504 - Student Health & Safety

 

 

 

504 - Student Health Services

 

 

 

Health services are an integral part of comprehensive school improvement, assisting all students to increase learning, achievement, and performance. Health services coordinate and support existing programs to assist each student in achievement of an optimal state of physical, mental, and social wellbeing. Student health services ensure continuity and create linkages between school, home, and community service providers. The school district’s School Improvement Plan, needs, and resources determines the linkages.

The superintendent [or designee] in conjunction with the school nurses will develop administrative regulations regarding this policy. The superintendent [or designee] will proved a written report on the role of health services in the education program to the board on an annual basis.


Adopted: 2/21
Related Policy (Code #): 504.1 through 504.12
Legal Reference (Code of Iowa): §§ 22.7; 139A.3, .8, .21; 143.1; 152; 256.7(24), .11; 280.23; 281 IAC 12.3(4), (7), (11); 12.4(12);
12.8; 282 IAC 15.3(14); 22; 641 IAC 7; 655 IAC 6; 42 USC §§ 12101 et seq; 34 CFR Pt 99, 104, 200, 300 et seq;
29 USC § 794(a); 28 CFR .35; 20 USC 1232g § 1400 6301 et seq
IASB Reference: 607.2
Mandatory Policy

 

 

504.1 - Student Health and Immunization Certificates

 

 

 

Students desiring to participate in athletic activities will have a physical examination by a licensed physician and provide proof of such examination to the school district. A physical examination is recommended for students enrolling in kindergarten or first grade. A physical examination, and proof of such examination, may be recommended by the administration for students in other grades enrolling for the first time in the school district.

A copy of the physical examination form signed by the physician will be on file at the student’s attendance center. Each student will submit an up-to-date certificate of health upon the request of the superintendent [or designee]. Failure to provide this information may be grounds for disciplinary action.

Students enrolling for the first time in the school district will also submit a certificate of immunization against Diphtheria, Pertussis, Tetanus, Poliomyelitis, Rubeola, Rubella, Hepatitis B, Varicella, the meningococcal vaccine, and other immunizations required by law. The student may be admitted provisionally to the attendance center if the student has not yet completed the immunization process but is in the process of doing so. Failure to meet the immunization requirement after the provisional period will be grounds for suspension, expulsion, or denial of admission. Upon recommendation of the Iowa Department of Education and the Iowa Department of Public Health, students entering the district for the first time may be required to pass a TB test prior to admission. The district may conduct TB tests of current students.

Exemptions from the immunization requirement in this policy will be allowed only for medical or religious reasons recognized under the law. The student must provide a valid Iowa State Department of Health Certificate of Immunization Exemption to be exempt from this policy.


Adopted: 6/70
Reviewed: 4/11; 4/12; 7/13; 10/14; 11/17; 12/20
Revised: 11/07; 4/18
Related Policy (Code#): 504.1-E
Legal Reference (Code of Iowa): §§ 139A.8; 280.13; 281 IAC 33.5; 641 IAC 7
IASB Reference: 507.1

504.1-E - Immunization Requirements

 

 

 

Attention Parents and Guardians

All students entering the Linn-Mar Community School District must meet minimum immunization requirements before they will be allowed to attend school. All students are required by state law to meet at least the minimum immunization requirements before they are allowed to attend school. A record of these immunizations must be on file at the student’s attendance center.

No student will be allowed to attend school without the minimum immunizations required by state law.

Minimum immunizations required to enroll in school are one dose of the following for elementary or secondary (K-12) students that are four years of age or older:

If your student was born on or after September 15, 2003:

  1. Diphtheria/Pertussis/Tetanus (DPT): Five doses with at least one dose of DPT received on or after four years of age;
  2. Polio: Four doses with at least one dose received on or after four years of age;
  3. Measles/Rubella: Two doses with the first dose received on or after 12 months of age and the second dose received no less than 28 days after the first dose or applicant demonstrates a positive antibody test for measles and rubella from a US laboratory;
  4. Hepatitis B: Three doses if the applicant was born on or after July 1, 1994; and
  5. Varicella (Chickenpox): Two doses received on or after 12 months of age unless the applicant has a reliable history of natural disease.

If your student was born after September 15, 2000; but before September 15, 2003:

  1. Diphtheria/Pertussis/Tetanus (DPT): Four doses with at least one dose of DPT received on or after four years of age;
  2. Polio: Three doses with at least one dose received on or after four years of age;
  3. Measles/Rubella: Two doses with the first dose received on or after 12 months of age and the second dose received no less than 28 days after the first dose or applicant demonstrates a positive antibody test for measles and rubella from a US laboratory;
  4. Hepatitis B: Three doses if the applicant was born on or after July 1, 1994; and
  5. Varicella (Chickenpox): One dose received on or after 12 months of age unless the applicant has a reliable history of natural disease.

If your student was born on or before September 15, 2000:

  1. Diphtheria/Pertussis/Tetanus (DPT): Three doses with at least one dose of DPT received on or after four years of age;
  2. Polio: Four doses with at least one dose received on or after four years of age;
  3. Measles/Rubella: Two doses with the first dose received on or after 12 months of age and the second dose received no less than 28 days after the first dose or applicant demonstrates a positive antibody test for measles and rubella from a US laboratory;
  4. Hepatitis B: Three doses if the applicant was born on or after July 1, 1994; and
  5. Varicella (Chickenpox): Two doses received on or after 12 months of age unless the applicant has a reliable history of natural disease.

