PENNSYLVANIA DEPARTMENT of HEALTH Division of School Health Beth Anne Bahn and Rosemary...

PENNSYLVANIA DEPARTMENT of HEALTHDivision of School Health

Beth Anne Bahn and

Rosemary Danchick-MoyerState School Health Consultants

March 22, 2009

SCHOOL HEALTH UPDATE 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]@state.pa.us

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

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

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


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


• 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

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

KI DISTRIBUTION PROGRAM FOR SCHOOLS

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 ReportAlso include data for:

Health exams, screens & select servicesChronic diseasesSerious School InjuriesMedication Administration

Important Law

• 24 P.S. § 11-1101Purdon'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 includethose 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 nursesSection 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 Nurse95 – Principal101 - 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)

• 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.

Enrollment of students

CHILD PROTECTION LAW

• Child Abuse Reporting LawAct 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 & Qualityhttp://www.ahrq.gov/prep/schoolprep/

CLARIFICATION ON ACT 48 REPORTING

• Letter sent to Supt. Dec. 2008Activities/Programs must be at least 3 hours in lengthPERMS won’t accept <3 hrs after Jan. 31, 2009

• Clarification letter being draftedRecommend at least 3 hrsPERMS will continue to accept 1 hr

activitiesTitle 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


• 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


• 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.”


• 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


If the expiration date on your RN license is:

You must complete 30 hours of Board approved CE from:

April 30, 2009 Not required for this renewal

October 31, 2009 Not required for this renewal

April 30, 2010 Not required for this renewal

Effective date of CE RequirementsEffective Dates of CE Requirements

RN CONTINUING EDUCAITON REQUIREMENT

If the expiration date on your RN license is:

You must complete 30 hours of Board approved CE from:

October 31, 2010 11/1/08 thru 10/31/10

April 30, 2011 5/1/09 thru 4/30/11

October 31, 2011 11/1/09 thru 10/31/11

April 30, 2012 5/1/10 thru 4/30/12

Effective Date of CE Requirements


• 49 PA Code § 21.134 Continuing education sources

Documentation needed on the certificate of attendance:

Full name of the providerFull address of the providerTitle of the activityDate of the activityLocation of the activityHours of continuing educationParticipant’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 insuranceMay be covered under the Tort Claims ActShould 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 judiciaryProvides 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 protectionIncludes 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 1506-8 225

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 child-care 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: 998,402

< 5th Percentile 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 (06-07)Arthritis: 4 (04-05) to 370 (05-06)Bleeding Disorder 185 (04-05) to 12 (05-06)

DATA ENTRY ERRORS

# Screened <5th

% 5th to 85th

% >85th to <95th

% >/= 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 8.0 578 9.3

1088 12 1.1 43 4.0 832 76.5 201 18.5

BMI Data Problems: 06-07 SY K-6 examples

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 yearsData 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/bmi/childrens_bmi/tool_for_schools.html

Calculates BMI and BMI-for-Age PercentileDoes not classify categories as DOH requiresUnable 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)


• 888 school nurse responses, representing:

393 School Districts

21 Charter Schools

6 Intermediate Units

4 Vo-Techs

10 Private Schools


• >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


• Weight63% Balance scales48% Digital scales51% scales calibrated49% scales not calibrated or don’t know when calibrated

• Height78% stadiometers32% measuring tape or scale device


• 92% notify all parents of students screened with results

• Ways that parents are notified of results:61% mail letter directly to parents17% mail with other materials directly to parents14% give letter to student to deliver to parents13% give letter with others materials to student to deliver to parents


• 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 programs59% Programs promoting healthy eating & activity77% Health risks of childhood overweight85% Resource materials on healthy eating and increasing physical activity

LESSONS LEARNED FROM GSP SURVEY

• Prescreening education yielded fewerparental 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 SchoolsEnrollment period extended to March 31, 2009School Nurse Pack Awards available

PA ADVOCATES FOR NUTRITION & ACTIVITY (PANA)

