If a child needs both special education and health services, then, as determined by the child’s IEP team, school nurse/health services should be made available to a child with the eligible disability of OHI as documented in the student’s IEP. Services related to an OHI-eligible child’s diabetes health care needs at school, including those involving the management and administration of insulin, are covered under the IDEA as nursing and health services rather than excluded from coverage as medical services requiring a physician to provide them. (See Clovis Unified School Dist. v. Office of Administrative Hearings, 903 F.3d 635, 641-643 (9th cir. 1990) discussing and applying Irving Independent School District v. Tatro, 468 u.s. 883 (1984) .) In California, by statute both a written statement from the child’s physician as well as a written statement from the child’s parent are required before either a school nurse or other designated school personnel may assist the child with the administration of medication. ( Cal. Ed. Code sec. 49423 .) Hence, decisions about what health care services a student will receive, including treatment while at school, such as the timing and dosage of insulin to be administered usually are based on the treating physician’s written orders. (See Cal. Ed. Code sec. 49423 .) In rare circumstances the IEP team will question the doctor’s treatment plan as being outside the standard of care and then request clarification from the treating physician or a second opinion with the consent of the parent, at the district’s expense. (See 34 CFR sec. 300.300; Shelby S. ex rel. Kathleen T. v Conroe Independent School Dist., 454 F.3d 450, 454-455 (5th Cir. 2006) (school district authorized to compel medical examination over parent objection and necessity demonstrated).) In addition, the IEP team is responsible for determining educational modifications. (See, Special Education Defined, above). E. Individualized Inquiries Required; Blanket Policies Prohibited As with Section 504 determinations discussed above in Part l.C., decisions by IEP teams must be based upon individualized inquiries. The IDEA and its implementing regulations are premised upon the fact that each child is “unique” ( 20 USC sec. 1400(d)(1)(A) ) and must receive an “individualized education program” ( 20 USC sec. 1401(14) ; see generally Porter v. Board of Trustees of Manhattan Beach Unified School Dist., 307 F.3d 1064, 1066 (9th Cir. 2002) quoting Bd. of Educ. v. Rowley, 458 U.S. 176, 188-189 (1982) (“right to public education for students with disabilities ‘consists of educational instruction specially designed to meet the unique needs of the handicapped child, supported by such services as are necessary to permit the child “to benefit” from the instruction”.) As a consequence, decisions about a specific child’s eligibility for services under the IDEA must not be based upon the generalized or “blanket” policies of a local education agency rather than the unique needs of the individual child. (See Part l.C., supra.) Therefore, policies that restrict the availability of health related services across-the-board would be out of compliance with the mandate to individualize decisions about special education and related services needs.
Chapter 23 – Provision of Healthcare Services, Charter SELPA As of 09/08/2017 CAHELP Governance Council Approved
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