If your student was born on or after September 15, 2000:

  1. Tetanus/Diptheria/Acellular Pertussis: One-time dose containing vaccine (Tdap) for applicants in grades 7 and above regardless of the interval service the last tetanus/diphtheria containing vaccine.

Also Required - Meningococcal Vaccine:

  1. One dose received on or after 10 years of age for students entering 7th grade and above if born on or after September 15, 2004;
  2. Two doses received for students entering 12th grade if born on or after September 15, 1999; and
  3. One dose if received when the student is 16 years of age or older.

Provisional/Conditional Enrollment: If your student has begun immunizations but has not yet received all the required immunizations, they may be able to attend school on a provisional or conditional basis. To qualify for provisional enrollment your student must have received at least one dose of each of the required immunizations. If your student falls into this category you must submit an Iowa Department of Public Health Provisional Certificate of Enrollment to the school. This certificate expires in 60 days, so you must have your student completely immunized during this time or they will not be permitted to attend school until the immunizations have been received. When your student has received all the required immunizations, you must submit a completed Certificate of Immunization to the school.


Adopted 6/96
Reviewed 7/13; 11/17; 12/20
Revised 4/11; 10/14; 4/18
Related Policy (Code#): 504.1

504.2 - Communicable Diseases

 

 

 

Students with communicable diseases will be allowed to attend school provided their presence does not create a substantial risk of illness or transmission to other students or employees. The term “communicable disease” means an infectious or contagious disease spread from person-to-person, animal-to-person, or as defined by law.

Prevention and control of communicable diseases will be included in the district’s Bloodborne Pathogens Exposure Control Plan. The procedures will include scope and application, definitions, exposure control, methods of compliance, universal precautions, vaccination, post-exposure evaluation, follow-up, communication of hazards to employees, and recordkeeping. The plan will be reviewed annually by the school nurses and superintendent [or designee].

The health risk to immunosuppressed students will be determined by their personal physicians. The health risk to others in the school district environment from the presence of students with communicable diseases will be determined on a case-by-case basis by the student’s personal physician, a physician chosen by the school district, or public health officials.

The parent/legal guardian will notify the superintendent [or designee] or school nurse when the student learns they have a communicable disease. It is the responsibility of the superintendent [or designee] when upon investigation the superintendent [or designee] or school nurse has knowledge that a reportable, communicable disease is present to notify the Iowa Department of Public Health via the Linn County Health Department. Student health data is confidential and will not be disclosed to third parties.

It is the responsibility of the superintendent [or designee] in conjunction with the school nurses to develop administrative regulations stating the procedures for dealing with students with communicable diseases.


Adopted: 6/88
Reviewed: 4/11; 4/12; 7/13; 10/14; 11/17; 12/20
Revised: 7/07; 11/07
Related Policy (Code#): 504.2-R; 504.2-E1-E4
Legal Reference (Code of Iowa): 29 USC §§ 701 et seq; 45 CFR Pt 84.3; 139A.8; 641 IAC 1.2-5, 7
IASB Reference: 507.3

504.2-R - Administrative Regulations Regarding Communicable Diseases

 

 

 

Exclusion of Students: A student with a communicable disease will be allowed to attend school provided their presence does not create a substantial risk of illness or transmission to other students or employees. If, in the judgment of the building administrator, there is any risk of the student transmitting the disease to others the building administrator will immediately exclude the student from school and may require the student be examined by a physician. The building administrator may also require a written statement of health from a physician in order for the affected student to return to school.

Alternative Program: If it is determined that the student will not be permitted to attend classes and/or participate in school activities, arrangements will be made to provide an alternative education program.

Return to School: Criteria will be established to determine whether a student with a communicable, contagious, and/or infectious disease including common childhood diseases will be permitted to attend classes. All cases will be reviewed on an individual basis.

Confidentiality of Information: Records of a student who has a communicable, contagious, and/or infectious disease other than a common childhood disease will be kept confidential and the name of the individual will not be revealed publicly.

Appeal Process: The student and/or parent may appeal decisions regarding exclusion from school. This appeal is to be submitted in writing to the superintendent [or designee]. The superintendent [or designee] will respond to the appeal within three school days. If the appeal is denied by the superintendent [or designee] the student and/or parent may continue the appeal with the Board of Directors at their next regularly scheduled meeting.


Adopted: 6/88
Reviewed: 4/11; 4/12; 7/13; 10/14; 11/17; 12/20
Revised: 9/02
Related Policy (Code#): 504.2; 504.2-E1-E4

504.2-E1 - Communicable Disease Chart

 

 

 

Click here to download a copy of the Communicable Disease Chart


Concise descriptions and recommendations for exclusion of cases from school.
Source: Iowa Department of Public Health

Disease
*Immunization
Available

Uusual Interval
Between Exposure
and First Symptoms
Main
Symptoms
Minimum Exclusion
from School
*Chickenpox

10-21 Days
[Average 14-16 Days]

Mild symptoms and fever, pocks are blistery, and scabs develop for most on covered parts of body Seven days from onset of rash until all blisters have crusted

Conjunctivitis
[Pink Eye]

24-72 Hours Tearing, redness, puffy lids, and discharge Until treatment begins or physician approves return
Erythema Infectiosum
[5th Disease]
4-20 Days Usual age is 5-14 years, unusual in adults, brief prodrome or low grade fever followed by erythema (slapped appearance on cheeks), lace-like rash on extremities lasting a few days to three weeks, and rash seems to recur After diagnosis; no exclusion
from school
*German Measles
[Rubella]
14-21 Days Usually mild, enlarged glands in neck and behind ears, and brief rash Seven days from onset of rash; keep away from pregnant women
*Haemophilus Meningitis 2-4 Days Fever, vomiting, lethargy, and stiff
neck and back
Until physician approves return
*Hepatitis A

