Abby Kelley elementary, middle and high school are operated by a team of highly skilled full time Registered Nurses whose time may be shared with one of the other buildings in the district for emergencies should a need arise.

.The Abby Kelley school nurses provides students with health services within the Comprehensive School Health Program which include:

Providing health services that increase school attendance.
Help prevent and control the spread of communicable diseases.
Administers specialized medical services to students (medications, tube feedings, insulin).
Verifies immunizations to keep the school in compliance with state mandates.
Screens for hearing and vision deficits, scoliosis, BMI, and SBIRT.
Provides health professional input and direction for school and community policies and programs.
Educates students and staff on managing their own health and wellness.
Assists in the evaluation of students for special education services.
First Aid assessment and treatment.

Emergency Contact Information

Each parent or guardian is asked to provide the school with the names and phone number of two (2) emergency contacts who may be contacted if a parent/guardian cannot be reached. Persons listed must be local and have access to transportation.

Please advise the school if/when there is a change to any contact information.

Illness/Injury during school hours

When a student becomes ill or injured at school the nurse or a trained staff member will administer initial treatments of minor injuries.

If school personnel believe that the student is experiencing a medical emergency, they will contact 911 for assistance. In the case of a medical situation, if the nurse’s decision is to call 911, then the school administration is instructed to assist in the nurse’s decision. If in that situation, a parent/guardian is present and on site, and does not want 911 to be called, the principal and the nurse will explain the emergency 911 protocol to the parent and contact 911 if he or she determines that the circumstances warrant intervention by emergency services.

In the event that a student is ill or injured and the School Nurse, Principal/Assistant Principal deem it appropriate for the student to go home, a parent, guardian or emergency contact will be notified and are expected to come for pickup the student within one (1) hour or sooner of the initial phone call. If the nurse or administrative team is unable to make contact with parent/ guardian or emergency contact to arrange pickup within 60 mins or sooner and student health is rapidly declining, the school nurse may determine if transport

by EMS (Emergency Medical Services) to the local hospital is medically necessary. Parents/ guardians are liable for costs incurred for emergency transportation services.

If nurse or administrative team is unable to make contact with parent/ guardian or emergency contact to arrange pickup within 60 mins of initial call (emergent or non emergent cases) a wellness check by the local authorities to the parent/guardian residence will be requested followed by the initiation of a 51a (report of neglect) to the Department of Children and Families.

Students will not be permitted to ride the bus home if vomiting, febrile, extreme discomfort due to illness or significant injury/pain as determined by the nurse.
Students that are home from school due to illness or sent home ill by the nurse, will not be permitted to attend the same day after school scheduled activities .

Outside of school illness or injuries

Injuries or illness that take place outside of school hours are the responsibility of families. If your student does become injured or ill outside of school hours, please DO NOT send them to school to be diagnosed by the Nurse versus having them evaluated by a doctor.. Nurses legally cannot diagnose illnesses or injuries and Abby Kelley does not have a school-based health center. Families should seek medical attention from their primary care doctor, urgent care or hospital. Your student will be encouraged to stay in class.

Injuries or illness that occur outside of school and require continued inschool nursing care will require a doctor’s order.

Compliance with Immunizations & Physical Exams

Massachusetts Department of Public Health requirements regarding student immunizations and physical examinations. These requirements are in place to help ensure the health and safety of all students and to maintain compliance with state regulations.

Immunization Requirements

Under Massachusetts law (105 CMR 220.500), all students must have documentation of the required immunizations before they may attend school. Students cannot attend preschool, elementary, or secondary school without proof that they have received all required immunizations according to the Massachusetts Department of Public Health schedule. Non compliance and failure to comply with the immunization schedule may result in exclusion from until compliance is met.

Massachusetts students must provide documentation of immunization, according to school requirements, or show a medical or religious exemption prior to entry. Exemptions need to be renewed and on file with the nurse annually.

https://www.mass.gov/doc/immunization-requirements-for-school-entry-updated-21226/download

Physical Examination Requirements

Massachusetts school physical requirements are created under the authority of 105 CMR 200.000: Physical Examination of School Children.

Mandatory Intervals: Under Massachusetts General Law c. 71, s. 57, physicals are required upon school entry (kindergarten or new transfer) and typically at intervals of 3 to 4 years (such as grades 4, 7, and 10 or 11, depending on the district).

AKFCS policy for physical exams outlines the following requirements: Physical exam within one year prior to entrance to school or within 30 days after school entry, upon entry to, Kindergarten, Grade 4, Grade 7, Grade 10, within one year for all newly transferred students, annually for all students with complex medical needs, and yearly if playing sports.

Non-Compliance Exclusion: If a parent or guardian fails to provide proof of a required physical exam or health assessment within the designated grace period (usually 30 days post-entry), the school district can bar the student from attending classes until the record is provided.

School health record form:

https://www.mass.gov/doc/massachusetts-school-health-recordphysical-examination-form-0/download

For more information, please see the DPH website at www.mass.gov.

