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8 Page 1 Policies and Regulations Acquired Immune Deficiency Syndrome (AIDS) and Other Bloodborne Infectious Illnesses 5458 Policy The Guilford Board of Education recognizes that serious infectious illnesses, such as Human Immunodeficiency Virus (HIV) infection, Acquired Immune Deficiency Syndrome (AIDS) and their related conditions have a tragic impact on those afflicted and involve significant and sensitive issues for students, faculty, and staff. The Guilford Board of Education also recognizes that both employees and students who contract such serious infectious illnesses may wish to continue their employment or education with the Guilford Public Schools. At the same time, the Board is committed to satisfying its obligation to provide a safe and effective educational and working environment for its students, employees, and visitors. Accordingly, Guilford Public Schools will take appropriate precautions to ensure that any health and safety concerns arising out of an individual s illness are managed in accordance with current medical knowledge and procedures. With these principles in mind, Guilford Public Schools has established this policy for students and employees with serious infectious illnesses. Although this policy focuses upon AIDS and HIV infection, it is also intended to apply, as appropriate, to other serious bloodborne pathogens, such as hepatitis C, cytomegalovirus, and hepatitis B, which are more common and more transmissible than HIV infection. The school system is aware that the best course of action for dealing with an illness will vary from case to case. Accordingly, these policy only attempts to outline the Guilford Public Schools approach to serious infectious illnesses, for each case must be addressed with proper regard for the context in which it arises. A. GENERAL POLICIES: 1. Guilford Public Schools complies with all federal, state, and local laws and regulations regarding HIV infection and AIDS. 2. Guilford Public Schools makes a concerted effort to provide ongoing AIDS education to its students and employees. As part of this effort, the Guilford Public Schools makes available information regarding its AIDS policy. In addition, the Guilford Public Schools provides information about the nature of the disease and how it is (and is not) transmitted. This information places special emphasis on methods for preventing the spread of AIDS. New arrivals to the Guilford Public Schools (both students and employees) will be advised during their orientation of the Guilford Public Schools AIDS policy and the availability of information on AIDS. 3. The principles of Universal Precautions (e.g. principles for handling blood and body fluids) have been implemented throughout the Guilford Public Schools and will be reviewed with all faculty and staff each year.

9 Page 2 4. At the present time, the overwhelming preponderance of available medical and scientific evidence and opinion, including statements from the United States Public Health Service and the Centers for Disease Control, holds that AIDS virus (HIV) is not casually transmitted in ordinary educational, occupational, or social settings or conditions. Accordingly, all members of the Guilford Public Schools community will be expected to continue to work with an employee or student with AIDS or HIV infection and not to harass or otherwise discriminate against such an individual. Any student or employee who does not adhere to these requirements shall be subject to disciplinary action. It is, moreover, the policy of the Guilford Public Schools that individuals with AIDS or HIV infection should be treated with compassion and understanding in dealing with their illness. 5. The Guilford Public Schools holds all medical information which it receives about medical conditions of an employee or student with AIDS in confidence. This means that the Guilford Public Schools restricts access to such information to those with a legitimate need for the information (e.g. Principal, nurse, classroom teacher). An exception to this rule will be allowed when the employee or student with HIV infection or AIDS authorizes wider disclosure of such information. Since the particular individuals with a need to have access to such information will vary from case to case, the Principal or School Medical Advisor will decide in each case whom to inform. Individuals who thereby gain access to this information are themselves expected to keep the information confidential in accordance with this policy and applicable law. 6. The Guilford Public Schools may from time to time change or discontinue this policy or adopt a new policy with respect to this subject, as it determines medical opinion and other circumstances warrant. B. EMPLOYEES WITH AIDS OR HIV INFECTION 1. The Guilford Public Schools strongly recommends that employees who suspect they might have contracted HIV infection take a test for antibodies to the virus. Those employees with asymptomatic or mildly symptomatic HIV infection have no specific obligation to report the infection to members of the school community. Employees with AIDS should inform the school s Principal or the School Medical advisor of their illness so that the school can effectively implement the provisions of this policy. This action by the employees is not required by law. 2. The Guilford Public Schools will provide reasonable accommodation for an employee disabled by AIDS or advanced HIV infection when needed to enable the employee to continue to perform the essential functions of his or her job or to otherwise benefit from the privileges of employment, so long as the accommodation does not impose an undue hardship upon the school. Furthermore, the school will not attempt to monitor the behavior or the activities of the affected individual in an unusual or exceptional manner. 3. An employee with AIDS will be allowed to work at the school as long as he or she is able to perform (with or without the aid of the aforementioned accommodations) the essential functions of his or her position and he or she does not present a health or safety risk to himself/herself or other employees or students, as for example, by the presence of severe

