FAPE IDEA question

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My nephew has DS and is medically fragile. His immune system is compromised and he often winds up in the hospital for a cold. He has been on a vent numerous times for extended periods and has a trach.

He is about to turn 3 and my sister has been told that he will no longer be able to receive services in the home...that she must bring him to clinics/centers to get his PT/OT/ST.

I am thinking because he is currently getting his services through EI and it is coinciding with the age of 3, that the reason for this is that he is transitioning to whatever they call the preschool program in her state.

Does anyone know if it is a violation of IDEA to require a medically fragile child to receive center-based services instead of home-based services?

You might be able to make this argument. If you win, he would receive services under the same program that serves home bound students. For example, if a student is sick with cancer, they might receive home tutoring while they are undergoing treatment. I don't know that a lot of these teachers are used to working with children that small. But that's neither here nor there, if you can prove he needs it, the school is required to provide it. It seem to me that it would benefit everyone to simply extend his ability to participate in the EI program, but I'm not an administrator. These things get complicated.

If his only challenge is Down Syndrome, you may have a hard time making this argument. We have kids in public schools all the time with DS. Yes, they often have more infections and often have heart issues, but its usually seen as best to have them in school. You make it sound like there are some extenuating circumstances though. DS doesn't usually involve trachs. Talk to your doctor.

So, yes. I do think that making a stink and insisting that he be served at home is probably a good idea. I believe the first step would be to get a letter of recommendation from he doctors outlining that it would be detrimental to his health or even life threatening, and that he requires home care. You present that letter to your special educator and to the superintendant of special education, if your district has one. These things are almost always a matter of negotiation. Be persistent, but don't let it frustrate you yet. Its a beauacrazy.

There can be gap between 3 and whenever kindergarten starts (and if kindergarten is even required. It isn't in my state.)

The nephew aged out of his one program, but isn't "officially" in school.

So the dog fight is the school district doesn't/or maybe can't allocated services because legally he doesn't have to be in school. They flat out don't want to pay for home bound services. Yes he has issues, but since he isn't officially in school, they aren't academic issues.

In my area IF he was in kindergarten, the district would have to pick up the tab if it is academically needed. OT to help hand strength to write or type. You will do battle for each service because it's an academic need based not medical.

Because the nephew is medically fragile, doesn't their insurance pick up any of the OT/PT/ST? The doctor can write scripts for those services, and insurance should pick up the cost.

I get wanting the school handling it because there is no copay and deductible.

It's a different ballgame once in school, and different from state to state.

In my state, County EC services transition to school districts ( to prek after) 3, Special needs along with a certain multiple of the poverty level determine eligibility for free pre-k, (Head Start is a different program). School districts can charge tuition to anyone else if they want but not too poor kids or special needs. I have no idea if this is mandated by the federal government or not--I suspect it is--but I suppose it is possible they are getting Federal grant money. (No way they would do it otherwise)