Second Step: Completing the IHP Template

The second step contains the required information, description, and examples of what the nurse will enter into the template.  

Student Identifiers

The IHP template contains one student identifier and four indirect identifiers that will need to be entered by the school nurse: 

1. The student’s name (first, last) The student’s date of birth
2. The student’s grade level
3. The student’s school district or accredited nonpublic school
4. The student’s attendance center (building name) (United States Department of Education, 2023)

The signature, credentials of the creator, and date of the IHP creation:

The school nurse develops the IHP and signs their name and professional credentials to coincide with the date when the IHP is created.

Date of the Individualized Education Program (IEP) or 504 Plan Review box (if applicable):

If the student has a health-related, regular, and ongoing health service in their IEP, the IHP is required and will be uploaded to the state system (ACHIEVE) as a supplement to the IEP. The uploaded plan is updated as needed and evaluated at least annually. 

The school nurse may enter the IEP or 504 review date on the IHP (if applicable). If not applicable, the school nurse would check the box next to “check box if not applicable”. (Iowa IDEA Information, 2023)

If a student is eligible under Section 504 of the Rehabilitation Act of 1973 (United States Department of Education, 2023), the student’s health services and IHP must be developed under Section 504’s regulations for evaluation, placement, and procedural safeguards. An IHP for a 504-eligible student may not be developed outside Section 504’s requirements. Section 504 teams may determine to attach an existing IHP to a 504 document. The accommodation plan/student progress in a Section 504 plan should be reviewed at least annually and more often upon a review request from the parent, educator, or others. The school nurse may enter the 504-review date on the IHP.  (United States Department of Education, 2023; Department of Education, 2015)

If a student is not eligible for health services within the federal programs of Individuals with Disabilities Education Act (IDEA) or Section 504, there will be no review date to complete on the template in this section. It is best practice for the school nurse to communicate with the school’s 504 coordinator and special education director annually on the IHPs developed in a building, whenever a substantial change to an IHP occurs, or when a new IHP is created. If the student has an IHP that does not fall under Section 504 or IDEA, the IHP may be kept as an educational record maintained securely by the school nurse in district records or student information systems. (Iowa IDEA Information, 2023)

Select the Identification of Additional Plans: 

IEP or 504 box: The school nurse may identify on the template if the student has an active IEP or Section 504 plan on the IHP. 

EAP or EEP box: The school nurse in collaboration with others may determine that the student’s ongoing health service requires an emergency action or evacuation plan to be created or attach an already developed evacuation plan to an IHP. There is a check box section to identify additional plans. 

Connecting Emergency Plans to the Student Information System (SIS) Tip: School nurses may flag this information or attach the plans in their school’s student information system or work with their technology team for access to streamline this communication with the student’s educators, special education director, 504 coordinator or others with a legitimate educational interest. 

By placing the IHP, EAP and EEP in the SIS, school nurses ensure that the educational record is secure in the student system versus in a filing cabinet or on an employee’s computer.

School Leadership Communication: School leadership may have educators sign assurances that they have reviewed the health forms and other plans (IHP, EEP, EAP or 504 plan) associated with students  on the educator’s roster in the SIS. Also, school administrators may have IT set the privacy for their view so they can review health services when addressing chronic absenteeism and other early warning systems. 

School Nurse Communication: If the student(s) health concerns are flagged or their plans are attached in the student information system, the school nurse may send out communication at the beginning of the school year requesting school personnel to check the health tab in the SIS of their roster of students to provide educators with the information that they need immediately on the first day of school. The school nurse must include a statement that the licensed educator may view and be aware of the student’s health needs, but will require additional training to be qualified or authorized to act in health service delivery to align with policy and licensure requirements. 

Emergency Planning: The emergency action plan or emergency evacuation plan is a component of the IHP as defined in regulation. The emergency action plan or emergency evacuation plan is developed to assist unlicensed personnel in addressing emergency care or evacuation for a student with a health condition (stable or unstable) that requires ongoing special health services. The plans follow a series of steps for unlicensed personnel to carry out. If the emergency action is invasive, unlicensed personnel must provide consent. 

Emergency Action Plan: The emergency action plan may be created by the school nurse or the student’s health care provider in collaboration with the school nurse who delegates the emergency health service or task to unlicensed or licensed personnel to address the student’s emergent ongoing health service needs. 

Emergency Evacuation Plan: The emergency evacuation plan may be written by the school nurse or others on the education team familiar with the student to address a student’s health needs to evacuate during an emergency or crisis safely. All unlicensed personnel receive training and demonstrate competency to implement an emergency action or evacuation plan. This training and competency are documented as required in policies for special health services.

