Medical Policies

I.  Health Procedure in a School Setting      

Registered nurses are the primary professionals who provide school health services. They coordinate services and health care procedures within the school setting.

Licensed practical nurses cannot work without periodic on-site supervision by a registered nurse, physician, or dentist. The physician’s order gives school systems permission to carry out a procedure in the school setting, but does not meet the criteria for LPN supervision.

Certified nursing assistants are not licensed health care professionals. Although they may assist students in some areas, they do not satisfy legal requirements for licensed professionals.

  1. Procedures – Designated personnel must complete appropriate in-service provided by appropriate health care professionals and must have continued supervision by appropriately licensed health care professionals.
  2. Procedures done by students without assistance – If a student has been taught to perform his/ her own procedure and does not need assistance, space must be made available for the student to perform this task. A nursing assessment, physician’s orders and parental authorization are highly recommended but are not required.
  3. Procedures done by students without assistance – Nursing assessment, physician’s orders and parental authorization are highly recommended, but are not required.
  4. Procedures done by students with assistance – Nursing assessment, physician’s orders and parental authorization are required. The nursing assessment will determine whether or not unlicensed assistant personnel can assist the student.
  5. All other healthcare procedures – All other health care procedures must be performed by licensed health care professional. Although nurses can legally perform all of these procedures, many will need specific orientation to perform these procedures in a school setting. Physician’s orders and parental authorization are required.

 

 

II. HIV/ AIDS Policy for Employees - Lebanon Special School District will provide in-service training and education annually regarding HIV/ AIDS and blood-born pathogens to all school system employees to prevent and manage exposure in the workplace.

It is also the intent of the Lebanon Special School District to provide, to the maximum extent possible, all rights and privileges to any school system employee diagnosed as having AIDS or HIV-related infection.

  1. No employee shall be required to have any blood test or medical consultation to determine HIV status. This does not preclude school official from requiring an employee to undergo an examination when another communicable illness is suspected.
  2. HIV/ AIDS information will remain strictly confidential. Permissible disclosure will occur pursuant only to a signed authorization for release, appropriate court order, or a lawful subpoena.
  3. No school system employee diagnosed with HIV infection or AIDS shall be prevented from continuing employment based solely on this diagnosis.
  4. As may be required by federal or state law, the school system must make reasonable accommodations to enable the employee to perform employment duties.
  5. In accordance with current law and regulations, the school system will take all reasonable actions to prevent any diagnosed employee from being subjected to adverse or discriminatory treatment.
  6. No disciplinary action or other adverse personnel action may be taken against an employee solely on the basis of HIV/ AIDS infection. Action may be taken only if the employee is disabled and the disability interferes with the employee’s ability to perform activities involved in employment.

Review of employment conditions will include the director, the employee’s physician, and a physician or nurse from the Department of Health as designated by the Regional Health Officer.

 

 

 

III. Family & Medical Leave Act Policy

The Family & Medical Leave Act of 1993 obliges certain employers to allow eligible employees to take an unpaid, job-protected leave for certain family and medical events. This law is designed to provide a minimum benefit and is not to be construed as rationale to reduce any employer-sponsored agreement, which is more generous. It is intended to assist employees in reaching a balance between family and work responsibilities with as little conflict as possible. The effective date of implementation of this federal mandate was August 5, 1993. Employers with fifty or more employees on each working day of twenty or more work weeks in the current or preceding year must comply. This law is very specific in most areas in its interpretation; however, there are certain provisions and stipulations, which are left to the local governing bodies to determine.

The following provisions and clarifications of local policy in the implementation of the FMLA as it relates to the employees of the Lebanon Special School District are recommended:

