Office Forcivilrights

UNITEDSTATESDEPARTMENTOFEDUCATION

OFFICE FORCIVILRIGHTS

. OldFederal Building

50 UnitedNationsPlaza, Room239

San Francisco,California94102

FEB282006

RobertJ.Henry

SchoolandCollegeLegalServicesofCalifornia

5350 SkylaneBoulevard

SantaRosa,California95403

(In reply,pleaserefertocasenumber09-06-2011.) DearMr.Henry:

TheU.S.DepartmentofEducation,OfficeforCivilRights(OCR),hascompletedits investigationoftheabove-referencedcomplaintfiledbyaStudent1againstNapaValley Collegeallegingdiscriminationbasedondisability.

The Student allegedthatthe College'sDisabled Students Programsand Services (DSPS) departmentfailedtoprovideherwiththelumbarsupportchairssherequested duetoabackinjury. Shefurtherallegedthat,whensheeitherlocatedchairsherselfor wasprovidedchairsthroughDSPS, thosechairswereeitherunavailablewhenshe neededthemorinappropriateforheruse. Sheallegedthatthenursingprogram faculty didnotcooperatewiththeimplementationofthisaccommodation.

Additionally,theStudentallegedthattheNursingprogramfacultyprohibitedherfrom completing theprogram'sclinicalcomponentbecausetheyconsideredthephysical limitationspresentedbyherdisabilitytocreatealiability.Shehasalsoallegedthatshe wasforcedoutoftheprogrambecauseshewasdrawingattentiontoherselfthroughher requestsforaspecialchair.

OCRinvestigatedtheseissuesundertheauthorityofSection504oftheRehabilitation Actof1973anditsimplementingregulation, whichprohibitsdiscriminationonthebasis ofdisabilityinfederallyassistedprogramsandactivities. OCRalsohasjurisdictionasa designatedagencyunderTitleIIoftheAmericanswithDisabilitiesActof1990andits implementingregulationovercomplaintsallegingdiscriminationonthebasisofdisability againstcertainpublicentities. TheCollegereceivesDepartmentfunds,isa public educationsystem,andissubjecttotherequirementsofSection504andTitleII.

OCRgatheredevidence through interviewswith the Student and relevant College faculty members and administrators. OCR also reviewed numerous documents submittedbytheStudentandtheCollege. OCRconcludedthattheCollege'sactions

1OCRnotifiedtheCollegeoftheidentityofthecomplainantinlettersdatedOctober24andNovember

14, 2005.Wearewithholdinghernamefromthislettertoprotect herprivacy.

Ourmissionisto ensureequalaccesstoeducationandtopromoteeducationalexcellencethroughouttheNation.

werein compliance with Section 504,Title II, and their implementing regulations. OCR'sfindings andreasonsforthisconclusionareoutlined below.

Findings

Issue1:Accommodation

oTheStudentenrolled intheCollege's nursingassociatedegree programinFall

2005,whichbeganonAugust15. Atthestartoftheprogram,sheinformedthe nursingfacultythatshehadabackinjury.

•The StudentmetwithaDSPScounselorattheCollegeon August17todiscloseher backinjuryandtorequestalumbarsupportchair. Atthetime,shedidnotprovide sufficientevidencetoestablishthatherbackimpairmentwasadisability. However, onAugust25,shesubmittedadditionalinformation. Thisinformationsatisfiedthe DSPScounselorthattheStudent waseligibleforDSPSservices.

•ADSPSspecialiststatedthattheStudentinitiallytoldherthattherewasachairin theclassroomthatwasappropriateforheruse. TheDSPSspecialistgave the Student asigntoputonthechair,reservingitforDSPSuse. TheDSPSspecialist statedthatshegavetheStudentthesignbeforereceivingherverification,contrary topolicy,becauseoftheStudent'sinsistence. TheStudentlatercomplainedabout thesign,anditwaschangedtostatesimplythatthechairwasreserved.

oTheStudenttold thenursingfacultythatshealsoneededaspecialchairinthe laboratory. Alabassistanthadalumbarsupportchairinthelabthatshewasnot using,andofferedittotheStudent,butsherefusedtouseit. OnoraboutAugust

25,anursingrepresentativecalledDSPStoaskforasecondchairtobeplacedin thelab. DSPSrepresentativesstatedthattheywerenotaware,untilthattime,ofthe Student'srequesttohaveachairinthelab.

