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 insure 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 mediation needed by Nurse Dependent

Students 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 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.

  1. 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.

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.

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.

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.

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