Necessary Health Services for FAPE: Irving School District v. Tatro (1984)
Amber Tatro was born with spina bifida. She had orthopedic and speech impairments and a neurogenic bladder. To prevent injury to her kidneys, Amber had to be catheterized every three or four hours by a procedure called “clean intermittent catheterization” (CIC). The procedure was described as a simple one that may be performed in a few minutes by a layperson with less than an hour’s training. Although the school agreed to provide special education for Amber, they refused to administer CIC because they viewed it as a medical service, not a related service. Initially, the U. S. District Court found that CIC was not a related service under the Education of All Handicapped Children Act (now IDEA) and that Section 504 of the Rehabilitation Act did not require the setting up of government health care for people seeking to participate in federally funded programs (Wrightslaw, 2021).
However, the U. S. Court of Appeals reversed this decision, and it held that CIC was a related service because Amber could not attend a school or benefit from special education without it. The case was remanded back to the District Court. The District Court held that because a nurse or other qualified person could administer CIC without engaging in the unauthorized practice of medicine, the procedure was not a medical service but was a related service (2021).
In 1984, Amber’s case was appealed to the Supreme Court.
Is medical treatment such as clean intermittent catheterization, a related service required under the Education for All Handicapped Children Act?
Is a public school required to provide and perform medical treatment prescribed by the physician of a handicapped child by the Education of All Handicapped Children Act or the Rehabilitation Act of 1973?
The Court held that CIC is a related service under the Education of the Handicapped Act:
CIC is a supportive service required to assist a handicapped child to benefit from special education. Furthermore, without having CIC services available during the school day, Amber would not have been able to attend school and benefit from special education (2021).
This Supreme Court Case impacted IDEA significantly, as it brought the lack of equity in related services to the forefront of education, whereby Students with Disabilities were provided more access to a free appropriate public education, and a less restrictive learning environment.
Congress wanted to primarily make public education available to handicapped children and to provide educational access that is purposeful for students. A service that enables a handicapped child to remain at school during the day is an important means of providing the child with meaningful access to education.
Figure 2
Spina Bifida Association