Policy JLC- Student Health Services and Requirements
Referrals for non-emergency care
1. To private physicians or clinics
Parents are responsible for care of their children. If a parent requests the name of a physician, he shall be referred to the Denver Medical Society Referral Center by a school nurse or school physician. No school employee shall refer a family to any individual physician.
2. To Nursing Services
Principals, teachers, special education staff or others may need additional health information about certain students and should contact health service personnel for such assistance. The school nurse shall make all contacts with private physicians or clinics for the purpose of giving or securing health information about a student.
Health information about students
1. Requesting health information
It is the responsibility of Nursing Services to secure health information about students from private physicians, hospitals or clinics. Signed parent permission slips shall be obtained as legal protection for the physician and the schools.
2. Transmitting health information
Every health report sent to Nursing Services shall be reviewed and shared with the school nurse who in turn shall give the information to the principal or teacher requesting it.
3. Receiving health information at school
If a health report is received at the school, it should be given to the school nurse. If additional help or interpretation is needed, Nursing Services should be contacted.
4. Releasing health information
When written requests for health information about students come from physi-cians, hospitals or clinics, the permission of parents to release such information may be required. Signed permission slips shall be obtained by requestees.
When phone requests come from physicians, hospitals or clinics, identification of the caller shall be checked before any information is released. A return telephone call should be made to verify the authenticity of the call. Permission of the parent may be needed according to the type of information sought.
Annual Screening Programs
The sight and hearing of all students in kindergarten, first, second, third, fifth, seventh and ninth grades or students in comparable age groups referred for testing shall be tested during the school year by the school nurse, teacher, principal or other qualified person authorized by the school district, as required by law.
The parents or guardian shall be informed when a deficiency is found.
This provision shall not apply to any student whose parent or guardian objects on religious or personal grounds.
Dental care clinic
The Denver Public Schools shall participate in a cooperative program with Kids in Need of Dentistry (KIND) to provide dental care for students who have no other dental resource.
1. Management and implementation of the facility shall be the responsibility of the KIND.
2. The Denver Public Schools shall provide physical facilities and supplies only. The participation of the school district shall be limited as noted above. The district shall not assume responsibility for personnel or policy decisions of the agency performing the dental care.
3. The Denver Public Schools disavows any professional liability.
Portions adopted January 5, 1959, February 21, 1964 and January 19, 1973
Revised to conform with practice: date of manual adoption
LEGAL REFS.: C.R.S. 18-6-101
C.R.S. 22-1-116
C.R.S. 22-32-110 (1)(bb)
C.R.S. 22-33-106 (2)
C.R.S. 25-4-901 et seq.
C.R.S. 25-6-102
File: JLC
CROSS REFS.: JEC, Student Admissions to/Withdrawals from School
JHD, Exclusions and Exemption from School Attendance
JLCB, Immunization of Students
JLCC, Communicable/Infectious Diseases
JLCCA, Students with HIV/AIDS
JLCD, Administering Medicines to Students
JRA/JRC, Student Records/Release of Information on Students
No student shall be permitted to attend or continue to attend any school in this district without meeting the legal requirements of immunization against disease unless the student has a valid exemption for health, religious, personal or other reasons as provided by law.
Students who do not submit a certificate of immunization or present a valid exemption shall be suspended and/or expelled from school until such certificate of exemption is received.
The administration shall set appropriate regulations to comply with the law.
Current practice codified 1993
Adopted: date of manual adoption
LEGAL REFS.: C.R.S. 22-33-106
C.R.S. 25-4-901 et seq.
6 CCR 1009-2
CROSS REFS.: JFC, Student Admissions to/Withdrawals from School
JHD, Exclusions and Exemptions from School Attendance
JKD/JKE, Student Suspension/Expulsion
JRA, Student Records
The school district is required to provide educational services to all school-age children who reside within its boundaries. By law, however, admission to school may be denied to any child diagnosed as having a disease whereby his attendance could be harmful to the welfare of other students.
The Board of Education recognizes that communicable diseases which may afflict students range from common childhood diseases, acute and short-term in nature, to chronic, life-threatening diseases such as human immunodeficiency virus (HIV) infection. This school district shall rely on the advise of the medical community in assessing the risk of transmission of various communicable diseases to determine how best to protect the health of both students and staff.
