Elementary Administrators in the Rutland Zone within School District No.23, through several collegial conversations, raised concerns regarding particular student needs that had surpassed our level of expertise and internal resources. A more cross-ministerial approach to intervention would better support student success. In September 2017, the Integrated Health Solutions Team was formed as a cooperative service for Rutland area families in collaboration with the Central Okanagan Family Hub.
School - Base Team (SBT) personnel from Pearson, Rutland, South Rutland, Ellison, Black Mountain, Belgo, Spring Valley and Quigley Elementary Schools.
Placing the child in the centre, the goal of the team is to work alongside parents to provide a wrap-around service to provide basic need resources and to expedite and refine the referral process to health professionals in a timely and effective manner.
Current estimates reveal that approximately 50% of residents who reside in the Rutland area in Kelowna do not have a family doctor. This presents increased frustration, anxiety and fear of parents that are unable to access applicable medical services efficiently and are required to wait in long lines at drop-in clinics in an attempt to explain the presenting concerns to General Physicians. Most recently, the drop in clinic located in Rutland has since closed causing further restraints to service as families struggle to find transportation to supplemental clinics in Kelowna.
"A school-based team is an on-going team of school-based personnel which has a formal role to play as a problem-solving unit in assisting classroom teachers to develop and implement instructional and/or management strategies to coordinate support resources for students with special needs within the school." (Special Education Services - A Manual of Policies, Procedures & Guidelines, British Columbia, 2016)
The IHS has allowed for the expansion of the School Base Team members commencing in September 2017 to provide opportunities for Public Health Nurses assigned to Rutland area elementary schools to attend weekly/bi-weekly School Base Team meetings. The Public Health Nurse will be the primary team member in assisting/consulting with parents and schools in completing the IHS medical referral form. In specific circumstances, the IHS Pediatrician and Child & Youth Mental Health providers may be requested to attend supplementary School Base Team meetings.
The IHS Medical Referral Form and applicable parent consents (see attached) will be collected by the school's Public Health Nurse and submitted to the IHS Medical Referral Coordinator for review. In the process of reviewing, the Medical Referral Coordinator may consult further with our Nurse practitioner, the IHS Pediatricians and/or the IHS Child & Youth Mental Health Consultant to discuss presenting concerns and route for further assessment.
In the absence of a family Dr, Public Health Nurses (PHN’s) are able to refer clients (students) to our Nurse Practitioner (NP), who then becomes the client’s primary care provider. As such, the NP can do assessments, order tests, prescribe medication and refer as appropriate to Pediatricians and other specialists where appropriate.
As per the referral form, the PHN will be able to communicate with the family Dr, or NP to help to set up appointments. The PHN can follow up with the NP/Dr and report back to the school if the appointment was attended, but will not be privy to any assessments. It will also be important to ensure that there is someone available to assist the family in attending their appointment. This piece is a work in progress!
The convenient component of this initiative is the medical service providers will meet and assess children directly out of the Central Okanagan Family Hub located at Pearson Road Elementary. The medical office is directly across the hall from the Hub and medical service providers can also refer parents to the Hub Facilitators who can provide families with information to access resources and the array of programs that are offered free of charge in the Hub Learning Room.