BOYERTOWN  AREA  SCHOOL   HEALTH   SERVICES

• IMMUNIZATIONS
• NEW STUDENTS
• MEDICATIONS
• MANDATED HEALTH SERVICES
• SCREENING REFERRALS
• ILLNESS: KEEPING YOUR CHILD HOME FROM SCHOOL
• COMMUNICABLE DISEASES
• ILLNESS AND INJURY AT SCHOOL
• REPORTING CHILD ABUSE
• STAFF
• OTHER HEALTH LINKS
• PHYSICAL EXAM FORM
• DENTAL EXAM FORM
• MEDICATION FORM

IMMUNIZATIONS 

ATTENTION PARENTS: NEW IMMUNIZATION LAWS FOR 2009-2010 - DON'T WAIT ----- VACCINATE NOW!! (open link UserFiles/File/Att Parent(2008)-immunizations.pdf )

To enroll, you must provide proof of immunizations for your child as required by the PA Department of Health. Proof of immunizations is a written record showing the dates (month, day, and year) your child was immunized. Failure to provide immunization records could result in your child being unable to begin school.

Please note that your child’s initial date of entry determines which immunizations are required.

Students who initially entered school PRIOR to August 1997 need proof of the vaccines listed below:
• Diphtheria-Tetanus
     3 doses of tetanus*
     3 doses of diphtheria*
• Polio
     3 doses of polio
• Measles
     2 doses of measles** with the first dose administered after 12 months of age or a blood test showing immunity.
• German Measles (Rubella)
     1 dose of rubella (German measles)** administered after 12 months of age or a blood test showing immunity.
• Mumps
     1 dose of mumps** administered after 12 months of age or a physician's written statement that your child had the
     disease.
• Hepatitis B
     3 properly spaced doses of Hepatitis B vaccine or a blood test showing immunity.
• Varicella (chickenpox)
     Age appropriate dose(s) of varicella vaccine or history of the disease. 

Students who initially entered school AFTER August 1997 need proof of the vaccines listed below:
• Diphtheria-Tetanus
     4 doses of tetanus* (1 dose on or after the 4th birthday)
     4 doses of diphtheria* (1 dose on or after the 4th birthday)
• Polio
     3 doses of polio
• Measles
     2 doses of measles** with the first dose administered after 12 months of age or a blood test showing immunity.
• German Measles (Rubella)
     1 dose of rubella (German measles)** administered after 12 months of age or a blood test showing immunity.
• Mumps
     1 dose of mumps** administered after 12 months of age or a physician's written statement that your child had the
     disease.
• Hepatitis B
     3 properly spaced doses of Hepatitis B vaccine or a blood test showing immunity.
• Varicella (chickenpox)
     1 dose of varicella vaccine or history of the disease.

* Usually given as DTP or DtaP or DT or TD
** Usually given as MMR

The only exceptions to the school laws for immunization are medical reasons and religious beliefs. If your child is exempt from immunizations, your child may be removed from school during a disease outbreak.

Keep a record of your child’s immunizations. Keep this record in a safe place. Your doctor’s office, medical clinic, or hospital may ask for this record. As your children become adults, they may need the record for college, for their job or if they travel out of the country.

Pennsylvania's school immunization requirements can be found in 28 PA.CODE CH.23 (School Immunization)

NEW STUDENT ENTRANCE REQUIREMENTS :

Families moving into the Boyertown Area School District, must bring a copy of each child's immunization record with you at the time of registration.

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MEDICATIONS 
MEDICATION PROCEDURE REQUIREMENTS ADOPTED SEPTEMBER 2006
MEDICATION FORM

The school district has established a medication policy to allow a student to take (or be given) medication at school, on field trips or at extra-curricular activities. Medications are defined as:
     • Any prescribed medication
     • Inhalers
     • Epi-pens
     • All over-the-counter medications including cough drops (secondary level only), vitamins and herbal supplements (*with the exception of standing order medications)

PROCEDURES:

