Ohio Department of Health
Update
DiAnn McMillen BSN, MS, RN, LSN
Head Start Impact SIIS
School Nurse Consultant
School Nursing Program
Overview
• Legislative Update
• House Bill 296- “the epi bill”
• House Bill 264- “the diabetes bill”
• House Bill 39- “the inhaler bill”
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Step Up & Be Counted!
Hearing and Vision
Immunizations
Essential Oils in the School Setting
Summary
Legislative Update
House Bill 296
“the epi bill”
House Bill 296
“The epi bill”
• ORC 3313.7110, 3313.7111, 3314.143, 3326.28,
3328.29-Effective spring 2014
• Allows schools to procure, maintain and administer
stock epinephrine autoinjectors
• Requires school policy and protocol developed with
a licensed prescriber
• Requires training for staff who may administer
House Bill 296
ODH Resource:
• Epinephrine Autoinjectors in Ohio Schools: A Trainthe-Trainer for School Nurses
• Online independent study through OhioTRAIN
(https://oh.train.org )
• Course #1051726
• Will provide 1.8 CNE
• Provides PowerPoint, handouts, skills checklists,
etc., for training UAPs
House Bill 296
ODH Resources:
• Under Guidelines and Publications:
• Sample Anaphylaxis Emergency Action Plan
• Sample Epinephrine Autoinjector School Policy
• http://www.odh.ohio.gov/odhprograms/chss/schn
urs/guidepub.aspx
House Bill 296
National Association of School Nurses Resources:
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Developed as a collaboration between NASN, NASSNC and
AAP
Includes:
• Sample Epinephrine Autoinjector School Policy
• Sample Epinephrine Autoinjector School Protocol
• Sample Epinephrine Autoinjector Reporting Form
http://www.nasn.org/ToolsResources/FoodAllergyandAnap
hylaxis/EpinephrinePoliciesProtocolsandReporting
House Bill 264
“the diabetes bill”
House Bill 264
“The diabetes bill”
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ORC 3313.7112 --Effective fall 2014
Addresses public and chartered nonpublic schools
To ensure a student with diabetes receives appropriate care,
the school:
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Provides care in accordance with prescriber’s orders
Shall inform parents regarding 504 eligibility
May administer diabetes medication
May provide training to school staff
Reports selected data to Ohio Department of Education
House Bill 264
“The board…shall ensure that each student…who has
diabetes receives appropriate and needed diabetes
care in accordance with an order signed by the
student's treating physician.”
• Checking and recoding blood glucose and ketones
• Responding to blood glucose levels out of target range
• Administering Glucagon, insulin, oral diabetes medications
• Understanding recommended schedules for food to
calculate medication dosages
• Following meal and activity instructions
House Bill 264
“…14 days after receipt of an order…of a student
with diabetes, the board…shall inform the student's
parent… that the student may be entitled to a 504
plan regarding the student's diabetes.”
• Responsibility of the administration
• ODE developed a letter to be used by district
• Nurse should be involved in 504 plan development
http://education.ohio.gov/Topics/OtherResources/Diabetes-Management
House Bill 264
http://education.ohio.
gov/Topics/OtherResources/DiabetesManagement
House Bill 264
“…diabetes medication may be administered…by a
school nurse or a school employee who is trained in
diabetes…medication …may be kept in an easily
accessible location”
ODE identified guidelines for training that include:
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Recognition of hypo/hyperglycemia, emergency situations treatment
Performance of blood glucose and ketone tests
Medication administration based on orders (must be recorded)
Understanding dietary recommendations
http://education.ohio.gov/Topics/OtherResources/Diabetes-Management
House Bill 264
“ …a board …may provide training that complies
with the guidelines …to a school employee at each
school attended by a student with diabetes. ”
• Coordinated by school nurse or licensed health care
professional with expertise in diabetes
• Before the beginning of school year or 14 days after diagnosis
• Includes determination of competence
• Include follow-up training as needed
House Bill 264
“The principal of a school attended by a student
with diabetes …may distribute a written notice to
each employee containing…“
Description of tasks to be performed and statements that:
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The school must provide diabetes care to a student
Participation is voluntary
Training will be provided
Who to contact if they are interested
The trained employee is immune from liability
No one can discourage staff or penalize those not volunteering
House Bill 264
“A student with diabetes shall be permitted
to attend the school the student would
otherwise attend…”
“…shall be permitted to attend to the care
and management …during regular school hours
and school-sponsored activities… ”
House Bill 264
“The student shall be permitted to perform diabetes care tasks
in a classroom, in any area of the school or school grounds,
and at any school-related activity, and to possess on the
student's self at all times all necessary supplies and
equipment to perform these tasks.…[or]…shall have access to
a private area for performing diabetes care tasks.”
