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Question:  What should the school nurse do when this year's health appraisals (physicals) do not have the BMI percentile or Weight Status Category (WSC) completed on the form sent to the school by the private provider?

Answer:  There are several strategies that the nurse could consider:

If the health certificate is incomplete, it would be advisable for the school nurse to return a copy of the form to the family for completion by the family’s private healthcare provider (from the NYS Department of Health Frequently Asked Questions).
The nurse can ask the private provider if the form could be faxed to them for completion.  The school nurse should not write on a health certificate from a private provider.
Your medical director could request that nurses do the heights, weights, and BMIs and then the nurse could provide them with a “Body Mass Index-for-Age Percentile Chart” to figure the WSC.
Your medical director could request that you go to the Online Calculator form the CDC   http://apps.nccd.cdc.gov/dnpabmi/Calculator.aspx   and input the student’s information, print it out, and provide them with that information.
Your medical director could assign WSC to those physicals done by private providers with missing information and attach a signed addedendum to each health appraisal.  The medical director must sign each Weight Status Category determination for the purposes of the statewide survey.
Information can be noted as missing at the time of the survey.

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Community Schools: The Executive Budget supports an innovative program designed to transform schools into community hubs that integrate social, health and other services, as well as after-school programming to support students and their families

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Question:  What is the nurses' role in calculating Body Mass Index (BMI) and determining the weight status category (WSC) (based on BMI-for-age percentile)?

Answer:

The amendment to Education Law Sections 903 and 904 was written to incorporate BMI and WSC determination as part of the health certificate or health appraisal.  Only the school medical director can perform and complete the health appraisal, and only a student's healthcare provider may perform and complete a health certificate.
For health appraisals completed at the school, a medical director may choose to have a written policy stating that the school nurses in his/her district can perform the height and weight measurement, calculate the BMI and determine the WSC.  The school nurse may write these on the health certificate for the provider if requested.  However, it is the responsibility of the medical director to interpret the WSC and what effect it may have on the student's health.  By signing the health appraisal form, the medical director is taking responsibility for the information on the form and is ensuring that any identified health problems are reported to the parent to arrange for follow-up.

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EHR | Health Maintenance Protocol eHealth

HealthWatcher automates sending those easy-to-forget reminders to your patients with medical advice and health care best practices

Providing sound health maintenance means including a full array of counseling, screening, and other preventive services designed to minimize the risk of premature sickness and death and to assure optimal physical, mental, and emotional health throughout the natural lifecycle. Today's leading EHR systems offer a wide variety of electronic health record (eHealth or EHR) features to optimize workflow and patient safety. For example, screening tests and physician counseling are important tools for identifying common yet potentially serious injuries, illnesses and diseases that can be prevented or cured with early intervention.

EHR Helps Obtain Successful Health Compliance Outcomes

EHR (eHealth) provides you the tools for successful management of patient populations, conditions, and preventive health routines ensuring patient compliance and preventive care. The HealthWatcher tool allows for customized profiles and protocols to ensure your practice complies with best practices and your patients adhere to your medical advice.

eHealth Maintenance Tailored to Your Practice Needs

With ADP AdvancedMD EHR, you can tailor your health maintenance solution to fit the unique needs of different groups of patients. For example, you can customize health maintenance information by diagnosis or by payer to accommodate carrier guidelines. Find out how ADP AdvancedMD can help your support staff quickly identify and reach out to patients who are due for tests or procedures.

Utilize Continuity of Care Protocols for Better Safety, Health Maintenance & Compliance
Our HealthWatcher (eHealth maintenance) module is part of our EHR and is a tool that helps the practice and provider follow continuity of care protocols. We support care plans, guidelines and protocols for the management of specific conditions based on factors such as age, sex, diagnosis and lab result values.

Benefits of HealthWatcher Maintenance in the EHR
Generates alerts for appointment recall, prescription refills and laboratory orders
Protocols can contain one or a series of tasks, renewable based on user-defined intervals
Health maintenance protocols can be assigned to an individual or group of patients
Interoperability >< Document & Image Management

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Question: Is there a document that gives an overview of the Application of the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to Student Health Records?

Answer: Yes. There is a document from the U.S. Department of Health and Human Services and the U.S. Department of Education that offers Joint Guidance on the Application of the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to Student Health Records. It gives an Overview of FERPA, an Overview of HIPAA, where FERPA and HIPAA may intersect and Frequently Asked Questions. It explains the relationship between FERPA and HIPAA and addresses the confusion of school administrators and health care professionals. The document is the Tool of the Week.

