News
School Health Services
No Child Left Behind
Anaphylaxis and Iowa
School Districts
Lighten
Up Iowa
Iowa's Eduportal
Medicaid
Administrative Claiming
Healthy And Well Kids in Iowa (hawk-i) Update
Iowa Statewide Poison
Control Center
School Health Program News
Iowa School Nurse
Listserv
Frequently Asked
Questions and Answers
Future Iowa
Conferences
Resources
Calendar
News: School Health
Services Newsletter
No Child Left Behind
(NCLB), formerly the Elementary and Secondary Education Act (ESEA) covers
funding for multiple federal education programs. Letter two, November 20 from
Judy Jeffrey, Administrator, Division of Early Childhood, Elementary, and
Secondary Education provides public school districts continuing information on
the NCLB requirements. The state has not received final rules for many parts of
the NCLB bill therefore, the letter addresses what is known at this time. Some
requirements could be more clearly defined over the next few months and as
information is received, it will be sent to districts.
The DE is aligning the new federal program requirements
under NCLB into the CSIP requirements. This information will be presented for
district teams: February 4 (Council Bluffs), February 5 (Sioux City), February
11 (Davenport), February 12 (Cedar Rapids), and February 25 (West Des Moines).
The participant outcomes of this awareness session focus on: Iowa policy
history; relationships among local, state and federal efforts and student
effects; how data from multiple sources interact to establish priorities;
alignment of needs, goals, and actions; and the incorporation of best practices
for professional development into the plan. More information at http://www.state.ia.us/educate/ecese/nclb/documents.html
The
Iowa Department of Public Health, Bureau of Emergency Medical Services
recommendation for Anaphylaxis in School is: “The individual school systems
engage in planning taking into consideration their total population of
students, risk stratification of students (known history of allergies),
proximity of the nearest EMS service program(s) and the location of clinics and
hospital emergency departments when determining maintenance needs for stock
supply of epinephrine in schools. Resource support could be obtained from your
county health department if needed to assess your situation and related needs.”
Timothy Peterson, MD, EMS Medical Director, IDPH, Bureau of EMS wrote the
recommendation, November 18, 2002. More information
on EMS can be found at http://www.idph.state.ia.us/pa/ems/default.asp Additional references at: AAAAI Position
Statement 26-Anaphylaxis in Schools and Other Childcare Settings, 1998, JACI,
102:2; August 1998, pp.173-6, http://www.aaaai.org/media/resources/position_statements/ps26.stm;
Position Statement 34-The Use of Epinephrine in the Treatment of
Anaphylaxis, JACI; 94:4; October 1994; pp. 666-668, http://www.aaaai.org/media/resources/position_statements/ps34.stm; and Academy of Pediatrics, Guidelines for Emergency
Medical Care in School (RE9954), Pediatrics 107:2, February 2001, pp. 435-436, http://aap.org/policy/re99.54.html.
Lighten Up Iowa is a five-month competition (January 6,
2003-June 6, 2003) encouraging Iowans to develop healthy activity and eating
habits with the ultimate goal of losing weight. Iowans are encouraged to form
teams of up to ten people and go the distance! Team competition will recognize
achievement in two areas: weight loss due to healthy, appropriate diet and
exercise and accumulated activity in the form of miles. Certificates will be
awarded for levels of achievement with the top teams officially recognized at
the 2003 Summer Iowa Games. Lighten Up entry form at lightenupiowa.org
The Iowa Eduportal contains over sixty forms in
twenty-three languages and our state IEP in Spanish, Bosnian, Vietnamese, and
Lao. Each district and AEA enrolls in the Eduportal with their own unique user
name and password to track usage. "Live Help" is available on the
site. For additional information go to http://www.state.ia.us/educate/ecese/is/ell/links.html or
contact Dolores Ratcliff, Consultant, Instruction of Unique Learners, Iowa Department
of Education, phone 515-242-5461.
Medicaid
Administrative Claiming (MAC)
Medicaid
Administrative Claiming Lead Agencies received a letter December 2, 2002 from
Sally Nadolsky, Iowa Department of Human Services (515-281-5796), Anieta
O’Hair, Iowa Department of Human Services (515-281-5496), and Janet Beaman,
Iowa Department of Public Health (515-281-3052) regarding MAC Policy Change.
