School district must provide ventilator-dependent student with nursing services under IDEA

Law Reporter, May 1999

Cedar Rapids Community Sch. Dist. v. Garret F., 119 S. Ct. 992 (1999).

The U.S. Supreme Court held that the Individuals with Disabilities Education Act (IDEA), 20 U.S.C. 1400 et seq.-which authorizes federal financial assistance to states that agree to provide special education and "related services" to children with disabilities-requires that a public school district provide a ventilator-dependent student with nursing services during school hours.

Here, the mother of a ventilator-dependent student asked the school district to pay for nursing services her child required during the school day. The district refused, claiming it was not legally obligated to provide continuous oneon-one nursing services. The mother requested a hearing before the state department of education, and an administrative law judge held that the IDEA required that the district pay for the services. A trial court approved the judge's ruling and granted summary judgment against the district. An appellate court affirmed, holding that the services were not "medical services," which are excluded from coverage under the IDEA.

Affirming, the U.S. Supreme Court cited Irving Independent Sch. Dist. v. Tatro, 104 S. Ct. 3371 (1984), which held that "medical services" referred only to services that must be performed by a physician-not to school health services. Here, the Court found, the requested services did not demand the training, knowledge, and judgment of a licensed physician.

The Court rejected defendant's proposal that in deciding whether the medical services exemption applies, courts should apply a multifactor test that examines ( 1 ) whether the care is continuous or intermittent, (2) whether existing school health personnel can provide the service, (3) the cost of the service, and (4) the potential consequences if the service is not properly performed. Although some federal courts have applied a multifactor test, the court said, defendant's proposed factors cannot be found in the IDEA or regulations issued under it. Moreover, defendant did not explain why these characteristics make one service any more "medical" than another.

Plaintiff's Counsel:

Douglas R Oelschlaeger, Cedar Rapids, Iowa

Diane Kutzko, Cedar Rapids, Iowa

[ Comment For other cases involving the IDEA, see Family ef Children's Ctr, Inc. v. School City, 13 F.3d 1052 (7th Cir. 1994), 37 ATLA L. Rep. 188 (June 1994), and Russman v. Sobol, 85 F.3d 1050 (2d Cir. 1996), 39 ATLA L. Rep. 293 (Sept. 1996). Documents in Family er Children's Ctr. and Russman are available through the Court Documents section in the back section of this issue, courtesy of plaintiffs' counsel.]