Microsoft word - 5420 - student health services.doc

STUDENT HEALTH SERVICES
The Board of Education recognizes that good student health is vital to successful learning and acknowledges its responsibility, along with that of parent(s) or guardian(s), to protect and foster a safe and healthful environment for the students. The school shall work closely with students' families to provide detection and preventive health services. In accordance with law, the school will provide vision, hearing, dental inspection and scoliosis screening. Problems shall be referred to the parent(s) or guardian(s) who shall be encouraged to have their family physician/dentist provide appropriate care. In order to enroll in school a student must submit a health certificate within 30 calendar days after entering school, and upon entering second, fourth, seventh and tenth grades. The examination, which must conform to state requirements, must have been conducted no more than 12 months before the first day of the school year in question. If a student is unable to furnish the health certificate, the school will provide a physical examination by a licensed provider. A request for exemption from the physical examination, or the requirement to provide a health certificate, must be made in writing to the school principal or designee, who may require documents supporting the request. The only basis for exemption is a claim that the physical examination is in conflict with the parent or guardian’s genuine and sincere religious belief. The Board recognizes that the State of New York may authorize and require the collection of data from health certificates in furtherance of tracking and understanding health care issues that affect children. The Board supports these efforts and expects administrators to cooperate and to observe the appropriate laws and regulations in carrying out those responsibilities, including those that relate to student privacy. In addition, students will be asked to provide a dental health certificate when they enroll in school and in accordance with the same schedule as the health
certificate.


A permanent student health record shall be part of a student's cumulative school record and should follow the student from grade to grade and school to school along with his/her academic record. This record folder shall be maintained by the school nurse. Schools shall also provide emergency care for students in accidental or unexpected medical situations. Each school in the district will include in its emergency plan a protocol for responding to health care emergencies, including anaphylaxis, and head injury. Parents/guardians will be notified of any emergency medical situation as soon as is practicable. It is the responsibility of the Board to provide all students with a safe and healthy school environment. To meet this responsibility, it is sometimes necessary to exclude students with contagious and infectious diseases, as defined in the Public Health Law, from attendance in school. Students will be excluded during periods of contagion for time periods indicated on a chart developed by the school nurse. It is the responsibility of the Superintendent of Schools, working through district health personnel, to enforce this policy and to contact the county or local health department when a reportable case of a communicable disease is identified in the student or staff population. Administering Medication to Students Neither the Board nor district staff members shall be responsible for the diagnosis or treatment of student illness. The administration of prescribed medication to a student during school hours shall be permitted only when failure to take such medicine would jeopardize the health of the student, or the student would not be able to attend school if the medicine were not made available to him/her during school hours, or where it is done pursuant to law requiring accommodation to a student's special medical needs (e.g., Section 504 of the Rehabilitation Act of 1973). "Medication" will include all medicines prescribed by a physician. Before any medication may be administered to or by any student during the written request of the parent(s) or guardian(s), which shall give permission for such administration and relieve the Board and its employees of liability for administration of medication; and the written order of the prescribing physician, which will include the purpose of the medication, the dosage, the time at which or the special circumstances under which medication shall be administered, the period for which medication is prescribed, and the possible side effects of the medication. Students are allowed to carry and apply parentally provided sunscreen without a prescription from a medical provider, assuming that the sunscreen is FDA approved and that the sunscreen is not treating a medical condition. Parents need to provide the district with written permission for students to use sunscreen. Permission slips and medical orders shall be kept on file in the office of In addition, in accordance with Education Law 919, the district shall make a nebulizer available on-site in school buildings where nursing services are
provided. Students with a patient-specific order, who require inhaled
medications, shall have access to the nebulizer. The district will ensure that it is
maintained in working order.


