The District will 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 will be referred to the parent(s) or guardian(s) who will be encouraged to have their family physician/dentist provide appropriate care. Upon request, the District will supply a list of dental providers offering free or reduced care compiled by New York State or Westchester County Department of Health.
The District will provide emergency care for students in accidental or unexpected medical situations. Additionally, the District and its schools will include within their emergency plans a protocol for responding to health care emergencies, including anaphylaxis, asthma, and head injury. Parents/Guardians will be notified of any emergency medical situation affecting their child as soon as is practical.
A permanent student health record will be part of a student's cumulative school record and will follow the student from grade to grade and school to school along with their academic record. A student’s health record will be maintained by the school nurse.
Health Certificates and Immunizations
New York State requires physical examinations of all students entering the District for the first time, and for each student entering pre- K or K and grades 1, 3, 5, 7, 9, and 11 within 30 days of entrance to school. Current physical examinations are also needed to participate in athletics, to obtain a working permit, and as needed for evaluation or re-evaluation of students suspected of having a disability or a student with a disability.
Commissioner’s Regulation 136.3 requires that each student submit a health certificate documenting the physical 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, and be signed by a licensed physician, physician assistant, or nurse practitioner who is authorized by law to practice in the state of New York or in the jurisdiction in which the examination was given, provided that the commissioner has determined that such jurisdiction has standards of licensure comparable to New York. 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. 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 or the parent/guardian 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 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’s/guardian’s genuine and sincere religious beliefs.
In order for their child to attend school, parents/guardians must provide acceptable proof of grade and age specific immunizations, as set forth in state law and regulation, unless exempted from immunizations for medical reasons in accordance with state law and regulation. The medical exemption must be completed and signed by a physician licensed to practice in NYS certifying that the immunization may be detrimental to the student’s health. Medical exemptions must be reissued annually to remain valid and approved yearly by the District’s Medical Director. Unless a student has a valid medical exemption or is in the process of receiving immunizations or blood tests for immunity, all students must have required immunizations prior to school attendance. The District may not permit a student who has not provided acceptable proof of immunization to attend school for more than fourteen days, which may be extended to thirty days if the student is transferring from out-of-state or from another country and can show a good faith effort to get the necessary certification or other evidence of immunization. The District will notify the Westchester County Department of Health if a student is denied admission or attendance in school due to lack of immunizations.
Homeless students will 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 will assist homeless students covered by that law in accessing health services described in this policy and accompanying regulation.
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.
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 designee(s), working through District health personnel, to enforce this policy and to contact the Westchester County Department of Health 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 will 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 when 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 will develop procedures for the administration of medication, which require that:
all medications will be administered by a licensed person unless the student is a “supervised student”or an “independent student”;
medications, other than as noted above, will be securely stored in the school 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;
the school nurse will 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 will be brought to school by the parent/guardian and will 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 will be discarded. Students with self-carry orders who are supervised or independent may carry medication to home and school with parent/guardian permission and provided that such written orders from the student’s physician are on file with the school nurse.
Before any medication may be administered to any student during school hours, the District requires:
the written request and signature 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
the written order of the prescribing physician or other authorized healthcare provider with signature, which will include the purpose of the medication, the dosage, the time at which or the special circumstances under which medication will be administered, the period for which medication is prescribed, and the possible side effects of the medication.
the original prescription bottle of medication, or the original over-the-counter package, properly labeled as to its contents.
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:
The student’s medication must be in the original labeled container, and include the student’s name, name of medication, dosage, frequency, and prescribing medical provider.
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 they 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.
Written parent/guardian permission.
Written authorizations from the student ’s physician will be kept on file in the school nurse’s office.
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 will be readily accessible to the student. Please note the District is not responsible for replacement of self-carry medication that is lost, stolen, damaged, or destroyed.
All documents pertaining to student medication will be kept on file in the school nurse’s office.
In addition, in accordance with Education Law 919, the District will make a nebulizer available on-site in school buildings where nursing services are provided. Students with a patient-specific order who require inhaled medications, will have access to the nebulizer. The District will ensure that it is maintained in working order. Parents/Guardians must supply the medication and tubing for student use.
Medications on School Trips:
Taking medication on field trips and at before- and after-school activities is permitted, if a student is independent in administering their own medication. On field trips or at other before- and after-school activities, teachers or other District staff may carry the medication so that the supervised student can take it at the proper time.