10 Page 3 neurologic or psychiatric impairment. If an employee contracts AIDS or advanced HIV infection, the Guilford Public Schools may require a letter from the employee s attending physician periodically stating that the employee is mentally and physically fit to continue to work in accordance with this standard. The Guilford Public Schools may also require from time to time, further medical evidence and a medical examination by a physician or physicians designated by the Guilford Public Schools, an expert in AIDS care, to ascertain the employee s fitness for work. 4. The Guilford Public Schools will review, on an on-going basis, the employment situation of an employee with AIDS or advanced HIV infection. Whenever practicable, the school will seek the advice of the employee and his or her physician. Any employment decisions the Guilford Public Schools arrives at through its reviews will be made in accordance with the Guilford Public Schools interpretations of its policies and the applicable laws and in the light of medical and scientific opinion and advice. In making employment decisions, the Guilford Public Schools shall consider: (i) the employee s physical and medical condition; (ii) the duties of the employee s position; (iii) the types of interaction between the employee and students and/or other employees; (iv) the characteristics of the disease (including known and proven means of transmission); (v) whether a substantial risk of transmission by the employee exists (as for example, by open wet sores or wounds which cannot be adequately covered); (vi) whether the possibility of transmission is enhanced by the behavior of the students (e.g., aggressive, violent, or other acting out behaviors such as biting, kicking, scratching, or throwing objects); and (vii) whether reasonable accommodations could be made which would allow the employee to continue working but would not impose an undue hardship on the school. This list of factors is not comprehensive, for the Guilford Public Schools may also consider other pertinent criteria in arriving at its decision. 5. The Guilford Public Schools treats AIDS and HIV infection in the same manner as other illnesses in terms of its employment policies and does not unlawfully discriminate against employees with AIDS or HIV infection with respect to their eligibility to participate in its employment benefit plans. Whenever practicable, the Guilford Public Schools will consider providing alternative job roles or flex time accommodations to HIV-infected individuals who are partially disabled by their infection. C. STUDENTS WITH AIDS OR HIV INFECTION 1. Students with AIDS or HIV infection are encouraged to inform the principal or School Medical Advisor of their medical condition so that the Guilford Public Schools can effectively implement the provisions of this policy. This action is not required by law. The Guilford Public Schools may then require a letter from the student s physician outlining the physician s medical opinion regarding the student s physical limitations and a statement regarding prognosis. The Guilford Public Schools may also, from time to time, require further medical evidence and a medical examination by a physician or physicians agreed upon by both the Guilford Public Schools and the child s guardians to ascertain the propriety of the student attending the school, to assess the child s medical progress, and to estimate his/her ability to fulfill the obligations and activities of a student of the Guilford Public Schools.

11 Page 4 2. The Guilford Public Schools will make reasonable modifications in its policies, practices, and procedures in order to allow a student with AIDS or HIV infection to benefit from the academic and other services offered by the school, so long as the modifications do not fundamentally alter the nature of service that the Guilford Public Schools provides. In addition, the Guilford Public Schools will provide whatever auxiliary aids and service that may be required to allow a student to benefit from the school s services, as long as the provision of such auxiliary aids and service does not constitute an undue burden on the school or fundamentally alter the nature of service that the school provides. In summary, Guilford Public Schools personnel will attempt to be flexible and to use the least restrictive means to accommodate the child s needs. 3. A student with AIDS will be allowed to remain at the school so long as his/her medical condition allows him or her to perform (with the aid of the aforementioned modifications and/or auxiliary aids and services) up to the Guilford Public Schools standards and does not present a health or safety risk to other students, faculty, or staff. It may be necessary to temporarily shorten the day for some students, to provide extra tutoring, and to make some accommodations for poor grades. While at school, a student with AIDS or HIV infection will be allowed to partake fully and equally in the educational, social, and extracurricular activities offered by the Guilford Public Schools, so long as such participation does not present a health or safety risk to the affected student or to other students, faculty, or staff. 4. The Guilford Public Schools will review on an on-going basis the enrollment of a student with AIDS or HIV infection and will make decisions regarding whether and under what circumstances the student can remain at the school. The Guilford Public Schools will make these decisions in accordance with the Guilford Public Schools interpretations of its policies and the applicable laws and in light of medical and scientific opinion and advice. In making such decisions, the Guilford Public Schools shall, whenever practicable, consider, among other factors, the opinions and recommendations of the student, the student s parents or guardians, and the student s physician. (cf. 4119/4219 Bloodborne Pathogens) (cf. 4120/4220 AIDS) Legal Reference: Connecticut General Statutes Duties of medical advisors Records not to be public Notice of disease to be given parent or guardian. 19a AIDS testing and medical information. Policy adopted: January 22, 2001 GUILFORD PUBLIC SCHOOLS Guilford, Connecticut

