miscellaneous section 17 table of contents portland … · child, the state medicaid agency has a...

PPS Department of Special Education Miscellaneous

17.1 Revised: September 2003

MISCELLANEOUSSection 17

TABLE OF CONTENTS

PORTLAND PUBLIC SCHOOLS SPECIAL EDUCATION – OPERATIONS.............................17.3Third Party Medical Reimbursement (TPMR) ...............................................................17.5Basic Health Service .......................................................................................................17.6Testing and Evaluation ...................................................................................................17.8TPMR Procedure Codes..................................................................................................17.9Emergency Evacuation Guidelines .............................................................................17.15Sample Plan for Emergency Evacuation of Individuals with Disabilities ...............17.22Sample Emergency Evacuation – Record of Individuals with Disabilities .............17.23Accidents and Injuries ..................................................................................................17.24

PORTLAND PUBLIC SCHOOLS SPECIAL EDUCATION – RESOURCES ............................17.25



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Portland Public Schools Special Education

OPERATIONS



THIRD PARTY MEDICAL REIMBURSEMENT

Background on Medicaid Reimbursement to Schools

Recent legislation and court decisions entitle school systems to Medicaid reimbursement for health careservices. The opportunity for reimbursement exists when health care services are provided under astudent’s Individualized Education Plan (IEP) or Individualized Family Services Plan (IFSP). Schoolsystems may seek non-educational sources, including public medical assistance or private insurance forfunding services, such as speech, psychological, occupational/physical therapy, health relatedassessments, nursing, or transportation mileage.

In 1991, OMAP (Oregon Medical Assistance Program) requested a state plan amendment from the Health CareFinancing Administration (HCFA) which added school-based health services to the list of covered Medicaidservices. This was intended to improve the ease of billing and allowed for a much larger array of reimbursablehealth related IFSP/IEP services.

Definition (OAR 410-133-020)

A school-based health service is a related health service required by an IEP or IFSP during a child’s education orpreschool program (410-133-060).

Although the school systems are financially responsible for educational services, in the case of a Medicaid eligiblechild, the State Medicaid agency has a responsibility for paying for the “related services” identified in the child’s IEPor IFSP if they are covered under the State’s Medicaid plan. The financial responsibility was clearly spelled out inthe 1997 Amendment.

Oregon Legislation Regulating the School Billing Effort

Oregon’s IDEA (special education) program is outlined in the Oregon Administrative Rules (OAR) 581,Division 15, Oregon Department of Education (ODEA).

Oregon’s School-Based Health Services (Medicaid) is outlined in the OAR 410.133, OMAP.

School Based Medicaid

TPMR is unique to schools and in no way impacts the individual Medicaid Assistance dollars.



BASIC HEALTH SERVICE

The following qualified staff may furnish reimbursable services within the scope of their licensure:

• Licensed physical or occupational therapist.• Licensed physical therapy assistant or certified occupational therapy assistant.• Licensed speech pathologist (CCC).• Speech pathologist in clinic fellowship year.• Licensed audiologist or audiometrist.• Licensed clinical or social worker.• Licensed counselor.• Licensed psychologist.• Basic school psychologist.• Standard school psychologist.• Standard counselor.• Child development specialist with master’s degree.• Masters of social work.• Registered nurse.• Licensed practical nurse.• Nurse practitioner.

Billing for Corrective treatment is appropriate ONLY when all of the following have been met:

• The student has been found eligible under IDEA.• The ongoing services address a documented medical, health, or psychological need.• The treatment has been recommended by a licensed medical practitioner and• The services have been determined by the IEP process.• The services are described in goals and/or objectives on the IEP, and/or modifications and adaptations that

support and relate to the IEP goals and objectives.• The service provider is qualified as listed above.• Keep in mind that not all “Medically qualified” staff are qualified to diagnose a medical condition; some may

treat under the supervision of a higher professional only and state laws governing the practices andprofessions must be respected and observed in all cases. See the individual OARs governing licensure forspecific information regarding “scope of practice.”

Billable Services Include:

• Direct therapy – individual.• Parent/Staff consultation.• Phone call conferencing to family members, physicians, or other service providers.• Writing treatment plans (IEP).• Participation in IEP meetings.• Home visits (not transit time).• Periodic testing to update student progress.• Coordinating services with outside caregivers-hospitals, medical equipment suppliers, etc.• Preparing therapy materials (making copies, creating materials or preparing communication boards)• Preparation of treatment setting/environment.