•The DSPS specialist obtained "padded" supportive chairs from the College's facilitiesdepartmentofatype theyroutinelyuseforstudentswithbackinjuries.She putoneinthelabfortheStudentshortlyafterreceivingtherequest.

o TheStudentcontactedDSPSonoraboutSeptember1toreportthatthechairshe wasusingintheclassroomwasnotconsistentlyavailable. TheDSPSSpecialist hadtroubleaccessingtheclassroom,butleftasecondchairoutsidetheroomon September7. ShecalledtheStudenttoinformherthatthechairwasthereforher.

oAtthattime,theStudentreportedtoDSPSspecialistthatthe"padded"chairinthe labwasnotcomfortableforher. TheDSPSspecialistthenreceivedpermissionfrom theDeanofDSPStoordertwonewlumbarsupportchairsfortheStudent'susein lectureandlab. ThenewchairswereorderedtheweekofSeptember12,andwere

inDSPSbySeptember19. Afteracoupleofdaysofassemblyandsomedifficulties accessingtheclassrooms,bothnewchairswereinplaceonSeptember22.

oTheStudentallegedinhercomplaintthattheCollegedidnotprovideachairinthe labbecauseitwasnotinthebudget. Later,theStudentstatedthatthenursing

. facultytoldherthataspecialchairwouldnotfitthroughthedoorbetweenthetwo

labrooms,andthatiswhyshecouldnothaveaspecialchairinthelab.

oNursingprofessors, the Dean ofthe nursingprogram, and the Dean ofHealth OccupationsallstatedthattheStudenthad supportivechairsavailableforherusein theclassroomandinthelabafterthefirstweekofclasses. Theystatedthatona numerousoccasions,althoughtheStudentwasawareofthechairs,shechosenot tousethem,insteadsittingon aregularchair,afilecabinet,orthefloor.

eAnursingprofessorstatedthatsherememberstwotimeswhenotherstudentswere sitting intheStudent'schair. Bothtimes,theprofessoraskedthestudentstomove. Theprofessorofferedtomakeanannouncementtotheclassdirectingthemnotto sit in thechairs,buttheStudentrefused. Theprofessorstatedthat,inthose instances,theStudent'schairwasoccupiedbecausetheStudentwaslatetoclass. Anursingprofessorstatedthatwhenshe askedtheStudentwhyshewasnot using thechair,theStudent saidthatpeoplewerejealousof herchair. TheStudent herselfwrotethat "otherstudentswerefeelingresentfulthat theydidn't havea specialchairforthemselves."

•TheDeanofDSPS,DSPSrepresentatives,theDeanofthenursingprogram,and thenursingfacultyallstatedthatneither theStudent'sbackdisability,northe Student'sallegeddifficultieswiththechairs,contributedtoheracademicdifficulties (discussedbelow). TheDeanfurtherstatedthattheStudentcametoherwithmany issuesandconcerns,butneverbroughtthe chairstoherattention. TheStudent herselfdoesnotallegethatproblemswiththechairscausedhertoperformpoorlyin theprogram.

Issue2:Dismissal

oDuringthefirsthalfofthefallsemester,nursingstudentsparticipateinonecourse.

Thiscourse,Nursing141,haslecture,seminar,andclinicalcomponents. Thefirst sixweeks oftheclinicalcomponentare completedintheon-campuslab,where students obtain the knowledge and. skills necessary to perform their clinical

placementsinlocalhospitals.

•During these first six weeks, student preparedness for clinical participation is evaluatedthroughvariousmeasuresincludingparticipationinthenursingskills labs, successfulcompletionofvariousskills tests(suchasavitalsignstest andamedical dosagecalculationexam),and completionofvideotapedskills.

8OnSeptember22,beforethehospitalclinicalbegan,anursingprofessordismissed theStudentfromthenursingprogram byinitiatingan"instructordrop."2

8The nursing professors deny that they dismissed the Student because ofher disability,oranymanifestationsofherdisability. TheDeanstatedthatbecauseshe considers nursing to be an intellectual profession, she does not endorseany physicalcapabilityrequirementsfornurses,nordoestheprogramhaveany.

