Educational Regulations Educational Regulations & Chronic Illness& Chronic Illness

Understanding What, Why, & Understanding What, Why, & WhenWhen

What What ??Federal regulations providing for educational Federal regulations providing for educational

needs of children with disabilities needs of children with disabilities WhyWhy??Chronic illness is a disability that affects a child’s Chronic illness is a disability that affects a child’s

readiness / willingness to learn, and adversely readiness / willingness to learn, and adversely affects their participation & attendance at schoolaffects their participation & attendance at school

WhenWhen??Anytime a child with a chronic illness is noted to be Anytime a child with a chronic illness is noted to be

having difficulty at school – especially due to having difficulty at school – especially due to his/her medical condition his/her medical condition

IDEIA - IDEIA - Individuals with Disabilities Education Individuals with Disabilities Education Improvement Act (2004)Improvement Act (2004)

History of the Law:History of the Law: Originally PL 94-142, the Education for All Handicapped Originally PL 94-142, the Education for All Handicapped

Children Act (1975)Children Act (1975) Became the Individuals with Disabilities Act in 1991 (IDEA) Became the Individuals with Disabilities Act in 1991 (IDEA)

before the reauthorization in ’04before the reauthorization in ’04

Today - Still called IDEA Today - Still called IDEA All school districts accepting federal funds All school districts accepting federal funds must complymust comply with these laws and regulationswith these laws and regulationsEnsures FAPE – Free / Appropriate Public Education Ensures FAPE – Free / Appropriate Public Education that emphasizes special education and related services that emphasizes special education and related services to meet the unique needs of a child with disabilitiesto meet the unique needs of a child with disabilities

Virginia’s compliance to IDEA outlined in…Virginia’s compliance to IDEA outlined in…

The Regulations Governing Special Education The Regulations Governing Special Education Programs for Children with Disabilities in VirginiaPrograms for Children with Disabilities in Virginia

315 pages315 pages Implements a program of Implements a program of

Special Education Special Education designed to educate and designed to educate and train Children with train Children with Disabilities in Virginia’s Disabilities in Virginia’s public schoolspublic schools

Currently being revised to Currently being revised to comply with changes comply with changes outlined in the 2004 re-outlined in the 2004 re-authorization of IDEAauthorization of IDEA

The The Code of VirginiaCode of Virginia delineates the Commonwealth’s delineates the Commonwealth’s responsibility for education of responsibility for education of children with disabilitieschildren with disabilities, ,

as follows:as follows:

The Board of Education is The Board of Education is responsible for preparing & responsible for preparing & overseeing the implementation overseeing the implementation of a special education program of a special education program by each school divisionby each school division designed to educate and designed to educate and train children with train children with disabilitiesdisabilities

Each School division must Each School division must provide free and appropriate provide free and appropriate education education (FAPE),(FAPE), including including special education, for the special education, for the children with disabilitieschildren with disabilities

The following statutes and regulations The following statutes and regulations are applicable to children with are applicable to children with

disabilities:disabilities:The requirements of The requirements of section 504 of the section 504 of the Rehabilitation Act of 1973Rehabilitation Act of 1973Americans with Disabilities Americans with Disabilities ActActEducation Department Education Department General Administrative General Administrative Rules (for federal grant Rules (for federal grant requirements)requirements)Virginians with Disabilities Virginians with Disabilities ActActNo Child Left Behind Act of No Child Left Behind Act of 2001.2001.

The Regulations mandate the provision of The Regulations mandate the provision of services to children with disabilities and services to children with disabilities and

establishes that…establishes that…

Disabilities have an adverse effect on Disabilities have an adverse effect on educational performanceeducational performance

Accommodates the need for the child to have Accommodates the need for the child to have special education to address the needs that special education to address the needs that result from the disabilityresult from the disability

Ensures access to the general curriculumEnsures access to the general curriculum, so , so that the child can meet the educational that the child can meet the educational standards that apply to all children.standards that apply to all children.

