Differences between Residential Facility Placements for Educational and Medical Reasons

         School districts are generally more familiar with legal requirements and procedures that apply when a doctor or court places a child in a residential facility for medical purposes than when an IEP team places a child in a residential facility for educational purposes. While both placement types focus on addressing the needs of children, their legal requirements vary significantly regarding the overseeing authorities, procedural structures, and the responsibilities of public entities.

Medical Placement by a Doctor/Juvenile Court

        Medical placements emphasize licensing, medical care plans, and judicial oversight for mental health cases. The child's placement must be based on a medical care plan that addresses the child’s medical, psychological, social, behavioral, and developmental needs, reflecting the necessity for inpatient care. See Iowa Code 135H.1 and 135H.14. 

        When a child is placed in a residential facility for medical purposes, the responsibility for finding the residential facility lies primarily with the Iowa Department of Health and Human Services (“HHS”) or the juvenile court, depending on the circumstances of the case.

       Educational Placement by an IEP Team

        Educational placements emphasize compliance with state education standards and collaboration between school districts and AEAs. When an IEP team places a child in a residential facility for education reasons, the placement must comply with specific statutory requirements under Iowa Code 282.34. 

        The provision of special education for a child placed at a residential facility is subject to the standards adopted by the Iowa State Board of Education that govern the educational programs and contracts between residential facilities and school districts. See Iowa Code 282.34 and 237C.4. The facility must provide an education program and services by either contracting with the school district where the facility is located, contracting with an accredited nonpublic school, or becoming accredited as a nonpublic school. See Iowa Code 282.34. Area education agencies (“AEAs”) are responsible for cooperating with the child’s school district of residence to share educational information, textbooks, and materials to ensure the child receives an appropriate education. Id. 282.30. 

  

Continuum of Placements: Residential Facility

        The IDEA (20 U.S.C. § 1400-1487) and Iowa special education law require public school districts to provide eligible children with a free appropriate public education (“FAPE”). 20 U.S.C. § 1412(a)(1)(B)(I); Iowa Code § 256B.2(1)(a), (2)(a) (2025); see also Kass v. W. Dubuque Community School District, 101 F.4th 562, 2024 U.S. App. LEXIS 11399 (8th Cir. Iowa 2024). Moreover, it requires public school districts to provide a FAPE tailored to a child’s unique needs, which includes ensuring that the IEP is implemented in a manner that enables the child to make appropriate progress in light of their circumstances. See D.L. v. St. Louis City Sch. Dist., 950 F.3d 1057 (8th Cir. 2020); see also 20 U.S.C. § 1400, § 1412; 34 C.F.R. § 300.1, § 300.39; Iowa Admin. Code r. 281—41.17 (2025). 

        Occasionally, an IEP team finds that a child's needs exceed the ability of the school district to provide the child with a FAPE in a school district setting. For this reason, state and federal law clarify that "special education" includes instruction in the classroom, home, hospital, or institution designed to meet the needs of children requiring special education; transportation and corrective and supporting services required to assist children requiring special education in taking advantage of, or responding to, educational programs and opportunities, as defined by rules of the state board of education. See 34 C.F.R, §300.39; Iowa Code 256B.29(b)(2025).

When the nature or severity of a child’s disability makes education in a regular classroom setting unsatisfactory, even with supplementary aids and services, IEP teams must consider more restrictive placements, including residential facilities. See 20 U.S.C. § 1412(a)(5); Mitchell v. Cedar Rapids Community Sch. Dis, 832 N.W.2d 689 (2013). The IDEA recognizes that some students with disabilities require full-time support in a residential facility to receive a FAPE. educational benefit. 

        IEP team placement of a child in a residential facility for educational purposes is part of the continuum of placements required under the IDEA and Iowa special education law. See Iowa Code 256B.2; Iowa Admin. Code r. 281-41.115(2)(a); see also D.L. v. St. Louis City School District, 950 F.3d 1057 (8th Cir. 2020).  

A child’s IEP team is authorized to determine that a child requires placement in a residential facility to provide a FAPE. See Independent School District No. 284 v. A.C., 258 F.3d 769, 771 (8th Cir. 2001); 20 U.S.C. § 1412(a)(10)(B); Iowa Admin. Code r. 281—41.116.  A public school district cannot unilaterally override an IEP team's determination that a child requires placement in a residential facility. See Iowa Code 256B.2 (explicitly stating that special education placements, including residential facilities, are to be provided when the nature or severity of the disability necessitates such arrangements, as determined by the IEP team); see also Iowa Code 282.31 (underscoring the binding nature of IEP team decisions by requiring the school district of residence to pay special education costs, including residential placements, determined necessary by the IEP team). 

    While public school districts retain some authority over educational decisions, they are constrained by the requirement to comply with the IEP team's determinations. See Southeast Warren Community School District v. Department of Public Instruction, 285 N.W.2d 173 (Iowa 1979) (in which the Iowa Supreme Court recognized that the legislature anticipated the need for specialized placements for certain students and established a framework for evaluation and placement that prioritizes the IEP team's recommendations.).