School Health

 

Overview

SCHOOL HEALTH SERVICES

The Bristol-Burlington Health District nursing staff provides comprehensive school health services by registered nurses and health aides designed to promote optimal health, safety and well-being of students enrolled in the Bristol schools. School health services include providing emergency care and first aid; assessment of student illness/injury and medical care needs; case management of students with chronic health condition; administration of medication and treatment during school hours; performing mandated screenings for vision, and scoliosis; controlling communicable diseases; health education and promotion; as well as serving as a liaison for students/ families to community health care providers and other resources.

SCHOOL DENTAL PROGRAM


The Bristol-Burlington Health District registered dental hygienists with signed consent by a parent/legal guardian provide an examination of teeth and gums of students in Kindergarten to Grade 8 as well as a dental cleaning as needed. The dental hygienist also documents findings with recommendations for follow up care with a dentist.

 

HEALTH ASSESSMENT REQUIREMENTS:

  • See Forms Section For A Health Assessment/Physical Examination Form.

A health assessment/physical examination is required for initial enrollment into Bristol schools. The health assessment /physical examination must be performed by a legally qualified practitioner of medicine such as a physician (M.D. or D.O.), physician Assistant (PA), or advance practice registered nurse (APRN) and must be documented on a Health Assessment Record form (blue form). Forms are available in the school health room office or on the Bristol – Burlington Health District website-at www.bbhd.org. If a homeless student, as defined by federal statute, lacks immunization/medical records, the school will enroll the child and refer the parent/guardian to the school nurse and district’s homeless liaison.

Pre-Kindergarten and Kindergarten:

  •  Any three (3) year old child entering a Pre-kindergarten program is required to have a health assessment dated within 365 days of entering school.
  • If a student enters a Pre-Kindergarten program as a three year old, the health assessment/physical examination must be repeated before entrance into Kindergarten within 365 days of entering school.
  •  Any  four (4) year old entering Pre-Kindergarten for first time is required to have a health assessment/physical examination dated with 365 days of entering school.
  •  Any student entering Kindergarten for the first time is required to have a health assessment/physical examination dated within 365 days of entering school.
  • (SEE FORMS SECTION – For A Health Assessment/Physical Examination Form)

Grades 6/7 and Grades 9/10:

Students are required to have a health assessment/physical examination as follows:

  • During sixth grade, as a requirement for seventh grade.
  • During ninth or tenth grade as requirement for eleventh grade.

 Student Transferring Within the District:

  1. Students within the district: do not need medical clearance from one school to the other.
  2. Students from parochial schools: do not need medical clearance from parochial schools to public schools within the district.

 Students Entering From Outside the District:

Students that are entering from outside the district within the State of Connecticut must have a current health assessment /physical examination that is in accordance with state mandated requirement.

Students Entering From Outside the State:

Students that are entering from outside the state must have a health assessment/physical examination that complies with the State of Connecticut law secs. 10-204 and 10-206, with required immunizations for the entering grade, and is completed within 365 days of the entrance date to the Bristol schools.

 Students Entering From Outside the Country – (outside the United States /U.S. Territory):

Students that are entering from outside the country (which is outside the United States and U.S. Territories) must have a health assessment/physical examination performed in the United States or U.S. Territories that is in accordance with the State of Connecticut requirements within 365 days of the entrance date of school. Immunizations for the entering grade will also be required. Immunizations received in their native country will be accepted if in compliance with the required immunizations of the State of Connecticut.

In addition, Tuberculosis screening or proof of a recent Mantoux tuberculin test and/or a negative chest x-ray will be required in accordance with the State of Connecticut guideline listing of high incidence countries for Tuberculosis. Test results and /or Chest x-ray (if necessary) must be obtained before entrance is allowed.

United States Military Base:

Students that are entering from a U.S. military base, may according to Connecticut General Statute 10-206, have a health assessment/physical examination performed by a legally qualified practitioner of medicine, an advanced practice registered nurse or a physician assistant stationed at a military base for enrollment in Connecticut schools.

Out of District Placement- Magnet /Private Placement:

Students registered in the Bristol schools but are not physically attending school within the district, medical clearance is not necessary. It is the responsibility of school health services of the school the student attends to ensure compliance of the State of Connecticut requirements for health assessment/physical examination and immunizations.

Returning from Out of District Placement:

  1. Within State: Students returning from out of district placement, will need medical clearance in accordance with state mandated physicals if coming from out of district placement within the state.
  2. Outside of State: Students returning from out of district, out of state placement, will need medical clearance and must have a health assessment/ physical examination within 365 days of the entrance date of school as well as the required immunizations for the entering grade.

