Providing Safe Health Care:
The Role of Education Support Professionals

Published by the National Education Association ESP Quality Program and the National Center for Innovation

Introduction

Safe and healthy children: In every school this is the bottom line, the foundation necessary for effective teaching and learning. Everyone who works in schools shares the common goal of ensuring students' well-being. As Education Support Professionals, we meet the challenge in a variety of ways, from providing a safe bus ride to school, to cooking nutritional lunches, to offering individualized attention in large classes.

Our student populations are changing in ways that make meeting the bottom line as crucial as ever, but more complicated. In recent years, greater numbers of students with disabilities are attending their neighborhood schools. In some instances, they come to school with physical conditions that require care and attention:

• Children with diabetes may need insulin injections during the school day.
• Children with gastrostomies need to be fed while they're at school.
• Children with spina bifida may need to be helped with catheterization.
• Children with epilepsy need medication at school to help control seizures.

But who provides that care? In an ideal world, every school would have licensed, certified health care personnel on the premises who would ensure the safety and well-being of our students by attending to their special health care needs. The National Education Association fully supports this position: At the 1995 convention, the NEA adopted a new business item opposing "any law, policy, or regulation that supports, permits, or requires any educational personnel who are not medically certified or licensed to perform any medical services or invasive procedures."

But this isn't an ideal world. In reality, more students with special health care needs are attending schools at a time when school district resources in many communities are level or declining, and when school nurse positions are often among the first to be pared back. The best available estimates indicate that only about one of three public schools has a full-time nurse on staff. In this environment of increasing demands, Education Support Professionals (ESP) are often asked, expected, or ordered by their supervisor to provide care and assistance to students with special health care needs.

It is the increasing expectations placed on Education Support Professionals that led to the creation of this handbook. It is written for the educational support person, who may or may not be a trained or licensed health care provider, but whose job has come to include caring for students with disabilities with special health care needs. It aims to provide guidance on many questions that arise for the ESP who works with these students, questions that include:

• What can I do to ensure the health and safety of students in my care who have special health care needs?
• What are my responsibilities as an educational support person and care provider?
• How can I get the training and supervision I need to care properly for students?
• Where can I go to get more information, as well as ideas for protocol and policy?
• How can my NEA affiliate help?

Providing Safe Health Care: The Role of Education Support Professionals is organized around these questions. Section 1, "The Laws Governing the ESP and the Care of the Student with Special Health Care Needs," discusses the legal precedents that have made our schools more inclusive, and the legal requirements surrounding health-related services in schools. Section 2, "Protocol for the Care of Students with Special Health Care Needs," outlines the chain of command for providing health care in local districts-both as it is, and how it can be improved. Section 3 and Section 4 outline training that can prepare ESP to better meet the health care needs of students in their care, and explain ways you can take action to ensure student and employee safety. Finally, the handbook offers a Glossary. (The Microsoft Word version and the hard-copy version of this publication which you can purchase from the NEA Professional Library also contain a Resources section and Endnotes.)

The goals of Providing Safe Health Care: The Role of Education Support Professionals are to:

• Inform Education Support Professionals and others at the school site about legal requirements relevant to providing safe health-related services to students, and
• Provide guidance regarding practices and policies that can empower Education Support Professionals to provide for the health and safety of students with special health care needs, and at the same time protect themselves from being placed in a situation requiring inadvisable, illegal, or dangerous actions.

Education Support Professionals, working with teachers, parents, school administrators, NEA local affiliates, and others, can play a powerful role in adopting and implementing programs and policies that ensure the safety and well-being of all children.

Our hope is that you will use this handbook as a pocket guide to your responsibilities and goals in working safely with students with disabilities with special health care needs.

To Section 1