Health Requirements and Services:

Approved: 01-8-2020

Emergency Medical Treatment, Administering of Medication, Stock Epinephrine, Naloxone Administration, Immunizations, Bloodborne Pathogens and Communicable Diseases, Lice Infestation, and the Utah State Board of Education Mandated Screenings. 

Policy JH “Safe Schools” 
Policy CCAE “School Nurse” 
Policy JI  “Wellness Policy”

Approved: _____________

Philosophy:

The South Sanpete Board of Education expects parents/guardians to be responsible for the medical needs of their children and use professional, licensed health care providers, and follow professional health care practices. The Board also realizes that due to extenuating circumstances that qualified, trained school personnel may be called upon to monitor and assist parents with a child’s unique medical needs. In addition, the Board expects the District’s schools to follow District policy and current State health laws, rules, and regulations to ensure the safety and well-being of all students.

Policy:

South Sanpete School District shall strive to maintain, enforce, accommodate, and provide a healthy, safe environment for all students. The student’s parent or legal guardian has the primary duty to inform school authorities (ie, principal, secretary or school nurse) about the child’s potentially life-threatening medical condition(s) while registering the student for school, or upon medical diagnosis of the medical condition. Once a school receives written documentation of this information, the school nurse shall develop an Individualized Health Plan for that student and provide training (as needed) to authorized school personnel for safe administration of medication while the student is at school. 
Reference: Utah Code 53A-11-601

1. School Consent to Emergency Medical Treatment

Students enrolled at South Sanpete School District may receive emergency medical care under emergent situations. Situations may include; loss of consciousness, excessive bleeding, and/or extreme respiratory distress. School personnel may provide emergency care including CPR and first aid to students to the best of their ability and training. In the above stated emergent circumstances, 911 will be contacted. In the event a parent or guardian with power to consent cannot be contacted prior to emergency medical services arrival, the student may be transported to the hospital upon school nurse, school personnel, and EMS determination. School nurses will provide CPR/FirstAid training for school personnel annually or more often as needed, and assure that 3 individuals or more staff in each building, will be actively certified in CPR and first aid. 
Medical directives such as a “DNR” (Do Not Resuscitate) will not be honored by school personnel. 

2. Administering Medication

Employees of the District may administer medication to a student during school hours, subject to the following conditions:

A. The student’s school must receive a completed “School Medication Authorization Form” signed by their licensed medical provider to administer medication during regular school hours. The student’s parent or legal guardian can obtain this form from the school nurse, or school district website. The School Medication Authorization Form indicates the diagnosis, route, dosage and time administered. 

B. The school nurse shall develop an Individualized Health Plan (in accordance with the licensed health care provider’s prescribed treatment) for students who have critical medical needs. These critical needs may include the administration of Glucagon, Epinephrine, Diabetes Medication, Asthma Medication, Diastat (seizure medication), Allergy Medication, etc. This plan shall include who will administer the medication, where the medication shall be stored, the training of designated personnel, maintenance of records, emergency information, etc. 

C. School personnel are prohibited from dispensing, providing, or recommending any type of medication or treatment to students.

D. Oral, topical, inhalant, and injectable medication may be administered only by trained school personnel, with proper written documentation from the school nurse. In some cases, students 12 years of age or older may be approved by the school nurse to self-medicate using these medications in non-emergent conditions. 

E. All medication that is to be given at school must be furnished by the parent or guardian, properly labeled with the name of the student, the name of the medication, the amount to be given (dose), and the duration of the treatment. Medication must be hand delivered to the school by the parent or legal guardian.

F. Controlled substances (medications) will be kept in a locked container. When parent/guardian provides this medication the school personnel and guardian will count and document the amount received.  Trained school personnel administering these medications will document each administration to account for medications given. Documentation must include medication, amount, date and time administered. The trained personnel must sign/initial the record each time the medication is given. The school nurse will periodically audit these documents.

G. Over-the-counter drugs shall be treated as a prescription medication in accordance with this policy, and must be in the original bottle, and labeled with the student’s name. This includes ibuprofen, acetaminophen, cold medicines, herbal remedies, essential oils and CBD oils (cannabis derived products) etc.

H. When employee assistance is required to administer medication to students, the school nurse shall train three individuals to ensure a qualified person is always available.