In conjunction with the nebulizer, the school stocks albuterol in the form of metered dose inhalers for students who are in need of emergency dosing when their personal prescription is empty. The district will develop procedures in collaboration with school health personnel that is approved by the district medical director and the Board of Education. Life-Threatening Allergies and Anaphylaxis Management The Board recognizes its role and responsibility in supporting a healthy learning environment for all students, including those who have, or develop, life- threatening allergies. The district will work cooperatively with the student, their parent/guardian and healthcare provider to allow the child to participate as fully and as safely as possible in school activities. When a student has a known life-threatening allergy reported on their health form or if the district has been informed by the parent of the presence of a life-threatening allergy, the district will assemble a team, which may include the parent, the school nurse, the child’s teacher, the building principal and other appropriate personnel, which will be charged with developing an individual health care plan. The plan will be maintained by the school nurse. The plan will guide prevention and response. If the student is eligible for accommodations based upon the IDEA, Section 504 or the Americans with Disabilities Act, the appropriate procedures will be followed regarding identification, evaluation and implementation of accommodations. Training Training to support the fulfillment of staff responsibilities in regard to student health services will be provided as part of the district’s ongoing professional development plan and in conformity with Commissioner’s regulations. Regulations The Superintendent shall develop comprehensive regulations governing student health services. Those regulations shall include the provision of all health services required by law, procedures for the maintenance of health records, and procedures for the administering of medication to students. The Superintendent shall also develop protocols, in consultation with the school physician and other appropriate district staff, for the management of injury, with particular attention to concussion. 4321, Programs for Students with Disabilities 5020.3, Students with Disabilities and Section 504 (provisions for appeal of child denied school entrance for failure to comply with immunization requirements); 901 et seq. (medical, dental and health services, BMI reporting); 919 (provide and maintain nebulizers); 6909 (emergency treatment of anaphylaxis) Public Health Law §§613 (annual survey); 2164 (immunization requirements) 8 NYCRR § 64.7 (administration of agents to treat anaphylaxis); § 135.4 (Physical Education); Part 136 (school health services program) Administration of Medication in the School Setting Guidelines, State Education Department, revised April 2002 Immunization Guidelines: Vaccine Preventable Communicable Disease Control, State Education Department, revised August 2000 Making the Difference: Caring for Students with Life-Threatening Allergies, New York State Department of Health, New York State Education Department, New York Statewide School Health Service Center, June 2008 Concussion Management Guidelines and Procedures, www.nysphsaa.org STUDENT HEALTH SERVICES REGULATION
Children must receive immunizations for diphtheria, polio, measles, mumps, rubella, hepatitis B, Haemophilus Influenzae Type b (Hib), pertussis, tetanus, pneumococcal disease (for children born on or after January 2008) and varicella prior to entering or being admitted to school. Parents must provide acceptable proof indicating required receipt of all vaccines in accordance with law and regulations. A child may be excluded from the immunization requirements based on a physician determined health reason or condition. This medical exemption must be signed by a physician licensed to practice in New York State. A child may also be excluded from the immunization requirements because the child’s parent/guardian holds a genuine and sincere religious belief which is contrary to the practice of immunization. A child will not be admitted to school or allowed to attend school for more than 14 days without an appropriate immunization certificate or acceptable evidence of immunization. This period may be extended to 30 days on a case-by-case basis by the Building Principal if the child is transferring from another state or country and can show a good faith effort to get the necessary certification or other evidence of immunization. When a student transfers out of the district, the parent/guardian will be provided with an immunization transfer record showing the student’s current immunization status which will be signed by the school nursing personnel or the school physician. A transcript or photocopy of the immunization portion of the cumulative health record will be provided to the new educational institution upon request. In the event that a parent is unable to provide an immunization record, the school nurse, or other authorized school district official, will access the New York State Immunization Information System (NYSIIS) to determine if the child has met immunization requirements. If the system indicates that the child has received the required vaccinations, the information will be entered as part of the student’s record, the source and date noted, and the documentation requirement will have been met. The administration of prescribed medication to a student during school hours is permitted only when the medication is necessary to allow the student to attend school or failure to administer the medication would seriously affect the student’s health. Parent(s) or guardian(s) must present the following information: a note from the family doctor containing the following information: student’s name, the date and name of the medicine, dosage and time to be administered, and list of possible side effects; and, a note from the parent(s) or guardian(s) giving the school nurse, teacher, Principal or other school staff permission to administer the medication; or a medication request form (which includes the family doctor and parent signatures) must be filed with the school nurse. The school nurse shall develop procedures for the administration of all medications will be administered by a licensed person unless the child is self-directed; medications shall be securely stored in the office and kept in their original labeled container, which specifies the type of medication, the amount to be given and the times of administration; the school nurse shall maintain a record of the name of the student to whom medication may be administered, the prescribing physician, the dosage and timing of medication, and a notation of each instance of administration; and all medications shall be brought to school by the parent(s) or guardian(s) and shall be picked up by the parent(s) or guardian(s) at the end of the school year or the end of the period of medication, whichever is earlier. If not picked up within five days of the period of medication, the medication shall be discarded. An adult must bring the medication to school in the original container. The administering staff member should clearly label the medication with the time to be given and dosage. Students are permitted to carry and apply sunscreen without a medical provider’s order under the following conditions: 1. the sunscreen is used to avoid overexposure to the sun and not for medical treatment of an injury or illness, if