STUDENT HEALTH NOTICES
By Jan Hobza
Below are several notices for parents and guardians regarding student health issues. Generally, these summarize Board of Education policies on student health. If more detailed information is necessary, please contact your school’s Principal. At North Bend Elementary School, that is Caryn Ziettlow at (402) 652-8122 and at North Bend Central Junior-Senior High School that is Brenda Petersen at (402) 652-3268.
PHYSICALS/IMMUNIZATIONS/MEDICATIONS. There are no major changes this year in the requirements for pre-school physical examinations and immunizations. In 2007, the state added a new requirement for a vision examination for students entering Kindergarten. Vision evaluations are encouraged, but not required for 7th graders.
For immunizations, incoming 7th graders must have their Hepatitis B shots completed by the time school starts in August. If there are problems with meeting that requirement, please contact your school’s Principal. Finally, there have been several changes in state law and regulation recently regarding the administering of medications. We must now have additional documentation for administering medications at school and the Legislature has passed new laws allowing students to self-manage asthma and diabetes. If your child has asthma or diabetes, please contact your school’s Principal.
PHYSICAL EXAMINATIONS. In accordance with state law, North Bend Central Public Schools requires that prior to the entrance of any child into Kindergarten and the 7th Grade, or in the case of transfer from out-of-state schools to any other grade in the school, the parent/guardian must submit written evidence of a physical examination of the child by a licensed physician, physician's assistant or nurse practitioner. This definition excludes chiropractors. The examination must have been administered within six months of the enrollment date. The law does not specify the content of the physical exam. Parents should consult their physician about that. The cost of the examination is to be borne by the parent/guardian. As a substitute for such evidence of a physical examination, an objection in writing to a physical examination of such child signed and dated by a parent or guardian of such child may be submitted to the school.
North Bend Central Public Schools requires evidence of a sports physical on the Nebraska Association of School Activities (NSAA) form for a student to compete in junior high or high school interscholastic sports. The district will not accept a waiver for sports participation. As a convenience, the school may arrange with an area physician for sports physicals during the summer, but the school district in no way sponsors such physicals or takes any responsibility for their content. Sports physicals meet the school's requirements, but some physician may recommend a more elaborate physical for incoming seventh graders. The sports physicals do not include immunizations.
VISUAL EVALUATION. Upon enrollment the parent/guardian shall also provide evidence of a visual evaluation by a physician, a physician assistant, an advanced practice registered nurse, or an optometrist, within six months prior to the entrance of the child into the beginner grade or, in the case of a transfer from out of state, to any other grade, unless the parent or legal guardian submits a written statement objecting to a visual evaluation. The visual evaluation is to consist of testing for amblyopia, strabismus, and internal and external eye health, with testing sufficient to determine visual acuity. A vision evaluation prior to entrance into the seventh grade is encouraged, but not required. The Superintendent or his/her designee shall notify the parent/guardian of the foregoing requirements and of the right ot submit affidavits or statements to object to the requirements, as applicable. The Superintendent or his/her designee shall also provide information to assist parents/guardians in receiving free or reduced-cost visual evaluations for low income families who qualify.
IMMUNIZATIONS: In accordance with state law, each student shall be protected by immunization against the following diseases, unless otherwise exempted from this requirement: diphtheria, tetanus, pertussis, polio, measles, mumps, and rubella, Hepatitis B, Varicella (chicken pox) and Haemophilus Influenzae type b (Hib) and other diseases as required by applicable law. For the purpose of complying with the requirement of immunization against the diseases listed above:
A. Students 2-5 years of age enrolled in a school-based program are considered to be immunized if they have received 3 doses of pediatric Hepatitis B vaccine, 4 doses of DTaP, DTP, or DT vaccine, 3 doses of Polio vaccine, 1 dose of MMR or MMRV vaccine given at or after 12 months of age, and 3 doses of Hib vaccine or 1 dose of Hib vaccine given at or after 15 months of age, 1 dose of varicella (chickenpox) or MMRV given at or after 12 months of age or written documentation (including year) of varicella disease as provided by parent/guardian or health care provider.
B. Students enrolling for the first time (Kindergarten), enrolling in Grades 1-12, except Grade 6,, and all transfer students from outside the state regardless of the grade they are entering are considered immunized if they have received 3 doses of pediatric Hepatitis B vaccine or 2 doses of adolescent vaccine if the student is 11-15 years of age, 3 doses of DTaP, DTP, DT or Td vaccine with at least one dose given on or after the child’s 4th birthday, 3 doses of Polio vaccine, 2 doses of MMR or MMRV vaccine given at or after 12 months of age and separated by at least one month, and 1 dose of varicella (chickenpox) or MMRV vaccine if given on or after 12 months of age and prior to 13 years of age. If give at over 13 years of age, 2 doses of varicella separated by at least one month, or or written documentation (including year) of varicella disease as provided by parent/guardian or health care provider.
