapy obtain a list of students receiving those services. Randomly select five (5) student names from each list and obtain Individual Education Plans (IEP) for each student selected. From the IEP's determine if the service(s) being provided the students were required in the individual student's IEP: e.g . the students being served by a contracted physical therapist should have physical therapy listed as a needed service in the IEP.
5. For all other contracted services. obtain a list of the students that are receiving those services. Randomly select five (5) student names from each list and obtain the records for those students. Determine if contracted services were provided to the children. For contracted evaluation services obtain a list of the students receiving evaluations. Randomly select five (5) student names from each list and obtain copies of evaluation reports. Determine if the evaluations have been completed on the students selected.

COMMENTS

:ORGIA DfPARTMENT OF EDUCATION iVI~ION Gf SPECIAL PROGRAMS ~OGRAM fOR EXCEPTIONAL CHILDREN JNITORING DOCUMENT, PSYCHOEDUCATIONAL CENTER PROGRAMS .L. 89-313 (Chapter I)

CENTER
OATE

REQUIREMENTS

Y N NA

COMPLIANCE INDICATORS

Has each child counted to generate funds under P. L. 89-313 receive some benefit from the project: :. 116b.50
0
I 00

1. Use sample of children from item
1-
2. Interview administrator to identify services that are being provided with P. L. 89-313 project funds to detenmine if a11/ some of the funds are being used to meet the individual special education needs. Compare services listed by the administrator with those services actually provided with project funds.

Are all special education and re-

lated services provided at no cost

to parents (including the cost of

room and board and non-medical care

which are provided in an institution

residential care facility in which a

child is placed for educational

purposes?)



116b.62(b)

1. Throuqh interviews determine if parents are charged for any special education or related services (including cost of room and board and non-medical care). If charges have been made, use the sample of students from item 1, and review placement documentation to detennine if any placements have been made for educational purposes.
2. If students have been placed for educational purposes, interview the administrator to determine if the parents have been charged for special education and related services (inc1udin9 the cost of room and board and non-medical
r", ....,.\

COMMENTS

t.J!(G II\- lJ; i'I\.(( ;\L.Kr ur [lJ~CI\ Tl ON
IVISIf" . ~PLCIAL PIWGI(J\l1~
UJr.k.~M turi EXCEPT IONAL CHIlORfN ONITORING DOCUMENT, PSYCHOEOUCATIONAL CENTER P~O'.iRAMS
.L. 89-313 (Chapter I)

REQUIREMENTS

Y N NA

---- - - e CENTER
0/\ IT

----
COMPLIANCE
INDICATORS

COMMENTS

RANSPORTATION

8. Were expenditures for transportation of handicapped children used only under the following conditions:

(a) The State educational agency

has detenmined that the trans-

portation is essential to ensure

the child's safety or to enable

the child to benefit from the

special education or the other

o

related services being provided;

J, (b) The school in which the child is

enrolled has made reasonable

efforts to secure other means of

or resources for transportation

of the child;

(c) There is no State law requiring

the provision of the service;

and

(d) The transportation is not

nonmal1y provided to other han-

dicapped children by the agency

in whose educational program

the child is enrolled?

Sec. l16b.63

l. If funds are expended for transportation obtain written documentation containing verification that all criteria met.

HSSEMINATlON 19. Have dissemination activities been
implemented?

DOE 10 of the approved project.

GENEP.Al PROJECT INFORt-:ATIO~;

Appli cant Agency Date(s) of Monitoring Visit Agency Administrator Total Original Amount Approved A~end~ent No. 1 A~ount Approved A~end~ent No. 2 A~ount Approved ~end~ent No. 3 Amount Approved

_

Project Number

_

Project Director- - - - -

Date of Approval - - - - - -

Date of Approval

_

Date of Approval - - - - - Date of Approval - - - - - -

GEORGIA DEPART~~~T OF EDUCATIO~ MO~ITOR(S)
(Na 11 e)

( Title)

0-10

PERSONS CONTACTED DU.RING ONSITE MONITORING VISIT

I-
I
Nam.

