SBHS Nurse Evaluation and Treatment Services include assessments, treatment services, and supervision of delegated health care services provided to prevent disease, disability, other health conditions or their progression, prolong life, and promote physical and mental health and efficiency.

This includes any medical or remedial services recommended by a physician or other licensed health care practitioner, within the scope of practice under state law for maximum reduction of physical or mental disability and restoration of a recipient to his or her best possible functional level. The Registered Nurse (RN) is responsible for periodic supervision for services provided to coordinating care and integrating nursing tasks and services that can be performed in the educational setting such as:

• Monitoring patient's seizure activity for breathing patterns, onset/duration of seizure, triggers/auras, level of consciousness, support after seizure, administering medication as ordered
  
  
• Monitoring/providing treatment for high and low blood sugar, checking urine keytones, blood glucose testing, carbohydrate calculations, assisting with insulin administration
  
  
• Ventilator care, suctioning, and equipment management
  
  
• Tracheotomy care, changing dressings, emergency trach replacement, suctioning, changing “nose,” and providing humidification as necessary; catheterization, assisting with or performing procedure for catheterization, monitor urinary tract infections, and performing skin integrity checks
  
  
• Gastrostomy tube feeding, administering tube feedings per physician order, monitoring skin status around the tube, and emergency treatment for button dislodgement
  
  
• Medication pumps, (e.g., insulin pump), calculate carbohydrate amounts in food/snacks, provide insulin bolus per physician order, emergency disconnect procedure and monitoring blood sugar
  
  
• Medication management, (e.g., monitoring signs and symptoms for medication administration), administering medications, observing for side effects

SBHS nursing evaluation and services shall be provided by Registered Nurses and Licensed Practical Nurses (LPN) who have graduated from a state-approved nursing program with a practical nursing certificate, diploma, or an associate, baccalaureate or masters degree in nursing, or from an equivalent program in a school of nursing outside of the United States or its jurisdictions; must have passed the State Board Test Pool Examination (SBTPE) before 1988, or the National Council Licensure Examination (NCLEX) after 1988; and be licensed to practice in Oregon by the Oregon State Board of Nursing.

An LPN may participate in the implementation of the plan of care for providing care to clients under the supervision of a licensed Registered Nurse, Nurse Practitioner, or physician, or Nurse Practitioners that meet the federal requirements at 42 CFR 440.166, and are licensed by the Oregon State Board of Nursing to practice in Oregon as a Nurse Practitioner.

SBHS Medicaid-reimbursed services and treatments are provided in accordance with Oregon’s Prioritized List of Health Services to recipients receiving services pursuant to an IEP/IFSP eligible under IDEA in the educational setting. The above-listed therapy services and treatments are examples of services that may be provided to eligible recipients in an educational setting under Oregon’s Medicaid program. The current Prioritized List of services can be found on the Health Services Commission Web site.

Important!  The SBHS rules define Oregon’s fee-for-service program to reimburse publicly funded education agencies for health services provided under the IDEA to Oregon’s Medicaid-eligible children. The SBHS rules are also a user’s manual designed to assist the Education Agency (EA) in matching state and federal funds for Oregon’s Medicaid-eligible students with disabilities. The SBHS rules are to be used in conjunction with:

• The General Rules governing the Division of Medical Assistance Programs (DMAP) (OAR 410 Division 120);
• The Oregon Health Plan (OHP) rules (OAR) 410 Division 141); and
• The Oregon Administrative Rules (OARs) in Chapter 581, Division 15, for the Oregon Department of Education (ODE) outlining Oregon’s program to meet the federal provisions of the Individuals with Disabilities Education Act (IDEA).

Please go to the SBHS information page and review the above listed rules for additional information.