“If the student performs any diabetes care tasks or uses
medical equipment for purposes other than the student's own
care, the board…may revoke the student's permission to attend
to the care and management of the student's diabetes. “
House Bill 264
“…a board or governing authority shall report to
the department of education…number of students with
diabetes enrolled…the number of errors associated
with the administration of diabetes medication to
students with diabetes …”
“…March of each year, the department shall issue a
report summarizing the information received by the
department …[and]… shall make the report available
on its internet web site.”
House Bill 39
“the inhaler bill”
House Bill 39
“The inhaler bill”
• ORC 3313.7113, 3313.7114, 3314.144, 3326.30,
3328.30-Effective spring 2016
• Allows schools to procure inhalers for use in
emergency situations
• Requires school policy and protocol developed with
a licensed prescriber
• Requires training for staff who may administer
House Bill 39
“The inhaler bill”
• Encouraged to maintain, at all times, at least two
inhalers at each school
• May accept donations of inhalers from a wholesale
distributor…and may accept donations of money
from any person to purchase inhalers
• Shall report to the department of education each
procurement and occurrence in which an inhaler is
used from a school's supply
House Bill 39
“The inhaler bill”
• Policy developed with a licensed health professional
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Specify definitive orders including the dosages to be
administered through them and number of uses before
disposal
Identify the one or more locations in each school…in
which an inhaler must be stored
Specify the conditions under which an inhaler must be
stored, replaced, and disposed
House Bill 39
“The inhaler bill”
• Policy developed with a licensed health professional
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Specify the individuals who may access and use an
inhaler to provide the inhaler to an individual in an
emergency situation
Identify the emergency situations
Specify that assistance from an emergency medical
service provider must be requested immediately after an
inhaler is used
Specify the individuals to whom an inhaler may be
administered in an emergency situation
Step Up & Be Counted!
Step Up & Be Counted!
A joint national data collection project of the
National Association of School Nurses (NASN)
and the National Association of State School
Nurse Consultants (NASSNC)
Step Up & Be Counted!
Goal: development of a national uniform,
standardized data set for all school nurses
around the country to collect specific data
points the same way
Step Up & Be Counted!
Role of the Designated State Data Champion:
• The person identified in the state to be the point
person for the state’s data collection
• To promote the program to all school nurses in the
state
• To develop process to collect data in aggregate form
from schools (districts, public, private, charter,
parochial, or other) and providing to national
database
Step Up & Be Counted!
Initial year data points (2014-15):
• the number of nurses in schools
• the number of children with diagnosed
chronic health conditions
• the disposition of children seen in the school
nurse office
Step Up & Be Counted!
Second year data points (2015-16):
• Data will be collected twice this school year
• Different data will be collected each time
• Report district level data when possible
• All data must be aggregated to protect
confidentiality of individual students
Step Up & Be Counted!
http://www.odh.ohio.gov/odhprograms/chss/
schnurs/nurseforms.aspx
Step Up & Be Counted!
http://www.odh.ohio.gov/odhprograms/chss/
schnurs/nurseforms.aspx
Step Up & Be Counted!
**Due by June 1, 2016**
While these data are not due until June, nurses need to start tracking them as soon as possible. You will need to provide the
date when data collection starts and ends. PLEASE report confirmed data so that you can be accurate in your counts. Do
NOT guesstimate.
