Source: http://www.wrightslaw.com/law/caselaw/case_Cedar_Rapids_SupCt_990303.htm
Timestamp: 2014-11-21 16:14:18
Document Index: 131436810

Matched Legal Cases: ['§300', '§300', '§300', '§1407', '§1401', '§1401', '§1401', '§1701', '§101', '§213']

Cedar Rapids Community School District v. Garret F. Wrightslaw l No Child Left Behind l IDEA 2004 l Fetaweb l Yellow Pages for Kids l Harbor House Law Press
Home > Law Library > Caselaw > Cedar Rapids v. Garret F., 526 U.S. 66 (1999) The Special Ed Advocate It's Unique ... and Free!
[5] In addition, the ALJ�s opinion contains a thorough discussion of "other tests and criteria" pressed by the District, id., at 52a, including the burden on the District and the cost of providing assistance to Garret. Although the ALJ found no legal authority for establishing a cost-based test for determining what related services are required by the statute, he went on to reject the District�s arguments on the merits. See id., at 42a-53a. We do not reach the issue here, but the ALJ also found that Garret�s in-school needs must be met by the District under an Iowa statute as well as the IDEA. Id., at 54a-55a. [6] "The regulations define �related services� for handicapped children to include �school health services,� 34 CFR §300.13(a) (1983), which are defined in turn as �services provided by a qualified school nurse or other qualified person,� §300.13(b)(10). �Medical services� are defined as �services provided by a licensed physician.� §300.13(b)(4). Thus, the Secretary has [reasonably] determined that the services of a school nurse otherwise qualifying as a �related service� are not subject to exclusion as a �medical service,� but that the services of a physician are excludable as such. " . . . By limiting the �medical services� exclusion to the services of a physician or hospital, both far more expensive, the Secretary has given a permissible construction to the provision." 468 U. S., at 892-893 (emphasis added) (footnote omitted); see also id., at 894 ("[T]he regulations state that school nursing services must be provided only if they can be performed by a nurse or other qualified person, not if they must be performed by a physician"). Based on certain policy letters issued by the Department of Education, it seems that the Secretary�s post-Tatro view of the statute has not been entirely clear. E.g., App. to Pet. for Cert. 64a. We may assume that the Secretary has authority under the IDEA to adopt regulations that define the "medical services" exclusion by more explicitly taking into account the nature and extent of the requested services; and the Secretary surely has the authority to enumerate the services that are, and are not, fairly included within the scope of §1407(a)(17). But the Secretary has done neither; and, in this Court, she advocates affirming the judgment of the Court of Appeals. Brief for United States as Amicus Curiae; see also Auer v. Robbins, 519 U. S. 452, 462 (1997) (an agency�s views as amicus curiae may be entitled to deference). We obviously have no authority to rewrite the regulations, and we see no sufficient reason to revise Tatro, either. [7] See Tr. of Oral Arg. 4-5, 12. [8] At oral argument, the District suggested that we first consider the nature of the requested service (either "medical" or not); then, if the service is "medical," apply the multi-factor test to determine whether the service is an excluded physician service or an included school nursing service under the Secretary of Education�s regulations. See Tr. of Oral Arg. 7, 13-14. Not only does this approach provide no additional guidance for identifying "medical" services, it is also disconnected from both the statutory text and the regulations we upheld in Irving Independent School Dist. v. Tatro, 468 U. S. 883 (1984). "Medical" services are generally excluded from the statute, and the regulations elaborate on that statutory term. No authority cited by the District requires an additional inquiry if the requested service is both "related" and non-"medical." Even if §1401(a)(17) demanded an additional step, the factors proposed by the District are hardly more useful in identifying "nursing" services than they are in identifying "medical" services; and the District cannot limit educational access simply by pointing to the limitations of existing staff. As we noted in Tatro, the IDEA requires schools to hire specially trained personnel to meet disabled student needs. Id., at 893. [9] See Tr. of Oral Arg. 4-5, 13; Brief for Petitioner 6-7, 9. The District, however, will not necessarily need to hire an additional employee to