On the first day of its new term, the U.S. Supreme Court last week asked for the Clinton administration’s views on whether public schools must foot the bill when medically fragile students require constant care in the classroom.
The main federal special education law, the Individuals with Disabilities Education Act, specifically exempts school districts from having to pay for “medical services” unless such services are conducted for evaluation or diagnostic purposes.
But lower federal courts disagree about whether constant or frequent classroom care by a nurse or similar attendant for severely disabled students constitutes medical services, for which districts are exempt, or “related” educational services, for which districts are responsible.
The high court on Oct. 6 asked the Department of Justice for its views on Cedar Rapids Community School District v. Garret F. (Case No. 96-1793). The Cedar Rapids, Iowa, district has appealed lower court rulings that required the district to pay for a full-time attendant for a 14-year-old boy who requires constant attention because he uses a ventilator and bladder catheterization.
‘Necessary’ Service?
The boy, Garret F., is paralyzed from the neck down as a result of a motorcycle accident. The district says in court papers that it would cost nearly $38,000 for one-on-one nursing while the boy is in school. The district now pays about $10,000 to provide a full-time classroom aide for the boy, so its net additional cost would be $28,000 a year for a nurse.
The boy’s mother argues in court papers that the services need not be provided by a nurse. A properly trained teaching aide could provide the services at no additional cost to the district, she says.
In February, a three-judge panel of the U.S. Court of Appeals for the 8th Circuit ruled unanimously that because the boy’s care is not provided by a physician, it qualifies as a support service “necessary to enable him to enjoy the benefit of special education.”
The appeals panel acknowledged that three other federal appellate courts have refused to make the test for medical services contingent on whether a physician was involved.
In its high court appeal, the Cedar Rapids district argues that the 8th Circuit has “effectively converted the IDEA from an education law to a law requiring school districts to pay catastrophic medical expenses of their students.”
Jim Bradshaw, a spokesman for the Department of Education’s office of special education and rehabilitative services, said the federal office would consult with the Justice Department on its reply to the high court.
In a policy letter issued last year to an Illinois district, the Education Department said special education cases involving “one-on-one nursing services” needed to be evaluated closely by individualized-education-program teams. Such teams are responsible for drafting appropriate plans for educating students with disabilities.
The department said most federal courts to address the issue have taken the view that if the care required by a disabled student is intermittent and could be administered by a regular school nurse, then it is a related service for which the district is responsible. But if a student requires continuous care, courts “generally have held that the service is an excluded medical service,” the department said.
The Justice Department is expected to take several months before filing its brief on the case.
Cases Denied
The high court also rejected appeals in several education-related cases last week. The court:
- Rejected appeals from the states of Arizona and California stemming from their lawsuits seeking reimbursement from the federal government for public services provided to illegal immigrants. The high court refused to hear Arizona v. U.S. and California v. U.S. (Nos. 96-1595 and 96-1596).
- Declined to review a federal appeals court ruling that upheld graduation prayers at Indiana University in Bloomington, Ind. The high court appeal was Tanford v. Brand (No. 96-1894).
