5420-R- Student Health Services Regulation

A. Immunizations  

Public Health Law, Education Law, and New York State Code of Rules and Regulations address immunization  requirements for children in New York State schools. The Registered Professional Nurse in each building shall  review the immunization mandates annually to ensure compliance.  

Each student must present acceptable proof of immunity upon registration. Students who are not fully  immunized may only be admitted to school if they (1) are in the process of receiving immunization or  obtaining blood tests (as described in state law and regulations); or (2) have been granted a medical exemption.  The following constitutes acceptable proof: documents indicating the required receipt of all vaccines such as  a certificate of immunization from a licensed physician or health facility, a signed transcript of the  immunization portion of the cumulative health record from the prior school, a migrant health record, a union  health record, a community health plan record, a signed immunization portion of a passport, serological proof  of immunity or a licensed physician diagnosed history of same disease.  

Medical exemptions may be issued if immunization is detrimental to a child’s health. Medical exemptions must  be on the medical exemption form approved by the New York State Department of Health, signed by a physician  licensed to practice medicine in New York State indicating the specific immunization, the medical  contraindication, and the length of time the exemption is for. Medical exemptions must be reissued annually to  remain valid. The Building Principal may require supporting documents for medical exemptions.  

Homeless students shall be admitted to school even if they do not have the required 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. 

B. Dental Health Certificate  

Each student will be requested to provide a dental health certificate at the same time that a health certificate is  required. The dental health certificate must be issued by a licensed dentist and describe the dental health  condition of the student. Parents and/or legal guardians of students who do not furnish a dental health  certificate within 30 days of the student’s entrance in such school shall be sent a notice indicating that a dental  health certificate is requested. If a dental health certificate is obtained, it shall be filed in the student’s health  record. Students with genuine and sincere religious beliefs may be excused from these requirements. 

C. Administering Medication to Students in School  

Only those medications which are necessary to maintain the student in school and which must be given during  school hours should be administered. Any student who is required to take medications during the regular  school day or while participating in school-sponsored activities (e.g., field trips, athletics) should comply with  all procedures. In addition to the required licensed prescriber’s order and written parental permission best  practice would have a student agreement form signed by the student.  

Any prescribed medication which requires administration through a subcutaneous, intramuscular,  intravenous or rectal route; or prescribed medications being administered through pumps, tubes or  nebulizers; or oral, topical or inhalant medication needed by Nurse Dependent student must be given  by a registered nurse or licensed practical nurses under the direction of a registered nurse. Administration of  such prescribed medications may not be performed by school staff.  

Parent(s) or guardian(s) must present the following information:  

A written order from a NYS duly licensed prescriber and written parental permission to administer  

the medication is required. All medications, including nonprescription drugs, given in school shall be  prescribed by a licensed prescriber on an individual basis as determined by the student’s health status.

Written orders for prescription and non-prescription medications should minimally include: 

  1. Student’s name and date of birth  
  2. Name of medication  
  3. Dosage and route of administration
  4. Frequency and time of administration  
  5. For PRN (as necessary) medications, conditions under which   medication should be administered  
  6. Date written  
  7. Prescriber’s name, title and signature  
  8. Prescriber’s phone number  
  9. List of possible side effects  

2. Special Considerations:  

  1. Medication orders must be renewed annually or when there is a change in  medication dosage  
  2. The pharmacy label does not constitute a written order and cannot be used in  lieu of a written order from a licensed prescriber  
  3. OTC medications must be in the original manufacturer’s container/package  with the student’s name affixed to the container. The same applies to drug  samples.  

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

  1. all regular, daily medications will be administered by the school nurse (RN) or LPN under  the direction of the school nurse, or in the absence of the school nurse, his/her designee. All  regular daily medications will be administered by the school nurse (RN) or LPN  under the direction of the school nurse, or in the absence of the school nurse, his/her  designee to Supervised Students. This includes PRN medications.  
  2. medications shall be securely stored in the health 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 (RN) 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(s) or guardian(s) and shall be  picked up by the parent(s) or guardian(s) at the end of the school year or the end of the  period of medication, whichever is earlier. If not picked up within five (5) days of the  period of medication or the end of the school year, the medication will be discarded.  

An adult must bring the medication to school in the original container.  

Student who may carry and use certain medications  

Students are permitted to self-administer medication under certain circumstances, in  accordance with state law and regulation. A student is authorized to carry and use the following  medications: rescue inhaler, epinephrine auto-injector, insulin, glucagon (and associated  diabetes testing supplies), if the following conditions are met: 

  1. An authorized medical 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.  

  2. Written parental permission.  

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.  

