Familiar caregiver as 1:1 at school

[Katie Mc]

Hi all - I am attempting to get my son’s elementary school to hire his current care attendant as his 1:1 aide for kindergarten next year. We currently employ the attendant via Medicaid funding, and he’s been with my son everyday at (private) prek for the last two years. He takes my son to all his therapies and is extremely attuned to his needs. My son is profoundly physically disabled (no independent ambulation, non verbal due to muscular weakness and dystonia). He is intellectually typical and uses an eye gaze device and non-verbal communication to indicate his needs and engage socially. The school agrees he needs a 1:1 but says they don’t have any openings to hire his (highly qualified) current aide. 

Do we have any recourse? I recently obtained a letter from his neurology team stating that they recommend a “familiar caregiver” to ease the transition to kindergarten. Is anyone aware of any studies or legal precedent supporting this kind of request? Anyone had success getting this kind of request integrated into an IEP?

[Carolyn Rowlett]

This is a tough one.  I'm sure Lisa will chime in with some great suggestions.  Here's what I'm thinking.

In general, a parent cannot dictate who the staff member is - but can dictate that they be trained to provide the necessary services and accommodations to the child.  So that would be one question to look into:  What is the training of the person(s) the school is considering for his 1:1?  If not sufficient (you'll need a report that sets out what your son needs), make that argument (which might lead to them hiring someone else).

You could also ask that during the transition period (and this is a huge transition) that your son's current care attendant be allowed to be the aid in tandem with whoever will be fulling this role at the school.  It might make the transition easier and you have the letter that this is recommended.  You would, of course, have to pay/have Medicaid pay for the current care attendant's time to help with the transition.

I don't know much about how Medicaid factors into this.  Does this funding stop when a child reaches Kindergarten?  Or would it be possible to continue with the same care attendant and just obtain the school's approval that this person be the 1:1?  (Can't see why they would object to this - would help them out tremendously - but there could be liability issues, union issues, etc.)

This is not my area of expertise so just speaking generally.  Hopefully others with more experience will join the discussion.

[JSD24]

School district HR makes personnel decisions - not the family.  What you can do is make sure, because of the unique needs your child has, that the paraprofessional assigned to him is trained in how he communicates and all of his other needs.

The letter from his doctor is an outside assessment that the school must 'consider' - but they don't need to follow what's in the letter.  If Medicaid would pay for an aide at school, you might be able to have this person continue as his aide.

This is for perspective:  Let's say you are an aide in a school.  The school board authorized 10 aides for the district and there are 10 aides on staff.  Someone comes in insisting the school hire their aide for their child.  Are you OK with being let go?

You can go to Google Scholar and search for cases in your state where there is legal precedence for this.  I cannot do that w/o knowing what state you live in.

[Katie Mc]

12 hours ago, Carolyn Rowlett said:

This is a tough one.  I'm sure Lisa will chime in with some great suggestions.  Here's what I'm thinking.

In general, a parent cannot dictate who the staff member is - but can dictate that they be trained to provide the necessary services and accommodations to the child.  So that would be one question to look into:  What is the training of the person(s) the school is considering for his 1:1?  If not sufficient (you'll need a report that sets out what your son needs), make that argument (which might lead to them hiring someone else).

You could also ask that during the transition period (and this is a huge transition) that your son's current care attendant be allowed to be the aid in tandem with whoever will be fulling this role at the school.  It might make the transition easier and you have the letter that this is recommended.  You would, of course, have to pay/have Medicaid pay for the current care attendant's time to help with the transition.

I don't know much about how Medicaid factors into this.  Does this funding stop when a child reaches Kindergarten?  Or would it be possible to continue with the same care attendant and just obtain the school's approval that this person be the 1:1?  (Can't see why they would object to this - would help them out tremendously - but there could be liability issues, union issues, etc.)

This is not my area of expertise so just speaking generally.  Hopefully others with more experience will join the discussion.

