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Highlights of School Health Care Services

June 4, 2012

Ann Powers, MS, RN, CPNPNurse Leader

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At a Glance…As of October 1, 2011 95% of the Student Emergency Health Cards were returned to the

nurse’s office indicating:

► 21% of our students are on MassHealth♦ 22% in 2010♦ Two MassHealth Dental Providers in Plymouth

► 24% have no recorded dental insurance/provider♦ Decrease of 2% from October, 2010

► 45% of student population could be considered to have limited or no access to routine/preventative oral health care

♦ Represents a 3% decrease from October, 2010♦ Represents a reversal in trend of yearly increases of 4% in 2010 and 7% in 2009

► 682 students are participating in the fluoride oral mouth rinse program (approximately 75% participation rate)

► 7714 students have signed permission slips for KI administration (95% of students)

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At a Glance…

Growth Screening Trends 2010-2011

►34% of Plymouth students screened in grades 1, 4, 7 and 10 are at risk for being overweight or obese♦ Represents a 1% increase from previous year

►34% of students in the same grades in other ESHS reporting districts in the state are at risk, no change from previous year’s data for other districts for 2009-2010

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School

# of Children Participating#

Treated

Hygiene Exam

Cleanings

Fluoride Varnish

SealantsWithoutInsuranc

e

Untreated Decay

Cold Spring 42 42 42 42 15 9 7

Federal Furnace

94 94 94 94 27 17 16

Hedge 67 67 67 67 25 5 9

Indian Brook

80 80 80 80 28 22 13

Manomet 80 80 80 80 39 17 13

Mt. Pleasant

40 40 40 36 5 4 5

NMES 102 102 102 102 28 9 24

PCIS 50 50 50 50 16 20 6

PSES 113 113 113 113 33 28 9

PSMS 51 51 51 51 15 13 2

West 69 69 69 69 28 13 9

Visit 1: Fall 2011

788 788 788 784 259 157 113

Polished LLC Dental Program

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Suspected Head Injuries / ConcussionsSeptember – December, 2011

Month StudentsIn school

StudentsExtra-

curricular

Staff

September 5 19

October 4 15 1

November 3 5

December 0 2 1

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Plymouth Public SchoolsHealth Care Services

Total Reported Special Health Care Needs2006-2011

0

500

1000

1500

2000

2500

3000

SHCN IHCP

200620072008200920102011

(Source: Student Health Cards, M.D. documentation)

7

0

100

200

300

400

500

600

700

800

900

1000

Allergies Asthma Cardiac ADHD/ADD Depression Diabetes Migraines Seizures Oth. Beh.*

200620072008200920102011

Plymouth Public SchoolsHealth Care Services

Selected Special Health Care Needs2006-2011

(Source: Student Health Cards, M.D. documentation)*Other Behaviors includes ASD population; data for 2009 is omitted due to inaccurate reporting

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Plymouth Public SchoolsHealth Care Services

Selected Special Health Care Needs 2010-2011

Physical/Developmental Conditions

Alle

rgie

s

Asth

ma

Au

to Im

mu

ne

Hem

op

helia

Sic

kle

Cell

Oth

er B

lood

Can

cer

Card

iac

Celia

c

Cystic

Fib

rosis

Dia

bete

s T

yp

e

I

Dia

bete

s T

yp

e

II

Bees

Food

Latex

TOTAL

31 288 16 88713

1 2 7 10 70 12 5 27 1

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Physical/Developmental Conditions

Emotional/Behavioral Conditions

IBS

Mig

rain

es

CP

Sp

ina B

ifid

a

Seizu

res

Oth

er N

eu

ro

Oth

er P

hysic

al/

D’m

en

tal

AD

HD

Au

tism

Dep

ressio

n

Eatin

g D

isord

ers

Oth

er

TOTAL

45 115 13 3 40 10 155 52565

75 12193

Plymouth Public SchoolsHealth Care Services

Selected Special Health Care Needs 2010-2011 (continued)