meet Garret�s needs. The District already employs a one-on-one teacher associate (TA) who assists Garret during the school day. See App. to Pet. for Cert. 26a-27a. At one time, Garret�s TA was a licensed practical nurse (LPN). In light of the state Board of Nursing�s recent ruling that the District�s registered nurses may decide to delegate Garret�s care to an LPN, see Brief for United States as Amicus Curiae 9-10 (filed Apr. 22, 1998), the dissent�s future-cost estimate is speculative. See App. to Pet. for Cert. 28a, 58a-60a (if the District could assign Garret�s care to a TA who is also an LPN, there would be "a minimum of additional expense"). [10] The dissent�s approach, which seems to be even broader than the District�s, is unconvincing. The dissent�s rejection of our unanimous decision in Tatro comes 15 years too late, see Patterson v. McLean Credit Union, 491 U. S. 164, 172-173 (1989) (stare decisis has "special force" in statutory interpretation), and it offers nothing constructive in its place. Aside from rejecting a "provider-specific approach," the dissent cites unrelated statutes and offers a circular definition of "medical services." Post, at 3-4 (" �services� that are �medical� in �nature� "). Moreover, the dissent�s approach apparently would exclude most ordinary school nursing services of the kind routinely provided to nondisabled children; that anomalous result is not easily attributable to congressional intent. See Tatro, 468 U. S., at 893. In a later discussion the dissent does offer a specific proposal: that we now interpret (or rewrite) the Secretary�s regulations so that school districts need only provide disabled children with "health-related services that school nurses can perform as part of their normal duties." Post, at 7. The District does not dispute that its nurses "can perform" the requested services, so the dissent�s objection is that District nurses would not be performing their "normal duties" if they met Garret�s needs. That is, the District would need an "additional employee." Post, at 8. This proposal is functionally similar to a proposed regulation�ultimately withdrawn�that would have replaced the "school health services" provision. See 47 Fed. Reg. 33838, 33854 (1982) (the statute and regulations may not be read to affect legal obligations to make available to handicapped children services, including school health services, made available to nonhandicapped children). The dissent�s suggestion is unacceptable for several reasons. Most important, such revisions of the regulations are better left to the Secretary, and an additional staffing need is generally not a sufficient objection to the requirements of §1401(a)(17). See n. 8, supra. FOOTNOTES - Dissent [1] The Act currently defines "related services" as "transportation and such developmental, corrective, and other supportive services (including speech pathology and audiology, psychological services, physical and occupational therapy, recreation, including therapeutic recreation, social work services, counseling services, including rehabilitation counseling, and medical services, except that such medical services shall be for diagnostic and evaluation purposes only) as may be required to assist a child with a disability to benefit from special education . . . ." 20 U. S. C. §1401(a)(17) (emphasis added). [2] See, e.g., 38 U. S. C. §1701(6) ("The term �medical services� includes, in addition to medical examination, treatment and rehabilitative services ... surgical services, dental services . . . optometric and podiatric services, . . . preventive health services, . . . [and] such consultation, professional counseling, training, and mental health services as are necessary in connection with the treatment"); §101(28) ("The term �nursing home care� means the accommodation of convalescents . . . who require nursing care and related medical services"); 26 U. S. C. §213(d)(1) ("The term �medical care� means amounts paid-- . . . for the diagnosis, cure, mitigation, treatment, or prevention of disease"). [3] Nor do I think that it is appropriate to defer to the Department of Education�s litigating position in this case. The agency has had ample opportunity to address this problem but has failed to do so in a formal regulation. Instead, it has maintained conflicting positions about whether the services at issue in this case are required by IDEA. See ante, at 7-8, n. 6. Under these circumstances, we should not assume that the litigating position reflects the "agency�s fair and considered judgment." Auer v. Robbins, 519 U. S. 452, 462 (1997). To Top
Rev: 01/15/07