Sunscreen  

Students are permitted to carry and apply sunscreen without a medical provider’s order under the  following conditions:  

  1. the sunscreen is used to avoid overexposure to the sun and not for medical treatment of an injury or illness; if sunscreen is required to treat a medical condition, the procedures for administering medication (above) apply;  
  2. the sunscreen is FDA approved for over the counter use;
  3. the student’s parents or guardians provide written permission annually for the student to carry and use the sunscreen.

The school nurse will keep written permission for students on file and develop procedures  pertaining to this policy. 

D. Student Medical Exams  

In accordance with Section 903 and 904 of the State Education Law, each student shall have a  physical exam given by the school doctor or designee or family’s licensed private health care  provider (physician, nurse practitioner, or physician’s assistant) upon entering grades pre-K or  kindergarten, and 1, 3, 5, 7, 9, 11. Findings are kept on record at the school on forms that can be  obtained from the health office.  

A physical exam is also required for athletic participation and when deemed necessary by the  Committee on Special Education and/or by the school nurse (RN), in consultation with the school  physician, and to obtain working papers. 

E. Illness in School  

 If a student becomes ill in school:  

  1. the school nurse (RN) or LPN under the direction of the school nurse, or in the absence of  the school nurse, his/her designee will determine if the student should remain in the health  office or return to class.  
  2. the school nurse (RN) or LPN under the direction of the school nurse, or in the absence of  the school nurse, his/her designee will call the parent, guardian or substitute parent, if  he/she feels the student should go home. It is the parent or parent-designee’s responsibility  to pick up the student from school. Every reasonable effort will be made to insure that an  ill student does not ride the bus with other students and that the ill student safely returns  home to the care of an adult. 
  3. If no parent, guardian or substitute parent picks up the student at school, or if no  parent/guardian or substitute parent will be home, the student will remain at the school  until such time as a parent, guardian or substitute parent becomes available to assume  responsibility for the child.  
  4. In the event that the parent/guardian or substitute parent cannot be located and the school  nurse (RN) or LPN under the direction of the school nurse, or in the absence of the school  nurse, his/her designee determine the student requires immediate medical attention, the  student will be transported via EMS to the nearest hospital.  

    F. Life-Threatening Allergies and Anaphylaxis Management  

The District shall assemble a team, including, but not limited to the student’s parent, the school  nurse, the student’s teacher, the building principal and other appropriate personnel, who shall  develop an individual health care plan to manage the student’s life-threatening allergy. Such plan  will be maintained by the school nurse and reviewed by the team on an annual basis.  

The District will stock epinephrine auto-injectors and will institute written protocols and procedures  for the use of non-patient specific epinephrine. The District shall ensure that designated staff are  appropriately trained. The School District Physician shall oversee the program, ensuring that designated  staff are appropriately trained. In addition, pursuant to SED guidelines, school nurses may provide  training to unlicensed school staff in administering epi-pens, epinephrine auto-injectors and glucagon prescribed by a licensed medical provider, to a child who has been diagnosed with the associated disease  in accordance with the process described in this policy and regulation. 

G. Medical Emergency Record  

All students shall have on file an annually updated medical emergency form signed and dated by  a parent/guardian that shall state the name and telephone numbers of the following:  

  1. the student’s parent(s) or guardian(s) at home and work;  
  2. alternate persons to contact if parent/guardian cannot be reached;  
  3. the name and telephone number of the student’s licensed health care provider; 
  4. medications currently being taken by the student;  
  5. any health conditions relevant to the student’s participation in school and school-sponsored  activities.  

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

For purposes of this regulation, the McKinney-Vento liaison shall assist homeless students covered  by that law in accessing school health services. H.

H. Student Return to School after Illness/Injury  

In general, students should be symptom-free before returning to school and resuming normal  activities. In some instances, students may be asked to provide a note from their licensed healthcare  provider 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 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.  

Adoption date: May 27, 1997  

Revised: September 24, 2001  

Revised: November 12, 2002  

Revised: March 10, 2008  

Revised: July 14, 2008  

Revised: August 18, 2008  

Revised: January 12, 2009  

Revised: December 10, 2012  

Revised: December 9, 2013  

Revised: May 11, 2015  

Revised: August 24, 2015  

Revised: March 28, 2016  

Revised: July 6, 2017  

Revised: August 13, 2018  

Revised: September 13, 2021  

Revised: June 8, 2026