Transcript PENNSYLVANIA DEPARTMENT of HEALTH Division of School Health

SCHOOL HEALTH UPDATE 2009
Beth Anne Bahn
PENNSYLVANIA
and
DEPARTMENT of HEALTH
Rosemary
Danchick-Moyer
Division of School Health
State School Health Consultants
March 22, 2009
DIVISION OF SCHOOL HEALTH
• Jon Dale, Director
• Beth Anne Bahn, State School Health Consultant
• Rosemary Danchick-Moyer, State School Health Consultant
• Administrative Officer
• Bill Barbour, STEPS School Health Coordinator
• Valerie Morgan, Administrative Support
• Six Regional School Health Consultants
DISTRICT OFFICE PROGRAM
STAFF
•
•
•
•
•
•
•
Diabetes
Cardiovascular
Injury Prevention
Chronic Disease
Tobacco Prevention
Maternal Child Health
Special Needs Health
Care
• Public Health Educator
• School Health
Consultant
• HIV
• STD
• Communicable
Disease
• Environmental Health
• Sanitarians
• Tuberculosis
• Immunization
• EMS Program
Specialist
REGIONAL SCHOOL HEALTH CONSULTANTS
NW - Linda Deeter
724-662-6068
[email protected]
NC - Andrea Dale
570-327-3400
[email protected]
NE - Lois Elick
570-826-2062
[email protected]
SC - Linda Katherman 717-787-8092
[email protected]
SE - Sue Templin
610-378-4352
[email protected]
SW - Vacant
724-830-2701
SCHOOL IMMUNIZATION
REQUIREMENTS
• Regulations expected to be final this
summer
• Too late for start in school year 2009
– 2010
• New regulations will go into effect for
school year 2010 - 2011
SCHOOL IMMUNIZATION
REQUIREMENTS
For Attendance in All Grades
•
•
•
•
•
•
•
•
•
•
4 doses tetanus
(DTaP, DT, Td)
(1 dose on or after 4 years old)
4 doses diphtheria (DTaP, DT, Td)
(1 dose on or after 4 years old)
3 doses polio
2 doses measles
(MMR)
2 doses mumps (MMR)
1 dose rubella
(MMR)
3 doses hepatitis B
2 doses of varicella vaccine or history of disease
SCHOOL IMMUNIZATION
REQUIREMENTS
For Entering 7th Grade
•Same requirements as “Attendance in All Grades”
PLUS
•1 dose tetanus/diphtheria/acellular pertussis
(if 5 yrs. have lapsed since last tetanus immun.)
•1 dose meningococcal conjugate
Tdap & meningococcal – no provisional – 1 dose
antigen
SCHOOL IMMUNIZATION
REQUIREMENTS
 Children under 5 years of age, attending a child
care group setting located in a public, private or
vocational school or in an intermediate unit or a
pre-K program, early intervention program or
private academic preschools follow the
immunization requirements in 28 Pa Code §27.77
 Children 5 years of age or older attending a child
care group setting follow the immunization
requirements in 28 Pa Code §23.83
SCHOOL IMMUNIZATION
REQUIREMENTS
• The changes were first published in the PA
Bulletin on February 9, 2008
• Comments were extended in a notice
published March 8, 2008.
• Comments were published May 3, 2008
• Continuing through regulatory process
• Final form regulations will be published in the
PA Bulletin, www.pabulletin.com
STATEWIDE IMMUNIZATION
INFORMATION REGISTRY (SIIS)
• Began in 1996
• Used primarily by hospitals, state health clinics
• Now marketing to private providers
• No cost to enter immunizations or view data
• “View only” access for school nurses
STATEWIDE IMMUNIZATION
INFORMATION REGISTRY (SIIS)
• To enroll for view-only access:
Go to www.health.state.pa.us/pasiis
Click on Provider enrollment
Complete the application & fax or mail it to the
Department
REVISION OF CH. 27
REGULATIONS
• Strengthens language for contact investigations
in schools
• Immunization administration would be reportable
via SIIS
• Update school and child day care section
• Will be published in PA Bulletin for comments
KI DISTRIBUTION PROGRAM FOR
SCHOOLS
WHAT: Potassium Iodide (KI) tablets provided to
schools who voluntarily request to
participate
WHY: KI protects thyroid from radiation during a release
WHO: Schools located within a 10 mile radius (Emerg.
Planning Zone)
WHERE: 5 nuclear facilities
HOW: Info/orientation and tablet pre-distribution
WHEN: Fall of 2002 and planned for 2009
FIVE NUCLEAR FACILITIES
Beaver Valley Power Station - Shippingport Borough (Serves
parts of Beaver Co.)
