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KDE School Health Services Karen Erwin, RN, MSN Education School Nurse Consultant July 13, 2010

KDE School Health Services Karen Erwin, RN, MSN Education School Nurse Consultant July 13, 2010. School Nurse Consultant Role. KRS 156.501

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KDE School Health Services Karen Erwin, RN, MSN Education School Nurse Consultant July 13, 2010

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  1. KDE School Health ServicesKaren Erwin, RN, MSNEducation School Nurse ConsultantJuly 13, 2010

  2. School Nurse Consultant Role • KRS 156.501 • Consults with school districts, local health departments, local boards of education, other statewide stakeholders, etc. to improve the delivery of school health services (administration of medication, the operation, maintenance or health care through use of medical equipment; or the administration of clinical procedures-KRS 156.502)

  3. Works with state and national stakeholders to improve school health services in Kentucky • Provides technical assistance, information and resources to school districts, local health departments that relate to the provision of school health services • Facilitates collection of school health services data • Email: Karen.Erwin@education.ky.gov • Phone: 502-564-5625

  4. School Health ServicesKRS 156.502 • Requires that school districts provide school health services & defines health services: 1. Administration of medications 2. Operation, maintenance or health care through use of medical equipment 3. Administration of clinical procedures

  5. Does not detail how school health services are to be administered (local school district decision) • KY Nursing Laws on delegation must be followed • Provides exemption from liability for unlicensed school personnel if KY Nursing Laws (KRS 314) and KRS 156.502 are followed

  6. School Policies and Procedures • All school districts are responsible for writing their own policies and procedures; many utilize policy KSBA policy writing service • Most school district Policies & Procedures online: School Health Policies for medication administration- 09224, 092241 • Policies for medication administration: 09224 or 092241 with AP 1 or AP21

  7. Family Education Rights Protection Act (FERPA ) governs confidentiality for all student education records Student education records include student health services records

  8. Contracting for School Health Services • School Health Coordinator • 504 and IEP Coordinator • School Board Policies and Procedures • Specific Contract language

  9. Health Records • Immunization Certificate • Vision Exam • Physical Exam Forms • Sports Physical Form • Screening Programs • Cumulative Health Records

  10. Immunization CertificatesKRS 214.034 • Must present within two weeks of initial enrollment: 1. Regular or Provisional 2. Medical Exemption 3. Religious Exemption (HSRG: Exhibits 3B, 3C & 3D) • Certificates must be presented again-usually prior to entering 6th grade

  11. Vision ExamKRS 156.160 (10) (g) • Required by January 1 of the first year enrolled in public school, public preschool or Head Start • Performed by optometrist or ophthalmologist • Kentucky Vision Exam Form (HSRG: Exhibit 3G)

  12. DentalScreening or Exam KRS 156.160 (i) Proof of dental screening or exam required no later than January 1 of the first year that a five (5) or six (6) year old is enrolled in a public school (begins 2010-2011 school year) Dental screening form can be found on the KDE website http://www.education.ky.gov/KDE/Administrative+Resources/Coordinated+School+Health/Health+Services/School+Health+Forms.htm

  13. Physical Exam Forms704 KAR 4:020 Section 2 • Required 1 year prior to initial enrollment and within 1 year prior to entering 6th grade • Must be on a KDE Preventative Health Exam Form (HSRG: Exhibit 3E and 3F) • Exam may be performed by MD, PA, ARNP, or EPSDT provider • TB skin test requirement removed from KRS 214.034 in 1998

  14. Deadline to present exam may be extended up to two (2) months…know your district policy! • Out-of-state transfer students must present evidence of a physical exam—may download KY preventative health exam form and have their LMD fill out before moving to Kentucky

  15. Sports Physical Exam FormsKRS 156.070 (d) • Sports Physical Exam Form is required if student is enrolled in high school athletic activity or sports (updated 2009) • Content of Sports Physical Form not as extensive as the Preventative Health Exam Form (cannot substitute for 6th grade physical) • May be performed by MD, PA, ARNP or Chiropractor