12 Page Regulation Communicable and Infectious Diseases/Bloodborne Pathogens Exposure Control Plan. The OSHA Bloodborne Pathogens Standard (29CRF ) covers all employees who could be "reasonably anticipated" to face contact with bloodborne pathogens and other potentially infectious materials as the result of performing their job duties. In accordance with this standard, the district has developed an Exposure Control Plan which contains the following information: 1. General Program Management 2. Exposure Determination 3. Compliance Methods 4. Work Area Restrictions 5. Personal Protective Equipment 6. Hepatitis B. Vaccine Program 7. Post-Exposure Evaluation and Follow-up 8. Training Availability of the Exposure Control Plan to Employees. A copy of the Exposure Control Plan is found in and available to all employees in each program site. Review and Update of the Plan. It is important to keep this Exposure Control Plan up to date. To ensure this, the plan will be reviewed and updated under the following circumstances: 1. Annually 2. Whenever new or modified tasks and procedures are implemented which affect opportunities for occupational exposure. 3. Whenever employees' jobs or responsibilities are modified or altered so that a new potential of occupational exposure may exist. 4. Whenever new or revised positions are established that may involve occupational exposure. Exposure Determination. CFR , paragraph (b) defines "occupational exposure" to mean "reasonably anticipated skin, eye, mucous membrane, or parenteral (i.e. intravenous subcutaneous) contact with blood or other potentially infectious materials that may result from the performance of an employee's duties. Other potentially infectious materials include the following: human body fluids (semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, saliva in dental procedures, any body fluids visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids).

13 Page 6 OSHA requires employers to perform an exposure determination concerning which employees may incur occupational exposure to blood or other potentially infectious materials. The exposure determination is made without regard to the use of personal protective equipment (i.e. employees are considered to be exposed even if they wear personal protective equipment). This exposure determination is required to list all job classifications in which employees may be expected to incur such occupational exposure, regardless of frequency. The following job classifications are in this category: 1. School Nurses 2. First Responders - First Aid Certified 3. Pre School Staff 4. Any staff member determined by medical advisor to be at risk due to unique circumstances In addition, OSHA requires a listing of job classifications in which some employees may be anticipated to have occupational exposure. Since not all the employees in these categories would be expected to incur exposure to blood or other potentially infectious materials, tasks or procedures that would cause these employees to have occupational exposure are also required to be listed in order to clearly understand which employees in these categories may be considered to have occupational exposure. The following job classifications are in this category: 1. Teachers and aides not specifically listed above 2. Principals 3. Tutors 4. Cafeteria workers 5. Custodians 6. Coaches Compliance Methods. Universal precautions will be observed at all district building sites* in order to prevent contact with blood or other potentially infectious materials. All blood or other potentially infectious materials will be considered infectious regardless of the perceived status of the source individual. Engineering and work practice controls will be utilized to eliminate or minimize exposure to employees. Where occupational exposure remains after institution of these controls, personal protective equipment shall also be utilized. At these sites, the following engineering controls will be utilized: 1. Sharps container in school health offices 2. Bio hazard bags in school health offices 3. Gloves available to all staff 4. Double-bagging (custodians) 5. Eye protection, plastic apron as needed in Special Needs and Developmentally Delayed classrooms 6. Gloves, plastic bags, proper clean up solution in all sport first aid kits

14 Page 7 It is the responsibility of the teacher and nurse in each site to monitor the storage and need for replacement of personal protective equipment. Hand washing facilities are also available to the employees who incur exposure to blood or other potentially infectious materials. OSHA requires that these facilities be readily accessible after incurring exposure. Hand washing facilities are located in: Some Classrooms Health Office All Bathrooms Some Staff Lounges Gym locker rooms Custodial Closets Some Administrative Offices *Sites: indicates all school district buildings and grounds Work Area Restrictions. In work areas where there is a reasonable likelihood of exposure to blood or other potentially infectious materials, employees are not to eat, drink, apply cosmetics, or lip balm, smoke, or handle contact lenses. Food or beverages are not to be kept in refrigerators, freezers, shelves, cabinets, counter tops or bench tops where blood or other potentially infectious materials are present. Mouth pipetting/suction of blood or other potentially infectious materials is prohibited. After removal of personal protective gloves, employees shall wash hands and any other potentially contaminated skin area immediately or as soon as feasible with soap and water. If employees incur exposure to their skin or mucous membranes, then those areas shall be washed or flushed with water as appropriate as soon as feasible following contact. All procedures will be conducted in a manner which will minimize splashing, spraying, splattering, and generation of droplets of blood or other potentially infectious materials. Equipment which has become contaminated with blood or other potentially infectious materials shall be examined prior to servicing or shipping and shall be decontaminated. Personal Protective Equipment. All personal protective equipment used at the sites will be provided without cost to employees. Personal protective equipment will be chosen based on the anticipated exposure to blood or other potentially infectious materials. The protective equipment will be considered appropriate only if it does not permit blood or other potentially infectious materials to pass through or reach the employees' clothing, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the protective equipment will be used. All personal protective equipment will be cleaned, laundered, and disposed of by the employer at no cost to employees. All repairs and replacement will be made by the employer at no cost to employees. All garments which are penetrated by blood shall be removed immediately or as soon as feasible. All personal protective equipment will be removed prior to leaving the work area. All personal protective equipment shall be disposable. After use such shall be rinsed with water or bleach/water