Limerick Generating Station - Limerick Twp. (Serves parts of
Berks, Chester & Montgomery Cos.)
Susquehanna Steam Electric Station - Salem Twp. (Serves parts
of Columbia & Luzerne Cos.)
Three Mile Island Nuclear Station - Londonderry Twp. (Serves
parts of Dauphin, Lancaster & York Cos.)
Peach Bottom Atomic Power Station - Peach Bottom Twp.
(Serves parts of Lancaster & York Cos.)
DEPARTMENT OF HEALTH WILL:
• Identify all schools within each Emergency
Planning Zone (EPZ)
• Provide procedures to request participation in the
program
• Develop and provide orientation sessions to school
health & administrative staff
• Provide guidance on how to incorporate KI
distribution plans into existing all-hazard plans
• Develop sample resource materials
• Distribute supply of KI tablets to schools
SCHOOLS WILL:
• Request participation in the plan
• Request the number of doses of KI that will be
needed for students & staff
• Identify staff (administration & health) to
receive orientation from DOH
• Accept or amend the KI plan for its school and
incorporate into all-hazard plan
• Develop plan for receipt, storage and
distribution of KI
SCHOOL DISTRICTS PROVIDING SERVICES
FOR PRIVATE/NON-PUBLIC SCHOOLS
• 28 PA Code § 23.51, Children to be provided
nursing services
A child in private, parochial & public schools
shall be provided with school nurse services in
the school which the child attends.
• 28 PA Code § 23.52, Administration
The school nurse services shall be provided
through the public school system & the
administration of this service shall be the
responsibility of the public school administrator
in consultation, as needed, with the private or
parochial school administrator.
SCHOOL DISTRICTS PROVIDING SERVICES
FOR PRIVATE/NON-PUBLIC SCHOOLS
• Provide school nurse services
• Review of health care needs including IHPs &
emergency plans as needed
SCHOOL DISTRICTS REPORTING DATA FOR
PRIVATE/NON-PUBLIC SCHOOLS
• If the school district is providing school health
services to private/non-public
ADMs included on Annual Health Report
Also include data for:
Health exams, screens & select services
Chronic diseases
Serious School Injuries
Medication Administration
Important Law
• 24 P.S. § 11-1101
Purdon's Pennsylvania Statutes and
Consolidated Statutes
• Title 24 P.S. Education
• Chapter 1. Public School Code of
1949
• Article XI. Professional Employes
• (A) Definitions (Refs & Annos)
• § 11-1101. Definitions
Important Law
The term "professional employe" shall include
those who are certificated as teachers,
supervisors, supervising principals, principals,
assistant principals, vice-principals, directors of
vocational education, dental hygienists, visiting
teachers, home and school visitors, school
counselors, child nutrition program specialists,
school librarians, school secretaries the selection
of whom is on the basis of merit as determined by
eligibility lists and school nurses.
TRANSFER FOR HEALTH RECORDS
• 24 P.S. §14-1409, Confidentiality, transference &
removal of health records
“… the district or school wherein the child is
newly enrolled shall request and the district or
school where the child previously attended
shall surrender the health record of the child.”
“…shall not destroy a child’s health record for a
period of at least two years after the child
ceases to be enrolled,…”
MAINTENANCE OF HEALTH
RECORDS
• 28 Pa Code, § 23.55, Maintenance of health
records
“Health records shall be maintained for each
child. These records shall be kept in the
school building where the child attends school
and shall be available to the school nurse at
all times. Records shall be transferred with
the child when he moves from one school to
another or from one district to another.”
MEDICATION ISSUES
• Do school nurses need a doctor’s order to
administer over-the-counter medications to
students?
49 PA Code § 21.14. Administration of drugs
“(a) A licensed registered nurse may
administer a drug ordered for a patient in
the dosage and manner prescribed.”
• Who can administer?
Nurses can, when a licensed provider,
authorized to prescribe, has written an order.
MEDICATION ISSUES
Securing medications? Is it necessary?
• “The Controlled Substance, Drug, Device and
Cosmetic Act” Act of 1972, P.L. 233, No. 64
Definition of practitioner’s includes nurses
Section 11. Professional Prescription,
Administration, and Dispensing.
Section 12. Records of Distribution of
Controlled Substances
MEDICATION ISSUES
• 28 PA Code § 25.61. General provisions
”(a) Persons maintaining stocks or having
controlled substances in production areas or on
hand for distribution shall provide effective
controls and procedures to guard against theft
and diversion of the substances.”
