5141 5141Students
Student Health Services
School District Medical Advisor/School Nurse
The Board of Education shall appoint a school district medical advisor and advisory committee and appropriate medical support service personnel, including nurses.
The school district medical advisor, in cooperation with the Board and the board of health/health department for the school district, shall:
1. Plan and administer each school's health program,
2. Advise on the provision of school health services,
3. Provide consultation on the school health environment, and
4. Perform any other duties as agreed between the advisor and the appointing board of education.
School health efforts shall be directed toward detection and prevention of health problems and to emergency treatment, including the following student health services:
1. Appraising the health status of student and school personnel;
2. Counseling students, parents, and others concerning the findings of health examination;
3. Encouraging correction of defects;
4. Helping prevent and control disease;
5. Providing emergency care for student injury and sudden illness;
6. Maintaining school health records.
Health Records
There shall be a cumulative health record for each student enrolled in the school district which will be maintained in the school health office. For the purposes of confidentiality, records will be treated in the same manner as the student's cumulative academic record.
Student health records are covered by the Family Educational Rights and Privacy Act (FERPA) and are exempt from the Health Insurance Portability Accountability Act (HIPAA) privacy rule. However, it is recognized that obtaining medical information from health care providers will require schools to have proper authorization and to inform parents that such information once released by health care providers is no longer protected under HIPAA but is covered under FERPA.
Regular Health Assessments
Prior to enrollment in pre-k special education, kindergarten, and during grade 6, each student shall have a health assessment by a legally qualified practitioner of medicine, an advanced practice registered nurse, a registered nurse, a physician assistant, a physician assistant stationed at any military base or the school medical advisor, herein referred to as health care provider to ascertain whether the student has any physical disability or other health problem which could be a barrier to learning.
Such health assessment shall include:
1. Physical examination which shall include hematocrit or hemoglobin tests, height, weight, blood pressure, and a chronic disease assessment which shall include, but not be limited to, asthma;
2. Updating of immunizations required under C.G.S. 10-204a and the Department of Public Health, Public Health Code, 10-204a-2a, 10-204-3a and 10-204a-4;
3. Vision, hearing, postural, and gross dental screening;
4. If required by the school district medical advisor and the local health department, testing for tuberculosis and sickle cell anemia or Cooley's Anemia. Students born in high risk countries and entering school in Connecticut for the first time should receive either TST (tuberculin skin test) or IGRA (interferon gamma release assay). Any individual found to be positive shall have an appropriate medical management plan developed that includes a chest radiograph. Students not already known to have a positive test for tuberculosis shall be tested if they meet any of the risk factors for TB infection, as described in the administrative regulations accompanying this policy.
5. Any other information including a health history as the physician believes to be necessary and appropriate.
A student will not be allowed, as the case may be, to begin or continue in district schools unless health assessments are performed as required. Students transferring into the district must provide evidence of required Connecticut immunizations and health assessments prior to school attendance which have been performed by a legally qualified practitioner of medicine, an advanced practice registered nurse, a physician assistant or the school medical advisor licensed to practice in the United States.
The Board of Education shall provide for health assessments, without charge, to all students whose parents or guardians meet the eligibility requirements for free and reduced price meals under the National School Lunch Program or for free milk under the special milk program. To meet its obligations pursuant to this section, the Board may utilize the school medical advisor or existing community resources.
The Board of Education shall annually designate a representative to receive reports of health assessments and immunizations from health care providers.
Health assessment results and recommendations signed by the health care provider shall be recorded on blue forms provided by the Connecticut State Board of Education (Dept. of Education Form: Health Assessment Record [HAR 3] rev. 2/00) and kept on file in the school the student attends. Upon written authorization from the student's parent or guardian, original cumulative health records shall be sent to the chief administrative officer of the school district to which such student moves and a true copy of the student's cumulative health records maintained with the student's academic records. The Superintendent's designee (school nurse) shall notify parents of any health related problems detected in health assessments and shall make reasonable efforts to assure that further testing and treatment is provided including advice on obtaining such required testing or treatment.
Students who are in violation of Board requirements for health assessments and immunizations will be excluded from school after appropriate parental notice and warning.
Vision Screening
All students in grades K, 1, 3, 4, & 5, will be screened using a Snellen chart, or equivalent screening, by the school nurse or school health aide. Vision screenings performed by a student's health care provider, as part of the mandated health assessments may be accepted in lieu of school screening. Additional vision screenings will also be conducted in response to appropriate requests from parents/guardians or professionals working with the student in question. Results will be recorded in the student's health record on forms supplied by the Connecticut State Board of Education, and the Superintendent or designee, shall cause a written notice to be given to the parent or guardian of each student found to have any defect of vision or disease of the eyes, with a brief statement describing such defect or disease.