1. Complete a Medication Authorization form, which needs to be signed by the parent/guardian and the prescribing physician. (Forms are found in all health rooms and/or can be downloaded by clicking this Authorization for School Medication Administration link).
2. All medication shall be hand delivered by the parent/guardian or designated adult. 
3. All medication, whether over-the-counter or prescription, must be in its original container and labeled with the child’s name, drug name, dosage, and time to be given in school. (Please note: Upon request, most pharmacists will provide two labeled containers for a prescription so that the medication can be brought to school in the properly labeled container.)
4. The medication will be kept in a secured, locked place in the nurse’s office or vault located in the main office.
5. It is the responsibility of the student to come to the nurse’s office at the time designated for administration of the medication. 
6. Each time the parent/guardian/adult brings to school more prescribed medications that is a controlled substance, the number of tablets will be counted and documented in the health suite by both parent and school nurse. 
7. Whenever there is a change in the medication directives, a parent/guardian or adult designee notifies the nurse in writing with a physicians note. 
8. At the end of the school year, a parent/guardian or adult designee must pick up any medication left in the health suite. Any unclaimed medication in the nurse's office will be destroyed. 
9. PLEASE NOTE: Medication authorization forms are active for the current school year only. A new medication authorization form must be completed yearly for ALL medication administered in school or on field trips.

If the above procedures are not followed, the nurse will not be able to administer the medication at school.

Standing Order Medications

The school district’s physician has authorized the administration of the following medications to elementary students. These medications include:

• Chloraseptic throat spray
• Benadryl
• Bacitracin

The school district’s physician has authorized the administration of the following medications to secondary students. These medications include:

• Acetaminophen (generic Tylenol ®)
• Aleve®
• Antacid
• Bismuth Subsalicylate (Peptobismol or Kaopectate)
• Chloraseptic throat spray
• Benadryl
• Bacitracin
• Ibuprofen (generic Advil ®)
• Visine

In order for the school nurse to administer any of these medications, a parent/guardian must give consent by checking the appropriate box on the Health Room Emergency Form that is distributed yearly to each student.

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 Guidelines for Students Using Inhalers and Epi-Pens

In compliance with the PA Health Bill 1113, ALL students in the elementary and secondary level, may carry and use his/her prescribed inhaler or Epi-Pen during the school day.

PROCEDURES:

1. " The Authorization for School Medication Administration " form must be completed and kept on file in the nurse's office (elementary and secondary students).
2. An asthma and/or allergy emergency care plan needs to be completed and filed in the health suite. 
3. The health care provider and parent must agree that the child is able and responsible to carry and self-administer his/her inhaler and/or epi-Pen during school activities. At the elementary level, the student must be able to demonstrate to the school nurse the proper technique for inhaler and epi-pen administration prior to being allowed to carry his/her inhaler/epi-pen. 
4. If a student uses his/her inhaler or epi-Pen during the school day, it is necessary that he/she notify the nurse as soon as possible. 
5. The nurse will assess the health status of the student, document the use of the medication and arrange for further medical attention as needed. 
6. The student's name must be on the inhaler or epi-Pen.
   

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 Guidelines for Students Taking Medication on Field Trips

Medication taken by a student during a field trip or an extra-curricular activity will only be permitted when:

1. Failure to take such medication would jeopardize the health of the student 
2. The student would not be able to participate in the field trip or extra-curricular activity if the medication were not made available.

Field Trip Forms
If your child requires medication on a field trip, please check the appropriate box on the field trip permission slip given to your child by the teacher. The completed field trip permission form requires:

• a parent signature 
• emergency contacts 
• medical concerns 
• a list of medications that are necessary during the length of the trip

If your child needs a particular medication that is NOT included on the list of standing orders or one that is NOT already on file in the health suite, then an medication authorization form MUST be completed and submitted prior to the field trip (see above procedure for completing medication authorization form). The medication must be hand delivered to school by the parent/guardian in the original container. In the case of extra-curricular activities, the parent/guardian is required to make delivery arrangements with the person in charge prior to the activity. All medication must be stored in the nurse's office prior to departure for the field trip or extra-curricular activity.

Incertain situations for field trips or extra-curricular activities, the student may self-administer his/her medication. (This pertains to all medications at the secondary level and Inhalers and Epi-Pens at the elementary level). The student should carry the exact dose of the medication in the original container. A copy of the "Authorization for School Medication Administration" form will be completed and kept in the health suite. The physician and parent will indicate on the form that the student is responsible and able to self-administer.


