IDENTIFICATION
SCHOOL
FIRST NATIONPRINCIPAL
SPECIAL EDUCATION CONTACT
Address
Telephone
Fax
Amount of FNESC/FNSA Special Education Program (SEP) Funding allocated to your school/community
Throughout this document, Special Education Program funding provided to your school by FNESC/FNSA is referred to as SEP funding.
Refer to the Special Education Program Funding Handbook for a description of this funding and for instructions on how to complete the workplan/reporting form.
TABLE OF CONTENTS
SECTION PAGE NUMBER(S)
Section A: General Information 3-6
(must be filled out by all schools)
Section B: Needs Not Met 7
(must be filled out by all schools)
Section C: Student Assessment 8
Section D: Early Intervention Programs/Activities 9-10
Section E: Individual Student or Small Group Programs/
Services 11-12
Section F: School Wide or Large Group Programs/
Services 13-14
Section G: Professional Development 15-16
Section H: Summary Budget 17
Part A: General Information (must be completed by all schools)
Please provide total numbers for each category.
1.Total number of students in the school funded by First Nations / INAC (on Nominal Roll)2. Total number of High Cost Special Needs students in the school funded by First Nations / INAC (on Nominal Roll)
ASSESSMENTS / Number
3. Total number of students referred for assessments to determine the
need for Special Education Services this year.
4. Total number of students referred but not yet assessed this school year.
5. Total number of students assessed this school year.
6. Total number of students with a current assessment on file prior to this school year.
INDIVIDUAL EDUCATION PLANS (IEP) / Number
7. Total number of students that have an individual education plan and received special education services this school year.
8. Of the students identified in number 7
a) How many students received high cost special education services at this school for the first time
(i.e. new special education programs)?
b) How many students received high cost special education services at this school in the previous school year (ie. Continuing programs)?
9. How often were IEP’s reviewed during the year?
Please indicate the number of IEP’s in each category, ensuring that the total corresponds to the answer in question number 7.
a) Every three months
b) Twice per year
c) Once per year
d) Not reviewed
10. What Indicators of Success can you report on the IEP Process for High Cost SEP for this school year?
Please put the number of students in each category.
100% / 75% / 50% / 25% / NONE
(a) Degree of achievement of objectives set for all students with an IEP this school year.
11. STAFFING FOR HIGH COST SPECIAL NEEDS STUDENTS / Number
a) Total number of certified teachers in the school
b) Total number of qualified special education teachers in the school.
c) Total number of teachers enrolled in special education certified training
d) Total number of para-professional workers in the school
(Please indicate the number in each category which should add up to the total number of paraprofessionals.)
i) One on one (paraprofessional/ student)
ii) Groups (more than one child but not a whole class)
iii) Whole class
e) Total number of para-professional workers enrolled in certified training in a field related to Special Education.
f) Total number of teachers who engaged in at least one of the professional development activities listed below in question number 12.
g) Total number of paraprofessionals who engaged in at least one of the professional development activities listed below in question number 12.
12. SPECIAL EDUCATION PROFESSIONAL DEVELOPMENT:
What professional development specific to special education was/will be made available to teachers, para-professionals and other people working
in special education this year?
Type of training
/ Yes / NoIn-school training
WorkshopsConferences
University / College Courses
Coaching / Mentoring
Other:
None
13. PROFESSIONAL SERVICES: Please indicate which special education professionals will provide/provided services to your school and who their employers are.
SERVICES PROVIDED
/EMPLOYER
Type of Service
/ Assessment / Intervention / Ongoing / First Nation / FNESC/FNSA / Provincial School SystemSpecial Education Teacher
Para-professionalPsychologist
Speech/Language Pathologist
PhysiotherapistProfessional Counseling
Occupational Therapist
Psychometrician
Dietician
Ophthalmologist/Optometrist
Medical Diagnostician
Assistive DevicesSupported Technology
Other
13. Networking: What other agencies does the school collaborate with to provide support and a service to high-cost special needs students and their families?
Agencies
/In the community
/ Outside communityChild and Family Services
/Social Services
/Health Services
/Social Assistance
/Day Care
/Head Start
/First Nations Organizations.
(please list) /Provincial Education Ministries
/Support / Advocacy Organizations
/Interagency organizations
/Other (please specify)
/
Section B: Needs Not Met
This section refers to the school’s inability to provide appropriate service to special needs students due to a lack of funds/resources.
Is/Was your school able to provide appropriate services to all of the special education students?
YES NO If no, please fill out the following table.
Please indicate the number of students if you are describing multiple students with similar needs. Photocopy additional pages if required.