MEDICATION ISSUES
• 28 Pa Code § 25.63. Security controls for
practitioners and research personnel
“(b) Controlled substances listed in Schedules
II, III, IV and V shall be stored in substantially
constructed, securely locked cabinets.”
MEDICATION ISSUES
• All medication in schools are personal property
for which the school nurse is responsible
• Recommendation: ALL medications should be
stored in locked space
• Should have a method of accounting for access to
these medications
DELEGATION
In PA, professional nurse law does not provide for
delegation of nursing functions to unlicensed
individuals
DELEGATION
• Emergency administration of an Epipen by a
trained individual does not require professional
nursing skill
• The nurse may train an unlicensed person in how
to respond using an Epipen
This Is Not Delegation
CERTIFICATION STAFFING &
POLICY GUIDELINES (CSPG)
• Located at PA Dept. of Education website,
www.pde.state.pa.us
• In search box, type in CSPG #
80 - School Nurse
95 – Principal
101 - Paraprofessional
CSPG 95 - PRINCIPAL
• Certification Assignment:
An educator holding a valid PA certificate as a
K12 Principal is qualified to perform the
following:
Supervision and direction of certified and
non-certified staff persons required for
school operation exclusive of directing
health services controlled by the Nurse
Practice Act.
CSPG 101 - PARAPROFESSIONAL
• Utilization of Paraprofessional Staff
#7. Paraprofessionals serving as health room
aides or other non-professional school district
employees shall not be directed to engage in
health-related activities reserved exclusively
for licensed professionals and controlled by the
Nurse Practice Act or other medically related
laws.
HOMESCHOOLED STUDENTS
• PA Public School Code of 1949, § 1327.1 states
these students must have:
Evidence of Immunizations in accordance with
Article XIV 1303 (a)
Evidence of Health & Medical services required
for students of the child’s age or grade level
per Article XIV
HOMESCHOOLED STUDENTS
• According to PDE’s Basic Education Circular (BEC)
on Home Education Programs, students must
receive the same health tests as public school
students
• According to the affidavit form available as part
of the BEC, the affidavit is to include attached
evidence of immunizations, physical & dental
exams & mandated screens
PDE BASIC EDUCATION CIRCULAR
(BEC)
Enrollment of students
• Date of Issue: January 22, 2009
• Documents which may be requested but not as a
condition of enrollment:
Picture identification,
Health or physical examination records,
Academic records,
Attendance records,
Individualized Education Program, and other
special education records
Although schools may ask for any of this information, they may not require it as a condition of
enrolling or admitting a child & they may not delay a child’s enrollment or attendance until these
documents are provided.
CHILD PROTECTION LAW
• Child Abuse Reporting Law
Act 179 of 2006
• School Nurses are mandated reporters
• Who to call: Childline (1-800-932-0313) and local
Child Protective Services
• Child may be interviewed at school without
parent notification
• Documentation of suspected abuse
HIPAA/FERPA GUIDELINES
• FERPA is a Federal law that protects the privacy
of students’ “education records”
• The HIPAA Privacy Rule requires covered entities
to protect individuals’ health records and other
identifiable health information and gives patients
rights over their health information
HIPAA/FERPA GUIDELINES
• NEW HHS/ED Joint Guidance on the Application of
FERPA and HIPAA to Student Health Records
• November 2008
• http://www.hhs.gov/ocr/privacy/index.html
PE & DENTAL MODIFICATIONS
• Districts may request modifications to accept
mandated physical and dental exams up to one
year prior to the year they are required
• School Board must vote to make the
modification; then the district sends a letter to
DOH, Division of School Health, providing notice
of the board decision
ALL-HAZARD PLANNING FOR
SCHOOLS
• Title 35, all public-funded schools shall develop
and implement ER preparedness plans…
• Subcommittee of PA Safe School Statewide
Advisory Committee
• PEMA, Dept. of Education, Dept. of Health,
Attorney General’s Office, State Police,
representatives from IUs and school districts
ALL-HAZARD PLANNING FOR
SCHOOLS
• School-based Emergency
Preparedness
AHRQ- Agency for Healthcare Research
& Quality
http://www.ahrq.gov/prep/schoolprep/
CLARIFICATION ON ACT 48
REPORTING
• Letter sent to Supt. Dec. 2008
Activities/Programs must be at least 3 hours
in length
PERMS won’t accept <3 hrs after Jan. 31,
2009
• Clarification letter being drafted
Recommend at least 3 hrs
PERMS will continue to accept 1 hr
activities
Title must include content
RN CONTINUING EDUCATION
REQUIREMENT
• June 29, 2006 Act 58 of 2006 was signed into
law
• Requires 30 hours of CEs every 2 years
• July 12, 2008 PA State Board of Nursing
released regulations (49 Pa Code §§ 21.131 –
21.134)
• School districts considered approved
providers, under PDE
RN CONTINUING EDUCATION
REQUIREMENT
• Begins with those renewing their RN license in
October of 2010
• CSNs may use their Act 48 hours
• CRNPs may use their CRNP CEs
• Additional information available at:
www.dos.state.pa.us
RN CONTINUING EDUCATION
REQUIREMENT
• 49 PA Code § 21.131 Continuing education
(c) Board audits: proof of completion
“(5) For school nurses, evidence that the
nurse's certification by the Department of
Education is current.”