15 Page 8 solutions if contaminated, then disposed of in plastic bag lined container in classroom or health office. This will be disposed of by the custodian wearing gloves. Gloves shall be worn where it is reasonably anticipated that employees will have hand contact with blood, other potentially infectious materials, non-intact skin, and mucous membranes. Gloves will be used when contact with blood or body secretion occurs or is suspected. Disposable gloves used at sites are not to be washed or decontaminated for re-use and are to be replaced as soon as practical when they become contaminated or as soon as feasible if they are torn, punctured, or when their ability to function as a barrier is compromised. Utility gloves may be decontaminated for re-use provided that the integrity of the glove is not compromised. Utility gloves will be discarded if they are cracked, peeling, torn, punctured, or exhibit other signs of deterioration or when their ability to function as a barrier is compromised. Masks in combination with eye protection devices, such as goggles or glasses with solid side shield, or chin length face shields, are required to be worn whenever splashes, spray, splatter, or droplets of blood or other potentially infectious materials may be generated and eye, nose, or mouth contamination can reasonable be anticipated. No situations at sites should require such protection. OSHA standard also requires appropriate protective clothing to be used under certain conditions. The clothing could be lab coats, gowns, aprons, clinic jackets, or similar outer garments. No situations should require that such protective clothing be utilized. Any contaminated surfaces will be cleaned and decontaminated immediately. Decontamination will be performed by utilizing a department issued/approved agent with a 1:100 solution of bleach in water. All disinfectants will be Tuberculocidal. All contaminated work surfaces will be decontaminated after completion of procedures and immediately or as soon as feasible after any spill of blood or other potentially infectious materials, as well as the end of the work shift of the surface may have become contaminated since the last cleaning. All bins, pails, cans and similar receptacles shall be inspected and decontaminated on a regularly scheduled basis by health office and custodial staff. Any broken glassware which may be contaminated will not be picked up directly with the hands. The following procedures will be used: Staff will stay at area to prevent further injury/contamination. Custodians will be called to sweep up glass fragments using gloves. Equipment will be immediately decontaminated. All contaminated sharps shall be discarded as soon as feasible in sharps containers which are located in each school health office.

16 Page 9 Hepatitis B Vaccine Program. All employees who have been identified as having exposure to blood or other potentially infectious materials will be offered the hepatitis B vaccine, at no cost to the employee. The vaccine will be offered within 10 working days of their initial assignment to work involving the potential for occupational exposure to blood or other potentially infectious materials unless the employee has previously had the vaccine or who wishes to submit to antibody testing which shows the employee to have sufficient immunity. Employees who decline the Hepatitis B vaccine will sign a waiver. Employees who initially decline the vaccine but who later wish to have it may have the vaccine provided at no cost. The school nurse will assist employees to get the vaccine. The school medical advisor will supervise the administration of the vaccine. Post-Exposure Evaluation and Follow-up. Employees will immediately report a possible exposure incident to the school nurse where available or to their building principal and will make out an incident report. The nurse or administrator will contact the school medical advisor or the Connecticut Department of Health Services to determine if an incident has occurred. When an incident is confirmed, the school medical advisor or designee will arrange for a confidential medical evaluation and follow-up including: 1. Documentation of the route of exposure and the circumstances related to the incident. 2. Identification and documentation of the source individual if feasible unless school medical advisor can establish that identification is infeasible or prohibited by state law. a. Source individual's blood will be tested as soon as feasible after consent is obtained, for HIV/HBV infectivity, unless source is a known carrier. If consent is not obtained, school medical advisor shall establish that legally obtained consent cannot be obtained. b. Results of the source individual's testing shall be made available to the exposed employee, and the employee shall be informed of applicable laws and regulations concerning disclosure of the identity and infectious state of the source individual. Minor students/clients' parents/guardians must be contacted and advised of the incident and their options. They should be encouraged to contact their own primary health care provider prior to giving consent for testing or disclosure. 3. Blood Collection a. The exposed employee's blood shall be collected as soon as feasible by an accredited laboratory and tested after consent is obtained. b. If the employee consents to collection but does not give consent for HIV serological testing, the sample shall be preserved for at least 90 days by the laboratory. If within the

