Healthcare

Arc Guide to Individualized Health Care Plan

Minnesota State Rule 121A.21 outlines School Health Services. Every school district with more than 1,000 students must provide services to promote student health through employed health personnel, typically a Licensed School Nurse. Nursing services within a school setting must be overseen by a Licensed School Nurse from the Board of Teaching.

 

Each student with health care needs is unique. When health care services are necessary during the school day, an Individualized Health Care Plan (IHCP) may be considered to address health care needs. An IHCP may be very simple, or may need detailed procedures that will require extensive documentation. The school district should adapt paperwork to meet the particular needs of a student. If an Individualized Health Care Plan is deemed necessary, the following information should be considered.

 

Determining Need for IHCP

  • Critical components to identifying the need for a Health Care Plan and for developing what the plan needs to include are:
    • Medical diagnosis
    • Treatments during and outside of school day
    • Medications
    • Frequent absences due to illness and/or hospitalizations
    • School day schedule adjustments
    • Specific health care needs (lifting, positioning, feeding, etc.)
  • The school liaison, potentially the Licensed School Nurse, must compile information from parents and health care professionals in order to generate an appropriate plan.
  • A licensed medical provider must provide:
    • An order/authorization for special health care services to be performed at school
    • Detailed information regarding the specialized health care procedures and administration of medications
    • A parent’s signature must accompany the medical provider’s order

 

Individualized Health Care Plan (IHCP)

  • Components include:
    • Overview of the medical condition and brief medical history
    • Primary and specialist health care provider(s) and condition(s)
    • Procedure(s) to be performed
    • Medication(s) and possible side effects
    • Special Equipment
    • Summary of physical limitations (if any)
    • A checklist of medication administration (this will assist school districts in documentation of authorized medical care given to student)
    • Summary of the health care needs of the student
      • Detail of necessary health care procedures at school, including medications and diet
      • Detail who will be responsible for each procedure
      • Detail use of equipment
        • Who authorized use
        • Who will maintain
      • Details for back-up for any part of the plan
    • Summary of precautions/adverse reactions and/or interventions
    • May also include health care goals and actions
    • Daily log charts of medication/treatment/procedure records (this will assist with documentation of authorized medical care given to student)
  • Personnel training plan for student with health care needs
    • Detail components for key personnel in health care procedures
    • Detail training administration of medications
    • Training schedule
    • Decision grid for Licensed School Nurse to delegate to key personnel
    • The IHCP must be signed and dated, with a review date noted

 

Additional plans to ensure the health and safety of a student may be necessary.

Plan development should be based on a student’s needs and the most appropriate manner of meeting those needs. Depending upon the student’s needs, plan development should include the IEP team, a district representative, and any staff who may lend expertise toward its

development. It should be determined whether the student’s health and safety needs can be adequately addressed in the IEP, or whether a separate plan should be developed. Typically, when there are a number of health needs and/or are more complicated, it is advisable to develop a specific plan(s).

Additional plans may include a Transportation Plan (assistance on special transportation vehicle), Emergency Procedures / Safety Plan (assistance with evacuation, elopement issues, etc.). These procedures can be included in the IEP accommodations/adaptations rather than developed into a separate plan as noted above.

 

  • Emergency Procedures / Safety Plan:
    • Summary of medical information
      • Diagnosis
      • Medications
      • Allergies
      • Precautions, etc.
    • Emergency names, places and numbers
      • Parent(s) day time contact information
      • Hospital
      • Primary and specialist licensed medical providers
      • Home care
      • Medical supplier responsible for equipment maintenance
    • Emergency procedure – Procedural considerations if an emergency occurs:
      • Someone to stay with the student
      • Life threatening emergency – call 9-1-1
      • Identify who you are and where you are
      • Explain the problem
      • Call or designate someone to call
        • The principal and/or health care provider (name and number)
        • The parent/guardian (name and number(s))
      • If NOT life-threatening, what staff members are trained to deal with an emergency and initiate the Emergency Plan (state name and phone number / how to reach)
        • State procedure to be followed
        • Documentation of procedure and date
  • Transportation Plan
    • Outline issues and procedures for transporting the student
    • Detail procedures to be followed for
      • The bus driver
      • The transportation aide and substitute
    • The Emergency Procedures Plan and Health Care Plans should be attached
      • The bus driver
      • The transportation aide and substitute

 

ALL plans should be noted and ATTACHED to the IEP. All staff working directly with the student should have access to the plan(s) necessary to support and meet student needs. Parent and IEP case manager should discuss which staff (general education teacher, paraprofessional, etc.) will have specific (or all) IHCP information, and how it will be accessed.

 

 

For further information or advocacy services, contact The Arc Minnesota at 952-920-0855 or toll-free at 833.450.1494 or visit www.arcminnesota.org. (Please note: This document is not legal advice, and should not be construed as such. Thus, no information herein should replace the sound advice of an attorney.)

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