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Ector County ISD 068901 HEALTH REQUIREMENTS AND SERVICES MEDICAL TREATMENT MEDICAL TREATMENT FFAC (REGULATION) Specialized health care treatments shall be provided as a related service when it is necessary for a child to receive a full appropriate public education as specified under Part B of the Education of the Handicapped Act (P.L. 101-476), Individuals with Disabilities Education Act (IDEA), and Section 504 of the Rehabilitation Act of 1973. Students requiring medication on field trips shall follow the same guidelines as during school hours. Medication must be in the original container, the proper label is in place, and the parent must sign the parent’s Request for Administration of Medication. Medications will be maintained in a secure place that is not accessible to students or others. The person administering the medication must first attend the Medication Administration Training class, or be supervised by a trained employee. ELIGIBILITY FOR SERVICE Specialized physical health care may be provided to any student requiring individualized health service necessary during the school day to enable the student to attend school. The informed consent must be completed and signed before the requested treatment can be administered or supervised by a designated school person. An admission, Review, and Dismissal Committee (ARD) consisting of personnel specified by local guidelines must approve special treatment as a related service on the Individualized Educational Plan (IEP). An Informed Consent for Medical Treatment must be completed, signed, and filed in the child’s confidential file [FFAC(EXHIBIT)A]. DO NOT RESUSCITATE ORDER The Do Not Resuscitate (DNR) order document(s) shall be processed as outlined in [FFAC(EXHIBIT)E]. A registered nurse and a certified nursing assistant are required by Texas law to comply with a physician’s order. A registered nurse and/or a certified nursing assistant employed by the district must comply with the DNR. No other school district employees are required to comply with a DNR. The DNR protocol is located in [FFAC(EXHIBIT)E]. Students subject to DNR Orders will have individual medical crisis plans discussed and developed by the ARD Committee which must include the campus nurse or Supervisor of Health Services. The parent will provide a copy of the DNR Order to the ARD Committee. The parent will assure the student wears the DNR wrist band/necklace at all times. PROVISION OF SERVICE A school nurse, or designated school person, shall be assigned the responsibility for providing the service by the Supervisor of Health Services. Instruction shall be provided by the parent or family doctor upon request prior to beginning the service. The District is not required to pay for or provide equipment needed for specialized treatment. If adaptive equipment is required, it must facilitate the achievement of specific objectives as stated in the individual educational plan. DATE ISSUED: 04/05/2017 FFAC(REGULATION) PAGE 1 OF 6 Ector County ISD 068901 HEALTH REQUIREMENTS AND SERVICES MEDICAL TREATMENT FFAC (REGULATION) EXTENT OF SERVICE The treatment shall be administered by the District as long as the need exists or until the child can perform the process. GUIDELINES In accordance with policy FFAC(LEGAL), the following guidelines shall be followed: 1. The authorization for the school to obtain emergency treatment shall be signed by the parent and kept on file. 2. In the event a student is deemed to require immediate medical care and the parent or legal relative cannot be contacted, a school employee may obtain medical care for the student. 3. The authorization or copy shall be signed by the school official and shall be given to the doctor, hospital, or other medical facility. For all out-of-town school-sponsored trips, the sponsor shall obtain a written authorization from the parent or guardian for necessary medical treatment. ADMINISTERING MEDICATION In accordance with policy FFAC(LOGAL), the following guidelines shall be followed: 1. A procedure book concerning the handling of student illness, accidents, and communicable or contagious diseases shall be available in the nurse’s office of each school. 2. The school may dispense medications if requested by a parent or legal guardian; however, unless an exception is recommended by the Director of Nursing Department, only FDA approved prescription and non-prescription medications within the therapeutic range may be administered by school personnel. The principal shall appoint a responsible person or persons, e.g., the school nurse or other office employee, to supervise the storing and dispensing of medications. Paraprofessional personnel who have been designated to administer medication must first attend the Medication Administration Training Program provided by the District. For legal purposes, written requests for dispensing medications to a student must be obtained from a parent, legal guardian or other person or persons having legal control of the pupil before such medications are dispensed. Changes in dosages of prescription medications must be in writing or given directly from the attending physician to the school nurse. Verbal order on medication changes from parents or guardians will not be accepted. DATE ISSUED: 04/05/2017 FFAC(REGULATION) PAGE 2 OF 6 Ector County ISD 068901 HEALTH REQUIREMENTS AND SERVICES FFAC MEDICAL TREATMENT (REGULATION) The person in charge of dispensing medications shall keep them in a secured place that is not easily accessible either to students or others in the building. Controlled medications will be counted by the nurse or school personnel when receiving the medication from the parent or designated adult. Except as authorized herein, no student shall be allowed to dispense or receive their own prescription medications or other medications without supervision from a school appointed representative. [See FNCF(LOCAL)] PRESCRIPTION MEDICATIONS PRESCRIPTION INSTRUCTIONS For the purposes of this regulation, prescription medications shall be defined as any medication prescribed by a licensed physician (M.D., D.O., or D.D.S.), whether or not said medications are obtained from a pharmacist or can be obtained as an over-the-counter medication. Only a thirty-day medication supply of any controlled substance medication can be maintained in the school’s possession at one time. Each student’s medication should appear to be in the original container and have affixed a prescription label, if applicable, including name, date, the name of the medication, and the directions concerning dosage. Instructions about the duration of the medication should be included. When prescription medication is an over-the-counter medication, it must appear in the original container and be properly labeled and the parent or legal guardian of the student must provide the school with appropriate directions from their doctor concerning dosage and