Restarting Safe Education & Testing (ReSET)
for Children with Medical Complexity

Priorities for a Safe Return to School for Children with Complex Health Needs

Children with complex health needs have serious medical conditions and often rely on medical devices or people to help them with daily activities.

Safe in-person school attendance can be hard because these children are at higher risk of severe COVID-19, their daily care can include high-risk procedures, and physical distancing and mask adherence can be difficult.

The unique circumstances facing children with complex health needs require extra attention to support safe in-person school attendance.

In Spring 2021, 460 Wisconsin families, school staff, and clinicians sent us over 1,100 ideas on how to help these children attend school during the pandemic.

The top 10 ideas shown below were prioritized by a team of 35 experts representing families, schools, clinicians and policymakers across Wisconsin.

As a central principle, the safety of children with complex health needs requires the safety of all children and staff at school. Families of children with complex health needs should be supported to make the best decision for their child with their health care providers and school staff when considering the risks of COVID-19.

PRIORITIES

  • Encourage all school staff who work in close proximity with children with complex health needs (e.g., aides, therapists, school nurses) to be vaccinated against COVID-19 and wear a mask whether vaccinated or not.
  • Ensure a respiratory protection plan is in place for school staff performing high-risk care, such as aerosol-generating procedures (e.g., tracheostomy suctioning, nebulized treatments, etc.). For those staff, that would include N95 mask fit testing or availability of Powered Air Purifying Respirator (PAPR).
  • Assign and maintain individual seats for children with complex health needs during transportation to and from school.
  • Educate school staff and families about the increased health risks of contracting COVID-19 for children with complex health needs.
  • Discuss COVID-19 mitigation strategies for children with complex health needs in Individualized Education Plan (IEP) meetings. Specifically, develop plans that outline the child’s daily routines and contingency plans which account for COVID-19 safety.
  • Ensure that each child with complex health needs has their own medical equipment or single use disposable equipment at school.
  • Plan to provide COVID-19 testing for staff and students at school.
  • Partner with health care providers about ways to keep each child with complex health needs safe at school and circumstances in which a child should stay home.
  • Have at least one medical staff (such as a school nurse) available to address acute COVID-19 symptoms or questions.
  • Provide families of children with complex health needs with the opportunity to change between in-person and virtual or homebound school based on illness or COVID-19 spread.

RESOURCES

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ABOUT

This information was developed by families, school staff, clinicians and policymakers across Wisconsin in partnership with the University of Wisconsin School of Medicine and Public Health, Healthy Kids Collaborative, Wisconsin Departments of Public Instruction and Health Services, Waisman Center UCEDD, and Family Voices of Wisconsin.

This research was, in part, funded by the National Institutes of Health (NIH) Agreement No. 1 OT2 HD107558-01 (award number OT2 HD107558). The views and conclusions contained in this document are those of the authors and should not be interpreted as representing the official policies, either expressed or implied, of the NIH.