• Writing progress reports and service logs.• Modifying equipment.• Preparing written correspondence.

Documentation Requirements:

• Date(s) of service.• Student’s name and date of birth.• Full signature and credentials of the person performing the service(s).• Description of the treatment.• Documentation of the student’s progress as required by IDEA.• One month of service per form.• Legible entries.• Provider initials after each entry.



TESTING AND EVALUATION

Billing for Screening, Testing, and Evaluation Services are allowed under the following circumstances:

• The services are necessary to determine a child’s initial or three year eligibility or non-eligibility under IDEA;or

• Further evaluation is necessary for a student who is currently eligible under IDEA but is suspected ofhaving additional disabilities.

Billing for Evaluation Services is allowed when the following have been met:

• Assessments determine a health related need (e.g., speech pathologist, physical therapy, etc.);• Assessments determine eligibility under IDEA;• Assessments yield a diagnostic report; or• Assessments are within the training and scope of practice for that professional.

Billable Evaluation Services Include:

• Student-practitioner interactive services;• Classroom observations by a licensed practitioner within the scope of practice defined in the• School Based Services guide;• Preparation of written evaluation/testing reports;• Review of health or medical records (including previous testing results or file reviews);• Consultation with family members, school personnel, physician, health care providers, or other service

providers;• Gathering family, social, or medical histories; or• Participation in MDT or IEP meeting(s).



TPMR PROCEDURE CODES

Code Description

NURSING

T1001 Nursing assessment/evaluation

T1002 RN Services

T1003 LPN/LVN services

T1004 Services of a delegated nursing aide

S5125 Attendant care services

G9005 Coordinated care, RN Supervision/delegation related services

COORDINATED CARE

G9003 Coordinated care, initial IEP (health only)

G9004 Coordinated care, annual IEP review (health only)

G9006 Coordinated care, home monitoring (health only)

G9007 Coordinated care, team conference (health only)

G9008 Coordinated care health professional oversight services (health only)

TRANSPORTATION

T2001 Non-emergent transportation; patient attendant/escort

T1004 Services of a delegated nursing aide

A0425 Ground mileage, per statute mile

PT/OT

97001 Physical Therapy evaluation

97002 Physical Therapy re-evaluation

97003 Occupational Therapy evaluation

97004 Occupational Therapy re-evaluation

97110Therapeutic procedure, one or more areas, each 15 minutes; therapeutic exercises to develop strength,endurance, range of motion and flexibility

97112— Neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture and/orproprioception for sitting and/or standing activities

97113 — Aquatic therapy with therapeutic exercises

97116 — Gait training (includes stair climbing)

97140Manual therapy techniques (eg, mobilization/manipulation, manual lymphatic drainage, manual traction),one or more regions, each 15 minutes

97150 Therapeutic procedure(s), group (2 or more individuals) Report 97150 for each member of the group.



(Group therapy procedures involve constant attendance of the physician or therapist, but by definition donot require one-on-one patient contact by the physician or therapist).

97504 Orthotic(s) fitting and training, upper extremity(ies), lower extremity(ies), and/or trunk, each 15 minutes

97520 Prosthetic training, upper and/or lower extremities, each 15 minutes

97530Therapeutic activities, direct (one-on-one patient contact by the provider (use of dynamic activities toimprove functional performance), each 15 minutes

97542 Wheelchair management/propulsion training, each 15 minutes

97703 Checkout for orthotic/prosthetic use, established patient, each 15 minutes

SPEECH/LANGUAGE

92506Evaluation of speech, language, voice, communication, and/or auditory processing disorder, and/or auralrehabilitation status

92507Treatment of speech, language, voice, communication, and/or auditory processing disorder, (includes auralrehabilitation); individual

92508 — group, two or more individuals

92510Aural rehabilitation following cochlear implant (includes evaluation of aural rehabilitation status and hearing,therapeutic services) with or without speech processor programming.

