25619-SSD-DST_Scope_of_Work_111325.pdf

13 November 2025

ATTACHMENT A

SCOPE OF WORK

(25619-SSD-DST)

The Scope of Work of this Agreement is to engage the Contractor's services to perform the services described herein.

The Contractor will provide supplemental nursing services to eligible medically fragile students of HCPS, in accordance with the School Health Services Act (§ 381.0056, Florida Statutes) and the Individuals with Disabilities Education Act (IDEA). All services will comply with federal, state, and local regulations and will be delivered in alignment with HCPS’s specifications.

• Comprehensive Staffing: The Contractor will supply all labor and oversight necessary to fulfill the nursing service staffing needs for medically fragile students

• Service Coverage: 1:1 nursing services will be provided at any HCPS location within Hillsborough County.

• Adaptability: The Contractor acknowledges HCPS’s right to adjust the number of schools served during the contract period and will accommodate such changes as required.

Contractor’s General Duties. The Contractor shall perform the Services in conformance with the Attachments, all incorporated herein, and in conformance with professional standards for performing services of a similar kind. Whether or not the Contractor’s performance of the Services, or any part or segment thereof, conforms with such standards shall be determined solely by HCPS. HCPS has assigned a representative (the "HCPS Representative") to provide direction to the Contractor regarding this Agreement and the Services herein.

The Contractor shall provide experienced, pediatric, Florida-licensed APRNs, RNs, or LPN nurses dedicated to working daily with medically fragile students who have complicated health issues.

Contractor’s Qualifications:

• Be licensed by the Florida Agency of Healthcare Administration, Florida Law.

• Be certified and demonstrate the capability to bill Medicaid.

• Have expertise in providing nursing services within a K-12 school setting and be cognizant of academic expectations for students with medically complex health conditions.

• Provide continuity of care by ensuring the same nurse(s) attend the student throughout the course of the day for the school year.

• Must provide nurses experienced in providing the nursing services based on the student’s medical orders and Individual Health Care Plan (IHCP).

• Must be able to provide nurses immediately who can provide for the medical needs of the students within the school setting and adhere to HCPS’s policies and procedures.

• Staff nurses who follow the nursing process (assessment, diagnosis, planning, implementation, and evaluation).

• Must staff nurses who can accompany the medically fragile student during transportation to and from school, if required, during the school day, and at school activities such as field trips or other activities.

• Provide oversight supervision of nurses assigned to students and coordinate nursing replacement or assume the nursing tasks in the absence of the assigned nurse.

• If staffing an LPN for a medically fragile student, the Contractor must provide supervision as required in the Nurse Practice Act.

• Staff nurses to establish and facilitate relationships with the staff and schools assigned.

• Coordinate with the Exceptional Student Education (ESE) payee, HCPS’s nursing designee, ESE supervisors and coordinators, 504 coordinators, ESE Specialist, district physician, school nurses, and other HCPS administrators to facilitate the appropriate plan of care for the medically fragile student with complicated health needs.

• The Contractor must provide nursing supervisor(s) with an active Florida RN or APRN license in compliance with Florida Law, dedicated to working the school year, including summer school and after-school activities if applicable.

Professional and Personal Qualifications:

• All APRNs, RNs, and LPNs shall be professionally licensed in compliance with Florida Law and must.

• The Contractor must provide copies of licensure, resumes, and CPR/First AID cards of nurses who are currently employed by the Contractor and would be assigned to medically complex students.

• To ensure student safety, the nurse’s skills and understanding of the student’s needs will be verified by the HCPS’s nursing designee.

• The Contractor must staff nurses with documented pediatric experience.

• Nurses shall be fluent in oral and written English. Documentation of bilingual capability is desirable, and should be identified on the resumes and submitted to the HCPS nursing designee.

• All nurses performing services under this Agreement shall adhere to HCPS’s rules and regulations regarding appropriate attire, wearing HCPS-issued ID badge, usage of proper language, prohibition of smoking, use and possession of controlled substances, alcoholic beverages, and any other restrictions or prohibitions that may apply.

• All nurses assigned to students must pass a Level 2 FDLE background check, FBI screening, and fingerprinting prior to providing any services. See Section 6.5, the Jessica Lunsford Act, prior to the performance of services.

Supervision – The Contractor will:

• provide APRN or RN supervision to oversee the assigned nurses and evaluate nursing staff in accordance with the nursing process; and

• provide professional training and provide proof of training upon request by HCPS; and

• meet monthly, if requested, with HCPS’s nursing designee to monitor effective coordination between HCPS and the Contractor related to the provision of nursing services for medically fragile students; and

• Maintain records required by HCPS, in compliance with the school health program. These may include, but are not limited to, daily and weekly logs/service counts, any HCPS required school health forms, IEPs, 504 plans, release of information related to medical care and/or orders, authorizations for medications and services utilized within the school health program, plan of care, and other records. These records shall be available for review by HCPS; and

• follow the rules, policies, and procedures of the assigned school site or center; and

• sign in and out. Nurses may not receive or make phone calls unless it is an emergency during work hours, and always remain with the student; and

• Nurses must wear an HCPS photo identification badge, which must include nursing credentials during contracted work hours.

