Whose job is it?

NEA Today, May 1999 by Simpson, Michael D

The Supreme Court has spoken. Under IDEA, school districts now have to provide disabled students with a wide range of quasi-medical services while at school. (See main story.) These include cleaning tracheotomy tubes, monitoring ventilator and other medical support systems, performing bladder catheterizations, and providing ostomy care.

To avoid the costs of hiring nurses or health care aides, some school districts may order teachers or other staff to perform these tasks. Can they do that?

IDEA doesn't answer this question, although it does require that service providers must be "appropriately and adequately prepared and trained."

The decision about who will do these jobs is left up to states and local school districts.

What recourse does an educator have? This issue of who provides health care services can be addressed by collective bargaining, state law, or the student's individualized education program (IEP).

The Michigan Education Association, for example, has developed model contract language guaranteeing that only school nurses can be required to provide health services, except in an emergency.

School employees in Iowa are protected by a state law recognizing their right to refuse to perform "special health services" and "intrusive non-emergency medical services" for students.

Many states have on the books "Nursing Practices Acts" that prohibit non-licensed persons from performing "nursing" services. But, frequently, these acts have exceptions for school employees.

A bill in the Georgia legislature to restrict teachers from providing medical care to students was derailed this spring by concerns about the cost of putting a nurse in every school.

A student's IEP also can specify the training or qualifications for the person who is to provide the health care services, such as a licensed practical nurse.

When and if these questions arise, school employees should always consult with their UniServ representative, because laws vary greatly from state to state.