Question: Can school health services staff share confidential health information with other school district staff members?

Answer: Health information can be shared under the Family Educational Rights and Privacy Act (FERPA) when such internal communications regarding confidential student health information is shared for legitimate educational purposes.   It must be shared in a confidential manner only with those individuals who are directly involved with the student in order to benefit the student and provide the student with appropriate educational services.

Question:  Can a school district be sued for disclosing confidential health information?

  Answer: The United States Court of Appeals for the Eighth Circuit ruled in 2006 that a student with disabilities can sue his school district under Section 504 of the Rehabilitation Act for "bad faith and gross misjudgment" because the district failed to protect him from discrimination and harassment by other students after a teacher disclosed his medical condition to the student body.

Link to article: http://www.healthinschools.org/2006/march8_alert.asp

Resources:

Legal Issues in School Health Services, edited by Nadine C. Schwab & Mary H.B. Gelfman, SunRise River Press, 2001.

Guidelines for Protection Confidential Student Health Information, National Task Force on Confidential Health Information, American School Health Association, 2000.

Health in Schools - healthinschools.org

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GENERAL
Family Educational Rights and Privacy Act (FERPA)

Family Policy Compliance Office (FPCO) Home

The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR Part 99) is a Federal law that protects the privacy of student education records. The law applies to all schools that receive funds under an applicable program of the U.S. Department of Education.

FERPA gives parents certain rights with respect to their children's education records. These rights transfer to the student when he or she reaches the age of 18 or attends a school beyond the high school level. Students to whom the rights have transferred are "eligible students."

Parents or eligible students have the right to inspect and review the student's education records maintained by the school. Schools are not required to provide copies of records unless, for reasons such as great distance, it is impossible for parents or eligible students to review the records. Schools may charge a fee for copies.

Parents or eligible students have the right to request that a school correct records which they believe to be inaccurate or misleading. If the school decides not to amend the record, the parent or eligible student then has the right to a formal hearing. After the hearing, if the school still decides not to amend the record, the parent or eligible student has the right to place a statement with the record setting forth his or her view about the contested information.

Generally, schools must have written permission from the parent or eligible student in order to release any information from a student's education record. However, FERPA allows schools to disclose those records, without consent, to the following parties or under the following conditions (34 CFR § 99.31):

School officials with legitimate educational interest;
Other schools to which a student is transferring;
Specified officials for audit or evaluation purposes;
Appropriate parties in connection with financial aid to a student;
Organizations conducting certain studies for or on behalf of the school;
Accrediting organizations;
To comply with a judicial order or lawfully issued subpoena;
Appropriate officials in cases of health and safety emergencies; and  IE:OBESITY EPIDEMIC OR WHATEVER THEY DECLARRE
State and local authorities, within a juvenile justice system, pursuant to specific State law.
Schools may disclose, without consent, "directory" information such as a student's name, address, telephone number, date and place of birth, honors and awards, and dates of attendance. However, schools must tell parents and eligible students about directory information and allow parents and eligible students a reasonable amount of time to request that the school not disclose directory information about them. Schools must notify parents and eligible students annually of their rights under FERPA. The actual means of notification (special letter, inclusion in a PTA bulletin, student handbook, or newspaper article) is left to the discretion of each school.

For additional information, you may call 1-800-USA-LEARN (1-800-872-5327) (voice). Individuals who use TDD may call 1-800-437-0833.

Or you may contact us at the following address:

Family Policy Compliance Office
U.S. Department of Education
400 Maryland Avenue, SW
Washington, D.C. 20202-8520

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Categories

A frequent use of the BMI is to assess how much an individual's body weight departs from what is normal or desirable for a person of his or her height. The weight excess or deficiency may, in part, be accounted for by body fat (adipose tissue) although other factors such as muscularity also affect BMI significantly (see discussion below and overweight). The WHO regards a BMI of less than 18.5 as underweight and may indicate malnutrition, an eating disorder, or other health problems, while a BMI greater than 25 is considered overweight and above 30 is considered obese.[10] These ranges of BMI values are valid only as statistical categories
Category     BMI range – kg/m2     BMI Prime
Very severely underweight     less than 15     less than 0.60
Severely underweight     from 15.0 to 16.0     from 0.60 to 0.64
Underweight     from 16.0 to 18.5     from 0.64 to 0.74
Normal (healthy weight)     from 18.5 to 25     from 0.74 to 1.0
Overweight     from 25 to 30     from 1.0 to 1.2
Obese Class I (Moderately obese)     from 30 to 35     from 1.2 to 1.4
Obese Class II (Severely obese)     from 35 to 40     from 1.4 to 1.6
Obese Class III (Very severely obese)     over 40     over 1.6

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Student Weight Status Category (WSC) Reporting
2012-2013 WSC Reporting Information


When:

All Student Weight Status Category Surveys must be submitted via the Health Commerce System by Friday, January 25, 2013.

