Legal Question of the Week – 1/27/14


By Attorney Thomas B. Mooney, Neag School of Education, University of Connecticut

The “Legal Question of the Week” is a regular feature of the CAS Weekly NewsBlast. We invite readers to submit short, law-related questions of practical concern to school administrators. Each week, we will select a question and publish an answer. While these answers cannot be considered formal legal advice, they may be of help to you and your colleagues. We may edit your questions, and we will not identify the authors. Please submit your questions to: legalmailbagatcasciacdotorg. ____________________________________________________________________________________________________________________

 

Dear Legal Mailbag:
We have a student who is clearly in need of long-term inpatient psychiatric care. There is a long history with this student, and we have followed the law to the letter in terms of interventions. However, a recent psychiatric evaluation (requested by the PPT but not conducted by school personnel) has confirmed the student’s need for long-term inpatient treatment. The student has coverage that pays for such long-term inpatient treatment.

My question is, since the school district paid for the psychiatric evaluation that recommended long-term hospitalization, must the district must pick up the tab? The student has insurance that would pay for the treatment, but I don’t know if the insurance company can now deny coverage because the recommendation was made through our evaluation. We haven’t had the PPT yet, and I don’t want to mess up.

Signed,
Being Careful

 

Dear Careful:

We can’t say what an insurance company will or will not do, but we can describe the school district’s legal responsibilities in such cases. When a student needs a particular program or support in order to benefit from special education, the school district is usually responsible. Moreover, school personnel must be careful about making recommendations as to what students need, because when school people make recommendations, it will usually be presumed that those recommendations are educational in nature and, as such, the responsibility of the school district. That said, here I think you are OK as to the recommended psychiatric hospitalization.

The IDEA excludes from the scope of required services medical services except those that are necessary for diagnostic purposes. School districts are responsible for the costs of this evaluation (as a diagnostic service), of course, but it is not responsible for all recommendations that result from the evaluation. Here, placement in a psychiatric hospital would be a medical service that is not the responsibility of the school district. Rather, the parents have a decision to make, and once the parents have decided whether to place the student for psychiatric reasons, school personnel should reconvene the PPT and decide how to provide educational services in that setting (or wherever the student ends up). The district will be responsible for providing FAPE to the student, but it will not be responsible for the costs of a placement made for medical reasons.

While the distinction drawn above is clear and consistent with statute, things are not always that simple. The courts have ruled that residential placement can be required for educational reasons when structure and constant attention is necessary for a student to benefit from educational services. Parents and school officials may agree on the need for residential placement but disagree on why it is necessary. In such cases, you should move carefully with the advice of counsel to do your best to assure that the district is responsible for residential placement only when it is legally required. The mere fact that the school evaluation recommends an inpatient hospitalization does not impose upon the district responsibility for such a medical service. But it does invite a discussion as to what services the student needs for educational reasons.