17 Page days, the employee elects to have the baseline sample tested, such testing will be done as soon as feasible. c. Post exposure prophylaxis, when medically indicated, as recommended by the U.S. Public Health Service. d. Appropriate counseling concerning precautions to take place during the period after the exposure incident. e. Information for the employee on what potential illnesses to be alert for and to report any related experiences to appropriate personnel. Information for Health Care Professionals. District employees will insure that the health care professional evaluating an employee after an exposure incident is provided the following information: - A copy of the regulations. - A description of the exposed employee's duties as they relate to the exposure incident. - Documentation of the route(s) of exposure and circumstances under which exposure occurred. - Results of the source individual's blood testing, if available. - All medical records relevant to the appropriate treatment of the employee including vaccination status which is the district's responsibility to maintain. Health Care Professional's Written Opinion. Employees will obtain a copy of the health care professional's written opinion when an employee goes for hepatitis B vaccination or following an exposure incident. If the latter occurs, the district will provide the employee with a copy of the evaluating health care professional's written opinion within 15 days of the completion of the evaluation. Written opinion will be limited to: - Is hepatitis B vaccine indicated and has it been given to the employee? - Has the employee been informed of the results of the evaluation? - Has the employee been told about any medical condition resulting from exposure to blood or other potentially infectious materials which require further evaluation or treatment? All other findings or diagnosis shall remain confidential between the health care professional and district employee and shall not be included in the written report. Record Keeping The superintendent of schools will establish and maintain an accurate separate record for each employee with occupational exposure in accordance with 29CFR This record will include:

18 Page The name and social security number of the employee. 2. Hepatitis B Vaccine Declination. 3. A copy of the employee's hepatitis B vaccination status including the dates of all of the hepatitis B vaccinations and any medical records relative to the employee's ability to receive vaccination. 4. A copy of all results of examinations, medical testing and follow-up procedures required by these guidelines. 5. The employer's copy of the health care professional's written opinion as required by these guidelines. 6. A copy of the information provided to the health care professional as required in these guidelines. Confidentiality. District administrators and health personnel will ensure that the above medical records are: - Kept confidential. - Not disclosed or reported without the employee's expressed written consent to any person within or outside the workplace except as required by this standard or as may be required by law. - Kept separate from the personnel record. - Provided upon request for examination and copying to the subject employee, to anyone having written consent of the subject employee or to OSHA designees. - Maintained for at least the duration of employment plus 30 years. Training. District employees shall ensure that all employees with occupational exposure participate in a training program at the time of initial assignment to tasks where occupational exposure may take place; when changes such as modification of tasks or procedures are implemented or institution of new tasks or procedures affect the employee's occupations exposure, and updated annually thereafter. A record of each training session will be filed in the Personnel Department. District employees occupationally at risk will receive a training program which will include: Modes of transmission of AIDS and Hepatitis B viruses; instructions on types of protective clothing and equipment generally appropriate for employees, as well as instructions on the basis for selecting the clothing and equipment; instructions on the actions to take and persons to contact if exposure has occurred; instructions on the requirements for work practices and protective equipment for each task they may perform; instructions on where protective clothing and equipment is kept; how to use it; and how to remove, handle, decontaminate, and dispose of contaminated clothing or equipment; and instructions on the limitation of protective clothing and equipment.

19 Page 12 Legal Reference: "Education for Children with Disabilities", 20 U.S.C. 1400, et seq. Section 505 of the Rehabilitation Act of 1973, 29 U.S.C. 706(7)(b) "Americans with Disabilities Act" The Family Educational Rights and Privacy Act of 1974,(FERPA), 20 U.S.C. 1232g, 45 C.F.R. 99 Connecticut General Statutes 10-76(d)(15) Duties and powers of boards of education to provide special education programs and services a Professional communications between teacher or nurse and student Duties of medical advisors Records not to be public Notice of disease to be given parent or guardian. 19a-221 Quarantine of certain persons. 19a AIDS testing and medical information. Regulation GUILFORD PUBLIC SCHOOLS adopted: July 1, 1998 Guilford, Connecticut

20 Page 13 Administering Medications to Students 5514 Policy Medications shall be administered in the schools only when it is not possible to achieve the desired effects by home administration during other than school hours and only upon written authorization of the attending physician, dentist, advanced practice registered nurse or nurse anesthetist, or licensed physician assistant and written authorization of the parent or guardian. Personnel authorized to administer medications shall be limited to the School District Medical Advisor (M.D.), a school nurse (RN), a Licensed Practical Nurse (L.P.N.), or licensed athletic trainers employed by the district if approved to do so by the School District Medical Advisor or school nurse. In the absence of these medical personnel, the Principal or a teacher designated by the Principal or a licensed physical or occupational therapist employed by the District, in writing shall be permitted to administer authorized medications upon completion of training in the safe administration of medications and be familiar with policy and regulations relating thereto. Coaches are also authorized to administer medication to students participating in intramural and interscholastic athletics, pursuant to the regulations of the State Board of Education. School Health Aides are not allowed to administer medications. In an emergency, if the student s physician or the School District Medical Advisor is not immediately available, any physician (M.D.) may be called to take appropriate emergency measures. A child with diabetes may test his/her own blood glucose level per the written order of a physician or advanced practice nurse stating the need and the capacity of such child to conduct self-testing. Such self-testing shall be pursuant to guidelines promulgated by the Commissioner of Education. Students may carry and self-administer medications, provided that: 1. A physician, dentist, advanced practice registered nurse or nurse anesthetist, or licensed physician assistant provides written orders for self-administration of medication; 2. There is written authorization for self-administration of medication from the student s parent or guardian; 3. The school nurse has evaluated the situation and deemed it to be safe and appropriate; has documented this on the student s cumulative health record; and has developed a plan of storage and supervision of such self-medication; 4. The student and school nurse have developed a plan for reporting and supervising selfadministration of medications by students and teacher notification; 5. The principal and appropriate teachers are informed that the student is carrying and/or selfadministering medication; 6. Medication is transported and maintained under student control according to individual student plans.

