In my last post I discussed a California court decision that overturned guidance issued by the California Department of Education directing California schools to allow trained lay people to administer insulin to students with diabetes. The court ruled that under California law only nurses could administer insulin. I noted that Section 504 and the Americans with Disabilities Act (ADA) would still require that California schools ensure that students with diabetes who need insulin administered during the school day receive that service. (Also see Helping the Student with Diabetes Succeed: A Guide for School Personnel) In this post I will elaborate on the Section 504 requirements to provide health-related services to students with disabilities.
Section 504 requires that public schools provide students with disabilities a free appropriate public education. Under Section 504, an appropriate education is defined as providing regular or special education and related aids and services that are designed to meet the individual educational needs of the student with a disability as adequately as the needs of students without disabilities are met. (34 CFR 104.33(b)) Some students with disabilities need health-related services that must be performed during the school day in order for the student to attend school. Unlike the IDEA, the Section 504 regulations do not define the term related aids and services. Generally related aids and services under Section 504 have been interpreted as similar to related aids and serivces under the IDEA. School health services and school nurse services are defined and included as related services under the IDEA. Thus, Section 504 requires that schools provide health-related services to students with disabilities. [Please note that under the IDEA, while school health services and school nurse services are related services, medical services (services provided by a licensed physician) are only required for diagnostic and evaluation purposes. Similarly, Section 504 does not require schools to provide on going medical treatment to students.]
Examples of 504 Health-Related Services
In Yuba City (Calif) Unified School Dist. 22 IDELR 1148 (OCR 1995), the Office for Civil Rights (OCR) determined that the Yuba City School District violated 504 because it failed to obtain a sufficient medical assessment of a student with diabetes before placing student. As a result, the district didn't have adequate knowledge of his health-related needs which prevented the district from developing a plan to meet those needs so the student could attend school.
In Prince Georges County (Md) Sch., 39 IDELR 103 (OCR 2003), OCR required the school district to provide a nurse to administer insulin injections to a student and a licensed health aide to monitor the student's medical needs during the school day. Moreover, because the school hadn't provided a nurse to provide the insulin injections, the student's parents had left their work and gone to school to provide the injections. So, the school disrict agreed to reimburse the paretns for their expenses and lost wages.
Mulitiple Chemical Sensitivity:
In Walpole Pub. Sch., 26 IDELR 976 (SEA Mass 1997) a hearing officer approved the school district's 504 high school transition plan for a student with chemical sensitivity syndrome. The district's plan included medical monitoring by a school nurse at least twice daily and the school adopting a medical protocol concerning the availabilty of oxygen. The parents had requested that the school district pay for placement at a private school, but the hearing officer ruled that the student could attend a public high school with the schools proposed 504 plan.
In Victor Valley (Calif.) Union High Sch. Dist., 38 IDELR 193 (OCR 2002) the school district agreed for a student with asthma to modify her physical education program in accordance with her doctor's recommendations, allow her to make up course work, and provide her with 1:1 tutorial assistance.
Attention Deficit Disorder
In Letter to Mentink, 19 IDELR 1127 (OCR 1993) the Office for Civil Rights noted that, under Section 504, a school district would be required to administer medication to a student with ADD if the medication was needed during the school day.
Remember that services under Section 504 are provided for students with disabilities as defined by Section 504 and through a 504 Plan. For more information on Section 504 and public schools please see my post Opening the School Door to Section 504.