RN CONTINUING EDUCATION
REQUIREMENT
• Submission of Continuing Education Information
by School Nurses
CSNs verify on their biennial renewal
application that they have complied with the
continuing education requirements for
certification by the school district.
If the CSN's renewal is selected for a
compliance audit, the nurse would submit
proof of current certification by the
Department of Education
RN CONTINUING EDUCATION
REQUIREMENT
Effective Dates of CE Requirements
Effective date of CE Requirements
If the expiration
date on your RN
license is:
April 30, 2009
October 31, 2009
April 30, 2010
You must
complete 30
hours of Board
approved CE
from:
Not required for this
renewal
Not required for this
renewal
Not required for this
renewal
RN CONTINUING EDUCAITON
REQUIREMENT
Effective Date of CE Requirements
If the expiration
date on your RN
license is:
October 31, 2010
April 30, 2011
October 31, 2011
April 30, 2012
You must complete
30 hours of Board
approved CE from:
11/1/08 thru
10/31/10
5/1/09 thru 4/30/11
11/1/09 thru
10/31/11
5/1/10 thru 4/30/12
RN CONTINUING EDUCATION
REQUIREMENT
• 49 PA Code § 21.134 Continuing
education sources
Documentation needed on the
certificate of attendance:
Full name of the provider
Full address of the provider
Title of the activity
Date of the activity
Location of the activity
Hours of continuing education
Participant’s Name
CRNP LIABILITY INSURANCE
• Act 48 of 2007
• Requires CRNPs to maintain professional
liability insurance
• CRNPs working in schools:
May be covered under their employer
May purchase their own liability insurance
May be covered under the Tort Claims Act
Should check with the school solicitor
LEGISLATIVE ITEMS
• Web site: www.legis.state.pa.us
• Search for bill status with H.B. or S.B. & the
number
• Search for bills by subject – School Health or
Registered Nurses
ENACTMENTS
• ACT 3 (SB 1, P.N. 1763: February 14, 2008) –
Amends the Right-To-Know Law
Extends the act in a limited way to both the
General Assembly and the judiciary
Provides a list of 30 exceptions for
executive agencies and local agencies,
which include among others Social Security
numbers, and individual medical records
Reduces the time period for response by a
Commonwealth agency and legislative
agency from 10 days to 5 days
ENACTMENTS
• Act 27 (SB 246, P.N. 2099: June 13, 2008) –
Creates the Smoke Free Pennsylvania Act
Prohibiting smoking in enclosed & substantially
enclosed areas
Imposing duties on the Department of Health
ENACTMENTS
• ACT 16 (SB 1278, P.N. 1844: May 13, 2008)
Providing for child medical support
Adding that a court order for child support
must include a requirement for medical
support
• Act 68 (HB 1693, P.N. 3393: July, 9 2008)
Social Worker title protection
Includes requirements for degree and three
years or 3,000 hours of supervised clinical
experience
ENACTMENTS
• Act 102 (H.B. 834, P.N. 4510: October 9, 2008)
Prohibits administration from requiring nurses
to work in excess
Exceptions include unexpected absences that
impact patient safety
• Act 87 (S.B. 684, P.N. 2475: October 8, 2008)
Establishes Child Death Review teams
PENDING LEGISLATION
• SB 30
Establishing a Child Abuse Identification
Training Program (DPW consulting with PDE)
• SB 31
Defining – day care & “eligible provider”;
regarding school students, kindergarten,
Keystone STARS, Pre-K Counts Program
PENDING LEGISLATION
• SB 55 School employees & Background checks
Felony offense charge but convicted of a 1st or 2nd
degree misdemeanor, only eligible for employment if a
period of 10 years has elapsed from the end of their
sentence
Administrator shall have the authority to require a
current report of criminal history record …when they
have reason to believe the employe has a conviction for
a criminal offense
School employes shall report convictions for criminal
offenses occurring in this Commonwealth and in Federal
or other state jurisdictions immediately
PENDING LEGISLATION
• SB 153
Requiring seat belts in school buses
• HB 132 Title 18 (Crimes & Offenses) § 912
Possession of weapon on school property
Commits misdemeanor of 1st degree if
possess a weapon in the buildings of, on the
grounds of, or in any conveyance providing
transportation to or from any elementary or
secondary publicly-funded educational
