Specialized Health Support Services in School Setting
The provision of health support services to students in school settings is governed by the Ministry of Education Policy/Program Memorandum 81(The Provision of Health Support Services in Schools) and Policy/Program Memorandum 161(Supporting Children and Students with Prevalent Medical Conditions (Anaphylaxis, Asthma, Diabetes, and/or Epilepsy) in School Ministry of Education). These policy documents outline the shared responsibility for the provision of health support services amongst the Ministries of Education, Health and Long-Term Care and Community and Social Services. “Supporting students with health/medical conditions in schools is complex. A whole-school approach is needed where education and community partners, including health care professionals, have important roles to play in promoting student health and safety and in fostering and maintaining healthy and safe environments in which students can learn.” (PPM No.161)
The York Region District School Board believes the provision of student health, medical and/or disability supports allows students to fully access school in a safe, accepting, healthy and inclusive learning environment that improves student success and well-being. Providing health, medical, and/or disability supports empowers students as confident and capable learners, to reach their full potential for self-management of their health, medical condition(s) and/or disabilities. The safety and well-being of all students is a shared responsibility of the Board, staff, schools, families, students, health care providers and third-party health care providers.
The York Region District School Board engages the services of external partners, such as, but not limited to York Region Public Health and Third Party Service Providers to support recommendations and the provision of health, medical and/or disability supports to students, as required. The Board will collaborate with parent(s)/guardian(s) to support a safe environment for their children while at school and during school-related activities. Health Care Plan(s) and/or Essential Routine Health Care Plan(s) outline the management of known conditions and are created for students who are at known risk for specific medical emergencies and who require daily routine management that may occur at school. Health Care Plans and/or Essential Routine Health Care Plans will be referenced in the Individual Education Plan (IEP), where applicable, and in accordance with page E13 of the Ministry of Education Policy and Resource Guide: Special Education in Ontario – Kindergarten to Grade 12.
Policy and Procedure 662 - Student Health Supports Working Document outlines all of the procedures regarding YRDSB provision of health supports.
Specialized Health Support Services
School Board Regulated Health Professional (RHP) Services
| Specialized Health Support Service |
Speech and language therapy Provision of:
|
| Agency or position of person who performs the service |
YRDSB S-LP |
| Eligibility criteria for students to receive the service |
Referral to YRDSB S-LP Services by school team for students with communication needs (e.g., language, literacy, pragmatics, speech, etc.) Students can be referred from time of school entry to graduation Proactive/preventative supports in kindergarten |
| Position of person who determines eligibility to receive the service and the level of support | YRDSB S-LP |
| Criteria for determining when the service is no longer required | YRDSB S-LP |
| Procedures for resolving disputes about eligibility and level of support (if available) | YRDSB Process through School Principal |
School Board Regulated Health Professional (RHP) Services continued
| Specialized Health Support Service |
Physiotherapy and Occupational Therapy Service Provision of:
|
| Agency or position of person who performs the service | YRDSB OT or PT |
| Eligibility criteria for students to receive the service |
Referral to YRDSB PT/OT Services by school team for students who are experiencing challenges accessing their curriculum and participating fully within the school context as a result of their physical or neurodevelopmental diversity.
Students can be referred when transitioning into YRDSB, upon school entry through to graduation
Services are provided by PT/OT assigned to the school and includes services that provide support to the broader classroom, program or student specifically |
| Position of person who determines eligibility to receive the service and the level of support | YRDSB PT/ OT |
| Criteria for determining when the service is no longer required | YRDSB PT/ OT |
| Procedures for resolving disputes about eligibility and level of support (if available) | YRDSB Process through School Principal |
School Board Support for Daily Medical and Personal Care Needs:
| Specialized Health Support Service |
Provision of non-regulated daily care activities can be completed by school board personnel including Educational Assistants within the context of the Educational Day Activities include:
|
| Agency or position of person who performs the service | School Board Personnel including Educational Assistants |
| Eligibility criteria for students to receive the service |
Medical documentation provided to school Daily Care activities do not meet the criteria of a Controlled Act* and must be part of the Routine Daily Care of the Student Activities are detailed by Parents/ caregivers and outlined in Student’s Health Care Plan, Essential Routine Care Plan or Administration of Medication form |
| Position of person who determines eligibility to receive the service and the level of support | Principal, Board Regulated Health Care Professionals (RHP) (i.e.PT/ OT) |
| Criteria for determining when the service is no longer required | Provision of medical directions, re-assessment from board RHP (PT/OT) |
| Procedures for resolving disputes about eligibility and level of support (if available) |
Principal and/or Student Services Coordinator |
Local Health Integration Network (LHIN) Services
|
Specialized Health Support Service |
Agency or position of person who performs the service |
Eligibility criteria for students to receive the service |
Position of person who determines eligibility to receive the service and the level of support |
Criteria for determining when the service is no longer required |
Procedures for resolving disputes about eligibility and level of support (if available) |
|
Nursing Services Provision of the following activities that meet criteria of a Controlled Act*:
|
Local Health Integration Network (LHIN)
|
Meets the criteria as outlined in PPM81 for provision of required nursing care including provision of controlled acts* that are required during the instructional day
Referral from Doctor And provision of Medical Directives to LHIN |
LHIN Care Coordinator |
LHIN Care Coordinator |
LHIN Process |
|
Nutrition Services provided by a Registered Dietitian |
LHIN |
Meets the criteria for LHIN referral to Dietitian Services |
LHIN Care Coordinator |
LHIN Care Coordinator |
LHIN Process |
*Controlled Acts as outlined in the Regulated Health Care Professional Act(1991) defines a controlled act as an activity that can cause harm if it is performed by an unqualified person e.g. Registered Nurse.
