RCN Application and Contract Forms

If you have any questions, or need assistance, please contact your START RCN Representative or Jana Benjamin, (616) 331-6482. Thank you for your leadership and everything you do to improve supports for students with ASD in Michigan.

Please note: This page will be updated regularly as forms and links become available.

RCN Updates

RCN Leadership Days

Notice about Data Collection, Goal-Setting, and Mid-Year Reporting (January 20, 2021):

The ongoing COVID-19 public health crisis and resulting remote/hybrid teaching and learning environments continue to pose unique challenges to collecting accurate program and student data. As with much this year, flexibility is necessary. Accordingly, START offers the following guidance to assist RCN in gathering and submitting beginning of year target student and/or classroom/program data to the best of the RCN’s ability under the prevailing circumstances and conditions in their geographic area. If you have any questions, or need assistance, please contact your START RCN Representative or Jana Benjamin, (616) 331-6482.

Target Student Data

  • Ideally, beginning of year baseline data is collected in the fall, and submitted by December 1 to provide several months for teams to implement strategies and for students to demonstrate progress. Of course, students can, and often do, demonstrate meaningful progress over shorter time periods. Particularly with the unique challenges of the current school year, it is important that data demonstrating such progress not be lost. Therefore, for any target student with whom you are using the IEP Implementation Coaching Checklist, or the START V3 Discovery Process, and for whom you were unable to collect data previously, you may collect and submit baseline target student data through February 15, 2021, with end of year data to be collected in May.

Program/Systems Data and Goal-Setting

  • Those classrooms/programs using the CETA-R/CETA-ROR, the Secondary Transition Recommendations Implementation Checklist, or the Peer to Peer Fidelity Checklist to set goals for improvement and report progress, and who were unable to complete the process of setting goals by January 1, 2021 due to circumstances related to the pandemic, may set goals by February 15, 2021 and report progress at the end of the year.

Peer to Peer Program Log

  • Programs that were active and running as of the March 2019 COVID-19 school closure, but which were suspended or limited by the impact of COVID-19 on their districts during the current 2020-2021 school year, should be reported as “Active” with the actual number of students participating this year indicated (even if that number is less than would be expected under typical circumstances). An explanation of the impact of COVID-19 on program operation (e.g., “fewer students participating due to COVID-19 limitations or restructured learning environments,” “program limited to __ students/grade levels”, or “suspended for the current year due to COVID-19”, etc.) should be added in the “Notes to START about data” section of the Peer to Peer Program log. Programs should be designated as not active (even if there were no students participating this year) ONLY if the reason they are not running is unrelated to the impacts of COVID-19 on school operation.
    • START has added a short version of this paragraph to the sample RCN P2P Data Collection Google Form available in the Options for Collecting ISD-Wide Peer to Peer Data document. RCNs may wish to add the following to their own P2P Data Collection Google Form or other tools for collecting Peer to Peer Program Data:
      • Any program limited or suspended because of COVID-19 should be reported as active, with the actual number of students involved during this school year (even if that number is 0). A note of explanation (e.g., “fewer students participating due to COVID-19 limitations,” “program suspended because of COVID-19,” etc.) should be included in “Notes to START about data.” Programs should be reported as not active ONLY if the reason they are not running is unrelated to COVID-19.

The START Project recognizes that data collection may be negatively impacted by the ongoing COVID-19 public health crisis and resulting remote/hybrid teaching and learning environments and/or school closures. START is committed to working with each RCN to submit required data to the best of the RCN’s ability under the circumstances present in their respective locations.

2020-2021 Reports and Applications

Reports 

Forms

Due Date

2020-2021 RCN Application

June 30, 2020

2020-2021 Contract Requirements Worksheet

October 26, 2020

Beginning of Year Target Student Reporting Form

December 15, 2020

2020-2021 Mid-Year Progress Report

February 1, 2021

End of Year Target Student Reporting Form

May 28, 2021

2020-2021 End of Year Progress Report

July 16, 2021

Financial Information

Planning and Running Effective RCN Meetings

  • Use the RCN Pacing Guide as a schedule to help guide you through the RCN Contract year. It includes important activities, data collection, and reporting by month.

Contract & Reporting Requirements by Priority Area

View the full 2020-2021 RCN contract priorities here. 

This section is currently being updated for 2020-2021

Priority Area #1: Professional Development (PD) with Impact

Tools to Support Goals

START Training Curricula

EPLI Trainer Application and Reporting Tools

Goal Requirements: 

  • Develop and implement a PD plan in collaboration with START-approved trainers and include coaching follow-up to ensure implementation of training content. This PD plan:
    • May include: 
      • Team(s) attend a START Intensive Training series.
      • RCN Trainers offer an intensive, team-based training series similar to the START Intensive Training (e.g., a “mini IT”) with a target student focus and/or a focus on the classroom level using the Classroom Environment and Teaching Assessment-Revised (CETA-R/CETA-ROR).
      • RCN- or ISD-level training on an evidence-based practice such as differentiating output, behavior support strategies, self-management, or data collection with coaching follow up for implementation fidelity.
      • Targeted trainings at building team meetings, staff meetings, or grade level meetings with coaching follow up for implementation fidelity.
    • And must: 
      • Include at least one RCN-provided stand-alone training per semester using START content delivered by START EPLI trainers, which will be included in the events listing on the START website, and will be open to the RCN and the broader region; and
      • Ensure there is an active trainer for each of the four EPLI modules, and include a plan to recruit and prepare new EPLI trainers if the RCN needs additional trainers.