Management of common communicable diseases shall be in accordance with Colorado Department of Health guidelines. A student who exhibits symptoms of a readily-transmissible communicable disease may be temporarily excluded from school attendance.
Students who complain of illness at school may be referred to the school nurse and may be sent home by the principal as soon as the parent or person designated on the student's emergency medical authorization form has been notified.
The district reserves the right to require a physician's statement authorizing the student's return to school.
In all proceedings related to this policy, the district shall respect the student's right to privacy.
When information is received by a staff member or volunteer that a student is afflicted with a serious, readily-transmissible disease, the staff member or volunteer shall promptly notify the school nurse or principal to determine appropriate measures to protect student and staff health and safety. The principal shall determine which additional staff members, if any, have need to know of the affected student's condition. Only those persons with direct responsibility for the care of the student shall be informed of the specific nature of his/her condition if it is determined there is a need for such individuals to know this information.
Parents of other children attending the school may be notified that their child has been exposed to a communicable disease without identifying the particular student who has the disease.
Parents of other children attending the school may be notified that their child has been exposed to a communicable disease without identifying the particular student who has the disease.
The superintendent shall initiate procedures to ensure that all medical information will be held in strict confidence. Any school staff member who violates confidentiality shall be subject to appropriate disciplinary measures.
LEGAL REFS: C.R.S. 22-33-104(2)(a)
C.R.S. 22-33-106(2)
Adopted: May 31, 1994
Nurse Practitioners practicing in Denver Public Schools that are housed in School Based Health Centers, may prescribe medication for a student. No other employee of the Denver Public Schools shall prescribe medication.
Medication will be given when a parent specifically makes a request and completes the STUDENT MEDICATION REQUEST RELEASE AGREEMENT/ PHYSICIAN'S ORDER FOR MEDICATION.
A safe and appropriate method of carrying out this request shall be developed by Nursing Services. It will be the responsibility of the school nurse to supervise the implementation of this policy. The parent's request must also be accompanied by a signed order from a licensed physician/nurse practitioner. This process must be followed for both prescription and over-the-counter medication. The order must include the name of the medication, dose, time, and route. A hysician's/ Nurse Practitioner's order may be faxed.
A new request must be initiated for each medication and each change of medication order. This includes changes in medication, dose, time, or route. In addition, a new form with the Physician's/Nurse Practitioner's order must be signed at the beginning of each school year for each medication. (No medications shall be self administered in grades ECE through 5.)
Asthmatic students enrolled in grades 6 through 12 will be allowed to carry their inhalers when a parent specifically makes a request and completes the "STUDENT MEDICATION REQUEST RELEASE AGREEMENT/PHYSICIAN'S ORDER FOR MEDICATION."
Parents should be encouraged to have the student's medication given at times other than school hours. Only when necessary will the school assume the responsibility of administering prescribed medication.
If a parent sends medication to school requesting that the school give it, and the aforementioned form is not completed, the school nurse is the only one who can call the physician/nurse practitioner and take a verbal order over the phone. The completed form must be submitted by the parent before any further doses will be given at school.
Injectable medication will be given when the injection is ordered by a Physician/ Nurse Practitioner. At least two people in the school should be trained to administer ALL medication. Ongoing supervision will be provided by the school nurse.
The medication supplied by the parent/guardian must be in the bottle dispensed by a pharmacy. The pharmacy label must include: student's name, name of medication, how often the medication is to be given, the dosage, and when appropriate, the date the medication is to be stopped.
All medication must be retained in a locked cabinet that is firmly affixed to a wall. If the medication must be refrigerated, then the school nurse is responsible for establishing storage. Medication cannot be stored in a refrigerator with food. The school nurse will notify the principal if there is a concern regarding this issue.
The proper disposal of unused medication is important. It is the responsibility of the parent to retrieve all unused medication from the school when the medication is discontinued, the school year ends, or the family transfers to another district. All medication left in the school will be disposed of by the school nurse.
An appropriate record of all medication dispersed by school personnel shall be documented and filed in the students health record.