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 MANDATED HEALTH SERVICES

Every child of school age living within the Commonwealth must receive the following health services:

PHYSICAL EXAMINATIONS
PHYSICAL EXAM FORM
Required upon original entry (kindergarten or first grade), 6th, and 11th grades. Examinations done by a family physician within one year prior to entry into the grade where an examination is required and recorded on a state form are acceptable by state regulations. Forms can be obtained through the health room or by clicking Physical Exam Form.

NOTE: When a physical examination is not completed by the family health care provider, a school doctor will complete an abbreviated examination, after permission to examine has been obtained from the parent/guardian. (Parent permission is noted on the yearly emergency form, which is completed at the beginning of each school year). The school nurse will notify the parent when the physical is scheduled. The parent is invited to be present during the examination. The Private physical forms are to be returned in to the health suite by SEPTEMBER 15 of the required school year.

**Sports physicals provided by the school district cannot be used for the required state mandated physical examination.
DENTAL EXAMINATIONS
DENTAL EXAM FORM
Required upon original entry (kindergarten or first grade), 3rd, and 7th grades. Parents are advised to have these examinations done by their family dentist because he/she is familiar with the child's past dental history and is prepared to provide any necessary treatment. Examinations done by a family dentist within one year prior to entry into the grade where an examination is required and recorded on a state form (Forms are available through the health room or by clicking the "Dental Exam Form" found above) are acceptable by state requirements.

NOTE: When a dental examination is not completed by the student’s family dentist, a school dentist will complete an abbreviated examination after permission has been obtained from the parent/guardian (Parent permission is noted on the yearly emergency form which is completed at the beginning of each school year). The health suite will inform each parent when the examination is scheduled. The parent is invited to be present during the examination. Private dental examination forms are to be returned to the health suite by SEPTEMBER 15 of the required school year.

GROWTH SCREENING

All students will be weighed and measured yearly in accordance with the PA state mandates.
Starting in the 2005-2006 school year, the Pennsylvania Department of Health requires school districts to begin calculating Body Mass Index (BMI). This request is a result of the increased prevalence of overweight and underweight conditions in our population, especially our children. These conditions are associated with the development of chronic illnesses during adulthood including diabetes, heart disease, high blood pressure, stroke and certain cancers.
For more information on BMI measures, you may wish to reference www.cdc.gov (retrieved from http://www.panaonline.org/). See “ALL THE BUZZ ABOUT BMI” below to find some tips on how to lower the BMI measurement as well as links to other helpful resources (http://www.dsf.health.state.pa.us/health/cwp/view.asp?A=180&Q=242392).

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You may have heard that this year, your school will be determining your BMI, which stands for Body Mass Index, in addition to measuring your height and weight. Below is some information that will help you to understand what the buzz is all about.

HEARING SCREENINGS

Grades kindergarten, 1, 2, 3, 7, 11, Special Education classes and all other children who are newly enrolled in the district or who have had a history of a hearing problem.

SCOLIOSIS SCREENING :

The school law requires that a screening for scoliosis be performed on all students in grades 6 (during the physical exam) and 7. The purpose of the screening program is to detect possible curvature in the spine. If this condition is corrected early with appropriate treatment, progressive spinal deformity may be prevented. The screening test is very simple and can be performed in less than a minute. This will be completed during the student’s gym class.
A check for evidence of spinal curvature will
be done on all students in Grades 6 (during the physical examination) and Grade 7.
Should a problem be detected in any of after the screenings or examinations offered by the school health program, a notice will be sent home recommending that the parents seek further evaluation and/or treatment. ThisPlease bring the referral form is to be completed by the doctor evaluating physician’s office for completion and treating the child and returned it to the nurse's officehealth suite.
We will appreciate your assistance and support in helping us fulfill the state school health regulations. We shall provide all the above services to your child. If you have any objections, or questions please contact the school health room.

VISION SCREENINGS

All students in all grades have their near and far vision checked annually. First grade students will be also tested with the plus lens and color vision. Second grade students will be tested for stereo depth perception.

WHAT DOES A REFERRAL MEAN?

IfF you receive a referral form after any school screening, it means that the screening detected a possible problem and further evaluation by a professional health care provider is recommended. Please have your private physician (or health care provider), dentist, or eye doctor complete the form after evaluating your child. Return the completed form to the school nurse. If you have any questions, contact the school nurse.

