JHC - Student Health Services

1. PURPOSE AND PHILOSOPHY

The Board of Education recognizes the strong relationship between student health and academic success; healthy students make better learners. Accordingly, the board complies with all state and federal laws and regulations governing student health issues. The board also follows all applicable Utah Department of Health and Utah County Health Department guidelines for students enrolled in district schools. 

The district has developed specific procedures to address various student health issues including required physical examinations, medical recommendations, health screenings, and/or immunizations; notification of illness or injury; and administration of medication. Many of these issues are addressed more fully in separate policies, as indicated below. 

The purpose of this policy is to promote optimal health in district students by anticipating, preventing, and removing health-related barriers to learning. The board’s overarching goal is to make it possible for all students to attend school regularly and maximize their learning potential.

2. SICK OR INJURED CHILD

In accordance with Utah Code Ann. § 53G-9-202, a school employee shall notify a custodial parent of a student who is injured or becomes ill at the school during the regular school day if:

The injury or illness requires treatment at a hospital, doctor’s office, or other medical facility not located on the school premises; and

The school has received a current telephone number for the party it is required to notify or make reasonable efforts to notify. 

The school employee shall also make reasonable efforts to notify any noncustodial parent if the noncustodial parent has made a written request for such notifications. 

Paragraph 2.2 does not apply to a noncustodial parent forbidden to have contact with the student under a court order or similar procedure. The custodial parent is responsible for providing the school with the noncustodial parent’s status…

3. INDIVIDUALIZED HEALTHCARE PLAN (IHP)

“Individualized healthcare plan” (IHP) is defined in the Utah Nurse Practice Act Rule, Utah Admin. Code R156-31b (“Rule”), and means a written document that 

is developed by the school nurse using the nursing process that includes assessment, diagnosis, outcome identification, planning, implementation, and evaluation;

outlines the provision of student healthcare services intended to achieve specific student outcomes;

includes a confirmed medical diagnosis by a licensed health care provider as defined in Utah Code Ann. § 78B-3-403, that is within the health care provider's scope of practice; and

may be used to develop an Emergency Action Plan (EAP) that instructs school staff how to manage a specific student's medical emergency.

4. SCHOOL NURSE

The District will provide school nurses. Each school nurse must be licensed and in good standing with the Division of Occupational and professional Licensing (DOPL). 

A school nurse may delegate tasks in the school setting in accordance with the Rule and this section. 

Before a registered nurse may delegate a task to be performed within a school setting, the registered nurse shall:

develop an IHP in conjunction with the student and each applicable parent or parent surrogate, educator, and healthcare provider; and

ensure that the IHP is available to school personnel.

Each task being delegated by a registered nurse shall be identified within the student's current IHP.

A registered nurse shall personally train each unlicensed person who will be delegated the task of administering medications that are routine for the student.

The training required under paragraph 4.2.3 shall be performed at least annually.

A registered nurse may not delegate to an unlicensed individual the administration of medication not allowed to be delegated under the Rule, including a medication:

that has known, frequent side effects that can be life threatening;

that requires the student's vital signs or oxygen saturation to be monitored before, during, or after administration;

that is being administered as a first dose in a school setting:

of a new medication; or

after a dosage change; or

that requires nursing assessment or judgment prior to or immediately after administration.

In addition to delegating other tasks as described above, a registered nurse may delegate to an unlicensed individual who has been properly trained, the following tasks regarding a diabetic student's IHP:

administration of a scheduled dose of insulin (breakfast or lunch) and dosage outside the schedule if the student has a pump or smart pen; and

administration of glucagon in an emergency situation, as prescribed by the practitioner's order or specified in the IHP.

5. SCREENING AND PHYSICAL EXAMINATION

All students who participate in competitive athletics must follow the written Health Examination Policy of the Utah High School Activities Association. 

District speech and hearing staff will annually administer audiometric screening to all kindergarten, first, and third grade students. Screening is also provided for students through referrals from parents, teachers, and administrators.