Thanks for these suggestions! I am waiting on a call back from our case worker about the Medicaid funding question so that will definitely be critical information to inform next steps. I will definitely request a list of trainings from my son’s therapists and check that against the education/ background of the aide they are considering for him. Very helpful thank you! 

[Lisa Lightner]

I agree with Carolyn and Judi on this one. It’s tricky because, legally, parents can’t dictate who the school hires—only that the person is qualified and trained to meet the child’s needs. That’s where you have the strongest footing.

If they name a person as a 1:1 in an IEP, if that person quits tomorrow, they're instantly out of compliance.

So yes, lean hard into specific training requirements in the IEP. Get your doctor or therapist to spell out exactly what skills, experience, or training the 1:1 must have—position it as a service requirement, not a staffing preference.—things like:

• Supporting eye gaze communication systems

• Physical positioning and mobility assistance

• Recognizing signs of medical distress related to his condition

• Supporting non-verbal social interaction

• Managing transitions with low stress and predictability

That shifts the conversation from “we want this person” to “we need someone with these skills.”

I also love the idea of asking for your current attendant to support the transition alongside the school’s staff. Frame it as a transition support, not a permanent placement. You already have medical backing for that, and it helps your child and the school.

As for Medicaid, every state handles that a little differently, but you can absolutely ask the school if they’d allow your current attendant to be on-site, even if you’re the one paying or using Medicaid to do so. Some schools are open to that, others have union or liability barriers—but you won’t know unless you ask.

[Katie Mc]

4 hours ago, Lisa Lightner said:

I agree with Carolyn and Judi on this one. It’s tricky because, legally, parents can’t dictate who the school hires—only that the person is qualified and trained to meet the child’s needs. That’s where you have the strongest footing.

If they name a person as a 1:1 in an IEP, if that person quits tomorrow, they're instantly out of compliance.

So yes, lean hard into specific training requirements in the IEP. Get your doctor or therapist to spell out exactly what skills, experience, or training the 1:1 must have—position it as a service requirement, not a staffing preference.—things like:

• Supporting eye gaze communication systems

• Physical positioning and mobility assistance

• Recognizing signs of medical distress related to his condition

• Supporting non-verbal social interaction

• Managing transitions with low stress and predictability

That shifts the conversation from “we want this person” to “we need someone with these skills.”

I also love the idea of asking for your current attendant to support the transition alongside the school’s staff. Frame it as a transition support, not a permanent placement. You already have medical backing for that, and it helps your child and the school.

As for Medicaid, every state handles that a little differently, but you can absolutely ask the school if they’d allow your current attendant to be on-site, even if you’re the one paying or using Medicaid to do so. Some schools are open to that, others have union or liability barriers—but you won’t know unless you ask.

Thank you! I knew that we could not request a specific person in the IEP (which is impractical for all the reasons you and others have noted) but I wasn't sure how to approach the request given that limitation. Now I have a direction to move in! 

We are in Virginia, which is a right-to-work state where public employees are prohibited from collective bargaining, so unions may not come into play. The liability concern would be the main issue, is my guess. I will definitely ask about our options to continue to employ our caregiver through medicaid at the very least to support the transition. 

Would you suggest submitting this information and the letters/reports from providers as an executive summary style document ahead of the meeting, or bringing it to the meeting and presenting it then? For context, the team at the school has not sent a draft IEP yet - the meeting is tentatively scheduled for next Friday. 

Thanks again!

[Carolyn Rowlett]

I would send any document that you may refer to during the meeting, in full, to the school team ahead of the meeting.  Concurrently, I would request in writing a draft IEP (if you have not already done so) three school days prior to the meeting (you might land on two days, which is fine - whatever is enough time for you to review before the meeting).  I would additionally state that if the team cannot provide a draft IEP before the meeting (with sufficient time for review), that the meeting be postponed until they can.