National Disability Insurance Scheme (NDIS) - Continuous Invasive Ventilation support at school procedure

Audience

All state schools.

Purpose

This procedure outlines the responsibilities and processes relating to NDIS providers providing Continuous Invasive Ventilation at school during school time. It supports implementing the NDIS provider access to state schools policy, and students being able to attend school safely and access and participate in education.

For NDIS provider access for other types of student support, refer to the National Disability Insurance Scheme (NDIS) provider access to state schools procedure. For health supports that are not Continuous Invasive Ventilation for students, refer to the Managing students health support needs at school procedure and the Administration of medications in schools procedure.

Overview

Principals have a non-delegable duty of care to the safety of students enrolled at and attending their school. Continuous Invasive Ventilation is required by a small number of students. The safe delivery of this support is essential to enabling students to attend school safely and access and participate in education. 

School staff, parents, health professionals and NDIS providers collaborate to manage identified health risks and undertake planning to ensure students receiving Continuous Invasive Ventilation are able to attend school safely.

This procedure sets out the responsibilities and processes involved:

• in developing NDIS delivered continuous invasive ventilation support and emergency plans;
• when considering a parent request for NDIS providers to deliver Continuous Invasive Ventilation at school, during school time;
• while NDIS providers access the school and provide the support;
• in supporting students receiving Continuous Invasive Ventilation from an NDIS provider at school; and
• when suspending or terminating NDIS provider access.

This procedure should be read in conjunction with the National Disability Insurance Scheme (NDIS) provider access to state schools policy.

Responsibilities

Principal

• Ensure steps are completed for the safe management of students’ health support needs at school.
• Approve the student's NDIS delivered continuous invasive ventilation support and emergency plan.
• Consider parent's NDIS Continuous Invasive Ventilation Access request and make the final decision about whether an NDIS provider can deliver Continuous Invasive Ventilation at school, during school time.
• Sign the Access Agreement (Continuous Invasive Ventilation).
• Advise the parent of their decision and the reason for that decision if the request is not approved.
• Advise  student and/or parent, as appropriate, and the NDIS provider immediately if concerns arise that, if not resolved, may result in the suspension or termination of the NDIS provider's access and discuss with the parent the reasons for terminating the Access Agreement (Continuous Invasive Ventilation).
• Advise the parent/s and NDIS provider in writing if the Principal decides to suspend or terminate access.
• Raise any concerns about the NDIS provider’s conduct with the National Disability Insurance Agency and the NDIS Quality and Safeguarding Commission.
• Advise the parent/s and NDIS provider, in writing, if the duration of the Access Agreement (Continuous Invasive Ventilation) is extended.

Principal or delegate

• Ensure consent is obtained to disclose information between relevant agencies involved using the Consent form to share student personal information with third parties (DoE employees only).
• Complete a request for service from the State schools nursing service.
• Seek advice from the region's Clinical Nurse Consultant and/or State Schools Registered Nurse when deciding whether to accept the parent's NDIS Continuous Invasive Ventilation Access request and to develop an NDIS delivered continuous invasive ventilation support and emergency plan.
• Ensure a copy of the NDIS delivered continuous invasive ventilation support and emergency plan is provided to the parents or student (if appropriate), and the NDIS provider
• Ensure a risk assessment is completed, as part of the NDIS delivered continuous invasive ventilation support and emergency plan, before the student commences attending school.
• Monitor the NDIS delivered continuous invasive ventilation support and emergency plan.
• Implement the strategies outlined in the NDIS delivered continuous invasive ventilation support and emergency plan including determining the number of school staff to be trained and able to deliver emergency health supports.
• Ensure the parent and NDIS provider sign the Access Agreement (Continuous Invasive Ventilation).
• Arrange for, and ensure NDIS provider personnel attending the school complete departmental mandatory training for external providers.
• Ensure the terms of the Access Agreement (Continuous Invasive Ventilation) are complied with by all parties, including the school.
• Advise parent if issues arise at the school that may impact on Continuous Invasive Ventilation being delivered at school, during school time, including any changes in school routine or staff.
• Ensure the provider is an NDIS Registered provider and its personnel delivering Continuous Invasive Ventilation supports provide evidence that they meet safety and training requirements as determined by specialist medical team.
• Ensure schedules provided by the NDIS provider cover any breaks required by NDIS provider personnel, so that students are supported by NDIS provider personnel at all times.
• Ensure enough trained school staff are available to support a student's emergency health plan, including providing emergency coverage for managing the student's ventilator needs, until the parents or ambulance arrives.
• Ensure all relevant staff are aware of students’ health conditions and protocols for sharing student’s personal information.
• Review the Access Agreement (Continuous Invasive Ventilation) and arrange for NDIS delivered continuous invasive ventilation support and emergency plans, including emergency health plans, to be reviewed at least once every six months.
• All documents and plans related to the student's care are maintained in OneSchool.