Non-Exhaustive Examples: 

Emergency action plan box checked: A student diagnosed with a severe allergy to peanut exposure requires an emergency action plan for Anaphylaxis at school. 

Emergency evacuation plan box checked: A student diagnosed with autism with auditory sensory issues requires an emergency evacuation plan when building alarms are activated.

Health Conditions or Other Impairments Impacting Educational Programming box:

The school nurse partners with the student’s family regarding the student’s health needs by asking “what matters most” to create a goal and to foster a better understanding of the child’s health conditions and other impairments impacting the student’s health for the current year. The school nurse also communicates with the student’s healthcare provider if the family has provided consent or the school nurse needs clarification in the healthcare provider's treatment plan. 

Remember: The student’s parents are not required to provide the district or school with health information or medical records regarding their student’s ongoing health needs. The school team may request the parent sign a release of information to communicate with the student’s healthcare provider about information that the parent has specified on the release for making decisions related to education programs. The school team may utilize procedural safeguards to ensure a comprehensive evaluation. 

The education program includes all curricular programs and activities on and off school grounds. 

Non-Exhaustive Example: Anaphylaxis (Allergen: Peanuts); Allergy to [insert] as reported by parent on registration form

Select the Equipment, Roles, Supplies, and Maintenance of Equipment box:

The school nurse selects one of three boxes on the template for equipment, roles, supplies, and maintenance for the school, the parent, or others. 

The first box is: Yes, Parents are responsible to provide and maintain equipment and supplies

The second box is: No, the school is responsible to provide and maintain equipment and supplies

The third box is: Other, please see notes below

If the “other” box is selected, the school nurse is required to complete the text box with a brief explanation. 

The school nurse checks the required box that the supplies and equipment are secure. 

In regulations: 

The individual health plan shall designate the roles and responsibilities of the school, parents, and others in the provision, supply, storage, and maintenance of necessary equipment. Parents shall provide the usual equipment, supplies, and necessary maintenance of the equipment unless the school is required to provide the equipment, supplies, and maintenance under the Individuals with Disabilities Education Act and 281—Chapter 41 or Section 504 of the Rehabilitation Act of 1973. Schools must store equipment in a secure area.

“Other, please see notes below” box Non-Exhaustive Examples:

Other: The school will supply the lift device, changing table and privacy screen. The parents will supply the wipes and briefs for the student’s hygiene care. 

Other: The school will supply the communication board and lift device. The parents will supply the student’s wheelchair, orthotics, gastric tube supplies and enteral nutrition.

Summary of Health Concerns and Other Essential Information box:

The summary of health concerns and other information is a text box on the template for the school nurse to enter information related to the student’s health conditions, other impairments, and include the identified health needs that the student will need during the school day for the current school year. 

The school nurse shares information in the “Summary of Health Concerns and Other Essential Information” with teams in the context of the IDEA, Section 504, or others with a legitimate educational interest.

The content in this box may include specific nursing tasks provided by the nurse or delegated to unlicensed or licensed personnel, use of a health device, or other relevant information needed for the education team. It may also include functions performed by a registered or licensed nurse for the student to access their program in management of their health condition or other impairment (stable or unstable) supported by existing documentation already required in the school’s policies or procedures. The box may include important conversation details between the family and student engagement. This box is for any communication pertinent to the education team. 

Non-exhaustive examples of dialogue in a “Summary of Health Concern and Other Essential Information” box:

 “The student has an IEP and health is not identified in the PLAAFP (present level of academic achievement and functional performance). The student requires emergency medication management as outlined in the EAP, provider information, and MAR (medication administration record) during the school year to address the ongoing health service needs for the student's diagnosis of Anaphylaxis. The school nurse and parents identified that the parents would like the school nurse to assist the student in identifying the allergen, a source that could result in exposure, and a way to prevent exposure.” 

“The student has an IEP and health is identified in the PLAAFP. The student requires medication management as outlined on information provided by the provider and additional forms per policy and procedure during the school year to address the ongoing health service needs for the student's nursing and health service needs for autism and asthma. The student requires a 1:1 associate throughout the day for safety, transitioning, toileting, hygiene and implementation of the EAP/EEP. The school nurse and parents identified that the parents would like the school nurse to assist the student in identifying a trigger for their asthma and one way to communicate when the student is having respiratory difficulty.”

“The student requires a 1:1 paraprofessional to assist with performing ADLs, safety, implementation of delegated tasks and emergency plans”