Students with intensive health care needs in schools

Entitlement to education

Students with complex or intensive health care requirements are entitled to education to the same extent as all other students. This group of students is covered under the Commonwealth Disability Discrimination Act 1992 and the Tasmanian Anti-Discrimination Act 1998 which use a very broad definition of disability, including some conditions not necessarily thought of as disabilities per se. Students with complex or intensive health care requirements should attend a school setting which is as close as possible to the norms and patterns of schooling experienced by other students. The school should provide the least possible restriction on their right to lead a normal life, while adequately catering for their special needs.

Enrolling a student

The Secretary of the Department of Education has ultimate responsibility for determining the enrolment of a student with intensive health care requirements in a regular or special school.

This responsibility also falls upon the principal of the school as part of ‘duty of care’ for students in their charge. Before enrolment of a student with intensive health care requirements the principal should assess the capacity of the school to ensure that:

• the student's medical needs can be met, given appropriate planning, training and support
• the student's condition is not likely to put the student at high risk of injury or life-threatening illness (given appropriate management) or to have an adverse effect upon the learning processes or safety of other students in the school
• staffing arrangements can be made to cater for the student adequately, by using either existing staff, specifically trained auxiliary staff or specialist staff
• school personnel are prepared, informed and willing to cater for the student, and
• the procedures instigated have been approved by the student's medical practitioner.

If a student develops intensive health care requirements after enrolment in a school, the principal should address these requirements as soon as possible.

Further advice

If the principal is unable to ensure an appropriate level of care for a student with intensive health care requirements, advice and direction from the Secretary through the Learning Services General Manager should be sought.

Reviewing the situation

Principals should ensure that a student with intensive health care needs has a Medical Action Plan that is reviewed:

• annually, unless circumstances change
• when the student's medical condition changes significantly.

Definitions

In addition to the need to provide for the general health care of students there are some students who have more intensive needs. Their requirements can be described as occurring along a continuum, divided into levels:

Level 1: students who have chronic conditions that are stable or controlled.

These students are not expected to have anything untoward occur at school but may require some medication or medical treatment as a routine medical procedure. They could be described as being mildly at risk.

Examples include students requiring catheterisation care, such as students with spina bifida, and most students with cystic fibrosis.

Support personnel require understanding of:

• the condition and consequences
• what to report to parents
• information that can be shared with students, staff and parents, as appropriate, and
• routine procedures such as use of oral medication.

Level 2: students with chronic conditions which may become acute.

These students may require health care management as a disciplined routine procedure because their condition is potentially unstable. It is possible, but unlikely, that they will require crisis-care management or transfer to hospital. These students may be described as having an intermediate degree of risk.

Examples include most students with asthma, epilepsy, diabetes or HIV.

Support personnel require understanding of:

• the condition and consequences
• what to report to parents
• how to monitor for changes in condition that may need routine procedures to take place, further assessment, or medical attention, and
• how to administer medication and record the procedures appropriately.

Level 3: students who have conditions which may cause their medical status to alter very rapidly.

These students may require both routine and crisis-care support.

Examples include students with severe allergies, epilepsy with unusually severe and/or frequent seizures, asthma that does not respond to routine treatment, and children with periodic unstable diabetes.

Support personnel require an understanding of:

• procedures to identify signs that the condition is worsening, so that a potential crisis can be averted
• what to report to parents
• the condition and the consequences
• how to implement a crisis management plan specifically designed for the student's needs, and
• how to administer treatment/medication and record the procedures appropriately.

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