Integrated Service Centers Presented by:

1. Integrated Service Centers Presented by: Janice Blake and Carine Jean-Pierre Health Directors, QISC

2. What does the Health Director Do?HD Responsibilities…. There are 2 Health Directors assigned to each ISC. • Inquiries from parents/ staff/ administration • ATS Health screens technical assistance • Training and or training coordination • Questions and Crisis Management • Oral Health • City-wide standardization of health programs and mandates • Various Other Health Programs • Liaise with STAKEHOLDERS • Collaborate and Coordinate • Immunization compliance • Immunization Exemption requests • Tuberculosis • Communicable Diseases • Section 504 Accommodations • Health Programs and Presentations • Link to Resources • Safety and Health • CPR/AED • Condom Availability • Vision Screening • School Based Health Centers

3. New York City Department of Education Integrated Service Center New York City Department of Health and Mental Hygiene Who’s Who in School Health? • NYCDOE • ISC Health Director • School Health Aide • Borough Nursing Director • School Nurse • NYCDOHMH • Supervising Physician • Field Physician • District Supervising Nurse • Supervising Public Health Nurse, PHN III • Senior Public Health Nurse, PHN II • Public Health Assistant • Public Health Advisor (MS and High Schools) ISC Health Director O S H NYCDOE NYCDOHMH Office of School Health

4. Immunization • The goal for SY 08-09 is to ensure that at least 98.5% of students on your school’s roster are “complete” with immunizations. Due date: 98.5% by the end of December and 98.5% by the end of June • Tdap – 1 dose is required for all students born on or after January 1, 1994 and entering the 6th or 7th grade • Hepatitis B – if administered before age 11, this is considered a pediatric vaccination, 3 doses are required Or • Hepatitis B – if administered after age 15, this is considered an adult vaccination, 2 doses are required – the documentation provided as proof should specify which was administered and entered into ATS accordingly

5. Immunization • Each year the DOHMH releases a “Medical Requirements For New School Entrants” flyer which provides information as to what vaccines are needed and the required number of doses. The double-sided one page sheet is provided to all schools and/or is available on the NYCDOE website on the OSH webpage • Students not in compliance with the required immunization may be labeled “Excludable” or “Provisional” on ATS • Students with an “Excludable” notation should receive a DOHMH “Warning” letter and 2 weeks later, an “Exclusion” letter

6. Immunization • Excludable – means the student should not be allowed to attend until the vaccination requirements are satisfied • Please be sure to keep records of which students receive “Warning” letters and dates and the same for “Exclusion” letters. Please inform your health coordinator/ principal of the students on the list • Principals who allow “excludable” students to attend are out of compliance with the laws of the NYSDOE – Public Health Law – Title VI--Section 2164 (7). • Principals who allow “excludable” students to attend are subject to fines by the NYSDOH. These fines are levied against the principal, not the school

7. Immunization – Medical Exemptions • Medical Exemptions – based on a documented medical reason from a NYS licensed physician, a parent requests that a student not take the required vaccination as the vaccination is detrimental to the student’s health • In such cases: • The parent submits a request to the school • The school forwards the request to the ISC Health Director • The ISC Health Director confers with the DOHMH Supervising Physician • The student is able to attend during the review process • If the Medical Exemption is granted, a notation will be made in ATS. The student is able to attend, the exemption expires in one year. • If the Medical Exemption is denied, the student becomes “Excludable” and should not be allowed to attend.

8. Immunization– Religious Exemptions • Religious Exemptions – parents submit a written requesting that the student be exempt from vaccinations due to religious beliefs which oppose vaccinations • In such cases: • The parent submits a request to the school • The school forwards the request to the ISC Health Director • The ISC Health Director forwards the letter to the Office of School Health for review • The student is allowed to attend during the review process • The school, the parent, and the ISC will receive a determination letter stating the status of the request • If the Religious Exemption is granted, a “R” notation will be made in ATS. The student is able to attend, the exemption is in place for the remainder of attendance in a NYCDOE public school. In some cases, the student is not allowed to attend during periods of a communicable disease. • If the Religious Exemption is denied, the parent may contact the ISC Health Director to resubmit the request. • If denied again, the student is “Excludable” and not able to attend until the required vaccinations have been obtained or has been successful in an appeal to the NYSDOE.

9. Immunization – ATS • There are helpful reports in ATS to keep track of things: • STAT --on the STAT screen you will see your compliance rate • RHIL – (Immunization Status List) will tell which students are “complete,” “excludable,” or “provisional” • May be organized via class, grade, alphabetical, or by ATS grouping (excludable, complete, provisional, etc.) • At this time Warning and Exclusion letters are not available on ATS.