Clinical Nurse Consultants or delegated State Schools Registered Nurses

• Provide advice to principals and schools about NDIS provider access and the requirements for the safe delivery of Continuous Invasive Ventilation supports at school.
• Develop, monitor and review (at least once every six months or more regularly as required) the NDIS delivered continuous invasive ventilation support and emergency plan including risk assessments in consultation with the student (where appropriate), parents, Children's Health Queensland Hospital and Health Service, the student's specialist medical team, the NDIS provider, and other departmental staff, such as therapists, if required.
• Clinical Nurse Consultant ensures current training (biannual) for relevant State Schools Registered Nurses in Continuous Invasive Ventilation and other health support procedures by Children's Health Queensland Hospital and Health Service.
• Provide training to school staff to implement the NDIS delivered continuous invasive ventilation support and emergency plan.
• As requested by the principal or delegate, contribute to risk assessments, planning and liaison with the specialist medical team, family and student.

Parents and/or student

• Complete a NDIS Continuous Invasive Ventilation Access request for an NDIS provider to deliver Continuous Invasive Ventilation at school, during school time.
• Provide current information to the principal and the State Schools Registered Nurse about their child’s health conditions, including written information from health and medical professionals and the ambulance plan prepared by the specialist medical team for emergencies.
• Provide all further information and documentation as requested by the principal or their delegate.
• Consent to information disclosure between relevant agencies involved using the Consent form to share student personal information with third parties (DoE employees only).
• Consent to and support the development of the NDIS delivered continuous invasive ventilation support and emergency plan.
• Enter into the Access Agreement (Continuous Invasive Ventilation) with the principal and the NDIS provider.
• Comply with the terms of the Access Agreement (Continuous Invasive Ventilation).
• Advise the principal or delegate in writing of any changes to the support being provided by the student's specialist medical team or the NDIS provider personnel, or changes to the NDIS provider.
• Ensure that equipment, medication, and consumables provided are supplied, fully charged, well maintained, in-date and clearly labelled with the student’s name, relevant instructions and dosage of medication.
• If required, make a request in writing to the principal that the duration of the Access Agreement (Continuous Invasive Ventilation) be extended.

Student's specialist medical team

• Collaborate with the school, Clinical Nurse Consultant and/or State Schools Registered Nurse, parents and the NDIS provider to develop the NDIS delivered continuous invasive ventilation support and emergency plan.
• Provide information on management of routine and emergency medication.
• Communicate changes in student’s health supports management with parents.
• Provide training for Clinical Nurse Consultants and relevant State Schools Registered Nurses in Continuous Invasive Ventilation.
• Provide training to the NDIS provider personnel and written confirmation that each of the relevant NDIS provider personnel providing the Continuous Invasive Ventilation support to the student at the school has satisfactorily completed training by the student's specialist medical team.

NDIS providers

• Provide evidence to the principal that the NDIS provider personnel providing Continuous Invasive Ventilation at schools meet and maintain the required competencies to provide safe care to the student and have knowledge and skills in ventilator and equipment management.
• Provide all required health supports and personal care supports for the student receiving Continuous Invasive Ventilation support.
• Enter into and comply with the Access Agreement (Continuous Invasive Ventilation) with the school and parent
• Collaborate with the school, Clinical Nurse Consultant and/or State Schools Registered Nurse, parents and the student's specialist medical team to develop the NDIS delivered continuous invasive ventilation support and emergency plan.
• Ensure NDIS provider personnel providing Continuous Invasive Ventilation at schools comply with their responsibilities under the NDIS delivered continuous invasive ventilation support and emergency plan.
• Provide copies of relevant documents to the school as required under the Access Agreement (Continuous Invasive Ventilation).
• Provide a list of NDIS provider personnel attending the school to provide ventilation supports (including replacement NDIS provider personnel who will provide Continuous Invasive Ventilation supports to cover NDIS provider personnel rest/meal break times and leave) and provide the school with details of blue cards and driver licences.
• Ensure NDIS provider personnel are available to deliver Continuous Invasive Ventilation at all times while the student is at school including during staff meal/rest break times and leave.
• Before the first day of the school term, provide a timetable to the principal outlining the personnel who will be providing Continuous Invasive Ventilation to the student at school and the back-up NDIS provider personnel who will provide Continuous Invasive Ventilation at school to cover NDIS provider personnel rest/meal break times and leave.
• Advise of NDIS provider personnel in attendance each day including contact details for emergency plan/procedures and staff tracking.
• Maintain confidentiality of all students and staff information in accordance with Department of Education requirements.

