Prescription Pads for      Education Problems            CAROLYN POINTER, JD              NOVEMBER 2, 2010          THE BE...
ThanksThanks to William B. Reichhardt, of the LawOffices of William B. Reichhardt & Associates, andto Angela Ciolfi and th...
What is a MLP? A medical-legal collaboration addresses the multiple needs of low-income patients  Provider training on l...
MLP|Charlottesville Sites UVA Pediatric Primary Care UVA Newborn Nursery Kluge Children’s Hospital UVA Pediatrics at O...
By the end of today,          you will be able to… 1.   UNDERSTAND HOW AN IEP IS SUPPOSED TO WORK.      2. IDENTIFY SPECIA...
What is ―the law‖?IDEA (IEP)                               504 (Accommodation Plan)                                       ...
IDEA: Sources of Law Federal statutes (20 U.S.C.A. § 1400 et seq.) Federal regulations (34 C.F.R. § 300 et seq.) Judici...
Terminology and Definitions             IEP – Individual Education              Program             LEA – Local Ed Agenc...
The School’s Requirement to Provide FAPE  A free appropriate public education ―FAPE‖  ―Appropriate‖ means that a child m...
What is ―meaningful educational progress‖?  Must address the child’s needs as defined by   eligibility for services in on...
The Life Cycle of an IEPChild Find   Evaluation   Eligibility             IEP/FAPE            Termination                 ...
Goals Vs. Methods The IDEA requires that the IEP state measureable  goals designed to meet the child’s unique needs  rela...
Common Special Education Problems The ―Diagnostic Disconnect‖ – Parents and    school do not agree about the nature and s...
Common Problems There is no defined baseline from which to measure progress. Goals and objectives are vague and not meas...
What Problems Do We Want to Solve? For Now – FAPE requires meaningful educational progress in the least restrictive schoo...
Most common special education claimsFailure to determine eligibility- IDEA or 504. IEP fails to provide FAPE – defective...
Recognizing when a case should go to formal               complaint processReasons to ConsiderFiling                      ...
Common Issues in Discipline Cases Findings and Procedures in the Manifestation Determination Review (MDR) Denial of FAPE...
Discipline of StudentswithDisabilities Students with disabilities receive extra protection  from disciplinary exclusion....
Overview of Discipline Procedures                            Misbehavior                Change in               Short-term...
Discipline of StudentswithDisabilities Short-term removal is a removal ≤ 10 school  days  school must provide due proces...
Is the behavior a manifestation of the disability? Was the behavior caused by the disability? Was the behavior directly ...
Whatis a FBA/BIP? 8 VAC 20-80-10 ―Functional behavioral assessment‖ means a  process to determine the underlying cause or...
Whenis a FBA/BIP required? A FBA/BIP is required:   When the child’s ―behavior impedes the child’s learning or    that o...
Dangerousness Exceptions If the behavior is a manifestation of the disability, then the child cannot be removed from the ...
No Manifestation If the conduct is NOT a manifestation of the  student’s disability, the school may change the  student’s...
I’m a doctor, not a advocate!ANYONE WHO CAN LEARN THE  KREBS CYCLE CAN LEARN    HOW TO BE A CHILD        ADVOCATE.        ...
Goals of Great Doctor Advocacy Access appropriate services for patient Minimize time needed for advocacy Develop good r...
Effective AdvocatesAccurately   assess the problem and identify solutionsMaintain credibilityBe creative in pursuit of ...
Dispute Resolution: 4 Options Informal resolution State complaint to VDOE   Can Be Made By ANYONE   Formal Complaint (...
When do doctors make the best advocates? Negotiating with school districts – the art of leverage.Paving a great paper tr...
Use charts to easily illustrate problems                          Use the LEA’s data for                           compari...
Advise Parents to Gather Information Copies of eligibility determinations and requests IEPs for last 3 years, FBA, BIP ...
Advocacy Tactics Know your audience – are you addressing parents, teachers, administrators, or lawyers? What needs to be...
Advocate in a letter Be specific and use examples How you know this child? What problems have you identified? How did y...
Advocate in a TEAM meeting Parents can invite anyone, including MDs, to IEP meetings The TEAM must consider your informa...
Tips for Advocates Obtain, review and understand complete educational    record, including witness statements, incident  ...