I. Students over the age of 12, who have met criteria outlined in “School Medication Administration Form” may self-administer medications at school. The school nurse, in conjunction with the parent, and the student’s licensed health care provider, may make an exception regarding the age requirement for extenuating circumstances. Students over the age of 12 may be allowed to self-administer over the counter medications, but may not carry more than one or two doses of medication on their person. Students must not share, sell, or distribute any prescription medications or over-the-counter medications to other students. 

J. A student with an Individualized Health Plan for Diabetes, Asthma or Anaphylactic Allergies may carry and self-administer prescription medications related to their diagnosis provided that the student's licensed medical provider has indicated that the student is responsible for, and capable of, self-administering the asthma or diabetes medication. Also that it is medically appropriate for the student to keep the medication with, or readily available to him or her at all times. If the medication is to be stored other than on the student's person, the student or parent/guardian shall inform the school nurse or administration where the medication will be kept to enable access for emergency use. 

Asthma. https://le.utah.gov/xcode/Title53G/Chapter9/53G-9-S503.html
Glucagon. https://le.utah.gov/xcode/Title53G/Chapter9/53G-9-S504.html
Epinepherine https://le.utah.gov/xcode/Title26/Chapter41/26-41.html

K. Regardless of the age of the student, the student is not allowed to have in their possession a controlled substance while at school. Students who violate these guidelines shall face disciplinary action.

L. Seizure medication. The school nurse has the responsibility to determine whether or not unlicensed personnel may be voluntarily trained to administer seizure rescue medication at school. Criteria met must be that the medication has historically brought the student safely out of a seizure while outside a hospital setting. If safety of the administration of the seizure medication in school cannot be determined, only the licensed school nurse, or a parent/guardian may administer the seizure rescue medication while at school. 
More information can be found at https://le.utah.gov/xcode/Title53G/Chapter9/53G-9-S505.html

M. Athletic coaches, and other school personnel are prohibited from encouraging the use or administering enhancement drugs, supplements, or remedies to students.

N. Authorization for administration of medication by trained school personnel may be withdrawn by the school at any time, following notice to the student’s parent or guardian.

O. Civil Liability Immunity School personnel and the employers of these personnel who provide assistance and comply with the licensed health care provider’s written prescription are not liable, civilly or criminally for any adverse reaction suffered by the student as a result of taking the medication and/or discontinuing the administration of the medication.
Reference: Utah Code 53A- 11-601 (3)

3. Stock Epinephrine Policy

    1. South Sanpete School District follows Utah law 26-41-103 (5) (a) in requiring each public or private school to have one emergency epinephrine auto-injector. Schools in South Sanpete School District have 2 per building. Stock epinephrine auto injectors are kept in the office for use by any staff member, or student. 
    2. Trained school personnel are authorized to administer emergency epinephrine auto-injections to provide rapid first aid for people suffering from a potentially fatal anaphylactic reaction. Every time epinephrine is administered at school, 911 will be called. Reference Utah law 26-41-102. 
    3. School staff are annually trained on signs and symptoms of anaphylactic reactions and indications for use of epinephrine at school. Utah law 25-41-106 provides immunity from liability for anyone trained to administer epinephrine auto-injectors for any action taken or not taken with respect to an anaphylactic reaction.

4. Naloxone Policy and Procedures

    1. It is the policy of South Sanpete School District to provide assistance to students, staff, and visitors who may be suffering from an opioid overdose as allowed by the Utah Overdose Response Act, Utah Code Ann. §§ 26-55-101 et seq. Under the Act, the District has made available an opiate antagonist, as defined in Utah Code §26-55-102 (e.g., Naloxone/Narcan Nasal Spray), to every school in our district for the treatment of an opiate-related drug overdose.
    2. An approved opiate antagonist may only be administered, in good faith, to revive the victim of any apparent opiate-related drug overdose by a law enforcement official, School Nurse or other trained school personnel responding to an emergency on school grounds. Nothing in this policy or applicable Utah law creates a duty or standard of care requiring the administration of an opiate antagonist. Opiate antagonist administration training will be provided at least annually, or as otherwise needed, by a school nurse.

5. Immunizations

PURPOSE AND PHILOSOPHY
Immunizations prevent the spread of communicable diseases and contribute to a safe and healthy learning environment for students and the broader school community. The Utah Immunization Rule for Students, Rule 396-100, requires that children attending school or childcare facilities be vaccinated against certain vaccine-preventable diseases. State law requires that unless for personal, medical, or religious exemptions, a student may not attend a public elementary, or secondary school though grade 12, or early childhood programs, including nursery or preschools.