If a student is going on a field trip but is not deemed independent, then the District may:
permit the parent/guardian to attend the activity and administer the medication;
permit the parent/guardian to personally request another adult who is not employed by the District to voluntarily administer the medication on the field trip or activity and inform the District in writing of such request; or
allow the student’s health care provider to be consulted and, if they permit, order the medication time to be adjusted or the dose eliminated.
train unlicensed school personnel - unlicensed personnel may be trained by a RN, NP, PA, or a physician to administer emergency epinephrine or glucagon via auto-injector to a student with a patient-specific order and written parent/guardian consent for such medication.
If no other alternative can be found, a school nurse (RN) or appropriate licensed health professional (LPN under the direction of RN/NP, Physician, or PA) must administer the medication.
Life-Threatening Allergies and Anaphylaxis Management
The District will work cooperatively with the student, their parent/guardian and healthcare provider to allow a student with life-threatening allergies to participate as fully and as safely as possible in school activities. It is recognized, however, that the District cannot guarantee the elimination of allergens from the school environment.
When a student has a known life-threatening allergy reported on their health form or if the District has been informed by the parent/guardian of the presence of a life-threatening allergy, if appropriate, the District will assemble a team, which may include the parent/guardian, the school nurse, the student’s teacher, the Principal and other appropriate personnel, which will be charged with developing an individual health care plan. Guidelines for Pre-K through Grade 5 Students with Life Threatening Allergies, which help to outline parent/guardian and school responsibilities will be available on the District website and in the school nurse’s offices. Parents/Guardians of students and students in grades 6-12 should contact the school nurse for any assistance they need to help manage their life-threatening allergies. The plan will be maintained by the school nurse and 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 pursuant to non-patient specific orders written by the school physician, 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 student who has been diagnosed with the potential for a severe reaction, in the event of the onset of a serious allergic reaction when a school nurse is not available.
During field trips, athletics, and other school events, a student’s Allergy Action Plan and epinephrine auto-injectors can be given to a designated individual (parent/guardian, parent/guardian designee with permission, or trained school personnel) who is familiar with the student’s health needs and will be readily available to the student. Students who are deemed independent with epinephrine and have appropriate medical paperwork on file with the school nurse may carry and use their own epinephrine auto-injector at school and during school events. Staff other than the school nurse will not be permitted to give Benadryl unless the student is self-directed with a self-carry order. Students must notify school personnel immediately if they have contact with a known allergen, or are experiencing symptoms, or have self-administered medication.
Care should be taken when planning field trips or other school events that may expose students to allergens (i.e., a student with a milk allergy attending a field trip at a petting farm with milk ingredients in the food for the animals, student with latex allergies participating in theater with stage makeup and props in use).
School personnel should consult with school health personnel when planning events to ensure appropriate time is given to provide necessary medical coverage. A cell phone or other means of communication should be available at school events held outside of a school building to ensure ready access to the school nurse or EMS as needed.
Emergency Transport
In the event of a life threatening medical condition or severe injury, 911/EMS will be called. Anyone can call 911, when possible the school nurse should assess medical situations first. If life threatening, a call to 911 should not be delayed. The parent/guardian should accompany the student in the ambulance when possible. If the parent/guardian is not on-site at the time the ambulance is leaving the school, a staff member will be assigned by the building administrator to accompany the student until the parent/guardian is present. Building level guidelines are also in place.
Automated External Defibrillators
The District will provide and maintain on site in each instructional school facility an AED.
Illness in School
If a student becomes ill in school:
The school nurse will determine if the student should remain in the school nurse’s office or return to class.
The school nurse will call the parent/guardian or emergency contact if they feel the student should go home. In general, a parent/guardian will pick up the student from school within a reasonable time as deemed by the Health Office Staff.
If there is to be a change in bus routing in order to carry the student to their home, that decision will be made by the administrator and the transportation supervisor.
If the route is to be changed, the transportation supervisor will inform the bus driver.
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 school nurse's office until such time as a parent/guardian or emergency contact becomes available to assume responsibility for the student. Parents/Guardians must provide the schools with an available emergency contact.
While in the school 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). Parents/Guardians or designees are expected to pick up the student within a reasonable time as deemed by the Health Office Staff to prevent transmission to others.
The school nurse will maintain appropriate records of all student visits.
Medical Emergency Record
All students will have on file in the student management system a health record which will 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. 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 will 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. Students with a fever and/or gastrointestinal symptoms will be advised to be dismissed home and return when 24 hours symptom-free. 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, school 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 under IDEA and New York’s Education Law Article 89
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
Amended date: August 26, 2024
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