504.11 - Student Special Health Services

The school board recognizes that there are some students who are in need of special health services during the school day.

Students with Individualized Health Plans (IHP) will receive confidential health services in conjunction with their Individualized Education Plan (IEP) or 504 Accommodation Plan.

The superintendent [or designee] in conjunction with licensed health personnel will establish administrative regulations for the implementation of this policy.


Adopted: 2/96
Reviewed: 4/12; 7/13; 10/14; 11/17; 12/20; 10/23
Revised: 9/09; 4/11
Related Policy: 504.11-R
Legal Reference (Code of Iowa): §§ 256.11(7): 256B; 273.2, .5, .9(2-3); 280.8; 281 IAC 14.2
IASB Reference: 507.08

504.11-R - Regulations Regarding Student Special Health Services

Some students require special health services to participate in their educational program. These students will receive special health services in conjunction with their educational program.

A. Definitions:

Assignment and Delegation: Occurs when licensed health personnel, in collaboration with the education team, determine the special health services to be provided and the qualifications of individuals performing the health services. Primary consideration is given to the recommendation of the licensed health personnel. Each designation considers the student’s special health service. The rationale for the designation is documented. If the designation decision of the team differs from the licensed health professional, team members may file a dissenting opinion.

Co-Administration: The eligible student’s participation in the planning, management, and implementation of the student’s special health service and demonstration of proficiency to licensed health personnel.

Educational Program: Includes all school curricular programs and activities both on and off school grounds.

Education Team: May include the eligible student, the student’s parents/guardians, administrator, teacher, licensed health personnel, and others involved in the student’s educational program.

Health Assessment: Health data collection, observation, analysis, and interpretation relating to the eligible student’s educational program.

Health Instruction: Education by licensed health personnel to prepare qualified designated personnel to deliver and perform special health services contained in the eligible student’s health plan. Documentation of education and periodic updates are on file at school.

Individual Health Plan: The confidential, written, preplanned, and ongoing special health service in the educational program. It includes assessment, nursing diagnosis, outcomes, planning, interventions, evaluation, student goals (if applicable), and a plan for emergencies to provide direction in managing an individual’s health needs. The plan is updated as needed and at least annually. Licensed health personnel develop this written plan with collaboration from the parent or guardian, the student’s health care provider, or education team.

Licensed Health Personnel: Means a licensed registered nurse, licensed physician, and other licensed health personnel legally authorized to provide special health services and medications under the auspices of the district.

Prescriber: Licensed health personnel legally authorized to prescribe special health services and medications.

Qualified Designated Personnel: Persons instructed, supervised, and competent in implementing the eligible student’s health plan.

Special Health Services: Includes, but is not limited to, services for eligible students whose health status (stable or unstable) requires:

  1. Interpretation or intervention;
  2. Administration of health procedures and healthcare; or
  3. Use of a health device to compensate for the reduction or loss of a body function.

Supervision: The assessment, delegation, evaluation, and documentation of special health services by licensed health personnel. Levels of supervision include situations in which licensed health personnel are:

  1. Physically present;
  2. Available at the same site; or
  3. Available on call.

B. Licensed health personnel will provide special health services under the auspices of the school. The duties of the licensed health personnel include:

  1. Participate as a member of the education team;
  2. Provide the health assessment;
  3. Plan, implement, and evaluate the written Individual Health Plan (IHP);
  4. Plan, implement, and evaluate the special emergency health services;
  5. Serve as a liaison and encourage participation and communication with health service agencies and individuals providing health care;
  6. Provide health consultation, counseling, and instruction to the student, parents/legal guardians, and staff in cooperation and conjunction with the prescriber;
  7. Maintain a record of special health services including the student’s name, special health services, prescriber or person authorizing, date and time, signature and title of person providing the special health service, and any unusual circumstances in the provision of such services;
  8. Report unusual circumstances to the prescriber, parents/guardians, and school administration;
  9. Assign, delegate to, instruct, provide technical assistance to, and supervise qualified designated personnel; and
  10. Update knowledge and skills to meet special health service needs.

C. Prior to the provision of special health services the following will be on file:

  1. Written statement by prescriber detailing the specific method and schedule of the special health services, when indicated;
  2. Written statement by the parent/guardian requesting the provision of the special health services;
  3. Written report of the preplanning staffing or meeting of the education team; and
  4. Written Individual Health Plan (IHP) available in the health record and integrated into the Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP).

D. Licensed health personnel in collaboration with the education team will determine the special health services to be provided and the qualifications of individuals performing the special health services. The documented rationale will include the following:

  1. Analysis and interpretation of the special health service needs, health status stability, complexity of the services, predictability of the service outcome, and risk of improperly performed service;
  2. Determination that the special health services, tasks, procedures, or function is part of the designated person’s job description;
  3. Determination of the assignment and delegation based on the student’s needs;
  4. Review of the designated person’s competency; and
  5. Determination of initial and ongoing level of supervision required to ensure quality services.

E. Licensed health personnel will supervise the special health services, define the level of supervision, and document the supervision.

F. Licensed health personnel will instruct qualified designated personnel to deliver and perform special health services contained in the Individual Health Plan (IHP). Documentation of instruction, written consent of non-administrative personnel to perform the service, and periodic updates will be on file at the school.

G. Parents/guardians will provide the usual equipment, supplies, and necessary maintenance for such unless the district is required to do so under the IDEA or Section 504 of the Rehabilitation Act. The equipment will be stored in a secured area. Personnel responsible for the equipment will be designated in the Individual Health Plan (IHP). The IHP will designate the role of the school, parents/guardians, and others in the provision, supply, storage, and maintenance of necessary equipment.

H. For students eligible under the IDEA and/or Section 504, the special school health services provided under these regulations will also comply with any additional or differing requirements imposed by the IDEA and/or Section 504.


Adopted: 2/96
Reviewed: 4/11; 4/12; 7/13; 10/14; 11/17; 12/20
Revised: 8/02; 10/23
Related Policy: 504.11
Legal Reference (Code of Iowa): § 256.11; 256B; 273.2; 273.5; 273.9; 280.8; 281 IAC 14
IASB Reference: 507.08-R(1)