Revocation of Services

Steps to follow when parent or adult student revokes consent for

Special Education services

General Information

• Parent/Guardian, or Adult Student, must make a request to withdraw consent for Special Education Services  in writing and date the request, (if unable to do so staff will assist).

Note: Attach Parent Withdrawal to PWN Document in PowerSchool IEP (PS IEP).

• When parent request is received the district responds in a timely manner (1-2 weeks) with a PWN. Contact Site Support for further information and/or questions.

• District staff completes a PWN document in PS IEP. Refer to the revocation PWN example to include critical components of PWN.

• Cease services for the student on date specifically stated in PWN.

• Complete and Finalize the PWN document in PS IEP. Attach withdrawal documentation received from parent. Send PWN to Parent/Guardian, or Adult Student.

Note: Revocation is not used if parent withdraws from Initial Assessments. A new Initial Assessment plan is completed and parent withdrawal is entered on signature page to stop the process.

Steps to complete the PWN In PS IEP

1. Check Proposal to initiate or change:
2. Check Other, enter a statement sample: ‘Parent revoking special education services’.
3. Check Parent/Guardian/Adult Student Requests Revocation of Services
4. Attach withdrawal documentation received from parent.
5. Complete the PWN Document (Refer to the revocation PWN example or last page for example PWN to include critical components of PWN.)

Finalize the PWN document.

Send PWN and Procedural Safeguards to Parent/Guardian, or Adult Student.

Revocation Refusal

If there is a case for refusal of revocation contact Site Support for further information and/or questions, before proceeding.

• Follow the same steps to complete PWN for refusal

Sample PWN

Transfer This Data to Revocation PWN in PowerSchool IEP

WRITTEN PRIOR NOTICE TO PARENT OF PROPOSED OR REFUSED ACTION

To the parents of  __________________________         DOB:  _____________     Date:  __________         

This notice is to inform you of the school district's decision not to initiate or change the identification, evaluation, or educational placement of your child.  Based on the information listed below, the district is proposing or refusing the following action:

(1)        Description of the action proposed or refused:

        The District acknowledges receipt of your written revocation of consent for special education and related services for your son/daughter, __(child’s name)___, dated ______.  The District proposes to honor your revocation of consent, and will cease providing special education and related services to _(child’s name)__ on _____(date).

2. Explanation for why the district is proposing or refusing to take the action described above:

Under the Individuals with Disabilities Education Act (“IDEA”) and its implementing regulations, upon receipt of your written notification revoking consent for special education and related services, the District must provide you with the prior written notice and may not continue to provide your child with special education and related services.        

 (3)        A description of any other options considered by the district and the reason(s) why those options were rejected:

State and federal laws and regulations provide protections and procedural safeguards for parents of students with disabilities.  A copy of a Notice of Procedural Safeguards is enclosed with this prior written notice.  By your revocation of consent for your child to receive special education and related services, these protections and procedural safeguards are no longer applicable to you and your child.  The services and modifications that were agreed to in your student’s most current IEP will no longer be available to your child.  Your child will not have any of the procedural safeguards available to students with disabilities in the event of any disciplinary action.  In addition, your revocation of consent releases the District from liability for providing a free appropriate public education (“FAPE”) for your child under the IDEA.  

4. A description of each evaluation procedure, test, record or report the district used as a basis for the proposed or refused action stated:

The District used ____ (review of records, assessments, report cards, standardized/informal tests, teacher and parent input, etc.) ___ in developing the most current IEP for your child.  The District offer of FAPE is ___(placement = SAI for ? hours, DIS services, BSP, etc.).  Your child will no longer receive these services and will be considered a general education student in every aspect of his/her school program, including discipline.        

 (5)        A description of any other factors relevant to the district’s proposal or refusal stated:

       At any time in the future, you may request a special education assessment of your child to determine his/her eligibility for special education services.  The assessment will be considered an initial assessment.

The protections under state and federal procedural safeguard provisions; including the right to file a complaint and/or request mediation or a due process hearing apply to students receiving services under IDEA.  Upon your revocation, these protections are not available to your child.  Refer to the enclosed NOTICE OF PROCEDURAL SAFEGUARDS for an explanation of these rights.  Contact the San Diego City School’s Office of the Ombudsperson at (619) 209-4594 or (619) 209-4595 for assistance in understanding your rights.  You may also contact the individual listed below if you would like further information or clarification of the proposed or refused action.

____________________________            ______________________________     ________________