Cobb County School District Administrative Rules
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Student Welfare: School Health Services
(See Form JLC-1, 2, 3, 4, 5, 6, 7 & 8)
JLC 3/14/07

RATIONALE/OBJECTIVE:

The Cobb County School District (District) recognizes the importance of the health and welfare of students and staff. Therefore, the District establishes a school health service program to address the health and safety of students and staff.

RULE:

All school nurses and Trained Personnel shall follow procedures and recommendations in “School Nursing/Clinic Procedures” (Form JLCD-1).

A. HEALTH CLINIC:
    1. Each school shall maintain a dedicated room, clinic, for student health care which will
        provide a private and confidential environment to care for sick/injured students. The
        dedicated room shall contain the clinic supplies and equipment necessary to meet the
        health care needs of students and as listed in the “CLINIC SUPPLIES AND EQUIPMENT
        CHECKLIST” (Form JLC-1).
    2. School nurses shall maintain a record of emergency information on all students.
    3. School nurses and Trained Personnel will not:
        a. Perform invasive procedures such as probing in the eyes, ears, nose, throat, or
            skin.
        b. Diagnose or prescribe treatment or medication.
        c. Transport students.
        d. Open or treat abscesses.
        e. Pull loose teeth.
        f. Remove or replace body jewelry (e.g., pierced earrings)
        g. Allow any unauthorized person to make a list of names from clinic
            cards/information.
        h. Examine intimate body parts of a student without the presence of two
           administrators or other designated employees who, if possible, must be the same
           gender as the student. Intimate body parts include the primary genital area, anus,
           groin, inner thighs, or buttocks of a male or female and the breast of a female.
           This includes cleaning or changing a student’s clothing.

B. HEALTH CARE SERVICE:
    1. Health Care Service, including the dissemination of medications, are provided by a
        licensed school nurse or other employee who has successfully completed clinic
        orientation training provided by the District’s Consulting Nurses (Trained Personnel)
        or school employees trained and authorized by the District’s county-wide Special
        Education Nurses in accordance with Administrative Rule JLCD (Medication).
    2. Standard precautions are based on the premise that anyone may potentially transmit
        an infection. Standard precautions and infectious control techniques should be used
        in all situations that have the potential to present a hazard for infectious materials.
        See “STANDARD HEALTH CARE PRECAUTIONS” (Form JLC-2) and “EXPOSURE TO
        BLOOD/BODY FLUIDS RESPONSE PROCEDURES “(Form JLC-3).
    3. Accidental exposure to blood, body products or body fluids places the exposed
        individual at risk of infection. The risk varies depending upon the type of body fluid
        and/or infection as well as the condition of the skin that is contaminated. Use
        protective barriers such as gloves, robes and eye/face protection greatly reduces an
        individual’s risk of exposure. If an exposure occurs, refer immediately to “EXPOSURE
        TO BLOOD/BODY FLUIDS RESPONSE PROCEDURES” (Form JLC-3).
    4. School staff who have knowledge of a blood-borne infection of others in the school
        are not at liberty to share that information with others without written consent.

