The special health needs of handicapped children in Prince George's County schools have become the focus of a squabble between the county health department and the school board.
For the past 11 months representatives of the County Office of the Handicapped and the County Council have met to decide which of the two agencies has jurisdiction to provide services such as catheterization in the schools. These meetings have produced little more than paper shuffling.
Because an agreement could not be reached before the start of the school year, the Board of Health, which is made up of members of the County Council, earlier this month told the health department, as an interim measure, to provide special medical services free at Randall and Reed schools and at the Duckworth Special Center.
The jurisdictional problem arose last October when the mother of a handicapped girl at Catherine T. Reed Elementary School complained to a council member about having to drive to the school twice a day to catheterize her child, a procedure to remove liquid wastes from the body. For the two years the child attended Holly Park Elementary, she had been catheterized by a nurse's aide.
But when the child was moved to Reed as part of an attempt by the county to integrate handicapped children into the school system, the system's attorney said the procedure could only be performed by the child's mother or a registered nurse.
Under state law, the school system is prohibited from using registered nurses in the schools, and the board told the parents they had to perform the services. According to the school do vision and hearing testing but are not allowed to give medication or treat children.
After the health department said it could do the catheterization service in the schools for a fee of $18 each visit, the council told the department to provide the services free while an arrangement is worked out with the school board for a more formal policy on the overall health needs of handicapped children in the schools.
After the initials directive, two other children needing catheterization were treated by county public health nurses. Health department officials said it has cost in excess of $12,000 since November to provide the service for the three children.
Conflicting medical opinions over the need for a nurse to provide the catheterization have been at the heart of the jurisdictional question since its outset. Dr. Donald Wallace, county health officer, said all of his medical advisers agree that catheterization can be done by a property trained nurse's aide or school staff member. The board of education, however, said the service is a medical one and must be done by a health professional.
With the impasse, the council ordered the health department to continue to provide the service and to give other special medical or personal health services at Reed, James Ryder Randall Elementary and at the Duckworth Special Center.
Health department officials said last week that public health nurses would provide the services until the department develops an "organizational structure," when, they said, they would probably hire a part-time non-professional to do the job. They are also planning a program to teach those children able to learn how to perform the services themselves.
"Perhaps one of the mothers might be interested in such a position," said Wallace's aide, Sally Buckley. "That is more economical for us, and the children would be familiar with the person and more comfortable. We just want these children to become as self-sufficient as possible."