SAMANTHA NEELY, GEORGE NEELY, CAROL NEELY, Plaintiffs-Appellees, v. RUTHERFORD COUNTY SCHOOL, Defendant-Appellant. United States Court of Appeals For the Sixth Circuit ON APPEAL from the United States District Court for the Middle District of Tennessee No. 94-5755

Findings of Fact: Samantha Neely is a 7 year old child attending school in Rutherford School District. Samantha suffers from a medical condition which required that she receive a tracheostomy. As a result of her condition, she must undergo regular suctioning of throat, nose and mouth in order to avoid serious or even life-threatening consequences. George and Carol, Samantha’s parents, believe that the IDEA obligates Rutherford County to provide Samantha with these services while she is in school and that Tennessee law requires that those services be provided by a licensed professional. When this case was first brought before the District court, the court found in favor of the parents, and required that the school provide and pay for the services. The district appealed the decision, and the court of appeals reviewed the case. It has been determined that caring for Samantha at school requires a well-trained medical professional because of the difficulty associated with some of the procedures that are, or may be, required. Also, the seriousness of the situation if Samantha’s breathing becomes blocked requires someone with enough training and experience to handle the medical emergency without panic. In addition, when Samantha has a cold, the suctioning services needed may be required every 20 minutes or so, or Samantha’s breathing could be blocked and serious brain damage or death could occur.

Issue: Samantha Neely requires medical services involving her tracheostomy tube which include frequent suctioning, monitoring of the tube itself (make sure it has not been dislodged), reinserting it if is becomes dislodged, and resuscitation if breathing stops. This care needs to be provided by a well-trained medical professional. The issue is who is responsible for the cost of the care.

Holding: The court of appeals reverses the ruling of the district court, finding that the procedures that Samantha requires are “medical services”, and place an undue burden on the school district.

Reasoning: Under the IDEA, schools are responsible for providing related services which are necessary for the child to be able to participate in their education. Medical services are excluded from the IDEA. It is the duty of the court to decide whether a service is considered a “related service”, which is an obligation of the school or a “medical service”, which is excluded as an obligation of the school. Tatro was a landmark case in that it established that related services that are medical in nature can become an obligation of the school. It can be interpreted to mean that any medical service that can be performed by someone other than a licensed physician falls outside the scope of the medical exception and must be provided by the school. Rutherford concedes that Samantha needs the services in question in order to participate in her education. The district court found the services to be “medical in nature” but it held that absent evidence that the care requested would be an undue burden on the school, it would be deemed a related service, and fall outside the medical services exclusion. Tennessee law requires that the service requested by Samantha be administered by a person with certain medical licenses. Thus, Tennessee law would not allow a school nurse to administer the service in question without the required license and training. This cost of providing the service is costly, and would put an undue burden on the school district. The care requested by Samantha falls within the “medical services” exclusion to the IDEA.