NDIS provider personnel

• Complete daily arrival and departure checklists and all other documents and records as required under the NDIS delivered continuous invasive ventilation support and emergency plan and provide to the school.
• Comply with the Access Agreement (Continuous Invasive Ventilation).
• Complete mandatory training as required by the principal.
• Comply with departmental policies and procedures or any other requirements .
• Present their blue card and current photo identification, such as a valid Driver Licence or Proof of age card when attending the school.
• Maintain confidentiality of all student and staff information in accordance with Department of Education requirements.
• Maintain records identified in the student NDIS delivered continuous invasive ventilation support and emergency plan.
• Deliver Continuous Invasive Ventilation at all times while the student is at school including during staff break meal/rest times and leave.
• Liaise with school staff including Head of Special Education Services, deputy principal or principal as required.

Trained school staff

• In the event that the NDIS provider personnel are unable to deliver Continuous Invasive Ventilation, at any time while at school, the school contacts the student's parents or calls an ambulance, and trained school staff deliver continuous invasive ventilation supports and/or emergency health procedures while waiting for parents to pick up the student or for the ambulance.

Process

Parent requests NDIS provider to deliver Continuous Invasive Ventilation supports

1. A parent makes a request for an NDIS provider to deliver Continuous Invasive Ventilation supports (and other personal care supports) at school during school time by completing an NDIS Continuous Invasive Ventilation Access request and provides it to the principal of the school which includes consent for:

• the principal or relevant school staff and the State Schools Registered Nurses or Clinical Nurse Consultant to discuss the support requirements with the specialist medical team and the NDIS provider and
• a service from the State Schools Nursing Service (State Schools Registered Nurse or Clinical Nurse Consultant).

2. The principal or delegate obtains consent to information disclosure between relevant agencies involved using the Consent form to share student personal information with third parties (DoE employees only).
3. The principal or delegate advises the Clinical Nurse Consultant in their region that the request has been made and seeks support to assess the request and develop the NDIS delivered continuous invasive ventilation support and emergency plan.
4. The Clinical Nurse Consultant or delegated State Schools Registered Nurse liaises with the NDIS provider and the specialist medical team to gather information about the student's needs including the:

• student's health needs;
• student's ambulance plan; and
• training provided to the NDIS provider by Children's Health Queensland Hospital and Health Service to deliver the Continuous Invasive Ventilation and other health supports to the student.

5. The principal makes a decision about granting in-principle access or refusing the request within a reasonable timeframe (generally 1-2 weeks providing all information is available) taking into account the issues outlined in the NDIS provider access to state schools policy and the student's human rights.
6. The principal informs the parent of their decision in writing:

• if access is granted in-principle, the principal advises the conditions of access, including further information required from the NDIS provider and the development of the NDIS delivered continuous invasive ventilation support and emergency plan and emergency health plan; or
• if access is refused, the principal provides reasons for the refusal.

Develop the NDIS delivered continuous invasive ventilation support and emergency plan

1. The Clinical Nurse Consultant or delegated State Schools Registered Nurse leads the development of the NDIS delivered continuous invasive ventilation support and emergency plan, in consultation with the student (where appropriate), the parents, Children's Health Queensland Hospital and Health Service, the student's specialist medical team and the NDIS provider, and other departmental staff, such as therapists, if required.
2. The NDIS delivered continuous invasive ventilation support and emergency plan will set out:

• roles and responsibilities of the student’s team, including NDIS provider personnel, and school staff;
• risk assessment and mitigation;
• changes to classrooms and other areas of the school needed to ensure Continuous Invasive Ventilation can be provided safely;
• access to required facilities, such as power points for ventilators, storage for back-up ventilators;
• supply and storage of medication;
• copy of the ambulance plan;
• providing emergency health support procedures;
• personal emergency evacuation plan;
• personal protective equipment;
• monitoring and procedure recording sheets to be completed;
• checklists for arrivals, departures and equipment checks; and
• plans and adjustments for student access and participation in schooling, including personal care, such as manual handling, and plans for student access and participation in learning including assistive technology.