92526 Treatment of swallowing dysfunction and/or oral function for feeding

92553 Pure tone audiometry, air and bone

92555 Speech audiometry threshold

92556 — with speech recognition

92557 Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)

92562 Loudness balance test, alternate biaural or monoaural

92563 Tone decay test

92564 Short increment sensitivity index (SISI)

92565 Stenger test, pure tone

92567 Tympanometry (impedance testing)

92568 Acoustic reflex testing

92569 Acoustic reflex decay test

92571 Filtered speech test

92572 Staggered spondaic word test

92576 Synthetic sentence identification test

92577 Stenger test, speech

92579 Visual reinforcement audiometry (VRA)

92607Evaluation for prescription for speech generating augmentative and alternative communication device,face-to-face with patient, first hour



92608 — each additional 30 minutes (list separately in addition to primary procedure)

92609 Therapeutic services for use of speech generating device, including programming and modification

92610 Evaluation of oral and pharyngeal swallowing function

96150Health and behavior assessment (e.g. health focused clinical interview, behavioral observations,psychophysiological monitoring, health oriented questionaires) each 15 minutes face-to-face with thepatient, initial assessment

96151 Re-assessment

96152 Health and behavior intervention, face-to-face, individual

96153 Health and behavior intervention, group (2 or more patients)

MENTAL HEALTH

90801Psychiatric diagnostic interview examination (includes a history, mental status, and a disposition, and mayinclude communication with family or other sources, ordering and medical interpretation of laboratory orother medical diagnostic studies)

90802Interactive psychiatric diagnostic interview examination using play equipment, physical devices, languageinterpreter, or other mechanisms of communication

H0031 Mental health assessment by non-physician

96100Psychological testing (includes psychodiagnostic assessment of personality, psychopathology,emotionality, intellectual abilities, eg, WAIS-R, Rorschach, MMPI) with interpretation and report, per hour

96111— extended (includes assessment of motor, language, social, adaptive and/or cognitive functioning bystandardized developmental instruments, eg, Bayley Scales of Infant Development) with interpretation andreport, per hour

90804Individual psychotherapy, insight-oriented, behavior modifying and/or supportive, in an office or outpatientfacility, approximately 20-30 minutes face-to-face with the patient

90805 — with medical evaluation and management services

90806Individual psychotherapy insight-oriented, behavior modifying and/or supportive, in an office or outpatientfacility, approximately 45-50 minutes face-to-face with the patient

90807 — with medical evaluation and management services

90808Individual psychotherapy, insight oriented behavior modifying and/or supportive, in office or outpatientfacility approximately 75-80 minutes face-to-face with patient

90809 With medical evaluation and management services

90810Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or othermechanisms of non-verbal communication, in office or outpatient facility approximately 20 to 30 minutesface-to-face with patient


90812Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or othermechanisms of non-verbal communication, in office or outpatient facility approximately 45 to 50 minutesface-to-face with patient




90814Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or othermechanisms of non-verbal communication , in office or outpatient facility approximately 75 to 80 minutesface-to-face with patient


H0004 Behavioral health counseling and therapy, per 15 minutes

90853 Group psychotherapy (other than of a multiple-family group)

90857 Interactive group psychotherapy

90862Pharmacologic management, including prescription, use, and review of medication with no more thanminimal medical psychotherapy

H0034 Medication training and support, per 15 minutes

CONTRACTED EVALUATION & MANAGEMENT[contact OMAP policy for specialist specific code(s)]

99202

New Patient. Office or outpatient visit for the evaluation and management of a new patient, which requiresthese three components: an expanded problem focused history; an expanded problem focusedexamination; and straightforward medical decision-making. Counseling and/or coordination of care withother providers or agencies are provided consistent with the nature of the problem(s) and the patient'sand/or family's needs.— Usually the presenting problem(s) are of low to moderate severity. Physicians typically spend 20 minutesface-to-face with the patient and/or family.

99203

New Patient. Office or outpatient visit for the evaluation and management of a new patient, which requiresthese three components: a detailed history; a detailed examination; and medical decision-making of lowcomplexity. Counseling and/or coordination of care with other providers or agencies are provided consistentwith the nature of the problem(s) and the patient's and/or family's needs.— Usually the presenting problem(s) are of low to moderate severity. Physicians typically spend 30 minutesface-to-face with the patient and/or family.

