The Little Rock School District Health Services is available to support health care in the educational setting as necessary. The school nurse and health services director are responsible for the following:

• Hearing and Vision Screenings for K, 1,2,4,6 and 8

• Height and Weight for all K, 2nd, 4th, 6th, 8th and 10th grades

• Scoliosis for 6th grade girls and 6th and 8th grade boys and girls

• Dental and Blood Pressure

• Enforcing the Arkansas Department of Health Policies and Procedures

• Training staff in first aid, ADE and CPR, Bleeding Control Measures

• Maintaining a confidential school health record on each student

A third party Billing Agent will be used to collect funds for vision and hearing screening services. Students name and date of screening will be disclosed to this agent. Parents must notify the school nurse if they do not approve of this Health Insurance billing and disclosure.

Definitions

“In process” means the student has received at least one dose of the required immunizations and is waiting the minimum time interval to receive the additional dose(s).

“Serologic testing” refers to a medical procedure used to determine an individual’s immunity to Hepatitis B, Measles, Mumps, Rubella and Varicella.

General Requirements

In compliance with the Family Education Right to Privacy Act (FERPA) (20 U.S.C. 1232g;34 CFR Part99), In order for a student to participate in any School Immunization Clinic, the appropriate health entity consent forms must be signed by a parent or guardian before vaccination(s) will be administered.

Unless otherwise provided by law or this policy, no student shall be admitted to attend classes in the District who has not been age appropriately immunized against1:

1. Poliomyelitis;

2. Diphtheria;

3. Tetanus;

4. Pertussis;

5. Red (rubella) measles;

6. Rubella;

7. Mumps;

8. Hepatitis A;

9. Hepatitis B;

10. Meningococcal disease;

11. Varicella (chickenpox); and

12. Any other immunization required by the Arkansas Department of Health (ADH).

The District administration has the responsibility to evaluate the immunization status of District students. The District shall maintain a list of all students who are not age-appropriately immunized or who have an exemption provided by ADH to the immunization requirements based on medical, religious, or philosophical grounds. Students who are not age-appropriately immunized when seeking admittance shall be referred to a medical authority for consultation.

The only types of proof of immunization the District will accept are immunization records provided by a:

A.        Licensed physician;

B.        Health department;

C.        Military service; or

D.        Official record from another educational institution in Arkansas.; or

E.        Immunization record from the statewide registry with the Official Seal of the State of Arkansas.

The proof of immunization must include the vaccine type and dates of vaccine administration. Documents stating “up-to-date”, “complete”, “adequate”, and the like will not be accepted as proof of immunization. No self or parental history of varicella disease will be accepted, as a history of varicella disease must be documented by a licensed physician, advanced practice nurse, doctor of osteopathy, or physician assistant. Valid proof of immunization and of immunity based on serological testing shall be entered into the student’s record. 

In order to continue attending classes in the District, the student must have submitted:

1. Proof of immunization showing the student to be age-appropriately vaccinated;

2. Written documentation by a public health nurse or private physician of proof the student is in process of being age appropriately immunized, which includes a schedule of the student’s next immunization;

3. A copy of a letter from ADH indicating immunity based on serologic testing; and/or

4. A copy of the letter from ADH exempting the student from the immunization requirements for the current school year, or a copy of the application for an exemption for the current school year if the exemption letter has not yet arrived.

Students whose immunization records or serology results are lost or unavailable are required to receive all age appropriate vaccinations or submit number 4 above.

While students who are not fully immunized or have not yet submitted an immunization waiver may be enrolled to attend school, such students shall be allowed to attend school on a temporary basis only. Students admitted on a temporary basis may be admitted for a maximum of thirty (30) days (or until October 1st of the current school year for the tetanus, diphtheria, pertussis, and meningococcal vaccinations required at ages eleven (11) and sixteen (16) respectively if October 1st is later in the current school year than the thirty (30) days following the student’s admittance). No student shall be withdrawn and readmitted in order to extend the thirty (30) day period. Students may be allowed to continue attending beyond the thirty (30) day period if the student submits a copy of either number 2 or number 4 above.

Students who are in process shall be required to adhere to the submitted schedule. Failure of the student to submit written documentation from a public health nurse or private physician demonstrating the student received the vaccinations set forth in the schedule may lead to the revocation of the student’s temporary admittance; such students shall be excluded from school until the documentation is provided.