Who:

Districts Selected for 2012-2013  Reporting
Lists school districts who are required to report aggregated information from school health certificates/appraisals for students who were in pre-Kindergarten or Kindergarten and in grades 2, 4, 7 and 10 in the previous school year (2011-2012).

BOCES, Charter, Private and 4201 designated schools are not required to report WSC data. New York City schools are exempt from state education law that requires this data to be reported to the State Health Department. The New York City Department of Education has developed a system of monitoring students to determine weight status using NYC FITNESSGRAM.

How:

BMI/Student Weight Status Category Reporting Training Registration Form 2012-13 Provides registration information for the last phone conference training session which will be held onon 1/14/13  on how to complete the WSC Survey. You will have the oppportunity to ask questions while viewing the forms online. All calls are from 3:00 - 4:00 PM  

FAQ's Regarding Student Weight Status Category Reporting
Provides and overview of the Student Weight Status Category Reporting System established by amendments to NYS Education Law in 2007, frequently asked questions regarding WSC reporting and resources avaialable. Last updated 5/17/10

                                                                                                                                                

Health Commerce System Portal Link to log on and enter WSC information for your district.



Why:

NYS Department of Health Letter to Schools Selected to Report for 2012-13
Provides background information and overview of the requirement for WSC reporting that was sent to Superintendents and School Nurses.

Recorded Student WSC Reporting Webinar for School District Staff This webinar provides information on how WSC reports can be used to collaborate between local health departments and schools. It is applicable for both school health and health department professionals.

NYS Weight Status Data Reporting and Obesity Statistics
Provides links to the NYSDOH WSC homepage with results from 2008-2010 state and county level reports, barriers to reporting (2011) and FAQ's on how the reports were created.

Who Can I Call?

For general questions regarding Weight Status Category Reporting call (51408-5126
Sample questions might include:

What type of data do I need to submit? (who, what grades, where do I find the WSC)
How do I tally the data?
Can I get more information on Weight Status Category Reporting?
For questions or difficulties logging onto the Health Commerce System or problems with your account or password, contact the Commerce Accounts Management Unit (CAMU) at 1-866-529-1890.

For technical questions, please call (51 473-1809 and ask for a Commerce Trainer.  

Resource Guides to Report Student Weight Status Category and Health Conditions Information

Section 1: Resources to Join the Health Commerce System (HCS)

On-Line School Survey Assessment, Health Commerce System Account Guide for HCS Access/Frequently Asked Questions
Section 2: Resources for HCS Coordinators:  How to Create and Assign HCS Accounts

HCS Account Creation Instructions
HCS Role Assignment Instructions
Section 3:  Resources for Public School Nurses: Tally Tools and How to Report School Building Level Data to the School District Nurse

BMI Part 1:  Weight Status Category Data
School Tally Sheet Instructions
School Tally Sheet
BMI Part 2:  Health Conditions Data
School Tally Sheet Instructions
School Tally Sheet
Section 4:  Resources for School District Nurses:  Tally Tools and How to Enter and Submit School District Data on the HCS

BMI Part 1:  Weight Status Category Data
District Tally Sheet Instructions
District Tally Sheet
How to Submit Student Weight Status Category Data on the HCS
New process for for 2013

BMI Part 2:  Health Conditions Data
District Tally Sheet Instructions
District Tally Sheet
How to Enter and Submit Data Health Conditions on the HCS
New process for for 2013
Section 5: Notification Resources

Parental Notification
Schools may provide notice to parents via the school newsletter, website, the pre-Kindergarten or Kindergarten registration packet, and/or other reasonable means. The forms below are for parent use who wish to opt out of reporting. It is suggested you inform parents that any opt out forms should be returned by January 2nd, 2013 as the survey will be due for submission by January 25th, 2013.

Sample Parental Notice for 2012 - 2013 school year (English)
Sample Parental Notice for 2012 - 2013 school year (Spanish)
Health Provider Notification
It is reccommended to follow up with the health care provider if they omit the WSC from the Health Appraisal, but not required that you do so.
Sample Follow Up Letter to Health Care Provider Who Omitted WSC on Health Appraisal

Quoted from bumblethru

And if the parent opts out????? Ya gonna be put in 'BMI JAIL'?

Quoted from Tommy

Senders sounds fat.