DSET referral form - Redmond School District

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Redmond School District Student Effectiveness Team (D-SET) Referral
The District Student Effectiveness Team (D-SET) is a collaborative problem solving
team for students eligible for Special Education in the Redmond School District.
D -SET may be utilized for the following purposes:
1. Consultation/assistance on intervention techniques/strategies for individual
students.
2. Brainstorm options for discussion at IEP meetings.
3. Access possible district Special Education program alternatives.
D-SET meets every Tuesday afternoon from 1:30-3:00.
Meetings will be scheduled for thirty minute time periods.
D- SET is comprised of the following members:
 District SET facilitator
 School Psychologist
 Counselor
 Relevant school staff
D- SET Procedures:
1. The D-SET process is initiated through an informal discussion with the case
manager and the school psychologist regarding student concerns and/or possible
placement needs. If placement is a concern a discussion will be held regarding
interventions being implemented in the least restrictive environment. If sufficient
data supports the potential need for a more restrictive environment a D-SET will
be scheduled. If sufficient data does not exist, the resident school will need to
explore additional interventions in the existing placement.
2. If sufficient data exists to indicate a need for a more restrictive environment, the
student may be referred to D-SET. The referring school must initiate a
conversation with the D-SET facilitator, with regard to possible outcomes and to
determine the school program representatives needed to attend the D-SET
meeting (e.g. school administrator, counselor, special education teacher,
representative of juvenile justice, etc.) The D-SET facilitator will invite the
participants. It is preferred to invite one or two representatives that have
knowledge of the student’s individual needs and interventions that have been
implemented, as well as data on student progress. It is important that the school
representatives have completed a thorough review of student records prior to the
meeting.
3. The resident school is responsible for completing the attached D-SET referral
form. In addition to the referral form, the resident school is responsible for
attaching copies of pertinent educational information such as: current IEP,
behavior intervention plan, psychological report, progress reports, discipline data,
and safe school report.
4. If the outcome of the D-SET meeting is that a student would benefit from a
different program in the district it is the responsibility of the student’s case
manager to schedule an IEP meeting at another date to discuss the options and
complete the necessary forms. The D-SET meeting is not to be used as an IEP
meeting. Remember only the IEP Team may initiate a change in program and
placement.
District SET Referral information:
Date of referral: ___________
Referred by: ________________________ IEP: Yes or No
Student:____________________ Grade:__________________ School:____________________
DOB:______________________ Eligibility:_______________ Case Manager:_______________
Parent(s):________________________________________ Phone:________________________
Present Concerns:
1–
2–
3–
Have these concerns been discussed with the school psychologist? ____________
(this must occur prior to a D-SET referral).
Does the student have a DSM IV diagnosis? Yes/No
If yes, please state: ______________________________________________________________
What building/community resources have been utilized (mental health, FAN, etc.)?
Identify the student’s strengths.
What building level special education services and/or specially designed instruction has occurred
for this student?
Describe interventions and results that have been implemented within the classroom or building
to address the specific behaviors of concern.
Attachments to include:
 Current Individual Education Plan (IEP) or Personal Education Plan (PEP)
 Most recent psychological report
 Behavior Intervention Plan
 Other pertinent information: (i.e., medical, functional behavioral assessment, discipline
referral data, class schedule, progress reports, etc.)
Desired District SET outcome:
____1. Problem solve more strategies/interventions to utilize with student
____2. Discuss access into a specific district program
 District Elementary Behavior Program (Options)
 District Middle School Behavior Program (Options)
 Regional Behavior Intervention Center (BIC)
 Empower Program – MS/HS self-contained program– located at Brown
 Home tutoring
 ABA
 Other
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