Parts of the letter follow:
Effective
January 1, 2003, the enhanced Federal-matching rate of 75 percent will no longer be available for the
activities performed by SPMP school staff according to the guidance from the
Centers for Medicare and Medicaid Services (CMS) on Skilled Professional
Medical Personnel (SPMP) in the school setting.
All
claims submitted from the school setting for the quarter beginning January 1,
2003 will be calculated at 50%. There is a diskette containing the modified
spreadsheet consisting of the revenue offset worksheet and quarterly claim
adjusted for the 50% FFP. Lead agencies are responsible to assure that all
local school district claims for the quarter beginning January 1, 2003 and
beyond are submitted using this template. If the claims are not submitted in
accordance with the instructions in this memo, they will be returned for
revision and resubmission.
The Council of State School Officers (CSSO) web site contains the
draft MAC guide in school based settings http://www.ccsso.org/ClaimingGuide.html.
States have until the beginning of the 2003-2004 school year to comply
with the provisions contained in the
guide. When the guide is finalized, Iowa will work with CMS on Iowa changes
followed by statewide training.
Healthy And Well Kids in Iowa (hawk-i) Update
▪ 4 counties with less than 40% ▪ 25
counties with 60-69%
▪ 23 counties with 40-49% ▪ 5 counties with
70-79%
▪ 40 counties with 50-59% ▪ 2 counties with
greater than 80%
Wellmark’s
Generic Drug Plan-Questions and Responses
1. If a hawk-i enrollee chooses a brand name
prescription instead of a generic (where there is a generic equivalent) does
the enrollee pay the entire cost of the prescription or does Wellmark pay up to
the amount that the generic would cost and the enrollee pay the remainder? If there is a generic equivalent and the hawk-i
enrollee chooses the brand name drug, then the hawk-i enrollee pays the
entire prescription cost.
2. If there is no
generic equivalent to a brand name drug, is there a cost to the hawk-i enrollee? There are two answers to this question. The hawk-i
enrollee pays for the drug if it is not on the list. If the drug is on the
list, the hawk-i enrollee does not have to pay.
3. In the process
of granting exceptions for coverage of brand name drugs, are adverse side
effects considered? (For example, a child has night terrors from using a
generic equivalent drug.) These are
handled case by case. When an instance like this occurs, Wellmark reviews the
individual case.
The
Covering Kids and Families School Based Outreach Committee met to discuss the Free and Reduced Lunch Application Form.
Currently the Free and Reduced Lunch Application Form has a mandatory passive
consent for families to receive information about hawk-i. (Every school
receives the Free and Reduced Lunch Form that states if you do not sign the
form; you will receive information about hawk-i.) When schools do not turn in
the requests to MAXIMUS, parents believe they will receive information about hawk-i
but then do not.
A
full-time Grassroots Outreach Coordinator will be selected by February 2003.
The next ICN Outreach Task Force meeting is January 9, 1:00 p.m.-3:00 p.m.
Topics will include updates on hawk-i, Covering Kids and Families,
and presentation on working with DHS income maintenance workers.
November
2002 the total number of children enrolled in hawk-i was 13,998. hawk-i
information and demographics are available at www.hawk-i.org/statedir Username: wildrose Password: goldfinch
The Iowa
Department of Public Health http://www.idph.state.ia.us/odedp/smallpox.htm and the Centers for Disease Control and
Prevention http://www.bt.cdc.gov/agent/smallpox/index.asp web sites have
current smallpox information, telephone numbers, and other information. The
sites continually post updates.
The Iowa Dental Care
for persons with disabilities provides up to $300 of free dental services for
children with disabilities from low-income families. School nurses help ensure
this program continues by referring students for dental care. For information
call or write to Gayle Gilbaugh, Project Coordinator, 100 Hawkins Drive, Center
fort Disabilities and Development, Dentistry Department, Iowa City, Iowa
52242-1011; phone 319-356-1513; e-mail gayle-gilbaugh@uiowa.edu
This statewide poison
control center was formed by linking services previously provided by two
separate centers. Its mission is to reduce morbidity, mortality, and costs
associated with poisonings, through providing statewide 24-hour telephone
management, consultation, poison prevention information, public and
professional education and research for the people of Iowa. The Statewide
Poison Control Center telephone number is 1-800-222-1222. Pamphlets and
stickers may be ordered at
http://www.iowapoison.com/
School
Health Program News-Education Development Center (EDC)
The School Health Program News (SHPN)
newsletter, funded by the Centers for
Disease Control and Prevention (CDC), Division of Adolescent and School Health
(DASH) and compiled by EDC promotes the concept of Coordinated
School Health Programs. The Newsletter, published three times a year (January,
May, and September) includes summaries of relevant research findings,
descriptions of model programs, interviews with recognized experts in the
field, and an extensive listing of available resources, conferences, and
training opportunities. SHPN editions from the last two years,
using adobe acrobat reader, at http://www2.edc.org/makinghealthacademic/Newsletter/volumes.asp Also access at http://www2.edc.org/makinghealthacademic/newsltr.asp
Future Iowa School Health Services Newsletters
will contain only Iowa News with monthly updates posted on the listserv. The School Health Programs News will be the
National News source for Iowa School Nurses.