•Instead,theprofessorsstatedthattheStudentwasdismissed fromtheprogram becauseshehadnotmetthecourseobjectives,andlackedthejudgmentandskills toentertheclinicalsetting.Theyfurtherstatedthatshedidnotattendtherequired laboratorysessions,anddidnothavetherequiredknowledgeintheareasofpatient safetyandcomfort,safe standardprocedures,hygiene,andinfectioncontrol.

oTheNursingProgram StudentHandbook(theHandbook) provides that"nursing facultymayrecommendthewithdrawalofanystudentwhosehealth,conduct,or academic performance makes it inadvisable for the student to continueinthe nursing program."

•TheHandbookfurtherstatesthat"facultymay removestudentsfromtheclinicalarea andrecommenddismissalofstudents fromthenursingprogramforunsafe, unprofessional, dishonest and/or·disruptive conduct." Unsafe nursing practice includes"anyactionorinactionthatthreatensapatient'ssafetyandphysicalhealth."

Qualifications

•TheStudentdidnotdemonstratesufficientcompetencyinavideoskill,aprimary waythat facultyassesspreparednessforthehospitalclinical.

eThevideoskillsaretapedinthelaboratoryandgradedbythefaculty. Eachstudent mustsuccessfullydemonstrateonerandomlyassignedskill(outofsix)ineachof threelevelsbytheninthweekofthesemester. Studentstypicallymustcompletea level1andalevel2skillbeforebeginningclinicalparticipation.

"Studentswhofailavideoskillareallowedtoretakeit. Thestudentmustredo the sameskillheorshefailedfirst,andthendoanotherrandomlyassignedskillatthe samelevel,beforeproceedingtoa skillat thenextlevel.

2AlthoughtheStudentclaimsthatshewithdrew fromthenursingprogramherself,theCollegeprovided documentation,includingregistrardatabaseprintouts,indicatingthat theStudentwasdismissedfromthe coursethroughan"instructordrop."

•The Student taped her first video skill ("Bathing a Client") on September16.

ProfessorsnotedthattheStudentwaiteduntilonlyafewdaysbeforethebeginning oftheclinicaltocompleteherfirstskill,andthatmost,ifnotall,oftheotherstudents hadcompletedtheirfirst(if notsecond)videoskillby thistime.

•AprofessorgradedthevideoskillonSeptember17and18,anddocumentedthat"it wasobviousthat[theStudent]hadnotpracticedthisprocedureaccordingtothis criteria,"concludingthattheStudentmade"manycriticalerrorsregardingsafety, infectioncontrol,andpatientcomfort." ThefacultyandtheDeanstatedthatthe videodemonstratedseveresafetyconcernsbothforthepatientandtheStudent. TheStudentfailedthevideoskill.

•TheStudentallegesthatthebedsheusedduringthevideoskillwasbroken,and wouldnotlower. Shestatedthatthiscontributedtoherpoorperformanceonthe skill. ImmediatelyaftertheStudent'svideo,however,thelabassistantconfirmed thatthebedwasfunctioningproperly.

•TheStudentstatedthatshehadscheduledatimetoredothelevel1videoskillon September20,thedaybeforetheclinicalorientationwas tobeheld. Shestatedthat shewasnotabletogotothelabatthetimeshescheduled,becausethenursing professorsheldameetingwithheratthattime. Sheallegesthatshethereforedid nothavethesameopportunitytomakeupthevideothatotherstudentshad.(OCR notes thatinherwrittencomplainttheStudentalternativelyallegesthattheSeptember20meetingcausedher tomissadoctor'sappointment.)

•ThefacultyacknowledgemeetingwiththeStudentonSeptember20,butstatethat theywerenotawarethattheStudenthadalabappointment,anddidnotdeterher frommakinguphervideoskill. Instead,they statethatthemeetingaddressed creatingaplantomakeuptheStudent'sdeficienciesandextensiveabsences.