LINKS FOR KIDS

• KidsHealth.org
• BAM.gov
• Dole 5 a Day
• Verb

• School Nutrition Program
• Max's Magical Delivery
• Pennsylvania Advocates for Nutrition and Activity (PANA)
• Department of Health Obesity Prevention

ANNUAL HEALTH REPORT CARDS

Annual "health report cards" detailing the results of your child's annual mandated growth, vision, hearing and scoliosis screening for their grade level, will be mailed to parents/guardians. If you have any questions or do not receive your child's health report card by the third quarter, please contact the health room at the school were your child attends.

We appreciate your assistance and support in helping us fulfill the state school health regulations. We shall provide all the above services to your child. If you have any objections or questions please contact the school health room.

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ILLNESS : WHEN TO KEEP YOUR CHILD HOME FROM SCHOOL

Occasionally, it may be necessary for your child to remain home from school due to illness. The following guidelines should be followed when determining if you should keep your child at home.

• Your child should be kept home following a nighttime bout of nausea, vomiting, diarrhea or fever. Keep at home and Watch for further symptoms.
• Your child should remain home if he/she has a temperature above 100 degrees. His/her temperature should remain normal for 24 hours prior to returning to school.
• Your child should not arrive at school with an injury that occurred at home to be evaluated by the school nurse. Please have any serious injury occurring at home evaluated by your health care provider.

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COMMUNICABLE DISEASES

In order to prevent the spread of a communicable disease, it is advisable to keep a child home from school when he/she shows any of the symptoms listed:

• Unusual skin eruptions                       Fever
• Symptoms of whooping cough          Chills
• Discharge or redness of eye(s)         Persistent cough

A student absent from school because of the condition listed below may not return to school before the specified time period has passed.

CHICKEN POX (VARICELLA) - - 5 days from the appearance of the first crop of vesicles, or when all the lesions have dried and crusted, whichever is sooner

DIPHTHERIA - - 2 weeks from the onset or until appropriate negative culture tests

**HEAD LICE - - After treatment is given and has no nits present and judged medically clear by the school nurse

H. FLU (HAEMOPHILUS INFLUENZA) - - Until made noninfective by appropriate course of antibiotic and/or determined noninfective Medical provider

IMPETIGO - - 24 hours after the institution of appropriate treatment

LICE (BODY) - - After completion of appropriate treatment and judged non-infectious by physician or school nurse

MEASLES - - 4 days from the onset of rash

MENINGOCOCCAL MENINGITIS OR MENINGOCOCCEMIA  - - Until made noninfective by appropriate course of antibiotic and/or determined noninfective by a Medical provider

MUMPS - - 9 days from the onset or until subsidence of swelling

PINK EYE - - 24 hours after medication is started or until judged not infective (without a discharge)

RINGWORM (all types) - - Until judged non-infectious by physician or school nurse which is usually immediately after the first treatment, if body lesions are covered. Neither scalp nor body lesions that are dried need to be covered

RUBELLA/GERMAN MEASLES - - 4 days from the onset of rash

SCABIES - - After completion of appropriate treatment and judged non-infectious by physician or school nurse

SCARLET FEVER (RESPIRATORY STREP) - - At least 10 days from the onset if no physician is in attendance or 24 hours after medication is started

SHINGLES (HERPES ZOSTER) - - 5 days from the appearance of the first crop of vesicles, or when all the lesions have dried and crusted, whichever is sooner

STAPH INFECTIONS (including Mellicillin Resistant Staphlococcus Aureus MRSA) - - may attend school as long as lesion is covered with clean, dry bandage. Follow your healthcare provider ’s instructions on proper care of the wound. Pus from infected wounds can contain staph and MRSA, so keeping the infection covered will help prevent the spread to others. Bandages or tape can be discarded with the regular trash.

TRACHOMA - - 24 hours after institution of appropriate treatment

WHOOPING COUGH (PERTUSSIS) - - 3 weeks from the onset or 5 days from start of appropriate antimicrobial therapy.

**BASD: No-Nit Procedure

A child with Head Lice (pediculosis capidis) will immediately be excluded from school. Authority to send a student home is found in the PA School Health Code 27.71.