Varies from 15-50 Days
[Average 28-30 Days]

Abdominal pain, nausea, fever, and skin/eyes may or may not turn yellow Fourteen days from onset of clinical disease and at least seven days from onset of jaundice
Impetigo 4-10 Days Inflamed sores with pus Twenty-four hours after antibiotic therapy has started or until physician approves return; avoid contact with drainage from lesions and cover lesions when attending school
*Measles 10 Days to Fever
14 Days to Rash
Begins with fever, conjunctivitis, runny nose, cough, and then blotchy red rash Four days from onset of rash
Meningococcal Meningitis

2-10 Days
[Commonly 3-4 Days]

Headache, nausea, stiff neck, and fever

Until physician approves return
*Mumps

12-25 Days
[Average 16-18 Days]

Fever, swelling, and tenderness of glands
at angle of jaw
Five days after onset or until symptoms have resolved

Pediculosis
[Head/Body Lice]

7 Days for Eggs to Hatch Lice and nits (eggs) in hair No need to send home upon diagnosis and return to school after initial treatment; no-nit policy is recommended
Ringworm  4-10 Days Scaly red patch; usually ring shaped

No exclusion from school; exclude from gymnasiums, pools, and contact sports

Scabies

2-6 Weeks for Initial Exposure
1-4 Days After Re-Exposure

Tiny burrows in skin caused by mites Until 24 hours after treatment
Scarlet Fever Scarlatina
Strep Throat
1-3 Days Sudden onset, vomiting, fever, later a fine rash (not on face), and rash usually only with first infections Twenty-four hours after antibiotics started and no fever

*Whooping Cough [Pertussis]

6-20 Days
[Average 9-10 Days]

Head cold, slight fever, cough, and characteristic whoop after two weeks

Five days after start of
antibiotic treatment

Readmission to School: It is advisable that school authorities require written permission from the health officer, school physician, or attending physician before any student is readmitted to school following any disease which requires exclusion, not mere absence, from school.


Reviewed: 7/13; 11/17; 12/20
Revised: 4/11; 10/14; 4/18
Related Policy (Code#): 504.2; 504.2-R; 504.2-E2-E4

504.2-E2 - Communicable Disease Outbreak

 

 

 

Action Steps:

  1. Encourage staff or families with students who may have a communicable disease to alert the school.
  2. Contact the school nurse if student/staff absentee rate is greater than 10% due to illness.
  3. Report rate to building principal and superintendent [or designee].
  4. Report rate to Linn County Health Department (319-892-6000).
  5. If school cancellation is recommended by Linn County Health Department, consult with building principal and superintendent [or designee].
  6. If cancellation should occur, superintendent [or designee] will assist in getting information to the families and public.
  7. Recommended guidelines about common communicable illnesses are available to families and staff from Linn-Mar Health Services. The school nurses will consult with administration regarding distribution of these guidelines.

Adopted: 11/07
Reviewed: 4/11; 4/12; 7/13; 10/14; 11/17; 12/20
Revised: 9/09
Related Policy (Code#): 504.2; 504.2-R; 504.2-E1; 504.2-E3-E4

504.2-E3 - Diseases Reportable to Iowa Department of Public Health

 

 

 

Click here to download a copy of the Reportable Diseases Chart


Report information requested on disease reporting form which may be obtained by calling 1-888-398-9696.

Emergency Reportable Diseases or Conditions: Report by Phone Immediately

Botulism # Measles Rabies (Human)
Cholera > Meningococcal Invasive Disease Vancomycin-Resistant Staph Aereus
Diphtheria    Plaque Yellow Fever
> Haemophilus Influenza Type B Invasive Disease # Polio  

Also, outbreaks of any kind, unusual syndromes, and uncommon diseases should be reported immediately by phone. These could be infectious, environmental, or occupational in origin and include food-borne outbreaks and illness secondary to chemical exposure (e.g. pesticides, anhydrous ammonia).

Agents of Terrorism
Diseases or syndromes of any kind caused by a biological, chemical, or radiological agent or toxin when the provider reasonably believes or suspects that the agent or toxin may be the result of a deliberate act such as terrorism. Examples of these agents or toxins include but are not limited to anthrax, mustard gas, sarin gas, ricin, tularemia, and smallpox.

Diseases Reportable by Mail or Phone

Common-Reportable Diseases Rare-Reportable Diseases
  Campylobacteriosis   Anthrax
  Cryptosporidiosis # Brucellosis
> Encephalitis, Arboviral   Cyclospora
# Escherichia Coli O157:H7 (And Related Diseases HUS & TTP) # Hansen's Disease (Leprosay)
  Giardiasis   Hantavirus Syndromes
# Hepatitis A, B, C, D, and E  Listeria Monocytogenes Invasive Disease
> Legionellosis # Malaria
# Lyme Disease   Mumps
# Pertussis   Psittacosis
  Rabies (Animal) # Rocky Mountain Spotted Fever
# Salmonellosis (Including Typhoid Fever) # Rubella (Including Congenital)
# Shigellosis # Tetanus
# Tuberculosis > Toxic Shock Syndrome
  # Trichinosis

Diseases Reportable Only By Sending Isolates to State Hygienic Lab (319) 335-4500

Enterococcus Invasive Disease Methicillin-Resistant Staphylococcus Aereus Invasive Disease
Group A Streptococcus Invasive Disease Streptococcus Pneumonia Invasive Disease

# Diseases that require follow-up by local health agency
> Diseases that require follow up by hospital infection control practitioner
Isolates in bold type should be sent to State Hygienic Laboratory
Report on a quarterly basis to UHL: Total number of Invasive Staphylococcus Aereus isolates


Adopted: 9/98
Reviewed: 4/11; 4/12; 7/13; 10/14; 11/17; 12/20
Revised: 11/07
Related Policy (Code #): 504.2; 504.2-R; 504.-2-E1-E2; 504.2-E4

504.2-E4 - Disease Reporting Card

 

 

 

Click here to download a copy of the Disease Reporting Card


Disease reporting is required by Iowa Administrative Code [641]-1 (139A).
To report call (800) 362-2736 or fax (515) 281-5698 or Iowa Disease Surveillance Systems (IDSS).

