Educating Students with Disabilities: Students with Medical Needs and Evaluations Under Section 504
Though there is no uniform definition of an "individual health care plan," schools sometimes use these plans for students who have medical needs that may arise in school. Individual health care plans are typically not developed pursuant to any formalized process, as is the case with developing plans under Section 504 or individual education programs (IEPs) under the Individuals with Disabilities Education Act (IDEA). Many schools rely upon the expertise of a school nurse, as well as input from a parent and from a child's treating physician when developing these plans for students. In Michigan, state law requires a "written emergency care plan" to be on file with the school if a student will be administered or use an inhaler or epinephrine auto-injector at school to treat anaphylaxis or to alleviate and prevent asthmatic symptoms. According to Michigan law, this "written emergency care plan" must "contain specific instructions for the pupil's needs," and must be "prepared by a physician…in collaboration with the pupil and the pupil's parent or legal guardian," and be "updated as necessary for changing circumstances." See Section 1179 of the Michigan Revised School Code, MCL § 380.1179.
While individual health care plans can be an important part of serving students with medical needs in school, according to a recent letter by the Office for Civil Rights (OCR), an individual health care plan may be insufficient for certain students with health-related conditions such as food allergies, asthma, diabetes, and other health impairments. A school must appropriately evaluate whether a student with any of these health conditions is a qualified student with a disability, as defined by Section 504 and Title II. This is true even if the student has an individual health care plan in place.
In Memphis City (TN) Sch. Dist. , 112 LRP 26130 (OCR, April 23, 2012), the OCR conducted a compliance review of a large district with an enrollment of 110,376 students. The OCR found that the school district had reason to believe that students with individual health care plans might in fact require special education and related services. The OCR found that most students in the school district with individual health care plans "were not evaluated pursuant to the process set forth in Section 504, nor were they provided procedural safeguards."
The school district agreed to implement a corrective action plan to resolve the OCR's affirmative investigation and compliance review. The plan included review by each school's designated nurse of the students' supporting documentation for a health-related condition, followed by a screening process and ultimately, where appropriate, a Section 504-compliant evaluation.
In light of the OCR's enforcement activities in this area, schools should carefully consider students with health-related conditions, and in particular, students with individual health care plans, for screening and evaluation for eligibility under Section 504. Schools should not rely on parent referral as the predominant means of triggering the Section 504 evaluation and eligibility process. Schools should broadly distribute and share a copy of the procedural safeguards with parents who report health-related conditions, and document the provision of same. Finally, schools should train school nurses and other appropriate building staff regarding the school's responsibilities under Section 504 and IDEA.
For a summary of OCR's enforcement authority and recent enforcement activities, see the OCR's most recent report, Disability Rights Enforcement Highlights .
Please contact your Clark Hill attorney for assistance with this and other issues impacting students with disabilities in your schools.
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