PROCEDURES:

• Parents will be promptly contacted and requested to pick up the student at school. 
• The child must have one adequate treatment with a pediculocide shampoo plus nit removal on the day they are sent home from school. 
•  The parent/guardian will be advised that they can either obtain a non-prescription, a prescription pediculocide shampoo, or other approved method(s) as directed by their physician. The nurse may require that parents present a box top from the pediculocide shampoo upon re-admittance. 
• If the infested student has school-age siblings that attend Boyertown School District, the building school nurse will screen these children for head lice. If the sibling attends another school, the school nurse will be notified.
• Following the day of the exclusion, the child may be readmitted to school if he/she is judged non-infested by the school nurse. A parent or parent designee must bring the child to the nurse’s office with a note describing treatment. The child is not to ride the school bus or attend class until cleared for readmission by the school nurse.
• Per the BASD "No nit" policy, if nits are found on the child's hair shafts, the child will be returned home until the student is found to be completely nit-free by the school nurse. 
• In seven days following the initial shampoo treatment, a second head lice (pediculicide) shampoo treatment is required to be applied by the parent/guardian. The school nurse will conduct a re-evaluation of the child. If lice or nits are found, the entire policy and procedure will be repeated and the child will remain out of school until judged non-infested by the school nurse. The final decision of re-admittance to school depends on the school nurse’s evaluation.
  
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ILLNESS AND INJURY AT SCHOOL

The Health Office personnel will administer first aid. If a child becomes ill in school or has a serious accident, the school will take appropriate actions, including the procedures permitted by parents as listed on the emergency card.

A certified school nurse or a staff nurse and the school physician supervise health services. All school health rooms are staffed during school hours to handle the routine administration of medication and medical emergencies.


 REPORTING CHILD ABUSE

Whenever there is reasonable cause to suspect child abuse, school officials are required by law to report these cases to county and state agencies. These agencies have the legal right to interview students at school without parental consent.

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 BOYERTOWN AREA SCHOOL DISTRICT SCHOOL HEALTH SERVICES STAFF

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 OTHER HEALTH LINKS

ADD-Children and Adults with ADD
http://www.chadd.org

American Academy of Pediatrics
http://www.aap.org/

Asthma
http://www.whatsasthma.org 
http://schoolasthmaallergy.com

Boyertown Area Community Wellness Council
http://www.victorymile.org

Cancer Information
http://cancernet.nci.nih.gov/cancertopics

CDC Health Information
www.cdc.gov

Centers for Medicaid & Medicare-Insurance Information
http://www.hhs.gov

Children’s Health Insurance Program (CHIP)
http://www.chipcoverspakids.com/

Chronic Fatigue/immune deficiency
http://www.cfids.org/

Consumer Health & Human Resources
www.healthfinder.gov

Department of Heath and Human Services
www.healthfinder.gov

Depression
http://www.nimh.nih.gov/publicat/depression.cfm

Diabetes
http://www.cdc.gov/diabetes/ 
http://www.diabetes.org/home.jsp
http://www.jdrf.org

Eating Disorders
http://mirror-mirror.org/eatdis.htm
http://www.phe.queensu.ca/anab

Food Allergy Network
http://www.foodallergy.org/

Head Lice*
http://www.headlice.org/

Immunizations
http://www.cdc.gov/vaccines/pubs/vis/default.htm

Kids’ Health - Nemours Foundation 
http://www.kidshealth.org/index.html

Mayo Clinic - General Health Information
www.mayoclinic.org

National Institute of Health
http://www.nlm.nih.gov/medlineplus/childrenshealth.html

Nutrition
http://www.panaonline.org/ 
http://www.cnpp.usda.gov

PA Department of Health
http://www.dsf.health.state.pa.us/health/site/default.asp

Pottstown Wellness Foundation
http://www.pottstownfoundation.org/

PTA
http://www.pta.org

Rape Prevention
http://www.nlm.nih.gov/medlineplus/rape.html

Success at School-Pediatric Network 
http://www.pediatricnetwork.org/school/index.htm

 * Listed for Health information only – Please note that products advertised on the above websites are not necessarily endorsed by BASD.

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 Created by MARGIE SCHELLINGER
Revised: 5/1/07-C.Devan/M.Schellinger