99204

New Patient. Office or outpatient visit for the evaluation and management of a new patient, which requiresthese three components: a comprehensive history; a comprehensive examination; and medical decision-making of moderate complexity. Counseling and/or coordination of care with other providers or agenciesare provided consistent with the nature of the problem(s) and the patient's and/or family's needs.— Usually the presenting problem(s) are of low to moderate severity. Physicians typically spend 45 minutesface-to-face with the patient and/or family.

99205

New Patient. Office or outpatient visit for the evaluation and management of a new patient, which requiresthese three components: a comprehensive history; a comprehensive examination; and medical decision-making of high complexity. Counseling and/or coordination of care with other providers or agencies areprovided consistent with the nature of the problem(s) and the patient's and/or family's needs.— Usually the presenting problem(s) are of low to moderate severity. Physicians typically spend 60 minutesface-to-face with the patient and/or family.

99211Established Patient. Office or other outpatient visit for evaluation and management of an establishedpatient, that may not require the presence of a physician. Usually the presenting problem(s) are minimal.Typically, 5 minutes are spent performing or supervising these services.



99212

Established Patient. Office or other outpatient visit for evaluation and management of an establishedpatient, which requires at least two of these three key components: a problem focused history, a problemfocused examination; straightforward medical decision making.

Counseling and/or coordination of care with other providers or agencies are provided consistent with thenature of the problem(s) and the patient's and/or family's needs.— Usually the presenting problem(s) are self limiting or minor. Physicians typically spend 10 minutes face-to-face with the patient and/or family.

99213

Established Patient. Office or other outpatient visit for evaluation and management of an establishedpatient, which requires at least two of these three key components: an expanded problem focused history,an expanded problem focused examination; medical decision making of low complexity.

Counseling and/or coordination of care with other providers or agencies are provided consistent with thenature of the problem(s) and the patient's and/or family's needs.— Usually the presenting problem(s) are low to moderate severity. Physicians typically spend 15 minutesface-to-face with the patient and/or family.

99214

Established Patient. Office or other outpatient visit for evaluation and management of an establishedpatient, which requires at least two of these three key components: a detailed history, a detailedexamination; medical decision making of moderate complexity.

Counseling and/or coordination of care with other providers or agencies are provided consistent with thenature of the problem(s) and the patient's and/or family's needs.— Usually the presenting problem(s) are of moderate to high severity. Physicians typically spend 25minutes face-to-face with the patient and/or family.

99215

Established Patient. Office or other outpatient visit for evaluation and management of an establishedpatient, which requires at least two of these three key components: a comprehensive history, acomprehensive examination; medical decision making of high complexity.

Counseling and/or coordination of care with other providers or agencies are provided consistent with thenature of the problem(s) and the patient's and/or family's needs.— Usually the presenting problem(s) are of moderate to high severity. Physicians typically spend 40minutes face-to-face with the patient and/or family.

96100Psychological testing (includes psychodiagnostic assessment of personality, psychopathology,emotionality, intellectual abilities, eg, WAIS-R, Rorschach, MMPI) with interpretation and report, per hour

96111— extended (includes assessment of motor, language, social, adaptive and/or cognitive functioning bystandardized developmental instruments, eg, Bayley Scales of Infant Development) with interpretation andreport, per hour

96117 Neurological testing battery (eg. Halstead-Reitan, Luria, WAIS-R) with interpretation and report, per hour

99241

Office Consultation for new or established patient, which requires these three components: a problemfocused history, a problem focused examination, and straightforward medical decision-making. Counselingand/or coordination of care with other providers or agencies are provided consistent with the nature of theproblem(s) and the patient's and/or family's needs. Usually the presenting problem(s) are self limited orminor. Physician typically spends 15 minutes face-to-face with the patient and/or family.

99242 Office Consultation for new or established patient, which requires these three components: an expanded



problem focused history, an expanded problem focused examination, and straightforward medical decision-making. Counseling and/or coordination of care with other providers or agencies are provided consistentwith the nature of the problem(s) and the patient's and/or family's needs. Usually the presenting problem(s)are of low severity. Physician typically spends 30 minutes face-to-face with the patient and/or family.