  1. FMLA states that a person requesting a leave must have been employed for twelve months prior to the request. The law further states that an employee is eligible for up to twelve weeks per twelve-month period. The employer may choose what method it will use in determining the twelve-month period after the first leave is granted.
  2. We recommend that the twelve-month period be measured forward from the time any employee’s first FMLA leave begins.
  3. FMLA allows employees to take leave for medical problems for themselves and their families or for the birth of a child, adoption of a child, continuing treatment, therapy, etc. The leave may be taken in increments if necessary; for example, going to take physical therapy treatments once a week for four hours. The employer under the law can require documentation supporting these requests provided they have a written policy in place at the time the leave is requested.
  4. We recommend that written documentation supporting the request to return to work be provided to the director’s office fifteen days prior to the employee’s return. Employees will be furnished with a formal Return-to-Work request form, which will need to be signed by them and subsequently by the director when the return to work request is made. Documentation of fitness to return work and the ability to perform their duties will be required.
  5. The employer under FMLA determines whether the employee may be paid accrued sick leave days during any part of the leave. It is recommended that employees may not use accrued sick leave for leave requested under the provisions of the Family & Medical Leave Act.
  6. The law requires that any portion of an insurance premium paid by the employer, must continue to be paid on behalf of that employee during the time that the employee is on leave under the provisions of the FMLA. The law further states that the employee is responsible for the portion of premium that he/ she is normally responsible for paying. The method of collecting for insurance premiums during the leave is left to the employer’s discretion.
  7. We recommend that any insurance premiums due from employees should be kept current and should be paid on a monthly basis to the Lebanon Special School District. We further recommend that if insurance premiums are not kept current, we as the employer may cancel coverage after the thirty-day grace period required by law.
  8. If the employee does not return to work after the leave, the Lebanon Special School District, under the FMLA guidelines, may recover any premiums paid for which compensation has not been made.
  9. We recommend that employees, who elect not to return to work after the leave, inform their employer as soon as possible after the decision is made.
  10. The law has some special rules relating to school district, which were successfully negotiated by the National School Boards Association. One provision allows the employer to require that leave be taken in blocks of time rather than intermittently.
  11. We recommend that the leave be taken in blocks of at least one week at a time. Exceptions to this recommendation would be considered on a case-by-case basis. For example, a teacher who might be taking chemotherapy for one day, but who might be able to return to work for the rest of the week. The needs of the students and the availability of a substitute will be considered in all cases.
  12. The law states that when it would be detrimental to the best interest of the students, that a teacher returning from a leave of absence be reinstated in an equivalent position. In order to declare any position equivalent to another, all like positions must be declared equivalent by the local Board of Education. For example, a teacher who had been teaching third grade when the leave began, might be reassigned to a fourth grade position, as needed, upon his/ her return, if the school board determines that this placement would be in the best interest of the students. The school board must at the time clarify that the two positions are equivalent and that the benefits and pay received would be equal in either position. Although this change of assignment would not result in a reduction in pay or loss of benefits in our school system, the clarification of what is meant by alternative position or equivalent position must be made to the employee.
  13. The recommendations made do not replace, modify, or affect any other part of the Family & Medical Leave Act or any other laws affecting the workplace and are proposed for the sole purpose of clarifying those positions which are left to the discretion of the employer. Further recommendations may be needed as the complexities of interpretation of the laws governing FMLA are tested and further legislative action is taken.
  14. Student Health Services – The major objective of student services is to protect and promote the health of the student.

Objectives:

1.     A safe, sanitary, healthful school environment shall be provided.

2.     Basic principles of healthful living shall be taught.

3.     School nurse to provide medical consultation and guidance, and to coordinate school health programs.

Student Health Services Shall Include:

1.     Identification of physical, mental, or emotional characteristics of students that will prevent them from attaining their potentialities through public education.

2.     Evidence of a complete medical examination of every student entering school for the first time.

3.     Proof of immunization required by the state except those who are exempt by statute.

4.     A medical examination as directed by the TSSAA of every student prior to participation in interscholastic athletics.

5.     A cumulative health record.

6.     A record for each student which contains information as to how and where to contact parents in the case of an emergency.

7.     A report of each accident taking place while the student is under the jurisdiction of the school.

8.     Basic first aid provided with parent/ guardian permission.

9.     Sick and/ or injured student shall be provided assistance by nurse or school personnel.

10.  Emergency 911 assistance shall be called in crisis after attempting to contact parents by school nurse or designated personnel.

11.  Suspected child abuse or neglect shall be reported to the Department of Children Services.

12.  School nurse shall follow up with any knowledge of a communicable disease and co-work with State Department of Health following Lebanon Special School District policy.

13.  Medication will not be routinely dispensed. Medication needed to assist child for medical and educational purposes shall only be given if written parental permission is obtained (See medication policy stating requirements).

14.  Teacher referral of students for available health services.

15.  HIV and STD education to grade determined by school system.

16.  Method for evaluation criteria, including the extent and use of available health services based upon the needs of students within the school.

 

  1. Pediculosis Capitis (Head Lice)

1.     Any student with pediculosis (head lice) will be sent home for treatment

2.     Student must be nit free upon returning to classroom

3.     The child shall be rechecked upon returning to school by designated school personnel.

4.     Each child in the classroom will be given a letter to take home noting head lice has been found in the classroom. No names will be given.

5.     Appropriate school personnel will be notified, so siblings can be checked by designated school personnel.

6.     School personnel (principal or designee) will have final determination regarding the child returning to the classroom.