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

2. School Nurse Consultant Role
KRS
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 )

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
Phone:

4. School Health Services KRS 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 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 ,
Policies for medication administration:
09224 or 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 Certificates KRS 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 Exam KRS (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. Dental Screening or Exam
KRS (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 school year)
Dental screening form can be found on the KDE website

14. Physical Exam Forms 704 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 in 1998

15. 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

16. Sports Physical Exam Forms KRS 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

17. School Screening Programs 704 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

18. 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)

19. 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

20. 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

21. 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

22. For More Information
NASN School Nursing: A Comprehensive Text, Chapter 13, pp
U.S. Department of Education, The Privacy of Student Information, A Resource for Schools

23. 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

24. 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

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

26. 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

27. 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

28. 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

29. 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.

30. Health Services Standards Document available on the KDE web site (Data Policy, Management and Research):

31. KDE Health Services Reference Guide
Phone: