Regional Collaborative Network (RCN)

2017-2018 Contract Progress Report Packet

According to the terms of the START Contract for Purchase of Regional Collaborative Network Services for 2017-2018, each RCN isrequired to submit two contract progress reports:

  1. Mid-Year Report:Due February 2, 2018
  2. Completed RCN Report Form
  3. Updated RCN Contract Requirements Worksheet
  4. Trainings Report Form
  5. Trainers Report Form
  6. Capacity Building Planning Tool
  7. Peer to Peer Support Program Log
  8. Financial Expenditure Report
  9. Mid-year Invoice (if payment is sought)
  1. End of Year Report: Due July 13, 2018
  2. Completed RCN Report Form (including SupplementalEnd of Year Narrative)
  3. Final RCN Contract Requirements Worksheet
  4. Trainings Report Form, Trainers Report
  5. Capacity Building Planning Tool
  6. Peer to Peer Support Program Log
  7. Financial Expenditure Report
  8. Final Invoice

Full report with required documents may be submitted by:

  • Dropbox: Your RCN’s Dropbox, in the START Contract Information/Mid-Year and End-of-Year folder
  • Email:
  • US Mail: GVSU - Autism Education Center, 401 W. Fulton – 388C DEV, Grand Rapids, MI 49504

RCN Contract Report Form

Report Date:

RCN Name:

RCN Contact Completing Report:

Phone:

Email:

Overall Progress on RCN Contract Goals:

Ahead of schedule

On schedule, as expected

Behind schedule – Explain:

Required Attachment:

Completed START RCN Contract Requirements Worksheet (verified as accurate as of the date of report submission)

RCN Financial Status:

On target for utilization of all contract funds

Expect underutilization of contract funds in the amount of $

Required Attachments:

Financial Expenditure Report

Invoice for reimbursement of outstanding expenditures to date

OR

No payment is being sought at this time

GOAL #1 - Professional Development (PD) with Impact:

  • Develop and implement a PD plan in collaboration with START-Approved trainers.

Trainings:

We have teams participating in START Intensive Training this year – complete table

We do not have teams participating in START Intensive Training this year

Level of Training / # Teams / # Participants / # Parents Attending / # Students Attending / ISDs sending teams For (Multi-County RCN only)
Early Childhood / NA / NA
K-12 / NA
Building Your Future

Total number of Mini IT series

(NOTE: Mini IT is defined as 3 or more training sessions attended by teams and delivered by START approved trainers using START content modules.)

Total number of other START Trainings presented by your RCN summarized from the RCN Trainings Report Form

Trainers:

Total # of ACTIVE Level 1 Trainers

(i.e. START approved trainers providing training in the current school year)

Total # of ACTIVE Level 2 Trainers

(i.e. RCN-approved trainers who present with Level 1 Trainers and provide specific implementation examples)

Required Attachments:

Completed RCN Trainers Report Form

Completed RCN Trainings Report Form

List Professional Development with Impact goals from the RCN grant application and briefly report progress on goals:

RCN Training Goals/Plans/Activities / Progress

GOAL #2 - Coaching for the Implementation of Evidence-Based Practices

  • Identify at least 2K-12 target students for single-county RCN, or at least 1 target students from each ISD within your RCN for multi-county RCN, with whom you will implement the IEP Implementation Coaching Checklist.

AND

  • Identify additional target students and/or buildings to complete the USAPT for a total of four data sets for single-county RCN, and a total of two data sets per ISD/RESA/LESA for multi-county RCN.

Target Student Data:For EACH K-12 Target Student with whom you are implementing the IEP Implementation Coaching Checklist listed on the START RCN Contract Requirements Worksheet*please verify:

Mid-Year:

Yes, the Baseline K-12 Target Student data has been submitted onlinefor all target students.

If no, please identify the target student for whom data has not been submitted online and explain the circumstances preventing entry of this data:

End of Year:

Yes, the End of YearK-12 Target Student data has been submitted onlinefor all target students.

