Legal Rights of Children with Epilepsy in School & Child Care

Administration of Emergency Antiepileptic Medication in Schools
Case Scenarios
Case Scenario 1 — No Nurse at School/Delegation Not Permitted
Shanika is a thirteen-year-old student with epilepsy who needs emergency antiepileptic
medication approximately once every two or three weeks at school. She attends a regular
middle school where she receives a combination of regular and special education services
because of learning disabilities and the impact of epilepsy on her educational progress.
This combination of regular and special education services is working well for her and
she is making good educational progress, as reflected by her grades and test scores. She
lives in a rural area and it frequently takes up to fifteen or twenty minutes for an
emergency vehicle to reach her school. Shanika lives in a state in which emergency rectal
administration of medication may not be delegated by a licensed nurse to an unlicensed
health aide. Shanika’s school has had a nurse on staff who has been administering
emergency medication to Shanika, but the nurse is nine months pregnant and is about to
go out on extended leave. The district does not have a replacement nurse to assign to the
school, as it is the middle of the year, and all staff are allocated for the remainder of the
year. The district has offered Shanika’s family two options: Shanika can transfer to a
separate special education school eight miles away from the current school and twelve
miles farther from her home, where there is a nurse on staff, or she can remain where she
is, and the school will call 911 when she has a seizure. Shanika’s parents do not believe
either of these options meets her needs appropriately and they seek legal assistance.
Discussion and Possible Advocacy Strategy: It is unfortunate that the school district
apparently did not plan for a replacement for the nurse at Shanika’s school; it would have
been clear early in the school year that the nurse would be available for only part of the
year. That said, it is unequivocally the district’s responsibility to ensure that Shanika’s
needs are met appropriately. A possible strategy to resolve this situation might include
the following steps:
1) Convene an IEP meeting to discuss the district’s proposed options and nursing
services. Request that the school district’s compliance officer or attorney attend the
meeting.
2) At the meeting, present progress reports, report cards, tests and other documents
that reflect the educational progress Shanika is making in her current placement. This
supports an argument in favor of continued placement of Shanika at her current school;
placement at a separate special education school would simply be too restrictive for her
educational needs.
3) If necessary, distribute copies of the comments to the IDEA regulations (Federal
Register, Vol. 71, No. 156, August 14, 2006, p. 46588). In this guidance, the Education
Department makes clear that placement of a student cannot be based on the configuration
of the service delivery system, administrative convenience or on other factors, such as the
category or severity of the disability, the availability of special education and related
services or the availability of space. To move Shanika to a separate special education
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