The District will not accept copies of applications requesting an exemption for the current school year that are older than two (2) weeks based on the date on the application.  Students who submit a copy of an application to receive an exemption from the immunization requirements for the current year to gain temporary admittance have thirty (30) days from the admission date to submit either a letter from ADH granting the exemption or documentation demonstrating the student is in process and a copy of the immunization schedule. Failure to submit the necessary documentation by the close of the thirty (30) days will result in the student being excluded until the documentation is submitted.

In the event of an outbreak, students who are not fully age appropriately immunized, are in process, or are exempt from the immunization requirements may be required to be excluded from school in order to protect the student. ADH shall determine if it is necessary for students to be excluded in the event of an outbreak. Students may be excluded for no fewer than twenty-one (21) days or even longer depending on the outbreak. No student excluded due to an outbreak shall be allowed to return to school until the District receives approval from ADH.

Students who are excluded from school are not eligible to receive homebound instruction unless the excluded student had a pre-existing IEP or 504 Plan and the IEP/504 team determines homebound instruction to be in the best interest of the student. To the extent possible, the student’s teacher(s) shall place in the principal’s office a copy of the student’s assignments:

• for the remainder of the week by the end of the initial school day of the student's exclusion; and

• by the end of each school's calendar week for the upcoming week until the student returns to school.2

It is the responsibility of the student or the student’s parent/legal guardian to make sure that the student’s assignments are collected.

Students excluded from school shall have five (5) school days from the day the student returns to school to submit any homework and to make up any examinations. State-mandated assessments are not included in “examinations” and the District has no control over administering state-mandated make-up assessments outside of the state's schedule. Students shall receive a grade of zero for any assignment or examination not completed or submitted on time.3

Annually by December 1, the District shall create, maintain, and post to the District’s website a report that includes the following for each disease requiring immunization under this policy:

• The number of students in the District that were granted an exemption by the Department of Health from an immunization;

• The percentage of students in the District that were granted an exemption by the Department of Health from an immunization;

• The number of students within the District who have failed to provide to the public school proof of the vaccinations required and have not obtained an exemption from ADH;

• The percentage of students within the District who have failed to provide to the public school proof of the vaccinations required and have not obtained an exemption from ADH; and

• The percentage of a population that must receive an immunization for herd immunity to exist.

Cross References:

ENTRANCE REQUIREMENTS

ABSENCES

MAKE-UP WORK

COMMUNICABLE DISEASES AND PARASITES

Legal References:

A.C.A. § 6-18-702

DESE Rules Governing Immunization Requirements in Arkansas Public Schools

ADH Rules Pertaining to Immunization Requirements 

Date Adopted: August 27, 2017

Last Revised:  September 27, 2019

Prior to the administration of any medication, including any dietary supplement or other perceived health remedy not regulated by the US Food and Drug Administration, to any student under the age of eighteen (18), written parental consent is required. The consent form shall include authorization to administer the medication and relieve the Board and its employees of civil liability for damages or injuries resulting from the administration of medication to students in accordance with this policy. All signed medication consent forms are to be maintained by the school nurse.

Unless authorized to self-administer or otherwise authorized by this policy, students are not allowed to carry any medications, including over-the-counter (OTC) medications or any dietary supplement or other perceived health remedy not regulated by the US Food and Drug Administration while at school. The parent or legal guardian shall bring the student’s medication to the school nurse. When medications are brought to the school nurse, the nurse shall document, in the presence of the parent, the quantity of the medication(s). If the medications are brought by a student, the school nurse shall ask another school employee to verify, in the presence of the student, the quantity of the medication(s). Each person present shall sign a form verifying the quantity of the medication(s).

Medications, including those for self-administration, must be in the original container and be properly labeled with the student’s name, the ordering provider’s name, the name of the medication, the dosage, frequency, and instructions for the administration of the medication (including times). Additional information accompanying the medication shall state the purpose for the medication, its possible side effects, and any other pertinent instructions (such as special storage requirements) or warnings. Schedule II medications that are permitted by this policy to be brought to school shall be stored in a double locked cabinet.

Students with an individualized health plan (IHP) may be given OTC medications to the extent that such medications are included in the student's IHP.

The district’s supervising registered nurse is responsible for creating procedures for the administration of medications on and off campus.

The school shall not keep outdated medications or any medications past the end of the school year. Parents shall be notified ten (10) days in advance of the school’s intention to dispose of any medication. Medications not picked up by the parents or legal guardians within the ten (10) day period shall be disposed of by the school nurse in accordance with current law and rules.