institution, any elementary or secondary
private school licensed by the PDE or any
elementary or secondary parochial school or
private residential rehabilitative institution
PENDING LEGISLATION
• HB 361
Diabetes testing included with immunization
requirements for attendance
• HB 358
Requires exact minutes of Physical Education
each week
K-5 150
6-8 225
PENDING LEGISLATION
• SB 184 School-based Child-care Assistance Act
Children are on their own before and after school
Purpose of this act is to encourage and support childcare services in public and private schools for school-age
children for the time period before and after the school
day
• HB 298
Children with exceptionalities attending nonpublic schools shall
be furnished a program of special education services which are
required by law to be offered to public school students and
which are appropriate to the needs of those children
MANDATED FORMULA FOR
REIMBURSEMENT
• Medical Services: The lesser of $1.60 X ADM
or certified costs
• Mandated Dental Services: The lesser of $.80
X ADM or certified costs
• Dental Hygiene Services Program: The lesser
of $2.00 X number of children served, not to
exceed ADM by grade level, or certified costs
• Nursing Services: The lesser of $7.00 X ADM
or certified costs
• Act 25 Supplemental Allocation: $9.70 X ADM
Prevalence of Obesity* Among U.S.
Children and Adolescents
(Aged 2 –19 Years)
NHANES – Natl. Health & Nutrition Examination Survey
No. of Students in Percentile Categories
SY 2006 – 2007 Grades K - 6
TOTAL NUMBER SCREENED:
< 5th Percentile
998,402
22,283
2.23%
5th to <85th Percentile
649,203
65.02%
85th to <95th Percentile
160,490
16.07%
> 95th Percentile
166,426
16.67%
DATA ENTRY
• Small errors in data make large
errors in percentages
• When data is widely variable it is not
considered to be valid
DATA ENTRY
• Everyone needs to keep their tally sheet, no
matter how the record is kept. (BMI for age
percentile groups; diabetics, procedures, etc.)
• When the numbers have been collected, calculate
the percentages. (i.e. What percentage of the
student population is obese? What percentage of
the student population has a diagnosis of
asthma? etc.
DATA PROBLEMS
• 2005-06 SY
Worked with 133/500 SD
• Impacted 2006-07 SY data
• 2007-08 SY
Data has fewer errors and less
variation
CHRONIC DISEASE ERRORS
• Examples of Problem Data:
Spina Bifida: 3 (05-06) to 43 (0607)
Arthritis: 4 (04-05) to 370 (05-06)
Bleeding Disorder 185 (04-05) to
12 (05-06)
DATA ENTRY ERRORS
BMI Data Problems: 06-07 SY K-6 examples
<5th
%
5th to
85th
%
>85th
to
<95th
%
978
101
10.3
0
0
556
56.9 321
32.8
1017
6
0.6
496
48.8
349
34.3 166
16.3
626
14
2.2
448
71.6
50
8.0
114
18.2
178
0
0
128
72.0
16
9.0
34
19.1
815
1
0.1
501
61.5
172
21.1 141
17.3
1073
200
18.6
221
20.6
424
39.5 228
21.3
6219
72
1.2
5072
81.6
497
8.0
9.3
1088
12
1.1
43
4.0
832
76.5 201
#
Screened
>/= to
95th
578
%
18.5
DATA ENTRY ERRORS
• Have CSN double-check entries before report
submitted
• Contacting school to clarify doesn’t mean the
data is wrong
• Maintain tally sheets for 5 years
Data validation lags 1 – 2 school years
Computer Resources
• Ensure that any computer program that
calculates uses the age in months and
years or uses the date of birth
• Ensure that any computer program that
calculates the BMI-for-Age Percentile does
not round to whole numbers
• Ensure that any computer program that
tabulates the number of students in each
category uses accurate cutoffs
RESOURCES
• CDC Children’s BMI Tool for Schools
http://www.cdc.gov/healthyweight/assessing/b
mi/childrens_bmi/tool_for_schools.html
Calculates BMI and BMI-for-Age Percentile
Does not classify categories as DOH requires
Unable to sort information in worksheet
RESOURCES
• CDC Children’s BMI Tool for Schools
http://www.cdc.gov/healthyweight/assessing/b
mi/childrens_bmi/tool_for_schools.html
Calculates BMI and BMI-for-Age Percentile
Does not classify categories as DOH requires
Unable to sort information in worksheet
ASTHMA SURVEY
• Collected for the DOH Asthma Program
• Completed March 15, 2009
• 613 respondents
• Awaiting the data
GROWTH SCREENING PROGRAM
(GSP) SURVEY
• School nurse survey conducted fall
2007
Collaborative effort w/ Div. of Nutrition
and Physical Activity
Web-based via Zoomerang
5 week open window (Oct. 15 – Nov.
