1. Susan Lawson, NCI School Health Nurse Consultant Inspector

2. 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

3. 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

4. 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

5. Required Health Records 702 KAR 1:160 Immunization Certificate or exemption certificate New physical form (combined for initial entry & 6 th 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

6. 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

7. Individual school health policies FERPA/HIPAA regulation (consent form 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

8. Delegation, training & supervision of unlicensed school personnel Delegation of Insulin – HB 98 passed in 2014 and 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

9. FERPA-HIPAA Guidance Document Joint Guidance on the Application of the Family Educational Rights & Privacy Act (FERPA) & the Health Insurance Portability & Accountability Act of 1996 (HIPAA) for student health records (November 2008)

10. Individual Education Plan Guidance (IEP) All IEP services are to be billed through schools, (provider type 21) LHD role in IEP services to be specifically written: 1. Will the nurse provide or not provide services? 2. Sharing student IEP list/names 3. Add LHD school nurse as part of the IEP team- not always necessary, depends on service needed 4. If LHD provides IEP services, reimbursement mechanism needed for the LHD

11. 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: Susan Lawson (502) 564- 2154, ext. 4412 Susand.lawson@ky.gov