Description of individual student & their needs / Assessment (informal or formal) / Reason(s) for lack of service / Estimated Cost of Service / Provincial Funding Equivalent (see handbook for $ amount)Eg. 1 student who has cerebral palsy, is multiple disabled, and has high needs. He also has many medical needs. This student has attended the public school since Kindergarten. His parents would like him to attend our school and be with his siblings and friends. / Assessment by specialist □
Assessment by FNESC staff □
Teacher observation/screening □
Medical Diagnosis X
No Assessment □
Other______/ $ for hiring staff (ie TA’s, teachers etc.) X
$ from capital (ie wheelchair ramp, modification on building for wheelchair) X
Transportation □
Programs X
Professional Development □
Other______□ / $ __$70000______
$ __$5,000______
$ ______
$ _$5000______
$ ______
$ ______/ $30,000
Eg. There are 9 students in grades 1,2, & 3 who are not reading at their grade level. The staff at the school felt it was important to prioritize the support and placed services with the behaviourally challenged students that presently attend the school. / Assessment by specialist X
Assessment by FNESC staff □
Teacher observation/screening X
Medical Diagnosis □
No Assessment □
Other______□ / $ for hiring staff (ie TA’s, teachers etc.) X
$ from capital (ie wheelchair ramp, modification on building for wheelchair) □
Transportation □
Programs X
Professional Development X
Other______□ / $ ___$40,000______
$ ______
$ ______
$ ___$5,000______
$ ___$3,000______
$ ______/ $28,188
(9x$3,132)
Assessment by specialist
Assessment by FNESC staff
Teacher observation/screening
Medical Diagnosis
No Assessment
Other______/ $ for hiring staff (ie TA’s, teachers etc.)
$ from capital (ie wheelchair ramp, modification on building for wheelchair)
Transportation
Programs
Professional Development
Other______/ $
$
$
$
$
$
Assessment by specialist
Assessment by FNESC staff
Teacher observation/screening
Medical Diagnosis
No Assessment
Other______/ $ for hiring staff (ie TA’s, teachers etc.)
$ from capital (ie wheelchair ramp, modification on building for wheelchair)
Transportation
Programs
Professional Development
Other______/ $
$
$
$
$
$
SECTION C: STUDENT ASSESSMENT
This section refers to assessments for students. For staff training in this area, see section G.
Will any students from your school be assessed within the school or at another location? YES NO
If yes, continue to fill out the assessment component of this report. If no, go to section D.
1. Budget for Assessment
Assessment(s) Description
/Total Cost $
/ $ SEP Funding / $ Gathering Strength Special Education Funding / $ Other Funding Used / Source(s) of Other Funding (if applicable)e.g. 3 psychoeducational assessments / $4500 / $3500 / $1000 / School Core budget
e.g. purchase CTBS tests / $1000 / $500 / $500 / 0 / N/A
Total amount of SEP funding to be used for assessments
Total amount of Gathering Strength Special Education Funding
Total amount of other funding to be used for assessments
SECTION D: EARLY INTERVENTION PROGRAMS/SERVICES
Will your community/school operate any Early Intervention Programs or Services? YES NO
If yes, fill out the Early Intervention component of this report. If no, go to section E.
1. Early Intervention Programs/Services
Description of Program/Service(Output) / Participants/People Served / Results Expected
(Outcomes) / Indicators of Results
(Performance Indicators) / Data Source/Collection Method
e.g. Will Provide a 2-day community awareness symposium about FAS/FAE. A consultant from the FAS/FAE support network will provide strategies. Meals/transportation will be provided for community members. / 100 / i. Increased community awareness of FAS/FAE
ii. Anticipate a decrease in FAS/FAE / i. 100 out of possible 150 will attend
ii. Anticipate fewer diagnoses of FAS/FAE in the longterm / i. registration sign in numbers (attendance)
ii. Fewer referrals for FAS/E assessment/diagnoses, and fewer diagnoses
Budget for Early Intervention Programs/Activities (include any staff training in the Professional Development Section G)
Total Cost $
/ $ SEP Funding / $ Gathering Strength Special Education Funding / $ Other Funding Used / Source(s) of Other Funding (if applicablee.g. FAS/FAE Symposium
/ Materials: food $1500, handouts $300Staff: Consultant $1500
Other: transportation $200 / $2000 / $1000 / $500 / $500 / First Nation
(name)
Materials:
Staff:
Other:
Materials:
Staff:
Other:
Materials:
Staff:
Other:
Materials:
Staff:
Other:
Total Amount of SEP funding
Total amount of Gathering Strength Special Education Funding
Total amount of other funding
SECTION E: INDIVIDUAL STUDENT OR SMALL GROUP PROGRAMS/SERVICES
Will your community/school operate any Individual Student or Small Group Programs or services? Please refer to the handbook for an explanation of this section. YES NO
If yes, fill out the Individual Student or Small Group component of this report. If no, go to section F.