C. All other students are considered immunized if they have received 3 doses of pediatric Hepatitis B vaccine or 2 doses of adolescent vaccine if the student is 11-15 years of age, 3 doses of DTaP, DTP, DT or Td vaccine with at least one dose given on or after the child’s 4th birthday, 3 doses of Polio vaccine, and 2 doses of MMR or MMRV vaccine given at or after 12 months of age and separated by at least one month. For the 2009-10 school year Varicella is required for students in Kindergarten through Grade 12, except for Grade 6, and all out of state transfer students.
D. On and after July 1, 2010, every student entering the 7th grade shall have a booster immunization containing diphtheria and tetanus toxoids and an acellular pertussis vaccine which meets the standards approved by the U.S. Public Health Service for such biological products, as such standards existed on January 1, 2009.
For purposes of compliance with the immunization requirement, North Bend Central Public Schools requires the presentation of an immunization history containing the name of the vaccine, the month and year of administration (the month, day and year for MMR vaccine), the name of the health practitioner, the agency where the immunization was obtained, and the signature of physician, parent, guardian, or of such other person maintaining the immunization history of the student, verifying that the student has received these vaccines. (See Appendix 3341 E2)
D. MEDICAL/RELIGIOUS EXEMPTIONS. Each student shall be protected against the diseases listed and submit evidence of immunization as described above. Any student who does not comply with these requirements shall not be permitted to continue in school, except as provided below. Immunization shall not be required for a student’s enrollment if he or she submits to the Superintendent or his/her designee either of the following:
(1) A statement signed by a physician, physician assistant, or nurse practitioner (this definition excludes chiropractors) stating that, in the health care provider’s opinion, the specified immunization(s) required would be injurious to the health and well-being of the student or any member of the student’s family or household; OR
(2) A notarized affidavit signed by the student or, if he or she is a minor, by a legally authorized representative of the student, stating that the immunization conflicts with the tenets and practice of a recognized religious denomination of which the student is an adherent or member or that immunization conflicts with the personal and sincerely followed religious beliefs of the student.
A student may be provisionally enrolled if he or she has begun the immunizations against the specified diseases prior to enrollment and continues the necessary immunizations as rapidly as is medically feasible. For purposes of complying with these requirements, a student is considered to have begun immunizations against polio, diphtheria, tetanus, Pertussis, hepatitis B, measles, mumps, and rubella if he or she has had at least one dose of DTaP/DTP/DT/Td, one dose of Hepatitis B, one dose of either trivalent OPV or one dose of IPV, and either one dose of the combined measles, mumps, and rubella vaccine or one dose of each vaccine for measles, mumps and rubella. Continuation of necessary immunizations as rapidly as is medically feasible shall be documented by a written statement from the student’s immunization provider which shows the scheduled dates to complete the required series. Failure to receive the necessary immunization as rapidly as is medically feasible shall result in exclusion of the student from attending school until either documentation of immunization or a medical statement or religious affidavit is provided to the school. The time interval for the completion of the required immunization series shall not exceed nine (9) months.
A student may also be provisionally enrolled if he or she is the child or legal ward of an officer or enlisted person, or the child or legal ward of the spouse of such officer or enlisted person on active duty in any branch of the military services of the United States, and the student is enrolling following residence in another state or in a foreign country. As a condition for the provisional enrollment of a student under this section, a parent or adult legal guardian of the student shall provide the school with a signed written statement certifying that the student has completed the course of immunizations required above.
The provisional enrollment of a student qualified for such enrollment shall not continue beyond 60 days from the date of such enrollment. At such time, the school shall be provided with written evidence of compliance with the immunizations requirements. The student shall not be permitted to continue in school after such date until evidence of compliance is provided.
BP 3341: PHYSICAL EXAMS AND IMMUNIZATIONS
E. HEALTH CHECKS. Each school year, the North Bend Central Public Schools will conduct health screenings of students for height/weight, sight and hearing, and such other conditions as required by law in accordance with the recommended screening schedule of the Nebraska Department of Health and Human Services. Parents/guardians will be notified in writing concerning any defects found as a result of these examinations. These are routine checks which are not intended to replace regular check-ups.
F. DISPENSING MEDICINE. Recent state law changes have further restricted the ability of school personnel to dispense medicine. The Board of Education policy on this topic states, in part:
“Medicine, including non-prescription medications, will only be provided to students with the permission of the student's parent/guardian and under the supervision of the school staff. Written permission from the student’s parent/guardian is required for the provision of prescription medications to students.
Students whose parent/guardian determines that they are responsible for administering their own medications, may keep the medication with them. However, the practice of students administering their own medications is discouraged. Parents should notify the Principal or school nurse and the child's teacher when the child is taking self-administered medication and should note any possible side effects.
