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Cedar rapids community school


CEDAR RAPIDS COMMUNITY SCHOOL DISTRICT v. GARRET F., a minor, by his mother

106 F.3d 822



Background: Garret F., a student in petitioner school district, is wheelchair-bound and ventilator dependent; he therefore requires, in part, a responsible individual nearby to attend to certain physical needs during the school day. The District declined to accept financial responsibility for the services Garret needs, believing that it was not legally obligated to provide continuous one-on-one nursing care. At an Iowa Department of Education hearing, an Administrative Law Judge concluded that the IDEA required the District to bear financial responsibility for all of the disputed services, finding that most of them are already provided for some other students; that the District did not contend that only a licensed physician could provide the services; and that applicable federal regulations require the District to furnish 'school health services,' which are provided by a 'qualified school nurse or other qualified person,' but not 'medical services,' which are limited to services provided by a physician. The Federal District Court agreed and the Court of Appeals affirmed



Issues: Does this fall under the Americans with disabilities act, and is the Cedar Rapids school district liable for providing a qualified nurse to attend to his needs during the school day.



Decision of the court: The Supreme Court ruled 7-2



Majority opinion: Justice Stevens wrote the majority opinion which may, in general, be viewed as a reaffirmation of the Tatro case. The Court ruled as follows:

1. The "related services" regulation under the IDEA broadly encompasses those supportive services that may be required to assist a child with a disability to benefit from special education.

2. Services that enable a disabled child to remain in school during the day provide the student with the meaningful access to education that Congress envisioned.

3. In Tatro, the Court had already "unmistakenly" adopted the bright line test that physician services are excluded except for diagnosis. The Court explained that in Tatro it had referenced the likely cost of the services and the competence of school staff as justifications for drawing a line between physician and other services but had unmistakenly previously adopted the physician services analysis.

4. The medical services definition under the IDEA does not embrace all forms of care that might loosely be described as medical in other contexts, such as a claim for an income tax deduction.

5. One of the services Garret needs is catheterization which was the issue in Tatro and the others can be provided by a school nurse or other trained personnel and do not demand the "training, knowledge, and judgment of a licensed physician."

6. While Garret needed in school services that were more extensive than Amber Tatro, his needs are no more "medical" than Amber's.

7. A new four-factor test proposed by the school district was not appropriate because it was "not supported by any recognized source of legal authority." The District proposed test would have included four factors:

o Whether the care is continuous or intermittent

o Whether existing school health personnel can provide the service

o The cost of the service

o The potential consequences if the service is not properly performed. The Court noted that these characteristics did not appear to make one service any more "medical" than another.



8. The medical services exemption limit based on physician services is ...

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