21 Page 14 Authorized medications may be administered during school activities as well as during school hours. A specific paraprofessional, through a plan approved by a school nurse supervisor and school medical advisor, may be designated to administer medication, including medication administered with a cartridge injector, to a particular student diagnosed with an allergy that may require prompt treatment to avoid serious harm or death. The approved plan also requires the written authorization of the student s parent/guardian and be pursuant to the written order from the student s doctor or APRN or physician assistant licensed to prescribe medication. In compliance with all applicable state statutes and regulations, parents/guardians may administer medications to their own children on school grounds. The Board of Education with the advice and assistance of the School District Medical Advisor and the Health Services Coordinator, shall review and revise this policy, and its attendant regulation, as necessary and at least biennially and submit it to the Department of Public Health as required by Regulations of the Connecticut Department of Public Health. Each school wherein any controlled drug is administered under the provisions of this policy shall maintain such records as are required of hospitals under the provisions of subsections (f) and (h) of section 21a-254 and shall store such drug in such a manner as the Commissioner of Public Health shall, by regulation, require. (cf Student Safety) (cf Suicide Prevention and Intervention) (cf Child Abuse) (cf Student Health Services) (cf School District Medical Advisor) (cf Student Medical Care at School) (cf Health Records) (cf Regular Health Assessments) (cf Interscholastic Sports/Health Assessment/Student Monitoring) (cf Vision Screening) (cf Hearing Screening) (cf Scoliosis Screening) (cf Bloodborne Pathogens) (cf Tuberculin Testing) Legal Reference: Connecticut General Statutes a Administration of medicines by school personnel (as amended by PA 99-2, PA 01-1 of Special Session and A ) b Immunity from liability for emergency medical assistance, first aid or medication by injection. School personnel not required to administer or render d Medical functions performed by physician assistants. Prescription authority a Licensure as advanced practice registered nurse. Connecticut Regulations of State Agencies a-1 through a-7

22 Page 15 P.A An Act Concerning the Provision of Medical Care for Students Health Care Needs P.A An Act Concerning the Use of Asthmatic Inhalers and Epinephrine Auto-Injectors While at School Policy GUILFORD PUBLIC SCHOOLS adopted: May 26, 1998 Guilford, Connecticut approved: May 22, 2000, June 10, 2002 revised: June 14, 2004 Reviewed: June 18, 2007 Reviewed: September 22, 2008 Approved: November 3, 2008 Reviewed: September 29, 2009 Approved: November 9, 2009

23 Page 16 Administering Medications to Students 5514 Regulation The Board of Education allows students to self-administer medication and school personnel to administer medication to students in accordance with the following established procedures. These procedures shall be reviewed and/or revised by the school medical advisor, the school nurse and the board of education and then submitted to the Connecticut Department of Public Health biennially as stipulated in C.G.S a-1 to A student requiring any medication during school hours must provide the following: 1. The licensed physician's or dentist's orders for medication on a school district form which specifies the student's name, condition for which the drug is being administered, name of drug and method of administration and dosage of drug. For students receiving medicine, the time of administration and duration of the order, side effects to be observed (if any) and management of such effects, and student allergies to food and/or medicine is also required on the form. This medical order must be renewed yearly if a student is to be administered medication by school personnel. 2. Written authorization from his or her parent or guardian allowing school personnel to administer said medication. This authorization shall be renewed yearly and shall include parental consent for school personnel to destroy said medication if not repossessed by the parent or guardian within a seven (7) day period of notification by school authorities. Unless otherwise directed by a physician, the parent or guardian must confirm that they have given at least one dose of the medication without any evidence of side effects or adverse reactions. 3. The medication must have its original correct label from the pharmacy or manufacturer. Students who are able to self administer medication may do so provided: 1. A physician or dentist provides a written order for self-administration of said medication. 2. There is written authorization for self-administration of medication from the student's parent or guardian. 3. The school nurse has evaluated the situation and deemed it to be safe and appropriate; has documented this on the student's cumulative health record, and has developed a plan for general supervision. 4. The student and school nurse have developed a plan for reporting and supervision of selfadministration and notification of teachers. 5. The principal and appropriate teachers are informed that the student is self-carrying or selfadministering medication.

