Stratham School v. Beth & David P. CV-02-135-JD 02/05/03 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE
Stratham School District
v. Civil No. 02-135-JD Opinion No. 2003 DNH 022 Beth and David P.
O R D E R
Stratham School District brings an action under the
Individuals with Disabilities Education Act ("IDEA"), 20 U.S.C.
1415(i)(2), challenging the decision of the New Hampshire
Department of Education issued on February 19, 2002.1 In that
decision, the Department concluded that Stratham School District
("District") is responsible under the IDEA for costs incurred fo
cochlear implant "mapping" and ordered the District to reimburse
the parents for travel to and from the audiologist and to pay fo
"mapping" services provided by the audiologist.2 The District
appeals the decision, arguing that cochlear implant mapping is
not a "related service" within the meaning of the IDEA.
1The hearing officer's decision is the decision of the New Hampshire Department of Education. See N.H. Rev. Stat. Ann. § 186-C:16-a & 16-b.
2Cochlear implant mapping refers to the programming necessary to make the system work. Background3
This case involves services for Hunter P., and was brought
on his behalf by his parents, Beth and David. Hunter was born on
July 30, 1996, and lives with his family in Stratham, New
Hampshire. Hunter has had a profound hearing loss in both ears
since birth and is, therefore, deaf. His parents and two
brothers have normal hearing and communicate through oral speech.
In September of 1997, Hunter was fitted with acoustical
hearing aids. Although the District apparently disputes this,
the hearing officer found that during the year Hunter used the
hearing aids it became apparent that he was not obtaining any
benefit from them due to his profound hearing loss. His parents
then decided that they wanted Hunter to use an auditory and oral
system for communication.
As a result of examinations. Hunter was found to be an
appropriate candidate for a cochlear implant. With advice from
Dr. Glen Johnson, Hunter's parents chose a Clarion cochlear
3Counsel were unable to comply with Local Rule 9.3(d) due to their personal dislike for each other. See Report and Recommendation at 4, Dec. 20, 2002. Although the magistrate judge concluded that sanctions were not appropriate, he detailed the history of the difficulties that counsel had with each other. When personality conflicts are allowed to interfere with the progress of a case, there is a disservice done to the litigants and the court. As a result, the court is left to construct background facts from the "redlined" factual submissions submitted by counsel for each side.
2 implant device manufactured by Advanced Bionics Corporation. Dr.
Johnson performed the surgery on March 3, 1999, to implant the
internal components of the device: a receiver-stimulator in
Hunter's skull under his scalp and an electrode array in the
cochlea of his right ear.
Six weeks after the surgery. Hunter met with Suzanne Lenz, a
clinical audiologist at Dartmouth-Hitchcock Clinic in Lebanon,
New Hampshire. Lenz fitted Hunter with the external components
of the device, which are a headpiece with a microphone and radio
freguency transmitter, placed behind his right ear, a speech
processor, and a cable connecting the headpiece to the speech
processor. The speech processor is carried in a pouch fastened
to Hunter's clothing. Once the external components were fitted,
Lenz activated and programmed the speech processor.
Although the District apparently disputes the number of
appointments, the hearing officer found that Hunter has had
seventeen subseguent appointments with Lenz and two appointments
with audiologist Linda Strojny. Lenz and Strojny are
audiologists, not physicians, who have experience with cochlear
implants.
As noted above, programming the speech processor is called
"mapping." Proper mapping is essential to the use of a cochlear
implant. Particularly in the case of a child, mapping must be
3 done accurately to permit adequate language development.
Improper mapping or improperly functioning equipment will have a
negative effect on an implanted child's education. Only a
specially trained audiologist can perform mapping. A speech
language pathologist works closely with the audiologist for
mapping, but a pathologist cannot map the device.
