Santa Barbara County SELPA
Special Education Local Plan Area …….A Joint Powers Agency
Request for Program Transfers and/or Services
Program Transfer Plan
Part 1 – Identification
Date of Request:
Name of Receiving Agency (new site):
Effective Date of Student Transfer:
Name of Sending Agency (existing site):
Part II – List Type of Programs and/or Services (or Students) being
Transferred:
A. Description of Program:
Number of:
Staff
Students
B. If partial transfer of program, list type of program and services
remaining:
SELPA51A 7-16-2013 (E)
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Santa Barbara County SELPA
Special Education Local Plan Area …….A Joint Powers Agency
PART III - Complete and attach or insert below a detailed plan for the program transfer
that complies with Section 56207(a) (1) thru (7) and other procedural safeguards.
(See Checklist and Below)
Instructions: Include in each section of the narrative the effect of the proposed transfer on
both students being transferred and students remaining in the current program, if any students
are remaining. Respond to examples only where they are applicable.
1. Pupil needs (Section 56207 (a) (1))
Examples:

Make a list of affected pupils, DOR, and impact of proposed changes in providing FAPE for
each student;

A plan to ensure students will receive assessment and evaluation to determine ongoing IEP
needs and continued eligibility;

A plan to account for the implementation of child find.
2. Continuum of Services (Section 5607 (a) (2))
Examples:
 Continuation of the current individualized education program for all affected students. The
number (FTEs) and qualifications of all certificated and classified staff providing related
services or designated instruction and services
3. Continuation of IEPs (Section 5607 (a) (3))
Examples:
 A plan for the implementation of each affected students’ IEP;
 If the proposed transfer involves a change in personnel or the site of service, the number
(FTEs) and qualifications of all certificated and classified staff providing specialized
instruction
4. LRE (Section 5607 (a) (4))
Examples:
 Contingency plans for providing placements or services other than those called for in the IEPs
of current pupils;
 What specific regional programs or MOU agreements with member LEAs are in place that will
be available to serve students who cannot be served by the proposed program configuration;
 What opportunities for participation in the general education class and curriculum are
available.
5. IEP Support Services (Section 5607 (a) (5))
Examples:
 Number (FTEs) and qualifications of support staff. Examples include:
• Psychologists
Speech/Language Specialists
• Program specialists
Adapted Physical Education Specialists
 Availability of indirect support services. Examples include:
• Financial services
• Administrative support
 The continuation of appropriate transportation services;
 The continuation of appropriate inter-agency agreements;
6. Assurance Statement (Section 5607 (a) (6))
Examples:
 Sending and receiving LEAs have met and agreed upon proposed program transfer;
 An assurance statement indicating the needs of all affected pupils with IEPs will be met.
SELPA51A 7-16-2013 (E)
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Santa Barbara County SELPA
Special Education Local Plan Area …….A Joint Powers Agency
7. Parent and Staff Involvement (Section 5607 (a) (7))
Examples:
 How will you involve a representation of parents of all affected students and staff in the
planning process?;
 The number of public meetings to which parents were invited and attended;
 The number of parents attending meetings;
 How and to whom invitations were transmitted;
 Evidence (such as minutes or agendas) that the information requested in numbers 1, 2, and 3
were discussed during those meetings;
 Special and non-special education staff (such as teachers, administrators, and classified staff)
who might be affected by the transfer in the planning process.
8. Equipment
Examples:
 Transfer of assistive technology or low-incidence equipment.
9. Facilities
Examples:
 The availability of physical therapy facilities or other specially modified facilities, if
appropriate;
 The square foot of instructional space per student.
Part IV - Procedural Safeguards Checklist.
This part serves as notification and assurance that the program transfer has been completed
with appropriate procedural safeguards.
IEP team meetings have been held for each affected student and IEPs have been completed
reflecting the new program operator and any change in program configuration.
Inter-agency agreements have been completed with all appropriate non-educational agencies.
Signing this document is an affirmation that this process has been completed and assures that
agreements are in place for students to receive services specified in their IEPs that are the responsibility
of non-educational agencies.
Each LEA has complied with provisions of the Education Code, such as Section 44903.7, relating
to the rights of employees affected by the transfer.
PART V - Resolution of Disputes
If a dispute arises between the sending or receiving agency regarding the proposed transfer, the matter
shall be resolved by the alternative dispute resolution process established pursuant to Ed. Code Section
56207(c) and 56205 (5) (b). Either party may contact the SELPA Director and request a dispute
resolution conference as per the SBCSELPA Local Plan.
PART VI – Receiving Board Certification
This is to certify that the LEA school board listed below approved the following motions regarding the
proposed programs and/or services transfer, including students:
SELPA51A 7-16-2013 (E)
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Santa Barbara County SELPA
Special Education Local Plan Area …….A Joint Powers Agency
Receiving District/LEA
SELPA51A 7-16-2013 (E)
Date of Board Meeting
Superintendent’s Signature
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