MPS allows Itinerant Mental Health services (therapy, case management, life skills, etc.) in the school setting when there is an educational benefit for the student, as determined by parent and school staff.
Below is an agreement that overviews responsibilities for MPS and the Itinerant Mental Health Provider Agency (Agency) regarding services provided to students in MPS buildings.
Policies, Liability and Safety
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Agency will conduct criminal background checks on all staff who have direct contact with MPS students on MPS property in accordance with
MPS policy
.
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Agency will maintain comprehensive general liability insurance, including coverage for death, bodily or personal injury, property damage, and liability coverages, with limits of not less than $1,500,000 each claim and $1,500,000 each occurrence. Agency may meet the limits above $1,000,000 per occurrence through umbrella/excess coverage.
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Agency will comply with all
MPS policies
and state/federal laws regarding student data privacy.
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Agency must immediately notify the MPS Mental Health Team at
mental.health@mpls.k12.mn.us
and Judy Brown
judy.brown@mpls.k12.mn.us
of any investigations, disciplinary action, or disruptions in licensure of any employee who actively meets with a student in an MPS building.
Release of Information and Consent to Meet with Student
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Agency will obtain parent/guardian consent to meet with student and obtain private student data using the
Itinerant Mental Health Provider ROI and Consent Form
and follow MPS processes for accessing student data. Consent forms are valid for the current school year only. Obtaining parent/guardian signed consent is the responsibility of Agency staff; MPS staff will not obtain this consent.
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Agency understands that MPS can withhold individual student data from organizations that do not provide valid reason to access data.
Scheduling Meetings with Students
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Agency staff will provide the following when requesting to meet with student in school:
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Copy of this signed Agency Agreement
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Copy of signed ROI/Consent Form
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Valid Photo Identification (State ID or Agency ID/work badge)
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Agency staff will follow each school’s process for requesting to meet with a student; meetings should take place at a time and frequency directed by School Staff and should not significantly interfere with a student’s educational program.
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Meetings are limited to one hour visits and one time per week.
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Due to space limitations, timing, staffing limitations or other considerations, schools may not be able to accommodate agency staff visits.
Responsibility
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Agency understands that it is not hired by MPS; no MPS funds are used for payment to see students.
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Agency understands that this Agreement must be renewed annually and that
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MPS has the right to revoke this agreement at any time.
Terminating Access
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MPS reserves the right to terminate meeting access without notice or cause to any individual as deemed necessary.
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If an Agency employee is deemed to be a risk or threat the Agency must immediately contact MPS Emergency Management & Safety at 612-668-0322.
By signing this agreement, Agency agrees to follow the processes and guidelines outlined above. Authorized Agency signer will share a copy of this signed agreement with individual providers who are covered under the agreement.
Note: A copy of your completed form will be emailed to you upon submission. Please ensure that your employees/representatives have a copy of the completed form as they will be asked to show it when they check in at a school building.