20. Number of student encounters/health office visits to RN resulting in the student returning to class or staying in school
during the 2015-2016 school year
21. Number of student encounters/health office visits to the RN resulting in 911 being called or regionally appropriate
equivalent during the 2015-2016 school year
22. Number of student encounters/health office visits to the RN resulting in the student being sent home during the 20152016 school year
23. Number of student encounters/health office visits to LPN/LVN resulting in the student returning to class or staying in
school during the 2015-2016 school year
24. Number of student encounters/health office visits to the LPN/LVN resulting in 911 being called or regionally appropriate
equivalent during the 2015-2016 school year
25. Number of student encounters/health office visits to the LPN/LVN resulting in the student being sent home during the
2015-2016 school year
26. Number of student encounters/health office visits to health aide/UAP (non-RN, non- LPN/LVN) resulting in the student
returning to class or staying in school during the 2015-2016 school year
27. Number of student encounters/health office visits to the health aide/UAP (non-RN, non- LPN/LVN) resulting in 911 being
called or regionally appropriate equivalent during the 2015- 2016 school year
28. Number of student encounters/health office visits to the health aide/UAP (non-RN, non- LPN/LVN) resulting in the
student being sent home during the 2015-2016 school year)
http://www.odh.ohio.gov/odhprograms/chss/
schnurs/nurseforms.aspx
Step Up &
Be Counted!
https://www.n
asn.org/porta
ls/0/2015_20
16_NASN_N
ASSNC_Unif
orm_Dataset
_Data_Points
.pdf
Step Up &
Be Counted!
https://www.n
asn.org/porta
ls/0/2015_20
16_NASN_N
ASSNC_Unif
orm_Dataset
_Data_Points
.pdf
Step Up &
Be Counted!
http://www.odh.
ohio.gov/odhpr
ograms/chss/s
chnurs/nursefo
rms.aspx
Step Up &
Be Counted!
http://www.odh.ohio.
gov/odhprograms/ch
ss/schnurs/nursefor
ms.aspx
Step Up & Be Counted!
To report data
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Send Email to Adolescent.Health@odh.ohio.gov
Attach spreadsheet to the email
In Subject line write “SU&BC”
In the Body of the email include:
• Name of District or Public, Private, or Charter or
parochial school
• Contact person: (name, phone number, email)
• Date report was submitted
Hearing & Vision
Hearing
http://www.odh.ohio.gov/odhprograms
/cfhs/hvscr/requir.aspx
2015 Ohio Hearing Screening Guidelines
Vision
Immunizations
Director’s Journal
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Updated in December, 2014
http://www.odh.ohio.gov/~/me
dia/ODH/ASSETS/Files/bid/imm
unizations/directorsjournalschoolrequirements%2012-52014.pdf
Includes definitions of
outbreaks
Basis of the Immunization
Summary
2015-16 Immunization Summary
http://www.
odh.ohio.gov
/odhprogram
s/bid/immuni
zation/imunc
hsc.aspx
Immunizations: Early Childhood
Child Care
Immunization
Requirement
• 5104.014
Medical
statement of
immunization
Child Care Vaccine
Requirement
• House Bill 536—Effective March 19, 2015
• Covers:
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Child day-care centers, parent cooperative centers,
part-time centers, drop-in centers, school-age child
care centers (ORC 5104.015)
Type A family day-care homes, parent cooperative
type A homes, part-time type A homes, drop-in type A
homes, school-age child type A homes (ORC 5104.017)
Type B family day-care homes (ORC 5104.018)
Child Care Vaccine
Requirement
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ORC 5104.014
30 days after enrollment & every 13 months thereafter
Parent provides a medical statement that child has been
immunized
Statement must include:
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Dates child received required immunizations
Any exceptions (medical, reasons of conscience, age
appropriateness, availability of influenza vaccine)
A component where parent indicates that they decline to have
child immunized
Immunizations
http://www.cdc.gov/vaccines/who/teens/downloads/parent
-version-schedule-7-18yrs.pdf
Essential Oils in the School Setting
Essential Oils
• Over the Counter (OTC)
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The law is silent
School should develop their own policy
• Environmental Toxin
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Concern with increasing Asthma & Allergy statistics
Considered an irritant
Not in the best interest of ALL children and staff
ODH Resources
ODH Trainings
http://www.odh.ohio.g
ov/odhprograms/chss/
schnurs/conf.aspx
Epinephrine Autoinjector
Live Webcasts
Online Independent Study
Ohio Department of Health (ODH)
School Nursing Program
http://www.odh.ohio.gov/odhprograms/chss/schnurs/schnurs1.aspx
Summary
• As the laws change updates are highlighted and
communicated on the School Nursing Bulletin
Board (SNBB)
• Contribute to Step Up & Be Counted!
• Hearing screening requirements have changed
for the school year 2016-17
• Immunization requirements are also changing
for the school year 2016-17
Questions?
Thank you for your attention!
DiAnn McMillen BSN, MS, RN, LSN
614-644-8248
diann.mcmillen@odh.ohio.gov