Under the direction of the school principal, school nurses will oversee vision screenings of students as required by Utah Code Ann. § 53G-9-404 and Utah Admin. Code R384-201. The nurses should abide by the guidelines outlined by the Utah Department of Health & Human Services in the Utah School Vision Screening Policy. As required, vision screenings will be conducted for students in the following grade levels: pre-kindergarten, kindergarten, first, third, fifth, seventh or eighth, and ninth or tenth. The 9^th or 10^th grade screening may be completed through a driver’s education class or program. All screenings will be performed by qualified individuals in accordance with state law. Screenings are also provided for students based on referrals from parents, teachers, and administrators.

If a parent requests that the child not participate in a vision screening, the district will not require the child to receive the vision screening.

The Utah Department of Health and Human Services (“UDHHS”) requires the completion of its vision symptoms questionnaire in certain situations.

When a student has failed to achieve benchmark status on the benchmark reading assessment in grades 1-3:

the district must notify the student’s teacher within 30 calendar days of the student’s performance on the benchmark reading assessment;

teachers must complete the vision symptoms questionnaire within 45 calendar days of the administration of the assessment and submit the questionnaire to the school nurse;

teachers need only complete the questionnaire once per school year; and

school nurses shall use the questionnaire to perform a secondary assessment and/or refer the student to an eye care professional.

When a student is being referred to special education for a suspected disability affected by vision difficulties:

teachers must complete the vision symptoms questionnaire and submit to the school nurse; and

school nurses shall use the questionnaire to perform a secondary assessment and/or refer the student to an eye care professional.

When a student has been referred by a parent or teacher for a vision concern:

the parent or teacher should complete the vision symptoms questionnaire and submit to the school nurse; and

school nurses shall use the questionnaire to perform a secondary assessment and/or refer the student to an eye care professional.

6. STUDENT MEDICATIONS

Medications may be administered to students only in accordance with Nebo School District Policy JHCD, Administering Medication to Students. 

7. STUDENT IMMUNIZATIONS

Utah law requires proof of a student’s immunization against communicable diseases, unless exempt. Immunization requirements and procedures are outlined in Nebo School District Policy JHCB, Immunization of Students.  

8. COMMUNICABLE DISEASES

In general, students with communicable diseases will not be permitted to remain in school when their presence poses a threat to the health of other students or employees.

Students with signs or symptoms of communicable diseases will be excluded from school for the period of communicability and readmitted in accordance with recommendations from their health care provider or state health agency guidelines.

The state health agency is responsible for initiating measures to suppress or prevent the spread of disease and for implementing regulations relating to quarantine, isolation, and other control measures to protect the public in the case of a pandemic. The district will coordinate efforts with the state and local health departments to implement such precautionary measures.

When a student is suspected of having a communicable disease, the school principal shall immediately notify the school nurse, who will then consult with the Utah County Health Department to take the appropriate action as required by state law.

The Utah Department of Health and Human Services has authority to investigate and control the causes of epidemic infections and communicable disease, and provides for reporting of such disease and any other health hazard that may affect public health. Utah Code Ann. § 26B-7-202.

A school nurse or school administrator must report to the local health department information related to any student suffering from or suspected of having a disease that is communicable as required by Utah Code Ann. § 26B-7-206 and Utah Admin. Code R386-702-4.

Reportable diseases and reporting requirements are outlined in Utah Admin. Code R386-702-3.

9. FIRST AID AND CPR

Under Utah Admin. Code R277-465, the District will provide CPR instruction consistent with Health Education Core Standards. 

10. STUDENTS WITH DISABILITIES

A student whose health condition prevents or limits participation in school or district programs may require an evaluation to determine if the student has a disability under Nebo School District Policy JR, Students with Disabilities under Section 504, or Policy JS, Special Education. Employees who have reason to believe a student has a disability and requires services or accommodations must refer the student for evaluation under the applicable policy.