Please access and read the SHPN three times a year.
Iowa School Nurse
Listserv-Please Sign On
The Iowa School Nurse (iowasn) Listserv allows you to send e-mail
messages to a large group of Iowa school nurses. You can use the listserv to
request information or advice and share news and initiatives with others on the
listserv. School nurses joining the iowasn listserv will add their e-mail
address to the online school nurse mailing list and can send messages to all
members at any time. When you post messages, the message automatically goes to
everyone on the list. Replies to a message also are sent to everyone on the
list, not just the original sender.
Joining the Iowa School Nurse Listserv. To join the
listserv, send an e-mail to: majordomo@listserver.iowaccess.org
with the words: subscribe iowasn in the body of the message. You receive a
verification notice after subscribing. You can cancel your membership the same
way, except, in the body of the message, type the words: unsubscribe iowasn
Sending Messages. To send a message to other
school nurses, type your title in subject, your message in the body, and send
to iowasn@listserver.iowaccess.org No other special commands are necessary and
joining is free.
Frequently Asked Questions and Responses
Question-Calendar of National Events
Where can I find a calendar of national health days?
Response-Access National Health Observances
at http://www.healthfinder.gov/library/nho/
Question-Child Abuse and Dependent
Abuse Education Are the requirements for Child Abuse
Education the same for licensed teachers and licensed nurses?
Response-No. The licensing board sets the
requirements. The Board of Educational Examiners (BoEE) requires proof of the
new education course on license renewal. The BoEE only has authority over those
school nurses who have an endorsement [282-IAC 14.140(11)] to teach health. The
Board of Nursing requires a course every five years. If a nurse took the course
in the last five years, the course meets licensing requirements. Renewing a
nursing license, the nurse responds to the questions: In your employment/self
employment as an RN or LPN, do you examine, attend, counsel, or treat children
or adults on a regular basis? If you answered yes, you must check one of the
boxes below:
__ Within the last five years, I have completed
the training program/s related to identification and reporting of child and/or
dependent adult abuse.
__ I am exempt from the abuse training
requirement because I am serving active duty in the military.
__ I am exempt for the abuse training
requirement because I hold a current waiver from the board.
__ None of the above choices, A through C, are
true.
The
course does not have to be offered by an IBON approved provider although it may
be.
Question Classroom
Self-management by a Student with Diabetes In our district there is a student with
diabetes whose parents REALLY want to self manage his diabetes in the classroom
(testing, taking insulin, and treating highs and lows). How responsible is the
school or an RN when there will not be an available adult in the classroom to
double check numbers or help trouble-shoot highs and lows? Is there a good
response for any upset parent that may call school and complain about this
happening in the classroom (disruption, exposure, students that have 'weak
stomachs'?
Response-The IHP is the key to service
implementation. A student’s IHP planned with the parents, student, physician,
and education staff determines the school services. Consider and include all
your questions when writing the plan. The plan could offer these student
opportunities to learn needed life-long living skills in a helping environment.
Address the level of supervision needs by the student and the supervision
details in the plan. The school and RN are responsible for what happens on its
property. Education of the participants, parents, and peers would also be an
important part of the plan.
Question-Cold Weather and Outside
Activities What policies or guidelines are available
for outdoor activities during cold weather?
Response-Understand the Weather Wind-Chill (30
is chilly and generally uncomfortable, 15 to 30 is cold, 0 to 15 is very cold,
-20 to 0 is bitter cold with significant risk of frostbite, -20 to -60 is
extreme cold and frostbite is likely, -60 is frigid and exposed skin will
freeze in 1 minute. See weather chart at
http://www.idph.state.ia.us/ and search for weather or
http://www.idph.state.ia.us/fch/fam_serv/hcci/products/weatherwatch.pdf
Question-Head Lice Five years ago Dr. Russell Currier talked with us about
head lice. After his visit, we changed our district policy. Before, when a
child was discovered with head lice they were sent home as soon as we could find
someone to pick them up. Sometimes they would sit out of class for hours
waiting. Now when students are identified with lice the family is notified and
the following day the child is checked for treatment. If live lice are found,
and nothing has been done, the policy is that they will be sent home that day.