'.raonl Cont.c:ttd

1

'oaitiof\/R"ation lD'rorram

I

I

I

!.
I

I

I

I

0-11

TO BE ADDRES~ED DURING PSYCHOED 89-313 AND VI-B ON-SITE 1. Check Fire Drill Instructions and Reports 2. Check for Occupancy Permit 3. Review Written Contractual Agreements with Consultants
4. Review Certificates and Licenses of Staff 5. Review Master List System
0-12

~Oku1A OPARfHCHT Of [OUCATION IViSION Of SP~CIAL PROGRAMS ~OG"AH fOR XCfPTIONAl CHllDRH TITLE VI-B ~IJUNIHG DOCUMENT, PSYCHOEDUCATIONAL CENTER ADOLESCENT PROGRAMS

CENTER OATE

RQUI RHNTS

y

PARTICIPATING STUDENTS 1. Are the types and nwnbers of handicapped students participating the same as those proJected in the approved proposal

N NA

.-
COMPLIANCE INDICATORS

1. Compare the proposal to the records of students served to date.

2.
-0 I
w

Is each handicapped adolescent student being provided with an educational program designed to meet the child's special educational needs?

3. Do all staff eqlloyed with VI-B

funds meet State Board of Edu- t

catlon standards?

I

4. Are the responslbilities of personnel funded through VI-B funds the same as described in the approved proposal?

1. Use sample of children from item 1.
2. Obtain case records to detennine if IEP's are developed for each identified child.
3. Note worksheet attached.
1. Obtain a list of certification and area of responsibl1ity of aP p~rsonnel paid fully or tn part wlth VI-B funds.
1. Compare i~fonmation obtained through interviews with the approved proposal personnel.

I

CCM4ENTS

EOWGIA __ ~ARTH[NT OF EDUCATION ,IVISION OF SPECIAL PHOGRAHS WOGWAH fOR XCfPTJOHAL CHILOPfN TITLE VI-B ~lfUHI~ DuCu~tNr, PSYCHOEDUCATIONAL CENTER ADOLESCENT PROGRAMS

CENTER DATE

RQUIIWtNTS I. EXPENDITURE/BUDGET
5. Are expenditures the same as indicated in the budget of the approved proposal?
0
-I
.::-

Y N NA

COMPLIANCE INDICATORS

1. Obtain requisition/purchase orders for all equipment and materials purehasedi compare with approved budget to determin~ if items purchased are the same as approved excepting a minor up ward or downward deviation due to 1nf1ation, shipping charges, etc., for a specific piece of equipment as long as the total amount is not in excess of lOX upward.
2. Obtain documentation through 1nterviews or review of records that all staff budgeted have been e~ 1oyed.
3. Obtain documentation through interviews and record review that contracted services, travel, and other expenses are the sameas in the approved proposal budget.

6. If equipment has been disposed of, has the agency followed the procedures outlined 1n General Provisions Regulations a~d has approval from the SEA been obta1ned1

1. Review copies of correspondence with the SEA requesting approval to dispose of equi~nent and a copy of the approval letter sent to the agency.

COMHEHTS
-

EO"GIA ._PARTH(NT Of EOUCATION
II VISION OF SPECIAL PHOGRAHS UOGUAM fOR [XCfPTIONAL CHILOPFN TITLE VI-B ~lJUMJNG DUCUMtNT. PSYCHOEDUCATIONAL CENTER ADOLESCENT PROGRAMS

CENTER DATE

RQUIWtfNTS I. EXPENDITURE/BUDGET
5. Are expendi tures the same as indicated in the budget of the approved proposal?
0
-I
.t:-

Y N NA

COM- PLIANCE
I~OICATORS

1. Obtain requisition/purchase orders for all equipment and materials purchased. compare with approved budget to detenminE if items purchased are the same as approved excepting a minor up ward or downward deviation due to inflation, shipping charges, etc., for a specific piece of equipment as long as the total amount is not in excess of lOX upward.
2. Obtain documentation through interviews or review of records that all staff budgeted have been efll)1oyed.
3. Obtain documentation through interviews and record review that contracted services, travel, and other expenses are the sameas 1n the approved proposal budget.

6. If equ1~ent has been disposed of, has the agency followed the procedures outlined 1n General Provisions Regulations a~d has approval from the SEA been obulnedl

1. Review copies of correspondence with the SEA requesting approval to dispose of equi~nent and a copy of the approval letter sent to the agency.