Child with a Disability Child with a Disability defined as:defined as:

A child evaluated as having:A child evaluated as having: mental retardationmental retardation hearing impairmenthearing impairment visual impairmentvisual impairment emotional disturbanceemotional disturbance orthopedic impairmentorthopedic impairment autismautism traumatic brain injurytraumatic brain injury other health impairmentother health impairment, specific learning disability, , specific learning disability,

deaf-blindness, or multiple disabilitiesdeaf-blindness, or multiple disabilitieswho need special education and related services.who need special education and related services.

Chronic Illness is addressed inChronic Illness is addressed inOther Health Impairment (OHI) CategoryOther Health Impairment (OHI) Category

Definition of Other Health Impairment:Definition of Other Health Impairment:“…“…having limited strength, vitality or alertness, having limited strength, vitality or alertness, including a including a

heightened alertness to environmental stimuliheightened alertness to environmental stimuli, that , that results in limited alertness with respect to the results in limited alertness with respect to the educational environment, that is due to chronic or acute educational environment, that is due to chronic or acute health problems such as asthma, ADD or ADHD, health problems such as asthma, ADD or ADHD, diabetes, epilepsy, heart condition”…and a few others diabetes, epilepsy, heart condition”…and a few others now including Tourette syndromenow including Tourette syndrome

Not all children with disabilities qualify Not all children with disabilities qualify for Special Educationfor Special Education

If it is determined through evaluation that a child has one If it is determined through evaluation that a child has one of the disabilities identified but only needs a of the disabilities identified but only needs a related related serviceservice, , the child is not a child with a disability under this the child is not a child with a disability under this partpart. . If the related service required by the child is considered If the related service required by the child is considered special education rather than a related service under special education rather than a related service under Virginia standards, the child would be determined to be a Virginia standards, the child would be determined to be a child with a disability.child with a disability.

Related ServicesRelated Services““Supportive services Supportive services as are required to assist a child with as are required to assist a child with a disability to benefit from special education” include:a disability to benefit from special education” include:

TransportationTransportation Speech-language pathology and audiologySpeech-language pathology and audiology Interpreting servicesInterpreting services Psychological servicesPsychological services Physical and occupational therapyPhysical and occupational therapy Therapeutic recreationTherapeutic recreation Rehabilitation counselingRehabilitation counseling Orientation and mobility servicesOrientation and mobility services Medical services for diagnostic and evaluation purposesMedical services for diagnostic and evaluation purposes Dance therapy, etc.Dance therapy, etc. Not an exhaustive list!Not an exhaustive list!

School Health ServicesSchool Health Services

Related servicesRelated services also includes: also includes: school health services and school nurse servicesschool health services and school nurse services social work services in schoolssocial work services in schools parent counseling and trainingparent counseling and training

It does not includeIt does not include a medical device that is surgically implanted, nor the a medical device that is surgically implanted, nor the

optimization, maintenance, or replacement of that deviceoptimization, maintenance, or replacement of that device. .

School Health Services & School Health Services & School Nurse ServicesSchool Nurse Services

Definition:Definition: ““Health services that are Health services that are

designed to enable a child designed to enable a child with a disability to receive with a disability to receive FAPE as described in the FAPE as described in the child’s IEP.”child’s IEP.”

School nurse servicesSchool nurse services are services provided by a are services provided by a qualified school nurse. qualified school nurse. School health servicesSchool health services are services that may be are services that may be provided by either a provided by either a qualified school nurse or qualified school nurse or other qualified personother qualified person

Special EducationSpecial Education

Specially designed Specially designed instructioninstruction, at no cost to the , at no cost to the parent, to meet the unique needs of a child with parent, to meet the unique needs of a child with a disability, including instruction conducted in:a disability, including instruction conducted in: a classrooma classroom HomeHome HospitalsHospitals InstitutionsInstitutions Other settingsOther settings Instruction in physical education. Instruction in physical education.