Specific Reporting Requirements and Forms

Priority Area #2: Coaching for Implementation of EBP

Tools to Support Goals

IEP Implementation Coaching Checklist and Process Tools

Coaching Tool Kit

Individual Student Data Collection Forms: Engagement, Independence & Social (required for the K-12 Target Student Data Form)

CETA-R/CETA-ROR

Goal Requirements

  • Establish/Sustain a coaching structure at the district and ISD level with coach leaders and building coaches
  • Single County RCN (4 data sets)
    • 2 target students using the IEP Implementation Coaching Checklist AND
    • 1-2 additional target students using the IEP Implementation Coaching Checklist OR 1-2 CETA-R/CETA-ROR
  • Multi County RCN (2 data sets per ISD)
    • 1 target student using the IEP Implementation Coaching Checklist AND
    • 1 additional target student using the IEP Implementation Coaching Checklist OR 1 CETA-R/CETA-ROR

Specific Reporting Requirements & Forms

  • Mid-Year/End of Year Contract Progress Report
  • Capacity-Building Tool (submitted with EOY reports)
  • K-12 Target Student Reporting Form
    • If your RCN Target Student is the focus student for a START Intensive Training Team, you will enter the Target Student data using the Intensive Training data link (emailed to the team from the START office). Please make a note on the RCN Contract Worksheet that your RCN Target Student is part of a START Intensive Training team. 
  • CETA-R/CETA-ROR: Complete by January 1 and set goals; data submitted with EOY report

Priority Area #3: BYF – Secondary Transition

Tools to Support Goals

V3 Discovery Checklist and Process Tools

Michigan Autism Council Secondary Transition Recommendations Checklist

Goal Requirements

  • 2 data sets per RCN
  • 1 target transition-age student using V3 Discovery AND 
  • 1 additional target student using V3 Discovery OR 1 secondary transition program evaluation using the Michigan Autism Council Transition and Adult Service Committee Recommendations Checklist

Specific Reporting Requirements & Forms

  • Mid-Year/End of Year Contract Progress Report
  • BYF Target Student Reporting Form
    • If your RCN Target Student is the focus student for a START Intensive Training Team, you will enter the Target Student data using the Intensive Training data link (emailed to the team from the START office). Please make a note on the RCN Contract Worksheet that your RCN Target Student is part of a START Intensive Training team. 
  • Secondary Transition Recommendations Checklist (if used to meet contract requirements) (submitted with EOY report)

Priority Area #4: Peer to Peer Support Programs

Tools to Support Goals

Peer to Peer Support Resources

Peer to Peer Fidelity Checklist

Peer to Peer Log Instructions

Peer to Peer Community of Practice Responsibility Checklist

Peer to Peer Data Package Summary for PPII Sites

Options for Collecting ISD-Wide Peer to Peer Log Data

Goal Requirements

Specific Reporting Requirements & Forms

  • Mid-Year/End of Year Contract Progress Report
  • Completed Peer to Peer Fidelity Checklists (submitted with EOY Report)
  • Completed PPII site data set (submitted with EOY Report)
  • Updated Peer to Peer Support Program Log (submitted with MY Report)

Priority Area #5: Family & Community Engagement

Tools to Support Goals

Passport

START Parent Information

Family and Community Engagement: RCN Guidance Document

Self-Advocacy 

Goal Requirements

  • Disseminate the Passport to school staff for use with families
  • Use START Engaging Families Guidance, Self-Advocacy resources and START Passport with 3 families/students, with 1 family/student conducting a self-advocacy presentation at an RCN meeting
  • Develop a plan to get meaningful input from, and provide information to, parents/families
  • Invite and involve MAF at least 1 RCN meeting relevant to families
  • Support attendance at the START Conference for at least two parents who are involved with your RCN or ISD

Specific Reporting Requirements & Forms

  • Mid-Year/End of Year Contract Progress Report

Priority Area #6: Optional RCN Activities

Tools to Support Goals

Individual Student Data Collection Forms: Engagement, Independence & Social (required for the K-12 Target Student Data Form)

CETA-R/CETA-ROR

V3 Discovery Checklist and Process Tools

Michigan Autism Council Secondary Transition Recommendations Checklist

Peer to Peer Support Resources

Peer to Peer Fidelity Checklist

Community Conversation Resources

Goal Requirements

  • Additional Priority 2 Target Students, Classrooms, or Buildings:
    • Additional target student(s) using the IEP Implementation Coaching Checklist
    • Additional CETA-R(s)/CETA-ROR(s)
  • Additional Priority 3 Secondary Transition Target Students or Programs:
    • Additional target student(s) using V3 Discovery
    • AND/OR Additional secondary transition program evaluation using the Michigan Autism Council Transition and Adult Service Committee Recommendations Checklist
  • Additional Priority 4 Peer to Peer Programs or Fidelity Tool Data:
    • Additional new or significantly expanded peer to peer support program(s)
    • AND/OR Additional Peer to Peer Fidelity Checklist(s)
  • Peer to Peer Regional Coach/Coordinator
  • Community Conversation
    • Plan and hold a new Community Conversation related to RCN contract priorities (e.g., secondary transition, peer to peer support, collaboration with community providers, or family engagement)
    • AND/OR Substantial follow-up from a prior Community Conversation
  • Other approved activities furthering RCN Contract Priorities

Specific Reporting Requirements & Forms

  • Mid-Year/End of Year Contract Progress Report
  • CETA-R/CETA-ROR
  • Secondary Transition Recommendations Checklist (submitted with EOY report)
  • Completed Peer to Peer Fidelity Checklists (submitted with EOY Report)
  • K-12 and BYF Target Student Data Forms

Page last modified February 1, 2021
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