Pursuant to Board Policy J-359 “Private Practitioners,” parents or legal guardians may choose to independently contract with private practitioners to access additional medical services which are outside of the student’s educational program. Knox County Schools welcomes private practitioners entering the school to help improve the health and wellbeing of students.

This procedure outlines the request process to authorize a private practitioner to administer medical services to a student on campus during the school day, and how authorized private practitioners are to conduct themselves while on school premises for this purpose. All such requests for authorization must be initiated by a parent or legal guardian via the Private Practitioner Portal on the KCS Health Services webpage. The Private Practitioner Portal will open each year on July 1st for submissions for the upcoming school year. Private practitioners who provide services under a separate Memorandum of Understanding with Knox County Schools are not necessarily governed by this Administrative Procedure and should consult their own Memorandum of Understanding, other KCS policies and procedures which may apply, and the executive principal of the school they are accessing to determine what expectations may apply.

The following documentation must be submitted by parents/guardians on the Private Practitioner Portal. All requested documents must be scanned and uploaded as PDFs.

• Private Practitioner Request Form
• Medical Release Form
• Parent Consent Form 
• A signed Letter of Necessity 

After all necessary documentation has been submitted by the parent or guardian (on or after July 1), private practitioners who will access the school virtually or in person should contact KCS Human Resources to schedule a TBI fingerprinting and drug screening to complete the necessary background check requirements. Private practitioners will be notified of the results of their background check by KCS Human Resources. Practitioners must also create an account on the Private Practitioner Portal on the KCS Health Services webpage to submit the following documentation:

• Signed Private Practitioner Agreement
• Photo to be used on school identification badge
• Proof of liability insurance*
• Medical treatment plan**
• Proof of up-to-date certification/licensure
• Certificate of insurance
• Completed Request to Provide Live Remote Services (if remote access is desired)

*Insurance coverage must provide for the requested practitioner’s medically-required services during the school day.

**Treatment plans are reviewed and maintained by KCS Health Services and are not intended for distribution or use beyond this department.

KCS Health Services will review all submitted documentation and coordinate with the principal at the relevant school to confirm that the requested services will not interfere with the educational process for the student involved or their peers. Knox County Schools reserves the right to deny any private practitioner access to KCS campuses either temporarily or permanently where, in the school system’s discretion, such access interferes with the safety or privacy of KCS students, violates this or other KCS policies or procedures, or interferes in any way with the educational environment and processes of the school. Examples of services which could create an interference with the educational environment and processes of the school include but are not limited to certain invasive medical procedures, services which would remove a child from their least restrictive environment as determined by a student’s IEP team, therapeutic services which are overly loud or distracting for the planned setting, and any service which includes isolation or restraint of a student.

Nothing in this procedure pertains to the behavior of students receiving services. Student discipline policies are located in Section J of the Knox County School Board Policies.

NOTIFICATION OF INITIAL CONFIRMATION OR DENIAL

KCS Health Services will notify the parent or guardian when their request has been confirmed. If it is determined that the requested services would create an irreconcilable interference with student safety, student privacy, the educational environment and processes of the school, or the school’s ability to supervise its students, KCS Health Services will notify the parent or guardian with a letter of denial.

STATEMENT OF GRIEVANCES AND APPEALS

Parents/legal guardians who receive a letter of denial may choose to appeal the decision. Appeals should begin with the submission of a written statement of grievances submitted to the Director of Student Supports. The Director of Student Supports will review the submitted grievances and provide a written response within fifteen (15) business days. All subsequent requests for appeal shall be submitted in the following order:

1. Assistant Superintendent of Student Success 
2. Director of Schools 
3. Board of Education 

Requests to appeal should be submitted to the appropriate office within fifteen (15) days from the issuance of the decision being appealed. Requests for appeal filed with the Board of Education will be heard within sixty days (60) from the date the request is received.  

CONFLICT RESOLUTION PROCEDURE***

Due to changing environmental conditions and educational requirements in schools, executive principals have the authority and discretion at all times to direct any private practitioners accessing their building pursuant to KCS Policy J-359 as to which school settings practitioners may access and at what times. Executive principals also have the authority and discretion at all times to direct a private practitioner to stop engaging in any practice or behavior that the executive principal believes is dangerous, violates student privacy or dignity, or is disruptive to the educational process, even if the practitioner is otherwise approved under Policy J-359. Where feasible, executive principals shall make reasonable efforts to communicate new rules or restrictions to private practitioners working in their buildings in a timely fashion so as to minimize last-minute disruptions or schedule changes.

In the event that a parent/legal guardian feels that a principal’s direction or restriction of a private practitioner they have hired has materially disrupted their student’s services on at least three separate school days during a particular nine-week period, they may appeal the principal’s decision. Such appeals shall be submitted in writing to the Office of the Ombudsman, whose decision shall be final.

The decision of the executive principal shall be binding upon the private practitioner during the pendency of the appeal.

*** Principals who believe that a private practitioner has violated law, policy, or written regulations should contact the Director of Student Supports with any proof of the alleged violation, including witness statements, and should take no action themselves beyond that which is required to ensure the immediate safety of students and staff.

NOTIFICATION OF DISCONTINUATION OF SERVICES

The employer of any approved private practitioner is responsible for notifying the Supervisor of Health Services in the event that the approved practitioner no longer works for their agency. Notification should be delivered in writing prior to the start of the next business day following the change in employment.   