To begin the mapping process, a specially trained
audiologist chooses a coding strategy, which is a plan for the
electrical stimulation of the electrodes implanted in the
cochlea. The audiologist then connects the speech processor to a
computer and uses the coding strategy to create a map for the
pattern and intensity of the electrical current to the electrodes
in order to create sound sensations. The goal is to determine
the amount of electrical current that will provide a comfortable
level of sound sensation. The speech processor may have three
maps to accommodate different listening environments. The
audiologist determines the mapping needs of each user based in
part on information provided by the user's family and school
staff. The speech processor has controls for volume and
microphone sensitivity.
In May of 1999, the District identified Hunter as being
eligible for special education services, under Part B of the
IDEA, because of his deafness. Hunter attended a three-week
4 summer program in Manchester, New Hampshire, called HEAR in New
Hampshire ("HNH"), which is directed by Michael Moon. The
District then placed Hunter at HNH, now located in Hooksett, New
Hampshire, for the school years from 1999 through 2001. When
Hunter began the program at HNH he had no spoken language and
responded in very limited ways to oral and auditory
communications.
At present. Hunter attends HNH in the morning, and four
afternoons each week he attends a special education preschool
program at Stratham Memorial School. Hunter's Individualized
Education Program ("IEP") provides for five hours per week of
speech therapy and three hours per week of service from a teacher
of the acoustically handicapped at HNH. Hunter's IEP includes
objectives based on his use of the cochlear implant and assumes
that he will learn to hear. If his mode of communication
changed, his IEP would also change.
The HNH staff check the cochlear implant eguipment each day
to be sure that it is functioning by asking the child to indicate
whether he can detect ten different sounds. If the eguipment
appears to be functioning but Hunter's responses are not what the
staff would expect, they refer him to the audiologist, Suzanne
Lenz, to perform further checks. Although the HNH staff can
choose among the three maps provided on Hunter's speech
5 processor, the HNH staff is not qualified to perform mapping.
Beginning in April of 2000, Beth P. began seeking
reimbursement from the District for mileage used to drive Hunter
to audiology appointments for mapping the speech processor. The
District decided that the trips for mapping were not covered by
the IDEA and, therefore, that the District was not obligated to
reimburse for mileage. In February of 2001, Beth P. requested
reimbursement for the insurance co-payments of $10 she was
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Stratham School v. Beth & David P. CV-02-135-JD 02/05/03 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE
Stratham School District
v. Civil No. 02-135-JD Opinion No. 2003 DNH 022 Beth and David P.
O R D E R
Stratham School District brings an action under the
Individuals with Disabilities Education Act ("IDEA"), 20 U.S.C.
1415(i)(2), challenging the decision of the New Hampshire
Department of Education issued on February 19, 2002.1 In that
decision, the Department concluded that Stratham School District
("District") is responsible under the IDEA for costs incurred fo
cochlear implant "mapping" and ordered the District to reimburse
the parents for travel to and from the audiologist and to pay fo
"mapping" services provided by the audiologist.2 The District
appeals the decision, arguing that cochlear implant mapping is
not a "related service" within the meaning of the IDEA.
1The hearing officer's decision is the decision of the New Hampshire Department of Education. See N.H. Rev. Stat. Ann. § 186-C:16-a & 16-b.
2Cochlear implant mapping refers to the programming necessary to make the system work. Background3
This case involves services for Hunter P., and was brought
on his behalf by his parents, Beth and David. Hunter was born on
July 30, 1996, and lives with his family in Stratham, New
Hampshire. Hunter has had a profound hearing loss in both ears
since birth and is, therefore, deaf. His parents and two
brothers have normal hearing and communicate through oral speech.
In September of 1997, Hunter was fitted with acoustical
hearing aids. Although the District apparently disputes this,
the hearing officer found that during the year Hunter used the
hearing aids it became apparent that he was not obtaining any
benefit from them due to his profound hearing loss. His parents
then decided that they wanted Hunter to use an auditory and oral
system for communication.
