Back to Board Policies

The District shall work closely with students' families to provide detection and preventive health services. In accordance with law, the District will provide vision, hearing, and scoliosis screening. Concerns shall be referred to the parent(s) or guardian(s) who shall be encouraged to have their family physician/dentist provide appropriate care.

Health Certificates and Immunizations

In order to enroll in school, a student must submit a health certificate within 30 calendar days after entering school, and upon entering Kindergarten, first, third, fifth, seventh, ninth, and eleventh 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 the School Physician or another authorized healthcare provider. Physicals are also required for school sponsored athletic activities. Physical examinations may be offered to candidates for interscholastic athletics who are unable to receive an examination from their authorized health care provider or the physical expires during the season of play to determine their physical fitness for the team or activity prior to any participation or practice of the candidate involved. Health certificates/appraisals will not be required where a student, the parent, or person in parental relation to the student, objects to the examination on the grounds that the examination conflicts with their genuine and sincere religious beliefs. 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 beliefs.

In order to enroll in school, students must also furnish documentation of having received required grade and age-specific immunizations against certain communicable diseases, as set forth in state law and regulation, unless exempted from immunizations for medical reasons in accordance with state law and regulation. Medical exemptions must be reissued annually to remain valid. Unless a student has a valid medical exemption or is in the process of receiving immunizations or blood tests for immunity, the District may not permit the child to remain in school for more than 14 days, or more than 30 days for an out-of-state or out-of-country transferee who shows a good faith effort to get the necessary certification or other evidence of immunization. The District will notify the Westchester County Health Department if a child is denied admission or attendance in school due to lack of immunizations.

In addition, it is recommended that a dental health certificate be provided for each student 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. The student’s health record shall be maintained by the school nurse in accordance with law.

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.

Homeless students shall be admitted to school even if they do not have the required health certificate or immunization records, but may be temporarily excluded if they show actual symptoms of a communicable disease that poses a significant risk of transmission to others (see “Communicable Diseases” below). The McKinney-Vento liaison shall assist homeless students covered by that law in accessing health services described in this policy and accompanying regulation.

Communicable Diseases

The District strives to provide all students with a safe and healthy school environment. Therefore, it is sometimes necessary to exclude students who have been diagnosed (clinically or through testing) or are showing symptoms of a contagious or infectious disease, 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 in collaboration with the school physician and local health department. During an outbreak of certain communicable diseases, if the Commissioner of Health or designee so orders, the District will exclude students from school who have an exemption from immunization or who are in the process of obtaining immunizations. The District will follow all of the Department of Health orders and/or the school physician’s directives with respect to quarantining for communicable diseases.

It is the responsibility of the Superintendent and/or his designee(s), working through District health personnel, to enforce this policy and to contact the county health department when a reportable case of a communicable disease is identified in the student or staff population.

Administering Medication to Students

The administration of prescribed medication to a student during school hours shall be permitted only when the medication is necessary to allow the student to attend school, failure to take such medicine would jeopardize the health of the student, 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 or other authorized healthcare medical provider.

The procedures to be followed for the administration of medication are dependent upon the status of the student as “nurse dependent,” “supervised” or “independent.” A “nurse dependent” student requires the assistance of a licensed health professional to administer medication; a “supervised student” may self-administer medication under the supervision of licensed health professional or trained unlicensed school personnel, such as a teacher, principal or other staff member; an “independent student” with the appropriate provider orders and attestation and written parent/guardian consent, may carry and self-administer their medication to prevent negative health consequences.

The school nurse shall develop procedures for the administration of medication, which require that:

1. all medications will be administered by a licensed person unless the child is a “supervised student”or an “independent student”;

2. medications, other than as noted above, shall be securely stored in the nurse’s office and kept in their original labeled container, which specifies the type of medication, the amount to be given and the times of administration;

3. 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

4. all medications shall be brought to school by the parent/guardian and shall be picked up by the parent/guardian 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 end date or last day of student attendance, the medication shall be discarded.

Before any medication may be administered to any student during school hours, the District requires:

1. the written request of the parent/guardian, which gives permission for such administration and relieves the District and its officers and employees of liability for administration of medication; and

2. the written order of the prescribing physician or other authorized healthcare provider, 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 permitted to carry and self-administer medication under certain circumstances, in accordance with state law and regulation. A student is authorized to carry and use a rescue inhaler, epinephrine auto-injector, insulin, and glucagon (and associated diabetes testing supplies), if the following conditions are met:

1. The child’s parent/guardian must bring the medication to school in the original labeled container, which must include the student’s name, name of medication, dosage, frequency, and prescribing medical provider.

