How to Guide for Health Care Plans

Student Health Care PlansBy: Suzanne TannerAshley Gish Annalisa Banks

Why the change?Currently each school has its own system Difficult to ensure each child is receiving proper careOur goal= A more congruent system between schools

2Slide 2: With each school having its own system it makes it very difficult to ensure that each child is being properly cared for. While we all do the best we can it is easy for things to be overlooked. So far we have not suffered any tragedy but I would rather implement precautions now then wait until after the fact. Im not trying to create more work for anyone but I think that this initial investment will help make it easier for secretaries, nurses, parents and students. The new systemModeled after JR Smith Elementary system

3JR Smith spent a lot of time getting their Health Care Plans in order last year and now have a great model that I would like to implement at all of the schools in the district. By streamlining this process and ensuring that the school staff and parents understand the process better I think it will encourage parents to be more compliant and make it a little easier for everyone involved. What Should A HCP Look Like?Childs nameChilds pictureConfidential

Health Care Plan for:Name:CONFIDENTIAL

The red folder is useful because it keeps the information confidential.The outside of the folder should have the childs name, have the childs picture and be marked confidential. For each student they need two red folders. One folder will stay in the office and one folder will accompany the students teacher to the classroom. Please choose the Avery 5664 label for your folders labels. Medication FoldersIf a student requires medication they must have an additional expandable file that is to be kept with the red health care plan folder.

If the student has medications please put them inside the expandable folder and keep it with their red HCP folder. Color CodingBlue folder-AsthmaRed folder-AllergiesGreen folder-DiabetesYellow folder-all other Conditions

In an emergency this is just one more precaution to make things as easily accessible as possible. Blue folder - Asthma Red folder - Allergies Green folder - DiabetesYellow folder All other conditionsNew StudentsIt all starts with the Health FormsA Health Care Plan may then be requiredSchool Health Serviceshttp://www.wasatch.edu//Domain/38

7Parents should fill out the health form annually that comes in their registration packet. If the student has a condition that requires a health care plan the parent should be given information regarding what forms ect. are required and where they can be found. Secretaries may refer parents to the website and /or to the school nurse. There is now a link to school health services (previously school nurse) on the districts website and soon we hope to have a link on each schools website. If you send a HCP home with a parent please remember to document it in SIS. When is a Health Care Plan required? The Big FiveDiabetesAsthmaSeizuresAllergies Medications

8The conditions listed are those that most frequently affect the children in our district. All children with one of these conditions MUST have a Health Care Plan in place. If a student has mild asthma and doesnt use an inhaler at school the parent may elect not to fill out a health care plan. However, if a student uses an inhaler at school a self administration form must be filled out and an asthma action plan given to their teachers. What if a parent refuses?Parents do have the right to refuse a HCP but it must be documented.However certain conditions require a HCP, no exceptions

9Slide 9: If a parent decides that they do not want a Health Care Plan it must be documented in SIS. If a refusal is made to the secretary they will document it. If it is made to the nurse they will document it. The nurse should be notified of a parents refusal in order to follow up on it. If the nurse deems a HCP necessary the parent must comply. Returning StudentsStudents must have an updated plan annuallySecretaries will contact parents to update HCP See notes for letter template

10Students are required to have an updated HCP complete with signatures EVERY YEAR. Secretaries will be responsible for sending home a note to parents requesting the updated plan at the end of the school year and again at the beginning of the next year if necessary. We have provided a link to a brief statement that can be sent home to parents. Dear Parent, Our records indicate that your child has a Health Care Plan on file at school. A new Care Plan is required for each new school year. Please complete the attached Health Care Plan and return to the school by the beginning of the 2012-13 school year. Please remember that a doctors signature is required. If you have questions, you can contact the school office. Or you can contact the school nurse by calling 435-657-3100 ext. 4144

The ProcessParents will return HCP to the students schoolSecretary will then email the nurse that they have received a new health care plan. Nurse is responsible for educating teachers on the HCP when applicable

11Parents should return the HCP to their students school. Secretaries please look through the HCP for necessary signatures; both parent and MD signature. The secretary will inform the school nurse via email that he/she received a HCP and who the students teacher is so that the school nurse can arrange for training. The process contWhen the secretary receives the HCP from the parent please email the students teacher so he/she can sign the HCP A copy of the plan should be made for the nurse, the schools files and the childs teacher.

When the secretary receives the HCP from the parent, please make a copy for the school nurse and keep in a school nurse file, a copy for the schools file and put it in the red folder and a copy for the teacher. Remember, at this point you should have two red folders, one for the file in the office and one for the classroom copy. The process contNurse is responsible for following up on all trainings for teachers and staff and contacting parents for individualized HCPs.