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School Year Activities Report Essential School Health Services Program

1. Month in which these health encounters occurred: School Year 2010-2011 District: PSD

2. Person completing report (include Name and Position):

3. Health Services Activity Number of student and staff health encounters for school year 2010-2011. (Do not count health screenings or casual conversations)

2010-2011School Year

NUMBER OF OFFICE VISIT TYPES BY PRIMARY ASSESSMENT

Health Maintenance1 Injury/First Aid

Mental/Behavioral Health2 Miscellaneous3 Total Encounters

STUDENTENCOUNTERS

52,836 14,673 1,758 14,484 83,751

STAFFENCOUNTERS

544 230 7 390 1171

Comments

•Total student encounters increased by 12%

•Total staff encounters decreased by 19%

1 An office visit for Health Maintenance should include all visits for an illness assessment, acute illness, chronic health condition, etc. It includes scheduled medication administrations (i.e. daily med administration for ADHD) and scheduled procedures completed (ostomy care, scheduled glucose testing) as well as all individual health education provided. These visits do not include visits for mandated screenings (vision, hearing, MDI or postural screenings).

2 Mental/Behavioral Health includes any office visit related to mental/behavioral health need although the student or staff may present with a somatic complaint.

3 Miscellaneous office visits are those that do not require any nursing assessment (i.e. requests for sanitary supplies, cleaning, etc.).

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Plymouth Public SchoolsHealth Care Services

Number of Health Office Encounters District-wide (Sept-Dec 2011)

0

5000

10000

15000

20000

25000

30000

UnScheduled Scheduled

2007-08

2008-09

2009-10

2010-11

2011-12

(Source: Healthmaster MA Monthly Report)

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Plymouth Public SchoolsHealth Care Services

Number of Students Returned to Class(Sept-Dec 2011)

(Source: Healthmaster MA Monthly Report)

0

5000

10000

15000

20000

25000

30000

35000

2007-082008-092009-102010-112011-12

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100

300

500

700

900

1100

1300

1500

1700

1900

911 UrgentReferral

DismissedIll

DismissedInjury

20072008200920102011

Plymouth Public SchoolsHealth Care Services

Significant Disposition of Students (Sept-Dec 2011)

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In Addition in 2011-2012…► Fall 2011 - Municipal Medicaid was unable to fund the school nurses as in previous years

to work 2 days prior to start of the school year, funded by Essential School Health Services Grant

♦ Activities include review new student health records, conduct student/parent health interviews, prepare for known SHCN, immunization compliance, etc.

► Fall 2011♦ 315 students immunized at Seasonal Influenza Clinics at Middle and High Schools

(52% decrease from 2010) ♦ 31 Elementary School students, 16 adult family members and 3 siblings immunized

at evening clinic (1st time held due to extra supply of flu vaccine)

► Ongoing review/ revision of nursing protocols and health related policies♦ Completed review / update of district health related policies♦ New Concussion and Food in Classrooms Policy passed♦ Concussion Procedural Guidelines complete (MA Concussion Law passed 2010)♦ Concussion Teams formed at High Schools, Middle Schools, and the Marching Band for

implementation of the Concussion Procedural Guidelines

► >200 staff, students, Judco drivers, and community members trained by the nurses in Heartsaver AED; Consistent with last year’s numbers

► Ongoing student nurse rotations: Cape Cod Community, Laboure, PPS Allied Health Students

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School Health Advisory Committee (SHAC)

► Ongoing discussion and planning for implementation of the MA School Nutrition Regulations in August, 2012

♦ Community Transformation Grant: Collaboration with SHAC members, Jordan Hospital Staff, and Food Service Personnel for student, staff, family education

► Developed Food in Classrooms Policy initial draft, revised version passed by School Committee in January, 2012

► Ongoing discussion regarding implementation of MA Concussion Regulations, including plans to educate students, staff, family and community

► Coordinated district wide Walking Works Program with BCBS for staff in Spring of 2011 and 2012

♦ Over 200 staff participating each year

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Thank You