As necessary, special educational provisions shall be made for students with handicapping conditions.
Hearing Screening
All students will be screened for possible hearing impairments in grades K, 1, 3, 4, & 5. Audiometric screenings performed by a student's health care provider, as part of the mandated health assessments may be accepted in lieu of school screening. Results will be recorded in the student's health record on forms supplied by the Connecticut State Board of Education, and the Superintendent or designee, shall cause a written notice to be given to the parent or guardian of each student found to have any defect of hearing, with a brief statement describing such defect.
As necessary, special educational provisions shall be made for students with disabilities.
Postural Screening
School nurses will screen all female students in grades five for scoliosis or other postural problems. Scoliosis screenings performed by a student's health care provider may be accepted in lieu of school screening. Additional postural screenings will also be conducted in response to appropriate requests from parents/guardians or professionals working with the student.
Results will be recorded in the student's health record on forms supplied by the Connecticut State Board of Education, and the Superintendent or designee, shall cause a written notice to be given to the parent or guardian of each student found to have any postural impairment or problem, with a brief statement describing such impairment or disease.
As necessary, special educational provisions shall be made for students with disabilities.
Parents will be notified of postural screenings.
Tuberculin Testing
In addition to tuberculin testing, if required by the school district medical advisor, as part of regular student health assessments, all new students, including preschool students, will be required to have at least one test for tuberculosis prior to entry in district schools, if determined to be at risk for exposure to TB.
Students entering from outside the United States will be required to have a new tuberculin test (PPD) and results reported prior to entry into New Hartford Public Schools.
A test for tuberculosis should be performed if any of the following risk factors prevail:
1. birth in a high risk country of the world (see list of countries in Appendix) and do not have a record of a TST (tuberculin skin test) or IGRA (interferon-gamma release assay) performed in the United States;
2. travel to a high risk country, staying at least a week with substantial contact with the indigenous population since the previously required examination;
3. extensive contact with persons who have recently come to the United States since the previously required examination;
4. contact with persons suspected to have tuberculosis, or
5. lives with anyone who has been in a homeless shelter, jail or prison, uses illegal drugs or has an HIV infection.
The results of the risk assessment and testing, when done, should be recorded on the State of Connecticut Health Assessment Record (HAR-3) or directly in the student's Cumulative Health Record (CHR-1)
Immunizations/Vaccinations
No student will be allowed to enter district schools without adequate immunization against the following diseases:
1. Measles
2. Rubella
3. Poliomyelitis
4. Diphtheria
5. Tetanus
6. Pertussis
7. Mumps
8. Hemophilus influenza type B
9. Any other vaccine required by Section 19a-7f of Connecticut General Statutes.
10. Hepatitis B
11. Varicella (chickenpox)
12. Hepatitis A
13. Pneumococcal disease
14. Influenza
15. Meningococcal disease
All students in grades K-6 are required to have received 2 doses of measles, mumps and rubella vaccine or serologic proof of immunity. Students entering kindergarten and seventh grade shall show proof of having received 2 doses of varicella vaccine, laboratory confirmation of immunity, or present a written statement signed by a physician, physician assistant or advanced practice registered nurse indicating the individual has had varicella based on family or medical history. (Varicella requirement effective August 1, 2011)
All students in grades K-12 are required to have 3 doses of Hepatitis B vaccine or serologic evidence of immunity.
Students shall be exempt from the appropriate provisions of this policy when:
1. they present a certificate from their health care provider or local health agency stating that initial immunizations have been given and additional immunizations are in process under guidelines and schedules specified by the Commissioner of Health Services; or
2. they present a certificate from their health care provider stating that in the opinion of such provider, immunization is medically contraindicated because of the physical condition of such student (this must be updated yearly); or
3. they present a written statement from their parents or guardians that such immunization would be contrary to the religious beliefs of such child or his/her parents/guardians; such statement to be officially acknowledged by a notary public or a judge, a court clerk/deputy clerk, a town clerk, a justice of the peace, a Connecticut attorney, or a school nurse; or
4. in the case of measles, mumps or rubella, present a certificate from a physician, physician assistant or advanced practice registered nurse or from the Director of Health in such child's present or previous town of residence, stating that the child has had a confirmed case of such disease; or
5. in the case of Hemophilus influenza type B has passed his or her fifth birthday; or
6. in the case of diphtheria, tetanus and pertussis, has a medical exemption confirmed in writing by a physician, physician assistant or advanced practice registered nurse (per C.G.S. 19a-7f).
The school nurse coordinator, working with the school medical advisor, will report to the local Director of Health any outbreak of State of Connecticut defined reportable communicable diseases.