Can’t I just write a prescription?          1. TEMPLATE LETTERS         2. CURBSIDE CONSULTS        3. REFER A FAMILY TO MLP
Prescription Pads for Education ProblemsTake an IEP and call me in the                                 Form letters to get...
Request an IEP evaluation     DATE     School Principal     School Address     Re: NAME OF STUDENT     Dear Principal ____...
Provide a clinical diagnosis    Dear Principal _________________:    I am writing to provide you with information aboutSTU...
Autism – as defined by VDOEDEFINITION: "Autism" means a developmental disabilitysignificantly affecting verbal and nonverb...
Characteristics of ASD – according to VDOE•Children with Aspergers Disorder demonstrate the following characteristics:Imp...
Steps 3, 4, and 5, according to VDOEThe childs educational performance is not adversely affectedprimarily because the chil...
Curbside Consults… it’s free and easy! When you aren’t sure what to do, call your MLP attorney and ask. When you’re not ...
What to do when a patient    needs a lawyer?    TELEPHONE:   434-977-0553 X117        FAX:     434-977-0558        CELL:  ...
Prescription pads for education problems 11.2.10
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Prescription pads for education problems 11.2.10

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Prescription pads for education problems 11.2.10

  1. 1. Prescription Pads for Education Problems CAROLYN POINTER, JD NOVEMBER 2, 2010 THE BETTY SAMS CHRISTIAN CHILD HEALTH ADVOCACY PROGRAM AT THE UVA MEDICAL CENTERMEDICAL LEGAL PARTNERSHIPS| CHARLOTTESVILLE
  2. 2. ThanksThanks to William B. Reichhardt, of the LawOffices of William B. Reichhardt & Associates, andto Angela Ciolfi and the JustChildren team at theLegal Aid Justice Center for their assistance withthis presentation.
  3. 3. What is a MLP? A medical-legal collaboration addresses the multiple needs of low-income patients  Provider training on legal issues and how they affect health  Patient identification from practices  Advice, counsel, and extended representation for patients and families in need  Curbside consults for providers Based on model at the Boston Medical Center
  4. 4. MLP|Charlottesville Sites UVA Pediatric Primary Care UVA Newborn Nursery Kluge Children’s Hospital UVA Pediatrics at Orange UVA Northridge Pediatrics UVA NICU
  5. 5. By the end of today, you will be able to… 1. UNDERSTAND HOW AN IEP IS SUPPOSED TO WORK. 2. IDENTIFY SPECIAL EDUCATION PROBLEMS.3. EFFECTIVELY ADVOCATE FOR PATIENTS WITH SPECIAL EDUCATION PROBLEMS.4. USE A ―PRESCRIPTION PAD‖ TO HELP PATIENTS WITH SPECIAL EDUCATION PROBLEMS.
  6. 6. What is ―the law‖?IDEA (IEP) 504 (Accommodation Plan)  ―No otherwise qualified individual The Individuals with Disabilities Education Act (IDEA) gives with a disability…shall, solely by children with disabilities the right reason of her or his disability, be to a ―free appropriate public excluded from the participation in, education‖ be denied the benefits of, or be Combination of federal and state subjected to discrimination under laws [includes LEAs]‖ Children identified as disabled can get special services via an  Modifies school requirements Individualized Education Plan under ADA (IEP) from the local school district  The child must have a physical or Services include… anything necessary for the student to access mental impairment which a FAPE (Free Appropriate Public substantially limits at least one Education) major life activity (walking, hearing, speaking, learning…)
  7. 7. IDEA: Sources of Law Federal statutes (20 U.S.C.A. § 1400 et seq.) Federal regulations (34 C.F.R. § 300 et seq.) Judicial decisions (federal and state) State regulations 20-81-10 et seq. Also Guidance documents from state and federal departments of education (Office of Special Education Programs (OSEP)
  8. 8. Terminology and Definitions  IEP – Individual Education Program  LEA – Local Ed Agency  IEE- Independent Ed Eval  FAPE- Free Appropriate Public Education.  BIP – Behavior Intervention Plan  FBA – Functional Behavioral Assessment  PLOP – Present Level of Performance.
