Educational staff and health care professionals are important partners in a community-based system of care for children with special health care needs (CSHN). Early intervention staff, teachers and primary health care providers can support each other in providing high quality and comprehensive services to these children and their families.

There are a number of important health issues that need to be addressed as part of a child's entry into or regular review of services in an eduation program.

For example,

• Does the child need to take medications at school?
  
• Does the child require a special diet or feeding program at school, e.g. suctioning, clean intermittent catheterization?

• Does the child need other special procedures/treatment at school?
  
• Does the child need adjustment in the classroom schedule or environment (e.g. a child who is easily fatigued or a child with peanut or latex allergy).
  
• Are there major safety considerations (e.g., safety of feeding a child with chronic lung disease on supplemental oxygen)?

• Do educational staff need more information on the diagnosis, a specific treatment or side-effects of treatment?
  
• Do educational staff need to monitor a specific health concern, e.g., seizure frequency?

Does this child need an individual health care plan (IHCP) and emergency management plan for this child for school and school-related activities? In general, children who require medications, special procedures, adjustment in the school schedule/ environment or special safety precautions will need an emergency management plan.  In addition, children who require direct nursing services for any reason or who fit the definition of "medically fragile" also will require an IHCP and emergency management plan.

Does the child need referral to health services? In general, consider referral to a health professional if:

• Child does not have a primary care MD
• Family has ongoing concerns about the child's health
• The cause (etiology) of the child's developmental disability and related problems is not known
• There has been a recent increase in symptoms or failure to make expected progress
• The child has frequently missed school due to illness
• The child needs formal hearing or vision testing

This section provides you with our guide to State and local services, tools to obtain meaningful health information from health care providers and families; one example of a protocol to help determine a child's need for nursing and other health related services in EI/ECSE; a general guidance on school services for students with chronic conditions developed by the National Heart Lung and Blood Institute; an example of a school health program for children with asthma developed by the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention; and an example of a specific health and school emergency management plan (Asthma Management in Educational Settings) available through the Center for Children with Special Needs, Seattle.

Resources

• Health Screening Questionnaire for EI/ECSE (Parents)
• Health Information Questionnaire (Health Care Providers)
• Health Screening Project for Early Intervention
• Student with Chronic Illness: Guidance for Families, Schools, and Students
• School Health Program for Asthma
• Asthma Individual Health Plan

An additional resource is Children and Youth Assisted by Medical Technology in Educational Settings, 2nd Edition, S Porter, M Haynie, T Bierle, TH Caldwell, and J Palfrey (Eds.), Paul H Brookes Publishing Co., Baltimore, 1997.  This is an excellent comprehensive review that presents a wealth of practical information as well as useful forms and checklists, including examples of Individual Health Care Plans and Emergency management plans.

EI/ECSE staff also should become familiar with resources for audiologic (hearing) testing and qualified children's eye specialists to help support families and health care providers in identifying and monitoring young children with potential hearing and vision impairments.

What care coordination services are available to assist families in your community? The Primary Care office is an important resource for care coordination services. In addition to services in the child's primary care office, the Child Development and Rehabilitation Center (CDRC) supports three local programs that provide assistance with care coordination and related services. They are the CaCoon program (Care Coordination), the Community Connections Network and our Medical Home Resource Teams. Limited care coordination services may also be available through the Exceptional Needs Care Coordination (ENCC's) of your child's health plan.

How can educators support medical home improvements? We encourage you to:

• Make sure that referral information (who to contact) for Early Intervention/Early Childhood Special Education (EI/ECSE) and other special education services is readily available to families and providers in primary care offices (e.g., brochures, posters, and contact lists).
• Regularly request (at least annually) health care information on children with special health needs and regularly update the primary care provider on the child's school progress.
• Identify ways to improve communications with primary care physicians - determine who to contact (is there an office care coordinator, what is the best way (phone, fax, or email) and time to discuss individual children, and how much information is appropriate (in general a brief summary is more likely to be read than a copy of the entire IFSP).
• Request health care information and encourage the participation of primary care providers in IFSP/IEPs.
• Meet regularly (annually or bi-annually) with primary health care providers (pediatric group or medical staff meeting) to update them on the EI/ECSE and special education services in your district.
• Encourage health professionals to participate in community planning groups.
• Identify medical home initiatives in your state and area and become familiar with medical home resources and materials.
• Attend a medical home training.

Note: The information and resources in this section are provided for educational purposes only. The information is not intended to provide medical advice or professional services and should not be used for treating a health care problem or disease and certainly not a substitute for professional care. If you have questions about some of this information, please talk with your health care provider.

In addition, resources information may change rapidly. If you notice an error in the referral guide or other materials, please contact us.