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2.6 Specialized Health Support Services in School Settings

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:

  • Assessment
  • Intervention
  • Consultation
  • Programming support for student(s) who present with speech and/or developmental language disorder
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:

  • Assessment
  • Intervention
  • Consultation
  • Programming support for student(s)
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:

  • Oral feeding
  • Shallow suctioning
  • Toileting
  • Non-sterile catheterization
  • Lifting and positioning
  • Assistance with mobility and equipment
  • Administration of oral medication (non-controlled act* medication)
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*:

  • Deep Suctioning
  • Management of tracheostomy
  • Management of mechanical ventilation 
  • Sterile Catheterization
  • Enteral tube feeding including N-G, Tube, G Tube, G-J Tube or J tube
  • Administration of medications 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