Student Reports Required: The Contractor will:

• prepare time logs, health service counts, nursing process reports, for each student, and other written records in the form and manner deemed appropriate by HCPS’s school health program;

and

• maintain student health records as required by HCPS’s school health program. These records will contain, but are not limited to, nursing care records, progress notes, IEP goals, 504 accommodations, treatment plans, physician’s authorization for medications and services, and reports; and

• store records in a location to be specified by the school site and HCPS; and

• execute records in such a manner as to be acceptable to Medicaid.

Professional Services: The Contractor will:

• provide nursing services to medically fragile students at designated school sites and/or affiliated locations (i.e., field trips); and

• provide a maximum of 40 hours per week for direct student services; and

• extension of maximum hours requires approval by HCPS’s nursing designee; and

• provide services within school hours, including transportation time, as requested by HCPS; and

• the nurse will either begin or end their day at the student’s home or meet the bus at the school bus compound or school site when students require a nurse on the bus; and

• perform specified duties and nursing services under the supervision of the assigned registered nurse (RN) supervisor; and

• provide general supervision and work with HCPS’s nursing designee.

Nursing duties may include, but not be limited to:

MEDICAL/NURSING SERVICES PERFORMED BY AN

LPN/RN/APRN

MEDICAL/NURSING SERVICES PERFORMED

BY AN RN/APRN

Ventilator management, tracheostomy suctioning and management, and medication administration include prescribed oral, intranasal, rectal, subcutaneous, and/or intramuscular injectable medications.

Prescribers include licensed providers under Chapter 464.

Administration of one-time and certain emergency medications that may require emergency CPR and advanced life support.

Diabetes management includes continuous glucose monitoring (CGM), carbohydrate counting, use of a glucometer, insulin administration, glucagon administration, and pump care.

Ventilator and a mechanically dependent student.

Seizure management to include vagal stimulators, oral, intra-anal, and rectal administration.

Deep suctioning, tracheotomy suctioning, and care.

Catheterization – clean; intermittent or sterile Sterile catheterization Gastric -tube management and feeding Gastric, or nasogastric tube feeding.

Suctioning - oral or tracheostomy Seizure management to include vagal stimulation and emergency medication administration

Nebulizer treatment Oxygen administration, pulse oximetry, interventions, and precautions.

• Allow HCPS to interview all nurses prior to placement. Pediatric experience is required and should be communicated to HCPS; and

• HCPS reserves the right to decline to utilize any proposed nurse and to request that an assigned nurse be removed from the assigned position at any time deemed to be in the best interest of HCPS and the student; and

• The Contractor must immediately staff a replacement nurse; and

• Should the Contractor be unable to provide an acceptable replacement, HCPS reserves the right to go to another service supplier; and

• provide replacement personnel who have credentials equivalent to the individual whom they replaced, and communicate with HCPS’s nursing designee prior to replacement; and

• annually observe, with HCPS’s nursing designee, each staffed RN and LPN. The observations will include, but not be limited to, resume review, documentation, work performance, and professional proficiency. An employee observation form will be completed annually; and

• the Contractor will provide written evaluations to HCPS upon request; and

• assign an administrative liaison and nursing supervisor to interface with HCPS personnel regarding the provision of nursing services and supervision; and

• participate in the assigned student’s IEP meetings as much as possible; and

• be responsible for supplies for the safety and protection of their employees, such as disposable gloves. Specific supplies, such as sterile catheterization packs or equipment, such as suction machines, are the responsibility of the parent; and

• additional school health supplies for the students are available from the school nurse as supplied to the school’s health room; and

• be responsible for the provision of any training, materials, and supplies required by the nurses;

and

• inform the nurses about the specifics of HCPS’s calendar, including holidays, early release and hurricane days, camps, Extended School Year (Summer School), and afterschool programs and activities.

Service Levels:

HCPS’s nursing designee shall email to the Contractor a list of nursing needs and/or changes for nursing services.

The Contractor shall provide the requested level of nursing service upon email notification.

Should HCPS reduce the required level of service for a student, the District staff will provide the Contractor with a minimum of five days’ notice of the reduction changes.

Confidential Student Information: The Contractor:

• is subject to all HCPS obligations related to compliance with student records confidentiality and laws regarding medical/health information; and

• must comply with the Family Educational Rights and Privacy Act (FERPA) and all State and Federal Laws (HIPAA) related to students’ education and health records.

Billing: The Contractor is required to:

• be Medicaid eligible to bill. Approximately 40% of referred students are Medicaid eligible; and

• provide a monthly invoice for services for each site, specifying the names of the nurse, the student's name, the school site, the dates of service, the beginning and ending hours, and the services provided weekly; and

• ensure that timesheets include the nursing provider’s name, the student’s name, the school’s name, and hours worked. The signed timesheet must be attached to the document for the hours worked.

• invoices must be clearly marked as to whether nursing services occur during the regular school day, or as a function of the afterschool program or activities; and

• bill only for actual hours worked; and

• not charge additional fees for travel, overtime, or mileage; and

• paid lunch is included (the employee is expected to work through lunch); and

• ensure that time billed for services may not begin more than 15 minutes before the beginning of the day and 15 minutes after the end of the day; and

• agree that the school day begins at bus pick up and bus drop off for students, requiring the nurse's services during HCPS-provided transportation; and

• agree that time billed for services to afterschool program students or activities will be on an hourly basis for services rendered during afterschool or activity hours.

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Contractor’s General Duties. The Contractor shall perform the Services in conformance with the Attachments, all incorporated herein, and in conformance with professional standards for performing services of a similar kind. Whether or not the Contracto...