Director’s Message

Jay Sicklick, Esq.

Welcome to the Fall issue of our Medical-Legal Partnership newsletter. In this edition, we focus on educational success – how a medical-legal partnership can team with clinicians and families to enhance educational outcomes for students with disabilities. 

Over seventeen years ago, the first case our newly forged Medical-Legal Partnership handled at Connecticut Children’s Medical Center involved a chronically ill child whose parents could not access educational services from their local school district. The pediatric primary care provider had attended numerous planning and placement team meetings (PPT) advocating for her patient’s right to attend school rather than receive home tutoring services as the district demanded. Although they refused to admit it, the district could not find a qualified para-professional to provide direct support to the girl even though her individualized education plan (IEP) required it. A draft of a Due Process complaint and a mediation session resulted in an immediate out of district placement for this student – primarily because of the pediatrician’s thorough report on the student’s medical and behavioral support needs. 

This was the first of many educational success stories for the partnership at CCMC, followed by countless advocacy gains – both individual and systemic. We hope this newsletter will provide you with some guide posts and advocacy tips to further enhance successful educational outcomes for your patients.  In addition, we invite your feedback on the articles below. 

Best,
Jay

Medical Director's Corner

Ada Fenick, MD

Case study: Child is held back in school. What should you do?
Providers are invited to comment.

Eight year old JM presents for well-child care. His mother states that he has been doing well in school and is now in second grade. Given his birthday, you realize JM should now be in third grade. 

When you ask, mom says his teacher last year thought JM could use the extra year to mature and improve his reading skills. Although she had no extra meetings with the school, JM's mother agreed.

How would you handle this? Should you support the parent and contact the school to determine why they never held a formal meeting for this student?  

Points to keep in mind:

• Pediatricians should develop a sense for child’s grade compared with age. A child held back may be a clue to a deeper educational problem.
• Parents who receive such recommendations may easily acquiesce. They may not know their rights. Children who are held back academically or for social reasons should be formally evaluated..
• A 2015 publication from the AAP entitled the Individuals With Disabilities Education Act (IDEA) for Children With Special Educational Needs may be found here.  

Back to School – Three Quick Advocacy Tips for Providers

Alice Rosenthal, Staff Attorney

Back to school can be stressful for children with disabilities. Here are three quick tips to keep in mind:   

1. Build positive relationships.
   Remind parents to build relationships with a child’s teachers and ensure the teacher has a copy of the most recent Individualized Education Plan (IEP). Confirm that the child is receiving the services s/he is entitled to. Sometimes schools do not have staffing to comply with the IEP, but that is no excuse!  Students with disabilities are protected by federal laws. If your patient is not receiving all of the recommendations provided in the IEP, please contact an MLPP attorney for further guidance!    
    
2. Be a partner in your patient’s education. 
   Medical visits are an opportunity to ask families about concerns with school. Ask if they feel their child is receiving an appropriate education, or ask the child how s/he feels about school. Ensure families provide the school with comprehensive medical documentation. Build relationships with schools to ensure they are providing the services and accommodations your patient needs. 
          
3. It’s never too early to ask for help. 
   Parents do not need to wait until further in the school year to ask for help. Keep a close eye on the child’s performance, especially if last year didn’t go as well as hoped. Children may struggle in school for many reasons. Identifying problems early is critical to success.     

For additional resources, the Center for Children’s Advocacy has a number of information guides for providers.  Check the full list of guides here. If you would like to schedule a training on how to maximize your advocacy skills in order to make sure that schools provide necessary educational services for your patients, please contact us.  

What are “504 Accommodations” and How Can I be a Better Advocate for Patients with 504 Plans? 

Bonnie Roswig, Senior Staff Attorney

"Children with disabilities have the right to be educated by pubic (and private) school systems regardless of their disability. By and large these children should be educated in a setting with their non-disabled peers and should be included in all school activities."

Most providers are familiar with special education services provided under IDEA, but what exactly is a “504 Plan?” Section 504 of the Rehabilitation Act of 1973 mandates inclusion. School systems are required to affirmatively identify children with disabilities and notify parents and children of their rights. Children protected by Section 504 are those who: 1) have a physical or mental impairment that limits one or more major life activity, 2) have a record of such impairment, or 3) are regarded as having such an impairment.

A child's "504 Team" includes individuals having knowledge of the child's medical condition. Accommodations are based on the specific medical needs of the child (there is no standardized list of accommodations). Accommodations can include assisted technology, extra set of books at home, breaks for access to nurse, social worker, bathroom, extended time for test taking, door to door transportation, etc.

For post-secondary programs, which are also required to provide accommodations, the student and/or parents must initiate access to accommodations and have medical documentation of the disability. Possible accommodations can include recording classes, remote attendance, assisted technology, housing with accommodations, transportation on campus, priority parking, etc.

Necessary accommodations for post-secondary programs should be discussed in high school. "Transition" meetings (discussion of post-secondary plans) should occur when the student is between ages 14 and 16 and should include services and supports neededto ensure post-graduation success.

For more information, please see the Center's publications: Protecting Children with Disabilities and Transitioning to College

CREC Open Choice Information Now Available

Capitol Region Education Council (CREC) develops cost-effective and high-quality programs and services to meet the educational needs of children in Greater Hartford.

Information on CREC's Open Choice application process as well as 2017 & 2018 information sessions is now available and can be found on their website here.

Important Upcoming Events

Free Seminar/Webinar - click to register
Chemical Strait Jackets: Over-Medication of Children in State Care
Tuesday, October 31, 2:00 pm - 3:30 pm

Panelists:
Sara Bartosz, JD, Deputy Director of Litigation Strategy
Children's Rights, New York; lead attorney for the Missouri class action M.B. v. Tidball

Mirela Loftus, MD, PhD, Child and Adolescent Psychiatrist
Institute of Living, Hartford, CT; 

Roumen Nikolov, MD, Medical Director and Chief of Psychiatry
Solnit Center, CT Department of Children and Families

Keep the Power On Utility Clinics
New Britain: Tuesday, Oct 24 at 1 pm, New Britain Senior Center
Hartford: Friday, Oct 27 at 1 pm, Saint Francis Hospital and Medical Center, Gengras Auditorium

We Want to Hear From You! 

Are you a pediatrician? Medical provider? Practice or hospital administrator? 

Please send us your feedback.
Send questions or let us know what you would like to see in an upcoming issue. 

Center for Children's Advocacy
65 Elizabeth Street, Hartford, CT 06105
211 State Street, Bridgeport, CT 06604
cca-ct.org/mlpp