IEPIEP (Individualized Education Program)(Individualized Education Program)

A formal document detailing A formal document detailing the “road map” to an the “road map” to an appropriate educational appropriate educational programprogram

Unique plan for every child Unique plan for every child found eligiblefound eligible

Includes:Includes: Present Level of PerformancePresent Level of Performance GoalsGoals Responsible Responsible

Individual/DisciplineIndividual/Discipline Related ServicesRelated Services Classroom Setting – or Classroom Setting – or

Placement, and DurationPlacement, and Duration

504 Plan504 Plan

Also a legal documentAlso a legal document

504 Plan used if a child’s chronic illness 504 Plan used if a child’s chronic illness primarily limits consistent access to learning primarily limits consistent access to learning opportunities, rather than impairing their ability to opportunities, rather than impairing their ability to learnlearn

Provides accommodations to enable child to Provides accommodations to enable child to achieve to their ability achieve to their ability

Ensures equal access to learning opportunities Ensures equal access to learning opportunities and environmentand environment

Section 504: Who is protected?Section 504: Who is protected?

All school-aged children who have a physical or All school-aged children who have a physical or mental impairment which substantially limits a mental impairment which substantially limits a major life activitymajor life activity

Major life activities include walking, seeing, Major life activities include walking, seeing, hearing, speaking, breathing, learning, working, hearing, speaking, breathing, learning, working, caring for oneself and performing manual taskscaring for oneself and performing manual tasks

Includes invisible disabilities – psychological Includes invisible disabilities – psychological problems, learning disabilities, and problems, learning disabilities, and chronic chronic health impairmentshealth impairments

IDEA vs. 504IDEA vs. 504

IDEAIDEA

If a child has a disability that If a child has a disability that adversely affects adversely affects educational performance, educational performance, the child is eligible for the child is eligible for special education special education services under IDEA. services under IDEA. They are also protected They are also protected under Section 504under Section 504

504504

If a child has a disability that If a child has a disability that does not adversely affect does not adversely affect educational performance, educational performance, the child will not be the child will not be eligible for special eligible for special education services under education services under IDEA, but will usually be IDEA, but will usually be entitled to protections entitled to protections under section 504 under section 504

Special Education vs. 504 planSpecial Education vs. 504 plan

Eligibility for special education is Eligibility for special education is not disability-specificnot disability-specific

Schools receive federal funding to Schools receive federal funding to provide remedial servicesprovide remedial services

IEP review meeting is required IEP review meeting is required before any change in placementbefore any change in placement

Special education requires a Special education requires a written IEP document written IEP document

Enforced by U.S. Office of Special Enforced by U.S. Office of Special Education Programs (OSEP). Education Programs (OSEP). Compliance monitored by State Compliance monitored by State Department of Education and Department of Education and OSEPOSEP

Adequate accommodations for Adequate accommodations for chronic illness can be provided chronic illness can be provided with a 504 planwith a 504 planSchools do not receive additional Schools do not receive additional financial funds for support services financial funds for support services or auxiliary aidsor auxiliary aids

No meeting required for any No meeting required for any change in placementchange in placement

Section 504 requires a written planSection 504 requires a written plan

Enforced by Office of Civil RightsEnforced by Office of Civil Rights

FAPE - IDEA / 504FAPE - IDEA / 504

In IDEA, FAPE means special education and related In IDEA, FAPE means special education and related servicesservices

In Section 504, FAPE means regular In Section 504, FAPE means regular oror special special education and related aids and services designed to education and related aids and services designed to meet the individual needs of persons with disabilities as meet the individual needs of persons with disabilities as adequately as the needs of non-disabled persons are adequately as the needs of non-disabled persons are met (Equal Access)met (Equal Access)

Individualized Health Care PlansIndividualized Health Care PlansIHPIHP

Can be used to provide many accommodations Can be used to provide many accommodations to student with chronic illnessto student with chronic illness

Similar to a 504 plan, but without procedural Similar to a 504 plan, but without procedural safeguardssafeguards

Does not entitle accommodations for Does not entitle accommodations for standardized assessmentsstandardized assessments