It is then counted as an unexcused absence. We do realize that it may take some
time to be lice free, and do not send them home if nymphs or eggs are found on
the recheck, but we continue to follow up on the progress. We just need to see
that the parents are working on the problem. Occasionally there are some
problems in this area. I know that the Iowa Communicable Disease Chart shows
that there is no exclusion from school for head lice. I would be interested to
know what the current thinking is on head lice policies in Iowa schools.
Response-IDPH recommendations are in the pamphlet, Getting Rid of Head Lice. It describes head lice, the recommended 14-day treatment
process, and children with head lice do not need to be sent home or miss school
at http://www.idph.state.ia.us/fch/fam_serv/hcci/products/lice.pdf Mass
screenings have not proven effective and are not recommended. Another resource-Head Lice Statement: AAP Discourages
"No Nit" Policies For School Return
http://www.aap.org/policy/0203.html
Question-IHP If
a student is taking ADHD medication at school, is an IHP required and is the
IHP attached to the IEP?
Response-The nurse determines the need for an
IHP. If the medication administration requires professional nursing judgment
this indicates the need for an IHP [“individual health plan when administration
requires ongoing professional health judgment”-281 IAC 41.12(11) b]. Indicate
the medication administration time, frequency, and provider on the IEP. If
there is an IHP, the location is noted. The IHP is similar to a teacher’s
lesson plan and is not attached to
the IEP.
Question-Iowa Vision Screening Program Guidelines, March 2001 What are the recommendations for school vision
screening?
Response-Local districts set vision screening
policy and procedures. The Iowa Vision
Screening Program Guidelines, March 2001 page 14, table 2 recommend the
following screening: preschool and kindergarten (one screening ages 3-5);
elementary grades 3 and 5; Middle and High at the discretion of local district
(committee felt this age would self-refer). Equipment is available for loan from
the AEA. Additional reference Guide to
Clinical Preventive Services Report of the U.S. Preventive Service Task Force,
Screening for visual impairment
http://cpmcnet.columbia.edu/texts/gcps/gcps0043.html
Question-Medicaid Direct
Service Billing Explain the
needed detail in the Individualized Education Program (IEP) for Medicaid Direct
Service Billing. Should ALL services have a time and frequency? Can billing be for a full day of one
on one nursing services?
Response-In the education setting,
the IEP is the authorizing agent for billing. The assessed need for the service
is indicated in the PLEP. This may be a concise summary. Note the specific
details in the Individual Health Plan (IHP) and the existence and location of
the IHP in the IEP. The service page must list ALL services, provider, time,
and frequency. This is the authorized time billable for Medicaid service. If
the service takes additional time, it is not
billable. If the service time changes dramatically, the IEP may be reconvened
to change the time. Billing for one on one nursing services providing CONSTANT and ONGOING
services requires rationale and documentation of needed services in the IEP.
These services may include monitoring, assessment, interventions based on
assessment, routine interventions (for example oxygen saturation every hour).
Equally important is the ongoing documentation of the monitoring, assessment,
results of assessment, and interventions, billing for the full day. The
documentation would have to be at least every hour, and the nurse would provide
health services. Assistance with education activities is not billable (for example helped with math). For more information
contact Dann Stevens Dann.Stevens@ed.state.ia.us
Question-Mononucleosis There are two known mononucleosis cases in different
parts of our school building. One parent was told to keep their child home for
a week and the other parent was told their child could attend half days. I need
information.
Response-Judy Goddard, IDPH Nurse
Epidemiologist, states after diagnosis students do not have to be excluded from
school. However, if the doctor determines the student's health does not allow
them to attend and benefit from school this decision considers the individual
student's health status. If the student is not well enough to learn they could
have various school attendance patterns to meet their individual health needs.
Judy also emphasized continuing education on maintaining good health including
mono symptoms, epidemiology, and prevention (hand washing and no sharing
involving saliva).
Question-National School Nurse Day When is National School Nurse Day?
