IDEA (Special Education) IDEA (Special Education) & 504& 504

The interface with School The interface with School Health ServicesHealth Services

**************Cheri Dotson, Retired SFPS Lead Cheri Dotson, Retired SFPS Lead

NurseNurse

cheridotson26@hotmail.comcheridotson26@hotmail.com

Individuals with Disabilities Individuals with Disabilities Education ActEducation Act

Children with DisabilitiesChildren with Disabilities

Special EducationSpecial Education

Related ServicesRelated Services

Federal Law & Recent LegislationFederal Law & Recent Legislation

Supreme Court IDEA Rulings that Supreme Court IDEA Rulings that impact Nursing Servicesimpact Nursing Services

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

Supreme Court IDEA Rulings that Supreme Court IDEA Rulings that impact Nursing Servicesimpact Nursing Services

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

Supreme Court IDEA Rulings that Supreme Court IDEA Rulings that impact Nursing Servicesimpact Nursing Services

Garret F & Charlene F. v. Cedar RapidsGarret F & Charlene F. v. Cedar Rapids Community School Community School District, 1999District, 1999

- Presented the question of whether the definition of related - Presented the question of whether the definition of related services requires a public school to provide a ventilator-services requires a public school to provide a ventilator-dependent student nursing services during school hours.dependent student nursing services during school hours.

- Supreme Court did acknowledge concerns about financial - Supreme Court did acknowledge concerns about financial burden of providing the services needed & limit of existing burden of providing the services needed & limit of existing staff; however, cost cannot be considered in determining a staff; however, cost cannot be considered in determining a required service & this issue is outside the Court’s authority. required service & this issue is outside the Court’s authority. (Selekman, 2006)(Selekman, 2006)

Eligibility Criteria for Special EducationEligibility Criteria for Special EducationIn addition to specific Learning Disabilities:In addition to specific Learning Disabilities:

AutismAutism Hearing Impairment/DeafnessHearing Impairment/Deafness Deaf-BlindnessDeaf-Blindness Visual Impairment/ BlindnessVisual Impairment/ Blindness Intellectual DisabilityIntellectual Disability Developmental Delay (Ages 3-9)Developmental Delay (Ages 3-9) Orthopedic ImpairmentOrthopedic Impairment Emotional DisturbanceEmotional Disturbance Speech-Language ImpairmentSpeech-Language Impairment Traumatic Brain InjuryTraumatic Brain Injury Multiple DisabilitiesMultiple Disabilities Other Health ImpairmentOther Health Impairment

Procedure for Placement in Special Procedure for Placement in Special EducationEducation

Need identifiedNeed identified Support TeamSupport Team

Initial Meeting & Recommendation of interventionsInitial Meeting & Recommendation of interventions Subsequent Meeting & evaluation of interventions/ need for Subsequent Meeting & evaluation of interventions/ need for

referralreferral

ReferralReferral Assessment & TestingAssessment & Testing

The evaluation must be sufficiently comprehensive to identify all The evaluation must be sufficiently comprehensive to identify all the child’s educational needs, whether or not, they link to the the child’s educational needs, whether or not, they link to the child’s disability categorychild’s disability category

Placement if qualifiesPlacement if qualifies

Initial Evaluation or ReevaluationInitial Evaluation or ReevaluationThe School Nurse RoleThe School Nurse Role

AssessmentAssessment HistoryHistory PhysicalPhysical

Identification of Health/Mental Health Identification of Health/Mental Health NeedsNeeds

Establish an Individualized Healthcare Establish an Individualized Healthcare Plan as appropriate to any identified needPlan as appropriate to any identified need

Documentation of School Health Services in Documentation of School Health Services in the Individualized Education Planthe Individualized Education Plan

Assessment at Initial Referral and on Assessment at Initial Referral and on ReevaluationReevaluation

What services are medically indicated in order What services are medically indicated in order for the student to access his/her education?for the student to access his/her education?

Individualized Healthcare Plan establishes the Individualized Healthcare Plan establishes the need (assessment), the plan (interventions), need (assessment), the plan (interventions), goals (general), and objectives (expected goals (general), and objectives (expected outcomes, specific)outcomes, specific)

Expected amount of time the student will Expected amount of time the student will receive School Health servicesreceive School Health services

Summary of the School Nurse’s Role in Summary of the School Nurse’s Role in the Special Education Processthe Special Education Process

Be involved in ongoing assessment of student health needsBe involved in ongoing assessment of student health needs Review Health Records, talk to the student, talk to the parents, Review Health Records, talk to the student, talk to the parents,

talk to the teacherstalk to the teachers Conduct formal initial and reevaluation assessmentsConduct formal initial and reevaluation assessments Conduct annual/periodic reviewsConduct annual/periodic reviews Determine if “school health services” are needed/would be Determine if “school health services” are needed/would be

beneficialbeneficial Document School Health Services on the IHP & IEPDocument School Health Services on the IHP & IEP

SAT and Section 504 ModelSAT and Section 504 Model

Section 504 of the Rehabilitation Act Section 504 of the Rehabilitation Act of 1973 (Reauthorized 2008)of 1973 (Reauthorized 2008)

Physical or mental impairments or limitations that Physical or mental impairments or limitations that are not IDEA eligible that require reasonable are not IDEA eligible that require reasonable accommodations to allow the student an equal accommodations to allow the student an equal opportunity to participate in schoolopportunity to participate in school evaluation to determine their needsevaluation to determine their needs reasonable accommodation in the appropriate educational reasonable accommodation in the appropriate educational

settingsetting reevaluation prior to changesreevaluation prior to changes remodeling facilities to provide access when neededremodeling facilities to provide access when needed

The 504 ConferenceThe 504 Conference Request for 504 Conference -->School Nurse Request for 504 Conference -->School Nurse

gathers & organizes datagathers & organizes data○ medical datamedical data○ formal/informal testingformal/informal testing○ performance documentationperformance documentation○ teacher observation/recordsteacher observation/records

Determination of eligibility --> Existence of a Determination of eligibility --> Existence of a disability that substantially limits a major life disability that substantially limits a major life activity activity

Develop a “Student Accommodation Plan” (The Develop a “Student Accommodation Plan” (The IHP is a part!)IHP is a part!)

Implement Student Accommodation PlanImplement Student Accommodation Plan Periodic review and update of 504 Plan/Student Periodic review and update of 504 Plan/Student

Accommodation Plan Accommodation Plan

Some Conditions That May Qualify As Some Conditions That May Qualify As Disabilities Under Section 504Disabilities Under Section 504

Attention Deficit/Attention Deficit Hyperactivity Attention Deficit/Attention Deficit Hyperactivity DisorderDisorder

Emotional DisordersEmotional Disorders Behavior DisordersBehavior Disorders Physical Impairments/Chronic Medical ConditionsPhysical Impairments/Chronic Medical Conditions Temporary Medical ConditionsTemporary Medical Conditions Communicable DiseasesCommunicable Diseases Drug and Alcohol AddictionsDrug and Alcohol Addictions The KEY is the committee is to modify the learning The KEY is the committee is to modify the learning

environment & make accommodations for success!environment & make accommodations for success!

The School Nurse, is the Medical Interpreter or The School Nurse, is the Medical Interpreter or Expert in the Educational Setting, but Health Expert in the Educational Setting, but Health

Assistants are vital to the care of studentsAssistants are vital to the care of students

YOU can YOU can make a make a difference for difference for students students every day!every day!