As a result of examinations. Hunter was found to be an
appropriate candidate for a cochlear implant. With advice from
Dr. Glen Johnson, Hunter's parents chose a Clarion cochlear
3Counsel were unable to comply with Local Rule 9.3(d) due to their personal dislike for each other. See Report and Recommendation at 4, Dec. 20, 2002. Although the magistrate judge concluded that sanctions were not appropriate, he detailed the history of the difficulties that counsel had with each other. When personality conflicts are allowed to interfere with the progress of a case, there is a disservice done to the litigants and the court. As a result, the court is left to construct background facts from the "redlined" factual submissions submitted by counsel for each side.
2 implant device manufactured by Advanced Bionics Corporation. Dr.
Johnson performed the surgery on March 3, 1999, to implant the
internal components of the device: a receiver-stimulator in
Hunter's skull under his scalp and an electrode array in the
cochlea of his right ear.
Six weeks after the surgery. Hunter met with Suzanne Lenz, a
clinical audiologist at Dartmouth-Hitchcock Clinic in Lebanon,
New Hampshire. Lenz fitted Hunter with the external components
of the device, which are a headpiece with a microphone and radio
freguency transmitter, placed behind his right ear, a speech
processor, and a cable connecting the headpiece to the speech
processor. The speech processor is carried in a pouch fastened
to Hunter's clothing. Once the external components were fitted,
Lenz activated and programmed the speech processor.
Although the District apparently disputes the number of
appointments, the hearing officer found that Hunter has had
seventeen subseguent appointments with Lenz and two appointments
with audiologist Linda Strojny. Lenz and Strojny are
audiologists, not physicians, who have experience with cochlear
implants.
As noted above, programming the speech processor is called
"mapping." Proper mapping is essential to the use of a cochlear
implant. Particularly in the case of a child, mapping must be
3 done accurately to permit adequate language development.
Improper mapping or improperly functioning equipment will have a
negative effect on an implanted child's education. Only a
specially trained audiologist can perform mapping. A speech
language pathologist works closely with the audiologist for
mapping, but a pathologist cannot map the device.
To begin the mapping process, a specially trained
audiologist chooses a coding strategy, which is a plan for the
electrical stimulation of the electrodes implanted in the
cochlea. The audiologist then connects the speech processor to a
computer and uses the coding strategy to create a map for the
pattern and intensity of the electrical current to the electrodes
in order to create sound sensations. The goal is to determine
the amount of electrical current that will provide a comfortable
level of sound sensation. The speech processor may have three
maps to accommodate different listening environments. The
audiologist determines the mapping needs of each user based in
part on information provided by the user's family and school
staff. The speech processor has controls for volume and
microphone sensitivity.
In May of 1999, the District identified Hunter as being
eligible for special education services, under Part B of the
IDEA, because of his deafness. Hunter attended a three-week
4 summer program in Manchester, New Hampshire, called HEAR in New
Hampshire ("HNH"), which is directed by Michael Moon. The
District then placed Hunter at HNH, now located in Hooksett, New
Hampshire, for the school years from 1999 through 2001. When
Hunter began the program at HNH he had no spoken language and
responded in very limited ways to oral and auditory
communications.
At present. Hunter attends HNH in the morning, and four
afternoons each week he attends a special education preschool
program at Stratham Memorial School. Hunter's Individualized
Education Program ("IEP") provides for five hours per week of
speech therapy and three hours per week of service from a teacher
of the acoustically handicapped at HNH. Hunter's IEP includes
objectives based on his use of the cochlear implant and assumes
that he will learn to hear. If his mode of communication
changed, his IEP would also change.
The HNH staff check the cochlear implant eguipment each day
to be sure that it is functioning by asking the child to indicate
whether he can detect ten different sounds. If the eguipment
appears to be functioning but Hunter's responses are not what the
staff would expect, they refer him to the audiologist, Suzanne
Lenz, to perform further checks. Although the HNH staff can
choose among the three maps provided on Hunter's speech
5 processor, the HNH staff is not qualified to perform mapping.
