Supreme Court Opinion Supports Student Disability Rights
From: Civil Rights Monitor Vol. 10, No. 3 (Summer 1999)
On March 3, 1999, the Supreme Court ruled 7-2 in Cedar Rapids v. Garrett I (No. 96-1793) that public schools are required by law to provide students with disabilities the care and services they need, so long as the assistance can be provided by someone other than a doctor.
The Court's decision interprets the Individuals with Disabilities Education Act (IDEA) which seeks to ensure that students with disabilities have access to a "free appropriate public education." The law provides that in addition to special education, school districts must pay for "related services" but need not pay for "medical services."
Background
The case involved a student, Garrett Frey, who was paralyzed at the age of 4 from the neck down due to a motor cycle accident. As a high school sophomore, Frey's mental condition and speaking ability were unaffected by the accident and he was able to control his motorized wheelchair with a puff and suck device that responds to head movements. In addition, he used a ventilator to breathe. During school hours, Frey required assistance for bladder cathetertization and the suctioning of his tracheotomy tube.
Garrett's family was able to provide the care he needed at school for several years. When he was in kindergarten, his aunt attended him; in the next four years, his family relied upon the settlement proceeds they received after his accident, their insurance, and other resources to employ a licensed practical nurse. Then, in 1993, Garrett's mother asked the Cedar Rapids school district to incur Garrett's nursing cost. The district refused, claiming such services were not part of school health care but rather, "medical services," not covered by IDEA.
Relying on Iowa State law and the IDEA, Garrett's family first requested a hearing before the Iowa Department of Education. An Administrative Law Judge (ALJ) ruled in the family's favor reasoning that the medical exclusion is limited to services that are "in the special training, knowledge, and judgment of a physician to carry out." The ALJ made a distinction between school health services provided by a qualified school nurse or other qualified person, and services provided only by a licensed physician. The school district's challenge to the ruling in both the district and appellate courts was unsuccessful. The school district then sought review in the Supreme Court asserting that the distinction between related services and medical services should not be made on the basis of who delivers the services but on the basis of factors such as: [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.
