"Children, including those with chronic health conditions, deserve
the opportunity to develop to their fullest potential through the
benefits of education and health care. Individualized attention to their
special health needs in school is of critical importance." Children
with Health Impairments in Schools, Pediatrics, October, 1990, American Academy of Pediatrics
Overcoming Obstacles to Health Management at School c. 1990 v. 7/02
WHAT ARE MY CHILD'S RIGHTS?
Basically, schools have an affirmative obligation to ensure a safe environment and to provide every child with a free and appropriate education. A school's obligations include providing supplementary services or program modifications for children with health impairments, whether or not the child is in special education. The goal is to remove health-related barriers to a student's successful participation in educational programs and extracurricular activities.
Potential barriers include handicapping policies and practices such as refusing to administer medication, lack of accommodations for variations in stamina or tolerance for exercise, poor environmental conditions, or the failure to provide a home instruction plan that allows students with frequent or intermittent absences to keep up with their peers.
Other obstacles include unfair or stigmatizing treatment such as retention or grading penalties, exclusion from activities, requiring parents to go along on field trips, or teasing or abuse by teachers or peers. WHAT CAN I DO IF A CHILD'S NEEDS ARE NOT BEING MET?
If you feel that a child's education, safety or health is a risk because of unreliable access to medication, excessive absences, inflexible school policies, inadequate health services, gaps in training or staffing such as the lack of a qualified school nurse, or poor maintenance or bad air quality, start with a written request to the school principal asking that the school formally document your child's needs.
The goal is to develop an individualized health plan for health management and a Section 504 plan with safety measures and guidelines for school staff.
The evaluation process must consider your physician's documentation of the child's condition, treatment, health management routines, and self-care responsibilities.
Also, parents can provide educational resources available from health care and educational organizations to update school personnel on the advances in understanding and treatment of a particular condition. AN INDIVIDUALIZED HEALTH MANAGEMENT PLAN
After the child's medical and educational needs are identified, parents and school staff, as a team, develop written implementation guidelines that enable the student to successfully manage his or her health at school.
This should include ongoing efforts to reduce risk and disruption in the student's daily routines as well as during "critical incidents" or "foreseeable events" such as gym class, recess, off-site events, field trips and potential emergencies.
The guidelines also should clarify the roles and obligations of specific school personnel as well as the staff education and communication systems necessary to ensure that the student's health and educational needs are met. WHAT IF THE SCHOOL DOES NOT COOPERATE?
Every school district should have a written document explaining the school district's procedures for how you can remedy a situation when something is not being done that should be or when something is being done that you feel is detrimental to a child.
If the school does not supply this document, request it from your state's department of education, special education office or its division responsible for managing complaints. It should be on the state website. FINDING HELP
National and local parent advocacy groups may also be a source of allies, advice and information.
Express your concerns to the school health section of your state chapter of the American Academy of Pediatrics and other medical associations, public health groups, and representatives in Congress with a special interest in health and education.
You can also contact the Washington headquarters or a regional office of the U. S. Department of Education, Office for Civil Rights whose role is to enforce compliance with Section 504 of the Rehabilitation Act of 1973, a federal law that prohibits discrimination on the basis of disability in education.
Section 504 covers individuals with any physical or mental impairment that substantially limits one or more major life activities or affects one or more body systems, i.e., breathing. It gives you the right to ask for consideration when you feel that policies or practices disadvantage your child.
OCR provides assistance in the form of information and mediation services and will investigate complaints of violations of federal regulations. If a school is found in violation, it is required to change the policies and procedures that violate the law. This will benefit not only the student or students who initiated the complaint but will broaden the path to health and quality education for everyone.
Write to me. I develop resources and advocacy projects that describe health and educational equity issues for students, identify model school standards, programs, policies, and guidelines that promote optimal student health, explain the relevant liability issues and laws (especially Section 504 of the Rehabilitation Act of 1973), and promote resources to improve communication and teamwork among families, schools and health professionals.
The more information and questions I receive about health management obstacles at school, the better I can document and illustrate the range and extent of the problems and identify the appropriate remedies. I invite you to write to me. Describe your situation or frustrations. Explain the child's condition and health management needs. All names will be kept confidential. I look forward to hearing from you.
ELLIE GOLDBERG, M.Ed. is an education and environmental health advocate for healthy children, safe schools and sustainable communities – clean water, clean air, clean energy and safe food. Inspired by the legacy of Rachel Carson, who taught that our health and security is intimately connected to the quality of our environment, Ellie is active in public health, environmental, educational and public policy organizations working to increase citizen engagement, government accountability and corporate responsibility on behalf of children and their healthy development.
