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This document outlines the key roles and responsibilities of agencies involved in school health services, focusing on contract development and essential operational components. It emphasizes the importance of complying with local resources and policies, ensuring proper health record management, and addressing the needs of students under the Disabilities Education Act. Additionally, it provides guidelines for managing and billing health services, as well as the roles of various stakeholders in relation to FERPA/HIPAA regulations and Individual Education Plans (IEPs).
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School Contracts2014 Sandi Clark- Pediatric Section Supervisor/School Health Consultant
Contract Development • Clearly define specific roles & responsibilities of each agency • Dependent upon local resources & policies • Provides understanding & gives direction • Meet with key agency personnel to assess needs & services that may be provided • Review, update & renegotiate annually
Correct contract verbiage – “school satellite clinic site” • “School-based health services “are described in 907 KAR 1:175 & are Federal Medicaid Services, under the Disabilities Education Act, required by schools • Services provided at satellite clinic sites are billed through Medicaid coverage under an MCO • Do not use the term “School Health Coordinator” in contract language. This is a mandated position by the state for school districts
Considerations • School districts responsible for writing own health policies & procedures • FERPA governs student education records, including health records • Key stakeholders- School Superintendent, School Health Coordinator, 504 & IEP Coordinator & Special Education Director/Coordinator • KDE is the lead agency of school health services working in conjunction with LHD’s to fulfill requirements
Required Health Records702 KAR 1:160 • Immunization Certificate • New physical form (combined for initial entry & 6th grade, BMI added) • Sports physical form • Vision & Dental exam/screening forms • Screening programs – vision & hearing • Cumulative Health Records include: medication & clinical procedures, health room visits documentation, parent/guardian communication, health exams & screening information
LHD Considerations • Nurse, clerk salaries, fringes, travel & training costs • Schedules , hours & supervision by LHD • Requirement of nursing substitutes • Office equipment, maintenance & repair • Job responsibilities/services to be provided • Attendance on field trips & home visits • Training requirements for nurses
Individual school health policies • FERPA/HIPPA regulation (consent from signed by parents to share health information between agencies) • Maintaining school health records & IC data entry • Adequate facilities • Services provided for faculty & staff • Responsibility for providing & sending out consent form for LHD school health services • Professional liability insurance for nurses provided by LHD
Delegation, training & supervision of unlicensed school personnel • Delegation of Insulin – HB 98 passed which allows for unlicensed school personnel (referred to as an non-licensed health technician) the delegation of administration of insulin, via vial/syringe, pen or pump, and carb counting • Kentucky Board of Nursing (KBN) proposed an amendment to 201 KAR 20:405 – Insulin Administration in School Setting by unlicensed assistive personnel to allow for delegation via pen & pump
FERPA-HIPPA Guidance Document • Joint Guidance on the Application of the Family Educational Rights & Privacy Act (FERPA) & the Health Insurance Portability & Accountability Act of 1996 (HIPPA) for student health records (November 2008)
Individual Education Plan Guidance (IEP) • All IEP service are to be billed through schools, (provider type 21) • LHD role in IEP services to be specifically written: • Will the nurse provide or not provide services • Sharing student IEP list/names • Add LHD school nurse as part of the IEP team- not always necessary, depends on service needed • If LHD provides IEP services, reimbursement mechanism needed for the LHD
Contract Questions • Related to billing & coding, contact: Local Help Operations (LHO) (502) 564-6663, Option 1 LocalHealth.Helpdesk@ky.gov • Related to School Health Services: Sandi Clark (502) 564- 2154, ext. 4409 sandik.clark@ky.gov