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Approved by: CMH, SPED Sup
Date: 3/4//13
Name of procedure: Guidelines for Exceptions of Placement and Services
for students with Medical Concerns.
Rational: Anoka Hennepin has a responsibility to provide a free and appropriate
public education for all students. Due to medical concerns students may require
special placement. Students who require special environmental conditions and/or
supports while attending their education may have contracted service to meet
those needs. Collaboration is necessary, appropriate, and provides safe services
for these students to benefit from their education.
A. Roles and Responsibilities
1. PRINCIPAL/Administrator Designee
Decisions about building program procedures are the responsibility of
the principal and questions about these matters are addressed to the
principal.
a. Directs school staff to establish a schedule to meet with the IEP
team (including the school nurse) on a regular basis to maintain
communication.
b. Encourages and supports school and agency staff in professional
communication of concerns and questions relative to practices
which will be in the best interest of the child.
c. Special Education Program Supervisors are located at Bridges,
ECSE sites, Pathways, RTLC, and T+ and fill the role at these
sites.
2. HEALTH SERVICE COORDINATOR
Additionally, all Health Service staff are responsible to the Health
Service Coordinator. Decisions about medical care and procedure are
the responsibility of the Health Service Coordinator and questions
about these matters are addressed to her. She is responsible for
placement recommendation of medically fragile students.
a. Is responsible for determining the quantity and frequency of
nursing services. Hours of school attendance (including
transportation time to and from school) may be eligible for
reimbursement by Third Party Billing. Hours outside attendance
and transportation times are not reimbursable.
b. Is responsible to determine how and where special health care
needs are provided including decisions with regards to medical
necessity of environmental controls such as air conditioning.
Shortened day or AM/PM placement concerns due to medical
conditions will also be considered.
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Approved by: CMH, SPED Sup
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c. Insures that the school nurse is aware of the medical needs of
the child.
3. PARENT
a. The parent is the advocate for the student’s educational program
and should communicate concerns about the school program
directly to the classroom staff with further follow through to the
supervisory staff if necessary.
b. Provide current consent to release data in order to obtain and share
health assessment and orders for care at school. In order to ensure
safe care at school it is imperative that district nursing staff have
the ability to communicate with the student’s private medical
provider and/or nursing agency.
c. For students enrolled in a program which includes parent
attendance (e.g. a parent-infant program with either in-home or incenter programming with parent instruction), it is the responsibility
of the parent to be present when staff are providing programming
instruction.
4. SPED SITE LEAD/CONTACT/DEPARTMENT LEADERS
Will provide the School Nurse with information on medically
involved students as their conditions change or new students join
the program using the attached form as related to exceptions to
placement and services.
5. TEACHER / SPED CASE MANAGER
a. Is responsible for the direction of all classroom activities and for
all persons working within the classroom setting.
b. Is responsible for case management of the student’s
educational program.
c. Calls team meetings
d. Completes the student’s IFSP/IEP. In consultation with the
school nurse and IEP team includes a statement of the nursing
role in the school setting in the adaptations section (i.e.
“nursing care for health needs while on the bus, at school, or
educational community outings.”) School nursing should also
be included as a support service.
e. Develops and implements the student’s daily schedule.
f. Ensures appropriate support services, including related
services are delivered as identified on the IFSP/IEP.
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Approved by: CMH, SPED Sup
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g. Responsible for defining and implementing interventions to
manage behaviors which directly impact the child’s medical
condition, in collaboration with the LSN.
h. Communicates directly with the parent regarding the child’s
educational program and keeps the Special Education lead
informed of significant changes with health and/or care needs.
i. There may be circumstances where education to other
students and families around the medical needs of a specific
student should be shared. These communications need to be
prepared and shared in consultation and collaboration with the
school nurse.
j. Foster appropriate communication between nursing personnel
and educational staff.
k. Maintains confidentiality of information derived from parent.
6. LICENSED SCHOOL NURSE
a. Is responsible for health services to all enrolled students.
b. Obtains current orders and medical information (at the beginning of
the school year and whenever the plan is changed).
c. Maintains confidentiality of information and obtains signed release
of information for any medical information shared outside of the
school setting.
d. Orients staff to student health care needs. Plans for care through
the individualized health plan (IHP) and emergency care plan
(ECP), trains the SPED LPN, and can act in case of an emergency.
e. Attends team meetings, IFSP/IEP as appropriate or requested by
case manager.
7. SPED LPN/SUB CONTRACTED AGENCY NURSE
The role of the Sped LPN/ agency staff is to attend to the medical need of
the students, to provide educational para strategies as instructed by the
teacher, and to work cooperatively with school staff for the medical and
educational benefit of the student.
a. SPED LPN/agency nurses are responsible for the student’s nursing
care at all times in all school settings, school site, and all
educational community outings. May include transportation.
b. SPED LPN/agency nurse will complete clinical documentation of
cares delivered as required by the School District and consistent
with nursing standards.
c. Make every attempt to insure suctioning and other medical services
are non-disruptive.
d. Maintains confidentiality of information received from parent. In
those cases where it is the judgment of the staff that it is in the
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interests of the child for information to be shared with school staff,
parental permission will be obtained. Information shared with staff
working with the student will then be shared in consultation and
collaboration with the school nurse.
e. When medical needs have been met and it is determined that
educational support is needed, the SPED LPN personnel will:
1. Involve the student in activities planned and prepared by the
teacher.
2. Assist the student to access the different educational settings.
3. Assist the student to access and use augmentative
communication devices or assistive technology.
B. General principles of communication and
cooperation
Confidentiality must be a priority for all persons involved in a student’s
program. Staff should not share information or have discussions about the
student in his/her presence, unless there is agreement that it will be of benefit for
the student to be an active participant in the process.
C. Process
1. Staff becomes aware of student with possible exception to regular
placement process.
2. Staff informs school nurse, Sped lead, and supervisor of concern.
3. Sped lead gathers information in collaboration with school nurse.
Complete the “Health information for placement of medically involved
students”.
4. Send information form to the Health Service Coordinator.
5. Case manager sets up and invites IEP team to meeting to consider
placement.
6. The change to reflect and the decisions made in regards to this placement
are added into the IEP.
7. Need for this exception with regards to placement are review at least
annually at the IEP meeting.