Schedule II Medications

The only Schedule II medications that shall be allowed to be brought to the school are

 Methylphenidate (e.g. Ritalin or closely related medications as determined by the school nurse), dextroamphetamine (Dexedrine), and amphetamine sulfate (e.g. Adderall or closely related medications as determined by the school nurse).1

For the student's safety, no student will be allowed to attend school if the student is currently taking any other Schedule II medication than permitted by this policy.3 Students who are taking Schedule II medications which are not allowed to be brought to school shall be eligible for homebound instruction if provided for in their IEP or 504 plans.

Self-Administration of Medication

Students who have written permission from their parent or guardian and a licensed health care practitioner on file with the District may:

1. Self-administer either a rescue inhaler or auto-injectable epinephrine;

2. Perform his/her own blood glucose checks;

3. Administer insulin through the insulin delivery system the student uses;

4. Treat the student’s own hypoglycemia and hyperglycemia; or

5. Possess on his or her person:

   • A rescue inhaler or auto-injectable epinephrine; or

   • The necessary supplies and equipment to perform his/her own diabetes monitoring and treatment functions.

A student may be authorized to self-administer a stress dose medication to treat the student’s adrenal insufficiency with:

1. The written authorization of the student's parent, legal guardian, or person standing in loco parentis; and

2. A written order from the student's treating physician stating that the student:

   • Is capable of completing the proper method of self-administration of the stress dose medication, and

   • Has been instructed on the details of the student’s medical condition and the events that may lead to an adrenal crisis.

The parent, legal guardian, or person standing in loco parentis of a student who is authorized to self-administer a stress dose medication shall sign an IHP developed by the school nurse for the school where the student is enrolled. The IHP shall include a requirement for the notification of appropriate staff following the self-administration of a stress dose medication, which shall include the school nurse, teacher of the classroom where the stress dose medication was administered, and a school administrator.

Students who have a current consent form on file shall be allowed to carry and self-administer such medication while:

• In school;

• At an on-site school sponsored activity;

• While traveling to or from school; or

• At an off-site school sponsored activity.

A student is prohibited from sharing, transferring, or in any way diverting his/her medications to any other person. The fact that a student with a completed consent form on file is allowed to carry a rescue inhaler, auto-injectable epinephrine, diabetes medication, stress dose medication, or combination does not require the student to have such on the student’s person. The parent or guardian of a student who qualifies under this policy to self-carry a rescue inhaler, auto-injectable epinephrine, diabetes medication, stress dose medication, or any combination on the student’s person shall provide the school with the appropriate medication, which shall be immediately available to the student in an emergency.

Students may possess and use a topical sunscreen that is approved by the United States Food and Drug Administration for OTC use to avoid overexposure to the sun without written authorization from a parent, legal guardian, or healthcare professional while the student is on school property or at a school-related event or activity. The parent or guardian of a student may provide written documentation authorizing specifically named District employee(s), in addition to the school nurse, to assist a student in the application of sunscreen. The District employee(s) named in the parent or legal guardian’s written authorization shall not be required to assist the student in the application of sunscreen. 

Emergency Administration of Glucagon and Insulin

Students may be administered Glucagon, insulin, or both in emergency situations by the school nurse or, in the absence of the school nurse, a trained volunteer school employee designated as a care provider, provided the student has:

1. An IHP that provides for the administration of Glucagon, insulin, or both in emergency situations; and

2. A current, valid consent form on file from their parent or guardian.

When the nurse is unavailable, the trained volunteer school employee who is responsible for a student with diabetes shall be released from other duties during:

A.        The time scheduled for a dose of insulin in the student’s IHP; and

B.        During emergency situations, Glucagon or non-scheduled insulin administration shall be given once other staff have relieved him/her from other duties until a parent, guardian, other responsible adult or medical personnel has arrived.

C.       

a.         Adrenal insufficiency Student Medication

Allows for school nurses and appropriately trained staff volunteers who are authorized by students parents to administer medication to a student diagnosed with Adrenal insufficiency.

A student shall have access to a private area to perform diabetes monitoring and treatment functions as outlined in the student’s IHP.

Emergency Administration of Epinephrine

The school nurse or other school employees designated by the school nurse as a care provider who have been trained and certified by a licensed physician may administer an epinephrine auto-injector in emergency situations to students who have an IHP that provides for the administration of an epinephrine auto-injector in emergency situations.