Common accommodations for students with Common accommodations for students with

health issues in their IEP, 504 Plan, or IHPhealth issues in their IEP, 504 Plan, or IHP

Allowance for frequent or extended absence (Intermittent Allowance for frequent or extended absence (Intermittent Homebound)Homebound)Written field trip provisions Written field trip provisions Classroom parties snack instructionsClassroom parties snack instructionsClass outline for missed classes Class outline for missed classes Flexible make-up work scheduleFlexible make-up work scheduleExtra time for class or home workExtra time for class or home workAllowed to leave class for clinic/bathroom/water/snack Allowed to leave class for clinic/bathroom/water/snack breaksbreaksFlexible schedulingFlexible schedulingPhysical education accommodations/instructionsPhysical education accommodations/instructions

Got It???

The Bottom LineThe Bottom Line

School health professionals play an important role in School health professionals play an important role in helping to identify & care for children with chronic helping to identify & care for children with chronic illnesses.illnesses.Federal & state governments provide legal guidance Federal & state governments provide legal guidance & assurances for children with special needs& assurances for children with special needsMedical, educational & therapy professionals Medical, educational & therapy professionals identify & evaluate children & recommend necessary identify & evaluate children & recommend necessary accommodations/plansaccommodations/plansPlans for children with special needs are highly Plans for children with special needs are highly individualizedindividualizedThere are a number of options for schools to use in There are a number of options for schools to use in developing individual plans right for each childdeveloping individual plans right for each child

Other ThoughtsOther Thoughts

Kids need to attend schoolKids need to attend schoolThey don’t want to look – or be They don’t want to look – or be treated – differentlytreated – differentlyRoom mothers need to know if Room mothers need to know if there is a child with a dietary there is a child with a dietary need / restrictionneed / restrictionWhen a student w/ diabetes When a student w/ diabetes has a low blood sugar, they has a low blood sugar, they need to have someone walk need to have someone walk with them to the school nurse with them to the school nurse (or other arrangements made)(or other arrangements made)Teachers need to leave Teachers need to leave detailed information for detailed information for substitute teachers!substitute teachers!Plan ahead so all children Plan ahead so all children can attend field trips!can attend field trips!

Copies of the Regulations available at Copies of the Regulations available at no costno cost

Including Braille copies, audio tapes, and large Including Braille copies, audio tapes, and large printprint

VDOE, PO Box 2120 Richmond, VA 23218-2120VDOE, PO Box 2120 Richmond, VA 23218-2120

1-800-229-38201-800-229-3820

www.doe.virginia.gov/VDOE/dueprocwww.doe.virginia.gov/VDOE/dueproc

ResourcesResourcesHelping the Student with Diabetes Succeed – A Guide for Helping the Student with Diabetes Succeed – A Guide for School Personnel (School Personnel (www.ndep.nih.gov/diabetes/youth/youth.htmwww.ndep.nih.gov/diabetes/youth/youth.htm - scroll to - scroll to middle of page. Also, look at side of page for middle of page. Also, look at side of page for School School Nurse News Nurse News Articles)Articles)ADA’s Packet on Education Discrimination (1-800-ADA’s Packet on Education Discrimination (1-800-DIABETES)DIABETES)www.childrenwithdiabetes.comwww.childrenwithdiabetes.comwww.vahealth.org/cdpc/diabeteswww.vahealth.org/cdpc/diabeteswww.diabetes.orgwww.diabetes.org – click on For Parents & Kids – click on For Parents & Kids & then & then click click Diabetes & the LawDiabetes & the Lawwww.diabetes.niddk.nih.govwww.diabetes.niddk.nih.govwww.doe.virginia.govwww.doe.virginia.gov – choose Special Education in the – choose Special Education in the scroll windowscroll windowwww.rhep.orgwww.rhep.org (our HEP website) – search the “Learning (our HEP website) – search the “Learning Library”Library”www.wrightslaw.comwww.wrightslaw.com – a comprehensive advocacy – a comprehensive advocacy resourceresource