Massachusetts Mandated Health Screenings

Abby Kelley conducts health screenings as required by Massachusetts General Laws and Department of Public Health regulations. These screenings are an important part of the school health program and are intended to identify potential health concerns that may affect a student’s ability to learn, participate, and succeed at school. School screenings are intended to supplement, not replace, routine medical care provided by a student’s primary care provider.

Depending on the student’s grade and age, mandated school health screenings may include:

Vision screening
Hearing screening
Postural screening
Height and weight/BMI screening

Screenings are conducted by appropriately trained school personnel in accordance with Massachusetts Department of Public Health guidelines. Parents/guardians will be notified of screenings as required.

Parent/Guardian Notification and Opt-Out

Parents and guardians have the right to be informed about school health screenings and, where permitted by Massachusetts law and regulation, may request that their child not participate. Opt -out must be submitted to the school nurse in writing.

Vision and Hearing Screening

In accordance with M.G.L. c. 71, § 57, upon entering kindergarten or within 30 days after school entry, the parent or guardian of each child shall present certification that the student within the previous 12 months has passed a vision screening conducted by personnel approved by the Department. The hearing of each student in the public schools to be screened in the year of school entry and annually through grade 3 (or by age nine in the case of ungraded classrooms), once in grades 6 through 8 (ages 12 through 14 in the case of ungraded classrooms), and once in grades 9 through 12 (ages 15 through 18 in the case of ungraded classrooms).

For any student who does not pass a vision or hearing screening, a written plan shall be developed by the school nurse, in consultation to the extent possible with a student’s parent or legal guardian, for appropriate follow up of the student.

BMI Screening

Weight and height shall be measured for each student in grades 1, 4, 7, and 10. The student’s Body Mass Index (BMI) score and corresponding percentile are calculated. Every effort will be made to protect student privacy during the screening process.

Postural Screening

All students in grade 5- 9 are required to receive an annual postural screening from the school nurse. Postural screenings are conducted in a manner that protects each student’s privacy, dignity, and comfort. Students are screened individually or in a private area by trained school health personnel. Students will be asked to follow the instructions necessary to complete the screening while maintaining appropriate coverage and privacy at all times.

SBIRT Screenings

Screening, Brief Intervention and Referral to Treatment is done in grades 7 and 9.

The screening uses the CRAFFT tool as recommended by the American Academy of Pediatrics’ Committee on Substance Abuse. Student screening sessions will be brief and conducted confidentially in a private,

one-on-one session.

https://masbirt.org/schools/caregivers

Dental Screenings

Abby Kelley Foster offers the opportunity for students to have a full dental screening through the Ronald McDonald Care Mobile including the application of fluoride twice a year.

Religious Objections

If parents have any objections based on their religion to routine physical examinations or other school protocols or practices, first aid in emergencies, or other medical procedures that might occur

in school, it is important that they contact the school in writing so that information may be recorded. Notwithstanding the receipt of such notice, if a staff member believes that the student is experiencing a medical emergency, they will contact 911 for assistance.

Bathroom or Spill Related Accidents

Kindergarten students are expected to have an extra labeled full pair of clothing (top, bottom, socks and underwear) in school as a backup for bathroom related accidents, spills etc. This backup does not have to be a school uniform.

Grades 1-12, In the event that a student needs a change of clothing due to a bathroom accident, extreme rip/tear or spill and student does not have a change of clothing, the nurse will be contacted to see if there is an appropriate spare article of clothing available. If in the case that there is no clothing available for the student, the parent, guardian, or emergency contact will be notified to request a change of clothes be dropped off.

Weather appropriate clothing

It is the responsibility of families to monitor weather conditions and be sure that your student is dressed appropriately. Layers are best as they can be removed. Students may choose to keep a spare uniform sweater in the class or locker should they become cold.

Students will not be sent to the Nurses to request weather appropriate clothing should they not be dressed appropriately.

Medical neglect and mandatory reporting

Medical neglect is, a form of child abuse, involves a caregiver’s failure to provide necessary medical care, leading to potential harm. Examples include delaying or refusing recommended medical treatment, ignoring obvious signs of serious illness, and failing to follow medical advice. Failure to provide documentation of required immunizations, screenings, physical exams, Contacting physicians for the required documents is the responsibility of the family, not that of the school nurse.
If families have not provided the school nurse with both the medication prescription and required documents after 3 attempted reach outs to the family (at least 24 hours apart) by the nurse or school administration, the family will be made aware that a 51A will be filed with the Department of Children and Families for medical neglect.

Abby Kelley Illness Policy and Procedures

If your child has a temperature of 100.0 degrees or greater within the last 24 hours they cannot be in school. Their temperature should be normal for 24 hours without the help of Tylenol, Motrin, or any other medication. Should your child return to school, the day after being sent home with a fever, parents/guardians will be called for pickup and are expected to come within an hour.
If your child has a diagnosis of strep throat, they need to remain at home until he/she has been on antibiotics for a full 24 hours.
If your child has vomited and is ill during the previous night or in the morning, they cannot attend school.
If your child has diarrhea and is ill during the previous night or in the morning, they cannot attend school.
If your child has a moist productive cough, chest congestion or thick nasal drainage, they should remain home.
If your child has red, itchy, or swollen eyes that itch or have yellow drainage, they should be seen by a doctor.