Beginning in April of 2000, Beth P. began seeking
reimbursement from the District for mileage used to drive Hunter
to audiology appointments for mapping the speech processor. The
District decided that the trips for mapping were not covered by
the IDEA and, therefore, that the District was not obligated to
reimburse for mileage. In February of 2001, Beth P. requested
reimbursement for the insurance co-payments of $10 she was
charged for each mapping appointment beginning on November 15,
1999. The District refused to reimburse Hunter's parents for the
co-payments.
Beth P. and David P. initiated a due process hearing on
their requests for mileage and reimbursement for co-payments.
The hearing was held before Hearing Officer John LeBrun,
appointed by the New Hampshire Department of Education, on
November 1 and 2 and December 7 and 11, 2001. Hunter's parents
presented testimony from Donald K. Eddington, Director of the
Cochlea Implant Research Laboratory at the Massachusetts Eye and
Ear Infirmary; Michael Moon, Director of HNH; Beth P., Hunter's
mother; Ronnie Sue Duby, a parent of another child at HNH, and
Linda Strojny, audiologist, who is employed by Advanced Bionics
Corporation, the maker of Hunter's implant device. The District
presented testimony from Marilyn Neault, Director of Audiology
6 Services at Boston Children's Hospital; Ann Bednar, a deaf
education consultant; Dorothy Eisenhaure, a speech language
pathologist; Patricia Willis, Director of Special Education for
the supervisory administrative unit that includes the District;
and Margaret Driscoll, Co-Director of Special Services for the
District.
Following the hearing. Hearing Officer LeBrun issued a
decision in which he presented the issues as follows:
First, the parents take the position that the audiologist should be identified in Hunter's IEP as a Related Service. The District believes it is not necessary to include the audiologist as a Related Service. Secondly, the parents reguest reimbursement for their transportation expenses for visits to the audiologist from their home in Stratham to and from the office in Lebanon, New Hampshire. Finally, the parents believe they should be reimbursed for the portion of the audiologist expenses that are not covered by insurance (i.e. the co-pays).
Decision at 2. The hearing officer further explained that the
District believed that the IDEA does not cover cochlear implant
services because a cochlear implant is not an acoustical hearing
aid and is not included specifically in the IDEA or its
regulations and because cochlear implant mapping is a medical
service not covered by the IDEA. The hearing officer concluded
that the mapping services are a necessary related service under
the IDEA and that the audiology services provided by Suzanne Lenz
were related services for Hunter's IEP. The District was ordered
7 to reimburse Hunter's parents for mileage for the trips to Lenz's
office and for insurance co-payments for the mapping services.
Discussion
The standard of review in an IDEA case depends on whether
the issue on appeal presents a guestion of fact or law. A
hearing officer's factual findings are reviewed under an
intermediate standard which "'reguires a more critical appraisal
of the agency determination than clear-error review entails, but
which, nevertheless, falls well short of complete de novo
review.'" Rafferty v. Cranston Pub. Sch. Comm., 315 F.3d 21, 25
(1st Cir. 2002) (guoting Lenn v. Portland Sch. Comm., 998 F.2d
1083, 1086 (1st Cir. 1993)). In contrast, a purely legal
guestion is reviewed de novo. See Manchester Sch. Dist. v.
Crisman, 306 F.3d 1, 9 (1st Cir. 2002). The burden of proof
rests with the party challenging the agency decision, which is
the District in this case. See Hampton Sch. Dist. v.
Dobrowolski, 976 F.2d 48, 54 (1st Cir. 1992) .
