Appendix A: California Department of Education (CDE) K.C. Settlement Agreement and Legal Advisory In general, the reauthorized IDEA includes “school nurse services” as a “related service.” ( 20 USC sec. 1401 (26) .) The statutory definition was expanded in the regulations to include school health services. ( 34 CFR sec. 300.34 .) California’s definition of designated instruction and services/related services is located in Education Code section 56363 and is synonymous with related services in the reauthorized IDEA in 20 USC section 1401 (26) . California’s designated instruction services thus do not deviate from the federal related services. 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 paren t 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 reg ulations 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 chi ld, supported by such services as are necessary to permit the child “to
BP 2006 – Provision of Healthcare Services
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Desert Mountain Special Education Local Plan Area (DMSELPA) (rev. 11/16)
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