  16. School Screening Programs704 KAR 4:020 Section 2 (11) • Each school district shall adopt a program of continuous health supervision • Continuous health supervision shall include scheduled, appropriate screening tests for vision, hearing and scoliosis • School districts determine the grades to be screened for vision and hearing during school yr • Scoliosis screening for 6th and 8th grades

  17. Keeping Health Records • Cumulative Health Record 1. Health Information 2. Medication Information 3. Other Health Services documentation 4. HSRG – Exhibit 3I • Record Retention 1. Hard copy 2. Electronic 3. Records Retention Schedule (HSRG – Appendix C)

  18. FERPA/HIPAA • FERPA (Family Educational Rights and Privacy Acts) applies to any educational agency that receives funds from the U.S Department of Education • FERPA protects privacy interests of students and their educational records • Preamble to HIPAA specifically excludes schools as “covered entities” since they are covered under FERPA • Student educational records are not subject to HIPAA except for the billing statement

  19. Educational Records Include: • Health records maintained by school employees or contracted employees who provide “school health services” • Health Services may include: health promotion, health maintenance and “related or supportive” services

  20. FERPA Related/Supportive Services • Anything that enables a student (especially student special healthcare needs) to: 1. Attend school 2. Maintain (or improve) health status during the school day 3. Progress toward independence in self-care in school setting and achieve educational success 4. Achieve educational success

  21. For More Information • NASN School Nursing: A Comprehensive Text, Chapter 13, pp 296-298 • U.S. Department of Education, The Privacy of Student Information, A Resource for Schools www.nces.ed.gov/pubs2006/stu_privacy/ferpa.asp

  22. Communicable Diseases • Bloodborne Pathogen Training 1. Required by OSHA 2. Must be reviewed yearly 3. Training must be “interactive” –ability to ask questions and receive answers during training session • KSBA has OSHA training for school district each year-ask who is responsible for Exposure Control Plan in your district • Some school districts have this training online

  23. Communicable Diseases • Head Lice – KSBA Policy excludes only for live lice • The American Academy of Pediatrics and the Harvard School of Public Health do not recommend exclusion from school for nits • Know you district policy

  24. Reportable Communicable Diseases • HSRG Chapter 5 • KRS 158.160 • MRSA is not a reportable disease • Reportable Disease Form (HSRG: Exhibit 5A) • Pandemic Flu-H1N1

  25. TB Risk Assessment • TB skin test no longer required for new school employees (704 KAR 4:020 Section 1) • At time of employment physical, assessed for risk of TB infection • New employee school physical exam form available KDE web site and HSRG www.education.ky.gov/KDE/Administrative+Resources/School+Health/Health+Services/School+Health+Forms.htm

  26. End of Year Reports • School health data to entered in to data base (Infinite Campus) • KDE Standards Document describes what data to be entered and reported: 1. Health Conditions 2. Health Conditions Flags 3. Immunizations

  27. 4. Physical Exams documented for initial entry and 6th grade 5. Vision exam for initial entry 6. Dental exam/screening 7. Screening results for vision , hearing and scoliosis screening (grades 6 & 8) KDE will have BOY WebEx trainings – know who is your IC Point of Contact

  28. End of Year Reports • Three reports: 1. Health Conditions and Health Condition Flags 2. Immunization Summary 3. Screening Summary • Be sure to attend BOY and EOY trainings (Trainings are via WebEx-know who your IC Point of Contact is for your district) • REPORTS DUE last Friday in May.

  29. Health Services Standards Document available on the KDE web site (Data Policy, Management and Research): www.education.ky.gov/KDE/Administrative+Resources/Data+and+Research/Student+Information+System/Data+Standards

  30. KDE Health Services Reference Guide http://www.education.ky.gov/KDE/Administrative+Resources/School+Health/Health+Services/HSRG+Table+of+Contents.htm • Email: Karen.Erwin@education.ky.gov • Phone: 502-564-5625

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