COMHENTS
-

:ORCIA DP~ ,A(NT OF EOUCATION

~'VOIGSIIMOMHfOORF

SPECIAL PROGRAMS EXCiPTlONAl CHILDRN

TITLE VI-B

JNIJUMIN~ DOCUMENT, PSYCHOEDUCATIONAL CENTER ADOLESCENT PROGRAMS

CENTER
DATE

RQUIRHfHTS

y N NA

COMPLIANCE INDICATORS

7. Is a P.L. 94-142 equipment inventory on file and kept up to date by the agency?
0
I
~
J1

1. Rev1 ew copy of the current equipment inventory.
2. Determine that property records provide for (1) list of equipment inclUding serial number and model if appropriate, (2) date our pur.. chase, (3) quan1ty or number received, (4) cost per unit, (5) and method of disposal, if appropri ate.
3. Review procedures which assure that all equipment purchased through proposal funds can be identified (e.g., labeling of equipment, coding, tracking listl 1nventory, etc.)

8. Are the materials and equipment purchased being used as described in the approved proposal?

1. Interview appropriate staff members to detenmine how materials and equipment are being utt11~ed.
~. Interview staff to determine if they are knowledqeable in the use of operation of the equipment.

9. Are profosal funds being utilized to proy de special education and related services?

1. Review the responsibilities of all personnel paid through proposa 1.

CCMtEfCTS

CEOUGIA DEPARTM(NT OF EOUCATION
DIVISION Of SPECIAL PROGRAMS PUOGWAM fOR EXCCPTIONAl CHIlOAfN TITLE VI-B MUNJ'UMINb OUCUMHT. PSYCHOEDUCATIONAL CENTER ADOLESCENT PROGRAMS

CENTER flATE

RQUlREHfHTS
o
(j\

. N NA

--
COMPLIANCE
I~OICATORS

2. Verify th.t .11 te.chers and te.chers .ides/p.r.professionals are directly involved in the special education program for eligible students. Attention should be paid to working hours, supervision, and assigned duties.
J. Review all project funded
personnel. For these individuals obtain a job description or other evidence of the emoloyee's duties. Oetenni ne the number of full time and part time employees. Interview with employee if necessary.

Fram the infonn.tton obtained. detennine if the administrative and clerical staff were necess.~ to carry out the proposal and the requirements of VI-B.

FrQII the infonn.tion-obt.ined

during the on-site visit and from

interviews with the project staff,

detenmine if the administrative

responsibilities. in your pro-

fessional judgment, warrant the

staff funded in the approved

,

project.

I

COMHENTS

~[OHGIA ,L1H....fM[NT OF rouCATlOH
HVISIOH Of SPECIAl. PROGIW1S
IUOGJcAM fOR UaPTlQNAl CHJlORfN TITLE VI-B IONITORING DOCUMENT, PSYCHOEDUCATIONAL CENTER ADOLESCENT PROGRAMS

CENTER
DATE

AEQUJIWtNTS

Y N NA

--
COHIll. ANCE INDICATORS

.-

10. Have VI-B funds been used to provide program availability to disturbed adolescents to all LEA's served by the center?
o
-I
'-J

1. Use sample of children from 1tell 1.
2. Interview administrator regarding referrals received from each LEA, students placed, students identified but awaiting placement and actions to be taken to identify eligible students if an inadequate number of referrals have been received from . an LEA.

III. LEAST RESTRICTIVE ENVIR~~MENT
11. Is the program housed in a fa-
cility which allows for interaction with non-handicapped youth? If not, is a comparable program available within the service IrM?

1. On-site visit to facility used by adolescent program.
2. Interview administrator regard. i ng LRL If facility does not meet LRE requirements, review steps being taken to relocate.

'COPItENTS

Appendix P Personnel and Health Insurance List

Fund Source
PERSONNEL AND HEALTH INSURANCE LIST

Center Fiscal Agent

.woo_

POSITION

Director

_ To be submitted with FY 84 proposal and October 20, 1983 Update as necessary and final list to be submitted June 14, 1984.

CERTIFICATE NO.

NO. OF

LEVEL OF AREA OF

YEARS

DEGREE CERTI FICAT ION CERTIFICATION EXPER.

ANNUAL SALARY

GRANT
Indicate System

APEG Source

PERCENT OF NO. OF MONTHS

TIME

CONTRACTED

STATE HEALTH INSURANCE

""'0 I