Disease and Reporting Information

Disease/Event Species/Type/Group
Specimen Source: Date Collected:
Onset Date: Date Reported to IDPH:
Epi Link?  Yes   No   Unknown Isolate to UHL?  Yes   No   Unknown
Reporter's Name: Phone:
Reporting Facility's Name:

Patient Information

Name (Last, First, Middle): Date of Birth:
Address: Age:
City/State/Zip/County: Gender:
Marital Status: Pregnant: Yes   No   Unknown
Race: White  Black/African American  American Indian  Alaska Native  Asian   Hawaiian/Pacific Islander  Other  Uknown
Ethnicity:  Hispanic/Latino  Not Hispanic/Latino  Unknown
If Minor, Parent Name: Home Phone:
Work Phone: Other Phone:
Long-Term Care Facility Resident: Yes   No   Unknown Facility Name:
Is the Case Employed: Yes   No   Unknown Employer Name:
City: State:
In this case does the case: Handle Food     Work in a healthcare setting Work in a lab setting
Is the case enrolled in school or attending a childcare facility: Yes   No   Unknown
School/Childcare Name: City:                                      State:
Hospitalized for this disease: Yes   No Where:
Admission Date: Was death due to this disease:

Healthcare Provider and Laboratory Information

Name and Title of Health Care Provider: Name of Laboratory:
Facility or Clinic: Laboratory Phone:
City and State: City and State:
Phone: Does the case have clinical symptoms:
Is the case lab confirmed:
Comments:

Adopted: 9/98
Reviewed 7/13; 10/14; 11/17; 12/20
Revised: 11/07
Related Policy (Code#): 504.2; 504.2-R; 504.2-E1-E3

504.3 - Student Injury or Illness at School

 

 

 

When a student becomes ill or is injured at school or a school-sponsored activity, the school district will attempt to notify the student's parent/legal guardian as soon as possible.

The district, while not responsible for medical treatment of an ill or injured student, will have employees administer emergency or minor first aid if possible. An ill or injured student will be released to the care of the parent/legal guardian or qualified medical personnel as quickly as possible.

It is the responsibility of the principal [or designee] to file an accident report for any incident with the superintendent [or designee] within 24 hours after the student is injured.

Annually, parents/legal guardians will be required to complete a medical emergency authorization form indicating the procedures to be followed, if possible, in an emergency involving their child. The authorization form will also include the phone numbers of the parent/legal guardian and alternative numbers to call in case of an injury or illness.

The superintendent [or designee] will be responsible, in conjunction with the district health services staff, to develop rules and regulations governing the procedures in the event a student should become ill or be injured at school or a school-sponsored activity.  The district reserves the right to take necessary actions to respond to a health or safety emergency.

Refer to Policy 504.3-R for regulations to follow regarding management of medical emergencies.


Adopted: 6/70
Reviewed: 4/11; 4/12; 7/13; 11/17; 12/20
Revised: 12/13; 10/14
Related Policy (Code #): 504.3-R
Legal Reference (Code of Iowa): § 613.17
IASB Reference: 507.4

504.3-R - Management of a Medical Emergency

 

 

 

The following information provides a basis for the management of a medical emergency. All schools throughout the Linn-Mar Community School District have emergency response teams that will respond to an emergency and follow guidelines per American Red Cross training.

Assess the Situation:

  • For safety of the individual (protect from further injury)
  • For safety of the responder (personal protective equipment, universal

    precautions as applicable to situation)

Assess Severity of Injury/Illness of Individual:

  • Airway
  • Breathing
  • Circulation
  • Obtain history of incident from individual witness if possible

Activate Building Emergency Response Team:

  • Call 911 for emergency medical assistance
  • Provide appropriate life support or first aid

Notify:

  • Family/emergency contact
  • School nurse
  • Building administration

No injured or ill student should be sent home or to a medical facility without the knowledge and permission of the parent/guardian or other responsible person. If emergency situation is life-threatening, call 911, even if parent/guardian cannot be reached.

Document incident using Complete Variance Report.


Adopted: 10/14
Reviewed: 11/17; 12/20
Related Policy (Code#): 504.3

504.31 - Administration of Medication to Students

 

 

 

The board is committed to the inclusion of all students in the education program and recognizes that some students may be required to take medications during the school day. 

Medications will not be administered without written, signed, and dated authorization from the parent/legal guardian requesting medication administration. The medication must be contained in a bottle which is labeled by the pharmacy or the manufacturer with the name of the student, name of the medication, the time of the day in which it is to be given, the dosage, and the duration given. A written record of the administration of medication procedure must be kept for each student receiving medication including the date; student’s name; prescriber or person authorizing the administration; the medication and its dosage; the name, signature, and title of the person administering the medication; the time and method of administration; and any unusual circumstances or omissions. Natural remedies and supplements, including essential oils and CBD, if needed, must be administered at home not in the school setting. Administration of medication records will be kept confidential. Protocols for administration of emergency medication will be posted.

