One-hundredfifty teachers of students with severe and multiple impairments were surveyed to identify the prev alence of health-related procedures being used in the classrooms, the person(s) routinely responsible for im plementing the procedure(s), and the persons the teach ers felt should be responsible for implementing the pro cedures. In addition, the survey identified the source of the teacher's information concerning health-related pro cedures for individual students, types of correspondence with the school nurse and the family physician, the teachers' awareness of the availability of school policy for implementing health-related procedures, the teach ers ' source of training on health-related procedures, and the relationship of the classroom location to visits by the school nurse. Seventy percent of the questionnaires were returned. Teachers indicated that all but one of the procedures listed were occurring in one or more of the classrooms. The teachers ndicated that, for the most part, they were primarily responsible for implementing the procedures on a routine basis. The teachers' re sponses indicated that they felt they should be respon sible for a specific group of procedures with the nurse and paraprofessional, or nurse and teacher in combi nation responsible for a different set of procedures. The family was used most often as a source of information for the health-related procedures. Contact with the school nurse was variable. Classrooms in integrated or rural settings were reported as visited less often by the school nurse than classrooms in either more segregated or urban settings. Only 21% of all the classroom teachers responding were aware of local district guidelines for the determination of who should be responsible for the implementation of health-related procedures.DESCRIPTORS: direct care staff, health care, medi cal treatment, medication, parent-professional rela tions, special education, special educators Schools are experiencing an increase in the number of students with severe and multiple handicaps who require medical and health-related procedures during the school day. These health-related procedures include, among others, administering medications, gastrostomy feeding, oxygen supplementation, and seizure monitor ing.Providing health-related procedures is critical in maintaining students' participation in the classroom.