For families of medically complex children, ensuring they receive the right medical support at school is often a battle. Many students need skilled nursing care for conditions such as tracheostomies, ventilator dependence, feeding tubes, seizure disorders, diabetes, and other significant health needs. While federal laws require schools to provide accommodations that allow students to access their education, many districts push back against requests for private duty nursing, leaving parents to advocate for services their child needs to attend school safely.
At K Altman Law, we work with families to ensure schools meet their legal obligations. If your child requires private duty nursing at school, there are steps you can take to secure these critical services.
What Is Private Duty Nursing at School?
Private duty nursing provides one-on-one, skilled medical care for children with complex medical conditions. Unlike a school nurse, who oversees the health needs of all students, a private duty nurse is assigned to a specific child for the entire school day. Their role is to monitor the child’s condition, administer medications, and respond to medical emergencies as needed.
Some children require private duty nursing due to:
- Tracheostomy care and suctioning
- Ventilator management
- Seizure monitoring and emergency medication administration
- Diabetes management, including insulin administration and blood sugar monitoring
- Tube feeding and medication administration
- Oxygen therapy and respiratory support
Without appropriate medical care, these students face serious risks, including life-threatening emergencies. Parents must ensure that their child has access to the care they need while at school.
Who Pays for Private Duty Nursing?
Many school districts claim they are not responsible for providing private duty nursing, but the law says otherwise. There are multiple funding sources that may cover the cost.
Medicaid
Medicaid provides coverage for private duty nursing for children with complex medical needs through various programs, including:
- Medicaid Waiver Programs, which offer services for children who need long-term care
- Home and Community-Based Services, which allow children to receive medical support in non-hospital settings, including schools
- EPSDT (Early and Periodic Screening, Diagnostic, and Treatment), which requires Medicaid to provide medically necessary services to eligible children
If your child qualifies for Medicaid, it may fully or partially cover private duty nursing at school.
Private Insurance
Some private health insurance plans provide coverage for private duty nursing, but the specifics depend on the policy. Parents may need to work with their child’s physician to provide detailed documentation proving the necessity of the service. Some insurance plans limit the number of hours covered per day, so families may need to explore additional funding sources.
School District Responsibility Under IDEA and Section 504
If a child’s medical condition affects their ability to attend and participate in school, private duty nursing may qualify as a related service under the Individuals with Disabilities Education Act (IDEA). This means that schools may be required to provide nursing support as part of a child’s Individualized Education Program (IEP).
In the Supreme Court case Cedar Rapids Community School District v. Garret F., the court ruled that schools must provide nursing services to students who need them to attend school, as long as the services do not require a physician. This case set a precedent that school districts cannot refuse nursing support simply because of cost.
Even if a child does not qualify for an IEP, they may still be entitled to private duty nursing through a Section 504 Plan, which ensures students with disabilities receive accommodations that allow them to access their education.
What to Do If the School Denies Private Duty Nursing
If your child’s school refuses to provide or accommodate private duty nursing, you have options to challenge their decision.
Step 1: Gather Medical Documentation
Obtain letters from your child’s doctors, specialists, and therapists detailing the medical necessity of private duty nursing. Be sure to include:
- A description of your child’s medical condition
- The specific tasks that must be performed at school
- The risks of not having nursing support in place
- A statement that private duty nursing is required for your child to safely attend school
Having strong medical documentation is critical when negotiating with the school district or filing a complaint.
Step 2: Request an IEP or 504 Plan Meeting
If your child already has an IEP or 504 Plan, request a meeting with the school to discuss adding private duty nursing as a required service. If your child does not have an IEP or 504 Plan, submit a written request for an evaluation under IDEA or Section 504 to determine eligibility.
During the meeting, present medical documentation and emphasize that private duty nursing is necessary for your child to receive a free and appropriate public education (FAPE). The school is legally required to consider your request and provide an official response.
Step 3: File a Complaint or Due Process Request
If the school refuses to provide private duty nursing despite medical necessity, parents have the right to file a complaint. Options include:
- Requesting mediation with the school district to negotiate a resolution
- Filing a state complaint with the Department of Education’s special education division
- Requesting a due process hearing, where an administrative law judge reviews the case
- Filing a civil rights complaint with the Office for Civil Rights (OCR) if the denial violates disability laws
Each of these steps can help enforce your child’s right to appropriate medical accommodations at school.
How K Altman Law Can Help
Navigating the legal and medical complexities of securing private duty nursing at school can be overwhelming. Parents often face resistance from school districts, insurance companies, and Medicaid providers. At K Altman Law, our team of education attorneys and licensed nurses work together to:
- Ensure IEPs and 504 Plans include medically necessary nursing services
- Advocate for children with complex medical conditions
- Hold schools accountable when they fail to provide required services
- Assist families in obtaining Medicaid or private insurance coverage for private duty nursing
If your child is being denied the medical support they need at school, we can help.
Contact us today at 855-KALTMAN to ensure your child receives the care they deserve.