sunscreen is required to treat a medical condition, the procedures for administering medication (above) apply; the sunscreen is FDA approved for over the counter use; the student’s parents or guardians provide written permission annually for the student to carry and use the sunscreen. The school nurse will keep written permission for students on file and develop procedures pertaining to this policy. Administering medication on field trips and at after-school activities. Taking medication on field trips and at after-school activities is permitted if a student is self-directed in administering their own medication. On field trips or at other after-school activities, teachers or other school staff may carry the medication so that the self-directed student can take it at the proper time. If a student is going on a field trip but is not self-directed (i.e., fully aware and capable of understanding the need and assuming responsibility for taking medicine), then the district may:  permit the parent or guardian to attend the activity and administer the medication. permit the parent to personally request another adult who is not employed by the school to voluntarily administer the medication on the field trip or activity and inform the school district in writing of such request. allow the student’s health care provider to be consulted and, if he/she permits, order the medication time to be adjusted or the dose eliminated. If no other alternative can be found, a school nurse or licensed person Administering epi-pen in emergency situations. The administration of epinephrine by epi-pen has become an accepted and extremely beneficial practice in protecting individuals subject to serious allergic reactions (e.g., individual has an anaphylactic reaction to a wasp sting or the ingestion of peanut butter). Pursuant to Commissioner’s regulations, registered professional nurses may carry and administer agents used in non-patient specific emergency treatment of anaphylaxis. In addition, pursuant to SED guidelines, school nurses may provide training to unlicensed school staff in administering epi-pens, prescribed by a licensed prescriber, to a child who has been diagnosed with the potential for a severe reaction, in the event of the onset of a serious allergic reaction when a nurse is not available. Use of Albuterol Metered Dose Inhalers. Students diagnosed with asthma whose personal albuterol prescription is empty may receive an emergency dose of school-stocked albuterol under the following conditions:  The student has a prescription ordering albuterol MDI or nebulized albuterol from their doctor which must include an order allowing the student to use the school’s stocked albuterol MDI if their personal prescription is empty;  The student’s parent/guardian must provide written permission for the student to be administered dosing from the school’s stocked albuterol MDI if their personal prescription is empty;  The school’s stock supply of albuterol is not to be used in place of the parent/guardian providing the medication for their child to the school. The school’s stock supply is for use only in the event that the student’s personal supply is empty while awaiting the parent/guardian to provide the school with a new one; and  The student must have their own labeled spacer, tubing and facemask, or mouthpiece provided by the parent/guardian that is used when administering their own or the school’s stock albuterol MDI. Specific procedures will be developed by school health personnel that will The process for obtaining and replacing the stock albuterol; The maintenance and cleaning of the school’s stock MDI and nebulizer; individual students’ MDIs and spacers; and/or students nebulizer tubing, facemask or mouthpiece; The protocol for informing parents that the school stock albuterol was used; and The protocol for informing parents/guardians of the need for replacement of their child’s albuterol medication along with any district imposed deadlines for doing so. This procedure will be approved by both the district medical director and the board of education. In accordance with Sections 903 and 904 of the state Education Law, each student shall have a physical exam given by the school doctor or family physician (including a physician, physician assistant or nurse practitioner) upon entrance to school and at grades pre-kindergarten or kindergarten, two, four, seven and ten. Findings are to be kept on record at the school on forms that can be obtained from the school nurse. In addition, the school will request a dental health certificate according to the same schedule. A student may be excluded from the medical examination requirements because the child’s parent/guardian holds a genuine and sincere religious belief which is contrary to medical examinations. The request for exemption must be in writing to the principal or his/her designee. In the event that the student’s medical history reveals that they have a known life-threatening allergy, the school nurse, in conjunction with the family, student, child’s teacher, and other appropriate staff, will develop and implement an individual health care plan which will guide prevention and response. 5420-R
The district will work with students in the self-management of their life- threatening allergy, or other chronic health conditions, by: 1. Adequately training staff involved in the care of the child. Assuring the availability of the necessary equipment and/or medications. Providing appropriately licensed and trained persons on school premises, as required by law. Providing ongoing staff and student education. If a student becomes ill or injured in school: The nurse will determine if the student should receive further medical attention, remain in the dispensary or return to class. The nurse will call the parent, guardian or designated emergency contact if he/she feels the student should go home. In general, a parent or guardian will pick up the student from school. The nurse will contact the Building Principal if he/she feels the child should be transported by bus to the home. If there is to be a change in bus routing in order to carry the student to his/her home, that decision will be made by the administrator and the transportation supervisor. If the route is to be changed, the transportation supervisor shall inform the bus driver. If no parent, guardian or designated emergency contact picks up the student at school, or if no parent/guardian or designated emergency contact will be home, the student will remain in the nurse's office until such time as a parent, guardian or designated emergency contact becomes available to assume responsibility for the child. All students shall have on file a medical emergency record which shall state the name and telephone numbers of the following: 1. the student's parent(s) or guardian(s) at home and work; any allergies or serious health conditions. 5420-R
Student Return to School after Illness/Injury In general, students should be symptom-free before returning to school and resuming normal activities. In some instances, students may be asked to provide a note from their doctor before they return to school or participate in the full range of school activities. The final decision to permit participation rests with the school physician. The Superintendent, in consultation with the school physician, nurse and other appropriate staff, will develop protocols to address a student’s return to activities when there has been a serious illness or injury. Adoption date:

Source: http://www.elmsd.org/district/boe/policy/5420.pdf