  9. 9. The School’s Requirement to Provide FAPE  A free appropriate public education ―FAPE‖  ―Appropriate‖ means that a child must have educational services and accommodations that allow the child to make meaningful educational progress in the least restrictive school environment.  The Individual Education Program (IEP) is a unique contract and a roadmap for each child
  10. 10. What is ―meaningful educational progress‖?  Must address the child’s needs as defined by eligibility for services in one or more disability categories.  To be meaningful, educational progress must be measureable and observable over time.  School cannot be required to implement a specific methodology, but must use viable research based programs.
  11. 11. The Life Cycle of an IEPChild Find Evaluation Eligibility IEP/FAPE Termination Revision Placement Annual Review Implementation
  12. 12. Goals Vs. Methods The IDEA requires that the IEP state measureable goals designed to meet the child’s unique needs related to his disability. Goals are to be academic and functional – to allow for meaningful progress in the general curriculum. Education practices must be based upon peer- reviewed research Methodology must have shown beneficial results in a number of controlled studies.
  13. 13. Common Special Education Problems The ―Diagnostic Disconnect‖ – Parents and school do not agree about the nature and scope of a child’s disability. Eligibility does not match the student’s diagnosis or needs. Therefore – Impossible to have viable IEP
  14. 14. Common Problems There is no defined baseline from which to measure progress. Goals and objectives are vague and not measurable. Failure to offer services relevant to the disability. Failure to offer alternative assessments Concentration on discipline procedures prevents attention to learning
  15. 15. What Problems Do We Want to Solve? For Now – FAPE requires meaningful educational progress in the least restrictive school environment. Now for Then – Compensatory services for demonstrated regression. Always – Establish some cooperative working relationship between parent and school.
  16. 16. Most common special education claimsFailure to determine eligibility- IDEA or 504. IEP fails to provide FAPE – defective as to level and scope of services and/or placement. Compensatory services needed for regression. Failure to provide transition plan/services
  17. 17. Recognizing when a case should go to formal complaint processReasons to ConsiderFiling Reasons to Avoid Filing Clear Noncompliance  Parents are just tired Clear Regression of of fighting with LEA Skills  Parents want to set Failure to Offer or precedent ―for all Define Placement other parents having Denial of Rights under same problem.‖ IDEA (i.e. denial of IEE)  As leverage to Clear Denial of FAPE recover attorney fees. Denial of Eligibility
  18. 18. Common Issues in Discipline Cases Findings and Procedures in the Manifestation Determination Review (MDR) Denial of FAPE by extended homebound exclusion without adequate services. Failure to provide FAPE in an alternative learning environment.
  19. 19. Discipline of StudentswithDisabilities Students with disabilities receive extra protection from disciplinary exclusion. School may not change the student’s placement (i.e., suspend) for behavior that is a manifestation of the student’s disability. Students who are suspended or expelled are entitled to FAPE.
  20. 20. Overview of Discipline Procedures Misbehavior Change in Short-term Placement removal Manifestation No MDR Determination Review No Services Behavior is a manifestation of No manifestation. disability. Placement may be Return to original changed, but placement + FAPE must be FBA/BIP provided.
  21. 21. Discipline of StudentswithDisabilities Short-term removal is a removal ≤ 10 school days  school must provide due process protections afforded to all students (notice + hearing) Change in placement is a removal > 10 consecutive school days (or shorter periods of repeated removals constituting a pattern)  School must provide:  due process provided to all students +  manifestation determination review hearing +  Services during removal
  22. 22. Is the behavior a manifestation of the disability? Was the behavior caused by the disability? Was the behavior directly & substantially related to the disability? OR Was the behavior the direct result of the school’s failure to implement the IEP? If the answer is ―YES‖ to any of these questions, the behavior is a manifestation of the child’s disability.  The child must be returned to the original placement  Functional Behavior Assessment + Behavior Intervention Plan (FBA-BIP)
  23. 23. Whatis a FBA/BIP? 8 VAC 20-80-10 ―Functional behavioral assessment‖ means a process to determine the underlying cause or functions of a child’s behavior that impede the learning of the child with a disability or the learning of the child’s peers. A functional behavioral assessment may include a review of existing data or new testing data or evaluation as determined by the IEP Team.‖ ―Behavior intervention plan‖ means a plan that utilizes positive behavioral interventions and supports to address behaviors that interfere with the learning of students with disabilities or with the learning of others or behaviors that require disciplinary action.‖
  24. 24. Whenis a FBA/BIP required? A FBA/BIP is required:  When the child’s ―behavior impedes the child’s learning or that of others,‖ the IEP Team shall ―consider the use of positive behavioral interventions, strategies, and supports to address the behavior.‖ (8 VAC 20-81-110(F)(2))  When the child’s behavior is a manifestation of the disability (8 VAC 20-81-160)  When the child’s behavior is not a manifestation of the child’s disability ―if appropriate.‖ (8 VAC 20-81-160(C)(6).