When administration of medications requires ongoing professional health judgement, an individual health plan will be developed by an authorized practitioner with the student and the student’s parent/legal guardian.

Students who have demonstrated competence in administering their own medications may self-administer their medication. A written, signed, and dated statement by the student’s parent/legal guardian will be on file requesting co-administration of medication when competence has been demonstrated. Students in grades 7-12, with written, signed, and dated authorization from the parent/legal guardian, may bring over-the-counter, non-prescription medications to the health office for administration. Students in grades 7-12 will be allowed a limited number of standard dose Acetaminophen or Ibuprofen each school year. The standard dose of these two medications will be provided by Linn-Mar Health Services. Acetaminophen and Ibuprofen will be given per board policy at the nurse’s discretion. Frequent dosing may require a physician’s order and the parent/legal guardian to supply the medication. All other over-the-counter medications for grades 7-12 must be supplied by a parent/legal guardian. The parent/legal guardian must supply any medications that need to be given in liquid/chewable form or different than the standard dose the district supplies.

By law, students with asthma or other airway constricting diseases or students with a risk of anaphylaxis who use epinephrine auto-injectors may self-administer their medication upon the written, signed, and dated approval of the student’s parent/legal guardian and prescribing licensed health care professional regardless of competency.

Persons administering medication will include authorized practitioners such as licensed registered nurses and physicians and persons to whom authorized practitioners have delegated the administration of medication, such as the school nurse or in the nurse’s absence the person who has successfully completed an administration of medication course reviewed by State Department of Health. Medications will be stored in a secured area unless an alternate provision is documented. 

In accordance with Iowa law Code 280.16 and amended by Senate File 462 (SF 462), a student with asthma or other airway-constricting diseases or students with a risk of anaphylaxis who use epinephrine auto-injectors may possess the student’s medication while in school and at school-sponsored activities. If the student abuses the self-administration policy, the permission to self-administer may be withdrawn. The school district and its employees acting reasonably and in good faith will incur no liability of any injury arising from self-administration of medication by the student. The student is responsible for maintaining self-administration records.

The superintendent [or designee] will be responsible, in conjunction with the school nurses, to develop rules and regulations governing the administration of medications, prescription and non-prescription, to students. Each student will be provided with the requirements for administration of medication at school.

Disposal of unused, discontinued/recalled, or expired medication will be in compliance with federal and state laws. Prior to disposal, school personnel will make a reasonable attempt to return medications by providing written notification that expired, discontinued, or unused medications need to be picked up. If medications are not picked up by the date specified, disposal will be in accordance with the disposal procedures for the specific category of medication.


Adopted: 5/91
Reviewed: 4/11; 7/13; 10/14; 12/20
Revised: 4/12; 4/16; 10/17; 4/18; 6/20
Related Policy (Code#): 504.31-E1-E2; 504.32
Legal Reference (Code of Iowa): §§ 124.101(1); 147.107; 152.1; 155A.4; 280.16; 280.23; 281 IAC 14.1; 655 IAC §6.2(152) 
Mandatory Policy

504.31-E1 - Medication Permission Form

 

 

 

Click here to download a copy of the Medication Permission Form


To ensure compliance with Linn-Mar policy for administering medication at school, the following procedures must be followed:

  • ALL MEDICATIONS MUST BE DELIVERED TO AND FROM SCHOOL BY THE PARENT/LEGAL GUARDIAN IN THE ORIGINAL AND PROPERLY LABELED CONTAINER. The container must include the following information: student name, medication, dosage, time, route, and physician. Written authorization and instructions must be provided by the parent/legal guardian for all medications. The school nurse will have the right to contact the prescribing physician to confirm or clarify medication instructions. The time of medication administration may need to be altered slightly to fit the student’s schedule.
  • For preschool through 6th grade students, a physician’s/dentist’s signature is required before any non-prescription, over-the-counter medications will be given. This includes Acetaminophen, Ibuprofen, cough medicines, etc. All medications administered for preschool through 6th grade students must be provided by the parent/legal guardian in their original and properly labeled containers.
  • High school and middle school students (Grades 7-12), in accordance with Health Services protocols for common complaints of pain or illness, may have limited over-the-counter medications with written or PowerSchool eRegistration parental consent. 
  • Students in grades 7-12 will be allowed a limited number of standard dose Acetaminophen or Ibuprofen each school year. The standard dose of these two medications will be provided by Linn-Mar Health Services. Acetaminophen and Ibuprofen will be given per board policy at the nurse’s discretion. Frequent dosing may require a physician’s order and the parent/legal guardian to supply the medications. All other over-the-counter medications for grades 7-12 must be supplied by the parent/legal guardian. The parent/legal guardian must supply any medications that need to be given in liquid/chewable form or that are different than the standard dose the district supplies.
  • If any medications remain after the last day of school, they will be discarded within 24 hours per federal and state laws.

Student Name: ___________________________________ Grade: ____________________

Medication: __________________________ Dosage: _____________ Time: ____________

Start Date: ________________ End Date: _______________ For: ____________ (Health Condition)

Parent/Guardian Signature: _________________________ Date: ______________________


Physician's/Dentist's signature required for non-prescription medications for students in preschool-6th grades.

Physician/Dentist Signature: ______________________________ Date: _______________________


Consent for Release of Information: I give permission for the parties named below to exchange written and verbal information with personnel at LMCSD regarding the above-named student. If this medication is for attention or behavior concerns, LMCSD may send behavior checklists to the physician named below. This permission is for one school year.