Starting July 1, 2018, students claiming an exemption to the required vaccinations must have their legal guardian complete an online educational module, or in person consultation at the local health department, and provide a copy of the completed form to the school official. Fee may be required at the health department. 

Students claiming exemptions for legally required immunizations, must provide a new exemption when entering Preschool, Kindergarten, and 7th grade.

F. REQUIRED IMMUNIZATIONS
Information on required immunizations can be found at http://www.immunize-utah.org

6. Bloodborne Pathogens and Communicable Disease Management 
  1. South Sanpete School District recognizes that staff and students may come in contact with bloodborne pathogens and/or communicable diseases during the school day.
  2. Bloodborne Pathogens. Since body fluids may contain a variety of potentially infectious organisms, it is important for all school personnel to know how to clean them up properly to prevent the spread of infection to students, other school personnel, and to themselves. All employees of Sanpete School District are required to participate in annual instruction in using Universal Precautions when dealing with cleanup of all blood or body fluids. The Universal Precautions must be observed in the cleanup of all blood or body fluids. All employees will treat all blood and body fluids as if known to be infected with HIV, HBV, and other bloodborne pathogens.
  3. Communicable Diseases. Communicable diseases are a leading cause of childhood morbidity, and school absences. Students and staff with communicable diseases, which can be transmitted directly or indirectly from one individual to another, require special consideration in the school setting. The transmission of infectious disease may be prevented by all school staff using procedures of effective infection control. In the school environment, the risk of exposure can be unpredictable, thus control measures that are simple and uniform across all situations have the greatest likelihood of compliance and success.

The spread of infectious disease can be prevented or deterred if students and staff adhere to basic principles of good personal hygiene, cleanliness, and recommended use of any necessary personal protective measures.

Schools are legally authorized to prohibit school attendance by students, if necessary, to prevent the spread of contagious disease.

The state health agency is responsible for initiating measures to suppress or prevent the spread of disease and for implementing regulations relating to quarantine, isolation, and other control measures to protect the public.

 Children with chronic infectious disease are entitled to a free appropriate public education in the least restrictive environment. If a student will be absent from school due to an infectious disease, reasonable accommodations could be appropriate.

 Persons with suppressed immune systems run a higher than normal risk of severe complications from common communicable illnesses.Students with a suppressed immune system may need to be temporarily excluded from school when there is an outbreak of a communicable disease for their own protection. Students with a suppressed immune system should have an individual health care plan in place with specific guidelines that will be implemented in the event of an outbreak.

 The decision to exclude the student from school should be made by the school nurse in conjunction with the student’s parent(s), licensed health care provider, and local health department. The school nurses are responsible for providing schools with the exclusion protocol. The assigned school nurse is responsible to provide in-service education for individual needs.

    1. Management of Communicable Disease Program. All employees, including those with chronic infectious diseases, have a right to confidentiality and access to employment as well as other rights, privileges, and services provided by federal and state laws. All children, including those with chronic infectious diseases, have a right to confidentiality and a free and appropriate public education. Students with chronic infectious diseases are eligible for all rights, privileges, and services provided by federal and state laws.Measures to isolate students with chronic infectious diseases are usually not necessary. The school should respect the right to privacy of the individual.  If a student has an infectious disease, such knowledge should be confined to those persons with a direct need to know. A student should never be discriminated against because of an infectious disease.
    2. School Nurse Responsibility. South Sanpete School District nurses should: Participate in the development and revision of communicable disease policies and procedures, and consult with local or state health department personnel as needed. Interpret communicable disease policies and procedures to school personnel, parents and students. Provide health information, and in-service programs regarding communicable diseases. Promote positive health practices for the school community. Develop individual health care plans for students with chronic communicable diseases. Recommend modification of the school program for infected students as needed. Monitor and assess students with communicable diseases. Monitor and assess the school environment for the effective infection control standards. Make recommendations for purchase of proper equipment and supplies. Serve as an advocate for students with communicable diseases. Acted as a liaison between the school, home, and medical/health agencies for students with communicable diseases. Keep up with current information, rules and regulations, policies, and procedures related to communicable disease.