Children’s Treatment Network (CTN) Hosted Rehabilitative Services delivered under partnership by YRDSB Regulated Health Professionals (PT, OT, and S-LPs)
| Specialized Health Support Service | Occupational therapy |
| Agency or position of person who performs the service | Children’s Treatment Network (CTN)** |
| Eligibility criteria for students to receive the service |
Students must meet the criteria as outlined by CTN for hosted rehabilitation services specifically a physical disability that impacts their physical functioning and is based on a long-term neuromotor, neuromuscular, select orthopaedic conditions or acquired brain injury within the last 2-5 years. Services are provided to address post-acute needs, post-surgical, home and community needs. |
| Position of person who determines eligibility to receive the service and the level of support | CTN Access Team |
| Criteria for determining when the service is no longer required | CTN Assessment |
| Procedures for resolving disputes about eligibility and level of support (if available) | CTN Process |
Children’s Treatment Network (CTN) Hosted Rehabilitative Services delivered under partnership by YRDSB Regulated Health Professionals (PT, OT, S-LP) Continued
| Specialized Health Support Service | Physiotherapy |
| Agency or position of person who performs the service | CTN** |
| Eligibility criteria for students to receive the service |
Students must meet the criteria as outlined by CTN for hosted rehabilitation services specifically a physical disability that impacts their physical functioning and is based on a long-term neuromotor, neuromuscular, select orthopaedic conditions or acquired brain injury within the last 2-5 years. Services are provided to address post-acute needs, post-surgical, home and community needs. |
| Position of person who determines eligibility to receive the service and the level of support | CTN Access Team |
| Criteria for determining when the service is no longer required | CTN Assessment |
| Procedures for resolving disputes about eligibility and level of support (if available) | CTN Process |
Children’s treatment network (CTN) Hosted Rehabilitative Services delivered under partnership by YRDSB Regulated Health Professionals (PT, OT, and S-LP) Continued
| Specialized Health Support Service | Augmentative and Alternative Communication supports (AAC) |
| Agency or position of person who performs the service |
YRDSB S-LP
YRDSB ACCS Team includes S-LP, CDA and OT)*** |
| Eligibility criteria for students to receive the service |
Referral by school team for students who are non or minimally verbal Referrals to ACCS Service are completed by YRDSB S-LP following their involvement as per CTN-ACCS referral criteria |
| Position of person who determines eligibility to receive the service and the level of support |
YRDSB S-LP
CTN ACCS Administrator |
| Criteria for determining when the service is no longer required |
YRDSB S-LP
CTN ACCS Assessment |
| Procedures for resolving disputes about eligibility and level of support (if available) |
YRDSB Process through School Principal
CTN ACCS Process |
**CTN Hosted Rehabilitation OT and PT services are delivered by YRDSB OT and PT staff via the CTN Hosted Partnership agreement. Hosted OT and PT services are delivered in clinic, home and community. Services work in collaboration with YRDSB school based OT/ PT services to address issues across school, home and community.
***Augmentative Communication Consultation Services (ACCS) are delivered by YRDSB S-LP, CDA & OT via the CTN Hosted partnership agreement. ACCS Services are provided in school, home and community settings.
Children’s Treatment Network (CTN) School Based Rehabilitative Services (SBRS) delivered by subcontracted External Providers *formerly the School Health Support Services (SHSS) Programs
|
Specialized Health Support Service |
Agency or position of person who performs the service |
Eligibility criteria for students to receive the service |
Position of person who determines eligibility to receive the service and the level of support |
Criteria for determining when the service is no longer required |
Procedures for resolving disputes about eligibility and level of support (if available) |
|
Speech correction and remediation (Provision of direct therapy for articulation, voice and/or fluency) |
Children’s Treatment Network - School-Based Rehabilitation Services (CTN-SBRS) |
Referrals to CTN SBRS S-LP Service are completed by YRDSB S-LP following their assessment as per CTN SBRS S-LP referral criteria
|
CTN-SBRS Administrator |
CTN-SBRS Assessment |
CTN-SBRS Process
|
|
Provision of acute chest/cardio- respiratory therapy |
SBRS PT |
Referral by School Board Occupational or Physiotherapist as per CTN SRBS Criteria |
Provision of acute chest/ cardio- respiratory therapy |
CTN- SBRS Assessment |
SBRS/ CTN Processes |
****Provision of rehabilitation services that augment services provided by the school board and do not duplicate Board services