Specific authorization for release of information protected by state or federal law:
My signature releases all information related to (check appropriate items below):

_____ Mental health/psychological  _____ Substance Abuse  _____Allergies   _____Asthma

Other (specify): ________________________________________________________________

Physician/Facility: __________________________________ Phone: ____________________

Parent/Guardian Signature: ___________________________ Date: _____________________


Reviewed: 7/13; 12/20
Revised: 10/14; 4/16; 10/17; 6/20
Related Policy (Code#) 504.31; 504.31-E2; 504.32
IASB Reference: 507.2; 507.2E1-E2

504.31-E2 - Authorization - Asthma or Other Airway Constricting Disease Medication or Epinephrine Auto-Injection Self-Administration Consent Form

 

 

 

Click here to download a copy of the Asthmas/Airway Constricting Disease Medication Self-Administration Authorization Form


Student Name:
Grade:
Medication:
Dosage:
Purpose for Medication:


The following must occur for a student to self-administer asthma or other airway constricting disease medications or for a student with a risk of anaphylaxis to self-administer an epinephrine auto-injector:

  • Parent/legal guardian provides signed, dated authorization for student medication self-administration;
  • Parent/legal guardian provides a written statement from the student’s licensed health care professional (A person licensed under Chapter 148 to practice medicine and surgery or osteopathic medicine and surgery, an advanced registered nurse practitioner licensed under Chapter 152 or 152E and registered with the Board of Nursing, or a physician assistant licensed to practice under the supervision of a physician as authorized in Chapters 147 and 148C) containing the following:
    • Name and purpose of the medication or epinephrine auto-injector
    • Prescribed dosage
    • Times or special circumstances under which the medication or epinephrine auto-injector is to be administered;
  • The medication is in the original, labeled container as dispensed or the manufacturer’s labeled container containing the student name, name of the medication, directions for use, and date;  and
  • Authorization will be renewed annually. In addition, if any changes occur in the medication, dosage, or time of administration the parent/legal guardian is to notify school officials immediately. The authorization will be reviewed as soon as practical.

Provided the above requirements are fulfilled, the school will permit the self-administration of medications by a student with asthma of other airway constricting disease or the use of an epinephrine auto-injector by a student with a risk of anaphylaxis while in school, at school-sponsored activities, under the supervision of school personnel, and before or after normal school activities, such as while in before-school or after-school care on school-operated property. If the student abuses the self-administration policy, the ability to self-administer may be withdrawn by the school or discipline may be imposed after notification is provided to the student’s parent/legal guardian.

Pursuant to state law, the district and its employees are to incur no liability except for gross negligence as a result of an injury arising from self-administration of medication or use of an epinephrine auto-injector by the student. The parent/legal guardian of the student will sign a statement acknowledging that the district is to incur no liability except for gross negligence as a result of self-administration of medication or an epinephrine auto-injector by the student as provided by law.


Medication:
Dosage:
Purpose for Medication:
Administration/Instructions:
Special Circumstances:
Discontinue/Re-Evaluate/Follow-Up Date:
Prescriber's Signature:
Date Signed:
Prescriber's Address:
Emergency Phone:
  • I request the above-named student possess and self-administer asthma or other airway constricting disease medications and/or an epinephrine auto-injector at school and in school activities according to the authorization and instructions;
  • I understand the district and its employees acting reasonably and in good faith will incur no liability for any improper use of medication or an epinephrine auto-injector or for supervising, monitoring, or interfering with a student’s self-administration of medication or use of an epinephrine auto-injector;
  • I acknowledge that the district will incur no liability except for gross negligence as a result of self-administration of medications or use of an epinephrine auto-injector by the student;
  • I agree to coordinate and work with school personnel and notify them when questions arise, or relevant conditions change;
  • I agree to provide safe delivery of medications and equipment to/from school and to pick up remaining medications and equipment;
  • I agree the information is shared with school personnel in accordance with the Family Educational Rights and Privacy Act (FERPA) and any other applicable laws;
  • I agree to provide the school with back-up medications approved on this form; and
  • I agree that the student will maintain self-administration records.
Parent/Legal Guardian Signature:
Date Signed:
Parent/Legal Guardian Address:
Home Phone:
Cell Phone:
Work Phone:
Additional Self-Administration Authorization Information:

Adopted: 4/16
Reviewed: 11/17; 12/20
Related Policy (Code#): 504.31; 504.31-E1; 504.32
IASB Reference: 507.2; 507.2E1-E2

504.32 - Stock Epinephrine Auto-Injector Supply

 

 

 

The Linn-Mar Community School District seeks to provide a safe environment for students, staff, and visitors who are at risk of severe allergic reactions. Therefore, it is the policy of the district to annually obtain a prescription for epinephrine auto-injectors from a licensed health care professional, in the name of the school district, for administration by a school nurse or trained and authorized personnel to a student or individual who may be experiencing an anaphylactic reaction.

Procurement and Maintenance of Supply: The district will stock a minimum of one pediatric dose and one adult dose epinephrine auto-injector in each school building. The supply of such auto-injectors will be maintained in a secure, dark, temperature-controlled location in each school building.

The school nurse or trained and authorized personnel will routinely check the stocked epinephrine auto-injectors and document in a log on a monthly basis: 1) The expiration date, 2) Any visualized particles, or 3) Any color change.

The school nurse or trained and authorized personnel will be responsible for ensuring the district replaces, as soon as reasonably possible, any logged epinephrine auto-injector that is used, close to expiration, discolored, or has particles visible in the liquid.

