P5317 Prescribed Special Health Care Services

A student may receive required health care services during regular school hours upon written request of the student’s lawful custodian; written prescription by a person licensed to practice medicine or dentistry and who is responsible for the student’s medical management; and authorization of the school nurse. Implementation of requests must follow Board of Education policies and applicable Kansas law.  

Administrative Implemental Procedures: 

1. Prescribed Special Health Care Services (PSHCS) are services prescribed by a person licensed to practice medicine and surgery or dentistry in the State of Kansas, which require medically related training to carry out. Services provided to selected public school students during the regular school day are necessarily provided at school to enable the student to attend school. 
2. Prescribed Special Health Care Services shall be provided when the following provisions have been met: 
   1. A licensed health care professional is involved in the planning and provision of Prescribed Special Health Care Services. 
   2. The performance of selected nursing procedures in the school setting has been properly delegated by a licensed registered professional nurse. 
3. Prescribed Special Health Care Services include, but are not limited to, catheterization, gavage feeding, suctioning, ostomy care, tracheotomy care, and subcutaneous, intracutaneous, and intramuscular injectable medications. Intravenous and intraspinal injections are specifically excluded. 
4. Prescribed Special Health Care Services shall be provided according to standardized procedures. The Health Services Office will maintain pre-approved protocols for most procedures developed by school nurses in collaboration with school administrators and health care providers. These will guide services according to the process described as follows. 
5. Request 
   1. Lawful custodial request is made to the school nurse. Written documentation of this request must include: 
      1. Lawful custodian signature 
      2. Student’s name and birth date 
      3. Requested procedure 
      4. Accessible phone numbers for lawful custodian and designees for all school hours 
      5. Authorization for information exchange with physician 
      6. Acknowledgement of receiving and understanding the Prescribed Special Health Care Services (PSHCS Guidelines) and Request to Administer Medication at School Guidelines 
      7. Physician’s signature 
      8. Diagnosis/health condition 
      9. Special services prescribed (medication/treatment, dosage, time/frequency, special instructions as needed) 
6. Planning 
   1. If standardized IHCP is available, nurse will review request for its appropriateness and initiate planning process. If standard IHCP is not available (i.e., request is for new procedures), IHCP is developed by nurse, with peer professional review, Health Services Office approval, and Employee Benefits and Insurance Management consultation if necessary. 
   2. If necessary, the school nurse, in collaboration with school administrator, identifies non-nurse school employees necessary to implement IHCP.  
   3. Conference(s) by school nurse with the lawful custodian, student, teacher (if appropriate), principal (if necessary), and delegated non-nurse school employee (if involved) will occur.  The purpose will be to discuss the IHCP and delineate the roles of all involved parties. These will be acknowledged by signatures. 
   4. The school nurse develops the IHCP and is responsible for the provision of services and supervision of the delegated nursing procedures. 
   5. Copies of final IHCP are maintained in the student’s health file and distributed by nurse to lawful custodian/student, physician’s office, and any other involved school personnel. 
7. Implementation 
   1. Plan may be implemented after all above steps are processed. (Plan may be implemented by nurse without step 6b until other personnel are delegated and trained.) 
   2. Medication and equipment needed for Prescribed Special Health Care Services will be provided to the school by the lawful custodian of the student or the lawful custodian’s designated adult. Each student’s medication shall be labeled according to BOE Policy 5316 - Administering Medication During School Hours. Special equipment items should also be identified by student’s name and all such items should be restricted to use of the owner only. The school district shall not be required to purchase medical equipment necessary to administer the IHCP for any student. Maintenance and service of the equipment shall be the responsibility of the lawful custodian. 
   3. Any and all amendments to IHCPs must be in writing signed by the student’s attending physician and the lawful custodian. 
8. Termination 
   1. When the duration of the PSHCS plan has ended or at the end of the school year, lawful custodians shall be responsible for picking up an unused medications and equipment. 
   2. Used syringes and needles and unclaimed medications will be disposed of by following the district’s hazardous waste guidelines. 
   3. All records and forms should be kept for five years after a service is completed, unless the service is part of the students Individual Education Program (IEP). 
   4. The termination of the Individual Health Care Plan by the lawful custodian, prescribing physician, or school must be by written notice. Otherwise, the IHCP will be terminated when the student withdraws from the Wichita Public Schools or at the close of the school year, whichever occurs first.  

Administrative Responsibility: Student Support Services 

Latest Revision Date: July 2011 

Previous Revision Date: March 1999 P5317 

Updated administratively for alignment purposes: January 2021 

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