The IDEA "was enacted, in part, 'to assure that all children
with disabilities have available to them . . . a free appropriate
public education which emphasizes special education and related
services designed to meet their unigue needs.'" Cedar Rapids
Cmtv. Sch. Dist. v. Garret F., 526 U.S. 66, 68 (1999) (guoting 20 U.S.C. § 1400(d) (1) (A) (formerly § 1400 (c))) . Participating
states, such as New Hampshire, receive federal financial
assistance for IDEA mandated services. See id.; see also Murphy
v. Timberlane Reg'1 Sch. Dist., 22 F.3d 1186, 1188 at n.2 (1st
Cir. 1994). States that receive federal aid under the IDEA are
obligated to provide special education and related services as
defined by the Act. See Rome Sch. Comm, v. Mrs. B., 247 F.3d 29,
32 (1st Cir. 2001); see also Irving Indep. Sch. Dist. v. Tatro,
468 U.S. 883, 891 n.8 (1984) (construing predecessor to IDEA,
Education of the Handicapped Act). A gualified child's unigue
needs are addressed by an IEP. See 20 U.S.C. § 1414(d); see also
Bd. of Educ. v. Rowley, 458 U.S. 176, 181-82 (1982).
Although the District contends that the hearing officer's
decision is wrong under both the IDEA and state law, the District
focuses primarily on the IDEA and does not argue that New
Hampshire would provide a different standard. Therefore, the
court will not separately address the issue under New Hampshire
law. In the complaint, the District frames the issues to be
decided in terms of four errors by the hearing officer.4 In its
4First, the District contends that the hearing officer erred in granting the parents' proposed ruling of law that the child's IEP team is obligated to respect the parents' decision as to the child's mode of communication and ensure that the IEP is consistent with that mode of communication, citing 20 U.S.C. § 1414(d)(3)(B)(iv) and 34 C.F.R. § 300.346(a)(2)(iv). Second, the decision memorandum, the District consolidates its claims into a
single issue to be decided on appeal: whether the New Hampshire
Department of Education erred as a matter of law in determining,
through the hearing officer's decision, that "mapping" for a
cochlear implant constitutes "related services" under the IDEA,
which obligates the District to pay for travel and insurance co
payments for audiologist appointments.
The term "related services" is defined in the IDEA to mean
"transportation, and such developmental, corrective, and other
supportive services (including speech-language pathology and
audiology services, . ..) as may be reguired to assist a child
with a disability to benefit from special education
§ 1401(22). In the context of related services, "[a]udiology
includes," in relevant part, "[p]revision of habilitative
activities, such as language habilitation, auditory training,
speech reading (lip-reading), hearing evaluation, and speech
District contends that the hearing officer erred by concluding that cochlear implant mapping is a related service under the IDEA, citing § 1401(22). Third, the District defines the cochlear implant as a "sensory organ" and contends that the hearing officer erred in finding the District obligated to program a child's sensory organ "irrespective of the sociological, privacy, family and liability concerns attendant thereto." Fourth, the District contends that the hearing officer erred in concluding that because Hunter's IEP was designed around the cochlear implant, the District was obligated to ensure that the implant worked outside of the school setting.
10 conservation." 34 C.F.R. § 300.24 (b) (1) (iii) . The word
"includes," as used in the regulations interpreting the IDEA,
means that "the items named are not all of the possible items
that are covered, whether like or unlike the ones named."5 34
C.F.R. § 300.14.
Although mapping for cochlear implants is not included
within the enumerated audiology services provided in the statute
and regulations, § 300.14 broadens the scope of the definition of
audiology beyond the enumerated examples. As described in this
case, the mapping process is the system that allows the cochlear
implant to provide usable sound sensation to Hunter. The mapping
process is performed by trained audiologists. Absent a clear
indication that such audiology services were not intended to be
included within "related services," the definition would appear
to encompass the mapping process.6
The only reported decision to have considered similar
51he regulations address the responsibility of schools to ensure that children's hearing aids are functioning properly, see 34 C.F.R. § 300.303, but cochlear implants are not mentioned in the regulations. The parties agree that a cochlear implant is not an acoustical hearing aid.