Training: A school nurse or trained and authorized personnel may provide or administer an epinephrine auto-injector from a school supply to a student or individual if they, reasonably and in good faith, believe the student or individual is having an anaphylactic reaction. Training to obtain a signed certificate to become personnel authorized to administer an epinephrine auto-injector will consist of the requirements established by law.

Authorized personnel will be required to provide a procedural skills demonstration to the school nurse demonstrating competency in the administration of stock epinephrine auto-injectors to retain authorization to administer stock epinephrine auto-injectors if the following occur:

  • Failure to administer an epinephrine auto-injector to a student or individual by proper route, failure to administer the correct dosage, or failure to administer an epinephrine auto-injector according to generally accepted standards of practice (“medication error”); or
  • Accidental injection of an epinephrine auto-injector into a digit of the authorized personnel administering the medication (“medication incident”).

Reporting: The district will contact emergency medical services (911) immediately after a stock epinephrine auto-injector is administered to a student or individual. The school nurse or authorized personnel will remain with the student or individual until emergency medical services arrive.

Within 48 hours, the district will report the following to the Iowa Department of Education:

  • Each medication incident with the administration of stock epinephrine;
  • Each medication error with the administration of stock epinephrine; or
  • Administration of a stock epinephrine auto-injector.

As provided by law, the district, board, authorized personnel or school nurse, and the prescriber shall not be liable for any injury arising from the provision, administration, failure to administer, or assistance in the administration of an epinephrine auto-injector provided they acted reasonably and in good faith.

The superintendent [or designee] may develop an administrative process to implement this policy.


Adopted: 4/16
Reviewed: 11/17; 12/20
Related Policy (Code#): 504.31; 504.31-E1-E2
Legal Reference (Code of Iowa): §§ 135.185; 279.8; 281 IAC 14.3
IASB Reference: 804.5

504.5 - Use of Motor Vehicles

 

 

 

The board recognizes the convenience to families and students of having students drive to and park at their school attendance center. Driving a motor vehicle to a student’s attendance center and being able to park there are privileges.

Students who drive to and park at their school attendance center will only drive to and park at their designated attendance center. Students may not loiter around or be in their vehicle during the school day without permission from the building principal. Students will leave their attendance center when there is no longer a legitimate reason for them to be at their attendance center. Students who drive will enter and leave the parking lot by the routes designated by the district.

Students who wish to drive to and park at their school attendance center will comply with the rules and regulations established by the building principal. Failure to comply with this policy or the district’s rules will be reason for revocation of school driving and parking privileges, as well as other disciplinary action including suspension and expulsion.


Adopted: 6/70
Reviewed: 4/11; 4/12; 7/13; 10/14; 11/17; 12/20
Revised: 9/09
Legal Reference (Code of Iowa): §§ 279.8; 321
IASB Reference: 502.10

504.7 - Emergency School Closings

 

 

 

The superintendent [or designee] will have the authority to close schools because of extreme weather or other emergency conditions for the length of time the emergency exists.

The superintendent will make provisions to publicly announce such closings via available mass communication media as soon as possible after the decision to close.


Adopted: 6/70
Reviewed: 4/11; 4/12; 7/13; 10/14; 11/17; 12/20
Revised: 9/98
Related Policy (Code#): 504.10; 701.11; 807.1-2; 902.7; 902.12-12R

504.8 - Student Insurance

 

 

 

An all-student insurance program may be offered to the students and parents of the district. The insurance company issuing such policies will be the same for all schools in the district and the choice of same will be determined by the Board of Directors upon recommendation of the superintendent [or designee].

It is the policy of the Board of Directors that the purchase of such a policy be completely voluntary and that no student or parent be urged to make such purchase. 

Bookkeeping and allied clerical tasks connected with the student insurance plan will not be done by school personnel but by the office of the local insurance agent concerned.


Adopted: 6/70
Reviewed: 4/11; 4/12; 7/13; 10/14; 11/17; 12/20
Revised: 9/09
Legal Reference (Code of Iowa): § 279.8
IASB Reference: 507.6

504.9 - Student Insurance for Interscholastic Athletics

 

 

 

The Board of Directors strongly recommends that a student participating in interscholastic athletics be adequately insured. A policy from an insurance company determined by the superintendent [or designee] may be obtained through the school.

If a parent wishes for their student to participate without the school-offered insurance, they must submit a written statement accepting full responsibility.


Adopted: 6/70
Reviewed: 4/11; 4/12; 7/13; 11/17; 12/20
Revised: 10/14
Related Policy (Code #): 502.5; 502.5-R2; 503.4
Legal Reference (Code of Iowa): § 279.8

504.10 - Emergency Drills

 

 

 

Students will be informed of the appropriate action to take in an emergency. Emergency drills for fire, weather, intruders, and other disasters will be conducted each school year.

Fire and tornado drills are conducted regularly during the academic school year with a minimum of two before December 31st and two after January 1st.

Intruder drills will be conducted regularly during the academic school year with a minimum of one before December 31st and one after January 1st.

Each attendance center will develop and maintain a written plan containing emergency and disaster procedures. The plan will be communicated to and reviewed with employees. Employees will participate in emergency drills. Licensed employees are responsible for instructing the proper techniques to be followed during the drills.


Adopted: 6/70
Reviewed: 4/11; 4/12; 7/13; 10/14; 12/20
Revised: 7/07; 11/17
Legal Reference (Code of Iowa): § 100.31; 281 IAC 41.25(3)
IASB Reference: 507.5

504.11 - Student Special Health Services

 

 

 

The board recognizes that there are some students who are in need of special health services during the school day.