1.0 Individual Student or Small Group Programs/Services (Please add additional pages if necessary)
Description of Program/Service(Output) / Participants/People Served / Results Expected
(Outcomes) / Indicators of Results
(Performance Indicators) / Data Source/Collection Method
e.g. Student with hearing impairment received regular speech/language services / 1 / - improved communication skills
- improved social interaction with peers / - student will engage in classroom discussions more often
- student will engage in play with peers on the playground / - anecdotal report from teacher/staff
- improvements in report card
2.0 Budget for Individual Student/Small Group Programs/Services (Please add additional pages if necessary, and include any staff training in the Professional Development Section G)
Program/Service / Budget /Total Cost $
/ $ SEP Funding / $ Gathering Strength Special Education Funding / $ Other Funding Used / Source(s) of Other Funding (if applicable)e.g. .25 Speech and Language Pathologist / Materials/Equipment:
Staff: $15,000
Other: / $15,000 / $15,000 / 0 / 0 / N/A
Materials/Equipment:
Staff:
Other:
Materials/Equipment:
Staff:
Other:
Materials/Equipment:
Staff:
Other:
Materials/Equipment:
Staff:
Other:
Total Amount of SEP funding :
Total amount of Gathering Strength Special Education Funding :
Total amount of other funding :
SECTION F: SCHOOL WIDE OR LARGE GROUP PROGRAMS/SERVICES
Will your community/school operate any School Wide or Large Group Programs or Services? Please refer to the handbook for a description of this section. YES NO
If yes, fill out the School Wide or Large Group component of this report. If no, go to section G.
1.0 School Wide or Large Group Programs/Services (Please add additional pages if necessary)
Description of Program/Service(Output) / Participants/People Served / Results Expected
(Outcomes) / Indicators of Results
(Performance Indicators) / Data Source/Collection Method
e.g. Implement a school wide Open Court reading program (K-6) / 50
students / i. Increase in reading levels
ii. Anticipate improvements in all subject areas
iii. Inclusion of behaviour disorder students / i. 70% of students reading at grade level
ii. Anticipate incr. in CTBS scores
iii Anticipate decrease in office referrals of behaviour disorder students / i. school – Woodcock Johnson reading test
ii. school – CTBS test results
iii. school data organization system
1.0 Budget for School Wide or Large Group Programs/Services (please add additional pages if necessary, and include any training costs in the Professional Development Section G)
Program/Service / Budget /Total Cost $
/ $ SEP Funding / $ Gathering Strength Special Education Funding / $ Other Funding Used / Source(s) of Other Funding (if applicable)e.g. Open Court Program / Materials/Equipment: $9000
Staff:
Other: / $9000 / $9000 / 0 / 0 / N/A
Materials/Equipment:
Staff:
Other:
Materials/Equipment:
Staff:
Other:
Materials/Equipment:
Staff:
Other:
Total Amount of SEP funding :
Total amount of Gathering Strength Special Education Funding :
Total amount of other funding :
SECTION G: PROFESSIONAL DEVELOPMENT
Will your community/school provide any Professional Development opportunities with SEP funding? YES NO
If yes, fill out the Professional Development component of this report. If no, go to section H.
1.0 Activities/Workshops/Training
Description of Activity/Workshop/Trainingand Location (Output) / # of Participants / # of days for the Activity / Results Expected
(Outcomes) / Indicators of Results (Performance Indicators) / Data Source/Collection Method
e.g. In-service for staff re: Individual Education Plans
In school / 10 / 1 / Staff more knowledgeable about I.E.P.s / Anticipate increase in student I.E.P.s / School # of IEP’s before and after
e.g. workshop for parents: stimulating oral language development in the home / 15 / 1 / Parents will have increased awareness of oral language development / Parental participation in workshop / School – attendance record of workshop
2.0 Budget for Activities/Workshops/Training
Activity/Workshop/Training
/Total Cost $
/ $ SEP Funding / $ Gathering Strength Special Education Funding / $ Other Funding Used / Source(s) of Other Funding (if applicable)e.g. Individual Education Plan In-Service / $500 / $500 / 0 / 0 / N/A
e.g. Oral Language Development workshop for parents / $2000 / $1000 / $1000 / 0 / N/A
Total Amount of SEP funding :
Total amount of Gathering Strength Special Education Funding :