21)
GROWTH SCREENING PROGRAM
(GSP) SURVEY
• 888 school nurse responses, representing:
393 School Districts
21 Charter Schools
6 Intermediate Units
4 Vo-Techs
10 Private Schools
GROWTH SCREENING PROGRAM
(GSP) SURVEY
• >70% agreed screening identifies students at risk
for underweight as well as overweight & obese
• School nurse is primarily responsible for
screening process
PE teachers & volunteers help
• 95% used computer program to calculate BMI
and BMI-for-Age Percentile
GROWTH SCREENING PROGRAM
(GSP) SURVEY
• Weight
63% Balance scales
48% Digital scales
51% scales calibrated
49% scales not calibrated or don’t know when
calibrated
• Height
78% stadiometers
32% measuring tape or scale device
GROWTH SCREENING PROGRAM
(GSP) SURVEY
• 92% notify all parents of students screened with
results
• Ways that parents are notified of results:
61% mail letter directly to parents
17% mail with other materials directly to
parents
14% give letter to student to deliver to parents
13% give letter with others materials to
student to deliver to parents
GROWTH SCREENING PROGRAM
(GSP) SURVEY
• 89% educate parents on the GSP process
• 71% provide info on health risks associated with
unhealthy weight
• School Nurses requested educational information
on:
58% Wt management programs
59% Programs promoting healthy eating &
activity
77% Health risks of childhood overweight
85% Resource materials on healthy eating and
increasing physical activity
LESSONS LEARNED FROM GSP
SURVEY
• Prescreening education yielded fewer
parental concerns
• Computers preferred method for
administering the program
• Everyone wants a good computer program
• Majority reported GSP process takes more
time
PA ADVOCATES FOR NUTRITION &
ACTIVITY (PANA)
A resource to support schools in meeting school
health GSP requirements
• Web site: www.nrgbalance.org
• nrgBalance Zone Schools
Formerly Keystone Healthy Zone Schools
Enrollment period extended to March 31, 2009
School Nurse Pack Awards available
PA ADVOCATES FOR NUTRITION &
ACTIVITY (PANA)
• Growth Screening Skills, Tools, and Resources
Archived webcast from January 2009
http://www.nrgbalance.org/training/webcast_p
rofessional_development.cfm
• Growth Screening Communications Kit
http://www.nrgbalance.org/for-schools/bmiabout.cfm
SCHOOL HEALTH WEB PAGE
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Data/reports from Annual Report Database
Laws and Regulations
Policies and Procedures
Manuals, Guidelines and Forms
Training opportunities, Grants and Funding
Information on Current and Future Health Issues
What’s New
www.health.state.pa.us/schoolhealth
SCHOOL HEALTH PROGRAM
MANUAL
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Introduction
Nurse Practice Act and Regulations
School Health Law and Regulations
Department of Education
Documentation/HIPAA/FERPA
Medication Administration
Immunization Requirements
Child Protection Law
SCHOOL HEALTH PROGRAM
MANUAL
• Special Education/Special Health Care Issues
• School Health Program – Screens
• School Health Program - Physical/Dental
Examinations and TB Testing
• Annual Request for Reimbursement and Report of
School Health Services
• Communicable Diseases
• Bloodborne Pathogens
• Environmental
• Resources
STEPS & STEPS YOUTH SURVEY
(SYS)
• Steps Youth Survey (SYS) is again being
administered in the Steps communities – Fayette,
Luzerne, and Tioga counties
• SYS administered in grades 9-12 during months
of March, April, and May if necessary
• 2009 SYS data will be compared to 2007 SYS
data which was the baseline year
STEPS & YRBS
• Steps School Health Coordinator assigned to
work with DOE to administer first ever Youth Risk
Behavior Survey (YRBS) in PA
• YRBS focuses on priority health risk behaviors in
youth resulting in significant mortality and
morbidity during both youth and adulthood
STEPS & YRBS (cont.)
