Transportation to School for Kids with Complex Medical Conditions
Going to school is obviously ideal for children with complex medical conditions or disabilities, but sometimes the process of just getting there can be overwhelming. How can children who need wheelchairs or who can’t even sit up be transported to school? Is it always the school’s responsibility to transport a child? This article will answer some of these questions by providing information on the legal and practical issues of transportation to and from school.
The Legal Stuff
In most states, school districts are required to provide transportation to school for children who live more than a mile or two away from their neighborhood schools. Each state has separate rules about busing, which may include how far you must live from the school to receive busing, and whether or not the state requires busing at all. To find out your state’s policy, search for your state board of education’s busing guidelines or policies.
In addition to these state-based requirements, students with Individualized Education Program (IEPs) may be eligible for transportation services if their disability or medical condition impacts their ability to go to school. In some cases, transportation may also be included in 504 plans for students who require assistance to attend school but who do not require special education services.
The Individuals with Disabilities Education Act (IDEA) includes transportation as one of the related services that children with IEPs may receive if needed. Transportation includes not only travel to and from school, but also travel between schools if necessary, and travel to any school-related events, such as field trips and certain extracurricular events.
Any child who is unable to walk to school or use traditional transportation methods to attend school due to a disability or medical condition is eligible for transportation as a related service. The following are just a few examples of children who are likely eligible for transportation assistance:
- A child who uses a wheelchair, crutches, or a walker
- A child who is unable to walk more than 50 feet
- A child with severe asthma, a heart condition, or another medical condition that can cause fatigue when walking
- A child with autism or an intellectual disability who cannot ride a traditional bus safely
- A child on oxygen or a ventilator
- A child who cannot regulate his/her body temperature
In some smaller school districts, it is common practice for the school to request that a parent transport a child with a disability or medical condition. Note that parents cannot be required to transport children under these circumstances, as it is ultimately the school’s responsibility. In addition, if the parent does choose to transport the child, he or she should be reimbursed for the costs of transportation.
Finally, in rare cases, a school will attempt to place a child on homebound education services in order to prevent the need to transport the child. If the child is medically safe enough to be transported, a school must provide transportation, even if it means they need to rent or buy additional equipment (such as a van with a lift or a car seat) in order to transport the child.
Developing the Transportation Section of the IEP
Each state or school district has its own IEP form, which may include transportation eligibility guidelines and standardized means of providing transportation as a related service. It is ultimately the responsibility of the IEP team to determine a safe and reliable method of transportation for each eligible child with an IEP, regardless of the form used.
The following are some accommodations you may wish to consider in determining a transportation plan for children with medical conditions or disabilities:
- A bus/van with a lift or ramp to allow wheelchair access
- A bus/van with wheelchair tie-downs
- The use of a regular or specialized car seat during transportation, either for physical support or to safely restrain a child
- A bus/van with air conditioning for children who have difficulty handling the heat
- A bus/van with an aide to assist the child on and off the bus, tie down a wheelchair, monitor behavior, or otherwise assist a child
- A bus/van with a nurse for any child with medical equipment such as a feeding tube, central line, tracheostomy, or ventilator, or for children who frequently require medical intervention, such as a child with a severe seizure disorder
- Door-to-door transportation
- A limited bus time or “last on and first off” policy for children with fatigue or significant medical conditions
- Off-time bus service for children with shortened school days or children who only attend partial days
- Specialized busing for required out-of-school activities such as field trips or community service, as well as extracurricular activities in some cases
It is in your child’s best interest to create a transportation plan that is as comprehensive and specific as possible, thinking in advance to account for all possible weather occurrences, as well as field trips and other necessary types of transportation.
Safety on the School Bus
Safety on the school bus is a big concern for parents, as children who are not transported safely may be injured in an accident, or may in some cases injure or be injured by another child or adult.
Children who have behavioral challenges should be secured appropriately, either using a seatbelt or car seat with a restraint system. A bus aide or attendant should be provided to make sure children remain safe throughout the trip.
Children in wheelchairs must be transported very carefully. The following guidelines are helpful:
- The bus driver or attendant should load and secure the wheelchair.
- Wheelchairs should always be loaded onto a bus lift facing outward, away from the bus.
- The bus driver or attendant should assist with transferring the student if he or she rides on a bus seat or in a car seat. The wheelchair should then be tied down to the vehicle during transport.
- Wheelchairs should be positioned forward facing for optimum safety. In rare cases, a child with severe physical disabilities or medical conditions may be safer riding rear facing. The decision to rear-face a wheelchair must be made in conjunction with both medical and transportation safety representatives, as most wheelchairs and tie-down systems are designed for forward facing use.
- Wheelchairs should be positioned as upright as possible during transport. A head support may be used for children who cannot hold their heads up without assistance.
- The wheelchair should have its brakes on, and should be tied down tightly in four locations.
- Most school districts require students in wheelchairs to have “transit-ready” wheelchairs for safety. These are sometimes called WC19 wheelchairs, because they have been designed with securement in mind and have been crash-tested for safety. A school is not required to provide a transit-ready wheelchair if a child does not have one. Most schools will attempt to find a safe way to transport the child or assist in using other resources to obtain a safer wheelchair.
- Children in wheelchairs should be secured at three points to the wheelchair and/or vehicle system. Traditionally, a lap belt on the wheelchair is used in conjunction with a shoulder belt in the vehicle. In some cases, the lap or shoulder belt may be attached differently, either to the vehicle or the chair itself. Both belts should be fitted correctly, low and across the pelvis and on the shoulder.
- Medical equipment should be secured either to the chair or to the vehicle. Wheelchair trays should be removed.
- An evacuation plan should be put in place to assist a child in a wheelchair off the bus.
Medical conditions should also be taken into account when determining safety. For example, the bus may need to be climate controlled for safety, or children prone to medical emergencies may need to be placed in the most easily accessible location of the bus.
When Problems Come Up
Sometimes, school districts are not willing to comply with federal laws to provide safe and reliable transportation for children. In this instance, you may choose to transport your child yourself, but you are entitled to reimbursement of your expenses from the school. In other cases, you may need to hold meetings with the school district or even file due process in order to obtain appropriate transportation services. If your child is unable to attend school due to transportation issues, the school must provide compensatory services for any missed school.
Finally, make sure to review your child’s transportation plan at least yearly and when your child’s needs change. Safe and appropriate transportation is your child’s educational right!