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(14.20) If my child is a special education student, when can “specialized physical health care services” be provided by someone other than a nurse?

(14.20) If my child is a special education student, when can “specialized physical health care services” be provided by someone other than a nurse?

Under state law, “specialized physical health care services” include catheterization, gastric tube feeding, suctioning, or other services that require medically related training.  [Cal. Ed. Code Sec. 49423.5(d).]  These services are typically provided by a school nurse, but also may be provided by other school staff if all of the following conditions are met:

  1. The staff are trained in administering the service;
  2. The staff must be competent in basic cardiopulmonary resuscitation and knowledgeable about the emergency medical resources available in the community;
  3. The staff are supervised by a school nurse or doctor;
  4. The service is determined by the school nurse or doctor, in consultation with the student’s doctor, to be all of the following:
    1. Routine for the student,
    2. Pose little potential harm for the student,
    3. Performed with predictable outcomes, as defined by the student’s IEP, and
    4. Does not require a nursing assessment, interpretation, or decision-making by the school staff.  [Cal. Ed. Code Secs. 49423.5(a)(2)(A)-(D).]

The staff supervision can be “immediate” (physically present), “direct” (school nurse or doctor is in the same building and available for consultation or assistance) or “indirect” (nurse or doctor is available by electronic means to provide any necessary instruction, consultation, or referral).  [5 C.C.R. Sec. 3051.12(b)(1)(D).]  If appropriate supervision is critical to the service, be sure to discuss this with the student’s doctor and provide documentation to the IEP team if necessary. 

The District may insist that a service requires some degree of “nursing assessment, interpretation, or decision making” that cannot be provided by anyone other than a nurse.  If you are concerned whether a nurse or other school staff is necessary to provide this service — or that your child may need to attend a different school with a nurse on site — these are issues to be discussed with your doctor and the IEP team.  The determination about whether a service requires nursing assessment, interpretation, or decision-making must be made in consultation with your child’s doctor.  [Cal. Ed. Code Sec. 49423.5(a)(2).]  If there is a disagreement, you can file for due process.  See Chapter 6, Information on Due Process/Compliance Procedures