• YRBS administered in grades 9-12 during months
of March, April, and May if necessary
• Sixty schools in PA randomly selected to
participate
• 2009 YRBS is will provide baseline data that is
generalizable to the PA’s high school population
STEPS & NACDD
• National Association of Chronic Disease Directors
(NACDD)
School Health Steering Committee
Steps School Health Coordinator assigned by
PA Chronic Disease Director to participate on
NACDD School Health Council.
STEPS & NACDD (cont.)
• Mission: Assist states and territories in
reducing the risk and burden of chronic
diseases in school communities
• The School Health Council serves State
Departments of Health staff involved in health
of children and youth
• Primary focus is link between healthy school
communities and student academic success
and policies that enhance this linkage
STEPS & NACDD (cont.)
• NACDD provides a voice for school health issues
at the national level in partnership with Directors
of Health Promotion and Education and the
Society of State Directors of Health, Physical
Education and Recreation
STEPS & THE FUTURE
• STEPS funding through the CDC ends September
21, 2009
• The State Steps program has been assisting
Steps communities with their sustainability plans
• Steps communities are actively seeking new
sources of funding and partnerships to continue
their work in policy, systems and environmental
change
STEPS & THE FUTURE (cont.)
• Steps successes nationally in schools,
communities, worksites, and in the health care
sector have contributed to transformation at the
CDC of the Steps program into the Healthy
Communities Program (HCP)
• To learn more about HCP visit the link:
http://www.cdc.gov/healthycommunitiesprogram/
TRANSITION PLAN FOR SPECIAL
EDUCATION STUDENTS
• Should include a health component
• Workshops and Trainings available through
PaTTAN (PA Training and Technical Assistance
Network) Online Registration: www.pattan.net
TRANSITION HEALTH CARE CHECKLIST
Updated June 2008
http://www.dsf.health.state.pa.us/health/lib/heal
th/familyhealth/hc_checklist_final_july2008.pd
f
Spanish December 2008
http://www.dsf.health.state.pa.us/health/lib/heal
th/familyhealth/transition_hc_checklist_spanis
h.pdf
TRANSITION AREAS TO CONSIDER
•
•
•
•
•
•
•
Communication
Transportation
Financial & Legal Concerns
HIPAA/ COBRA
SSI/SSDI/Medicare/Medicaid/CHIP
Health & Medication Insurance
Assistive Technology
TRANSITION MEDICAL HOME
• Term defined by the American Academy of
Pediatrics (AAP) and The Academy of Family
Physicians (PAFP)
• An approach to providing comprehensive health
services in a high-quality and cost-effective
manner
• Provides considerations for all adolescents,
especially those with special needs, when
transitioning from schools to adulthood
SOCIAL SECURITY INCOME (SSI)
& WORKING
• Students with SSI can work
• There are several programs that protect the SSI
and the wages
• Students and parent/guardians should be
referred to the local Social Security
Administration Office’s Working Incentive
Program Liaison
CERTIFIED SCHOOL NURSES
PA 19992000
PA 20012002
PA 20032004
PA 20042005
PA 20052006
PA 20062007
Full time
1706
1915
2000
2041
2051
2051
Part time
72
131
127
124
132
150
1778
2046
2127
2165
2183
2201
Students
Served
1,845,610
2,045,970
2,056,284 2,060,376 2,051,047
2,035,587
Average
CSN
Caseload
1038
999
Total
966
952
940
925
CERTIFIED SCHOOL NURSES
PA 19992000
PA 20012002
PA 20032004
2000
PA 20042005
2041
PA 20052006
PA 20062007
Full time
1706
1915
2051
2051
Students
Served
1,845,610
2,045,970
2,056,284 2,060,376 2,051,047
2,035,587
Average
CSN
Caseload
1082
1068
1028
1009
1000
992
(Counting
PT)
(1038)
(999)
(966)
(952)
(940)
(925)
LEARNING MANAGEMENT SYSTEM
(LMS)
• All School Personnel Eligible
• Offers on-line courses for school staff & Act 48
hours through the Division of School Health
• 58 hours available in 26 courses
• 830 school personnel signed up
TOPICS UNDER LMS FOR CE
• Assessment I & II
Exam, Documentation,
Clinical Decision Making
• Bioterrorism & Infections
SARS, MRSA, WMD
• Management I & II
Asthma, Seizure, N&V,
Allergic Reaction, D.M.,
Obesity, Hypoglycemia
• Environmental Trauma
Hypothermia, Animal
Bites
• NIMS – National Incident
Management System
• The role of School Nurses
in Wellness
• Disaster Nursing
• Orthopedic Trauma
• Drug Abuse
• Trauma I & II
• Grant Writing
• Multi-Hazard Emergency
Planning for School Nurses
LMS (cont.)
