There are a variety of services other than special education services that students with chronic health conditions may be entitled to under the Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act (Section 504).
Related services are defined in the IDEA as supportive services required to enable a student with a disability to benefit from special education. Such services include:
- Audiology
- Counseling services
- Early identification and assessment of disabilities in children
- Interpreting services
- Medical services
- Occupational therapy
- Orientation and mobility services
- Parent counseling and training
- Physical therapy
- Psychological services
- Recreation
- Rehabilitation counseling services
- School health services
- Social work services
- Speech-language pathology services
- Transportation
For the full definitions of each type of service, see 34 C.F.R. § 300.34.
Medical Services vs. School Health Services
The IDEA defines “medical services” as services provided by a licensed physician only for diagnostic and evaluation purposes. The statute excludes services provided by licensed physicians for other purposes, such as treatment.
Examples of Services That Require Medical Provider Orders
- Ostomy care
- G-tube feeding
- Vagus Nerve Stimulation
- Insulin injections
- Tracheostomy suctioning
- Administering prescription medication
However, two U.S. Supreme Court cases, Cedar Rapids Community School District v. Garret F. (1999) and Irving Independent School District v. Tatro (1984), determined that if a service can be provided in the school setting by a nurse or qualified layperson, that service is not excluded under the IDEA.
Such services are instead considered school health services, which students with disabilities are entitled to under the IDEA.
Keep in mind that certain health services require medical orders from your child’s healthcare provider. If that is the case, reach out to your child’s doctor as early as possible at the beginning of each school year to get such orders. Some school districts may even have a specific form to be completed, so be sure to communicate with your school’s health office as well. For more information on what services may require medical provider orders, see Guidelines for the Delivery of Specialized Health Services in the School Setting: An Arizona Resource Guide for Schools (2019).
Note: If your child’s Individualized Education Program (IEP) or 504 Plan includes school nurse services, the school district must plan to have coverage for the nurse’s vacations and absences. You should not be required to go to the school to provide services for your child, or to keep your child home, when their provider is absent. If the district is not able to provide services that ensure your child’s safety, the district must identify and pay for an appropriate placement where your child can receive such services while obtaining an education.
Medical Devices
Regarding surgically implanted medical devices, schools are not required under the IDEA to provide services for optimization of the device’s functioning or replacement of the device. However, that does not limit the school’s responsibility to appropriately monitor and maintain medical devices needed to maintain a child’s health and safety—including breathing, nutrition, or operation of other bodily functions—while they are at, or transported to and from, school. 34 C.F.R. § 300.34(b).
Documenting Services
If your child needs any related services, such services are typically documented in either an IEP under the IDEA or a 504 Plan under Section 504, depending on their eligibility. For more information, see Chronic Health Conditions: Eligibility Under Federal Laws and Differences Between a 504 Plan and an IEP.
For some students with chronic health conditions, a school district may develop an Individualized Health Plan (IHP). IHPs are focused exclusively on a student’s medical needs. Unlike IEPs and 504 Plans, IHPs are not subject to any formal procedures and therefore can vary from one district to another. They are typically developed with school health office staff.
Keep in mind, however, that creating an IHP for a child does not relieve a district of its obligation to determine the child’s eligibility for special education services. A child can have both an IHP for their school health services and a 504 Plan or IEP for all other special education and related services.