The Alternative Press

New Jersey took a giant step forward recently toward the delivery of appropriate services for children with special needs. Vulnerable children who were affected by ongoing and chronic medical conditions have been the subject of discussion ever since the United States Congress passed the Education of All Handicapped Children Act (now called the Individuals with Disabilities Education Act) in 1975. Interestingly, New Jersey played a direct role in that landmark legislation, as it was introduced and sponsored in the Senate by Harrison Williams of New Jersey.

Over the years, the Individuals with Disabilities Education Act evolved to address all types of disabilities, including debilitating medical conditions. The category of “Other Health Impaired” was included in the federal law and eventually was added to our State Law in New Jersey (N.J.A.C. 6a:14). Nevertheless, the needs of many children with serious medical conditions were largely ignored by school districts. Subsequent litigation indicated that these medical issues made the delivery of an appropriate education impossible without an effective intervention.

Our recently passed State law will help to resolve the dilemma. Senators James Beach and Joseph Vitale served as the primary Sponsors in the Senate, with Herb Conaway, Nancy Munoz, Daniel Benson, and Troy Singleton serving as the primary sponsors in the Assembly. One of the major issues that the bill addressed was the need to have qualified nursing staff available for these children during the school day. According to the final language of the bill:

“The Legislature finds and declares that school nursing is a separate and distinct specialty within the nursing and educational professions and that therefore competence in specified areas of health and education is needed in order for school nurses to act as health advocates for school-age children.”

Over the years, school districts had resisted the pleas of parents who requested medical care, as delivered by qualified staff, for their children during school hours. Many children were simply unable to engage in academic activities because of the severity of their medical conditions, without support. The final language of the bill includes additional specificity:

“The Legislature further finds and declares that medically fragile students are often diagnosed with medical conditions and life-threatening diseases, including cerebral palsy, seizure disorder, and other neurological diseases, that require mechanical ventilation and emergent intervention by providers of clinical nurse services while attending school.  Medically fragile students who require clinical nursing services while attending school should expect and receive the same level of care they receive at home.  Maintaining a continuity of care for medically fragile students creates a safer environment at school, fosters learning, and gives parents confidence that their children’s medical needs are being met by qualified health care providers.“

The credentials of the nursing professionals are also addressed in the bill. Clinical nurses, for example, will be required to have the same license certifications as is mandated by the Department of Human Services for New Jersey Family Care Nurses and those serving Medicaid patients.

This writer has represented the families of medically fragile children in contested cases where serious medical conditions, such as acute arthritis, has prevented a child from walking from class to class, resulting in the student being threatened with failing grades. In another case, a student with acute asthma was rushed from school to a hospital by ambulance so often that the student was in danger of not graduating. In each of these cases, the delivery of appropriate medical care by a qualified professional during the school day would have solved the issue without the need for a legal struggle.

Perhaps more interesting, the protections that have now been afforded to these children, thanks to the passage of this recent bill, were mandated by the Congress many decades ago. Adherence to the law, and a proper recognition of the needs of these students would have made this new legislation unnecessary. Nevertheless, thanks to the work of the legislators in the Senate and Assembly, the delivery of an appropriate education to medically fragile children will now be possible.