DISABLED: High Court Says Schools Must Pay for Nursing Care
In a decision that represents a huge victory for proponents of disability "mainstreaming" but that could saddle schools with substantial medical costs, the Supreme Court ruled yesterday that school districts must provide for nursing care for disabled children. In its 7-2 decision, the court significantly expanded the scope of the 1975 Individuals with Disabilities Education Act (IDEA), requiring schools to pay for virtually all medical services that can be provided by someone other than a physician, including intensive one-on-one nursing care (Savage/Colvin, Los Angeles Times, 3/4). Writing for the majority, Justice John Paul Stevens said, "This case is about whether meaningful access to the public schools will be assured, not the level of education that a school must finance once access is attained" (Remez/Stansbury, Hartford Courant, 3/4). Dissenting Justice Clarence Thomas, who was joined by Justice Anthony Kennedy, wrote that Congress passed the IDEA "to increase the educational opportunities available to disabled children, not to provide medical care for them." Thomas added that the ruling "blindsides unwary states with fiscal obligations that they could not have anticipated" (Greenhouse, New York Times, 3/4).
The ruling upheld a lower court decision against the Cedar Rapids, IA, Community School District in the case of a paralyzed boy on a ventilator who requires "bladder catheterization and the suctioning of his tracheotomy tube." The school, which receives some federal funding under the IDEA -- the amount is disputed by lawyers for the plaintiffs and the defense -- "balked at spending an additional $30,000 to hire a nurse" for the boy (Biskupic, Washington Post, 3/4).
The National School Boards Association said that in-school nursing services for the nation's 17,000 "medically fragile" students "would cost an extra $500 million each year." Association Executive Director Anne Bryant said, "We worry that school districts will endure a great strain because of today's decision. It takes the focus of schools away from being educators and into being medical service providers" (Los Angeles Times, 3/4). American Federation of Teachers President Sandra Feldman said, "Unless Congress acts to provide adequate funding, it is inconceivable that districts can shoulder the additional cost of providing the care necessary to allow seriously disabled students to attend public schools" (Greenburg, Chicago Tribune, 3/4). Advocates for the disabled dismissed the financial estimates as overblown, saying many districts already provide the required services. Wayland, MA, School Superintendent Gary Burton said, "There are probably very few children with that degree of handicap. It's not as outrageous as it sounds." He concluded, "[W]e're committed to educated handicapped children, and it does not offend me that the cost is higher" (Mueller, Boston Herald, 3/4).