Based on the Individuals with Disabilities Education Act (IDEA), school districts must evaluate any student who appears to have one or more of thirteen disabilities. The request for such an evaluation may come from the student’s parent(s) or from any school district staff member who interacts with the student. If this evaluation indicates that a student does, in fact, have any of those disabilities, then the student must be classified as a special education student.
As set forth in the Individuals with Disabilities Education Act, school districts must provide a free and appropriate education in the least-restrictive setting to all of their special education students. In addition to providing appropriate educational services to those students, school districts also must provide whatever related assistance, equipment, services, etc. that these students need in order to receive those educational services (Note: The related services that are most commonly provided include the following: audiology services; counseling services; medical services; occupational therapy; physical therapy; psychological services; social work; speech/language therapy; and transportation).
The federal government, along with individual states, provides some of the funds that school districts use to pay for special education assistance, equipment, and services. The vast majority of these costs, however, are paid for via the school districts’ own funds. (Note: most school districts generate their own funds through local property taxes and/or local sales taxes).
If a special education student is eligible for the Title XIX/Medicaid program or the Title XXI/State Children’s Health Insurance Program (SCHIP) program, then the school district is entitled to claim federal reimbursement for some of the assistance, equipment, and services that it provides to that student. (Note: in order to qualify for such reimbursement, the assistance, equipment, and service must be included in the applicable state’s 'Title XIX/Medicaid State Plan or it must be specified in the student’s Individual Education Plan; it must be provided by a properly certified/licensed professional who is employed by or under contract to the School District; and it must be properly documented). In addition to the above, school districts are also entitled to claim federal reimbursement with respect to their allowable administrative costs. Examples of such allowable administrative costs include, but are not limited to, the following: application assistance; coordination and monitoring of health services; eligibility outreach; information dissemination; interagency coordination; and service referral.
In addition to the Individuals with Disabilities Education Act school districts must also comply with all of the applicable provisions of the Family Educational Rights & Privacy Act, the Health Insurance Portability & Accountability Act, and the Deficit Reduction Act of 2005. In this regard, those statutes impose the following additional requirements on school districts:
- Family Educational Rights & Privacy Act (FERPA): This statute was enacted by congress to protect the privacy of student educational records. In this regard, school districts generally are required to obtain permission from the student in order to release any such information concerning the student’s educational records to any third party (Note: FERPA allows access to such information by school district staff who have a 'legitimate educational interest' in same).
- Health Insurance Portability & Accountability Act (HIPAA): This statute required the U.S Department of Health and Human Services to develop a series of rules concerning health-related data. In this regard, these rules are intended to standardize the communication of electronic information between health care providers and insurers and to protect the privacy of this information.
- Deficit Reduction Action of 2005 (DEFRA 2005): This statute was intended to reform the Medicare and Medicaid programs and to reduce the federal government’s related costs by $11 billion over five (5) years. Under Section 6032 of DEFRA 2005, every entity that receives at least five million dollars ($5,000,000) per year of Title XIX/Medicaid funds must establish by January 1, 2007 written policies for all of its employees and for all of the employees of its agents and/or contractors. In addition, all such entities must provide detailed information about false claims, false statements, and whistleblower protections under the applicable federal and state fraud and abuse laws.