Individualised Support Plan (PAI)
When is a PAI required?
There are specific PAIs for certain illnesses that require urgent action, such as allergies, epilepsy and diabetes. The PAI formalises the conditions for looking after children with these illnesses.
A PAI does not need to be put in place for other illnesses that do not require urgent action, for instance dietary intolerances or acute illnesses.
Who sends the PAI and to whom?
A PAI must be signed by the child's attending doctor and parents (see 'délégation de soins' – delegation of care). After it has been signed, one of the two parties sends the PAI to the Division of School Medicine and Health of Children and Adolescents (Division de la médecine scolaire et de la santé des enfants et adolescents), which signs it off and forwards it to the establishment attended by the child (school or SEA - education and care establishment), either directly, or through an intermediary, depending on the situation.
The PAI has expired. Is it still valid?
A child for whom a PAI has been put in place has specific, long-term healthcare needs that extend beyond any date mentioned in the PAI. The PAI therefore remains valid, even after its expiry date and until it is renewed, modified or discontinued.
Catering services cannot refuse to provide a meal after the PAI has expired.
Are PAI forms originating in France valid in Luxembourg?
Yes, they are, and the PAI formalities do not need to be completed again using a Luxembourg form.
What should I do if my child's PAI is discontinued?
The PAI simply provides teaching staff with official guidelines about the child's care. If the PAI is discontinued by the prescribing doctor or the parents (for example, if the child's health improves), urgent medication will no longer be stocked or administered by the school or the education and care establishment (SEA).
Is the PAI mandatory until the child turns 18?
If the child is independent, there is no problem with not having a PAI in place. However, this means that teachers will not administer medicinal products if the young person cannot do it themselves. Instead, they will call 112, like they would for any other health problem that occurs at school.
Who checks the emergency kits?
The parents are responsible for checking the emergency kit, and for replacing any expired medicinal products. In some situations, parents are contacted by the school medical services to remind them they need to come in and check the emergency kit.
Who needs to be told that there is a PAI in place in schools and education and care establishments?
The PAI must be sent to school and care personnel on a need-to-know basis, insofar as it contains the personal and confidential medical data of the pupils covered by the PAI. For example, it is important that a PAI for food allergies be forwarded to catering staff.
Can expired medicinal products be administered? Can they cause unwanted side effects? Who is responsible?
It is the parents who are responsible for checking the expiry date of their child's medicinal products. In an emergency, and if no other medicine is available, an expired medicine can be administered. There is no risk of unwanted side effects.
How do sports or cultural establishments receive the information in the PAI if they need it?
The parents must provide these establishments with the information. The Division of School Medicine and Health of Children and Adolescents only sends the PAI to schools and SEAs.
If a child has a simple or strict elimination diet, are catering service providers aware of the protocols concerning allergens?
A best practice guide for food hygiene in SEAs (education and care establishments) has been published as a reference document for meal providers. It provides answers about elimination diets, their implementation, the PAI and training on food allergens.
Guide de bonnes pratiques d'hygiène - SEA - Sécurité alimentaire - Luxembourg
What does 'close monitoring' mean in the case of an epileptic child taking part in physical activities? Must there be one person for each child that needs to be monitored (i.e., 2 people if there are 2 epileptic children doing the same activity), or can one person monitor more than one child?
'Close monitoring' means observation from a reasonable distance (from the side of the swimming pool, for example). An epileptic seizure can happen at any time, especially when the illness is not optimally managed. Certain situations – such as at the swimming pool, for example – will require closer monitoring. If there is more than one epileptic child doing the same activity, the monitoring can be done by one person.
A child is going to be spending time in a company to gain work experience. Who sends the PAI to the establishment in question?
It is the parents who decide whether or not to pass on the PAI, and they are responsible for forwarding and explaining it.
Does the PAI remain valid after the child finishes secondary education?
If the person covered by the PAI holder wishes the PAI to continue after they have left school, this is done on their initiative and is their responsibility. It is no longer the Division of School Medicine's responsibility.
Some colleges have a first aid unit made up of teachers and pupils who may be required to take emergency action for a student with a PAI. Who can take the emergency action in this unit?
Only people from the education and care establishments in charge of the child, i.e. adults, can take urgent measures (see délégation de soins signed by the parents on page 2 of the PAI). A student can treat another student but cannot shoulder the responsibility for applying the PAI.
My child has a PAI and travels to and from school on a school bus. They need to have their emergency kit on them at all times. How are bus journeys with the emergency kit organised?
It is the parents' responsibility to contact those involved to discuss arrangements on a case-by-case basis.
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