99243

Office Consultation for new or established patient, which requires these three components: a detailedhistory, a detailed examination, and medical decision-making of low complexity. Counseling and/orcoordination of care with other providers or agencies are provided consistent with the nature of theproblem(s) and the patient's and/or family's needs. Usually the presenting problem(s) are of moderateseverity. Physician typically spends 40 minutes face-to-face with the patient and/or family.

99244

Office Consultation for new or established patient, which requires these three components: acomprehensive history, a comprehensive examination, and medical decision-making of moderatecomplexity. Counseling and/or coordination of care with other providers or agencies are provided consistentwith the nature of the problem(s) and the patient's and/or family's needs. Usually the presenting problem(s)are of moderate to high severity. Physician typically spends 60 minutes face-to-face with the patient and/orfamily.

99245

Office Consultation for new or established patient, which requires these three components: acomprehensive history, a comprehensive examination, and medical decision-making of high complexity.Counseling and/or coordination of care with other providers or agencies are provided consistent with thenature of the problem(s) and the patient's and/or family's needs. Usually the presenting problem(s) are ofmoderate to high severity. Physician typically spends 80 minutes face-to-face with the patient and/or family.



PPS EMERGENCY EVACUATION GUIDELINES

For Individuals With Disabilities

These guidelines apply to anyone who has a condition, disability or behavior that limits his or her independence orjudgment to evacuate a building during an emergency or drill without the assistance of equipment and/or anotherperson(s).

• Each school should have an emergency evacuation plan for individuals with disabilities that incorporatesthese guidelines. That plan shall be communicated to staff, students, and parents at the beginning of eachschool year and throughout the year when appropriate, (e.g., a new person with a disability joins theschool).

• Refer to the district guidelines on emergency evacuation for persons who are in wheelchairs, deaf or hardof hearing, visually impaired, and significantly impaired (Attachments A,B,C,D).

• Refer to the district guidelines for students with IEPs that address special needs for emergency evacuationand earthquake response (Attachment E).

• Each school and district building should identify a licensed staff person who will supervise the emergencyevacuation procedures for individuals with disabilities in that school or district building, including identifyinga staff person to coordinate each student’s evacuation plan (identifying adult/student assistants, training,etc.).

• Administrators of each school and district building should designate a key person to keep current andmaintain a record of any and all individuals with disabilities in the school or district building. This recordshall include names, disabilities, locations, time schedules, persons responsible for assisting them duringan emergency, and the location of any special equipment needed for the evacuation.

• The designated supervisory person or persons will take the record of individuals with disabilities as theyevacuate the building and verify that all individuals with disabilities have evacuated the building.

• The administrator of the school or building will assign a person and one or more back-up persons to eachindividual with a disability. That person will provide appropriate assistance at the time of an emergencyevacuation or drill.

• Where able-bodied students can be utilized, it is prudent to develop a system using staff to supervise theexiting of the individuals with disabilities while the able-bodied students physically assist with evacuation.Students must be carefully selected and trained.

• All persons and back-up persons assigned to assist in emergency evacuations will be trained on necessaryand safe procedures at the beginning of each school year and as needed throughout the year.

• The location of any special equipment needed to evacuate individuals with disabilities shall be included inthe school and district building plan.

• Individuals with disabilities and persons trained to assist them will have an equal amount of opportunities topractice evacuation drills as persons without disabilities.



• Emergency planning for individuals with disabilities must be reviewed periodically so that new personsknow what to do during an emergency.



Attachment A

Guidelines for Emergency Evacuation of Students Using Wheelchairs on Stairs

1. School staff may consult the physical therapist assigned to the building to assist in developing appropriateprocedures.

2. Review type of wheelchair used by student (i.e., manual wheelchair vs. powered wheelchair).

3. Review severity of disability and weight of the students (e.g., does the student have use of trunk and/orupper extremities).

4. Review abilities of those assisting the student in relationship to the student in wheelchair (e.g., strength,fitness level, size).

Methods of Evacuation

1. Identified staff and/or students can be trained to bump the student in a manual wheelchair down/up thestairs by tipping the wheelchair onto the back wheels and lowering the chair down/up each stair using twoassistants, one at the back and one at the front.

2. Identified staff and/or students can be trained to carry the student down/up the stairs while in a manualwheelchair. This will require two persons, one on each side of the wheelchair.

