May 2023:
The MLO Minute: “Thank a Nurse (Including Your School Nurse!) This Week!” —
By Dennis McAndrews, Esq., Founder and Managing Partner Emeritus, and Caitlin McAndrews, Esq., Senior Partner Delaware/D.C. Metro —
This week, our nation celebrates Nurse Appreciation Week, and most of us are keenly aware of the growing reliance of the healthcare system upon nurses, who are increasingly responsible for greater levels of patient care. The same is true in public and charter schools, where the role of school nurses has expanded significantly over the past decade, with school nurses now often expected to provide frontline mental health contacts with students, as well as a variety of ever-increasing traditional nursing services for children with a wide variety of health issues. In a recent conversation with a wonderful school nurse, she indicated that 50% of her student contacts now involves a mental health issue.
Our firm expresses its appreciation to nurses everywhere for the incredible care that they provide, and recognizes with admiration the increasing role of school nurses for children every day. Under IDEA (Individuals with Disabilities Education Act) and Section 504 (Section 504 of the Rehabilitation Act), children with disabilities who require school health services or school nurse services in order to attend school and receive an appropriate program must be provided those services by their school at no cost to their parents. These services must be outlined in a child’s IEP or 504 plan.
Related services under IDEA include school nurse and school health services, which are health services designed to enable a child with a disability to receive a free appropriate public education or FAPE. School nurse services must be provided by a qualified school nurse. School health services may be provided by a qualified school nurse or other qualified person.
Schools are responsible for providing services that are necessary to maintain the health and safety of children at school, including services for breathing, nutrition, and other bodily functions (e.g., suctioning a tracheotomy, urinary catheterization) if these services are not the type of services that must be provided by a licensed physician.
A school’s obligation to provide nursing services can include full-time, one-on-one nursing services if that is what is necessary to provide a child with FAPE. In addition to the classroom, these services must also be provided during transportation to and from school if needed.
When a child’s IEP or 504 plan requires a school nurse to provide services, the child’s school must provide for coverage during nurse absences even if the school district contracts with a third party to provide its students with nursing services. Asking the child’s parent to come to the school and provide the services is an implementation failure and constitutes a denial of FAPE, as is a requirement that a child remain home because there is no nurse to perform nursing services as outlined in the IEP or 504 plan.
If a child has a medical or health need, a school nurse must be involved in the IEP or 504 plan process. A school nurse can help ensure that all areas of need are evaluated, explain medical evaluation data, determine the adverse impact the condition has on the child’s education, and determine the individualized health needs of the child.
If you believe that your child is being denied appropriate school health or nursing services, or any other denial of FAPE, we are available to discuss the matter with you. Our initial consultation is free of charge, and most cases are handled without payment of hourly fees by parents to our firm.