IEP FAQs: Do Nursing Services Belong in the IEP?

Print Friendly, PDF & Email
Share

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

Subscribe
Notify of
24 Comments
Inline Feedbacks
View all comments
Lisa
10/22/2020 6:12 pm

What constitutes an appropriate nurse’s assessment for a standard initial and triennial IEP?

Jennifer
01/02/2020 3:30 pm

I have a son who is 8 years old and is diagnosed with ADHD. He is on medicine for this but we have had to figure out what medicine works best. His medicine sometimes wears off in the afternoon. When that happens the teacher makes him write his name on the board. This happens frequently and it has made my child not want to go to class. He also gets his recess taken away. Is there any kind of rule or whatever for this teacher to not do this since he has an IEP? We have already met with the teacher but it absolutely breaks my heart for him because he will cry at night because he doesn’t want to go to that class and is ridiculed in front of his peers. We are also meeting with a specialist to see if h has any other issues because he has major anxiety issues. Thank you

Chuck
01/03/2020 2:01 pm
Reply to  Jennifer

Your child is not being successful at school. In situations like this parents basically have 2 options. You can try working with the principal &/or special ed director to reach a solution & revise his IEP. Or you can make a complaint to the state education agency. It is generally better to try the first before using the second option.

Chuck
01/06/2020 3:15 pm
Reply to  Wrightslaw

Great Advice, for this and many other situations parents are dealing with.

Wrightslaw
12/19/2019 4:27 pm

Jessica: There are MANY cases about school districts refusing to provide school nurse services to children with disabilities who can’t attend school or receive a FAPE unless they receive these services. Schools will continue to ignore the Courts until parents take the time to learn how to use the cases as part of their advocacy for their children.

The U.S. Supreme Court has issued two decisions about school nurse services. Both support your position.

The first case, Irving Independent Sch. Dist. v. Amber Tatro, was published in 1984 … so it has been out there for decades. The Supreme Court held that a medical treatment for CIC is a related service and that the school is required to provide it.

The second case, Cedar Rapids v. Garret F., is about Garret F., a child who was paralyzed in an accident when he was four years old. He could not attend school without 1:1 school nurse services.

After the Court issued the decision in Garret F.’s case, we wrote an article,
“Supreme Court Says, ‘Congress Intended to Open the Door to All Qualified Children.’ ” https://www.wrightslaw.com/info/relsvcs.garretf.htm

After reading this article, you will know what the law says and what Courts have held. You will be in a stronger position to make your case to your local school officials and your school board.

I suggest you make copies of the two cases and include them as attachments to a letter to the school principal, the Director of Special Ed, and your school district Superintendent. If necessary, you may need to send copies of your letter and the cases to your school board and/or State Department of Education.

You can use the text of the question you posted on the blog as the basis of your letter.

* WRIGHTSLAW RULE: AN EMAIL DOES NOT HAVE THE POWER OF A LETTER *

Please keep us posted.

Jessica
12/18/2019 1:57 am

My son has a Broviac (central line) and requires IV fluids to be administered during the day. His school does not have anyone with a medical background on staff and I have requested a 1:1 RN. They are denying the need and said that despite the 2 dr notes, they have to obtain more data. He has been home now for 20 days and the school said that he can attend but not his nurse, yet, they are providing him “FAPE.” Do you have any cases that are similar to a central line as the situation is quickly escalating?

Chuck
12/18/2019 2:12 pm
Reply to  Jessica

If you have not involved the district special ed director, I suggest doing that. You may need to get the state education agency involved. Your state parent training & information center can assist you learning about that and other options you have. http://www.parentcenterhub.org/find-your-center

Hannah
04/04/2019 11:59 pm

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
04/05/2019 2:36 pm
Reply to  Hannah

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
04/05/2019 5:11 pm
Reply to  Peter

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
04/05/2019 3:23 pm
Reply to  Hannah

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
10/18/2018 2:08 pm

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.

Lisa
10/22/2020 6:16 pm
Reply to  Maryann

Have you received an answer to the question in your post? I have the same question.

Chuck
10/23/2020 2:13 pm
Reply to  Lisa

I would think that some state or national nursing association would have guidance on this. At one time the TX health dept. required nurses to develop health plans for certain students with disabilities. There was a lot of guidance given for nurses. But this was discontinued some time ago.

JANE
08/27/2018 1:32 am

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
08/27/2018 2:42 pm
Reply to  JANE

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
12/04/2015 11:42 am

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
08/27/2018 2:22 pm
Reply to  Tammy

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

kathy
10/04/2013 7:33 pm

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
06/30/2010 7:02 pm

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

Michaux
06/30/2010 2:51 pm

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
06/29/2010 5:19 pm

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
07/28/2009 10:09 am

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.