The parent of a student who has an authorizing IHP, or the student if over the age of eighteen (18), shall annually complete and sign a written consent form provided by the student's school nurse authorizing the nurse or other school employee(s) certified to administer auto-injector epinephrine to administer auto-injector epinephrine to the student when the employee believes the student is having a life-threatening anaphylactic students with an order from a licensed health care provider to self-administer auto-injectable epinephrine and who have written permission from their parent or guardian shall provide the school nurse an epinephrine auto-injector. This epinephrine will be used in the event the school nurse, or other school employee certified to administer auto-injector epinephrine, in good faith professionally believes the student is having a life-threatening anaphylactic reaction and the student is either not self-carrying his/her /epinephrine auto-injector or the nurse is unable to locate it.

The school nurse for each District school shall keep epinephrine auto-injectors on hand that are suitable for the students the school serves. The school nurse or other school employee designated by the school nurse as a care provider who has been trained and certified by a licensed physician may administer auto-injector epinephrine to those students who the school nurse, or other school employee certified to administer auto-injector epinephrine, in good faith professionally believes is having a life-threatening anaphylactic reaction.

Emergency Administration of Albuterol

The school nurse or other school employees designated by the school nurse as a care provider who have been trained and certified by a licensed physician, advanced practice registered nurse, or physician assistant may administer albuterol in emergency situations to students who have an IHP that provides for the administration of albuterol in emergency situations.

The parent of a student who has an authorizing IHP, or the student if over the age of eighteen (18), shall annually complete and sign a written consent form provided by the student's school nurse authorizing the nurse or other school employee(s) certified to administer albuterol to administer albuterol to the student when the employee believes the student is in perceived respiratory distress.

The school nurse for each District school shall keep albuterol on hand. The school nurse or other school employee designated by the school nurse as a care provider who has been trained and certified by a licensed physician, advanced practice registered nurse, or physician assistant may administer albuterol to those students who the school nurse, or other school employee certified to administer albuterol, in good faith professionally believes is in perceived respiratory distress. 

Emergency Administration of Anti-opioid

The school nurse for each District school shall keep anti-opioid injectors on hand. The school nurse, other school employee, volunteer, or student may administer anti-opioid in accordance with the District’s procedures to a student who the school nurse, or other observer, in good faith believes is having an opioid overdose.

Emergency Administration of Emergency Adrenal Insufficiency Medication

The school nurse or other school employees designated by the school nurse as a care provider who have been trained and certified by a licensed physician may administer an injectable emergency dose medication in emergency situations to students who have an IHP that provides for the administration of an injectable emergency dose medication in emergency situations.

The parent of a student who has an authorizing IHP, or the student if over the age of eighteen (18), shall annually complete and sign a written consent form provided by the student's school nurse authorizing the nurse or other school employee(s) certified to administer an injectable emergency dose medication to administer an injectable emergency dose medication to the student when the employee believes the student is having an adrenal crisis due to adrenal insufficiency.

Students who have met the requirements to be authorized to self-administer a stress dose medication under this policy shall provide the school nurse an emergency injectable dose of the student’s medication. This emergency injectable dose will be used in the event the school nurse, or other school employee certified to administer an injectable emergency dose medication, in good faith professionally believes the student is having an adrenal crisis due to adrenal insufficiency.

l. § 17-87-103(11) provides for the administration of Glucagon, insulin, or both to students suffering from diabetes.

Legal References:     

Ark. State Board of Nursing: School Nurse Roles and Responsibilities

Division of Elementary and Secondary Education and Arkansas State Board of Nursing Rules Governing the Administration of Insulin and Glucagon to Arkansas Public School Students with Diabetes

A.C.A. § 6-18-701

A.C.A. § 6-18-707

A.C.A. § 6-18-711 and (14)

A.C.A. § 6-18-714

LRSD conducts routine health screenings such as hearing, vision, and scoliosis due to the importance these health factors play in the ability of a student to succeed in school. The intent of the exams or screenings is to detect defects in hearing, vision, or other elements of health that would adversely affect the student’s ability to achieve his/her full potential.

The rights provided to parents under this policy transfer to the student when he/she turns eighteen (18) years old.

Except in instances where a student is suspected of having a contagious or infectious disease, parents shall have the right to opt their student out of the exams or screenings by using form 4.41F or by providing certification from a physician that he/she has recently examined the student.

The only types of proof of immunization the District will accept are immunization records provided by a:

• Licensed physician;

• Health department;

• Military service; or

• Official record from another educational institution in Arkansas.

The proof of immunization must include the vaccine type and dates of vaccine administration. Documents stating “up-to-date”, “complete”, “adequate”, and the like will not be accepted as proof of immunization. No self or parental history of varicella disease will be accepted. Valid proof of immunization and of immunity based on serological testing shall be entered into the student’s record.

