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4884-1724-9679, v. 1 <br />ORANGE COUNTY SCHOOLS <br />(OCS) PERSONNEL <br />ORANGE COUNTY HEALTH DEPARTMENT <br />(OCHD) PERSONNEL <br />● Excludes any student from school who does not present <br />documentation of immunizations that complies with G.S. 130A- <br />440 <br />● Completes HATF accurately and <br />completely <br />School Nurse <br />● Reviews each cumulative folder/health folder for the presence of <br />a completed HATF <br />● Informs parent/guardian when HATF is not present in cumulative <br />folder/health folder or when mandatory components of the form <br />are incompletely/incorrectly completed <br />● Keeps principal informed of students not in compliance <br />● Assists parents in obtaining kindergarten physicals as needed <br /> <br />E. Health Assessment Transmittal Form (Grades K-12) <br />Objective: To assist schools in complying with North Carolina G.S. 130A -440 (B). (NOTE: Children entering NC Public Schools <br />for the first time must present an appropriately completed Health Assessment Transmittal Form within the first 30 days of <br />enrollment.) <br />School <br />● Informs parent/guardian of requirements and have <br />parent/guardian read and sign registration form acknowledging <br />having been advised of requirement <br />● Informs parent/guardian of consequences of not completing form <br />OCHD Staff <br />● Schedules appointments for assessments <br />● Advises clinic manager if appointments <br />slots are not available within the timeframe <br />needed <br />Principal <br />● Excludes any student from school who does not present a <br />completed form in accord with G.S. 130A-440 (B). specifications <br />OCHD Clinical Staff <br />● Completes form accurately and completely <br />School Nurse <br />● Reviews each cumulative folder/health folder for the presence of <br />a completed form <br />● Informs parent/guardian when form is not present in cumulative <br />folder/health folder or when mandatory components of the form <br />are incompletely/incorrectly completed <br />● Keeps principal informed of students not in compliance <br />● Assists parents in obtaining health assessments as needed <br /> <br />F. Children with Special Health Care Needs <br />Objective: To identify and coordinate management of health problems that may interfere with learning and comply with the <br />State Board of Education Policy on “Special Health Care Services” (policy #GCS-G-006-.0402) <br />i. Counseling and Consultation <br />School <br />● Includes the nurse as a member of one or more of the following <br />committees (504, SAT/STT, IEP team) where students may be <br />identified and referred for nursing and other health care <br />interventions <br />● Provides the nurse access to records of exceptional children <br />when necessitated by a legitimate educational interest <br />● Services will be provided under Section 504 of Americans with <br />Disabilities Act (ADA) <br /> <br />School Nurse <br />● Serves as a member of either the 504, SAT/SST, or IEP <br />committee(s) as appropriate. <br />● Provides counseling and consultation to parent/guardian and <br />school personnel on health-related issues. <br />● Reviews the health records of exceptional children as indicated <br />● Assists in appropriate screening and referral for further <br />evaluation as needed. <br />● Reviews and interprets findings with school personnel and <br />discusses planned follow-up. <br />● Refers students to the EC/504 coordinators for evaluation if the <br />nurse receives information regarding a potentially disabling <br />medical condition <br />● Assists parent/guardian of children needing special health care in <br />securing services. <br />● Develops an IHP (Individualized Health Plan)/EAP (Emergency <br />Action Plan) for children with potentially life-threatening <br />conditions, significant health problems as appropriate and any <br />student needing a specialized medical procedure at school <br /> <br />DocuSign Envelope ID: CEF0A315-C0D6-4618-8F2A-729FFE153BB6