Efforts to improve outcomes for students amidst a climate of school accountability have led to a myriad of education initiatives, perhaps none as profound and widespread as the tiered intervention models offered by the RTI and MTSS frameworks. While those who advocate for tiered intervention models argue that these systems bring support to students in need efficiently, others would argue that these models delay needed services to students while cumbersome and often ineffective interventions creating another version of the wait-to-fail approach that has dominated public education. As recently noted by Thomas et al. (2020) there is a need for evaluation of RTI implementation to inform best practices and enhance sustainability over time. In Louisiana, although MTSS has essentially been implemented since before 2010, there is little research examining the effectiveness of this process as it pertains to addressing the needs of struggling students. In response to the need to reflect on current practices, the present study seeks to examine the effectiveness of the MTSS process in one local school district in a suburban school district in south Louisiana. The concept of effectiveness was quantified using three dominant themes throughout the study: are schools implementing the process consistently, is the process being implemented efficiently, and did the process culminate with accuracy in decision making for referred students. Results indicated that while schools were procedurally consistent in implementation of student assistance team (SBLC team) procedures as intended, data indicates that the SBLC team process for routing students to needed special education services remains inefficient; students who ultimately qualified for special education services under the category of Autism spent twice as long in interventions as students who ultimately qualified under the category of SLD, and three times longer than students who eventually qualified only for 504 supports. In contrast, however, there is guarded optimism that school teams are doing a good job of teasing apart students in need of specialized instruction from other students who are struggling but can be supported in general education, and students who were routed to special education had statistically lower achievement scores in comparison to non-referred and 504 referred student. It appears that schools are implementing the procedure consistently, and are making accurate decisions, but are laboriously slow in doing so. Results indicated that from a procedural integrity and an outcome accuracy standpoint, the MTSS process appears to be implemented effectively in the target district. But these two variables alone do not fully embody the concept of effectiveness as operationalized in the present study. The duration variable is a crucial indicator of effectiveness and indicates that the process is inefficient for students who ultimately need special education services. Thus, it took an examination of all three aspects of the process (input, moderating process efficiency, and outcome accuracy) to conclude that the process is not effectively supporting all students, particularly those with more significant needs. Local and regional implications were discussed, as was the caution of using RTI/MTSS implementations as part of the eligibility process for special education, particularly for conditions beyond learning problems. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]