School staffs are not permitted to recommend or require that a student be prescribed psychotropic medication(s) to attend school. School staffs must obtain prior written permission to implement behavioral testing; prior written agreement for the disclosure of results of applied testing, and prior written agreement for the disposition of results of testing from parents/guardians and students when applicable. All school staffs should discuss behavioral concerns with parents/guardians and may suggest to parents/guardians that consultation with appropriate health care providers may be beneficial to the student.
Adopted: September 1, 1956
Revised to conform with practice: February, 1994
Revised: April 13, 2000
Revised: October 2, 2003
LEGAL REFS.:
Colorado Nurse Practice Act, State Board of Nursing, 1995
Delegatory Clause to Colorado Nurse Practice Act,1998
C.R.S. 12-38-102
C.R.S. 12-38-103 (4)
C.R.S. 12-38-108
Guidelines for School Medication Administration, 3rd Edition,
1998
Guidelines for the Administration of Medication in School, (RE9328), American Academy of Pediatrics, 92, (3), 1993, p 499-500
Student accidents or illnesses
No treatment of injuries except first aid shall be permitted in the schools. First aid is that immediate help given by the best qualified person at hand in case of accident or sudden illness.
It is proper and lawful for school personnel to give emergency care to sick or injured students whenever the illness or injury comes to the attention of school personnel on school property, on school buses, in any group under school supervision off of school property, or adjacent to school environs. Whenever serious emergencies occur on a school bus, the driver shall drive at once to the nearest hospital to obtain emergency medical attention.
No drugs shall be given at any time unless it be aromatic spirits of ammonia in case of fainting. The administering of aspirin for headaches or pain or the giving of sodium bicarbonate is forbidden.
Principals and department heads shall be responsible for familiarizing personnel in each unit with policies and procedures for handling illnesses and injuries involving students. At least one person in each building shall have had special training in first aid.
Emergency information cards for all students shall be completed each year by parents or guardians of all students at the time of enrollment and shall be on file in school offices.
When athletic teams are participating away from their home school, coaches shall have in their possession duplicate copies of emergency cards for all participating athletes.
Whenever a situation requires additional attention beyond first aid measures given at school, references on the emergency cards should be contacted. When no adult listed on the emergency card can be reached or if such urgent care is needed that the time does not permit several telephone calls, the staff member in charge shall dial 911 and request the Denver City and County Fire Rescue Squad, give name and address of the school building, and state if an ambulance is needed.
The fire rescue squad in the immediate area shall respond to the emergency call and if an ambulance has been requested it shall be sent from the Denver Health and Hospitals. The injured or ill person may be taken to the closest hospital emergency room. A Denver Public Schools employee should accompany the student if the parent/guardian is not present.
These procedures shall be followed for all emergencies involving students at school, at school-sponsored activities and at athletic events unless a physician is in attendance at the latter to direct handling of such emergencies.
Liability in the administration of first aid*
In determining the propriety or nonpropriety of administering first aid in any emer-gency situation, the test of liability to be applied is that of what the ordinary prudent person equipped with like knowledge would do under the same or similar circumstances.
The element of emergency definitely must be present and a long-standing injury or illness or an occurrence not of an emergency nature would not justify the administration of first aid or in particular of anything that could be deemed a continuous course of treatment.
Ordinarily in the case of an emergency or accident, there is a duty to afford reasonable first aid. The question of whether first aid is negligently administered is a question of fact to be judged by the standards of what an ordinary prudent person possessed of like knowledge would have done under the same or similar circumstances.
A person need not be unduly fearful of liability in administering first aid if there is an emergency if the person stays within normal areas of first aid and acts in good faith and to the best of his knowledge and ability at the time. There would be more hazard involved through an overly cautious attitude in failing to administer first aid in the event of an accident than there would be in the administration of first aid.
If the emergency is severe, then the first thing to do is summon a physician or the city ambulance in addition to notifying the parents. As noted, once the student is turned over to the public health authorities, the person's responsibility for first aid treatment ceases.
*Extracted from an opinion rendered by the attorney for the Denver Public Schools, January 25, 1965
Portions adopted September 1, 1965, August 16, 1974 and December 17, 1976
Revised to conform with practice: date of manual adoption
File: JLCE
LEGAL REFS.: C.R.S. 13-21-108
C.R.S. 24-10-106.5
CROSS REFS.: JLIB, Student Dismissal Precautions
JLCD, Administering Medicines to Students