•Inanyevent,thefacultystatedthat,basedon theStudent'svideoperformanceand theirobservationsofherinthelab,theywouldhavehadconcernsregardingher abilitytoconductskillsintheclinicsafelywithoutintensiveadditionalpractice,even ifshewasabletopassthefirstrequiredvideoskills.

oThefacultydescribedanothernursingstudentenrolledintheprogramduringthe samesemester. Althoughthatstudentpassedthelevel1video,theyhadsafety concernsrelatedtoherparticipationintheclinicaswell,primarilybecauseshe had a difficulttime following directions. This studentwas also dismissed fromthe programbeforetheclinicalbegan. Shedidnothaveadisability.

•Thefacultyalsonotedthat,totheirknowledge,theStudentdidnotpasstheVital Signsskillstest required to begintheclinical,andhad notpassedthemedical dosagecalculationexamrequiredtopassthecourse.

Attendance

•The nursing faculty stated that the Student'spoor attendance andparticipation duringthefirstsixweeksofthe programwasanotherreasonforherdismissal.

•TheCollegeattendancerulesstatethattheinstructor"maydropthestudentfromthe class"ifthestudent"isabsentforasmanytimesasaclassmeetseachweek."

•Further,theHandbook states:"Nursingstudentsarepreparing towork. ..for employerswhorequire[them]tobedependableandreliableaswell assafeingiving patientcare.Therefore,itisexpectedthatstudentswillbepresentandontimeforall classes,includinglectures,tests,seminars,collegelaboratorysessionsaswellas clinicalandcommunityexperiences.Studentsareresponsiblefornotifying their instructorbeforeanyexpectedabsenceortardiness." Topassnursingcourses, students"meet allattendancerequirements."TheHandbookalsostatesthat failure tomakeuplaboratoryhourscanresultinafailureforthecourse.

•ProfessorsdocumentedtheStudent'sabsencefromacriticalthinkingseminar,a six­ hourbodymechanicslabsession,alabsessiononhowtodothevideo skillstesting, andasix-hour presentationonmedicationadministration. Oneprofessornotedthat theStudenthadmissedatotalof21.5instructionalhoursduringthefirstsixweeks.

•AlthoughtheStudentallegesthatsomeofherabsenceswereindirectlyrelatedto herdisability(sheallegesthatshehadmedicalappointmentsrelatedtoherback condition)thefaculty statedthattheStudentdidnotcontactthembeforethese missedsessions. Further,thefacultynotedthattheStudent'sreasonsformissing sessionswereofteninconsistent,andwereoftennotmedical. Forexample, dueto theStudent'sconcernabouthavingtoappearincourt,aprofessorwrotealetter for theStudentexplainingthatherattendanceeachdaywasmandatory.

•ThefacultyalsodocumentednumerousinstancesinwhichtheStudentwaslateto classandtolabsessions. She didnotcontactthefacultybeforethesetardyarrivals. Further,theystatedthatonvariousoccasions,whiletheStudentattendedlab,she didnotengagewithotherstudentsasrequired.

•TheStudentallegesthatshemadeupasignificantportionofthelabworkthatshe missed. Thefaculty,however,describedthewaysinwhichtheStudent'sattempts tomakeupthemissedworkwereinsufficient,andsubmitted documentation supportingtheirconclusions.

•TheStudentfurtherallegesthatshewasnotgivenasufficientorfairopportunityto makeupherabsences. ShestatedthatonSeptember20, herprofessorstoldher

thatsheshouldwithdrawfromtheprogrambecauseanyattemptshemadetocatch upwouldresultinfailure. Shestatedthatshewastoldnottobothertoattendthe clinicalorientationonSeptember21. (OCRnotesthat,inherwrittencomplaint,the Studentstatesthatshewas toldtogototheorientation.)

•ProfessorsstatethattheSeptember20meetingwasheldtoinformtheStudentthat shewouldhavetowithdrawfromtheprogramunlesssheundertookanaggressive makeupplan. Theytoldherthatifshewantedtocontinueintheprogram,shemust attendtheclinicalorientation,andshouldmeetwith themonSeptember22tocreate aplantoincreaseherskilllevelandcompletethelaboratoryworkshemissed.

•The Studentdid notattend the September21 clinicalorientation (andfailedto contacttheinstructor),didnotmeetwiththefacultyonSeptember22,anddidnot attendclassonSeptember22. Shewasthendismissedfromtheprogram.

