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Department of Coordinated School Health Shunji Q. Brown-Woods, Ed.D., MHA Director 901-473-2693 brownwoodssq@scsk12.org 1 School Health: What Every New Teacher Needs to know?

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Reducing the Barriers to Learning Community and Parental Involvement is one component of CSH Every day in America, children come to school not ready to learn Absenteeism No AYP ADHD Bullying ASTHMA Diabetic 2

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Session Objectives Understand CSH structure, purpose and responsibilities Introduction to Policy 6043Health Care Management Health Information First Aid and Emergency response training know where your AED is located Confidential Health Information Individualized Health Care Plans CAADS (cardiac, asthma, allergy, diabetes, and seizure related chronic health issues) Who to contact regarding health related concerns 3

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CSH Purpose & Responsibilities Ensure delivery of high quality health services Oversee: School Nursing/health services Mental Health Center services Four (4) regional School-based clinics Northside High, East High, Westwood High, and Sheffield High School Family Care Centers (employee health clinics) 901-473-2628 appointment line Family Resource Centers Employee Wellness/Health Promotion for Staff State Coordinated School Health grant functions School Health Compliance Special Projects CPR/AED/First Aid training Vision/Hearing Screening for students CDC HIV/YRBS grant Bloodborne Pathogen (BBP) Exposure training and immunization program for Hepatitis B 4

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Health Care Management #6043 Purpose To provide an efficient and effective district-wide school health program to address the health education and health service needs of students attending Shelby County Schools. Policy Statement The Shelby County Schools Board believes that academic success is impacted by the overall well- being of the student; and that a fundamental mission of the school system is to help students remain healthy. It is therefore the policy of Shelby County Schools to provide an effective system of programs to support student health and learning. 5

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Policy Summary 6 Covers 11 broad areas in health care management: First Aid Student Accident Reports Physical Examinations Immunizations IHPs Medication Administration Diabetes Seizure Allergy Communicable Diseases and AIDS Psychological as well as social services.

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First Aid and Emergency Medical Care Faculty and staff of each school shall be prepared to provide basic first aid in response to general medical emergencies. The objective of the SCBE is to have an adequate number of staff at each site who are trained and certified in CPR and other first aid emergency techniques. In accordance with state law any person who in good faith provides emergency care or assistance at the place of the emergency or accident will not be liable for any civil damages as a result of any act or omission. 7

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Student Accident Reports Any accident involving students that occur on the property of Shelby County Schools and/or while under the approved supervision of District employees shall be reported in writing to the office responsible for student services within twenty-four (24) hours after the accident occurs. Report should include the following; Persons name Date of the accident An explanation of the accident Care used for treating the individual Principal signature Reports should be kept on file in the principals office for one (1) yr. 8

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School Health Screenings/Evaluations Services 9 Services include: Vision and Hearing assessments Body Mass Index (BMI=Height and Weight) assessments Blood Pressure EPSDT The district will provide healthcare services (preventive and early intervention health services) and health referral services whose test results indicate a possible condition that may interfere or tend to interfere with the students academic progress. Services shall be conducted by qualified healthcare providers. School-Based Health Clinics shall be available to increase access to healthcare services for all Shelby County students. Health Care monitoring will occur through school based health screenings for students entering PK, K, 2, 4, 6, 8, and Lifetime Wellness courses. Students entering the District from another district will be asked to provide evidence of completion of an EPSDT or preventive well-child screening within the last 12 months.

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Confidentiality EmployeesVolunteers and Contractors 10 Shall safeguard student medical information from unauthorized disclosure except as permissible by law or as a required function to perform his/her job responsibilities; and/or in cases where the student poses an imminent threat of harm to him/herself or others. An employee who misuses, alters, removes, or improperly uses confidential student medical information shall be subject to disciplinary action up to and including termination. Volunteers whose activity may place them in a position where they may gain knowledge of a students healthcare information as well as other entities contracted by or working in collaboration with the District shall be held to the same professional standards as an employee of Shelby County Schools. Sanctions for breach of confidentiality may apply.

