SUBJECT: Health Care Services for Students with Special Needs
The Board recognizes that students with special health care needs are entitled to public education. Therefore, the Board delegates to the Administration responsibility for developing policy to provide necessary health care services for students with special health care needs in accordance with state and federal law. (See Section 504 of the Rehabilitation Act of 1973, the Utah Nurse Practice Act, the Nurse Practice Act Rules, and Individuals with Disabilities Education Act of 1990.)
- Administrative Policy
The Administration may provide accommodations to students with special health care needs who require individualized health-related services/interventions by Jordan School District and its personnel to enable their participation in the educational process. This policy shall be administered within health and safety parameters according to the following administrative policy provisions:
- Definition of Special Health Care Needs
Students shall be considered as having a special health care need if one or more of the following conditions applies:
- The student requires administration of medication during the school day in order to access his/her educational program. (Note: If the student's only special health care need is administration of medication during the school day, the student's services shall be administered according to Policy AS85—Medication in the School Setting and the provisions of this policy shall not apply.)
- The student requires administration of support procedures during the school day in order to access his/her educational program.
- The student uses a particular health care device that monitors or compensates for the loss of a body function.
- The student's health condition may require routine or emergency health care procedures.
- The student's health condition may require substantial, complex, or frequent health care services to avert death or further disability.
- The student's individual education program requires support health care services.
- Requesting Special Health Care Services/Interventions
Procedures for requesting special health care services/interventions are as follows:
- The student's parent formally requests special health care services/interventions by completing the “Jordan School District Request for Special Health Care Services and Release of Confidential Information” form available online, or from the school principal. This form must be submitted each year.
- The student's parent shall provide all of the forms and information necessary to enable the District nurse to make an initial assessment of the student's condition. This may include:
- A statement from the student's primary health care provider which describes the special services/interventions required and how they are to be administered.
- Other health-related evaluations or information as requested by the District nurse.
- Except for students subject to IDEA or §504 of the Rehabilitation Act, expenses for health-related evaluations and assessments shall be the responsibility of the parent. Parents who need financial assistance obtaining required health-related evaluations or information shall be advised to contact the Utah State Department of Health.
- The principal shall provide liaison services and facilitate communication with the parents, school nurse, primary health care provider, school staff, and other agencies as necessary.
- Responding to Requests for Services/Interventions
The process for reviewing and approving or denying requests for special health care services/interventions shall be as follows:
- The school principal shall forward the “Jordan School District Request For Special Health Care Services and Release of Confidential Information” form to the school nurse for an initial health care assessment.
- The District nurse shall review the “Jordan School District Request for Special Health Care Services and Release of Confidential Information” form and all accompanying documents and evaluations to determine the following:
- What health care services/interventions are required; e.g., medications, special diet, school or classroom modifications, equipment, supplies, etc.
- Whether the requested services/interventions are necessary during the school day to enable the student to access his/her educational program.
- Whether the requested services/interventions can reasonably be accommodated by school personnel.
- Whether the requested services/interventions can legally be provided by school personnel who are not licensed nurses or health care practitioners. (Note: Nursing activities not specifically addressed in the Utah Nurse Practices Act may be performed by a non-licensed individual provided the activity does not require exercising nursing judgment and the activity is delegated and supervised by a licensed nurse.)
- Whether the requested services/interventions constitute supportive rather than medical services.
- The District nurse shall report the findings of the initial health care assessment to the school principal with a recommendation to grant or deny the request for special services/interventions.
- The District nurse may organize a Health Care Team to develop an individual health care plan for the student if needed.
- The principal shall forward the request to the District Compliance Officer if any of the following conditions apply:
- The requested services are “medical” (services that can only be rendered by a physician) rather than “support” services.
- The requested special services/interventions cannot be provided by school personnel in accordance with the Utah Nurse Practice Act.
- The request for services is denied by the District nurse.
- District Review and Right of Appeal
- The District Compliance Officer shall notify the parents and District nurse in writing if the request for special services/interventions is denied.
- The parents shall be informed in writing that decisions of the District Compliance Officer may be appealed to a Health Services Panel composed of the Coordinator of Educational Support Services, the appropriate Administrator of Schools, and a designated District nurse. Appeal procedures are as follows:
- A written appeal shall be submitted to the Superintendent of Schools within 10 days of the determination of the District Compliance Officer.
