Student Intervention Team 20 Cook Street, Room 10 San Francisco, CA 94118 (415) 750-4500 fax (415) 750-8653 ERMHS (Educationally Related Mental Health Services) REFERRAL PROCESS Who is Eligible? Mental health services are available to any student in special education (with an active IEP) who is determined to need mental health assistance in order to access his/her education. There is no cost to parents for mental health services written into the student’s IEP. Who Should be Referred? Students eligible for ERMHS mental health services generally have these characteristics: Emotional/behavior symptoms that adversely affect the student’s educational performance Symptoms that cannot be defined solely as a behavior disorder or a temporary adjustment problem The student’s level of functioning (including cognitive) is at a level sufficient to enable them to benefit from mental health services When Should I Refer? An ERMHS referral can be made by members of the IEP team when a student in special education needs mental health services to help them in the educational environment. Certain things should be considered prior to making a referral: The school needs to have implemented interventions with this student for at least 12 weeks. These interventions can include: counseling services, parent counseling and training, social work services, psychological services (please call your SIT contact with any questions). If the student’s special education eligibility is emotional disturbance and the student is demonstrating emotional/behavioral characteristics that impede academic performance, the IEP team can make an immediate referral. The school can make an immediate referral if the behavioral/emotional needs are impacting academics and the student cannot be served at the school site (consult with you SIT contact person). How do I make a referral? A member or members of the IEP team fills out the referral form and obtains the appropriate signatures. For a referral to be accepted for review, all items listed below must be included: Written response to each question contained within ERMHS Referral Form (pages 1-4) Student’s most recent annual IEP, and any relevant addendums with signature page and parent’s/ educational rights holder’s signature Student’s most recent Psycho-Educational/Speech Language Report Other items that are useful for the referral: We highly encourage the school sites to connect with the parent/caregiver to fill out page number 5 of the referral –Observed Child Behaviors Checklist (to be completed by the parent/caregiver) Other relevant information that may support the need for service (e.g. recent report cards, etc.) Where is the Completed Referral Packet Sent? Return the entire referral packet via SFUSD interoffice mail to: Student Intervention Team 20 Cook Street San Francisco, CA 94118 QUESTIONS: PLEASE CONTACT THE STUDENT INTERVENTION TEAM 750-4500 10/1/11