medical services is referred to in both Tatro and Tokarcik but that limitation did not affect the outcome of those cases because neither child required a licensed physician to do the CIC. Moreover, in both cases the child was in a special education placement and merely required the CIC to continue in the placement. The procedure was relatively inexpensive, required only a few minutes, and could be performed by a nurse, nurse's aide or layman trained in its operation and use. Indeed, an adult or older child could perform the procedure on herself.
The Court is not unmindful of the pain and the anxiety that the Jeffersons must have suffered when Alexandra had a breakdown. All of these cases evoke a great deal of sympathy, and as Judge Higginbotham observed in Tatro v. Texas, 481 F. Supp. at 1226, such cases "tug at the heart strings." Certainly, the fall of 1981, and the following year must have been very difficult for this family due to the concern over the mental health of a daughter who had shown such promise, the desire to provide her with the best care possible, and the anxiety over how ever increasing bills could be paid. But the Court must be guided by the law and legal precedent and not by emotion.
After carefully considering all of the relevant facts in this case, and the applicable law, the Court concludes that DCPS is not financially responsible for Alexandra's hospitalization at Chestnut Lodge. When she was placed in that facility it was for medical reasons, as opposed to educational reasons. It was simply not a case of a special educational placement. This notwithstanding the fact that within a few days after placing Alexandra at Chestnut Lodge the parents submitted a request for a special educational program and placement at Chestnut Lodge. At that time Alexandra was seriously ill, mentally ill, and required immediate hospitalization. She remained in the hospital for primarily medical reasons although she began to participate in a special educational program at the Lodge School. DCPS is financially responsible for Alexandra's attendance at the Lodge School and for any "related services" to that placement, but it is not financially responsible for her hospitalization.
The hospital component of Chestnut Lodge did not and does not represent a special education placement since such placement is made for medical as opposed to educational reasons.
Even if the Court were to conclude that the parents placed Alexandra at the hospital for what they felt were special education reasons, it remains that the placement at the hospital is and was not a related service as that term is defined in 20 U.S.C. § 1401(17) and 34 C.F.R. § 300.13. This is so for three reasons. First, the primary reason for the placement was medical, the child was suffering from a serious and severe illness. Second, the placement was not made in support of a special education program for Alexandra. Third, and perhaps most important, medical services, except to the extent that they are required for diagnostic and evaluation purposes only are not related services. What Alexandra received when she was placed at Chestnut Lodge was hospitalization. Although the term "handicapped children" includes children who are schizophrenic, for the reasons just stated, Alexandra's hospitalization was not covered by EAHCA.
Congress could have expanded on the definition of related services to include the facts in this case but did not do so. While they included some medical services, they carefully circumscribed those services by defining related services to include only limited medical services required for "diagnostic and evaluation purposes only." If Congress had expanded on the definition to include the type of hospitalization received by Alexandra, the definition would have allowed every child who suffers from a mental illness, including all those who may be at St. Elizabeth's Hospital and similar institutions, to have their programs paid for by state educational institutions. Clearly, that was not the intention of Congress.
Defendants argue that there is a relationship between Alexandra's mental illness and the hospitalization and that therefore this is a part of her special education program. If she had not been medically treated, she would have been unable to take advantage of and receive the benefit of her special education, but the same would apply to any illness. A handicapped child who is struck by an automobile or who suffers a severe fall, or who suffers a heart seizure or stroke, may require medical treatment before he can benefit from a special education course, but the state is not responsible for such treatment. Of course, the accident or illness may cause a handicap which had not previously existed, and insofar as that handicap is concerned, the child would be entitled to the benefits of the EAHCA, but that does not address the question here.
The few courts which have dealt with this question have had to concern themselves with the limitations on life support systems required to be provided under the EAHCA. This Court agrees with the courts in Tatro and Tokarcik that those limitations are set forth in the EAHCA itself. Having reached this conclusion based upon the above facts as found by the Court, the Court concludes that DCPS is not financially responsible for Alexandra's inpatient or outpatient hospitalization at Chestnut Lodge. DCPS is of course financially responsible for any related services as defined in the statute while Alexandra attends the Lodge School.
DCPS is entitled to reimbursement for the costs of hospitalization, both inpatient and outpatient except to the extent relieved from payment by the Court.