Using Garret F. to Advocate for Assistive Technology.

On March 3, 1999, the United States Supreme Court issued its decision in Garret F. v. Cedar Rapids Community School District, 526 U.S. 66 (1999).  The case was decided by the Court in a 7-2 decision in favor of the child’s right to receive one-on-one nursing as a related service.  Although this case does bear directly on the provision of AAC or technology, this decision may be useful in advocating for assistive technology.

Garret F. is a child who is in school in Iowa.  He uses a motorized wheelchair for mobility and requires a ventilator to breathe.  He filed for due process to require the District to provide him with one-on-one nursing to maintain his ventilator and assist with his other physical needs.  The District took the position that it was not obligated to provide the requested nursing to Garret as part of his related services.  The hearing officer ruled in favor of the child, and the District appealed the case to Federal Court and finally to the U.S. Supreme Court.

The District took the position that the decision to provide the services requested should depend on a four part test.  Specifically, it asserted that the decision should depend on the following:

1. Whether the care is continuous or intermittent;
2. Whether existing school health personnel can provide the service;
3. The cost of the service; and
4. The potential consequences if the service is not properly performed.

The Court unequivocally rejected this analysis.  It saw that the District’s position was an effort to define the scope of the services it would provide based upon cost, thereby avoiding providing such services.  The Court stated that:

“Through its multi-factor test, the District seeks to establish a kind of undue-burden exemption primarily based on the cost of the requested services.  The first two factors can be seen as examples of cost-based distinctions: intermittent care is often less expensive than continuous care, and the use of existing personnel is cheaper than hiring additional employees.  The third factor – the cost of the service – would then encompass the first two.  The relevance of the fourth factor is likewise related to cost because extra care may be necessary if potential consequences are especially serious.”

The Court further stated that IDEA “does not employ cost in its definition of ‘related services’ or excluded ‘medical services,’ accepting the District’s cost-based standard as the sole test for determining the scope of the provision would require us to engage in judicial lawmaking without guidance from Congress.”

The obvious significance of this case is that many children who need one-on-one nursing care as a related service in order to go to school now have a court defined right to these services.  More generally, this case squarely confronts the issue of cost in defining the scope of related services.  The Court has firmly held that cost simply cannot be a factor in determining the scope and extent of related services.  However, cost will obviously always be an unspoken criterion.  More legitimately, for example, if two devices are capable of meeting a child’s needs, the district may opt for the cheaper device.

The Garret F. case is an important case to read when faced with Districts that are unwilling, either overtly or tacitly on the basis of cost, to provide the necessary AAC device and other assistive technology, and the training and personnel to make the device an integral part of the child’s education.

Comments

[Paula Wiggins]

Charlie,

This blog is very informative. I'm only sorry I didn't read it sooner. I would have liked to hear Barbara Doyle again. She gave me so much insight on getting my son ready for the future. I'm looking forward to reading the blog weekly.

Thanks for giving parents another tool to keep in touch with the law and our rights.

Paula Wiggins

[Lakshan]

Perhaps What do you do?At the moment, I'm firgiung out what to do with a stupid question.Most of my socialization now occurs at work, so I haven't been asked this question in a long time. But I faced it plenty before I moved here. People can't stand the idea of not doing something. Well, let me revise: Middle-to-upper-class white abled folk can't understand how someone could not do something, that is, have an established, high-status, high-ambition career. I don't run in to a whole lot of questioning in groups with a greater proportion of lower-income folks (in my experience) about my job; they usually know that a job is a job, and if you don't have one then you just don't have one, and it doesn't make your life empty. Not that lower-class circles don't also have a value system that includes work-worship; some lower-income folk with whom I am acquainted just can't see not doing something as anything other than pure apathy/laziness/slacking/freeloading/lack of ethic. But I usually read more of a value on subsisting, whereas in higher-class circles I read more of a value on status/definition.And, of course, it almost always leads to I wish I could stay in bed/sit on the couch/watch TV all day! Disability is not your sick day. When I was stuck in the house all day, I could not stop longing to get out and do something. I desperately wanted to be working a regular job, or learning something, just doing something outside the house. But I couldn't. And yet most people interpreted my condition as being one of laziness and youthful irresponsibility, even knowing how deeply and passionately I longed to get outside and how much trouble I had with everyday tasks they saw those two things and still somehow came out with slacker kid. Probably because are taught to distrust our perceptions and experience (). It is only if you think the pain and fatigue and external barriers don't exist that you can interpret that condition as irresponsibility/lack of motivation. Especially when confronted with an excess of motivation!There's no good way to respond to it that I've found. All I've ever been able to do is either sputter or say Trade me, please, I want so badly to be able to work! Which, of course, they don't seem to hear at all. Sigh..-= amandawb4s last blog .. =-.