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.


Do you have any questions related to RCN contract funds or data in response to the school closure? Visit the RCN FAQ page for answers to your questions


2020-2021 Reports and Applications

Reports

Form

Due Date

2020-2021 RCN Application

June 30, 2020

2019-2020 Reports and Applications

Reports 

Forms

Due Date

Beginning of Year Target Student Reporting Form

October 25, 2019
(Collected by October 14, 2019)

2019-2020 Contract Requirements Worksheet

October 28, 2019

2019-2020 Mid-Year Progress Report

February 3, 2020

End of Year Target Student Reporting Form

May 29, 2020
(Collect after April 13, 2020)

2019-2020 End of Year Progress Report

July 17, 2020


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

Priority Area #1: PD with Impact

Goal Requirements

  • Develop & implement a PD plan with START-approved trainers
    • Participate in START IT
    • Mini IT
    • Single Trainings
  • Submit at least one PD per semester to post on the START website

Specific Reporting Requirements and Forms


Priority Area #2: Coaching for Implementation of EBP

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 
    • OR 1-2 USAPT
  • 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
    • OR 1 USAPT

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: Complete by January 1st and set goals; data submitted with EOY report
  • USAPT: Complete by January 1st and set goals; data submitted with EOY report

Priority Area #3: BYF – Secondary Transition

Goal Requirements

  • 3 data sets per RCN
  • 1 target transition-age students 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

Goal Requirements

Specific Reporting Requirements & Forms

  • Mid-Year/End of Year Contract Progress Report
  • Completed Peer to Peer Fidelity Checklists (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 Info Portal

Goal Requirements

  • Utilize the passport with families
  • Involve families and MAF in RCN meetings
  • 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

Goal Requirements

  • Additional Priority 2 Target Students, Classrooms, or Buildings:
    • Additional target student(s) using the IEP Implementation Coaching Checklist
    • AND/OR Additional CETA-R(s)
    • AND/OR Additional USAPT(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
  • USAPT
  • 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