3. The NDIS delivered continuous invasive ventilation support and emergency plan must be developed within a reasonable timeframe considering the information that needs to be gathered from a range of stakeholders.
4. The parents or the student (if appropriate), the NDIS provider and the principal sign the NDIS delivered continuous invasive ventilation support and emergency plan.
5. The signed NDIS delivered continuous invasive ventilation support and emergency plan is stored on OneSchool in the Student Health Plan
6. The principal or delegate provides a copy of the NDIS delivered continuous invasive ventilation support and emergency plan to the parents or student (if appropriate), and the NDIS provider.
7. The NDIS provider ensures its NDIS provider personnel delivering Continuous Invasive Ventilation are provided with a copy of the NDIS delivered continuous invasive ventilation support and emergency plan.

NDIS provider provides information to the school

1. The NDIS provider provides details of the nature and type of NDIS supports to be provided at the school, during school time.
2. The NDIS provider confirms with the principal or delegate, in writing or by email, the names and contact numbers of NDIS provider personnel who will be providing Continuous Invasive Ventilation to the student at school, during school time.
3. The NDIS provider provides details of any proposed use of school equipment or materials.

Enter into an Access Agreement (Continuous Invasive Ventilation)

1. The principal or delegate ensures that the NDIS provider provides the necessary documents to the school before the Access Agreement (Continuous Invasive Ventilation) is signed.
2. Once all required material is provided by the NDIS provider, the principal, parent and NDIS provider sign the Access Agreement (Continuous Invasive Ventilation) that outlines the roles and responsibilities of all parties.
3. The school will store all Information received relating to the NDIS Continuous Invasive Ventilation access request, including evidence of training undertaken by the NDIS providers' personnel, worker clearances under the Student Plan section in OneSchool and the Access Agreement (Continuous Invasive Ventilation) and continuous invasive ventilation support and emergency plan in the health plan section of the Student Plan.
4. Before the NDIS provider or NDIS provider personnel access the school premises and commence to deliver the Continuous Invasive Ventilation to the student at the school, the NDIS provider must provide to the school with certified copies of relevant documents evidencing for each NDIS provider personnel:

• their Working with Children (blue card) clearance details;
• photo identification, such as a valid Driver Licence or Proof of age card;
• written confirmation from Children's Health Queensland Hospital and Health Service that they have been trained to deliver the Continuous Invasive Ventilation for the student;
• have read the and completed the student protection fact sheet and Mandatory All Staff (MAST) and any other requirements notified by the school;
• satisfactorily completed of all necessary health care training including first aid, CPR and anaphylaxis training;
• hold all other necessary qualifications or approvals to undertake the activities required as part of delivering the NDIS supports;
• have satisfactorily completed relevant school-based induction for the school where the support is being provided; and
• have satisfied any other requirements as notified by the principal and as outlined in the Access Agreement (Continuous Invasive Ventilation).

5. The NDIS provider also provides the principal or delegate certificates of currency for the following insurances:

• workers compensation insurance (or personal injury insurance in the case of sole traders undertaking the work themselves);
• professional indemnity insurance for not less than $10 million (which includes coverage for providing Continuous Invasive Ventilation supports); and
• public liability insurance for not less than $20 million per claim.

Preparing to deliver supports at school

1. The principal or delegate will arrange for the State Schools Registered Nurse to train relevant school staff to support the student in the case of an emergency and to understand and be able to follow the relevant aspects of a student's NDIS delivered continuous invasive ventilation support and emergency plan.
2. The principal or delegate will ensure identified school staff have been trained in any required processes for safe handling of the student (e.g. assisting with the student's personal emergency evacuation plan) as required in the Manual tasks – assisting students with physical impairments procedure.
3. If further training is required, the principal or delegate must arrange that the NDIS provider accesses school-based induction and other required training, if not already undertaken by NDIS provider personnel.
4. All NDIS provider personnel must follow the school's sign in procedure each time they attend the school to deliver Continuous Invasive Ventilation.
5. School staff must sight, for each NDIS provider personnel attending the school:

• current Working with Children (blue card) clearance details; and
• current photo identification, such as a valid Driver Licence or Proof of age card.