  25. 25. Dangerousness Exceptions If the behavior is a manifestation of the disability, then the child cannot be removed from the placement unless:  Child possessed or carried weapons or drugs to school; or  Child inflicted serious bodily injury on another person while at school or school function, or  Hearing officer or judge has determined the child is too dangerous to remain at school The child may then be removed to an interim alternative educational placement for up to 45 days, but must still receive FAPE.
  26. 26. No Manifestation If the conduct is NOT a manifestation of the student’s disability, the school may change the student’s placement, but MUST provide FAPE during removal. Services during removal MUST start on the 11th day of removal and allow the student:  To make progress on IEP goals AND  To participate in the general curriculum Advocate for an FBA and/or BIP—and be prepared to explain why doing an FBA and/or BIP is appropriate
  27. 27. I’m a doctor, not a advocate!ANYONE WHO CAN LEARN THE KREBS CYCLE CAN LEARN HOW TO BE A CHILD ADVOCATE. -JEROME A. PAULSON
  28. 28. Goals of Great Doctor Advocacy Access appropriate services for patient Minimize time needed for advocacy Develop good relationships with community partners
  29. 29. Effective AdvocatesAccurately assess the problem and identify solutionsMaintain credibilityBe creative in pursuit of remediesEstablish or repair a collaborative parent-school relationship
  30. 30. Dispute Resolution: 4 Options Informal resolution State complaint to VDOE  Can Be Made By ANYONE  Formal Complaint (written, signed, statement of violation)  Schools Submit Response  Investigation by VA DOE  60 days to VA DOE decision  1-year statute of limitations Mediation Due process hearing  state or federal court
  31. 31. When do doctors make the best advocates? Negotiating with school districts – the art of leverage.Paving a great paper trail.  What are your experiences with schools?  What can you do?  What should they do?
  32. 32. Use charts to easily illustrate problems Use the LEA’s data for comparison charts. Charts can show: o Lack of progress o Loss of skills o Inability of LEA to track data. o Regression
  33. 33. Advise Parents to Gather Information Copies of eligibility determinations and requests IEPs for last 3 years, FBA, BIP Work samples, teacher notes/emails, parent- teacher journals –progress reports for annual goals. All school and private testing-SOL history and report cardsAll of this should be available under FERPA, but parents may need to pay reasonable copying fees
  34. 34. Advocacy Tactics Know your audience – are you addressing parents, teachers, administrators, or lawyers? What needs to be included? Ask an expert for help… What is the best vehicle for your input? Letter, call, attending a meeting?
  35. 35. Advocate in a letter Be specific and use examples How you know this child? What problems have you identified? How did you identify them? What services or accommodations would help your patient? How do you know this? How can the recipient contact you? Use your title to impress, but don’t use lingo that can be unclear to non-medical folks.
  36. 36. Advocate in a TEAM meeting Parents can invite anyone, including MDs, to IEP meetings The TEAM must consider your information when making decisions Use your title to impress, but be wary of too much ―lingo.‖ Follow up in writing!
  37. 37. Tips for Advocates Obtain, review and understand complete educational record, including witness statements, incident reports, and statements by client. Make sure you know who the ―Parent‖ is – in some cases, there may be active biological and foster parents, as well as interested relatives or other guardians. Respond immediately to student discipline situations Understand dates, deadlines and notice requirements, & make sure parents are also aware. Put concerns, confirmation of meetings, agreements, etc. in writing. Create a record. Give schools a chance, and the information necessary, to do the right thing before assuming the worst.
