507.8R1 - Special Health Services Regulation

Some students who require special education need special health services in order to participate in the educational program.  These students will receive special health services in accordance with their individualized educational program.

 

A.    Definitions

"Assignment and delegation" - occurs when licensed health personnel, in collaboration with the education team, determine the special health services to be provided and the qualifications of individuals performing the health services.  Primary consideration is given to the recommendation of the licensed health personnel.  Each designation considers the student's special health service.  The rationale in accordance with licensed practice for the designation is documented.  If the designation decision of the team differs from the licensed health professional, team members may file a dissenting opinion in the student’s education record.

"Co-administration" - the eligible student's participation in the planning, management and implementation of the student's special health service and demonstration of proficiency to licensed health personnel.

"Educational program" - includes all school curricular programs and activities both on and off school grounds.

"Education team" - may include the eligible student, the student's parent, administrator, teacher, licensed health personnel, and others involved in the student's educational program, or as described in the Individuals with Disabilities Education Act or Section 504 of the Rehabilitation Act of 1973.

"Health assessment" - health data collection, observation, analysis, and interpretation relating to the eligible student's educational program.

"Health instruction" - education by licensed health personnel to prepare qualified designated personnel to deliver and perform special health services contained in the eligible student's health plan.  Documentation of education and periodic updates are on file at school.

"Individual health plan" - the confidential, written, preplanned and ongoing special health service in the educational program.  It includes assessment, nursing diagnosis, outcomes,  planning, interventions, evaluation, student goals, if applicable, and a plan for emergencies.  The plan is updated as needed and at least annually.  Licensed health personnel develop this written plan with collaboration from the parent or guardian, individual’s health care provider or education team.

"Licensed health personnel" - includes licensed registered nurse, licensed physician, and other licensed health personnel legally authorized to provide special health services and medications under the auspices of school.

"Prescriber" - licensed health personnel legally authorized to prescribe special health services and medications.

"Qualified designated personnel" - persons instructed, supervised and competent in implementing the eligible student's health plan.

“Special health services" - includes, but is not limited to, services for eligible students whose health status (stable or unstable) requires:

• Interpretation or intervention,
• Administration of health procedures and health care, or
• Use of a health device to compensate for the reduction or loss of a body function.

"Supervision" - the assessment, delegation, evaluation and documentation of special health services by licensed health personnel.  Levels of supervision include situations in which licensed health personnel are:

• physically present.
• available at the same site.
• available on call.

 

B.     Licensed health personnel will provide special health services under the auspices of the school.  Duties of the licensed personnel include the duty to:

• Participate as a member of the education team.
• Provide the health assessment.
• Plan, implement and evaluate the written individual health plan.
• Plan, implement and evaluate special emergency health services.
• Serve as liaison and encourage participation and communication with health service agencies and individuals providing health care.
• Provide health consultation, counseling and instruction with the eligible student, the student's parent and the staff in cooperation and conjunction with the prescriber.
• Maintain a record of special health services.  The documentation includes the eligible student's name, special health service, prescriber or person authorizing, date and time, signature and title of the person providing the special health service and any unusual circumstances in the provision of such services.
• Report unusual circumstances to the parent, school administration, and prescriber.
• Assign and delegate to, instruct, provide technical assistance and supervise qualified designated personnel.
• Update knowledge and skills to meet special health service needs.

 

C.     Prior to the provision of special health services the following will be on file:

• Written statement by the prescriber detailing the specific method and schedule of the special health service, when indicated.
• Written statement by the student's parent requesting the provision of the special health service.
• Written report of the preplanning staffing or meeting of the education team.
• Written individual health plan available in the health record and integrated into the IEP or IFSP.

 

D.    Licensed health personnel, in collaboration with the education team, will determine the special health services to be provided and the qualifications of individuals performing the special health services.  The documented rationale will include the following:

• Analysis and interpretation of the special health service needs, health status stability, complexity of the service, predictability of the service outcome and risk of improperly performed service.
• Determination that the special health service, task, procedure or function is part of the person's job description.
• Determination of the assignment and delegation based on the student's needs and qualifications of school personnel performing health services. 
• Review of the designated person's competency.
• Determination of initial and ongoing level of supervision, monitoring and evaluation required to ensure quality services.

 

E.     Licensed health personnel will supervise the special health services, define the level and frequency of supervision and document the supervision.

 

F.     Licensed health personnel will instruct qualified designated personnel to deliver and perform special health services contained in the eligible individual health plan.  Documentation of instruction, written consent of personnel as required in Iowa Code 280.23 and periodic updates are on file at school.

 

G.    Parents will provide the usual equipment, supplies and necessary maintenance for such, unless the school is required to provide the equipment, supplies, and maintenance under the Individuals with Disabilities Education Act or Section 504 of the Rehabilitation Act of 1973.  The equipment is stored in a secure area.  The personnel responsible for the equipment are designated in the individual health plan.  The individual health plan will designate the role of the school, parents, and others in the provision, supply, storage and maintenance of necessary equipment.