TheStudentdiscussedherdismissalwiththeDeanofHealth Occupations. He upheldthefaculty'sdecisiontowithdrawherfromtheprogram. TheStudentwas giventheopportunitytoreenrollintheprogramconsistent withtheCollege'spolicy.

Analysis

TheregulationimplementingSection504,at34CFRSection104.43(a),provides that qualifiedpersons withdisabilities maynotbeexcluded from participationin,orbe deniedthe benefitsof,anyoftheCollege'seducationalaids,benefitsorservicesonthe basisofdisability.TheCollege,specifically,maynotexcludeanyqualifiedstudentfrom acourseoranyotherpartofitseducationprogramoractivity. 34CFR§104.43(c).A corresponding requirement exists under Title II of the ADA at 28 CFR Section

35.130(a). Additionally, theregulationrequiresthattheCollegeprovidereasonable, requested auxiliary aids and services as necessary in order· to facilitate students' participationintheCollege'sprogram. 34CFR§104.43(d). Asimilardutytoprovide reasonable modifications under Title II of the ADA is found at 28 CFR Section

35.130(b)(7).

Issue1:Accommodation

OCRfoundthattheCollegewasincompliancewiththeapplicablelawwithrespectto theprovisionofauxiliaryaidsandservicesfortheStudent. TheCollege'sDSPSoffice acceptedthe Student'sdescriptionofherdisabilityandherrequestforalumbarsupport chair. Initially,theStudentindicatedthattherewasachairin.theclassroomshecould use(which wasthusreservedforheruse),anddidnotrequestachairinthelab.Within afewdaysofreceivingtherequestforachairinthelab,DSPSdeliveredapadded, supportivechairfortheStudent'suse. Withinsixdaysoflearningthattheclassroom chairwasnotconsistentlyavailable,DSPSdeliveredasecondpaddedchairforthe Student. Furthermore,DSPSreadilyorderednewchairsfortheStudentuponlearning

fromherthatthepaddedchairswerenotadequate. Intwoweeks’ time,DSPSordered, received,assembledandplacedthenew chairsfortheStudent'suse.

OCRdeterminedthatDSPSimplementedtheStudent'srequestedauxiliaryaidswithin areasonabletimeframe. Further,OCRfoundthattheindividualsinDSPSandinthe nursingprogramconsistentlyattemptedtoaddresstheStudent'sissueswiththechairs, bypurchasingandprovidingalternativechairs,ensuringthechairswereavailablefor theStudent'suse, encouraging the Studentto usethe chairs, and counselingthe Studentoverconcernsshehadabouttheuseofthechairs. Finally,OCRfoundthat anyinconsistencyinthechairs'availabilitydidnotcontributetotheStudent'sacademic difficulties.

Issue2:Dismissal

OCRalsofoundthattheCollegewasincompliancewiththeapplicablelawwithrespect tothedismissaloftheStudentfromtheprogram.

Dismissingastudentwithadisabilityfromaprogramisnotdiscriminatoryifthestudent isnot"otherwisequalified"toparticipate intheprogram. Undertheregulations implementingSection504andTitleIIoftheADA,a"qualified"postsecondarystudentis onewhomeetstheessentialacademicandtechnicalstandardsoftheinstitutionwithor withoutreasonable accommodation. See34 CFR§104.3(1)(3);28CFR§ 35.104. Academic requirementsmayincludethatastudentmaintainacertaingradepoint average.Technicalrequirementmayincludeattendancerules. Demonstratingmastery ofcertainskillsmightfailintoeitherorbothofthesecategories.Ofcourse,anindividual with adisabilitywhohasdocumentedherorherdisabilityandhasfollowedreasonable rules forestablishingeligibilityforacademicadjustmentsandauxiliaryaides (accommodations)isentitledtobeheldtotheacademicandtechnicalstandardswith thebenefitofreasonableaccommodations.

Inthiscase,theStudentcontends thatshewasnotdismissedforfailingtomeet academicandtechnicalstandards. Rather,sheallegesthatthefacultybelievedthat someonewithherdisabilitycouldnotsafelyperformasanurse,andthatthefaculty resentedherforherdisabilityandher accommodationrequest.

