Legal Guidelines for the Delivery of Special Health Care Services in Schools

Abstract

The Individuals with Disabilities Education Act includes school health services in a list of possible related services. The rising costs associated with education and the request for more extensive and costly services by children who have special health care needs have made the delivery of these services in schools as part of free, appropriate public education increasingly controversial. An examination of relevant documents and court decisions from the past 10 years provides insight into congressional intent, federal regulations, and local implementation of service delivery related to children with extensive health care needs.

The Division of Labor Among Systems of Therapeutic Care for Children with Disabilities

“…Beginning in the late 1980s, researchers found that speech/language, occupational, and physical therapy for children with special health-care needs (Palfrey, Singer, Raphael, & Walker, 1990) and mobility limitations (Walker, Palfrey, Butler, & Singer, 1988) were provided and funded largely through public schools. This pattern of provision is due to the IDEA (originally passed in 1975 as the Education for All Handicapped (Bartlett, 2000;Rapport, 1996;Thomas & Hawke, 1999). In 1984, the U.S. Supreme Court ruled in Irving Independent School District v. Tatro that clean intermittent catheterization (CIC) was a necessary related service, concluding that it was a school health service that did not require a physician (Bartlett, 2000;Rapport, 1996;Thomas & Hawke, 1999).…”

Perceived Effectiveness and Barriers to Physical Therapy Services for Families and Children With Friedreich Ataxia

“…Given the challenges these families face in obtaining services for their children, it is imperative for therapists working within the school system to not only educate school personnel, but also become knowledgeable in federal, state and local regulations guiding the provision of rehabilitative services to be able to advocate most effectively for their patients. 40,41 …”

Supporting Students With Health Needs in Schools: An Overview of Selected Health Conditions

“…Rapport (1996) identified medication delivery, skin care, and catheterization, as well as gastronomy and respiratory care, as examples of healthrelated services and procedures that some students with disabilities may need to benefit from their special education programs. As a result of the seminal related services ruling in / rving Independent School District v. Tatro (1984) the U.S. Supreme Court determined that clean intermittent catheterization did constitute a school health service.…”