• Growth Screening Skills, Tools, and Resources

Archived webcast from January 2009http://www.nrgbalance.org/training/webcast_professional_development.cfm

• Growth Screening Communications Kithttp://www.nrgbalance.org/for-schools/bmi-about.cfm

SCHOOL HEALTH WEB PAGE

• 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

• Introduction • Nurse Practice Act and Regulations• School Health Law and Regulations • Department of Education• Documentation/HIPAA/FERPA• Medication Administration• Immunization Requirements• Child Protection Law

• 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

SCHOOL HEALTH PROGRAM MANUAL

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 2008http://www.dsf.health.state.pa.us/health/lib/health/familyhealth/hc_checklist_final_july2008.pdf Spanish December 2008http://www.dsf.health.state.pa.us/health/lib/health/familyhealth/transition_hc_checklist_spanish.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 1999- 2000

PA 2001-2002

PA 2003-2004

PA 2004-2005

PA 2005- 2006

PA 2006- 2007

Full time 1706 1915 2000 2041 2051 2051

Part time 72 131 127 124 132 150

Total 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 999 966 952 940 925

CERTIFIED SCHOOL NURSES

PA 1999- 2000

PA 2001-2002

PA 2003-2004

PA 2004-2005

PA 2005- 2006

PA 2006- 2007

Full time 1706 1915 2000 2041 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(Counting PT)

1082

(1038)

1068

(999)

1028

(966)

1009

(952)

1000

(940)

992

(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 & IIExam, Documentation, Clinical Decision Making

• Bioterrorism & InfectionsSARS, MRSA, WMD

• Management I & IIAsthma, Seizure, N&V, Allergic Reaction, D.M., Obesity, Hypoglycemia

• Environmental TraumaHypothermia, 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 IUNE- August 14 & October 16NC- October 12

TRAINING

• State Board of NursingMay 4th- Special Informational Session

Continuing Ed for RNsSafe Standards of PracticeProfessional ConductAdvanced PracticeRegulatory Update

May 5th- Regular Board meetingAllentown, PAwww.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.orgQuick & Easy Guide to Green Cleaning in SchoolsQuick & Easy Guide to School Wellness

• PDE Nutrition Curriculum

http://www.pde.state.pa.us/nutrition/Nutrition_Curriculum 4 lesson plans per grade grouping (K-3, 4-6, 7-9, and 10-12 )

SERVICE K 1 2 3 4 5 6 7 8 9 10 11 12Special

Education Notes

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

Medical Examination * * X X Age Appropriate

*Required on original entry- K or 1st grade

Dental Examination * * X X Age Appropriate

*Required on original entry- K or 1st grade

Growth Screen X X X X X X X X X X X X X X

Hearing Screen X X X X X X X

Scoliosis Screen X X

6th grade physical may be used in lieu of 6th grade screen

Tuberculin Test * * X Age Appropriate

*Required on original entry- K or 1st grade.

Unless approved to discontinue

MANDATED SCHOOL HEALTH SERVICES

SERVICE K 1 2 3 4 5 6 7 8 9 10 11 12

Special Educati

on Notes

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

Vision Screen-Convex Lens Test (Plus Lens) X

As Needed

1st grade students meeting criteria & new students (any gr) not previously screened

Vision Screen-Color Vision Test * * As

Needed

*1st or 2nd grade & new students (any gr) not previously screened

Vision Screen- Stereo/Depth Perception Test * *

As Needed

*1st or 2nd grade & new students (any gr) not previously screened

MANDATED SCHOOL HEALTH SERVICES

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 PDEFor access-contact your ESL coordinator

www.transact.com

PA-HEALTH ALERT NETWORK (HAN)

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65 4

2

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41

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1

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31 5

22 1

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10

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9

251

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CSNs by County Registered with PA-HAN

HAPPY SCHOOL NURSE’S DAY May 6, 2009

PENNSYLVANIA DEPARTMENT of HEALTH Division of School Health Beth Anne Bahn and Rosemary...

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