If no, please identify the target student for whom data has not been submitted online and explain the circumstances preventing timely entry of this data:

*If your target student has changed since you completed your Contract Requirements Worksheet, and you have not already done so, please notify the START office at

USAPT data: For EACH building completing the USAPT, listed on the START RCN Contract Requirements Worksheet* please verify:

Mid-Year:

Yes, the USAPT data has been submitted onlinefor all buildings.

If no, please identify the building that has not submitted its USAPT online and explain the circumstances preventing entry of this data:

End of Year:

Yes, the USAPT data has been submitted onlinefor all buildings.

If no, please identify the building that has not submitted its USAPT online and explain the circumstances preventing entry of this data:

*If your USAPT building(s) has changed since you completed your Contract Requirements Worksheet, and you have not already done so, please notify the START office at

Coaching Data (as detailed in the Capacity Building Tool):

Number of Coach Leaders in RCN

Number of Building Coaches in RCN

Number of Buildings with coaches in RCN

Number of Buildings completing the USAPT

Number of Buildings using the IEP Implementation Coaching Checklist

Required Attachment:

START Capacity Building Tool, updated for each ISD/RESA/LESA

List Coaching for the Implementation of EBP goals from the RCN grant application and briefly report progress:

RCN Training Goals/Plans/Activities / Progress

GOAL #3 - Secondary Transition

  • Identify at least 4 transition-age target students* for employment or post-secondary education focus and use of the START V3 discovery processOR identify at least 3 transition-age target students* for employment or post-secondary education focus and use of the START V3 discovery process AND utilize the Michigan Autism Council transition & Adult Services Committee Recommendations and the Secondary Transition Recommendations Implementation Checklist with at least 1 program to set goals for program improvement.

AND

  • Plan and complete at least 2 Community Conversations through your RCN, OR plan and complete 1 new Community Conversation AND demonstrate substantial follow-up for 1 or more previous Community Conversations that shows defined goals and includes families.

Target Student Data: For EACH Transition Age Target Student with whom you are implementing the V3 Discovery Process, as listed on the START RCN Contract Requirements Worksheet*, verify:

Mid Year:

Yes, the Secondary Transition / BYF Target Student data has been submitted onlinefor all target students.

If no, please identify the student for whom data has not been submitted and explain the circumstance preventing timely entry of that data:

End of Year:

Yes, the End of Year Secondary Transition / BYF Target Student data has been submitted onlinefor all target students.

If no, please identify the student for whom data has not been submitted and explain the circumstance preventing timely entry of that data:

# of Teams completing V3 Discovery Process with their Target Student

*If your target student has changed since you completed your Contract Requirements Worksheet, and you have not already done so, please notify the START office at or your START RCN Representative.

Program Data: If you used the Michigan Autism Council Transition & Adult Services Committee Recommendations and the Secondary Transition Recommendations Implementation Checklist with at least 1 program to set goals for program improvement, list:

ISD / District / Program / Contact Name and Email

Community Partners and Community Conversations:

# of meetings / trainings with community partners, (describe)

# of Community Conversations held

# of Community Conversations with substantial follow up

Name of Communities that Participated
in a Community Conversation / Lead Facilitators / # of Participants
Name of Communities that Participated
in a follow up to a previous Community Conversation / Lead Facilitators / Follow-up activities (describe briefly)

List Secondary Transition goals from the RCN grant application and briefly report progress:

RCN Secondary Transition Goals/Plans/Activities / Progress

GOAL #4 - Peer to Peer Support Programs

  • Establish a comprehensive peer to peer support program in at least 3 new buildings in the RCN Region

AND

  • Use the START Peer to Peer Fidelity Tool to strengthen and expand existing peer to peer support programs in at least 1 building.

