On September 25, 2018, the department of Public Instruction (department) received a complaint under state and federal special education law from XXXXX (parent) against the XXXXX (district). This is the department’s decision regarding the complaint. The issue is whether the district, during the 2018-2019 school year, properly responded to a parent’s request regarding specific staff qualifications.
A student’s individualized education program (IEP) must specify any related services required to assist the child to benefit from special education. Related services may include school nurse services. 34 CFR § 300.320(a)(4) and 34 CFR § 300.34(a).
Pursuant to Wisconsin’s standards of practice for registered nurses, a school nurse may decide to delegate a nursing task, such as administration of medication or performance of other nursing procedures, to other school personnel. Delegation is a legal term that refers to the transferring the authority to perform a selected nursing task to a competent individual in specific situations. The nurse retains accountability for tasks that have been delegated to other school staff. Before deciding to delegate a task to other school staff, the nurse must determine whether the school staff member being asked to perform the task has appropriate educational preparation and has demonstrated the ability to perform the task. When the nurse delegates a nursing task, the process starts by training school personnel to perform the task. After the initial training, the registered nurse must also provide ongoing observation, monitoring, direction, and assistance to those performing the task. Wis. Admin. Code § N 6.03(3)(a-d).
The IEP of the student who is subject of this complaint indicates the student requires school nurse services, specifically tube feeding, to benefit from special education. The IEP specifies the student is to receive this service five minutes daily. The IEP also specifies that all staff in the student’s classroom will receive training from the school nurse in tube feeding and emergency care plans for the student. Training is specified as approximately 20 minutes, continuing until the nurse is convinced the staff member has demonstrated competency at the task. Any staff member new to the classroom are to be trained before interacting with the student. The IEP indicates the student requires a one-to-one educational assistant for the entire school day. The student’s tube feeding is generally provided by the educational assistant assigned to work with the student.
The student’s IEP team met on September 25, 2018. At the meeting the parent raised concerns about the educational assistant assigned to work with the student. The parent asserted the educational assistant was not appropriately qualified to meet the student’s needs. The IEP team was not able to reach consensus on appropriate qualifications for the educational assistant, and the parent requested the meeting be suspended and continued at a later date. Subsequently, the parent provided the district a letter from the student’s physician stating that a registered nurse was required for tube feeding the student. The parent provided no other information from the student’s medical providers as to the reasons the student required a registered nurse for tube feeding. The IEP team reconvened on October 5. At the meeting the parent specifically requested that the student be provided with a registered nurse to address the student’s tube feeding needs. The IEP team, which included the school nursing supervisor for the district, reviewed the student’s health needs and information provided by the parent. The school nursing supervisor determined that the tube feeding task could be safely delegated to classroom staff trained as specified in the IEP and the IEP team agreed.
The district properly responded to the parent’s request regarding the specific qualifications of the education assistant by having the student’s IEP team consider the needs of the student and by having the school nurse supervisor confirm the student’s tube feeding could be appropriately delegated to the student’s educational assistant.
This concludes our review of this complaint, which we are closing. This decision is final for the IDEA State Complaint process.
//signed CST 11/21/2018
Carolyn Stanford Taylor
Assistant State Superintendent
Division for Learning Support