Providing health services for children with special health care needs on out-of-state field trips.

An increasing number of children attend school with special health care needs. Title II of the Americans with Disabilities Act (ADA) requires all school-sponsored activities to be easily accessible to all students. School-sponsored field trips enhance students' education, and students who require health services may not be excluded. For students with special health care needs, fully participating in the field trip experience presents unique challenges. These challenges are further complicated by out-of-state field trips due to variances in nurse practice acts, variances in delegation regulations, and most recently, state-by-state participation or nonparticipation in the Nurse Licensure Compact. Review of state laws, regulations, and nursing scope of practice for school health services is critical when planning and problem solving for students requiring health services on out-of-state field trips.