IDEA (Special Education) & 504 The interface with School Health Services ******* Cheri Dotson, Retired SFPS Lead Nurse

Individuals with Disabilities Education Act Children with Disabilities Special Education Related Services Federal Law & Recent Legislation

Supreme Court IDEA Rulings that impact Nursing Services The Rowley decision – based on this decision, school districts now determine the need for related services for a student by applying the “Rowley test”. The Rowley decision – based on this decision, school districts now determine the need for related services for a student by applying the “Rowley test”. - Amy, 8 year old student with a hearing impairment, was enrolled in a regular ed. class and doing well. -Parents requested an interpreter for the deaf be provided - Supreme Court concluded that Amy did not need an interpreter & that her educational program complied with the requirements of FAPE since she performed better than the average child in her class (Selekman, 2006)

Supreme Court IDEA Rulings that impact Nursing Services Tatro v. Irving Independent, 1984 Tatro v. Irving Independent, Student with spina bifida, attending SPED classes with an IEP that included speech, physical & occupational therapy, but they refused to provide clean intermittent catheterization because the district considered it a medical service. - the Supreme Court determined the definition of medical services did exclude physicians’ services, but not nursing services. -Established “bright-line test” or the 2-step test: A related service must be provided if it will assist the student to benefit from SPED & the service is not performed by a physician. - In subsequent action, parents or guardians were given the right to be reimbursed for reasonable legal costs if they prevail. (Selekman, 2006)

Supreme Court IDEA Rulings that impact Nursing Services Garret F & Charlene F. v. Cedar Rapids Community School District, 1999 Garret F & Charlene F. v. Cedar Rapids Community School District, Presented the question of whether the definition of related services requires a public school to provide a ventilator- dependent student nursing services during school hours. - Supreme Court did acknowledge concerns about financial burden of providing the services needed & limit of existing staff; however, cost cannot be considered in determining a required service & this issue is outside the Court’s authority. (Selekman, 2006)

Eligibility Criteria for Special Education In addition to specific Learning Disabilities: Autism Autism Hearing Impairment/Deafness Hearing Impairment/Deafness Deaf-Blindness Deaf-Blindness Visual Impairment/ Blindness Visual Impairment/ Blindness Intellectual Disability Intellectual Disability Developmental Delay (Ages 3-9) Developmental Delay (Ages 3-9) Orthopedic Impairment Orthopedic Impairment Emotional Disturbance Emotional Disturbance Speech-Language Impairment Speech-Language Impairment Traumatic Brain Injury Traumatic Brain Injury Multiple Disabilities Multiple Disabilities Other Health Impairment Other Health Impairment

Procedure for Placement in Special Education Need identified Need identified Support Team Support Team Initial Meeting & Recommendation of interventions Initial Meeting & Recommendation of interventions Subsequent Meeting & evaluation of interventions/ need for referral Subsequent Meeting & evaluation of interventions/ need for referral Referral Referral Assessment & Testing Assessment & Testing The evaluation must be sufficiently comprehensive to identify all the child’s educational needs, whether or not, they link to the child’s disability category The evaluation must be sufficiently comprehensive to identify all the child’s educational needs, whether or not, they link to the child’s disability category Placement if qualifies Placement if qualifies

Initial Evaluation or Reevaluation The School Nurse Role Assessment Assessment History History Physical Physical Identification of Health/Mental Health Needs Identification of Health/Mental Health Needs Establish an Individualized Healthcare Plan as appropriate to any identified need Establish an Individualized Healthcare Plan as appropriate to any identified need

Documentation of School Health Services in the Individualized Education Plan Assessment at Initial Referral and on Reevaluation Assessment at Initial Referral and on Reevaluation What services are medically indicated in order for the student to access his/her education? What services are medically indicated in order for the student to access his/her education? Individualized Healthcare Plan establishes the need (assessment), the plan (interventions), goals (general), and objectives (expected outcomes, specific) Individualized Healthcare Plan establishes the need (assessment), the plan (interventions), goals (general), and objectives (expected outcomes, specific) Expected amount of time the student will receive School Health services Expected amount of time the student will receive School Health services

Summary of the School Nurse’s Role in the Special Education Process Be involved in ongoing assessment of student health needs Review Health Records, talk to the student, talk to the parents, talk to the teachers Conduct formal initial and reevaluation assessments Conduct annual/periodic reviews Determine if “school health services” are needed/would be beneficial Document School Health Services on the IHP & IEP

SAT and Section 504 Model

Section 504 of the Rehabilitation Act of 1973 (Reauthorized 2008) Physical or mental impairments or limitations that are not IDEA eligible that require reasonable accommodations to allow the student an equal opportunity to participate in school Physical or mental impairments or limitations that are not IDEA eligible that require reasonable accommodations to allow the student an equal opportunity to participate in school evaluation to determine their needs evaluation to determine their needs reasonable accommodation in the appropriate educational setting reasonable accommodation in the appropriate educational setting reevaluation prior to changes reevaluation prior to changes remodeling facilities to provide access when needed remodeling facilities to provide access when needed

The 504 Conference Request for 504 Conference -->School Nurse gathers & organizes data Request for 504 Conference -->School Nurse gathers & organizes data ○ medical data ○ formal/informal testing ○ performance documentation ○ teacher observation/records Determination of eligibility --> Existence of a disability that substantially limits a major life activity Determination of eligibility --> Existence of a disability that substantially limits a major life activity Develop a “Student Accommodation Plan” (The IHP is a part!) Develop a “Student Accommodation Plan” (The IHP is a part!) Implement Student Accommodation Plan Implement Student Accommodation Plan Periodic review and update of 504 Plan/Student Accommodation Plan Periodic review and update of 504 Plan/Student Accommodation Plan

Some Conditions That May Qualify As Disabilities Under Section 504 Attention Deficit/Attention Deficit Hyperactivity Disorder Attention Deficit/Attention Deficit Hyperactivity Disorder Emotional Disorders Emotional Disorders Behavior Disorders Behavior Disorders Physical Impairments/Chronic Medical Conditions Physical Impairments/Chronic Medical Conditions Temporary Medical Conditions Temporary Medical Conditions Communicable Diseases Communicable Diseases Drug and Alcohol Addictions Drug and Alcohol Addictions The KEY is the committee is to modify the learning environment & make accommodations for success! The KEY is the committee is to modify the learning environment & make accommodations for success!

The School Nurse, is the Medical Interpreter or Expert in the Educational Setting, but Health Assistants are vital to the care of students YOU can make a difference for students every day! YOU can make a difference for students every day!