24 Page Such medication is transported to the school and maintained under the student's control within these guidelines. Medication may be administered by a licensed nurse, or in absence of such licensed personnel, principals and teachers. They shall not be held liable for any personal injuries which may result from acts or omissions constituting ordinary negligence. A licensed practical nurse may administer medications to students if she can demonstrate evidence of one of the following: 1. Training in administration of medications as part of their basic nursing program; 2. Successful completion of a pharmacology course and subsequent supervised experience; 3. Supervised experience in medication administration while employed in a health care facility. Medication will be administered according to the following procedures: 1. The school nurse will develop a medication administration plan for each student before medication may be administered by any staff member. The school nurse will also review monthly all documentation pertaining to the administration of medication for students. 2. Principals, teachers, coaches, physical and occupational therapists approved by the school medical advisor and school nurse will be formally trained by the school nurse prior to administering medication. The school nurse, under the direction of the chief medical officer, will annually instruct school district staff members in the administration of medication, including A. Review of state statute and school regulations regarding administration of medication by school personnel. B. Procedure for administering the medication, safe handling and storage of medication, and recording. C. Medication needs of specific students, medication idiosyncrasies, desired effects, potential side effects, reactions and other observations. 3. A current list of principals and teachers successfully trained and approved to administer medication along with documentation of the annual update of trainees shall be maintained in the school and submitted to the superintendent by the nursing supervisor by October 31 of each year. 4. Coaches are also authorized to administer medication to students participating in intramural and interscholastic athletics per the regulations promulgated by the State Board of Education.

25 Page 18 A child with diabetes may test his/her own blood glucose level per the written order of a physician or advanced practice nurse stating the need and the capacity of such child to conduct self-testing. Such self-testing shall be pursuant to guidelines promulgated by the Commissioner of Education. A specific paraprofessional, through a plan approved the Health Services Coordinator and School Medical Advisor, may be designed to administer medication, including medication administered with a cartridge injector, to a particular student diagnosed with an allergy that may require prompt treatment to avoid serious harm or death. The approved plan also requires the written authorization of the student s parent/guardian and be pursuant to the written order from the student s doctor or APRN or physician assistant licensed to prescribe medication. Handling and Storage of Medications. All medication, except those approved for keeping by students for self-medication, must be delivered by the parent or other responsible adult and shall be received by the nurse assigned to the school. The school nurse must: A. Examine any new medication to insure that it shall be properly labeled with dates, name of student, medication name, dosage and physician's name, and that the medication order and permission form are complete and appropriate. B. Develop a medication administration plan for the student before any medication is given by school personnel. C. Record on the Student's Individual Medication Record the date the medication is delivered and the amount of medication received. D. Store medication requiring refrigeration at 36 F - 46 F. E. Store prescribed medications in a securely locked storage compartment. Controlled substances shall be contained in separate compartments, secured and locked at all times. In the absence of the school nurse or nurse substitute, the school principal or designee, who has been trained to administer medication, shall be responsible for the key/s to the locked cabinet/s. No more than a forty-five (45) school day supply of a medication for a student shall be stored at the school. All medications, prescriptions and nonprescription, shall be stored in their original containers and in such a manner as to render them safe and effective. Access to all stored medications shall be limited to persons authorized to administer medications. Each school shall maintain a current list of those persons authorized to administer medications. Destruction/Disposal of Medication. At the end of the school year or whenever a student's medication is discontinued by the prescribing physician, the parent or guardian is to be contacted and requested to repossess the unused medication within a seven (7) school day period. If the parent does not comply with this request, all medication is to be destroyed by the school nurse in the presence of witness (school physician, principal, teacher) according to the following procedures:

26 Page Medication will be destroyed in a nonrecoverable fashion. A. Liquid medication should be poured into a sink or water closet. B. Any medication in pill or tablet form should be crushed and poured into a sink or water closet. 2. The following information is to be charted on the student's health folder and signed by the school nurse and witness: A. Date of destruction. B. Time of destruction. C. Name, strength, form and quantity of medication destroyed. D. Manner of destruction of medication. 3. Controlled substances shall not be destroyed by the school nurse. In the event that any controlled substance remains unclaimed, the Health Services Coordinator shall contact the Connecticut Commissioner of Consumer Protection to arrange for proper disposition. A medication administration record shall include the: A. Name of the student; B. Name of medication; C. Dosage of medication; D. Route of administration; E. Frequency of administration; F. Name of prescribing physician or, in the case of ibuprofen or acetaminophen in grades 7-12 being given to a student, the name of the parent/guardian authorizing the medication be given; G. Date medication was ordered; H. Quantity received; I. Date medication is to be reordered; J. Student allergies to food and/or medicine;

