By John Worthington, Esq., Coordinator of Special Education Law, Foundation for Educational Administration
When working with parents of students with disabilities and navigating the myriad legal requirements under the Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act of 1973 (Section 504), a constant source of information and often frustration for school districts is prescriptions, notes and reports from outside medical providers, often obtained by parents on their own initiative. While information from medical providers and other professionals is often essential to evaluating and serving students with disabilities, school districts must carefully assess the information and make informed decisions as to eligibility and programs and services for students. For, while all such information must be considered, and such consideration documented, determinations as to eligibility, program and services rest with IEP and Section 504 teams, not medical or other outside providers.
NJDOE Guidance
Furthering this point, on April 16, 2025, the New Jersey Department of Education issued a broadcast memorandum – Clarification on the Intersection Between Prescriptions and Referrals for Special Education Services -reminding school districts that prescriptions from a medical practitioner are not referrals to the child study team for a determination of eligibility for special education and related services. Rather, referrals may only be made by parents, school district staff and State agency staff. Likewise, prescriptions, notes and reports from medical practitioners are not orders in the sense that a school district must adhere to what they say. Rather, school districts must consider all such recommendations and make appropriate determinations in accordance with applicable laws.
Obligation to Consider Medical Information in Writing IEPs and 504 Plans
Essentially, prescriptions and reports from providers provide essential data and information for school districts to consider and utilize when writing IEPs, Section 504 Plans and Individualized Health Plans (IHPs). However, they are not orders that must be followed regardless of whether the applicable person or team agrees that the information is appropriate for serving a student with an IEP, IHP or Section 504 Plan. Decisions as to eligibility, program and services legally rest with IEP and Section 504 teams, after consideration of all relevant data and information, including that which provided by parents.
While directions for medical care and medications need to be followed (subject to confirmation by the school physician through a conversation with the treating physician when necessary) many recommendations in prescriptions and reports of medical and other providers are not of a medical nature. Instead, statements such as “provide the student an IEP or 504 Plan” and recommendations for the contents of same are suggestions to be considered, not orders that must be followed. When such requests are received, IEP and Section 504 teams must consider the information provided, and document that they have done so, but the team retains jurisdiction to determine eligibility under the IDEA and Section 504, and the contents of an IEP of 504 plan.
Key NJDOE Regulations
In this regard, relevant NJDOE regulations provide:
N.J.A.C. 6A:14-2.5(c)4. Any independent evaluation submitted to the district board of education, including an independent evaluation obtained by the parent at private expense, shall be considered in making decisions regarding special education and related services.
N.J.A.C. 6A:14-3.4(a) The child study team, the parent, and the general education teacher of the student who has knowledge of the student’s educational performance or, if there is no teacher of the student, a teacher who is knowledgeable about the school district’s programs shall: 1. Review existing evaluation data on the student including evaluations and information provided by the parents . . .
N.J.A.C. 6A:14-3.4(i). When conducting an initial evaluation or reevaluation, the reports and assessments of child study team members or related services providers from other public school districts, Department of Education approved clinics or agencies, educational services commissions or jointure commissions, or professionals in private practice may be submitted by the parents to the child study team for consideration. Each report and assessment shall be reviewed and considered by the child study team member or related services provider with relevant knowledge or expertise. A report, or component thereof, may be utilized as a required assessment, if the assessment has been conducted within one year of the evaluation and the child study team determines the report and assessment meet the requirements of (h) above.
These regulations emphasize the need to consider all information from outside providers, but also that district staff (the Child Study Team in these regulations) make determinations, not the providers submitting reports, prescriptions and notes.
Revised Law on Home Instruction
Recent New Jersey legislation further supports this point. The legislation addresses which medical providers can provide a written determination of the need for medical home instruction. The law provides as follows:
P.L. 2025, c. 240, C.18A:40-11.1: Request for home instruction
1. a. A parent or guardian requesting home instruction due to a student’s temporary or chronic health condition or need for treatment that precludes participation in the student’s usual education setting, whether general education or special education, shall submit to the board of education a request that includes a written determination from the student’s physician, physician assistant, or advanced practice nurse documenting the projected need for confinement at the student’s residence or other treatment setting for more than 10 consecutive school days or 17 cumulative school days during the school year.
b. The provisions of this section shall be in addition to any other requirement for the receipt of home instruction established pursuant to State Board of Education regulations.
This statute provides clarification of who can provide medical documentation for home instruction requests, but of equal importance, it emphasizes that the notes from medical providers are NOT directives that must be followed by school districts without any scrutiny or independent determinations being made. Rather, all applicable legal requirements remain in place in addition to the allowance for multiple provider types being permitted to provide the needed documentation to initiate the process. As such, the law reinforces that IEP and Section 504 teams retain their authority to make determinations as to eligibility, programs and services, while considering input from medical practitioners and other providers when making such determinations. Note too that school districts may contact outside providers to clarify the contents of prescriptions, orders and notes from medical and other providers without violating FERPA or State student records laws. Such contacts seeking clarification of notes provided by parents constitute permissible sharing of information in accordance with HIPPA and FERPA. The same is true with respect to reports from other providers as well, such as psychologists and psychiatrists, OTs, PTs, Speech Language Specialists. Information provided by these practitioners must be considered by IEP and Section 504 teams, but final decisions as to eligibility, programs and services rests with the teams, not the individual making recommendations in reports. However, while the provisions of an IEP, Section 504 plan and IHP are legally required to be developed by appropriate staff, those staff/team members often need appropriate guidance to address eligibility and appropriate programs and services for students.
Thus, while prescriptions, notes and reports are an important source of information that must be considered, they should not be automatically followed by teams. That would in essence constitute an impermissible abdication of authority and could result in inappropriate or incorrect determinations as to eligibility, programs or services for individual students. If such incorrect determinations are made, those determinations rest with the school district, and liability accrued through challenges to such determinations would inure to the school district, not to the provider who submitted the prescription, note or report.
In this regard, school districts should develop policies and procedures to effectively address and document their consideration of prescriptions, notes and reports while meeting established needs of students. Such policies and procedures require a thoughtful process that effectively meets the educational and medical needs of students, while ensuring that determinations are made by appropriate personnel and teams.
Moving Forward
This article sets forth considerations for school districts when they receive prescriptions, notes and reports from medical and other professionals suggesting eligibility for, or the contents of, IEPs and Section 504 plans. While school district must consider all such information, and document that they have done so, decisions as to eligibility for IEPs and Section 504 plans, and as to the programs and services set forth therein, remains with the IEP and Section 504 teams. District policies should require consideration of such information, and that such consideration be documented. School districts should also ensure that all staff understand how to address and consider prescriptions, notes and reports from medical and other providers when evaluating students for eligibility and determining programming and services under IDEA and Section 504.