• To become a registered user:
www.health.state.pa.us
Send an email to [email protected] and provide
your name, email address, phone number and
job title or description
http://key.emsed.com/login.asp
TRAINING
• Action for Healthy Kids Conference cancelled
• New School Nurse Orientation
NC- August 19
• School Health Updates
SC- April 29, Capitol Area IU
NE- August 14 & October 16
NC- October 12
TRAINING
• State Board of Nursing
May 4th- Special Informational Session
Continuing Ed for RNs
Safe Standards of Practice
Professional Conduct
Advanced Practice
Regulatory Update
May 5th- Regular Board meeting
Allentown, PA
www.dos.state.pa.us/nurse
DIABETES MANUAL
• Developed by Bureau of Chronic
Diseases, Diabetes Program &
Division of School Health
• Being mailed to every public school
building in the Commonwealth,
including charter schools
•Adapted from National Diabetes
Education Program (NDEP) to match
PA statutes/regulations
MEDICATION MANUAL
• Draft completed
• Currently under review by
Dept. of Education
Dept. of State, Board of Nursing
• Then Review by stakeholder
organizations
• Then Final Approval by Dept. of
Health
RESOURCES
• Healthy Schools Campaign
www.healthyschoolscampaign.org
Quick & Easy Guide to Green Cleaning in
Schools
Quick & Easy Guide to School Wellness
• PDE Nutrition Curriculum
http://www.pde.state.pa.us/nutrition/Nutriti
on_Curriculum
4 lesson plans per grade grouping (K-3, 46, 7-9, and 10-12 )
MANDATED SCHOOL HEALTH
SERVICES
K
1
2
3
4
5
6
7
8
9
10
11
12
Special
Education
School Nurse Services
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Maintenance of Health
Record
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Immunization
Assessment
X
X
X
X
X
X
X
X
X
X
X
X
X
X
SERVICE
Medical Examination
*
*
X
Dental Examination
*
*
Growth Screen
X
X
X
X
Hearing Screen
X
X
X
X
Scoliosis Screen
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Notes
Age
Appropriate
*Required on original
entry- K or 1st
grade
Age
Appropriate
*Required on original
entry- K or 1st
grade
X
X
6th grade physical
may be used
in lieu of 6th
grade screen
X
*Required on original
entry- K or 1st
grade.
Tuberculin Test
*
*
X
Age
Appropriate
Unless approved to
discontinue
MANDATED SCHOOL HEALTH
SERVICES
K
1
2
3
4
5
6
7
8
9
10
11
12
Special
Educati
on
Vision Screen-Far Visual Acuity Test
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Vision Screen-Near Visual Acuity Test
X
X
X
X
X
X
X
X
X
X
X
X
X
X
SERVICE
Vision Screen-Convex Lens Test
(Plus Lens)
Vision Screen-Color Vision Test
Vision Screen- Stereo/Depth
Perception Test
Notes
X
As
Needed
1st grade students meeting
criteria & new students (any
gr) not previously screened
*
*
As
Needed
*1st or 2nd grade & new
students (any gr) not
previously screened
*
As
Needed
*1st or 2nd grade & new
students (any gr) not
previously screened
*
ENGLISH AS SECOND LANGUAGE
(ESL)
• Requirement of “No Child Left Behind”
Medical forms available : exam forms,
asthma/action plans, parent/guardian
screening notifications, health history, etc
Translated into 20 most common languages in
PA
Transact – Contract through PDE
For access-contact your ESL coordinator
www.transact.com
PA-HEALTH ALERT NETWORK (HAN)
CSNs by County Registered with PA-HAN
3
1
1
2
5
2
1
1
16
6
1
1
2
1
5
1
2
4
2
2
5
1
2
7
1
1
2 5 2
4 7 2
6 9 4
6
10 5 3 4
4
1
5 3
4
2
HAPPY SCHOOL NURSE’S
DAY May 6, 2009