IEP FAQs: Do Nursing Services Belong in the IEP?

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If a child is wheelchair-bound and needs a catheter, is this something that belongs in the IEP?

Exactly whose responsibility is it to handle catheters for wheelchair-bound students? I would think it qualifies as a medical procedure and that a nurse would need to do it?

Does the child need these services to attend school?

If he cannot attend school, how will he receive FAPE?

School nurse services are a related service (§1401 (26)) and as such, should be listed in the child’s IEP (§1414 (d)(1)(A)).

The Commentary to the federal regulations (p.46571) says “The public agency also is responsible for providing services necessary to maintain the health and safety of a child while the child is in school, with breathing, nutrition, and other bodily functions (e.g., nursing services, suctioning a tracheotomy, urinary catheterization) if these services can be provided by someone who has been trained to provide the service and are not the type of services that can only be provided by a licensed physician.”

https://www.wrightslaw.com/idea/comment/46547-46579.reg.001-100.definitions.pdf

In 1984, the Supreme Court held that a treatment like catheterization
(CIC) is a related service and the school is required to provide it.
(Irving Independent Sch. Dist. v. Amber Tatro 468 U.S. 883 (1984)).

https://www.wrightslaw.com/law/caselaw/ussupct.tatro.htm

In 1999, the Supreme Court issued a decision on a similar issue in
Cedar Rapids v. Garret F., 526 U.S. 66. The Garret F. case involved a
child who was paralyzed in an accident, and was ventilator dependent.
The question presented in Garret F. was whether the definition of
“related services” in §1401(a)(17) requires a school district to
provide a ventilator-dependent student with nursing services during
school hours. The Court held that that the school must provide these
services. Without these services, the child would not be able to
attend school and would not receive FAPE.

https://www.wrightslaw.com/law/caselaw/ussupct.garret.htm

Catheterization is a nursing procedure and should be done by an appropriately trained nurse. Most teachers are not trained nurses so they should not be asked to do this procedure.

The definition of school nurse services in 300.34(c)(13) has been expanded and re-named school health services and school nurse services. The expanded definition clarifies that “school nurse services” are provided by a qualified school nurse, and “school health services” may be provided by a qualified school nurse or other qualified person.

https://www.wrightslaw.com/idea/law/idea.regs.sumry.chngs.pdf

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Hannah

My daughter is on an IEP and she has a trach and a G-tube. Her IEP says that she needs a one on one nurse with her. Her nurse will be going away on vacation and she will be away for two days of school. I asked if I could attend those two days of school with my daughter so that she wouldn’t have to miss and the school program director told me I would just need to fill out a CORE and show my license when I could go in as a volunteer. Then I received an email from the sped coordinator for the town saying that it would not be appropriate for me to go with her since her IEP requires her to have a one on one nurse. Are there any laws that protect my daughter from being forced to stay home from school?

Peter

Yes – Section 504 and IDEA. Is there a reason the school cannot provide a substitute for the time the regular nurse is not available? It should be the school’s responsibility to have a contingency plan in place to ensure continuing services for you child – what happens when the regular nurse is off sick, or her car breaks down?

Hannah

Yes Chuck and Peter, if the school nurse stays home then Addie just stays home. They have never trained a substitute on my daughters care. Now they are telling me that they are going to find a sub nurse and send her with Addy but it is way too short of a timeframe for her to be trained on my daughters care since their will only be one week in between now and the time needed for her to be taken to school. My daughter travels with a ventilator a suction machine and has a G-tube as well as is Deaf, has two bone conduction aids, and skeletal dysphasia. I don’t think that one or two days of training would be enough to send her off with someone who has never worked with her before. I would feel more comfortable just doing it myself but I don’t know why they are not allowing it.

Chuck

Since the IEP says one on one nurse, the school should provide a nurse, if they are not willing to let you come. You can make a quick complaint to the state education agency, if they will not work with you. If she stays home, they are not providing FAPE for those 2 days.

Maryann

What requirements should the School Nurse have in regard to information for an IEP? That is, should Vital Signs be included besides hearing/vision/weight/height? I have spoken to over 35 nurses from 2 different NJ Counties and it seems that every school has their own regulations–this does not make sence to me.

JANE

What if School district agreed to nursing services in IEP for my daughter’s FAPE and then at start of school has no one hired…….. my child was forced into “administrative homebound” over lack of staffing on their part. They were 100% adamant that she had to return to school……. and they would provide services and now are unable to secure a nurse who wants the position

Chuck

The state education agency may need to get involved through the state dispute resolution processes. Your state parent training & information center can assist you. http://www.parentcenterhub.org/find-your-center

Tammy

I am a school Nurse and I often don’t have time to attend IEP because of no coverage, but I am asked to sign the IEP is that legal?

joannie

No. You cannot sign an IEP saying you were a participant if you did not participate.

kathy

if a child is receiving homebound services from the local school district AND intermediate unit, could this child get nursing services within the home?
Child’s IEP is from local school district.

dee

The information you offer is amazing. I wish I had found you sooner!

Michaux

well in our school district very few of the schools have a nurse on staff….so it really wouldn’t matter if the child required nursing services….in an ideal world this would be great but budgets get cut and nonessential personal are the ones who dont get hired or get the cut….sad isnt it????

adel

There is a big push for INCLUSION in Hudson County. Not all children belong in INCLUSION.
How does a parent reach out to the state dept. of education to complain about the excessive power some school district have about placing “ALL”children in INCLUSION.

Karen

I found this information to be extremely helpful. I had a student who required a nurse, and I was uncomfortable administering meds in the event of a seizure. Eventually, it was determined that the child requires a nurse. Thanks for the info.