Prescription medication will be given to students only by the following school staff:
Health Care Professionals (School Nurses). This means an individual who holds a current license from the Department of Health and Human Services Regulation and Licensure for whom administration of medication is included in the scope of practice. For purposes of this Policy, such individuals are referred to as “school nurses.”
Medication Competent Staff. This means a staff member of the school who has been determined to be competent to administer medication by: (i) a recipient with capability and capacity to make an informed decision about medications (at a minimum, the recipient must be age 19 or older), (ii) a caretaker for the student, or (iii) by the school nurse.
The overall accountability for monitoring the therapeutic benefit of the medication and accountability for monitoring side effects and contraindications shall be the responsibility of the student’s parents. They shall submit an acceptance of responsibility for direction and monitoring document on an appropriate form to be devised by the Superintendent or his/her designee. The parent and his/her physician must provide clearly marked dosages and instructions regarding provision of the medication to the student.
All medications, other than medications to be self-administered as described above, shall be stored in secure areas in accordance with the manufacturer’s or dispensing pharmacist’s instructions for temperature, light, humidity, or other storage instructions. Only staff authorized by the district as responsible for the provision of medications shall have access to the medications. Medications sent on field trips shall be in containers identified for the student with directions for right dose, right time, and right route and the medication container shall be given to the person designated as responsible for the provision of the medication. Any medication errors must be immediately reported to the person responsible for providing direction and monitoring, e.g., the parent or other health care professional or provider.
...Verbal parental permission is sufficient for a teacher or Administrator to provide a one-time dosage of non-prescription aspirin-like products. Such permission is required each time these products are to be administered."
G. SELF-MANAGEMENT OF MEDICATION. The Nebraska Legislature passed a measure in 2006 that allows students to self-manage the administration of medication for certain medical conditions. Based on this law, NBCPS has adopted Board Policy 3344 which states in part:
“Students with asthma, anaphylaxis or diabetes will be permitted to self-manage such medical conditions upon:
(1) written request of the student’s parent or guardian;
(2) authorization of the student’s physician;
(3) receipt of a signed no liability statement from the parent or guardian; and
(4) development of an asthma or anaphylaxis or a diabetes medical management plan for the student.
Students with such a medical management plan may possess the necessary medication to manage their medical condition under the conditions established in the plan and not be subject to discipline for such possession. Provided that, if the student uses or allows the medication to be used for any reason other than as prescribed or as provided in the plan or possesses the medication other than as provided in the plan the student shall be subject to discipline in accordance with the student conduct and drug-free school policies.”
H. ASTHMA/ALLERGIC REACTION. The North Bend Central Public Schools Board of Education has adopted Board Policy 3343 and an accompanying Administrative Regulation designed to implement the Asthma/Anaphylaxis Protocol required by the Nebraska Department of Education. The Protocol calls for the training of staff and the administering of emergency medication through Epi-Pen containing albuterol in case of a life-threatening asthma attack or allergic reaction. The parent or guardian of a student may sign a waiver requesting that their student not receive emergency treatment under the Protocol. The waiver may be obtained from the district’s School Nurse, Diane Hines. If your child suffers from asthma or is subject to allergic reactions, please notify the School Nurse before the start of the school year.
ACCIDENT INSURANCE--The school district does NOT provide insurance for student accidents and injuries. Insurance coverage for accidents is only provided if the district is found to be negligent or otherwise liable. However, low cost student accident insurance is available through Student Assurance Services. A packet of information will be sent home with all students on the first day of school.
Through the Nebraska School Activities Association, the school provides catastrophic insurance coverage for athletes in Grades 9-12 at no cost to the student. Catastrophic coverage for students in Grades 7-8 and for K-12 students engaged in non-athletic activities is provided by the district at no cost. This coverage comes into effect only when a catastrophic level of expense has been reached.
KIDS CONNECTION HEALTH INSURANCE PROGRAM. Applications for Kids Connection, the state-sponsored children's health insurance program, will NOT be distributed through the schools this year. However, parents may obtain information through the toll-free number, 1-877-NEB-KIDS (1-877-632-5437) or at the Nebraska HHS web site at www.hhs.state.ne.us. Some additional information may be provided through the school later this fall, according to HHS.
The Kids Connection health insurance program provides health care coverage to children of low income working families in Nebraska. Kids Connection is an expansion on the state's Medicaid program and provides health care coverage for children in families whose income is below the established threshold. Pregnant women with the same income level will also be included. The program is designed to provide routine, preventative health care and basic hospitalization for children needing coverage. Certain mental health services are included and pregnant women with the same income level are also included. Good nutrition and good health have a definite impact on student learning. Please take advantage of Kids Connection and the free/reduced school lunch program if you qualify.