TRANSFERRING SERVICES BETWEEN KNOX COUNTY SCHOOLS

Approved requests for privately contracted medical services will follow any student who transfers or changes schools over the course of a single school year. Both the private practitioner and the principal of the student’s previous school are jointly responsible for notifying the principal of the student’s new school of the student’s need for private medical services while at school, within ten (10) school days of the transfer.

SERVICES EXTENDING BEYOND A SINGLE YEAR

All approvals for private practitioners expire at the conclusion of each school year. Parents/legal guardians interested in requesting services for a subsequent year should submit all necessary documentation for any new requests prior to or during the following school year. Practitioners shall also be required to sign a new Private Practitioner Agreement and re-upload all required documentation (except the background check) to the Private Practitioner Portal.
 

Background checks, including TBI fingerprinting, are valid for five calendar years for all individual practitioners who continuously provide services in Knox County Schools. Practitioners extending their services beyond five years, or those who experience a break in in-school services lasting more than eight months, will be required to complete a new background check.
 

Private practitioners need only complete drug testing once per continuous service period. Practitioners who experience a break in in-school services lasting more than eight months will need to complete new drug testing.

PROCEDURES FOR PRIVATE PRACTITIONERS WHILE ACCESSING SCHOOL CAMPUSES

Private practitioners are expected to follow all policies, rules, and procedures set forth by Knox County Schools, and the oral or written directions of building-level administration, while present on Knox County Schools campuses. Private practitioners should be particularly cognizant of the following procedures:
 

1. Private health services being provided to the student on school premises during the school day must not interfere with the education of the student receiving services or of any other student. Private practitioners are not permitted to interfere with the proper implementation of a student’s Individualized Education Program (“IEP”), Section 504 Plan, Behavior Intervention Plan, or any other educational program or plan deemed necessary or appropriate by the executive principal or KCS. In order to protect their right to be educated in the least restrictive environment appropriate,
   students may not be removed more than momentarily from the educational environment with their peers in order to access private services.
2. Private practitioners accessing Knox County Schools under this policy are not permitted to exact discipline of any kind on any student while on school premises. Student discipline while at school remains the sole responsibility of Knox County Schools staff and administration.
3. In no circumstance shall any private practitioner isolate or restrain a child under their care while on school premises, nor shall they direct any other person to do so. Violation of this procedure may result in immediate termination of access privileges to KCS schools. KCS staff are likewise not permitted to request such an action by any private practitioner. In the event that a student in crisis must be placed in isolation or restrained, private practitioners should not follow the child into any space designated for isolation of students in crisis.
4. In no circumstance shall any private practitioner perform any type of corporal punishment on a student while on school premises, nor shall they direct any other person to do so. Violation of this procedure may result in immediate termination of access privileges to KCS schools. KCS staff are likewise not permitted to request such an action by any private practitioner.
5. Prior to commencing services for a student in a new school, private practitioners should schedule a meeting, which may be virtual, with the school’s executive principal or their designee. Private practitioners and building-level administration shall collaborate to determine a service schedule. This service schedule shall be written out and included in the student’s educational record. The service schedule need not contain any private health information beyond the days and times that services will be provided, and whether they will be provided remotely.
6. KCS staff are ultimately responsible for the care of all students while at school, and shall make all decisions about the student’s education, including but not limited to student safety, behavioral interventions, and discipline.
7. All private practitioners must check in with the front office and classroom teacher at the beginning and end of each session. In the event that services are being provided remotely, the provider accessing the school remotely must check in with front office staff and the classroom teacher via videoconference at the beginning of each session by providing their name and destination and displaying their KCS-provided identification remotely using their device’s camera.
8. Private practitioners who wish to provide remote services to a particular student must receive additional, separate authorization from KCS Health Services to do so. Such authorization may be requested via submission of a completed Request to Provide Live Remote Services, signed by all necessary parties.
9. In no circumstance shall any private practitioner photograph or record any student or staff member while on campus. Violation of this procedure may result in immediate termination of access privileges to KCS schools.
10. In the event that a private practitioner, having received prior approval for remote access under the process outlined above, chooses to access a KCS school remotely as part of a health service, the practitioner shall not permit themselves to be visible on camera while students other than the student receiving services are present, nor shall they permit themselves to be heard by students other than the student receiving services.
11. In order to protect our students’ privacy and promote opportunities for student socialization, remote private health services will generally not be allowed to take place in school common areas which receive significant traffic, such as hallways, cafeterias, playgrounds, and gymnasiums.
12. Knox County Schools will not be responsible for facilitating remote access for services during the school day. Any practitioner accessing schools under KCS Policy J-359 shall be fully responsible for any and all logistical concerns relating to remote access services. In no event shall a child be removed from the educational environment or supervision of KCS staff to receive remote services, nor will KCS commit to providing designated spaces or technology to facilitate such services. Private practitioners may utilize KCS guest wifi connections where available, and should reach out to building-level administration to obtain any necessary passcodes to do so.
13. Knox County Schools administration and staff are coordinating with our students’ private practitioners to promote student wellbeing while at school. Any private practitioner who has questions about any of these procedures or would like clarification or planning assistance in providing services in a way that does not interfere with the educational environment or processes of a school is encouraged to reach out to the building-level principal.

A copy of this administrative procedure shall be provided to each private practitioner who applies to access Knox County Schools under Knox County School Board Policy J-359.