Response-National School Nurse Day was always the fourth Wednesday in
January. The National School Nurse Day 2003 is May 7. After numerous requests
to incorporate this day into National Nurse Week, May 6-12, NASN will begin
celebrating this day on the Wednesday within National Nurse Week beginning in
2003. For more information, visit the School Nurse
Recognition page at http://208.5.177.157/recognition.htm
February 9-11 State Parent-Educator
Connection Annual Conference (PEC) Ames,
http://www.state.ia.us/educate/ecese/cfcs/idea/pecc.html
March 25-26 Public
Health Conference: CHANGING THE FUTURE, Scheman Conference Center, Ames. This Conference provides an excellent
opportunity to gather information and resources, share experiences, discuss
policy issues and strategies, and connect with each other. Through plenary
sessions, concurrent issue-based sessions, round tables, and business meetings,
conference participants will have the opportunity to explore the future of
public health and learn how to maximize resources to ensure quality programs
and services that reflect the core functions of public health: assessment,
policy development, and assurance. For more information, visit www.iowapha.org or www.ieha.net
Sponsors include the Iowa Public Health Association; Iowa Environmental
Health Association; Iowa Department of Public Health: Bureau of Family Health,
Bureau of Nutrition, Bureau of Oral Health, and the Center for Local Public
Health Services & Health Improvement; University of Iowa College of Public
Health; Child Health Specialty Clinics; and Des Moines University.
April 4-5 ISNO,
Adventureland Inn, Altoona
August 14-15 Governor’s
Conference on Public Health-Barn Raising IV. Overview and a link for more
information at http://www.idph.state.ia.us
October 7-8 Mental
Health Conference-Tribal Topics & Leaders, Ames. Overview and a link for
more information at http://www.idph.state.ia.us
September 25-26 School Nurse Conference, West Des Moines, Nancy Lathrop
319-335-7075
Resources
ADHD: New Non-Stimulant Drug The Food and Drug Administration has approved the first
new drug in three decades for treatment of the symptoms of attention deficit
hyperactivity disorder (ADHD). Strattera (atomoxetine), marketed by Eli Lilly
and Company, is not defined as a
stimulant under federal drug laws, and appears to have no potential for abuse.
http://www.healthinschools.org/2002/nov27_alert.asp
Adolescents Most Sensitive To
Addictive Drugs, Study Says A new study reveals that the
adolescent brain may be more sensitive to addictive drugs such as cocaine and
amphetamines, than the brains of adults or newborns. The study, published in
the Neuroscience journal, found a greater increase in gene-regulating protein
in the brains of adolescent mice after long-term exposure to the drugs than in
very young or adult mice. More at
http://www.jneurosci.org/cgi/content/abstract/22/21/9155.
Asthma
The updated National Asthma Education and Prevention Program (NAEPP)
Guidelines is now on the web at
http://www.nhlbi.nih.gov/guidelines/asthma/index.htm and click on Full Report-Update 2002. A
print version will be available from the NHLBI Health Information Center around
February 2003. Also posted, is the Asthma Data and Surveillance information
sheet explaining apparent discrepancies in asthma prevalence estimates
resulting from changes in National Health Interview Survey methodology in 1997.
To view or download the information sheet, go to http://www.nhlbi.nih.gov/health/prof/lung/index.htm and click on Asthma Data and Surveillance.
Autism Information Center The Centers for Disease Control and
Prevention (CDC) has an online Autism Information Center. The center includes
information about autism spectrum disorders (ASDs); CDC and other federal
activities; state activities funded by CDC; education, services, research
resources; and activities to help children use the Internet to learn about
ASDs. The information center web site will be expanded over time. Autism
Information Center at http://www.cdc.gov/ncbddd/dd/ddautism.htm
DARE-New Study
The University of Akron evaluated the new D.A.R.E. (Drug Abuse
Resistance Education) 7th grade curriculum. The findings show improvements in
students' decision-making skills, drug refusal skills, and beliefs that drug
use is socially inappropriate. The new curriculum is delivered through
D.A.R.E., which operates in 80 percent of U.S. school districts. The Robert
Wood Johnson Foundation funded the study. Access the full press release at http://www.asapstudy.org/media/mediapage.html
Data-Updated State Health Data Available on State Health Facts Online State Health Facts Online, a free Internet resource from the Kaiser Family Foundation, updates and provides new data on nearly 50 topics. The design of the State Health Facts Online allows journalists, state and federal policymakers, researchers, and the general public access to health po