Know Your Child’s Healthcare Service Rights at School
The California Legislature expressly states its intent in the Education Code that individuals with exceptional needs should not be placed at school sites other than those they would attend but for their specialized physical health care needs. That being said, there are a number of regulations regarding the child’s right to health services.
Under the California Education Code, school nurse assistance (or other designated school personnel assistance) may be provided to any pupil who is required to take medication prescribed by a physician/surgeon during the school day. In order to receive assistance, the school district must obtain 1) a written statement from the physician detailing the name of the medication, method, amount, and time by which the medication is to be taken, and 2) a written statement from the parent/guardian indicating the desire for the school district’s assistance.
For students with prescription auto-injectable epinephrine, it is possible to for a student to carry and self-administer the medication at school. In order to do so however, the district must obtain: 1) a written statement from the physician detailing the name of the medication, method, amount, time by which the medication is to be taken, and confirmation that the student is able to self-administer, and 2) a written statement from parent/guardian consenting to the self-administration, providing a release for the school personnel from civil liability resulting from the self-administration of the medication.
Note that these written statements mentioned above shall be provided at least annually and more frequently if the medication, dosage, frequency of administration, or reason for administration changes.
For individuals with exceptional needs who require specialized physical health care services (SPHCS) during the school day, assistance may be provided by qualified persons. Specialized physical health care services refer to those services prescribed by the child’s licensed physician/surgeon requiring medically related training for those performing the services which are necessary for the child to attend school. Qualified persons to perform such services are those who possess the appropriate service credentials or those who hold a valid certificate of public health nursing issued by the Board of Registered Nursing.
Additionally, qualified designated school personnel can also render such services if they are trained in the administration of specialized physical health care, perform those services under the supervision of a credentialed school nurse, public health nurse, or licensed physician, and the services are determined, in consultation with the physician treating the pupil, to be: 1) routine for the student, 2) pose little potential harm, 3) performed with predicable outcomes, and 4) do not require a nursing assessment, interpretation, or decision-making by the designated school personnel. Persons rendering specialized physical health care services must also be competent in basic cardio-pulmonary resuscitation and be knowledgeable of emergency medical resources.
The California Code of Regulations further emphasizes that the qualified school nurse, public health nurse, or licensed physician responsible for supervising the physical health care of an individual with exceptional needs in the school setting must: 1) coordinate the health care services on the school site, 2) consult with the appropriate personnel, 3) make appropriate referrals and maintain communication with health agencies providing care to the individual, and 4) maintain or review physician and parent requests and daily records. Furthermore, specific services provided are to be documented daily and maintained on a district-approved form along with the signature of the personnel rendering services.
If a Student requires regular nursing services throughout his or her school day in order to receive an appropriate education, a school district may be required to provide a full day nursing services to that student on an individualized basis. This usually only occurs on rare occasions, however if a student truly requires that level of care in order to receive an appropriate education, then the district must provide the service.
Arden Hoang, Summer Intern
Elizabeth Curtis, Associate Attorney
Cal. Educ. Code § 49423.5(h).
Cal. Educ. Code § 49423(b).
Cal. Educ. Code § 49423(b)(2).
Cal. Educ. Code § 49423(b)(3).
Cal. Educ. Code § 49423.5(a).
5 CCR § 30551.12
Cal. Educ. Code § 49423.5(a)(2)(A).
Cal. Educ. Code § 49423.5(a)(2)(A)-(D).
Cal. Educ. Code § 49423.5(c)
CCR § 30551.12(b)(3)(D)(1)-(4).
By, Elizabeth Curtis, Esq./Arden Hoang (Intern)