Deliver student supports

1. The NDIS provider personnel deliver the Continuous Invasive Ventilation supports at school for the student. These supports include the student's ventilation supports, health support procedures and daily personal care.
2. The NDIS provider personnel deliver the supports as agreed in the NDIS delivered continuous invasive ventilation support and emergency plan including:

• completing daily arrival and departure and equipment checklists; and
• completing required daily records of support provided as included in the NDIS delivered continuous invasive ventilation support and emergency plan.

3. The NDIS provider personnel advise parents when consumables and equipment need replacing or are malfunctioning.
4. The NDIS provider personnel advise the classroom teacher who advises the principal immediately of any event where student safety is at risk.
5. In the event of an emergency health event, the NDIS provider personnel advise the classroom teacher or accessible staff. School staff are to call Triple 0 and follow the school emergency protocol and the NDIS provider personnel implement the emergency health plan as relevant.

Review student supports

1. The principal or delegate will:

• review the student's NDIS delivered continuous invasive ventilation support and emergency plan and Access Agreement (Continuous Invasive Ventilation) at least every six months (unless more frequent review is required), in consultation with the student (as appropriate), their parents, the NDIS provider, other school team members (as required, including the State Schools Registered Nurse or Clinical Nurse Consultant), and the student's specialist medical team
• initiate review of NDIS delivered continuous invasive ventilation support and emergency plan when planning for transitions between schools or year levels
• ensure parents are aware of the requirement to advise the school in writing of any changes to the support being provided by the specialist medical team or the NDIS provider personnel providing the support
• ensure the specialist medical team are aware of the requirement to:
  • communicate changes in the student’s health supports management with parents, NDIS provider and the school; and
  • collaborate when planning transitions to school or between schools, or transitions out of school upon school completion. 

Terminating and suspending access

1. The principal will:

• raise any concerns with the student’s parent and the NDIS provider and NDIS provider personnel (where relevant), about the NDIS support being provided at school, during school time.
• suspend or terminate the NDIS provider’s access, if the principal’s concerns impact on the student's health and safety, or other staff and students' health and safety, or are not resolved after discussions with the student’s parents and the NDIS provider
• suspend the NDIS provider's access if:
  • the NDIS delivered continuous invasive ventilation support and emergency plan requires significant review and the current plan does not provide safe delivery of care for the student;
  • the NDIS provider personnel require further training, including accessing school mandatory training; or
  • other requirements that impact on the student's safety or the health and safety of other students and staff in the school cannot be met within a reasonable timeframe as determined by the principal.
• continue the suspension until the NDIS provider or NDIS provider personnel have met the principal's requirements
• terminate the NDIS provider's access if the NDIS provider personnel;
  • provide unsafe care;
  • endanger other students' or staff health and safety including inappropriate conduct such as a breach of the Code of Conduct or privacy concerns;
  • engage in repeated behaviour that interferes with the good management and running of the school; or
  • do not comply with the Access Agreement (Continuous Invasive Ventilation) and the NDIS delivered continuous invasive ventilation support and emergency plan.
• advise the parent and NDIS provider in writing that:
  • access has been suspended, the period of suspension and the grounds for suspension and requirements for resumption of access; or
  • the Access Agreement (Continuous Invasive Ventilation) is terminated and the grounds for termination.
• raise any concerns regarding the NDIS provider’s conduct with the National Disability Insurance Agency and the NDIS Quality and Safeguarding Commission, if required.

2. If the NDIS provider or parent has a concern relating to suspension or termination of access the parent or NDIS provider can request a meeting with the school principal to discuss the decision and/or make a complaint in accordance with the department's Customer complaints management procedure.

Definitions

Legislation

• Anti-Discrimination Act 1991 (Qld) 
• Disability Discrimination Act 1992 (Cwlth)
• Disability Standards for Education 2005 (Cwlth)
• Education (General Provisions) Act 2006 (Qld)
• Human Rights Act 2019 (Qld)
• Information Privacy Act 2009 (Qld)
• National Disability Insurance Scheme Act 2013 (Cwlth)
• Public Records Act 2002 (Qld)
• Public Service Act 2008 (Qld)
• Work Health and Safety Act 2011 (Qld)

Delegations/Authorisations

• Nil

Other resources

• NDIS access request form
• Administration of medications in schools procedure
• Managing students' health support needs at school procedure 
• Manual tasks ­– assisting students with physical impairments procedure
• Consent form to share student personal information with third parties (DoE employees only)

Superseded versions

Nil