Student Welfare 7521
SUBJECT: STUDENTS WITH LIFE-THREATENING HEALTH CONDITIONS
Students come to school with diverse medical conditions which may impact their learning as well as their health. Some of these conditions are serious and may be life-threatening. As a result, students, parents, school personnel, and healthcare providers will work together to provide the necessary information and training to allow children with appropriately documented chronic and serious life- threatening health problems to participate inclusively and safely in the school setting. This policy encompasses an array of serious or life-threatening medical conditions such as but not limited to anaphylaxis, diabetes, seizure disorders, or severe asthma and acute medical conditions such as substance overdose. Students within the District with known life-threatening conditions will have an Emergency Care Plan (ECP) and/or Individualized Healthcare Plan (IHP) and if appropriate, an Individualized Education Plan (IEP) or Section 504 Plan.
For those students with chronic life-threatening conditions such as diabetes, seizure disorders, asthma, and allergies, the District will work cooperatively with the parent(s) and the healthcare provider(s) to:
a) Obtain appropriate health care provider documentation of medical need for accommodation, as well as routine, and emergency orders for the management of the condition in the school setting.
b) Develop an ECP for the student to ensure that all appropriate personnel are aware of the student's potential for a life-threatening reaction;
c) If appropriate, develop an IHP that includes all necessary treatments, medications, training, and educational requirements for the safe management of the student by staff working with the child at a level of understanding commensurate with their skills. If the student is eligible for accommodations based upon the Individuals with Disabilities Act (IDEA), Section 504 of the Rehabilitation Act of 1973, or the Americans with Disabilities Act, the appropriate procedures will be followed regarding evaluation and identification;
d) Provide training by licensed medical personnel (e.g., registered professional nurse) in the recognition and emergency management of a specific medical condition for specific students;
e) Follow specific physician-generated medical-legal documents duly executed in accordance with the laws of New York State with specific medical orders regarding the care of specific students with severe life-threatening conditions; appropriate health care provider authorization in writing for specific students that includes the frequency and conditions for any testing and/or treatment, symptoms, and treatment of any conditions associated with the health problem; and directions for emergencies;
SUBJECT: STUDENTS WITH LIFE-THREATENING HEALTH CONDITIONS (Cont'd.)
f) Secure written parent permission and discuss parental responsibility that includes providing the health care provider's orders, providing any necessary equipment, and participation in the education and co-management of the child as he/she works toward self-management;
g) Allow independent students (e.g., those students with physician attestation forms indicating they are competent) to carry life-saving medication in accordance with relevant laws, regulations, and procedures. The District will also encourage parents and students to provide duplicate life-saving medication to be maintained in the health office in the event the self-carrying student misplaces, loses, or forgets their medication;
h) Provide appropriate and reasonable building accommodations.
In addition, the District will work toward assisting students in the self-management of their chronic health condition based upon the student’s knowledge level and skill by:
a) Training staff involved in the care of the child, as appropriate;
b) Advising families of the importance of their provision of the necessary equipment and/or medications. Equipment and medications are provided by parents/guardians and prescribed by the child’s attending physician;
c) Having standing emergency medical protocols for nursing and/or other staff; when appropriate;
d) Having the school medical director write a non-patient specific order for anaphylaxis treatment agents for the school’s registered professional nurse or other staff, as designated by the Administration and allowed under federal and New York State laws and regulations, to administer in the event of an unanticipated anaphylactic episode;
e) Having the school medical director write a non-patient specific order for Naloxone (Narcan) for the school's registered professional nurse and as allowed under federal and New York tate laws and regulations, to administer in the event of suspected opioid overdose;
f) Maintaining or ensuring the maintenance of a copy of the standing order(s) and protocol(s) that authorizes them to administer emergency medications;
g) In accordance with District practice and as permitted by New York State law, maintaining stock supplies of life- saving emergency medications such as epinephrine auto-injectors or Naloxone (Narcan) for use, especially in first time emergencies;
h) Allow the school registered nurse, nurse practitioner, or physician to train unlicensed school personnel to administer emergency life-saving medications, such as, but not limited to epinephrine via auto-injector or emergency glucagon, to students with both a written provider order and parent/person in parental relation consent during the school day, on school property, and at any school function. Such training will be done in accordance with specifications outlined in the Commissioner’s regulations. Documentation of training should be maintained and updated by the trainer and stored in the student’s permanent health record. All life-saving efforts made by a non-licensed school staff member are permitted under the “Good Samaritan Law” (Public Health Law Section 3000-a);
i) Including appropriate accommodations for students with life-threatening health condition in building-level and district-wide school safety plans.
j) Educating students regarding the importance of immediately reporting symptoms of an allergic reaction.
Epinephrine Auto-Injectors (EAIs)
The Board-appointed District Physician has issued standing orders to enable the District to provide and maintain EAIs on-site in its instructional facilities. This allows for trained Building Administrators who have completed a New York State Department of Health (NYSDOH) course, to administer EAIs to any student or staff member who demonstrates symptoms of anaphylaxis, regardless of whether such person has a prior history of severe allergic reactions. The District will store EAIs in the school health office to allow for appropriate access for use during emergencies and will notify the Board appointed District Physician and District Nurse Practitioner of every use of an EAI. The District permits the training of school employees to administer stock EAIs to students and staff members who do not have a patient-specific order for such medication.
Creating an Allergen-Safe School Environment
The risk of accidental exposure or cross-contamination is always present in school, particularly for students with food allergies. The school setting is a high-risk environment for accidental ingestion of a food allergen due to the presence of a large number of students, increased exposure to food allergens, and cross-contamination of tables, desks, and other surfaces.
In an effort to prevent accidental exposure to allergens, the District will monitor the following high-risk areas and District operated and/or sponsored activities:
b) Food sharing;
c) Materials used in art, science, and other projects;
e) Fund raisers and bake sales;
f) Parties and holiday celebrations;
g) Field trips;
h) Before and after school programs operated by the District.
The District will work toward assisting students in the self-management of their chronic health condition based upon the student's knowledge level and skill by:
a) Training staff involved in the care of the child, as appropriate;
b) Working with families and treatment providers to facilitate the availability of the necessary equipment and/or medications;
c) Developing an emergency care plan for the student; and
e) Providing ongoing staff and student education.
Americans with Disabilities Act, 42 USC §12101 et seq.
Individuals with Disabilities Education Act (IDEA), 20 USC §§1400-1485
Section 504 of the Rehabilitation Act of 1973, 29 USC §794 et seq.
34 CFR Part 300
Education Law Sections §§6527 and 6908
Public Health Law Sections §§2500-h (Anaphylactic policy for school districts) and 3000-a
NOTE: Refer also to Policy #7513 – Administration of Medication
Revised Policy Adopted: 9/13/16
Revised Policy Adopted: 8/8/17
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