The Vance County Board of Education tonight will consider the first of what will be a series of health-related policy revisions.
“You’re going to begin to see a series of items related to health care because they need reviewing,” Marty Smith, the school system’s director of strategic planning, told the school board’s Policy Committee at its monthly meeting April 20.
The changes to the policy on the administration of medication during school hours are so extensive, Smith said, that she rewrote the policy from scratch instead of indicating the changes by striking through outdated sections.
Sherri Baker, the school system’s head nurse, explained that the biggest change in the policy is that it now makes a distinction between long-term medication and short-term medication. The latter applies for medicine that is given for no more than 10 days.
The key difference for short-term medication is that a prescription bottle can serve as a replacement for a physician’s signature on a consent form.
“We also had to address some other issues with regard to explaining to parents,” Baker said.
The new policy breaks out special procedures for self-medication, which apply when a student needs to carry emergency treatment for a permanent condition such as asthma or diabetes or a severe allergy. It does not cover something like aspirin for a student who battles headaches.
The existing policy bans any self-medication by students, but Baker said some emergencies make the time required to get to a central medicine cabinet life-threatening.
To get permission to carry something like insulin or epinephrine for emergencies, a student must submit annual written requests from a health care provider and a parent; must pass a review of the request by the school nurse; must go through health counseling with the school nurse, including the consequences for sharing the medication with other students; and must sign a self-medication contract with the nurse. The student’s teacher will get a copy of the student’s health plan “as confidentiality permits” and may be asked for feedback on the student’s ability to responsibly carry medicine at all times.
Ability, not age, is the key to getting permission for self-medication, Baker said. “We have some children as young as 5 that have had a condition long enough that you might feel comfortable with, whereas I have some 12-year-olds that I wouldn’t let carry an inhaler.”
Medications that aren’t approved for self-administration must be kept in a locked, secure location and must be administered by trained personnel only. Each school will put designated staffers through annual training on giving medication to students.
“We’re probably not giving as much medicine as we once did,” Baker said, largely because more medications are being given once a day before school.
The policy includes nonprescription medication, such as Tylenol and Motrin. Parents and physicians must sign consent forms annually for the use of nonprescription medicines as well as prescriptions. In either case, the medicine must be kept in the locked, secure location, and the student must go through the office or the school nurse to get the medicine.
A parent may not give permission over the phone for a child to take an aspirin, nor may a student keep his or her own aspirin for use when needed.
The penalties for taking medication without following the policy are covered under student disciplinary policies.
Policy Committee members Gloria White and Robert Duke supported the policy changes, even though White expressed doubts about the need to control the use of aspirin.
“It’s pretty straightforward,” Duke said.
Also straightforward is a new policy that is up for first reading before the Board of Education tonight. The policy on the use and disclosure of health information is a response to the privacy standards that have resulted from the federal Health Insurance Portability and Accountability Act of 1996.
The policy asks parents to sign a release allowing school personnel to share health information with anyone in the school system who will provide care or otherwise has a need to know. “The use and disclosure of this information … is sometimes essential within the school setting to obtain necessary accommodations for the student during school hours,” the policy reads.
White requested that Baker and Smith prepare a list of accompanying procedures that spell out to parents when the health information might be shared.
The Policy Committee reviewed such a set of procedures for a separate policy April 20: the maintenance and disposal of items that are worth less than $5,000. Duke wanted to ensure that the school board receives a semiannual accounting of the sale of assets worth $500 to $5,000.
The committee forwarded those procedures to the school board, but no action will be required.
In a final matter, the Policy Committee reviewed a one-page policy on staff-student relations and sent it to the Personnel Committee for further review.
The policy is clear: “All employees, except student employees, are prohibited from dating, courting or entering into a romantic or sexual relationship with any student enrolled in the school district regardless of the student’s age. Employees engaging in such inappropriate conduct will be subject to disciplinary action, up to and including dismissal, and may be subject to criminal action.”
Employees also may be fired if they suspect a colleague of such an inappropriate relationship but fail to report it.
Smith said there’s currently one line in the employee handbook’s ethics section that covers student-employee relationships. The proposed policy, recommended by state School Boards Association, breaks out and clarifies the no-tolerance policy for such relationships.
“This is basically a common-sense thing,” Superintendent Norm Shearin said.