Educable Child (2023-2024)

Before student applications can be accepted, the school must file the necessary documentation with the Mississippi Department of Education (MDE) Educable Child Program and be approved as a private school facility. 

If our office can be of assistance, please contact Janika Cheers at 601-359-3498.

1. Educable Child Procedures

2. Private School Approval Application 

• Directions
• School Approval Application
• School Calendar
• Data Sheet Instructions
• Data Sheet
• Certification Update
• Assurances

3. Educable Child Approved Facilities

4. Student Application and Reimbursement and Due Dates

5. Applications

(The entire application package must include the forms or reports as listed. Applications must be the latest revised version posted for the 2023-2024 school year.)

School District

1. Public School District Application for Financial Assistance when placing a student with a disability in a private school/facility(DI-SE-F10) - (Yellow)
2. A copy of the child’s current Determination of Eligibility and a copy of the current Evaluation Report (ER)
3. A current Individualized Educational Program (IEP) developed in accordance with regulations
4. Reimbursement Forms 1st-5th PP (5A)
   • First Pay
   • Second Pay
   • Third Pay
   • Fourth Pay
   • Fifth Pay

Parent

1. Parent/Guardian Application for Financial Assistance when placing a child with a disability in a private or parochial school (D1-SE-F11) - (Green)
2. A copy of the child’s current Determination of Eligibility and a copy of the current Evaluation Report (ER)
3. A current Educable Child Form for Parentally-Placed Students
4. Reimbursement Form
   • First Pay $600                  First Pay $1000
   • Second Pay $600            Second Pay $1000
   • Third Pay $600                Third Pay $1000
   • Fourth Pay $600              Fourth Pay $1000
   • Fifth Pay $600                 Fifth Pay $1000

Parent-Medicaid

1. Application for Financial Assistance (SDE-BSS-F11) - (Blue)
2. A copy of the child’s current certification by Division of Medicaid which specifies the requirement for inpatient care in an Intermediate Care Facility for the Intellectual Disability (ICF-ID) or Psychiatric Residential Treatment Facility (PRTF) and the period for inpatient care
3. A copy of the child’s current Determination of Eligibility and a copy of the current Evaluation Report (ER)
4. A current Educable Child Form for Parentally-Placed Students
5. Reimbursement Forms

• First Pay
• Second Pay
• Third Pay
• Fourth Pay
• Fifth Pay

Mississippi Department of Human Services (DHS)

1. Application for Financial Assistance (DI-SE-F68) - (Pink)
2. A copy of the child’s current Determination of Eligibility and a copy of the current Evaluation Report (ER)
3. A current Individualized Educational Program (IEP) developed in accordance with regulations
4. Current (within one year) court order/legal document which grants custody of the child to the MS Department of Human Services or other State Agency
5. Reimbursement Forms
   1. First Pay
   2. Second Pay
   3. Third Pay
   4. Fourth Pay
   5. Fifth Pay

6. Invoice Form

7. Drop/Placement Form

8. Semi-Annual LEA Visit to Non-Public School

9. Travel Reimbursement Directions

• Travel Reimbursement Request Example
• Travel Reimbursement Request
• SharePoint Instructions

10. Rate Letter 2023-2024

NOTE: Forward all forms and reports to the Mississippi Department of Education, Office of Special Education, Attention: Educable Child Program, P.O. Box 771, Suite 301, Jackson, MS 39205. Faxed copies will not be accepted.