In order to continue attending classes in the District, the student must have submitted:

1. Proof of immunization showing the student to be fully age appropriately vaccinated;

2. Written documentation by a public health nurse or private physician of proof the student is in process of being age appropriately immunized, which includes a schedule of the student’s next immunization;

3. A copy of a letter from ADH indicating immunity based on serologic testing; and/or

4. A copy of the letter from ADH exempting the student from the immunization requirements for the current school year, or a copy of the application for an exemption for the current school year if the exemption letter has not yet arrived.

Students whose immunization records or serology results are lost or unavailable are required to receive all age appropriate vaccinations or submit number 4 above.

Students with communicable diseases or with human host parasites that are transmittable in a school environment shall demonstrate respect for other students by not attending school while they are capable of transmitting their condition to others. Students whom the school nurse determines are unwell or unfit for school attendance or who are believed to have a communicable disease or condition will be required to be picked up by their parent or guardian. Specific examples include, but are not limited to: Varicella (chicken pox), measles, scabies, conjunctivitis (Pink Eye), impetigo/MRSA (Methicillin-resistant Staphylococcus aureus), streptococcal and staphylococcal infections, ringworm, mononucleosis, Hepatitis A, B, or C, mumps, vomiting, diarrhea, and fever (100.4 F when taken orally).1 A student who has been sent home by the school nurse will be subsequently readmitted, at the discretion of the school nurse, when the student is no longer a transmission risk. In some instances, a letter from a health care provider may be required prior to the student being readmitted to the school.

To help control the possible spread of communicable diseases, school personnel shall follow the District's exposure control plan when dealing with any blood borne, foodborne, and airborne pathogens exposures. Standard precautions shall be followed relating to the handling, disposal, and cleanup of blood and other potentially infectious materials such as all body fluids, secretions and excretions (except sweat).

In accordance with 4.57—IMMUNIZATIONS, the District shall maintain a copy of each student's immunization record and a list of individuals with exemptions from immunization which shall be education records as defined in policy 4.13. That policy provides that an education record may be disclosed to appropriate parties in connection with an emergency if knowledge of the information is necessary to protect the health or safety of the student or other individuals.

A student enrolled in the District who has an immunization exemption may be removed from school at the discretion of the Arkansas Department of Health during an outbreak of the disease for which the student is not vaccinated. The student may not return to school until the outbreak has been resolved and the student's return to school is approved by the Arkansas Department of Health.

The parents or legal guardians of students found to have live human host parasites that are transmittable in a school environment will be asked to pick their child up at the end of the school day. The parents or legal guardians will be given information concerning the eradication and control of human host parasites. A student may be readmitted after the school nurse or designee has determined the student no longer has live human host parasites that are transmittable in a school environment.

Each school may conduct screenings of students for human host parasites that are transmittable in a school environment as needed. The screenings shall be conducted in a manner that respects the privacy and confidentiality of each student. 

Rewards

Food and beverages are not to be used as rewards for academic, classroom or sports performance.  A list of non-food rewards is posted on the LRSD website in the Wellness Policy.

Fundraising

Schools are encouraged to host non-food related fundraisers.  All fundraising activities are to have a 50/50 balance of healthy and less healthy offerings for sale on or off campus.  Fundraisers that promote physical activity are preferred.

Little Rock School District recognizes the need for education, early intervention, and prevention services in regards to student mental, emotional, and behavioral health. To meet these needs, LRSD partners with community School-Based Mental Health (SBMH) agency providers. The providers are contracted with the District, rather than employed by the District. SBMH services are available to all schools and students in the District. Services provided by these agencies include but are not limited to:

• Individual Therapy

• Family Therapy

• Group Therapy

• Interventions

• Medication Management

• Educational meeting attendance

• Home visits

• Other services necessary for the support and success of LRSD students and families

Referrals for SBMH services generally come from the school guidance counselor. However, parents, teachers, and other school staff, can refer students based on observation or knowledge of potential issues. Student confidentiality is maintained unless a student has threatened to harm themselves or others.

The Mental Health Services Department is committed to serving the needs of the whole child and inspiring them to be healthy in all aspects of life.

Students who receive a sanction for smoking or other drug related charges will be required to enroll in a drug treatment program.  Parents will have the option to enroll their child either onsite at the school or seek outside resources.  Failure to comply with a drug treatment program may result in an expulsion recommendation should there be a second offense.