Peer to Peer Support Program Data (*as reflected in the most current Peer to Peer Support Program Log):

Total number of districts with Peer to Peer Support Programs in place

Total number of buildings with a Peer to Peer Support Program in place

Total number of Peer to Peer Support Programs in place

Elementary:

# of Elementary Peer to Peer Support Programs

Middle School:

# of Middle School Peer to Peer Support Programs

# of Middle School Peer to Peer Support Programs offered for credit

High School:

# of High School Peer to Peer Support Programs

# of High School Peer to Peer Support Programs offered for credit

K-12 (Academy/Charter):

# of K-12 (Academy/Charter) Peer to Peer Support Programs

# of K-12 (Academy/Charter) Peer to Peer Support Programs offered for credit

Center-Based:

# of Center-Based Peer to Peer Support Programs

# of Center-Based Peer to Peer Support Programs offered for credit

# of NEW Peer to Peer programs established in 2017-2018*

(*since completion of 2016-2017 End of Year Report)

Total number of students with ASD participating in Peer to Peer Programs

Total number of Peer Mentors/LINKS participating in Peer to Peer Programs

Name(s) of district(s) and building(s) that used the Peer to Peer Fidelity Tool

Required Attachment:

Peer to Peer Support Programs Log (updated for each ISD/RESA/LESA)

List Peer to Peer Support goals from the RCN grant application and briefly report progress:

RCN Peer to Peer Goals/Plans/Activities / Progress

GOAL #5 - Family and Community Engagement

  • Utilize START Passports and Passport Resources with families and students with ASD. The goal is to implement the Passport across grade levels with as many families and students as possible while maintaining the integrity and fidelity of the Passport process.

AND

  • Increase parent and family involvement in RCN, particularly family members involved in local autism/disability organizations and community organizations.

AND

  • Invite and actively involve parent mentors from Michigan Alliance for Families (MAF) in regular RCN meetings and planning for RCN contract.

Passport Data: List the number of Passports actively used* with students and their families:

Name of ISD/District / RCN Contract worksheet goal / # used with
students and families

*“Actively Used” means that the Passport was presented to the family and the family and school team actively engaged in goal setting and planning.

Parent and Family / Community Involvement:

How many times did a parent representative attend your RCN meetings?

How many times did a parent mentor from Michigan Alliance for Families (MAF) attend your RCN meetings?

If the MAF parent mentor or another parent attended, were they regularly on the meeting agenda?

Yes

No

If you did not have a parent representative or a MAF representative attend, please describe the barriers to participation.

List Family and Community Engagement goals from the RCN grant application and briefly report progress:

RCN Family Engagement Goals/Plans/Activities / Progress

In what way(s) has START and the RCN made a significant impact on programming for students with ASD in your region?

Provideat least two of the following about your RCN:

  • Interesting and important facts or data
  • Story or mini case study of how START/RCN training, supports, and interventions has created a significant improvement for a student and/or their family. (Please change names for confidentiality or obtain permission)
  • Information on a success story or product (e.g. news article, awards) from your RCN that supports implementation of evidence-based practices.
  • Contribution to START newsletter, leadership day, or conference breakout
  • Other unique or impactful information you wish to share

1

RCN:

Mini IT Training Series Report Form - (2017-18 AY)
ISD/District Hosting / Topic / Training Date / # of Teams Attending / Total # Attendees / Length of Training / Trainers / # of Parents
Name of Districts / ISDs Participating in Mini IT
Other RCN Trainings (2017-18 AY)
ISD/District / Topic / Training Date / Number Attended / Length of Training / Trainers Involved

1

EPLI LEVEL 1 TRAINER SUMMARY

RCN Name: School Year:

Level 1 Trainer Name / Approved Module Areas
Ed strategies
Behavior support / Active for current academic year
Yes/No / Level 1 report* form completed
Yes/No

*Each Active EPLI Level 1 Trainer is required to complete an individual EPLI Level 1 Trainer Report to maintain their START approval. This Report Form is available on the START Website and as Appendix A to this Report Form

EPLI LEVEL 2 TRAINER SUMMARY

RCN Name: School Year:

Level 2 Trainer Name / Expertise /
Focus Area / Recommended by
two Level 1 Trainers
(list names) / RCN
Approval Date

1

Appendix A

Submit to RCN Representative

Mid-Year (February 2) and End-Year (July 13) Reports

EPLI Level 1 Individual Trainer Report

Name of Trainer: Position: Employer:

Report all trainings conducted with START materials EXCEPT those trainings conducted through the RCN as mini IT or other ongoing
team-based trainings. These trainings are reported using a separate document and do not need to be recorded here.

Training Date / Module / Section(s) / District / # Participants Attended / Length of Training / Co-Trainer(s)

1