- The Health Services Panel shall review the findings of the District Compliance Officer and make a determination about the school's ability to provide the special health care services requested.
- Parents shall be notified of the Health Services Panel's decision in writing.
- Individualized Health Care Plans
- An individualized Health Care Plan shall be developed by the District nurse for all students who qualify for special health care services/interventions.
- Plans shall be developed prior to placement if the student's condition is life threatening or capable of causing serious injury to the student or to other students or staff members. Until a health care plan can be developed, the student may be placed in the Home and Hospital or other appropriate instruction program. However, if the student is designated under either §504 of the Vocational Rehabilitation Act or receives education pursuant to an individualized education program, then the IEP team must be convened prior to any change in placement to address the health needs for school.
- Each individualized health care plan may include the following components:
- A description of the student's health condition.
- A description of the services/interventions to be performed with specific, detailed instructions from the student's health care provider.
- Written permission from the parents to administer any required medications or perform any required procedures.
- A list of the school personnel assigned by the school principal to perform the services/interventions. If the parent, privately employed nurse, or other non-employee is to perform the service, parent must provide prior written permission.
- A description of any recommended safety precautions and/or signs of distress which could indicate the onset of a medical emergency.
- Instructions for emergency interventions including:
- Emergency numbers for family and alternative contacts.
- The preferred emergency room if requested by primary medical provider or parent.
- A list of school personnel who are acquainted with the student's condition and able to render emergency assistance.
- Evacuation procedures.
- Other information the District nurse deems necessary.
- Instructions for special transportation services, if applicable, including:
- The mode of transportation to and from school.
- The maximum recommended travel time each way.
- Equipment and adaptations necessary for transportation; e.g., lifts, wheelchair restraints, oxygen, etc.
- Special staffing or training required for transportation personnel.
- An implementation date.
- The completed individualized health care plan shall be maintained by the school as a "private" record in accordance with the Government Records Access Management Act. Eligible students under IDEA or Section 504 must have health care plans attached to their IEP or 504 plan.
- Parents shall notify the principal in writing of any changes in the student's condition which may require a modification of the health care plan. The health care team shall be reconvened, if necessary. The principal shall notify the District nurse of any changes in the student’s condition.
- Staff Assignments
- The school principal, in conjunction with the District nurse, shall assign staff members to perform special health care services/interventions outlined in the Individualized Health Care Plan. Such assignments shall be within the limits of Policy AS85—Medication in the School Setting by school personnel, and the Utah Nurse Practices Act and other applicable statutes and regulations.
- The school principal shall see that staff members assigned to provide special health care services/interventions for students understand and use Universal Precautions Against Blood Borne Diseases.
- The school principal and District nurse shall cooperatively determine the in-service training necessary to enable the assigned staff members to successfully perform the required services/interventions.
- Following in-service training and prior to rendering special health care service/interventions, the District nurse shall verify the staff member's ability to safely perform the assigned duties.
- The District nurse shall advise the school principal regarding supervision of staff members assigned to perform special health care service/interventions.
- The school principal may notify other staff members of the student's need for special health care services/interventions within the limits of the Family Educational Rights and Privacy Act (FERPA) and the Government Records Management Access Act (GRAMA) and the Health Insurance Portability and Accountability Act (HIPPA).
- The school principal shall notify the District nurse and staff members assigned to provide special services/interventions of any changes in the student's condition that have necessitated changes in the Individualized Health Care Plan.
- Provisions for Health and Safety
- The school principal shall be responsible to see that all staff members receive training in the use of Universal Precautions Against Blood Borne Diseases.
- The school principal shall be responsible to see that the necessary equipment, materials and supplies are provided to staff members who are required to perform special health care services/interventions.
- Universal Precautions Against Blood Borne Diseases shall be used in handling and disposing hazardous materials.
- Upon the recommendation of the State Health Department or recommendation of a personal physician based on a staff member's special medical condition, the District shall pay for immunizations and/or related testing for staff members whose assignment to provide special health care services/interventions places them at increased health risk.
- Staff members shall not be required to perform special health care services or interventions if so doing places them in imminent danger or exposes them to serious health risk.
- If the safeguards outlined in this policy are not implemented, staff members may refuse to perform special health care services/interventions and shall appeal to the District Compliance Officer in accordance with the procedures outlined in Policy DP315 NEG—Grievance Procedures.