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Individualized Healthcare Plans IHPs shall be written by school nurse staff to address student specific health conditions and shall include: 1. A specified timeframe to develop a student IHP that must be reviewed with the parent/guardian (at least once per school year); 2. The medical condition; health assessment; emergency plan; identified health needs; and procedures/treatments required during school hours; 3. Relevant documents, such as a physicians statement. The IHP should be distributed to school employees with a legitimate need to know. Special Cases: If a student is identified as special education, IHP shall be a part of the IEP and shall be maintained in the special education records. HIV/AIDS cases are considered to be unique and shall be responded to in accordance with policy and corresponding rules and regulations. 11

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Administering Medicines to Students If under exceptional circumstances a student is required to receive medication during school hours and parent cannot be at school to administer the medication, only the school nurse or the Principals designee will administer the medication in compliance with the regulations that follow: (see policy for detailed regulations) 12 General Written instructions will be signed by the parent or legal guardian. Signed instruction form will be kept on file at the school. All medication must be brought to school by the parent or guardian, unless other arrangements have been approved by the school Principal, but under no circumstances shall a student bring the medication to school by himself/herself Parents of the student must assume responsibility for informing the school Principal of any change in the students health or change in medication. Should medications of an invasive nature be required to be given the school personnel for emergency action, proper physician orders and instructions will be obtained and proper training will be given to appropriate personnel. The school system retains the discretion to reject a request for administration of medicine. A copy of this procedure will be provided to parents upon their request for administration of medication in the schools.

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Psychological and Social Services The District shall make psychological and social service programs available for all students of Shelby County Schools. Each school shall provide a social service program for all students through cooperative efforts of the principal, teachers, and school counselors. The Principal, in consultation with the social service provider and the office responsible for student support and Coordinated School Health, shall ensure the development of a program of social services. Confidentiality in Psychological Services Confidentiality shall be maintained by any District employee providing services related to psychology services except: 1. Where there is a clear and present danger to the student or other person; 2. To consult with another psychologist when it is in the best interest of the student; 3. When the student and/or parent waives this privilege in writing; or 4. When required by federal law. 13

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Overview of Common Chronic Illness High Priority Health Conditions CCardiac AAllergy AAsthma DDiabetes SSeizure

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How we Identify Priority Health Conditions Confidential Student Health Forms Nurse reviews health information and communicates with parents/guardians to determine the appropriate level of care needed to address student health needs at school. Once information is shared at the school level a school health plan (IHP), Health Information Fact or Condition Sheet is developed and shared with school staff who have a legitimate need to know. (HIPAA) (FERPA)

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Protecting Student Health Information 16

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Confidential Student Health Information 17 ...personal, sensitive information obtained most often by a health professional concerning the physical, developmental, or mental health of an individual student. A students health history might also include sensitive family information. Source: Guidelines for Protecting Confidential Student Health Information. Pg. 11. Published by ASHA National Task Force on Confidential Student Health Information

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Ethical Responsibilities & Issues 18 Responsibility to Respect Privacy Privacy is a fundamental right of individuals to be free from intrusion. Responsibility to Do No Harm Careful consideration of need to know balanced with best interest of individual students Can disclosure be justified for the students benefit? To what extent might personal bias affect my judgment? Responsibility to Disclose Some Types of Information Suspected Child Abuse Self-injury or Suicide Possible Harm to Another Person Duty to Warn If known threat exists to a student has been identified by health professionals, then this information should be disclosed.

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Legal Obligations & Confidentiality Family Educational Rights and Privacy Act of 1974 FERPA provides parents with access to all their childs school records, including health records, and stipulates that these records may not be released outside the school without specific parental consent except in a few circumstances: When a student intends to enroll in another school Research and/or evaluation studies focused on improving instruction or care; or An emergency in which disclosure is necessary to protect the health or safety of the student or other individuals. Only that information necessary to reduce the danger may be shared and then only with necessary medical, administrative, or law enforcement personnel. 19

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Legal Obligations & Confidentiality HIPAA Education records in public schools are covered by FERPA and are specifically exempted from the HIPAA Privacy Rule. Nonetheless, there are multiple practice considerations for schools that relate to HIPAA p. 18 Source: Protecting and Disclosing Student Health Information: How to Develop School District Policies and Procedures. Published by ASHA 2005 20

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CSH Model Components Comprehensive school health education Physical education Health services Nutrition services Counseling, psychological, and social services Healthy school environment School-site health promotion for staff Family and community involvement in schools 21

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Students cannot be totally committed to Learning until basic needs are addressed MASLOW 23

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Important Numbers to know... 24 CSH Department main line: 901-473-2693 Employee Health Services Family Care Center appointment: 901-473-2628 Health Services/School Nursing: 901-473-2668 Mental Health Center Crisis Hotline: 901-473-2200 Employee Assistance Program: 901-458-4000