Checklist for Assigned Mediator

WestVirginiaDepartmentofEducation

Office of Federal Programs

Checklist for Assigned Mediator

•Reviewassignmentmemorandumandrequestformediationinformation. Theassigned mediatorcontactsparties,byphoneorinwriting,toscheduletime,locationofthe mediation;andnotifybothpartiesandtheOfficeofFederalPrograms(OFP)ofthetime andlocationofscheduledmediation.

Assignmentpacketwillinclude:

√ Assignmentmemorandum

√ Requestformediation

√ BlankConfidentialityAgreementform

√ BlankMediationAgreement Form

√ BlankMediationConclusionWithoutAgreement Form

√ ProceduralSafeguards

•Conductmediationsession(s).

•Formsneededatmediationsession:

√ConfidentialityAgreement

√MediationAgreementform

√ Mediation(conclusionform without Agreement)

Aftermediation:ForwardtoLorraine ElswickatOFP.

•Invoiceforservicesrendered

•ConfidentialityAgreement

•CopyofMediationAgreementformsignedbypartiesor

•MediationConclusionWithoutAgreementform(concludedwithoutagreement)

WESTVIRGINIADEPARTMENTOFEDUCATION CONFIDENTIALITYAGREEMENT

To Be Completed At The Conclusion Of The Mediation Session

Student:______County:______

DateMediationFiled _DueProcessHearingDecisionDue_

Parent(s)'.______Parent'sCounsel:______Address:______Address:______

Phone:Phone:

SpecialEducationDirector:______LEA'sCounsel:______Address:______Address:______

Phone:Phone:

We,theundersigned,agreetothefollowing:

1) Themediator,theparties,andtheirattorneys(ifapplicable)agreethattheyareallstrictlyprohibitedfrom revealingtoanyone,including ajudge,dueprocesshearingofficerorarbitrator thecontentofanydiscussions whichtakeplaceduring themediationprocess. Thisincludesstatements made,settlement proposalsmadeor rejected,evaluations regardingtheparties,theirgoodfaith,andthereasonsaresolutionwasnotachieved,ifthat bethecase. This doesnotprohibit thepartiesfromdiscussing information, onaneed-to-know basis, with appropriatestaff,professional advisors,andwitnesses.

2) Thepartiesandtheirattorneys(ifapplicable)agreethattheywillnotatanytimebefore,duringoraftermediation, callthemediatororanyoneassociatedwiththemediatorasawitnessinanyjudicial,administrative,orarbitration proceedingconcerning thisdispute.

3) Thepartiesandtheirattorneys(ifapplicable)agreenottosubpoenaordemandtheproductionofanyrecords, notes, workproduct, or the likeofthe mediator inany judicial, administrative, orarbitration proceeding concerningthisdispute.

4) If,at alatertime,eitherpartydecidestosubpoenathemediatororthemediator's records,themediatorwillmove toquashthesubpoena. Thepartymakingthedemandagreestoreimbursethemediatorforallexpensesincurred, includingattorneyfees,plusthemediator's then-current hourlyrateforalltimetakenbythematter.

5) Theexceptiontotheaboveisthattheaboveisthatthisagreement tomediateandanywrittenagreementmade andsignedbythepartiesasaresultofmediationmaybeusedinanyrelevantproceeding, unlessthepartiesagree in\writingnottodoso. Information whichwouldotherwisebesubjecttodiscovery,shallnotbecomeexemptfrom discoverybyvirtueofitbeingdisclosedduringmediation.

Signed______

(Parent)(LEArepresentative)

Signed______Signed ______

(Parent)(LEACounsel)

Signed _ Signed ______

(Parent'sCounsel)(Mediator)

Revioed 2121/()3OSE

MEDIATIONAGREEMENT

WestVirginiaDepartmentofEducation

OfficeofFederalPrograms

County: / Student:
CountyRepresentative: / Parent(s)/Guardian(s):
Date: / Mediator

Agreement

MediationAgreement

Themediationprocessisvoluntaryonthepartofallparticipantsandisnotused todeny or delayanyparticipant's righttoadueprocess hearing, ortodenyany otherrights affordedunderIDEA2004,andisconducted byaqualifiedandimpartialmediatorwho istrainedin effective mediationtechniques. All discussions that occurred duringthe mediation process shall be confidential and may not be used as evidence in any subsequentdueprocesshearingsorcivilproceedings.

We the undersigned have participated in a voluntary mediation conference,and understandthatthissignedwrittenmediationagreementisenforceableinanyStateCourt ofcompetentjurisdictionorinaUnitedStatesDistrictCom1.

Parent(s)/Guardian(s)/Representative(s)

Signatures

Date

SchoolOfficial(s)/CountyRepresentative(s)

Signatures

Date

MEDIATIONCONCLUSIONWITHOUTAGREEMENT

WestVirginiaDepartmentofEducation

OfficeofFederalPrograms

County: / Student:
CountyRepresentative: / Parent(s)/Guardian(s):
Date: / Mediator

Wetheundersignedhaveparticipatedinavoluntarymediation confer13nceandhavebeen unabletoresolvetheissuesofdisagreement. Oursignaturesbelowindicatetheconference resultedinnowrittenagreement.

Wepledgethatthemediationdiscussionswillremainconfidentialandunderstandthatthese discussionsmaynotbeusedasevidenceinanysubsequentdueprocesshearingorcivil

proceedings.

Parent(s)/Guardian(s)

Signatures

Date

SchoolOfficial(s)/CountyRepresentative(s)

Signatures

Date