"Manifestation of Disabilities Determination Process for Students With Section 504 Plans" - Georgia (United States)

Manifestation of Disabilities Determination Process for Students With Section 504 Plans is a legal document that was released by the Georgia Department of Education - a government authority operating within Georgia (United States).

Form Details:

  • Released on August 1, 2018;
  • The latest edition currently provided by the Georgia Department of Education;
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Page background image
Type Name of School District Here
Manifestation of Disabilities Determination Process for Students with Section 504 Plans
S
1 – S
I
ECTION
TUDENT
NFORMATION
_______________________________________________
______________________
____________________
Student Name
GTID
Birthdate
___________________________________________________________
________
____________________
School
Grade
Today’s date
_____________________________________________________
__________________________________________________
Section 504 Qualifying Disability
Parent/Guardian
S
2 – M
D
R
G
ECTION
ANIFESTATION
ETERMINATION
EVIEW
UIDELINES
THIS MANIFESTATION DETERMINATION MUST OCCUR WITHIN 10 SCHOOL DAYS OF ANY DECISION TO CHANGE THE PLACEMENT OF
A CHILD WITH A DISABILITY DUE TO A VIOLATION OF THE CODE OF CONDUCT. The manifestation determination review is conducted
by child's parent and the relevant members of the child's Section 504 Team, as determined by the parent and the school system.
NOTE: A manifestation determination review is required only when a child is removed from his current placement for MORE THAN
10 SCHOOL DAYS to an interim alternative educational setting (IAES), another setting or via suspension, and for additional removals
of more than 10 cumulative days in that same school year for separate incidents of misconduct, and the removals constitute a
pattern. Schools may make such short-term removals for violations of a code of student conduct to the extent that such alternative
settings are also applied to students without disabilities. In addition, schools may remove a student to an IAES for not more than 45
school days without regard to whether the behavior is determined to be a manifestation of the child's disability in cases where a
child carries or possesses a weapon to or at school, on school premises or at a school function; knowingly possesses or uses illegal
drugs, or sells or solicits the sale of a controlled substance, while at school, on school premises, or at a school function; has inflicted
serious bodily injury upon another person while at school, on school premises, or at a school function.
S
3 – R
R
I
ECTION
EVIEW OF
ELEVANT
NFORMATION
Description of the behaviors for which the suspension/expulsion is being considered, including information
regarding the circumstances surrounding the incident or infraction, witnesses’ reports, student’s statement,
and any outstanding related/similar events that have not yet been addressed through disciplinary action.
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Page 1
Georgia Department of Education
Model Form | August 2018
Type Name of School District Here
Manifestation of Disabilities Determination Process for Students with Section 504 Plans
S
1 – S
I
ECTION
TUDENT
NFORMATION
_______________________________________________
______________________
____________________
Student Name
GTID
Birthdate
___________________________________________________________
________
____________________
School
Grade
Today’s date
_____________________________________________________
__________________________________________________
Section 504 Qualifying Disability
Parent/Guardian
S
2 – M
D
R
G
ECTION
ANIFESTATION
ETERMINATION
EVIEW
UIDELINES
THIS MANIFESTATION DETERMINATION MUST OCCUR WITHIN 10 SCHOOL DAYS OF ANY DECISION TO CHANGE THE PLACEMENT OF
A CHILD WITH A DISABILITY DUE TO A VIOLATION OF THE CODE OF CONDUCT. The manifestation determination review is conducted
by child's parent and the relevant members of the child's Section 504 Team, as determined by the parent and the school system.
NOTE: A manifestation determination review is required only when a child is removed from his current placement for MORE THAN
10 SCHOOL DAYS to an interim alternative educational setting (IAES), another setting or via suspension, and for additional removals
of more than 10 cumulative days in that same school year for separate incidents of misconduct, and the removals constitute a
pattern. Schools may make such short-term removals for violations of a code of student conduct to the extent that such alternative
settings are also applied to students without disabilities. In addition, schools may remove a student to an IAES for not more than 45
