The Molalla River School Dístrict (MRSD) is supported by the Columbia Regional Inclusive Services program (CRIS) for low incidence dísabilities for students that are deaf, hard of hearing, blind, or have low vision. ln order to access these services, MRSD must complete a referral to Columbia Regional Program including documentation of the student's disability that warrants eligibility. Please follow the referral procedure from Columbia Regional detailed here. 

Blind and Visually Impaired Student Referral Information

• We have a new Student Referral Form. 

• If you suspect that a student will be eligible for special education under the category of Visual Impairment (VI):

  1. Obtain a medical eye report completed by an optometrist or ophthalmologist. This report should inlude diagnosis and acuities, and should be included with the referral. CRP's eye report form is recommended. 

  2. Complete a CRP Student Referral Form.  

  3. For a student moving in with an existing VI eligibility, please include the move-in eligibility form and IEP.

  4. Fax or mail the completed referral and eye report to CRP.

     • Fax: 503-916-5576

     • Mail: Columbia Regional Program - 833 NE 74th Ave. - Portland, OR 97213

• When CRP receives the referral:

  1. CRP contacts the person who submitted the referral.

  2. The referring district or agency convenes the evaluation planning meeting to obtain parent consent to evaluate. A teacher of the visually impaired (TVI) is available upon request to assist with evaluation planning. 

  3. Under procedures/tests, the consent to evaluate should list:

     • Functional Vision Assessment: To determine how a child uses vision in functional, everyday tasks. Used to determine educational impact and guide IEP planning.

     • Learning Media Assessment (for children age 3 and up): To determine the student's primary learning/literacy medium.

  4. The TVI conducts the assessment(s).

  5. The referring district convenes a meeting to review evaluation results, determine eligibility, and write/amend the eligible student’s IEP.

• FREQUENTLY ASKED QUESTIONS REGARDING REFERRALS FOR BVI SERVICES

• • Q. What are the requirements to establish eligibility under Vision Impairment and receive regional BVI services?

  • A. There are three conditions that must be met to establish eligibility under VI.

    1. One or more of the following medical criteria:

• • • The student’s residual acuity is 20/70 or less in the better eye with correction.

    • The student’s visual field is restricted to 20 degrees or less in the better eye.

    • The student has an eye pathology or a progressive eye disease which is expected to reduce acuity to 20/70 in the better eye or reduce visual field to 20 degrees or less in the better eye.

    • The assessment results of a licensed ophthalmologist or optometrist are inconclusive, and the student demonstrates inadequate use of residual vision

• • 1. The team determines that the child's disability has an adverse impact on the child's educational performance.*

    2. The team determines that the student needs special education services including specially designed instruction to address the educational impact of the visual impairment.

• • • *"Adverse impact" is determined differently depending upon the age of the student. For students in kindergarten through age 21, the student’s disability has an adverse impact on the student’s educational performance. For children age three up to kindergarten, the student's disability has an adverse impact on the child’s developmental progress.

• Q. Who is responsible for obtaining the medical eye report?

• • A. The referring district, program or ESD is responsible for obtaining and submitting the medical eye report along with the CRP referral. The eye report is necessary to complete the VI eligibility determination.

•  Q. Can the standard Medical or Health Assessment Statement or Medical Condition Statement be used for VI evaluations and to establish eligibility?

• • A. Not by itself. The Medical or Health Assessment Statement or Medical Condition Statement provides very limited information and lacks the details necessary (e.g.: diagnosis, acuity) for determining eligibility.

• Q. What can I do to ensure that we obtain the eye report in a timely manner?

• • A. Here are some tips:

    • Obtain a signed release of information from the parents as soon as possible between the medical eye care provider and Columbia Regional Program.   Some providers (like Casey Eye/OHSU and Kaiser) require that you use their own release of information form.

    • Call first and ask if clinic has specific process for requesting reports.

    • Consent form should include the name of the clinic and/or specific doctor who is releasing this information.

    • Fill out the form carefully; requests are likely to be denied if parts of the request are incomplete.

    • Consent form should include releasing information to the district or program and Columbia Regional Program.

    • Include the child’s date of birth.

    • Submit the request for the medical eye report right away. Turn-around times vary by clinic.

• Q. Do you have a list of contacts for eye health care professionals in the community?

• • A. We don’t maintain a provider list. EI/ECSE agencies have lists of providers, and families can check with the primary care provider, insurance provider, or do an online search.

• Q. What kind of evaluations do we need to do an eligibility for a vision impairment?

• • A. The Teacher of the Visually Impaired (TVI) will conduct a Functional Vision Assessment for children of all ages. The Teacher of the Visually Impaired (TVI) will additionally conduct a Learning Media Assessment for children age three and older.

• If you have additional questions, contact Kate Dilworth kdilwort@pps.net or call 503.916.5570 ext. 78243

Deaf and Hard of Hearing (DHH) Student Referral Information

• We have a new Student Referral Form. 

• When referring students to request an evaluation to determine eligibility under Hearing Impairment (HI), you must include a copy of a current audiogram with the referral.

• When requesting an audiological evalution (only available to children aged birth-to-five), you must provide documentation of two failed hearing screenings.

• To initate services from a teacher of the deaf/hard of hearing for a student with an existing HI eligibility, you must submit a copy of the current HI eligibility statement with the referral, a copy of the current IEP or IFSP, and (if available) a copy of a current audiogram and medical or health assessment statement.

• Fax or mail the completed Student Referral Form and required documents to:

  • Fax: 503-916-5576

  • Mail: Columbia Regional Program - 833 NE 74th Ave. Portland, OR 97213

• FREQUENTLY ASKED QUESTIONS REGARDING DHH REFERRALS

• (in development)

• If you have additional questions, contact Stephanie Corvi scorvi@pps.net or call 503.916.5570 ext. 78317