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SPECIALIZED HEALTH CARE SERVICES

ADMINISTRATIVE REGULATION - 5141.24

Definitions

Specialized physical health services are those health services prescribed by the student's licensed physician requiring medically related training for the individual who performs the services and which are necessary to enable the student to attend school.  These services include catheterization, gastric tube feeding, suctioning, or other services that require medically related training.  (Education Code 49423.5; 5 CCR 3051.12)

In order to be qualified means the ability to demonstrate competence in cardio-pulmonary resuscitation, current knowledge of community emergency medical resources, and skill in the use of equipment and performance of techniques necessary to provide specialized physical health care services for individuals with disabilities.  In addition, for designated school personnel, qualified means being trained in the procedures to a level of competence and safety which meet the objectives of the training as provided by the school nurse, public health nurse, licensed physician, or other programs which provide the training. (Education Code 49423.5; 5 CCR 3051.12)

Training means preparation in the appropriate delivery and skillful performance of specialized physical health care services.  (5 CCR 3051.12)

Supervision involves the review, observation, and/or instruction of a designated school person's performance and of physical health care services, but does not necessarily require the immediate presence of the supervisor at all times.  (5 CCR 3051.12)

Provision of Services

A student with disabilities who requires specialized health care services during the school day, as identified in his/her individualized education program (IEP), may be assisted by any of the following individuals:  (Education Code 49423.5, 56345)

  1. Qualified persons who possess an appropriate credential pursuant to Education Code 44267 (service credential with specialization in health), Education Code 44267.5 (service credential with specialization in health for school nurse), or a valid certificate of public health nursing issued by the Board of Registered Nursing
  1. Qualified designated school personnel trained in the administration of specialized physical health care if they perform those services under the supervision of a credentialed school nurse, public health nurse, or licensed physician and the services are determined by the credentialed school nurse or licensed physician, in consultation with the physician treating the student, to meet all of the following criteria:
    1. Constitute routine care for the student
    1. Pose little potential harm for the student
    1. Can be performed with predictable outcomes, as defined in the student's IEP
    1. Do not require a nursing assessment, interpretation, or decision making by the designated school personnel

(cf. 6159 - Individualized Education Program)

Specialized health care or other services that require medically related training shall be provided pursuant to Education Code 49423.  (Education Code 49423.5)

(cf. 5141.21 - Administering Medication and Monitoring Health Conditions)

Schools shall provide appropriate accommodations for safety and necessary physical care services.  The student's personal privacy and dignity shall be assured.  (5 CCR 3051.12)

A qualified school nurse, public health nurse, or licensed physician responsible for supervising the physical health care of students with disabilities in the school setting shall:  (5 CCR 3051.12)

  1. Coordinate the health care services to the students with disabilities on the school site
  1. Consult with appropriate personnel regarding management of health care services for students with disabilities
  1. Make appropriate referrals and maintain communication with health agencies providing care to students with disabilities
  1. Maintain or review licensed physician and parent/guardian requests and daily documentation records

The licensed physician of a student with disabilities who is required to receive physical health care services shall provide a written statement detailing the procedure and time schedule by which such procedures are to be given.  In addition, the student's parent/guardian shall provide a written statement indicating his/her desire that the district assist the student in the matters set forth in the physician's statement and granting consent for the delivery of such services.  (5 CCR 3051.12)

For each student with disabilities, the district shall maintain the physician and parent/guardian statements, as well as the specific standardized procedures to be used if the services are provided.  The district shall also maintain daily documentation of specific services provided and shall include the signatures of the personnel who performed the procedure.  This documentation shall be maintained in accordance with the requirements for confidentiality of student records and shall be classified as mandatory interim student records. (5 CCR 3051.12)(cf. 5125 - Student Records)

Legal Reference:

EDUCATION CODE

44267  Services credential with specialization in health
44267.5  Services credential with specialization in health for school nurse
49423  Administration of prescribed medication for student
49423.5  Specialized physical health care services
49426  School nurses
56000-56606  Special education programs, especially:
56345  Individualized education program contents

BUSINESS AND PROFESSIONS CODE

2700-2837  Nursing, especially:
2726  Authority not conferred
2727  Exceptions in general
CODE OF REGULATIONS, TITLE 5
3051.12  Health and nursing services

UNITED STATES CODE, TITLE 20

1232g  Family Educational Rights and Privacy Act of 1974
1400-1482  Individuals with Disabilities Education Act

CODE OF FEDERAL REGULATIONS, TITLE 34

300.1-300.818  Individuals with Disabilities Education Act, especially:
300.34  Related services

COURT DECISIONS

Cedar Rapids Community School District v. Garret F., (1999) 526 U.S. 66
Clovis Unified School District v. Office of Administrative Hearings, (1990) 903 F.2d 635
Taylor v. Honig, (1990) 910 F.2d 627

Management Resources:

WEB SITES

California Department of Education, Health Services and School Nursing: http://www.cde.ca.gov/ls/he/hn
California School Nurses Organization:  http://www.csno.org