school days without regard to whether the behavior is determined to be a manifestation of the child's disability in cases where a
child carries or possesses a weapon to or at school, on school premises or at a school function; knowingly possesses or uses illegal
drugs, or sells or solicits the sale of a controlled substance, while at school, on school premises, or at a school function; has inflicted
serious bodily injury upon another person while at school, on school premises, or at a school function.
S
3 – R
R
I
ECTION
EVIEW OF
ELEVANT
NFORMATION
Description of the behaviors for which the suspension/expulsion is being considered, including information
regarding the circumstances surrounding the incident or infraction, witnesses’ reports, student’s statement,
and any outstanding related/similar events that have not yet been addressed through disciplinary action.
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Page 1
Georgia Department of Education
Model Form | August 2018
Type Name of School District Here
Manifestation of Disabilities Determination Process for Students with Section 504 Plans
Administrator Observations/Comments
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Parent Observations/Comments
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Teacher Observations/Comments
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Page 2
Georgia Department of Education
Model Form | August 2018
Type Name of School District Here
Manifestation of Disabilities Determination Process for Students with Section 504 Plans
☐ Yes
☐ No
Section 504 Plan reviewed as part of the MDR?
A.
Functional Behavior Assessment conducted? ☐ Yes ___________________
☐ No
B.
(date)
C. Behavioral Intervention Plan in developed? ☐ Yes ____________________
☐ No
(date)
If yes:
i.
Enter date the BIP was most recently reviewed: _________________________
(date)
☐ Yes
☐ No
ii.
Is the behavior in question related to behavior addressed in the BIP?
S
4 – M
D
T
D
ECTION
ANIFESTATION
ETERMINATION
EAM
ECISION
Based on the review of the relevant information about the student, what is the consensus of the members of the team
regarding the following:
A. Did the student’s disability have a direct and substantial relationship to, or cause, the behavior subject to
☐ Yes
☐ No
disciplinary action?
B. Did the LEA’s failure to implement the student’s Section 504 plan directly result in the behavior subject to
☐ Yes
☐ No
disciplinary action?
If the answer to either question is YES, the conduct IS a manifestation of the child’s disability
If the answer to both questions is NO, then the conduct IS NOT a manifestation of the child’s disability.
----------------------------------------------------------------------------------------------------------------------------------------------------------------
☐ The Team determined that both questions #1 and #2 were answered “NO”.
The behavior is considered NOT a MANIFESTATION of the student’s disability.
☐ The Team determined that either question #1 or #2 was answered “YES”.
The behavior MUST be considered a MANIFESTATION of the student’s disability.
Page 3
Georgia Department of Education
Model Form | August 2018
Type Name of School District Here
Manifestation of Disabilities Determination Process for Students with Section 504 Plans
S
5 – RESULTS OF THE ABOVE DETERMINATION
ECTION
• If the behavior IS a manifestation, the student
may not
be suspended. The Section 504 Plan must be
reviewed and modified, as appropriate, to address the appropriate behaviors.
• If the behavior IS NOT a manifestation, the student may be disciplined in the same manner as students
who are not disabled are disciplined.
• If the parents disagree with the determination that the behavior was not a manifestation of the
student’s disability, or disagree with the placement decision, parents may file a grievance with the LEA,
file a complaint with the Office of Civil Rights, or seek whatever judicial relief may be available.
MDR Team Signatures:
__________________________
__________
__________________________
__________
Parent/Guardian
Date
Teacher
Date
__________________________
__________
__________________________
__________
Parent/Guardian
Date
Teacher
Date
__________________________
__________
__________________________
__________
Student
Date
Resource Officer
Date
__________________________
__________
__________________________
__________
Section 504 Coordinator
Date
Nurse
Date
__________________________
__________
__________________________
__________
Administrator
Date
School Psychologist
Date
__________________________
__________
__________________________
__________
School Counselor
Date
Other
Date
Page 4
Georgia Department of Education
Model Form | August 2018
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