Policy 5141.24 - Specialized Health Care Services

Rule 5141.24

Definitions

Specialized physical health services means those health services prescribed by the student's licensed physician requiring medically related training for the individual who performs the services and which are necessary during the school day to enable the student to attend school. These services include catheterization, gastric tube feeding, suctioning, or other services that require medically related training.

Qualified means the ability to demonstrate competence in cardio-pulmonary resuscitation, current knowledge of community emergency medical resources, and skill in the use of equipment and performance of techniques necessary to provide specialized physical health care services for individuals with disabilities. In addition, for designated school personnel, qualified means trained in the procedures to a level of competence and safety which meets the objectives of the training as provided by the school nurse, public health nurse, licensed physician, or other programs which provide the training.

Training means preparation in the appropriate delivery and skillful performance of specialized physical health care services.

Supervision means review, observation, and/or instruction of a designated school person's performance and of physical health care services, but does not necessarily require the immediate presence of the supervisor at all times.

Provision of Services

A student with disabilities who requires specialized health care services, as identified in his/her individualized education program (IEP), during the school day may be assisted by any of the following individuals:

1. Qualified persons who possess an appropriate credential pursuant to Education Code 44267 (service credential with specialization in health) or Education Code 44267.5 (service credential with specialization in health for school nurse), or a valid certificate of public health nursing issued by the Board of Registered Nursing.
2. Qualified designated school personnel trained in the administration of specialized physical health care if they perform those services under the supervision of a credentialed school nurse or licensed physician and the services are determined by the credentialed school nurse or licensed physician, in consultation with the physician treating the student, to meet all of the following criteria:
   1. Constitute routine care for the student
   2. Pose little potential harm for the student
3. Are performed with predictable outcomes, as defined in the student’s IEP
4. Do not require a nursing assessment, interpretation, or decision Making by the designated school personnel Specialized health care or other services that require medically related training shall be provided pursuant to Education Code 49423 (administration of prescription medication).

Schools shall provide appropriate accommodations for safety and necessary physical care services. The student's personal privacy and dignity shall be assured.

A qualified school nurse, public health nurse, or licensed physician responsible for supervising the physical health care of students with disabilities in the school setting shall:

1. Coordinate the health care services to the students with disabilities on the school site
2. Consult with appropriate personnel regarding management of health care services for students with disabilities
3. Make appropriate referrals and maintain communication with health agencies providing care to students with disabilities
4. Maintain or review licensed physician and parent/guardian requests and daily documentation records

The licensed physician of a student with disabilities who is required to receive physical health care services shall provide a written statement detailing the procedure and time schedule by which such procedures are to be given. In addition, the student's parent/ guardian shall provide a written statement indicating his/her desire that the district assist the student in the matters set forth in the physician's statement and granting consent for the delivery of such services.

For each student with disabilities, the district shall maintain the physician and parent/guardian statements, as well as the specific standardized procedures to be used if the services are provided. The district shall also maintain daily documentation of specific services provided and shall include the signatures of the personnel who performed the procedure. This documentation shall be maintained in accordance with the requirements for confidentiality of student records and shall be classified as mandatory interim student records.

The parent/guardian of students who require specialized physical health care services during the school day shall provide a written request for the needed physical health care service. This request shall include:

1. The student's name, address and phone number.
2. The physician's name, address and phone number.
3. The needed health care procedure.
4. Statement authorizing qualified school personnel to perform the procedure, as approved by the physician.
5. Statement agreeing to notify the school immediately of any change in the child's regimen or the authorizing physician.
6. Statement agreeing to provide all supplies needed for the procedure.
7. Consent of transfer of medical information.

The student's physician shall submit a written statement authorizing the administration of the specified physical health care service. This statement shall indicate:

1. The student's name and address.
2. Condition for which treatment is to be given.
3. Specific procedure to be given.
4. Time schedules for the procedure.
5. Precautions, possible untoward reactions and recommended intervention.

Staff designated to perform the specialized service shall maintain and sign a daily record of these services on a district form. This form shall be kept either in the student's classroom or in the school office, depending on the health services being provided