Planning for care. For life.

New School, New Beginning – A Case Study

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A seven year old boy and his family were referred to National Care Advisors to help support a move into a new house and school district. Because the child would be switching school districts, we provided education consultation and advocacy in conjunction with nurse case management that resulted in increased educational resources allowing for higher student achievement for the child. The boy faced many challenges since birth, including:

  • Global developmental delays
  • Tracheostomy and gastro-intestinal tube
  • Educationally diagnosed intellectual disability

With our assistance, the child was able to enroll in a highly ranked school district where he qualified for special education services provided by the public school system. Through our collaborative approach working with the family, school district, and financial manager, we were able to:

  1. Provide appropriate skilled nursing and a 1:1 personal assistant through the school district without impacting Medicaid waiver hours for home care
  2. Create an IEP that is customized to his needs and achieve best classroom placement
  3. Secure appropriate PT, OT, ST services included in his IEP
  4. Establish a positive ongoing relationship between the parents and the school district

Most importantly, the child is now showing significant improvement in the school setting with increased communication, socialization with peers, learning life skills and attending mainstreamed classes as he prepares for middle school.


A beneficiary’s Financial Manager made a referral to NCA for educational consultation to assist a young student with the transition out of an urban school district to a smaller suburban school system in order to have access to more direct instruction that would meet his individual needs to improve his overall quality of life and expected outcomes. The young boy suffered a birth injury at 24 weeks gestation that resulted in global developmental delays, including the need for a tracheostomy and gastro-intestinal tube. This injury also resulted in an educational diagnosis of an intellectual disability that impeded his overall success in the general education environment.

The child was living in an urban neighborhood within the boundaries of a school system that was lacking sufficient resources to meet his numerous educational needs. He had an inappropriate school placement with an unfitting Individualized Education Program (IEP) and an overall negative outlook toward school. The student was in need of updated educational evaluations that highlighted his strengths and needs, a more comprehensive IEP that included appropriate goals and objectives, and access to a functional curriculum with intensive related services. In addition, the student was in need of advocacy to assist in the transition from full time Medicaid provided individual nursing services to a combination of school provided part-time nursing and a full-time 1:1 personal assistant while in the learning environment.

National Care Advisors Involvement:

In conjunction with nurse case management services, National Care Advisors provided educational consultation and advocacy to assist the family in efficiently completing the registration process at his new school. Updated school based comprehensive educational evaluations were then completed, which led the way for an appropriate classroom placement with access to a proper curriculum (including increased speech and language, occupational therapy, physical therapy, and vision therapy) and allowing for significant documented progress academically, physically, emotionally, and socially.

NCA assisted the family in obtaining the proper paperwork from the student’s previous school and notifying the Special Education Department within the new district of his enrollment. We worked to build communication and a good relationship between the school and home, often overlooked in the process. NCA also advocated for the student during tours of potential programs within the district and provided consult when a Notice of Recommended Educational Placement (NOREP) within a Life Skills classroom was agreed upon with the full IEP team.

After a few weeks of the child’s new placement, it was clear that the student needed a more intensive functional program with a smaller student to teacher ratio and increased therapies sessions. NCA then initiated communication with the Director of Special Education within the district to supportively collaborate with the team on considering alternative options. As a result, the team discussed a change of placement to a Multi-Disabilities (MDS) Classroom run by the county’s Intermediate Unit and overseen by the district. Although this was deemed a more restrictive environment for the student, the team acknowledged that a lesser restrictive classroom was tried and found to be unsuccessful. Within three days, the decision was made, a revised NOREP was signed and delivered to the IEP team, transportation was arranged, and the student began his new program successfully.

Since transitioning to the MDS classroom, NCA has maintained its work with the IEP team and family to ensure the student’s continued success. After one year, the student showed medical improvement and was able to be undergo a decannulation procedure to remove his tracheostomy. At that time, the family had continued to use the nursing services provided through Medicaid while in the school environment. NCA worked with the family and the school to build trust and reach a level of comfort to have the school provide part-time nursing services which were prescribed as necessary by the student’s physician and legally required for him to access the curriculum in the Least Restrictive Environment as mandated by law. NCA also helped advocate for the student to receive a full-time 1:1 personal assistant throughout the school day to aide in his continued growth and independence.

In addition to ensuring these appropriate services were in place for the student, NCA collaborated with both the Intermediate Unit and the overseeing Local Education Agency (LEA), the district, to have the student evaluated for an appropriate augmentative communication device. The student trialed several devices with various communication programs in order to identify the best fit for the individual student. Once a particular device and program was decided upon, the device was added to the student’s IEP. The LEA then purchased the device with all necessary programs for the student to use across all environments, including home, school, and the community.

NCA also partnered with the occupational and physical therapists at the school to develop a sensory room for the student at home. The NCA nurse case manager and education consultant met with the family to determine the allotted space in the home for the sensory equipment. Then, NCA consulted with the IEP team at the school to identify preferred and appropriate equipment that the student benefits from during school based therapy sessions. NCA assisted the family’s Financial Advisor in ordering the equipment and having it properly installed for the student in the home.


During this student’s most recent IEP meeting in October, the team met to discuss the student’s overall progress and to update his educational plan. The team members discussed how the student is currently:

  • Making intelligible utterances across all environments and to a variety of people
  • Ambulating throughout the school building primarily by independently walking (while still having access to gait trainers and wheelchairs when needed)
  • Utilizing his augmentative communication device to request items, comment, and to actively participate in academic group lessons
  • Identifying money concepts and completing simple addition and subtraction computations
  • Developing pre-writing skills
  • Socializing with peers on the school playground
  • Attending mainstreamed classes to increase his exposure to the general education population
  • Preparing to transition to middle school

The family has established a healthy and productive working relationship with the Department of Special Education with both the Intermediate Unit team that is running the educational program for the student as well as the overseeing LEA that approves the placement within program.

NCA continues to provide educational consultation services to this student, the family, and the IEP team as preparations are made for middle school next year. NCA is working to help schedule tours of classrooms and various programs to allow for a comfortable and smooth transition as well as continued success for this student as he moves forward with his education. NCA is committed to ensuring all team members continue to be aware of this individual’s challenges and more importantly his strengths.

About National Care Advisors Education Consulting and Advocacy Services:

National Care Advisors provides a broad range of education consulting and advocacy services, including IEP review, public/private school advocacy, school transition support and post secondary education planning. Our masters trained special education consultant works collaboratively with our nurse case managers to assist special needs individuals and their family, financial, and legal support team navigate the education system to ensure all children, regardless of ability, are able to achieve academically.  Want to learn more about our services and team? Contact us today to discuss how we can help your loved one or client reach their potential.