Oral Health Assessments
Parents are encouraged to have oral health assessments for their child(ren) prior to public school enrollment, in grade 6 or 7. Such assessment may be conducted by a dentist, dental hygienist, physician, physician assistant (PA), or an advanced practice registered nurse (APRN), if he or she is trained in conducting such assessments as part of a DPH-approved training program. When conducted by a dentist the oral assessment must include a dental examination. If another such provider conducts the assessment, it must include a visual screening and risk assessment.
Parent/guardian consent is required prior to the oral health assessment. The assessment is to be made in the presence of the parent/guardian or another school employee. The parent/guardian must receive prior written notice and have a reasonable opportunity to opt his/her child out of the assessment, be present at the assessment, or provide for the assessment himself or herself.
A child's public school enrollment continued attendance shall not be denied for his/her failure to receive the oral health assessment.
The District may host a free oral health assessment event at which a qualified provider performs such oral health assessments. Parents/guardians will be given prior notice of such a free screening event providing the parents/guardians the opportunity to opt their children out of the assessment event. If the parent/guardian does not do so, the child must receive an assessment free of charge. The child is prohibited by the legislation from receiving any dental treatment as part of the assessment event without the parent's/guardian's informed consent.
The results of an oral health assessment shall be recorded on forms supplied by the State Board of Education. The provider performing the assessment must completely fill out and sign the form. Recommendations by the provider shall be in writing. For any child who receives an oral health assessment, the results must be included in the child's cumulative health record.
Appropriate school health personnel shall review the assessment results. If it is determined that a child needs further testing or treatment, the Superintendent or designee, shall give written notice to the child's parent/guardian and make reasonable efforts to ensure that further testing or treatment is provided. Such efforts include determining whether the parent/guardian obtained the necessary testing or treatment for the child and, if not, advising the parent or guardian on how to do so. The results of the further testing or treatment must be recorded on the assessment forms and reviewed by school health personnel.
As with other school health assessments no records of oral health assessments may be open to public inspection; and each provider who conducts an assessment for a child seeking to enroll in a public school must provide the assessment results to the school district's designated representative and a representative of the child.
Student Medical Care at School
School personnel are responsible for the immediate care necessary for a student whose sickness or injury occurs on the school premises during school hours or in school-sponsored and supervised activities.
Schools shall maintain files of emergency information for each student. If a student's injury requires immediate care, the parent or guardian will be called by telephone by the nurse, the building Principal or other personnel designated by the Principal, and advised of the student's condition. When immediate medical or dental attention is indicated, and when parents or guardians cannot be reached, the student will be transported, via 911, to an emergency care facility unless otherwise indicated in the student's emergency information data. In this event, the student's health care provider/dentist and the school district medical advisor will be notified of school district actions.
(cf. 5141.4 - Child Abuse and Neglect)
(cf. 5141.5 - Suicide Prevention)
(cf. 6171 - Special Education)
Legal Reference: Connecticut General Statutes
10-203 Sanitation.
10-204a Required immunizations, as amended by PA 15-174 & PA 15-242.
10-204c Immunity from liability
10-205 Appointment of school medical advisors.
10-206 Health assessments, as amended by PA 07-58, PA 11-179 and PA 18-168.
10-206a Free health assessments.
10-207 Duties of medical advisers, as amended by PA 12-198.
10-208 Exemption from examination or treatment.
10-208a Physical activity of student restricted; boards to honor notice.
10-209 Records not to be public. (as amended by PA 03-211)
10-210 Notice of disease to be given parent or guardian.
10-212 School nurses and nurse practitioners.
10-212a Administration of medicines by school personnel.
10-213 Dental hygienists.
10-214 Vision, audiometric and postural screening: When required; notification of parents re defects; record of results. (As amended by PA 96-229 An Act Concerning Scoliosis Screening)
10-214a Eye protective devices.
10-214b Compliance report by local or regional board of education.
10-217a Health services for children in private nonprofit schools. Payments from the state, towns in which children reside and private nonprofit schools.
Department of Public Health, Public Health Code - 10-204a-2a, 10-204a-3a and 10-204a-4.
Federal Family Educational Rights and Privacy Act of 1974 (section 438 of the General Education Provisions Act, as amended, added by section 513 of P.L. 93-568, codified at 20 U.S.C. 1232g).
42 U.S.C. 1320d-1320d-8, P.L. 104-191, Health Insurance Portability and Accountability Act of 1996 (HIPAA)
PA 18-168 An Act Concerning the Department of Public Health's Recommendations Regarding Various Revisions to the Public Health Statutes, Sections 7-9, 539 & 540.
Policy adopted: December 18, 2007
Policy revised: September 20, 2011
Policy revised: June 4, 2013
Policy revised: May 21, 2019
NEW HARTFORD PUBLIC SCHOOLS
New Hartford, Connecticut