School Readiness Specials Needs Rate Request

School Readiness Special Needs Rate Application

One application per child
Please review the entire application. Supporting documentation must be collected before starting a application. Applications cannot be saved and submitted at a later date.
The Early Learning Coalition of Sarasota County is committed to ensuring access to inclusive early learning environments for children with special needs enrolled in the School Readiness (SR) Program. The Special Needs Rate (SNR) provides an enhanced reimbursement rate to eligible providers to support the additional resources, staffing, and accommodations required to meet the documented needs of eligible children.

Child Eligibility

A child may be considered for SNR if the child:

Is actively enrolled in the School Readiness Program; and has at least one qualifying document on file, including:
- Individualized Family Support Plan (IFSP)
- Individualized Education Program (IEP)
- Therapy or evaluation report
- Documented physical, mental, emotional, or behavioral diagnosis
Provider Eligibility

Provider must be contracted with the ELC for School Readiness and must submit the SNR request on behalf of the child. Parent or legal guardian consent is required.
- Documentation of the child’s diagnosis and any accommodations that exceed ADA requirements must be submitted to the Early Learning Coalition (ELC) to justify this rate.
- Documentation must be completed by a licensed health, mental health, education, or social service professional who is not the child’s parent or an employee of the provider.
- ELC staff will conduct periodic quality checks to verify service delivery.
- This application must be re-submitted when qualifying documentation expires.
- Eligible diagnoses may include, but are not limited to: Autism Spectrum Disorder; Deaf or Hard of Hearing; Developmental Delay; Dual Sensory Impairment; Emotional or Behavioral Disability; Intellectual Disability; Language Impairment; Orthopedic Impairment; Physical Therapy needs; Specific Learning Disability; and Traumatic Brain Injury, Visual Impairment, etc.
Name of person completing this form*

First NameLast Name
Email address of person completing this application.*
example@example.com
Provider ID*
DEL Provider Portal identification number
Provider Business Name*
(example: ELC Learning Center)
Provider Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Child's Name*

First NameLast Name
Child's Date of Birth*

MonthDayYear
Date
Upload a copy of the child's current IEP, IFSP or other official documentation to the link below. Eligibility requires a documented physical, mental, emotional, or behavioral condition verified by a licensed health, mental health, education or social service professional other than the child's parent or person employed by the child care provider.

Click here to Upload Documentation
Developmental DelayAutism Spectrum DisorderDeaf or Hard of HearingDual Sensory ImpairmentEmotional or Behavioral DisabilityIntellectual DisabilityLanguage ImpairmentOrthopedic ImpairmentPhysical TherapySpecific Learning DisabilityTraumatic Brain InjuryVisual ImpairmentOther
If other is selected please explain.
Please provide a list of accommodations established, that exceed ADA requirements, to support the child in the classroom. Accommodations should be categorized within in each of the five domain areas below. Not all domains are required for approval. If you plan to offer any additional services, please include those as well.

Domain Areas:
• Curriculum and Learning Environment
• Social and Emotional Behavior
• Independent Functioning
• Health Care
• Communication

You’ll need to open the form, download it to your computer, complete it, digitally sign it, and upload it.

Accommodation Request Form
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The parent consent form follows a different protocol. You’ll need to open the form, download it to your computer, print it, then have parent/guardian handwrite answers and sign, then scan and upload it.

Parent / Guardian Consent Form
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Under Rule 6M-4.500(7), Florida Administrative Code, a child care provider may be reimbursed by the coalition at a higher rate if caring for any SR child with special needs requiring additional care beyond services required by the Americans with Disabilities Act (ADA). To receive a special needs rate, the provider must submit a list of services it is providing to each child with special needs, in addition to the routine school readiness services. The rate may be negotiated up to twenty percent (20%) above the established coalition reimbursement rate for infant care . The rule further clarifies that the child’s condition requiring a special needs rate must be validated by a licensed health, mental health, education, or social service professional other than the child’s parent or person employed by the child care provider.
If you have any questions about the special needs differential for school readiness children, please contact Lorrie Young at 941-954-4830 x 226 or lyoung@elcsarasota.org
Digital Signature- By signing this application, I confirm that the information provided is accurate and complete to the best of my knowledge and agree to update The Early Learning Coalition of Sarasota County if there are any changes in the child's diagnosis or attendance.*
Should be Empty:

School Readiness Special Needs Rate Application

Please review the entire application. Supporting documentation must be collected before starting a application. Applications cannot be saved and submitted at a later date.