10. Tuberculosis – Middle and High Schools Only • The goal for SY 08-09 is to ensure that at least 90% of new entrants (ATS Code 58) are “complete” for TB • Tuberculosis is only a requirement for students entering NYC schools for the first time at the secondary level. • Mantoux (PPD) Tuberculosis Skin Test or Quantiferon Blood test results are required. • All positive (+) results require follow up chest x-ray • Periodically review ATS RHTL report-- may be organized via class, grade, alphabetical, or by ATS grouping (excludable, complete, provisional, etc.) • There are “Warning” and “Exclusion” letters specifically for TB

11. 504 -- Request For Educational Accommodations • Some students require accommodations in school so that they are able to participate in DOE programs. As set forth in §504 of the Rehabilitation Act of 1973, Chancellor’s Regulation A-710 outlines the process and procedures • A § 504 accommodation is often requested when a student has a disability, requires some accommodation, and does not qualify for an IEP • Accommodations vary and may include: • Testing Accommodations • Medical Accommodations • Classroom Accommodations • Paraprofessional

12. § 504 -- Request For Educational Accommodations • Requests must be made annually • School-based 504 team should have a §504 Coordinator • §504 Coordinator should be a pedagogue • §504 Coordinator determines the composition of the team • A good team should consist of: • A principal appointed §504 Coordinator • at least 2-3 persons other than the student’s parents • at least one person familiar with the student’s abilities (current or last year’s teacher) • at least one person able to interpret reports or evaluations • at least one person able and knowledgeable of the accommodations available to meet the student’s needs

13. §504 -- Request For Educational Accommodations • Chancellor’s Regulation A-710 • School Based §504 Team should: • Meet and make determination within 30 days of receipt of written request • Inform parents of meeting • Determine student’s eligibility and appropriateness of requested accommodations • Forward Notice of Determination Eligibility and Accommodation Plan to parent • Enter data into ATS – all requests and all actions should be entered • Maintain records in student file • Inform parents of the appeal process • Review R504 ATS report • Confer with ISC Health Director as needed

14. Other Accommodations • Health Paraprofessionals – only approved after review by your ISC Health Director • **Medication Authorization Form – allows a student to take medication in school. A form should be on file for students with Asthma, Diabetes, or Allergies • **School Diabetes Management form replaces theGlucose Monitoring Form • Medically Prescribed Treatment (Non-Medical) ** These forms should be turned into the school nurse

15. Defined: a disease that may be transmitted directly or indirectly from one individual to another Await communicable disease response instructions Informed of possible communicable disease Contact Principal Contact School Nurse Contact ISC Health Director Communicable Diseases Communicable Disease Action Chart

16. Communicable Diseases Relevant to School Health • Not every communicable disease poses a public health threat • Not every communicable disease requires a letter home to parents When in doubt, contact your school nurse and ISC Health Director

17. Vision Screening • Chancellor’s Regulation A-701 informs us that vision screening should be done by DOE staff for students in attendance as per the mandate. • The goal for the current year: 100% of students within the mandate are screened. • Students required to be screened: • 3rd graders • 5th graders • Special Education students • New entrants (within 6 months) • Those referred or with history of vision problems • Those on the RHVX ATS reports • Those not screened by DOHMH teams

18. Vision Screening: A To Do List • Schools Must: • -- form a vision team (staff from the school) • -- designate a School Vision Team leader • -- order vision charts (FAMIS) • -- review screening requirements/ set up schedule and location • -- print class lists from ATS • -- screen students • -- record data into ATS – ATS is able to generate follow-up letters!!!! • -- contact your ISC Health Director if training is required • Screening and data entry should be completed by March 31, 2009

19. Condom Availability Program • A program for high school students only, students in grades 9—12 • Some new schools are exempt from participation, contact your ISC Health Director • Requires a Health Resource Room (HRR) – a space where students may access health information, including free condoms • Requires 1 male and 1 female staff member to make condoms available • HRR staff must be trained • Condoms should be available at least 10 periods per week • Students must be made aware of the program via posters, flyer, wallet cards, etc.

20. AED/CPR • AED stands for Automated External Defibrillators • There should be at least one in every building at the front security desk • Each school is required to have at least 2, but it is desired that there be 6 trained staff members • Training is free of charge for all DOE employees and available by contacting: Emergency Skills Inc., 212-564-6833. • Certificates expire after two years, to recertify, the 6 hour class must be taken again • For more information, contact your ISC Health Director or your AED Program Manager

21. Other School Health/ Health Director Programs • Your ISC Health Director is able to assist you with and or provide more information on:

22. Who’s Who in your school ? Please inform your Health Director • Health Coordinator – the person in the know regarding student health matters / oversees the health programs in the school/ coordinates and sends out notices • §504 Coordinator – the person who heads up the school-based 504 team • Pupil Accounting Secretary– in schools where there is no school aide, enters health information into ATS • Vision Team Leader – heads up the school-based vision team/ ensures that the mandated students are screened and data recorded • AED/CPR Contact – person to serve as liaison between the schooland other DOE agents regarding the program • Health Resource Room staff – heads up the school health resource room staff/ coordinates the program

23. School Health Contact List

24. School Health Contact List -- Borough Nursing Director

25. School Health Contact List -- Borough Nursing Director

26. MORE INFORMATION…. • Health Compliance for School Staff • There are two parts to this webcast. The webcast will cover in more detail: immunizations, tuberculosis, and vision data entry – with an emphasis on ATS • September 23 (Part I) 10 am or 3pm • and • September 29 (Part II) 10am or 3 pm • Register at: learningtimes.com

27. Webcast Evaluation Thank you for participating in our Webcast. CLICK to COMPLETE EVALUATION>> http://www.zoomerang.com/Survey/survey.zgi?p=WEB227U7TGEGMM Updated 9-08 27 27