ThereasonarticulatedbythefacultyfordismissingtheStudentwasthatshewasnot qualifiedtoadvancetotheclinicalstageofthenursingprogram, notbecauseofher disability,butbecauseofherlackofpreparedness.andthesafetyissuesthatitposed. ThepreponderanceoftheevidencecollectedbyOCRaffirmedthisexplanation.

Asdiscussedabove, OCRfoundnoevidencethatdelaysorinconsistenciesinthe receiptofanauxiliaryaid(alumbarsupportchair)adverselyimpactedtheStudent's abilityto meet the College's academic and· technical standards.There is mixed evidencethatherattendanceproblemswererelatedtoherdisability,butnoevidence thather disability hindered her abilityto report her absences as required bythe

College'sestablishedrules. Similarly,thereisnoevidencethatsherequested,asan accommodationforherdisability,amodificationtotheCollege'sexistingattendance rules. Thus,OCRwouldconcludethattheStudenthadbeendiscriminatedagainst based upon her disability only if itfoundthat she had actually met the College's academicandtechnicalstandardsbutwasnonethelessdismissedforfailing tomeet them, or ifshewasdismissedforfailingtomeetstandardsthatweredifferentthanthose enforceduponnon-disabledindividuals.

OCRfoundthattheStudentwasheldtothesamestandardsasall otherstudentsinthe nursingprogram,andthattheCollegereasonablyconcludedthatshewasnotqualified tocontinueintheprogramduetoherfailuretomasterrequiredskillsandhernumerous unexcusedabsences.

TheHandbookgivesthefacultytheauthoritytodismissanystudentwhoseconductor academicperformancemakesitinadvisableforthestudenttocontinueintheprogram, andfurtherprovidesthatstudentsmaybeprohibitedfromparticipatingintheclinical anddismissedfromtheprogramforunsafe orunprofessionalconduct. Thenursing faculty'sconclusionthattheStudentlacked thejudgmentandskillstoentertheclinical setting, and did not have a sufficientlevel of knowledge about patient safety,is supported bytheStudent'sperformanceonhervideoskillandherlackofcompletionof requiredlabexperiences. OCRreviewedthevideoskilltapeofthestudent. Without more,OCRwouldnotbequalifiedtomakeadeterminationofnursingskill. However, nothingOCRviewedonthetaperevealedanobviousorlogicalcontradictiontothe determinationmadebythenursingfaculty,andnothinginthetapesuggestedthatthe faculty'sconclusionwasapretextfordisabilitydiscrimination.

OCRfoundthattheStudentwasgivenanequalopportunitytocompletethevideo skills successfully,andwasgivenextraopportunitiestoattempttomakeupherabsences anddevelopthenecessaryskilllevel. AlthoughtheStudentallegesthatthefacultytold herthatshewould havetowithdraworshewouldfail,OCRfound thatthefaculty insteadsetoutspecificexpectationstheStudentwouldhavetomeet(i.e.,attendthe clinicalorientation,attendclassregularly,meetwiththeprofessorsonaspecifieddate tocreateamakeupplan)inordertocontinueintheprogram. TheStudentfailedto meettheseexpectations. Anothernursingstudent, whohadnodisabilities,was dismissed during the same semester on performance standards similar to those imposedontheStudent. Bothstudentsweregiventheopportunitytoreenrollinthe program consistent withtheCollege'spolicy.

Insum,OCRfoundthatthefacultyreasonablyconcludedthattheStudentfailedtomeet theessentialacademicandtechnicalstandardsofthenursingprogram. Thisfailure cannotbeexplainedbyanabsence ofanapprovedaccommodationorbytheapplication ofdifferentorhigherstandardsthanthoseappliedtonon-disabledstudents. Accordingly, theStudentwasnotaqualifiedindividualwitha disabilityandherdismissaldidnotviolate Section504orTitleIIoftheADA. OCRfindstheCollegeincompliancewithTitleII, Section504,andtheirimplementingregulationswithrespecttotheissueinvestigatedin thiscomplaint.OCR isclosingthiscomplaintasofthedateofthisletter.

OCRwouldliketothanktheCollegeforitscooperationinthe investigationofthis matter.Ifyouhaveanyquestionsaboutthisletter,pleasecontactJamesWoodat(415)

556-4247.

Charles R.Love

ProgramManager

Cc:Dr.ChristopherMcCarthy,President

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