  38. 38. Can’t I just write a prescription? 1. TEMPLATE LETTERS 2. CURBSIDE CONSULTS 3. REFER A FAMILY TO MLP
  39. 39. Prescription Pads for Education ProblemsTake an IEP and call me in the Form letters to get startedspring…  Request an IEP evaluation  Request written copies of evaluations  Request school records  Provide a diagnosis
  40. 40. Request an IEP evaluation DATE School Principal School Address Re: NAME OF STUDENT Dear Principal _______: I am writing because I am concerned about STUDENT’s academicprogress. I am specifically concerned that _______________. I wouldlike STUDENT to be evaluated for eligibility for an IEP and a 504 Plan. I look forward to working with you to help STUDENT. Pleasecontact me at: PHONE EMAIL ADDRESS if I can provide more information. Sincerely, NAME
  41. 41. Provide a clinical diagnosis Dear Principal _________________: I am writing to provide you with information aboutSTUDENT, my patient since _____. I am a board certifiedpediatrician, graduated medical school in ____, and INSERTCREDENTIALS HERE. STUDENT was diagnosed with [mental retardation, hearingor visual impairment, speech or language impairment, seriousemotional disturbance, orthopedic impairment, autism,traumatic brain injury, specific learning disability – see attacheddraft diagnoses worksheets] in ____. This diagnosis was basedon ____ (tests, evaluations, etc with dates). STUDENT’S disability adversely affects HIS/HEReducational performance by _____________ue to thisimpairment, the child needs specially designed instruction inorder to succeed in school.
  42. 42. Autism – as defined by VDOEDEFINITION: "Autism" means a developmental disabilitysignificantly affecting verbal and nonverbal communicationand social interaction, generally evident before age three, thatadversely affects a childs educational performance. Othercharacteristics often associated with autism are engagement inrepetitive activities and stereotyped movements, resistance toenvironmental change or change in daily routines, andunusual responses to sensory experiences. Autism does notapply if a childs educational performance is adversely affectedprimarily because the child has an emotional disturbance. Achild who manifests the characteristics of autism after agethree could be identified as having autism if the criteria in thisdefinition are satisfied.
  43. 43. Characteristics of ASD – according to VDOE•Children with Aspergers Disorder demonstrate the following characteristics:Impairments in social interaction, such as marked impairment in the use of multiple nonverbalbehaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate socialinteraction; failure to develop peer relationships appropriate to developmental level; a lack ofspontaneous seeking to share enjoyment, interests, or achievements with other people (i.e., by a lack ofshowing, bringing, or pointing out objects of interest); or lack of social or emotional reciprocity arenoted; andRestricted, repetitive and stereotyped patterns of behavior, interests, and activities such asencompassing preoccupation with one or more stereotyped and restricted patterns of interest that isabnormal either in intensity or focus, apparently inflexible adherence to specific, nonfunctional routinesor rituals, stereotyped and repetitive motor mannerisms, persistent preoccupation with parts of objects.•Children with Autistic Disorder demonstrate impairments in:Social interaction; and Restricted, repetitive, and stereotyped patterns of behavior as listed above; andImpairments in communication, such as delay in, or total lack of, the development of spoken language(not accompanied by an attempt to compensate through alternative modes of communication such asgesture or mime). In individuals with adequate speech, marked impairment in the ability to initiate orsustain a conversation with others, stereotyped and repetitive use of language or idiosyncratic language,or lack of varied, spontaneous make-believe play or social imitative play appropriate to developmentallevel is noted.
  44. 44. Steps 3, 4, and 5, according to VDOEThe childs educational performance is not adversely affectedprimarily because the child has an emotional disturbance.There is documentation of an adverse effect on educationalperformance due to one or more documented characteristics ofautism.List and/or describe:Due to the identified Autism, the student needs speciallydesigned instruction.
  45. 45. Curbside Consults… it’s free and easy! When you aren’t sure what to do, call your MLP attorney and ask. When you’re not sure what to say, call your MLP attorney and ask. When you aren’t sure if this is a case, call your MLP attorney and ask.
  46. 46. What to do when a patient needs a lawyer? TELEPHONE: 434-977-0553 X117 FAX: 434-977-0558 CELL: 434-284-0882 EMAIL: CAROLYNP@JUSTICE4ALL.ORG

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