27 Page 20 K. Date and time of administration or omission including reason for omission; L. Dose or amount administered; M. Full legal signature of the nurse (RN), principal, or teacher administering the medication. A record of the medication administered shall be entered in ink on an individual student medication record form and filed in the student's cumulative health folder. If the student is absent, it shall be so recorded. If an error is made in recording, a single line shall be run through the error and initialed. A physician's verbal order, including a telephone order, for a change in any medication may be received only by a school nurse. Such verbal order must be followed by a written order within three (3) school days. 1. Reactions to medication shall be reported to the school nurse, the parent, and the student's physician. 2. Records of controlled substances shall be entered in the same manner as other medications with the following additions: A. The amount of controlled drug shall be counted and recorded on the individual student medication record form after each dose given. B. A true copy (carbon or NCR) of the forms shall be retained by the school for 3 years and the original filed in the student's permanent health record. C. Loss, theft or destruction of controlled substances shall be immediately, upon discovery, reported to the Health Services Coordinator who will contact the Connecticut Commissioner of Consumer Protection. In the absence of a licensed nurse, only principals and teachers who have been properly trained may administer medication to student. Principals and teachers may administer oral, topical, or inhalant medications. Injectable medications may be administered by a principal or teacher only to a student with a medically diagnosed allergic condition which may require prompt treatment to protect the student against serious harm or death. Investigational drugs may not be administered by principals or teachers. Medication Errors. An error in the administration of medication shall be reported immediately to the school nurse, the parent and the prescribing physician. The school nurse will initiate appropriate action and documentation in a student incident report in the student s cumulative health record. In case of an anaphylactic reaction or the risk of such reaction, a school nurse or any other person trained in CPR and First Aid, may administer emergency injectable and/or oral medication to any

28 Page 21 student in need thereof on the school grounds, in the school building, or at a school function according to the standing order of the chief medical advisor or the student's private physician. Administration of Emergency Medication under CGS a. In the absence of a school nurse, the administrator or teacher may give emergency medication by injection or orally to students with a medically diagnosed allergic condition which would require such prompt treatment to protect the child from serious harm or death so long as the administrator or teacher has completed training in administration of such medication. In the event of a medication emergency, the following will be readily available: A. 911 B. The name of the person responsible for the decision-making in the absence of the school nurse; C. The physician, clinic or emergency room to be contacted in such an emergency; D. The local poison information center. Legal Reference: Connecticut General Statutes a Administration of medicines by school personnel. (as amended by P.A ) b Immunity from liability for emergency medical assistance first aid or medication by injection. School personnel not required to administer or render. Connecticut Regulations of State Agencies a a-7 Administration of medicines by school personnel Code of Federal Regulation P.A An Act Concerning the Provisions of Medical Care for Student s Health Care Needs. Regulation GUILFORD PUBLIC SCHOOLS adopted: May 26, 1998 Guilford, Connecticut approved: May 22, 2000; June 10, 2002 revised: June 14, 2004 Reviewed: June 18, 2007 Reviewed: October 27, 2008 Approved: December 8, 2008

29 Page Policy Animals In the Schools In general, the presence of animals in the schools is discouraged. Only when there is a direct connection to the curriculum should animals be permitted. Conditions under which animals will be allowed will follow guidelines established in conjunction with the Guilford Public Schools Medical Advisor: Parents/guardians will request permission of the principal for an animal to be brought into the classroom or onto school grounds. Parents/guardians will be notified by the teacher prior to an animal being brought into the classroom. Accommodations will be made for students and staff who are allergic to animals. To avoid potential salmonella infection, only small mammals such as rabbits and guinea pigs in cages, or baby chicks kept in cages, or reptiles contained in glass cages with no touching allowed will be permitted. Working service animals will be allowed per State and Federal guidelines. Their presence must not interfere with the orderly operations of the building. The following animals will not be allowed in school buildings, but will be allowed on school grounds with appropriate supervision: farm animals, dogs, cats, ferrets, horses, cattle and sheep. Proper evidence of rabies immunization must be provided for any animal brought onto school grounds or into the buildings when state regulations require such immunization for the class of animals. All students and staff must wash their hands before and after contact with any animal. Legal References: Connecticut General Statutes Boards of education to prescribe rules, policies and procedures. 46a-42 Mobility impaired person 46a-44 through 46a-64 Public accommodations and transportation, admittance to. (Access of guide and assistance dogs to modes of public transportation and in places of public accommodation. Section 504 and the Federal Vocational Rehabilitation Act of 1973, 20 U.S.C. 706(7)(b) American Disability Act of 1989 Policy GUILFORD PUBLIC SCHOOLS Adopted: June 12, 2000 Guilford, Connecticut Reviewed: June 18, 2007 Reviewed: November 23, 2009 Approved: December 14, 2009