7. Lice Policies and Procedures

  1. Students diagnosed with live head lice do not need to be sent home early from school; they can go home at the end of the day. Instructions will be given to parent or caregiver on evidence based treatment of head lice. The student may return to class after appropriate treatment has begun. Nits may persist after treatment, but successful treatment should kill crawling lice. 
  2. Both the American Academy of Pediatrics (AAP) and the National Association of School Nurses (NASN) advocate that "no-nit" policies should be discontinued. “No-nit” policies result in unnecessary absenteeism. Additionally, classroom screenings are discouraged since subsequent cases are rarely found, nor are they cost-effective. Classroom or school notifications are discouraged because it has been shown to increase community anxiety, increase social stigma causing embarrassment of affected infested students, and puts students’ rights to confidentiality at risk
  3. Head lice can be a nuisance, but they have not been shown to spread disease. Personal hygiene or cleanliness in the home or school has nothing to do with getting head lice.

8. Vision screening.

Philosophy. South Sanpete School District Philosophy. A child's ability to see greatly impacts his or her ability to learn. A school vision screening program is a cost effective approach that plays a vital role in the early identification of serious vision problems that might negatively affect the physical, intellectual, social, and emotional development of the individual student.

*** It is important for any parent/ guardian of students at South Sanpete School District to understand that; vision screening is not a substitute for a complete eye exam, and vision evaluation by an eye doctor. ***

Procedures. A new law passed in 2019 (UCA 53G-9-404) has set standards for vision screenings in Utah schools. 

  1. A child under nine years old entering school for the first time in this state must present the following to the school
    1. a certificate signed by a licensed physician, optometrist, or other licensed health professional approved by the office, stating that the child has received vision screening to determine the presence of amblyopia or other visual defects; or
    2. a written statement signed by at least one parent or legal guardian of the child that the screening violates the personal beliefs of the parent or legal guardian. A vision screening opt-out form can be obtained from the school nurse.
  2. School nurses, and other trained volunteers regularly administer Tier 1, or distance vision screenings to all present preschool, kindergarten, first grade, third grade, fifth grade, and seventh grade students in South Sanpete School District. Tenth grade students may be screened as part of their driver’s education course. 
  3. Tier 2 vision screenings, which may include near vision testing, convergence insufficiency, color deficit, and/or eye muscle tracking will be performed under the following conditions:  
    1. K, 1st, 2nd and 3rd grade students who do not pass their reading benchmarks, after a “Vision Screening Questionnaire” is filled out by the teacher or parent.
    2. If a parent or teacher requests a vision screen by the school nurse the parent must fill out a “Vision Screening Questionnaire.” The school nurse then has 30 days to determine which Tier of vision screening to use, or may determine to refer to medical provider. 
    3. Special education initial evaluation, and every 3 years for re-evaluation. 
  4. The Ephraim Lions Club has been approved by the Utah State Board of Education to administer instrument-based screening device visual exams to students attending South Sanpete School District. 
  5. South Sanpete School District Nurses and trained volunteers are not liable for damages that result from acts or omissions related to the vision screening, unless the acts or omissions are willful or grossly negligent.
9. Scoliosis Screening
  1. Philosophy. The current Utah law states that the decision for schools to provide the screening should be determined at the local school level. Guidelines have been established by the Utah Department of Health to help local schools in their decisions on how to implement school scoliosis screenings. In South Sanpete Schools, information will be given to parents on scoliosis screening instructions at home. Included in the instructions will be an optional permission request for the school nurse to screen their student at school. This information will be given in grades 5th-8th. 
  2. Procedures. When a school nurse receives the written parent/guardian permission request to screen students, the following procedures will be used; boys and girls will be screened separately in an area that accommodates the need for privacy. Two adults will be present for security/liability reasons. It is recommended that students wear gym clothes, ideally wearing shorts to allow better visualization of the waist, hips, and legs. Students being screened by school nurse will be asked to remove their shoes, and any thick over coats/sweaters/hoodies. One layer of clothing will always remain in place.

10. Height and Weight Screening. 

Procedure. South Sanpete School District partners with the Utah Department of Health in collecting data of height and weight from one 1st, 3rd, and 5th grade class in one school in our district on alternating calendar years. This project enables UDOH to track the prevalence of obesity among elementary school students statewide. If your student is involved in this data collection, you will be given written notice, and opportunity to opt-out of the data collection.

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