If the nurse suspects your child may have ringworm or impetigo, you will be notified. He/she should be seen by a physician and may return to school with a doctor’s note with a diagnosis. With these diagnoses, your child should remain at home until he/she has been on the course of treatment for a full 24 hours. With ringworm, the area should remain covered by a bandage while in school. (Please see the nurse for more information.)
Please contact the school or school nurse if your child has a communicable disease, such as chicken pox, measles, ringworm, impetigo or scabies.

Medication Policy

It is the responsibility of the parent/guardian to keep track of their students medication expiration dates and quantity on hand with the school. Parents/guardians should contact the nurse to arrange drop off of more medication when supply runs low or is nearing expiration.

Prescription medications may be administered at school by the nurse with a written order from a licensed healthcare provider, with written parent permission, and in the original prescription labeled bottle.

Medications must not be expired and must be in the original unopened packaging with the original pharmacy label attached. Medications will not be accepted in plastic baggies or other containers from home.

Under Massachusetts Department of Public Health regulations (105 CMR 210.008), no more than a 30 school-day supply of a student’s prescription medication may be stored at a school nurse’s office. Medication must be verified and counted by the nurse and parent/guardian at the time of drop off and pick up. Controlled medications require parent/guardian to meet, count & verify quantity and sign off prior to dropping off or picking up medications.

Students cannot self-medicate during the school day with medication brought in from home.

Daily medications that are scheduled to be given outside of school hours are the responsibility of the parent/guardian and need to be given at home. Clinical research heavily validates that timing ADHD medication so that it is fully active before the school day starts dramatically improves classroom behavior, focus, and seatwork productivity. These medications should be given immediately upon waking or, roughly 30 to 60 minutes before school starts. This timing allows the medication to take effect by the time morning routines and the school day begin, while avoiding sleep disruptions. https://pmc.ncbi.nlm.nih.gov/articles/PMC4576958/

For the safety of your child and others, children CANNOT transport medication to and from school. They must be handed off from a responsible adult, to the nurse and the same when giving medication back.

Arrangement for end of the year medication pickup will be made by the nurse. Emergency medications will need to be kept in school until the last day. Medications that are not picked up on the last day of school will be properly disposed of. Medications will not be kept in the building over the summer until the next school year.

Over-The-Counter Medications (OTC):

The school physician, in consultation with the District Lead Nurse, is responsible for the OTC medication policy and will sign off on a standing order for pre-determined OTC medications prior to the start of each academic year.

The standing order OTC medications may not be given to students without written parent/guardian permission. Telephone consent is not accepted.
OTC medication can only be given by the school nurse. OTC medications cannot and will not be delegated in ordinance with

https://www.mass.gov/regulations/105-CMR-21000-the-administration-of-prescription-medications-in-public- and-private

The standing order OTC medications shall only be given once during the school day and not more than 3 times in 30 days.
AKFCS Health offices shall maintain a supply of physician approved standing order OTC medications for each health office.
Cough drops are considered an over the counter medication and will not be distributed by the school health office.
Benadryl (diphenhyamine) or any other OTC allergy medication will not be administered for seasonal allergies or dermatitis related concerns. If benadryl is a standing order on a students action plan, students will need to be picked up by parent/guardian immediately following administration. Students with Benadryl on their action plan, must have their own supply provided by the parent/guardian as well as a valid medication order to accompany the benadryl.
OTC medications will not be given within the first hour of arrival to school or within the last hour prior to the end of the school day (unless a nurse deems medically necessary and/or the student is being dismissed by parent or guardian or designated adult immediately after administration).

Over the counter medication (acetaminophen, ibuprofen etc) will be administered by the school nurse with a signed parent/guardian consent. A new consent must be submitted every school year and dated after June 30th to reflect the new school year.

Emergency Medication

Emergency medications such as Seizure medications, Epi pens, Inhalers Adrenal medications ect, must also be accompanied by a signed action plan and a doctor’s order. Action plan and order must be signed by both the prescriber and the parent/guardian. All Doctors orders and action plans must be dated after June 30th Medications will not be accepted without all proper documentation.

Students who do not have their emergency medication and all required documents on file with the School Nurse, will not be permitted to attend scheduled field trips or before and after activities without their emergency medications.

Elementary school students may consume cough drops (dropped off to the school by a responsible adult). Cough drops will need to be accompanied by a parent/guardian written consent and must leave them in the nurse’s office as they are considered an over the counter medication.

There will be no exceptions to these medication requirements.

Abby Kelley Lice Policy

If a student is found to have head lice or nits (eggs) during school hours, the parent/guardian will be contacted for pick up. Students will not be allowed to attend school until proper treatment has been obtained and the student is lice and nit free. After treatment, parent/guardian should contact the school nurse to arrange for the nurse to recheck the student prior to reentry. The parent/legal guardian is required to bring the child to the nurse’s office for a recheck before being cleared to return to school. If there is evidence of lice or nits, the parent/guardian will need to take their student home and continue to treat. If the student is cleared by the nurse, they may return to class. Parents/guardians will be responsible for their students continued care and rechecks.