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    • Early Intervention and Special Education Services
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    Interagency Rates Committee – Forms

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    • ​FY 2021 Budget Application FormExcel link to FY 2021 Budget Application Form
    • FY 2021 Lease/Mortgage SummaryExcel document link to FY 2021 Lease/Mortgage Summary
    • FY 2021 Levels of Intensity Score SheetWord document link to FY 2021 Levels of Intensity Score Sheet
    • FY 2021 Program Description FormWord document link to FY 2021 Program Description Form
    • FY 2021 Budget Identification FormWord document link to FY 2021 Budget Identification Form
    • FY 2021 Staffing Pattern GridExcel document link to FY 2021 Staffing Pattern Grid
    • FY 2021 IRC Forms ChecklistWord link to FY 2021 IRC Forms Checklist
    • FY 2021 Treatment Foster Care - Difficulty of Care ComputationWord document link to FY 2021 Treatment Foster Care - Difficulty of Care Computation
    • FY 2021 Treatment Foster Care and Foster Care Medically Fragile Programs Board Rate ComputationWord document link to FY 2021 Treatment Foster Care and Foster Care Medically Fragile Programs Board Rate Computation

    Last Update: 11/04/19


    Contact Information

    Interagency Collaboration Branch - IRC
    Maryland State Department of Education
    Division of Early Intervention and Special Education Services
    Attention: Karen M. Powell, MS, LCSW-C, Section Chief
    200 West Baltimore Street
    Baltimore, MD 21201
    Phone: 410-767-0233
    Fax: 410-333-0298
    Email: karen.powell2@maryland.gov
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    Interagency Rates Committee

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