duration of the medication. When the duration of the medication is completed, unused portions of the medication should be returned to the parent, or permission given to destroy the remainder. Medication errors will be documented on the Incident Report - Medication Administration [FFAC(EXHIBIT)D]. The medication error must be reported immediately to the school nurse and the principal. The school nurse will report the error to the parent, the physician, and the Supervisor of Health Services. The Incident Report - Medication Administration will be sent to the Supervisor of Health Services. At the end of the school year, all medications should be returned or destroyed. REVIEW All requests for dispensing medication should be reviewed at the beginning of each school year with renewed (written) permission obtained from the parent or legal guardian to continue the medication. DATE ISSUED: 04/05/2017 FFAC(REGULATION) PAGE 3 OF 6 Ector County ISD 068901 HEALTH REQUIREMENTS AND SERVICES FFAC MEDICAL TREATMENT (REGULATION) Inhalers used by students shall be treated as any other prescription INHALERS medication; however, if the parent, legal guardian, or other person or persons having legal control of the student furnish the District with a medical doctors letter requesting that the student be allowed to maintain possession of the inhaler and be permitted to administer the medication and the parent and physician agree that the student can be trusted with said medication, then the student may be allowed to maintain possession of the inhaler and dispense the medication. Said notice or letter from the doctor must set forth that such medication to be administered by the student is medically necessary. [See FFAC(EXHIBIT)B] INJECTIONS Hypodermic injections may be given at school only when the family physician addresses a written request for the services to the Supervisor of Health Services, giving detailed information concerning the administration of the medication and patient follow-up. The written request from the student’s physician shall be kept on file. Parents shall be instructed to furnish sterile disposable syringes and needles with the medication. Used syringes and needles shall not be discarded in the wastebasket, but shall be destroyed according to established procedures. PARENTAL REQUEST FORM The form, Parents Request for Administration of Medication by School Personnel, [FFAC(EXHIBIT)C] shall be completed and kept for each student receiving medication(s) at school. SCHOOL HOURS ONLY All medication given at the school shall be for medicines that medically require dispensing during the regular school day. Any medication that can be administered before or after school hours shall be dispensed by persons other than school personnel. FOOD ALLERGIES In accordance with SB 27 from the 82nd Legislative Session, ECISD shall develop and maintain a Food Allergy Management Plan retained in the office of the Food Services Director. The plan shall be described in the Student Handbook and reviewed annually. The plan will contain procedures that will limit the risk posed to the students with common food allergies, specific training components of employees responsible for decreasing risk of anaphylaxis, and assistance available to parents requesting assistance with food allergies of the student. STUDENTS AT RISK The following procedures will be followed when a student is identified at the beginning of school, at entry, or any time when the student is diagnosed as having a food allergy. 1. Parents/guardians will be supplied the Health Services (HS) Dept. form entitled “Health Related Information for the School Nurse”. The principal/designee gives the completed form to the school nurse to review. DATE ISSUED: 04/05/2017 FFAC(REGULATION) PAGE 4 OF 6 Ector County ISD 068901 HEALTH REQUIREMENTS AND SERVICES FFAC MEDICAL TREATMENT (REGULATION) 2. If the parent indicates the student has a food allergy, the nurse will contact the parent for specific information to include the severity of the problem and what adjustments if any are needed during the school day. 3. The nurse will develop a specific care plan using the HS form for this purpose, “Individual Health Care Plan”. 4. A meeting will be assembled by the nurse to include the nurse, the ECISD Dietician, campus principal or designee, and the student’s teacher(s) to discuss/modify if needed the Individualized Health Plan. 5. The nurse will train those identified by the principal as needing to have information specific to the student’s diagnosis and medical needs. Training will include signs and symptoms of food allergies and emergency response generally and specifically to the student. 6. The ECISD Dietician shall develop strategies to reduce risk of exposure specific to the student. 7. In the event of a food allergy reaction, the nurse will be notified by those assisting the student. The nurse will reassemble those at the meeting to discuss alternate plans if needed. STUDENTS NEEDING ASSISTANCE WITH TOILETING The following procedures will be followed when a student is identified as requiring assistance with toileting: 1. The Principal and the School Nurse will ask the parents/guardians to attend a meeting to discuss the specific needs and background medical information on the student’s health. The School Nurse will develop an individual Health Plan in consultation with the student’s physician, the classroom teacher, the Principal, the School Counselor, and/or other personnel specially trained and determined on a case by case basis. A bowel and bladder program will be instituted specific to the needs of the child. Children with special health needs will receive accommodations. Additional meetings can be scheduled as needed. 2. Parents/guardians will be asked to provide additional supplies such as extra clothing and wipes to clean the child after bathroom accidents. The Nurse will assist the child after bathroom accidents. The Nurse will assist the child to get cleaned and encourage independence with this activity as time progresses. 3. To ensure the safety and health of other students in the classroom, when appropriate, parents will be asked to have the student in pull ups or diapers to hold feces DATE ISSUED: 04/05/2017 FFAC(REGULATION) PAGE 5 OF 6 Ector County ISD 068901 HEALTH REQUIREMENTS AND SERVICES FFAC MEDICAL TREATMENT (REGULATION) and/or urine and prevent exposure to others per public health guidelines. The student will be changed into regular underwear as soon as possible with training. 4. Efforts will be made to keep toileting needs as confidential as possible. The child can be assisted with a reward system. Efforts will be made by the School Counselor to address any unresolved behavioral problems that may be involved with the child. 5. In an appropriate case, the District will convene a Section 504 committee for the student. [See Board Policies FB(LEGAL) and FB(LOCAL).] DATE ISSUED: 04/05/2017 FFAC(REGULATION) PAGE 6 OF 6