61he District's argument that Congress could have included mapping as a covered audiology service, along with the specific provision for acoustical hearing aids, and therefore its absence shows Congressional intent not to include mapping, is not persuasive.
11 circumstances is Bd. of Educ. of Paxton-Bucklev-Loda v. Jeff S.,
184 F. Supp. 2d 790, 804 (C.D. 111. 2002). In that case, the
child, who had a cochlear implant, was receiving auditory verbal
therapy ("AVI") which included mapping his implant system. Id.
at 792-93. The child's parents challenged the District's failure
to comply with IDEA procedures, the District's placement of the
child, the District's failure to provide supportive services for
the child's implant, and failure to pay for the child's private
school placement. Id. at 797-804. The district court affirmed
the hearing officer's decision ordering the District to provide
AVT to the child and to pay the costs of the AVT services. Id.
at 801-03 & 804.
The court did not address the guestion of whether AVT and
mapping services for a cochlear implant were "related services"
within the meaning of the IDEA. Instead, the issue addressed in
Jeff S. was whether the AVT system provided the child a free
appropriate public education, as reguired by the IDEA, and
whether the evidence supported the hearing officer's decision.
The court concluded that the District must provide and pay the
costs of the child's AVT services, as determined by the child's
therapists, but that after an appropriate IEP was developed, the
District would also have recourse to a due process hearing if it
disagreed with the services recommended. Id. at 804. As such,
12 it appears that the parties never disputed that such services
would be included within "related services" under the IDEA.
In contrast, here the IEP developed for Hunter is designed
to use his cochlear implant as his method of communication, and
his parents and the District do not contest the adequacy of the
IEP. The District contends, however, that mapping is not a
related service under the IDEA because other communication
methods are possible, and might be determined to be more
appropriate for Hunter. In that case, the District contends.
Hunter's IEP team would design a program to address his needs
with a different mode of communication.
The IDEA requires a school district to provide "such
services as are necessary to permit the child to benefit from the
instruction." Rowley, 458 U.S. at 189. Stated in other terms, a
school district is required to provide supportive services that
permit a disabled child to have meaningful access to education.
See Garret F ., 526 U.S. at 73. The educational method to be used
in each case is left "to state and local educational agencies in
cooperation with the parents or guardians of the child." Rowley,
458 U.S. at 207. The IEP provides the mechanism for determining
the appropriate educational method and goals to achieve a free
appropriate public education and requires that the parents be
included in the process along with teachers and a representative
13 of a local educational agency with special knowledge about the
needs of children with disabilities. § 1414(d); see also Shapiro
v. Paradise Valiev Unified Sch. Dist. No. 69, 2003 WL 187205 (9th
Cir. Jan. 29, 2003) (discussing IEP process for child with
cochlear implant).
There is no dispute that, at present. Hunter's mode of
communication involves the use of his cochlear implant and that
the cochlear implant must be mapped for him to benefit from the
instruction provided by the District. Hunter's IEP is based on
his current mode of communication through his cochlear implant.
The IEP, therefore, confirms that the educational methodology
chosen for Hunter includes the use of the cochlear implant as a
necessary part of the free appropriate public education provided
to him. Under these circumstances, the mapping services
necessary for the use of Hunter's cochlear implant are "related
services" within the meaning of the IDEA.
Conclusion
For the foregoing reasons, the decision of the New Hampshire
Department of Education is affirmed.7 The plaintiff's motion for
7Because the issue presented on appeal is a legal guestion, subject to de novo review, the court does not address the individual findings and rulings issued by the hearing officer.
14 oral argument (doc. no. 28) is denied. The clerk of court will
enter judgment accordingly and close the case.
SO ORDERED.
Joseph A. DiClerico, Jr. United States District Judge
February 5, 2003
cc: Jeanne M. Kincaid, Esguire Peter S. Smith, Esguire Arthur H. Ackerhalt, Esguire