Students with individualized health plans will receive confidential health services in conjunction with their Individualized Education Plan (IEP) or 504 Accommodation Plan.

The superintendent [or designee] in conjunction with licensed health personnel will establish administrative regulations for the implementation of this policy.


Adopted: 2/96
Reviewed: 4/12; 7/13; 10/14; 11/17; 12/20
Revised: 9/09; 4/11
Related Policy (Code #): 504.11-R
Legal Reference (Code of Iowa): §§ 256.11(7): 256B; 273.2, .5, .9(2-3); 280.8; 281 IAC 14.2; 20 USC §§ 1400 et seq; 34 CFR Pt 300 et seq
IASB Reference: 507.8
Mandatory Policy

504.11-R - Administrative Regulations Regarding Special Health Services

 

 

 

Some students require special health services to participate in their educational program. These students will receive special health services in conjunction with their educational program.

A. Licensed health personnel will provide special health services under the auspices of the school. The duties of the licensed health personnel include:

  1. Participate as a member of the education team;
  2. Provide the health assessment;
  3. Plan, implement, and evaluate the written individual health plan;
  4. Plan, implement, and evaluate the special emergency health services;
  5. Serve as a liaison and encourage participation and communication with health service agencies and individuals providing health care;
  6. Provide health consultation, counseling, and instruction to the student, parents/legal guardians, and staff in cooperation and conjunction with the prescriber;
  7. Maintain a record of special health services;
  8. Report unusual circumstances to the prescriber, parents/legal guardians, and school administration;
  9. Assign, delegate to, instruct, provide technical assistance to, and supervise qualified designated personnel; and
  10. Update knowledge and skills to meet special health service needs.

B. The record of special health services will include:

  1. Student’s name;
  2. Special health services;
  3. Name of prescriber or person authorizing;
  4. Date and time;
  5. Signature and title of person providing special health services; and
  6. Unusual circumstances in the provision of such services.

C. Prior to the provision of special health services the following will be on file:

  1. Written statement by prescriber detailing the specific method and schedule of the special health services, when indicated;
  2. Written statement by the parent/legal guardian requesting the provision of the special health services;
  3. Written report of the preplanning staffing or meeting of the education team; and
  4. Written individual health plan available in the health record and integrated into the IEP or IFSP.

D. Licensed health personnel in collaboration with the education team will determine the special health services to be provided and the qualifications of individuals performing the special health services. The documented rationale will include the following:

  1. Analysis and interpretation of the special health service needs, health status stability, complexity of the services, predictability of the service outcome, and risk of improperly performed service;
  2. Determination that the special health services, tasks, procedures, or function is part of the designated person’s job description;
  3. Determination of the assignment and delegation based on the student’s needs;
  4. Review of the designated person’s competency; and
  5. Determination of initial and ongoing level of supervision required to ensure quality services.

E. Licensed health personnel will supervise the special health services, define the level of supervision, and document the supervision.

F. Licensed health personnel will instruct qualified designated personnel to deliver and perform special health services contained in the individual health plan. Documentation of instruction and periodic updates will be on file at the school.

G. Parents/legal guardians will provide the usual equipment, supplies, and necessary maintenance for such. The equipment will be stored in a secured area. Personnel responsible for the equipment will be designated in the individual health plan. The individual health plan will designate the role of the school, parents/legal guardians, and others in the provision, supply, storage, and maintenance of necessary equipment.


Adopted: 2/96
Reviewed: 4/11; 4/12; 7/13; 10/14; 11/17; 12/20
Revised: 8/02
Related Policy (Code#): 504.11
IASB Refernce: 507.8R1

504.12 - Wellness

 

 

 

The school board promotes healthy students by supporting wellness, good nutrition, and regular physical activity as a part of the total learning environment. The district supports a healthy environment where students learn and participate in positive dietary and lifestyle practices. By facilitating learning through the support and promotion of good nutrition and physical activity, schools contribute to the basic health status of students. Improved health optimizes student performance potential.

The school district will provide a comprehensive learning environment for developing and practicing lifelong wellness behaviors. The district encourages healthy goals to positively influence a student’s understanding, beliefs, and habits as they relate to good nutrition and regular physical activity. In accordance with law and this belief, the board commits to the following:

  • Nutrition Education and Promotion: Schools will provide nutrition education and engage in nutrition promotion that helps students develop lifelong healthy eating habits;
  • Physical Activity: Schools will provide students with age and grade appropriate opportunities to engage in physical activity that meets the Iowa Health Kids Act; and
  • Other School Based Activities that Promote Wellness: As appropriate, schools will support students, staff, and parents’ efforts to maintain healthy lifestyles.

Foods offered by Linn-Mar Nutrition Services will meet or exceed the district’s nutritional standards. Foods will be served with consideration toward nutritional integrity, variety, appeal, taste, safety, and packaging to ensure high-quality meals. The Linn-Mar Community School District recognizes that school meals will be available for all students in attendance.

The district will develop a local Wellness Committee comprised of representatives from the staff, parents, and community with appropriate expertise. The local Wellness Committee will develop a plan to implement and monitor the effectiveness of this policy, set the district’s wellness goals, and provide a report on an annual basis.

The superintendent [or designee] will be responsible in developing administrative regulations and wellness goals.


Adopted: 8/06
Reviewed: 4/12; 7/13; 10/14
Revised: 11/17; 12/20
Legal Reference (Code of Iowa): §§ 256.7(29); 256.11(6); 81 IAC 12.5; 58.11; 42 USC §§ 1751 et seq; 42 USC §§ 1771 et seq
IASB Reference: 507.9; 507.9R1
Mandatory Policy