Exhibit Page 32 of 66. Exhibit 21

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28 Exhibit 22 Clinical Nurse Manager Roles and Responsibilities Responsible for oversight of all contractually required Basic School Health Services.in accordance with Florida Administrative Code Chapter 64F , and the most recent version of the Florida School Health Administrative Guidelines. Responsible for oversight of all contractually required specialized services in Full Service Schools per Florida statute, section , including but not limited to nutritional services, economic and job placement services, parenting classes, counseling for abused children, mental health and substance abuse counseling, and adult education for parents. Provide training and guidance to all staff providing services on the following and ensure adherence to the same: Technical Assistance Guidelines The Role of the Professional School Nurse in the Delegation of Care in Florida Schools Guidelines for the Care and Delegation of Care for Students with Asthma in Florida Schools Guidelines for the Care and Delegation of Care for Students with Diabetes in Florida Schools EMERGENCY GUIDELINES FOR SCHOOLS FLORIDA STATUTES AND ADMINISTRATIVE CODE REQUIREMENTS FOR SCHOOL HEALTH SERVICES AND RELATED ACTIVITIES IN SCHOOLS Florida School Health Administrative Guidelines Broward County Public Schools Coordinated Student Health Services Provide RN Supervisors and RN s with one on one face to face supervision at a minimum of one time per month and document same. Conduct on-site quality assurance for each of the schools one time per quarter utilizing the Health Room review and the Health Record Review and document findings. Exhibit Page 59 of 66

29 Exhibit 22 Provide Technical Assistance to staff providing School Health Services in accordance with School Health Guidelines. Follow-up with Principals on school health issues. Act as Subject Matter Expert in accordance with School Health Guidelines. Assist with Communicable Disease Investigations and Management, and provide consultation to Principals. Reports suspicion of abuse/neglect according to Florida State law. Ensure all required documentation is completed and submitted on time according to contract requirements. Ensure collection of all required school health data. Review school health data reports for accuracy and completeness. Responsible for providing DOH Broward all of the contractually required monthly, quarterly and annual reports. Develop and facilitate a minimum of five(5), mandatory trainings per year, to staff under this contract, on topics approved by DOH Broward in order to safely provide School Health Services. Exhibit Page 60 of 66

30 Exhibit 22 Registered Nurse Supervisor (RNS) Roles and Responsibilities Adhere to and train Health Support Technicians on: Florida School Health Administrative Guidelines The Role of the Professional School Nurse in the Delegation of Care in Florida Schools Guidelines for the Care and Delegation of Care for Students with Asthma in Florida Schools Guidelines for the Care and Delegation of Care for Students with Diabetes in Florida Schools EMERGENCY GUIDELINES FOR SCHOOLS FLORIDA STATUTES AND ADMINISTRATIVE CODE REQUIREMENTS FOR SCHOOL HEALTH SERVICES AND RELATED ACTIVITIES IN SCHOOLS Broward County Public Schools Coordinated Student Health Services Visit each assigned school at a minimum of one time per week. Provide daily communication and coordination with Health Support Technician. Provide weekly supervision with Health Support Technician. Provide Technical Assistance for School Health Services Program. Review the immunization compliance report for each assigned school by September 15 and follow up with the parent/guardian of those students not in compliance. As needed, child specific trainings should be completed and documented for all students with chronic health conditions requiring interventions at school. Trainings are to be provided to teachers, HSTs, and other school staff who have interactions with the student. Trainings should be completed within 30 calendar days of the start of school or within 30 calendar days of notification of a new chronic health condition. Complete Vision, Scoliosis, and BMI Screenings for students who were absent or new to the school at the time of the scheduled screenings within 30 calendar days of scheduled screening date or school entry date. Notify Broward County Public Schools, Coordinated Student Health Services, of any students that need the hearing screening due to being absent or new to the school at the time of the scheduled hearing screenings. Exhibit Page 61 of 66

31 Exhibit 22 Complete 3rd follow-up for failed screens and document outcomes. Complete health assessments, Individual Healthcare Plans and Emergency Care Plans by October 1 of each year. After October 1 when a new or newly diagnosed student with a chronic health condition is identified, a Student Assessment Checklist should be completed and if needed an Individualized Health Care Plan and, if warranted, an Emergency Care Plan should be completed within 30 calendar days as appropriate Facilitate health trainings on medical conditions for school staff. Follow-up with Principals on school health issues. Consult as School Health Subject Matter Expert. Assist with Communicable Disease Investigations and Management and consult with Principal s as needed. Report suspicion of abuse/neglect according to Florida state law. Consults with parents/guardians at school regarding student s health as needed. Provide case management including referrals, follow-up and linkage with community resources as needed. Documents and reports data using the Monthly Summary Log, Monthly Data Collection Log, Screening results, referrals, follow-up attempts, FTE Week report, In-Kind Services in Full Service Schools Form and RN Supervisor School Visit Log. Delegate responsibilities to the HST following the Role of the RN in Delegation of Care in Florida Schools When the RNS delegates responsibilities, the RNS must be available to provide direction, supervision, and immediate intervention in a situation as needed. Such availability may be facilitated by use of a telephone, cell phone, pager, or other electronic device. Conduct and document skills assessments at the beginning of the school year and every 90 days after with health support technicians (HSTs) under their supervision utilizing the Skills Assessment Checklist. Provide ongoing supervision to HST staff and document. Exhibit Page 62 of 66