2. An authorized healthcare provider must provide written permission that includes an attestation that the student’s diagnosis requires the medication; the student has demonstrated that he/she can self-administer the prescribed medication effectively; the name of the medication, the dose, the times when it is to be taken, the circumstances which may warrant use and the length of time during which the student may use it.

3. Written parent/guardian permission.

4. All written authorizations shall be kept on file in the office of the school nurse.

If a student is authorized to carry and use medication, as described above, the parent/guardian is permitted to give extra medication and supplies that the District will maintain in accordance with the written directions submitted by the authorized medical provider. Such extra medication and supplies shall be readily accessible to the student.

All documents pertaining to student medication will be kept on file in the nurse’s office.

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. Parents must supply the medication and tubing for student use.

Life-Threatening Allergies and Anaphylaxis Management

The District will work cooperatively with the student, their parent/guardian and healthcare provider to allow a child with life-threatening allergies 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 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.

Administering epinephrine in emergency situations. The administration of epinephrine by auto-injector (such as epi-pen or Auvi-Q) has become an accepted and extremely beneficial practice in protecting individuals subject to serious allergic reactions (e.g., individual has an anaphylactic reaction to an insect sting or the ingestion of a food allergen). Pursuant to Commissioner’s regulations, registered professional nurses may carry and administer agents used in non-patient specific emergency treatment of anaphylaxis.

The District will stock epinephrine auto-injectors to be used on any student or staff member having symptoms of anaphylaxis, whether or not there is a previous history of severe allergic reaction. The School Physician will oversee use of the auto-injectors, ensuring that designated staff are appropriately trained.

In addition, pursuant to SED guidelines, school nurses may provide training to unlicensed school staff in administering epinephrine auto-injectors, 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.

Illness in School

If a student becomes ill in school:

1. The nurse will determine if the student should remain in the nurse’s office or return to class.

2. The nurse will call the parent/guardian or emergency contact if he/she feels the student should go home. In general, a parent/guardian will pick up the student from school.

3. The nurse will contact the Principal if he/she feels the child should be transported by bus to the home.

4. 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.

5. If the route is to be changed, the transportation supervisor shall inform the bus driver.

6. If no parent/guardian or emergency contact picks up the student at school, or if no parent/guardian or emergency contact will be home, the student will remain in the nurse's office until such time as a parent/guardian or emergency contact becomes available to assume responsibility for the child.

7. While in the nurse’s office, to the extent possible, students showing symptoms of communicable diseases will be kept separate from students with non-transmissible illness or injuries, and the District will take measures necessary to minimize disease transmission (e.g., physical barriers, face coverings, heightened hygiene procedures).

The nurse will maintain appropriate records of all student visits.

Medical Emergency Record

All students shall have on file in the student management system a health 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;

2. the student's next of kin;

3. an emergency contact;

4. the student’s healthcare provider;

5. any allergies or serious health conditions.

Parents/Guardians will be responsible for yearly updates to the emergency contact list in the student management system through the parent portal and for notifying the school nurse of any health changes.

Students diagnosed with diabetes shall have a written diabetes management plan maintained as part of the student’s cumulative health record. Students diagnosed with asthma or other respiratory disease requiring a rescue inhaler and students diagnosed with life-threatening allergies or diabetes may have an emergency action plan maintained as part of the student’s cumulative medical record. The diabetes management plan and emergency action plan will be developed in accordance with state regulations and District procedures.

Student Return to School after Illness/Injury

In general, students should be symptom-free before returning to school and resuming normal activities. In the case of communicable diseases, students must no longer be contagious. In some instances, students may be asked to provide a note from their licensed health care provider or meet specific indicators 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 public health authorities, 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.

Cross-ref: 4321, Programs for Students with Disabilities

5550, Student Privacy

8130, School Safety Plans and Teams

8131, Pandemic Planning

Ref: Education Law §§310 (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); 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

Adoption date: December 1, 1995

Amended date: November 17, 2008

Amended date: January 11, 2021