SISSecretaries will enter into SIS the childs health condition from the registration Health Form.Remember to click Alert and ConfidentialThe nurse and secretaries will document any correspondence with the parent/student in regards to the HCP

Slide 14: Secretaries will enter in the health form data they receive at registration into SIS and will click alert and confidential boxes so that the information shows up in the students profile sheet under health alerts. Any additional correspondence with the patient regarding HCPs needs to be documented in SIS but does not require an alert. Example: contacted parent, mailed HCP, HCP pending. We need to contact the parent at least 3 times regarding filling out a HCP. This way even if we dont have a care plan for the student we have a record that we tried. If its not documented in SIS it wasnt done. 14Student Health Care PlansEach student must have their own folder All folders should be stored in a locked file cabinet

Each student must have their own folder. All folders must be kept in a locked file cabinet. Health SummarySecretaries will be responsible for creating a health summary of all students with HCPs at the beginning of each school year. It should include the following information:Students nameDiagnosisTeacher and gradeAny relevant info re: diagnosis

16A health summary is mostly for your own information. If you choose you may also run a health report on SIS. Compiling this information yourself allows you to organize this information by health conditions where the report is alphabetical. Copies of this summary should be provided to the office, school principal and any necessary specialists that will be working with the student. This list is CONFIDENTIAL. Specialists should be given a modified copy of the list that contains only the students they will be directly working with. AuditsAn audit will be conducted twice a year.Dates TBASchool nurse will notify secretary prior to audit

17An audit will be performed two times a year by the school nurse to ensure safe delegation and training. The nurse will contact the secretary prior to an audit. If HCPs are not up to date with all necessary signatures the secretary will be responsible for contacting all parents to update the information. If the parents do not comply the nurse will then contact the parents. Health DocumentsWeve outlined all of the most common diagnoses and listed all of the necessary forms online. This document is also on the districts website under School Health Services.Steps for Health Care Plans.doc

18Please make yourself familiar with the new website. It is listed on the District Website under School Health Services inside the Department tab. We have organized it in such a way that it will allow parents and secretaries access to information, forms and current health events. Periodically we will be making updates and adding trainings so please check it regularly. Any feedback you have would be appreciated.

Health Conditions and required forms

19The Health Documents tab is going to be your new best friend, please take the time to understand which forms are required for each condition. We have tried to outline it and make it as simple as possible. If you have any questions please contact the school nurse.AsthmaIf a student has Asthma (seasonal, mild or severe), you will need the following forms:Asthma Self-Administration FormAsthma Action PlanBoth forms need to be submitted annually

Asthma: If a student has Asthma (seasonal, mild or severe), you will need the following forms: Asthma Self Administration form and Asthma Action PlanAsthmaIf the students asthma is severe or you would like assistance in administering an inhaler from school personnel please have parents fill out these additional forms:

Wasatch County School Districts-Authorization of School Personnel to Administer MedicationAsthma Health Care Plan (as needed)Daily Medication Administration

If a students asthma is severe or you would like assistance to administer an inhaler from school personnel please fill out these additional forms: -Wasatch county School District Authorization of School Personnel to Administer Medication-Asthma Health Care Plan (as needed)-Daily Medication AdministrationDiabetes A student that has Diabetes will require several forms. These forms as well as an explanation of them are available on the School Health Services website.

A student that has diabetes will require several forms. These forms as well as an explanation of these forms are on the School Health Services website. Food AllergiesIf a student has an Allergy (severe food, insects, latex, etc.), you will need the following forms:Food Allergy or Other Allergy Health Care Plan

23If a student has allergies and requires an Epi-Pen, they must also have an Epi-Pen Authorization form. If a student requires an inhaler you must submit the Asthma Self Authorization form. All medications given for an allergic reaction must be written on the Food Allergy Action Plan. All forms must be signed by a doctor and submitted annually. The following slide lists all of the required formsFood AllergiesIf school staff needs to administer an Antihistamine and/or Epi-pen you will need:Anaphylaxis Emergency Action PlanWasatch County School Districts-Authorization of School Personnel to Administer medicationDaily Medication Administration SheetEpinephrine Auto Injection (EAI) Authorization FormAsthma Self-Administration Form

Anaphylaxis Emergency Action Plan-School personnel to Administer Medication-Daily medication administration sheet-epinephrine auto injection authorization form-asthma self admin formSeizuresParents must submit a Seizure School Health Care Plan signed by their doctor annually. Seizures action planWasatch County School Districts-Authorization of School Personnel to Administer medication Daily Medication Administration Sheet

Seizures. The medication authorization is needed only if the student requires medication. Many of our seizure students dont require medications. Diastat or other rescue meds can be kept on hand but may only be administered by EMS or school nurse if authorization has been provided. Medication Use and AdministrationIf a student needs any Medication at School, you will need the following forms:Wasatch County School Districts-Authorization of School Personnel to Administer medication Daily Medication Administration Sheet

Preschool through 4th grade students cannot carry medications on them except for inhalers, epi pens and diabetic supplies/insulin. 5th grade through 12th grade students may carry a one day dose of medication on them with the exception of narcotics. Narcotics are not allowed at school. Please make sure that the daily medication forms are filled out completely with the medication name, dose, route, time and parent and staff signature. Please indicate medication count received. Other Health ConcernsIf a student has any Other Health Concerns, please have parents contact the school nurse for Individualized Care Plans.

27Parent/guardian may fill out a HCP for any condition if they feel that the HCP will help school staff to understand their childs health issues but a HCP may not be required.Questions from parentsAny questions should be addressed to the school nurse:Suzanne Tanner RDH, RN, BSNSchool NurseCell: 435-654-8289 Office: 435-657-3100 ex 4144

Slide 28: Questions from parents: The nurse is a resource here for you. Please call or email with any questions that you might have. Questions email:suzanne.tanner@wasatch.edu

If you have any questions feel free to call or email the school nurse.