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Special Education: ‘Medical Model’ or ‘Educational model’ ?

By Ellen Chambers


School districts sometimes tell parents they cannot or will not provide certain services for an eligible child with a disability because, they say, the service reflects a “medical model. We are a school so we follow an educational model.”


The educational model versus medical model argument is a fabricated construct that school districts sometimes use to avoid their responsibility to provide certain services to a student. There are also many districts who believe that such an argument has a sound legal basis. It does not. There is no reference to either an educational model or a medical model in special education law. A discussion about whether a given service is part of a medical or educational model is irrelevant to the special education decision making process.


To be clear, it was never Congress’ intent that schools be responsible for the full range of a student’s medical care. It is well established that services which meet the “medical services exclusion” are not the responsibility of a school district.


Medically excluded services are those services that must be performed by a licensed physician. This was articulated clearly in the U.S. Supreme Court case Cedar Rapids v. Garret F., 526 U.S. 66 (1999):


“The scope of the ‘medical services’ exclusion is not a matter of first impression in this Court. In Tatro we concluded that the Secretary of Education had reasonably determined that the term ‘medical services’ referred only to services that must be performed by a physician, and not to school health services. 468 U. S., at 892-894.”


If a parent is requesting a service for a child and the school district refuses to provide it using the argument: “that’s a medical model” or “that’s a medical service,” the best way to redirect the conversation is to politely point out that:


1. Special education law does not recognize an educational versus medical model distinction. Rather, special education law requires that districts provide eligible students with disabilities a free appropriate public education (FAPE) that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment and independent living.[1] 


2. The relevant discussion, then, is one that explores the question: does the service meet the ‘medical service’ exclusion established by the United States Supreme Court? This is done by asking a simple question:


“Can the requested service be performed or provided only by a licensed physician?”


If the answer is yes, the school is not responsible for providing it. If the answer is no, the school is responsible for providing it if it is recommended by the Team as necessary in order for the student to receive a FAPE.



Copyright © 2011 Ellen Chambers. All rights reserved.

[1] 20 U.S.C. § 1400(d)