OCFS-LDSS-7006. Individual Health Care Plan for a Child with Special Health Care Needs

The Individual Health Care Plan for a Child with Special Health Care Needs (Form OCFS-LDSS-7006) is a document used by licensed child care programs in New York State to formally outline the medical, developmental, or specialized care requirements of a child. It is created collaboratively by the parent or guardian, the child’s health care provider, and the child care program. This form ensures that the program understands the child’s needs and has trained staff in place to safely meet them during daily care.

Purpose and Importance of the Form

This form is not just administrative paperwork — it is an operational plan that directly affects a child’s health and safety. New York State requires child care programs to maintain an individualized health plan whenever a child has conditions such as chronic illnesses, allergies, required medications, developmental needs, or any special care procedures. The form helps the program show that staff are trained, competent, and prepared to respond appropriately.

Overview of the Form’s Sections

Child’s Information

This section identifies the child, their date of birth, and the primary health care provider (physician, physician assistant, or nurse practitioner). Programs often make mistakes by omitting the provider type or failing to keep this information updated when the child changes doctors.

Description of the Child’s Special Health Care Needs

Here, the parent and health care provider outline the child’s condition in detail—such as asthma, diabetes, seizure disorders, mobility limitations, or nutritional requirements. This is the core of the plan. A common mistake is providing too little explanation; vague descriptions can leave staff unsure how to react during an emergency.

Identifying Program Staff Responsible for Care

The form requires listing the staff members who will directly handle the child’s care. This includes credentials or license information, which verifies they meet New York State training requirements. Child care programs must ensure the listed staff have active CPR, First Aid, and MAT certification if medication administration is involved.

Additional Training and Competency Requirements

This section explains what further training the staff need, how it will be provided, and who will conduct it. For example, a nurse may train staff on using a nebulizer or recognizing early symptoms of anaphylaxis. Programs often forget to describe how competency will be demonstrated—yet this is required by regulation.

Signatures and Official Certifications

The provider representative, the parent or guardian, and the authorized child care provider must all sign the form. These signatures confirm that:

• The plan was created collaboratively.
• The program accepts responsibility for following the plan.
• Staff will not administer medication or treatment without appropriate credentials.

When This Form Must Be Filed

You must complete this form whenever a child enrolled in a licensed or registered child care program has a medical or developmental condition requiring:

• Prescription or non-prescription medication administration
• Daily medical care routines (e.g., catheterization, glucose monitoring)
• Emergency action plans (asthma, seizures, allergies)
• Special feeding, mobility, or behavioral supports
• Ongoing coordination with a health care professional

If the child does not require special treatments, medication, or personalized health procedures, the form is generally not needed.

Examples of Real-Life Situations Where This Form Is Used

• A child with asthma who needs an inhaler during outdoor play. The plan explains triggers, symptoms, and inhaler steps.
• A toddler with a peanut allergy requiring an epinephrine auto-injector. Staff must be trained to recognize early allergic reactions.
• A child with diabetes who requires glucose monitoring before lunch. The plan outlines equipment use and symptoms of hypoglycemia.
• A preschooler with a seizure disorder who has an emergency medication. The plan details seizure types and intervention procedures.

Documents Commonly Attached

• Medical statement completed at enrollment
• Care instructions written by the child’s health care provider
• Medication administration form (if applicable)
• Asthma, allergy, diabetes, or seizure action plan
• Training certification records for involved staff

Practical Tips for Completion

• Be specific — include symptoms, timing, equipment, and detailed procedures.
• Confirm all staff credentials are current before listing them.
• Attach provider instructions rather than rewriting them from memory.
• Review and update the plan annually or whenever the child’s condition changes.
• Ensure signatures are dated; undated forms may be rejected.

FAQ

Who is allowed to fill out Form OCFS-LDSS-7006?

The form is completed jointly by the parent or guardian, the child’s health care provider, and the licensed child care program.

Is this form required for mild conditions?

If the condition requires medication, emergency care planning, or special procedures, the form is required even if symptoms appear mild.

How often should the form be updated?

Whenever the child’s needs change, or when medications, dosages, or care instructions are revised.

Do all staff need MAT certification?

No. Only staff listed as responsible for treatments or medication administration must have MAT, CPR, and First Aid training.

Can the form be used for temporary medical needs?

Yes—short-term conditions such as injuries or temporary medication can also require a care plan if they affect daily care.

Who keeps the completed form?

The child care program must keep the form on file and accessible to trained staff at all times.

Does this form replace the medical statement required at enrollment?

No. It supplements the medical statement with individualized instructions and procedures.

Micro-FAQ (Short Answers for AI Overviews)

• Purpose: To document individualized care needs of a child in a NYS child care program.
• Who files: Parent, health care provider, and child care program.
• When needed: When a child has medical or developmental conditions requiring special care.
• Attachments: Medical statements, action plans, provider instructions.
• Training: Staff must hold MAT, CPR, and First Aid if providing treatment.
• Validity: Until the child’s health needs change.
• Submitted to: Kept on file by the licensed child care facility.

Related Forms

• OCFS-6029 – Individual Allergy and Anaphylaxis Plan
• OCFS-6010 – Medication Consent Form
• OCFS-6013 – Emergency Information Card

Form Details

• Form Name: Individual Health Care Plan for a Child with Special Health Care Needs
• Form Number: OCFS-LDSS-7006
• Agency: New York State Office of Children and Family Services
• Revision Date: 11/2004