32 Exhibit 22 Registered Nurse (RN), Role and Responsibilities Adhere to: Florida School Health Administrative Guidelines The Role of the Professional School Nurse in the Delegation of Care in Florida Schools Guidelines for the Care and Delegation of Care for Students with Asthma in Florida Schools Guidelines for the Care and Delegation of Care for Students with Diabetes in Florida Schools EMERGENCY GUIDELINES FOR SCHOOLS FLORIDA STATUTES AND ADMINISTRATIVE CODE REQUIREMENTS FOR SCHOOL HEALTH SERVICES AND RELATED ACTIVITIES IN SCHOOLS Broward County Public Schools Coordinated Student Health Services Recognizes signs and symptom of illness. Provides comfort measures for minor discomforts/illnesses; manages minor illnesses/injuries of children. Complete health assessments, Individual Healthcare Plans and Emergency Care Plans for all students with chronic health conditions, at assigned schools, by October 1 of each year. As needed, child specific trainings should be completed and documented for all students with chronic health conditions requiring interventions at school. Trainings are to be provided to teachers, HSTs, and other school staff who have interactions with the student. Trainings should be completed within 30 calendar days of the start of school or within 30 calendar days of notification of a new chronic health condition. After October 1 when a new or newly diagnosed student with a chronic health condition is identified, a Student Assessment Checklist should be completed and if needed an Individualized Health Care Plan and, if warranted, an Emergency Care Plan should be completed within 30 calendar days as appropriate Maintains Daily Clinic Log. Recognizes health room visit patterns and documents same. Exhibit Page 63 of 66

33 Exhibit 22 Utilizes and maintains standard/universal precautions techniques (adheres to instructional training and policies.) Maintains OSHA requirements Monitors and correctly interprets vital signs. Correctly monitors and follows plan of care for individual students. Notifies parents/guardians if students are too ill to remain in class/school. Follows wound treatment protocol. Promotes Florida KidCare. Performs First Aid and CPR if and when needed. Maintains First Aid supplies and equipment, maintains inventory of supplies and equipment. Follows medication administration protocols. Depending on workload and responsibilities, may assist School Board of Broward County (SBBC) with routine screenings of vision, height and weight (BMI) and scoliosis screening. Notify Broward County Public Schools, Coordinated Student Health Services, when a child is in need of a hearing screening. Assists with third follow up of abnormal findings for vision, hearing, height and weight (BMI) and scoliosis screenings. Notifies Principal and DOH Broward of any Communicable Disease. Reports suspicion of abuse/neglect according to Florida state law. Maintains a healthy, safe, clean and hazard free Health Room. Develops and provides Child Specific Trainings on health conditions to all staff who have interactions with child. Review the immunization compliance report for each school by September 15 and follow up with the parent/guardian of those students not in compliance. Documents and reports data utilizing Student Medication Log, Daily Diabetic Log, DOH-Broward Unduplicated Log, Daily Clinic Log, Daily Summary Log, Monthly Summary Log, School Monthly Data Collection Log, FTE Week report, In-Kind Services Form in Full Service Schools. Provide case management including referrals, follow-up and linkage with community resources as needed. Consults with parents/guardians at school regarding student s health as needed. Provide or assure provision of and document all Full Service School activities in accordance with Florida Statute, section , including but not limited to nutritional services, economic and job placement services, parenting classes, counseling for abused children, mental health and substance abuse counseling, and adult education for parents. Exhibit Page 64 of 66

34 Exhibit 22 Health Support Technician, Role and Responsibilities The Health Support Technician (HST) provides support to the Registered Nurse Supervisor (RNS). The HST reports directly to the RNS for any school health issues and concerns. The RNS is available to provide direction, supervision, and immediate intervention in a situation as needed. Such availability may be facilitated by use of a telephone, cell phone or . Adhere to: Florida School Health Administrative Guidelines The Role of the Professional School Nurse in the Delegation of Care in Florida Schools Guidelines for the Care and Delegation of Care for Students with Asthma in Florida Schools Guidelines for the Care and Delegation of Care for Students with Diabetes in Florida Schools EMERGENCY GUIDELINES FOR SCHOOLS FLORIDA STATUTES AND ADMINISTRATIVE CODE REQUIREMENTS FOR SCHOOL HEALTH SERVICES AND RELATED ACTIVITIES IN SCHOOLS Broward County Public Schools Coordinated Student Health Services Health Room Visits and Health Care Recognizes signs and symptom of illness, reports serious problems to RN Supervisor. Provides comfort measures for minor discomforts/illnesses; manages minor illnesses/injuries of children. Maintains Daily Clinic Log, Daily Diabetes Log, Daily Summary Log and Daily Unduplicated Log. Recognizes health room visit patterns; documents and refers to RN Supervisor. Utilizes and maintains standard/universal precautions techniques (adheres to instructional training and policies). Maintains Occupational Safety & Health Administration (OSHA) requirements. Monitors and correctly interprets vital signs: refers abnormal finding(s) to the RN Supervisor (adheres to instructional training). Correctly monitors and follows plan of care for individual students. Notifies parents/guardians if students are too ill to remain in class/school. Exhibit Page 65 of 66

35 Exhibit 22 Follows wound treatment protocol. Promotes Florida KidCare. Reports suspicion of abuse/neglect according to Florida State law. Emergency Care Performs First Aid and CPR if and when needed. Maintains First Aid supplies and equipment, maintains inventory of supplies and equipment. Medication Administration After training, follows medication administration protocols. Documents medications given on the Student Medication Log. Tracks blood sugar readings and amount of insulin student received on the Daily Diabetic log, for each diabetic student. Screening examinations Depending on workload and responsibilities HST may assist Broward County Public Schools with routine screenings of vision, height and weight (BMI) and scoliosis screening. Assists with third follow up of abnormal findings for vision, hearing, height and weight (BMI) and scoliosis screening. Communicable Disease Notifies Principal of any suspected Communicable Disease. Environmental Health Maintain a healthy, safe, clean and hazard free Health Room. Exhibit Page 66 of 66