C. IMMUNIZATIONS:
The District recognizes the importance of protecting the health and welfare of students and staff from the spread of communicable diseases. The District, Cobb and Douglas Public Health, and/or the Georgia Department of Human Resources has the authority to require immunizations or other preventive measures including quarantine, isolation and segregation of persons with communicable diseases or conditions likely to endanger the health of others. These agencies may require quarantine or surveillance of carriers of diseases and persons exposed to or suspected of being infected with infectious diseases during such period until they are found free of the infectious agent or disease.
    1. All students, prior to entering school in the District, shall be required to present
        certification of immunization to the proper school officials in compliance with all state
        and local regulations [O.C.G.A. § 20-2-771(b)]:
        a. Students who are not eligible for adequate immunization certificates must begin
            the necessary series of immunizations pursuant to O.C.G.A 20-2-771 (b) and
            Department of Human Resources Rule 290-5-4-.02.
        b. If a parent/guardian objects to immunizations on the grounds of conflict with
            religious principles/practices, he/she may complete a waiver (Form JLC-4; See also
            Administrative Rule JLCB [Admissions/Withdrawals]). The school must keep the
            waiver on file and available for inspection by health officials in lieu of an
            immunization certificate. The waiver may be canceled and the student withdrawn
            at the discretion of the appropriate health authority when the threat of epidemic
            disease in the community makes such action appropriate:
            (1) Religious Exemptions: The school must keep the affidavit on file and available
                 for inspection by health officials in lieu of an Immunization Certificate.
                 Affidavits denoting religious exemptions do not expire.
            (2) Medical Exemptions: There must be an annual review of medical exemptions,
                 and certificates must be reissued with or without indication of exemption.
        c. If a student has a physical disability and if, in the opinion of a licensed physician,
            there is no clear prospect of when the student’s disability or disabilities can be
            removed, at his/her discretion the licensed physician may issue a Certificate of
            Immunization indicating medical exemption. A Certificate of Immunization
            indicating medical exemption shall be subject to review as provided by the
            certifying or another licensed physician. The licensed physician must conduct an
            annual review of the exemption and subsequently may reissue it from year to year
            until and unless there is cause to believe that immunization or a specific
            immunization may finally be accomplished without danger to the student’s health.

D. MEDICAL INFORMATION REPORT:
The District may request the submission of Form JLC-8 (Medical Evaluation Report) in order to provide the District with some of the medical information necessary to determine: 
1. A student’s eligibility as a child with a disability for special education services or
    Section 504 accommodations;

2. A student’s medically necessary nutritional needs/accommodations; and/or,

3. Any services to be provided or made available by school nursing staff. (For some

    students, more detailed doctors’ orders may be necessary)

E. ILLNESS/INJURY:
    1. Sick or injured individuals will be cared for per standard First Aid guidelines:
    2. All students who show definite signs of illness or injury shall be sent home. If a
        contagious disease is suspected, students awaiting parent/guardian arrival shall be
        separated from other students when possible.
    3. The District shall not deny a student with a communicable disease an education solely
        because of the infection. If there is a reasonable cause to believe that a student has
        a communicable disease, the determination of a student’s inclusion/exclusion shall be
        based on reasonable medical judgment. See “INCLUSION/EXCLUSION OF STUDENTS
        WITH POSSIBLE COMMUNICABLE DISEASE” (Form JLC-5).
    4. The School Nurse, Principal or designee shall determine whether or not the student
        will be allowed to stay in school due to certain injuries or possible illnesses, see
        “PROCEDURES WHEN STUDENTS SHOW SIGNS OF ILLNESS OR INJURY”
        (Form JLC-6).

F. EMERGENCY MEDICAL SERVICES (EMS)/911:
The school Emergency Medical Plan should include actions to be taken in medical emergencies and should be activated in the event of a medical emergency. Additionally:
    1. It is the school nurse’s decision as to when EMS/911 is to be notified and what
        information is to be given concerning the condition of the individual.
    2. When the school nurse is not on the premises, the administrator in charge makes the
        decision to initiate the emergency management plan.
    3. When EMS personnel arrive they assume full responsibility for the care of the
        individual(s).
    4. Parents/guardians are responsible for any charges that arise as a result of the
        involvement of Emergency Medical Services.
    5. Do not leave the child unattended.
    6. A parent/guardian and, if necessary, the student’s emergency contacts should be
        notified as soon as possible.

F. SPECIAL EDUCATION NURSING SERVICES:
Personnel who are responsible for the education and care of disabled children with special health care needs must receive training from persons who are qualified to provide such training and licensed to perform the procedure being taught. Staff training should be updated annually or as needed due to a change in a student's medical condition or a change in the staff working with the student.

Adopted: 10/12/05
Revised: 3/14/07