Opinion ID: 2278481
Heading Depth: 1
Heading Rank: 6

Heading: Omission of Administration of Medication from the IEP

Text: The provision of a FAPE, which a state must satisfy with respect to all disabled children, necessarily includes personalized instruction and such supportive services as are reasonably calculated to enable the child to achieve passing marks and advance from grade to grade. Bd. of Educ. v. Rowley, 458 U.S. 176, 188-89, 102 S.Ct. 3034, 3042, 73 L.Ed.2d 690 (1982). As discussed previously, the IEP serves as the blueprint for the special education services provided to disabled children to ensure their proper access to a FAPE. Appellee relies heavily on the fact that administration of medication is not enumerated in A.A.'s IEP as a related service to be provided by the HCPS. The HCPS claims that, while the IDEA contemplates generally the administration of medication as a potential related service, not every disabled child is entitled to every potential related service mentioned in the IDEA. Instead, it argues, the related services due a child are restricted to those contained in his or her particular IEP, which presumably is tailored to his or her special circumstances, unless or until the child's parents petition to have an additional service added. Simply put, the HCPS contends that, because A.A.'s IEP does not enumerate the administration of medication as a specific related service in her case, she is not entitled to such a service under the IDEA. In response, A.A.'s parents point to the October 2002 IEP Team Meeting, at which they signed forms [23] that reflected the parties' agreement that the HCPS would administer Indural, Geodon, and Nurontin at 12:30 p.m. each school day. The parents argue that, by signing these forms, the HCPS was agreeing to provide the medications to A.A. as a service related to A.A.'s special education plan, notwithstanding there being no mention of the administration of these medications in the IEP itself. Therefore, according to the parents, the provision of A.A.'s medications should be considered effectively as part of A.A.'s IEP. They also contend that, for the purposes of the motion to dismiss, the HCPS twice conceded that it was obligated to administer the medications to A.A. as a related service. Because we hold that a related service need not be included necessarily in the child's IEP in order to form the basis for a due process complaint, we forgo a determination on this record whether the administration of medication was included implicitly in A.A.'s IEP. This conclusion comports not only with relevant case law, but with the overarching purpose of the IDEA to ensure that all disabled children have access to a free appropriate public education. Precedent of the U.S. Supreme Court supports our conclusion that the administration of medication constitutes a related service, whether mentioned in an IEP or not. In Irving Independent School District v. Tatro, 468 U.S. 883, 104 S.Ct. 3371, 82 L.Ed.2d 664 (1984), the Supreme Court considered whether a school board was required by the IDEA to provide clean intermittent catheterization (CIC) to a child with a disability, even though the service was not contained in her IEP. 468 U.S. at 885, 104 S.Ct. at 3373. The Court outlined a two-step process to determine whether the school must provide a related service. The first step is to consider whether the service is a supportive service . . . required to assist a handicapped child to benefit from special education, and the second step is to determine whether the service is excluded from this definition as a medical service serving purposes other than diagnosis or evaluation. Tatro, 468 U.S. at 890, 104 S.Ct. at 3375-76. The Tatro Court concluded that the child required a CIC in order to remain in class and benefit from her special education program and that the service could be performed in a few minutes by a lay-person with less than an hour's training. Tatro, 468 U.S. at 885-88, 104 S.Ct. at 3373-75. Therefore, the Court affirmed the order of the District Court, mandating that the board of education modify the child's IEP to include the provision of CIC during school hours. Tatro, 468 U.S. at 888, 104 S.Ct. at 3375. Similarly, in Cedar Rapids Community School District v. Garret F., 526 U.S. 66, 119 S.Ct. 992, 143 L.Ed.2d 154 (1999), the parents of a ventilator-dependent child, who required constant individual services throughout the school day, requested that the school district accept financial responsibility for the child's health care services. Cedar Rapids, 526 U.S. at 69-70, 119 S.Ct. at 995-96. The district denied the request, claiming it was not legally obligated to provide continuous, one-on-one nursing services. Cedar Rapids, 526 U.S. at 70, 119 S.Ct. at 996. Following its decision in Tatro, the Court held that the school district could only refuse to provide medical services which inherently must be performed by a physician. Cedar Rapids, 526 U.S. at 74, 119 S.Ct. at 997 (citing Tatro, 468 U.S. at 892-94, 104 S.Ct. at 3377-78). Although the child's IEP did not contain any reference to administration of medication, the district was held to be required to provide the child's service because the individualized care requested did not demand the training, knowledge, and judgment of a licensed physician and was necessary for the child to access her FAPE. Cedar Rapids, 526 U.S. at 74, 119 S.Ct. at 997. The Supreme Court's decisions in Tatro and Cedar Rapids suggest that an IEP does not take the form of a strict contractual relationship between the parties and is not the be-all-end-all of those services, and only those services, which must be provided to a disabled child. The HCPS, in its brief, advances this very claim, relying on Ms. K., Mother and Next Friend of S.B. v. City of South Portland, 407 F.Supp.2d 290, 301 (D.Me.2006), to explain that an IEP is not governed by the law of contracts and is not itself a legally binding contract. In this regard, it is entirely correct. Because an IEP is not evaluated as if it were a fully-integrated contract, an appropriate administrative body, here the ALJ, could order, based on a due process complaint, the IEP to be modified so that it is reasonably calculated to enable the child to receive educational benefits. Rowley, 458 U.S. at 207, 102 S.Ct. at 3051. While an IEP document may reflect the discussions and educational plan contemplated for a disabled child, a school district is nonetheless required to provide the child with a FAPE, which includes personalized instruction and such supportive services as are necessary to fulfill the underlying purpose of the IDEA. Thus, the fact that A.A.'s IEP does not acknowledge explicitly A.A.'s entitlement to the administration of medication is not determinative in this case. The absence of an administration of medication provision from A.A.'s IEP does not portend that such a service is not required by the IDEA. Rather, Tatro and Rowley stand for the proposition that if a particular service necessary for a disabled child to access their FAPE is absent from their IEP, such a shortcoming or oversight may not be used to defeat a disabled child's otherwise legitimate claim under the IDEA. We agree with A.A.'s parents that the provision of a FAPE necessarily includes the provision of all related services contemplated by the IDEA and others reasonably calculated to be necessary for the child to benefit from his or her specialized education. In both Tatro and Cedar Rapids, the related services were not outlined in the children's IEP's, yet the Supreme Court nonetheless required the school boards in those cases to provide the services and allowed claims for such unrecognized services to form the basis of IDEA due process complaints. We recognize that, generally, a court should not intervene in questions of educational policy so long as a school district has offered a program of specialized services reasonably calculated to enable a child to receive educational benefit. Gill v. Columbia 93 Sch. Dist., 217 F.3d 1027, 1037 (8th Cir.2000). Here, it is undisputed that A.A. generally requires these medications (at some dosage strength) in order to have a chance to function more normally in the classroom setting and attain the benefits of her special education, thus meeting the definition of supportive services. Justifying withholding the medications from A.A. simply because the service is not enumerated in her IEP would be contrary to the principle that a school must provide the services that enable the child to benefit from special education. Additionally, the record here reflects that the medications easily can be provided by someone other than a trained physician, such as a school nurse, and therefore are not an excluded medical service. [24] Thus, under the apparent facts in this case, the administration of these medications to A.A. would be a related service.