In 1987, Garret Frey of Cedar Rapids, IA, was severely injured during a tragic motorcycle accident. While his spinal cord injury left him with quadriplegia and ventilator-dependent at four years of age, his mental capabilities were unaffected. Today, as a sophomore, he attends regular classes in a typical school program. Thus far, his academic performance has been a success. Frey is capable of speaking, controls his motorized wheelchair through use of a suck and puff straw, and operates a computer with a device that responds to head movements.
While at school, Frey needs assistance with urinary bladder catherization once a day and suctioning of his tracheotomy tube as needed-roughly once every six hours and when eating and drinking at lunchtime. He also needs assistance in the event his ventilator malfunctions or if he were to experience autonomic hyperreflexia. During Frey's early years in schoo], his family used settlement proceeds they received after the accident, their insurance, and other resources to employ a licensed practical nurse. However, in 1993, when Frey started fifth grade, his mother requested the Cedar Rapids Community School District provide Frey's nursing services. The District refused, stating that it was not obligated to provide continuous one-on-one medical care (The United States Court of Appeals for the Eighth Circuit 1O6f.3b822 [8th Cir., 1977] 25IDELR439). Relying on Iowa law and the Individuals with Disabilities Education Act (IDEA), Frey's mother requested a hearing before an Administrative Law Judge (ALJ) and the Iowa Department of Education. Frey's lawyer argued before the AU that his nursing services qualify as related services. The school district argued that the services are medical services that are excluded from the definition of supportive services and ultimately from the definition of related services.
The District's lawyers estimated that the cost for Frey's medical care "would be $30,000 to $40,000 per year in addition to the $10,000 to $12,000 now spent to provide Frey with a teacher assistant and other services. Frey's lawyer argued that the District's estimates are inflated and that a registered nurse could take over the duties of the teacher, costing the school district about $18,000 a year (Access New England, Spring, 1999).
The ALJ concluded that most of the requested services are already provided by the District to other students and that the care necessitated by Frey's ventilator dependence does not demand the training, knowledge, and judgment of a licep.sed physician. Ventilator services may be continuous, more costly, and may require additional school personnel, but they are not truly medical. Thus, the AU concluded that IDEA required the District to bear financial responsibility for all of the services in dispute, including continuous nursing services.
"The District challenged the AU's decision in Federal District Court, but that Court approved the AU's IDEA ruling and granted summary judgment against the District Id., at 9a,15a. The Court of Appeals affirmed 106 F.3d822 (CA81997)." On March 3, 1999, the U.S. Supreme Court issued a 7-2 decision ruling that IDEA requires school districts to provide nursing services if such services are necessary for a child with a disability to receive an education (Supreme Court of the United States, No. 96-1793, March 3, 1999).
In delivering the opinion for the Court, Justice Stevens cited federal laws dating back to the 1970s requiring schools to provide "special education and related services" to children with disabilities. This case concluded that schools must offer any assistance necessary to keep a student in school short of a physician's care. Stevens explained that, "Under the statute, our precedent, and the purposes of IDEA, the district must fund such related services to help guarantee that students like Frey are integrated into public schools" (Access New England, Spring, 1999).
This is a substantial victory for families of children with disabilities who have become increasingly assertive about their rights under Federal Law (The New York Times, March 4, 1999). However, many parents, educators, and political leaders contend that Congress did not seriously consider the cost of accessibility to local education associations (LEA) when it passed IDEA. Moreover, many LEAs throughout the country would argue that afford ability is of critical concern to public schools in the current climate of financial wars occurring between regular education and special education. The increasing. cost of special education will remain a hot button issue that will not go away until educating children with disabilities becomes both a national and state obligation and not just one imposed on financially strapped LEAs.