3. Identified staff and/or students can be trained to carry the student down/up the stairs while another personbumps the empty manual wheelchair down/up the stairs. If the student is carried and the wheelchair is notbumped down/up the stairs, the student should be placed on the ground until a chair can be located. Thisprocedure may also be appropriate for a student in a power wheelchair.

4. Identified staff and/or students can be trained on the use of an Evac-U-Trac. This is a portable evacuationdevice designed so that an average size person can safely move another person of any size down stairs.The student is transferred to the Evac-U-Trac and moved down the stairs. This procedure is typically usedwhen a student is in a power wheelchair.

Use of Student Volunteers

The designated supervisory person and the student in the wheelchair jointly can choose responsible and physicallycapable volunteer students with good attendance to assist with evacuation. Students who volunteer must have asigned release from their parents giving permission for their child to help in an emergency. School staff or thephysical therapist assigned to the school must train volunteer students in back care and lifting, followed by anobservation during an evacuation drill.



Attachment B

Guidelines for Emergency Evacuation of Individuals Who Are Deaf or Hard of Hearing

1. In buildings that regularly employ an individual who is deaf or hard of hearing and in buildings that housedeaf/hard of hearing classrooms, strobe lights are installed in targeted rooms (rooms that regularly houseindividuals who are deaf/hard of hearing restrooms, libraries, hallways, staff lounges, etc.). The strobelights are connected to the individual building’s emergency alarm system and are activated with thebuilding’s alarm system.

2. In buildings that do not regularly house individuals who are deaf/hard of hearing the following procedureswill be followed:

When an individual who is deaf/hard of hearing enters a district building and checks in at the mainoffice, he/she should be asked to sign in and to give his/her location and schedule. A writtenexplanation of the emergency/evacuation system and its rationale should be given to each individualwho is deaf/hard of hearing when he/she signs in at the office. It should read:

WE DO NOT HAVE EMERGENCY STROBE LIGHTS INTHIS BUILDING. FOR YOUR SAFETY IN EMERGENCIES(FIRES, EARTHQUAKES, ETC.) PLEASE SIGN IN. WE NEEDTO KNOW WHERE YOU ARE IN THE BUILDING AND YOURSCHEDULE. WE WILL ASSIGN A PERSON TO ALERT YOU INCASE OF AN EMERGENCY. THANK YOU FOR YOUR COOPERATION.

3. The designated person in the building who keeps and maintains records of any individuals with disabilitiesshould assign a “buddy” to the individual who is deaf/hard of hearing. A buddy should be a person in closephysical proximity (either in the same room or next door). The buddy should be given EmergencyEvacuation Cards to show the individual who is deaf/hard of hearing in case of an emergency. Thereshould be two cards:

CARD 1: EMERGENCY — GET OUT OF BUILDING

CARD 2: EMERGENCY — GET UNDER DESK/TABLE



Attachment C

Guidelines for Emergency Evacuation of Individuals with Visual ImpairmentsProcedures for Students

All students who meet the Individuals with Disabilities Education Act criteria under Vision Impairment will requireassistance in evacuating a school building. The school or building administrator shall designate staff to act assighted guides in escorting the student who is visually impaired out of the building. The sighted guide will need toremain with the student and when it is deemed safe, escort the student back inside the school to a familiar location.

The administrator and the student with the visual impairment jointly can choose volunteer students with goodattendance who are considered responsible to act as sighted guides. In this case, the supervisor shall obtain asigned release from the volunteer student’s parents indicating that they give permission for their child to help in anemergency.

Procedures for Adults

Regular school staff with visual impairments should be asked what, if any, type of assistance they will need in caseof evacuation. The staff person should be able to indicate what type of assistance is required (e.g., someone towalk next to him or her as a sighted guide).

All other adults with visual impairments should be asked, upon checking in at the school office, if they will needassistance in evacuating the building in case of an emergency. The only special training that might be requiredwould be how to act as a sighted guide.



Attachment D

Guidelines for Emergency Evacuation of Students with Significant Disabilities

The school team will determine whether Procedure I or Procedure II as described below should be followed foreach student with significant disabilities. Procedure I is appropriate for those students who are able to understandan explanation of the purpose and procedures of a fire drill or other emergency evacuation. Procedure II should befollowed for all other students.

Procedure I

At the beginning of each year, the teacher should talk to the student with significant disabilities about fire drills andexplain their purpose. Even if the student is verbal, visual information to assist the student in communicating shouldbe prepared so that the student can take it out of the building during a drill or evacuation. The administrator shalldesignate a staff member or responsible volunteer student with good attendance to escort the student out of thebuilding to a specified safe place (e.g., a particular parking lot or street corner). The student should have theopportunity to practice the fire drill procedure multiple times within the first few weeks of school.

Procedure II

Establishing a routine is the key to this procedure. The administrator shall designate a staff member or responsiblevolunteer student with good attendance to escort the student out of the building to a specified safe place. It will behelpful if the designated escort explains, step by step, what the student is to do. Accordingly, it will be important forthe designated person to be familiar with the student’s communication system. The student will need to practicethese procedures regularly at the beginning of the school year until a routine is established and then periodicallythroughout the school year.

If the Student Becomes Combative

A combative student is one who will not leave the building or refuses to return to the building. A student mightbecome combative with the noise and confusion that naturally accompanies fire drills. At the beginning of eachschool year, time should be spent desensitizing the student to the sound of the bell and practicing walking incrowded hallways. If a student becomes combative during a drill, the designated escort should use the visualcommunication system to let the student know he or she will need to leave the building. The student should then becued to take a couple of breaths to relax. The designated person should escort the student out of the building tothe specified safe place.

If all procedures are unsuccessful, a designated team skilled in using safe restraining techniques can carry thestudent out of the building to the specified safe place. At the safe place, the designated escort can try calming thestudent by using the visual communication system and relaxation techniques. Once the student is calm and the drillis over, the student can be escorted back into the school.



Attachment E

Evacuation Guidelines for Students with IEPS

Since some students have conditions, disabilities or behaviors which limit judgment or independence, evacuationfor fire and earthquake presents special problems. For individuals who need special procedures, the student’sprimary teacher must develop an evacuation plan.

The physical therapist, autism specialist, vision specialist, hearing specialist, nurse or other team member assignedto the student can assist building staff in developing special procedures. Safety of adults and students should beconsidered in any plan.

Earthquake Response Procedures for Students with Special Needs

Since some students have conditions, disabilities, or behaviors that limit judgment or independence, earthquakeresponse presents special problems. In these cases the teacher may include this information in the evacuationplan.

The person(s) designated to help the student with a disability will:

• Help the student get under a desk or table.

• Help the student move away from objects that may fall.

• Cover or protect student’s head as much as possible.

• Help the student remain where he or she is until the earthquake has ceased.

• Help the student evacuate the building after an earthquake.

• If outdoors, help the student to remain in a safe place and assist student to move away from buildings,streetlights, utility wires, and large trees.



Sample Plan for Emergency Evacuation of Individuals with Disabilities

Individual With Disability: Date:

______________________________________________________________________________

School: Supervisory Person:

______________________________________________________________________________

Location of Special Equipment

Equipment Location

Names of persons and their replacements who are designated to aid persons with disabilities:

Designated Persons Designated Replacements

Evacuation Plan:______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Training Plan (include trainer(s), context, schedule):______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________



Sample Record of Individuals with Disabilities

School Person MaintainingSCHOOL Supervisor This Form School Year

_____________________________________________________________________________

NAME DISABILITY SCHEDULE

(Times &Locations)

LOCATION

of SpecialEquipment

HELPER #1 HELPER #2

C:\EH&S Data\Safety Docs\Disabled Evauation.doc



MEMORANDUM

October 15, 2003

To: All Special Education StaffPrincipals

From: Maxine Kilcrease, Director of Special EducationConnie Bull, Special Education Legal Counsel

Re: Accidents and Injuries

If a student injures himself or another student, District staff must complete an “Accident/Injury Report” which, amongother things, requires staff to contact the parent about the incident. A copy of this document must be given to theprincipal, and the other sent to Risk Management located at the BESC.

PORTLAND PUBLIC SCHOOLS501 North Dixon St. Portland, OR 97227

Mailing Address: P.O. Box 3107 Portland, OR 97208-3107

Maxine Kilcrease, Ph.D., Director

Telephone: (503) 916-2000 / 916-3152 Fax: (503) 916-3174

SPECIAL EDUCATION & TAG




Portland Public Schools Special Education

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