 

 INTERSCHOLASTIC SPORTS PARTICIPATION

Health Assessment/Physical Examination Requirement:
A health assessment /physical examination is required for a student to participate in practice and interscholastic sports.

 The health assessment /physical examination must be performed by a legally qualified practitioner of medicine such as a physician (M.D. or D.O.), physician Assistant (PA), or advance practice registered nurse (APRN)
The Health Assessment Record Form (blue form HAR-3 rev. 4/17) is used as the Sports Participation Health Assessment Record. This form must be completed prior to students participating in practice and interscholastic sports. It must be completed by parents/legal guardians (front page) and the health care provider (page 2 and page 3). Forms are available in the school health room office or on the Bristol – Burlington Health District website-at www.bbhd.org. Please contact your School Nurse if you have questions.

   ALL SPORTS PHYSICALS ARE VALID FOR A PERIOD OF 13 MONTHS FROM THE DATE OF THE PHYSICAL EXAM.

 INTERMURAL SPORT PARTICIPATION
Health Assessment/Physical Examination Requirement:

A current health assessment /physical examination record (blue form) is required for a student participating in practice and intramural sport.
Please contact your School Nurse if you have questions.

 

IMMUNIZATION REQUIREMENTS:

All students are to comply with the State of Connecticut immunization requirements for enrolled students in Connecticut schools. Proof of immunizations are required for all new entrants. Requirements change from year to year.

New entrant definition: new to Bristol school district including preschoolers and all students from another private, parochial, or charter school in the same or another community.

  • One exception: students returning from private approved special education placements.In addition to the required immunizations for initial entry into school for Pre-Kindergarten and Kindergarten, additional immunizations are required depending on the grade level or age.

The school must enroll any homeless student even if the student is unable to produce the required medical and immunization records.

Medical Exemption: If a student should not be immunized due to medical reasons or medical contraindications, a medical exemption form statement from the health care provider must be completed and provided to the school nurse. This exemption is to be renewed annually.
(SEE FORMS SECTION – For A Medical Exemption Form)

Religious Exemption: If a student is not immunized due to contrary to religious beliefs, a religious exemption form must be completed, signed and officially acknowledged by any of the following: notary public, judge, clerk/deputy clerk of a court, town clerk, justice of the peace, attorney and submitted to the school nurse before enrolling in school for the first time and before entering seventh grade.

  • (SEE FORMS SECTION – For A Religious Exemption Form)

In addition to the required immunizations for initial entry into school for Pre-Kindergarten and Kindergarten, additional immunizations are required depending on the grade level or age. The school must enroll any homeless student even if the student is unable to produce the required medical and immunization records.

For further information regarding immunizations contact your school nurse

IMMUNIZATION CLINIC:

  • Bristol- Burlington Health District has an immunization clinic and is provider of State of Connecticut Vaccines for Children Program.
  • Immunization Clinic Hours – Wednesday (except holidays) 2:00 – 3:30 p.m. BY APPOINTMENT ONLY
    Call the Bristol –Burlington Health District for more information at 860-584-7682.

 

STUDENT MEDICATION ADMINISTRATION INFORMATION:

A medication authorization form is required for any medication (including any prescription, controlled or over- the – counter medicine preparation) to be given/taken during school hours. The form must be filled out properly and signed by both the parent/guardian and the health care provider. Forms are available in the school health room office or on the Bristol – Burlington Health District website-at www.bbhd.org. All medication must be in original container with proper labels. A request may be made to the pharmacist to prepare two separate bottles, if medication is given at home and at school.  Only a 90 day supply is allowed in school.

A student may NOT transport medication to school under any circumstance. Medication must be brought to school and picked up at the end of the school year by a parent/guardian. Parents of students requiring medication during school should contact the school nurse.

A student with a verified chronic medical condition is permitted to self-administer prescribed medication. The appropriate section of the medication authorization form must be completed and signed by the health care provider and parent/guardian to give authorization and indicate that the student is capable of self-administering the medication.  Self- administration means the control of the medication by the student at all times and is self-managed by the student according to the individual medication plan. The medication form must be submitted to the school nurse for review. The school nurse will assess the student’s competency and deem it to be safe and appropriate for the student to self-administer medication.

A student with asthma may carry an inhaler or a student with medically-diagnosed allergies may carry a cartridge injector (epinephrine) in school at all times to ensure prompt treatment to protect the student against serious harm or death. A medication authorization form must be completed and signed by the health care provider and the parent/guardian. The appropriate section of the medication authorization form must be completed and signed by the health care provider and parent/guardian to give authorization and indicate that the student is capable of self-administering the medication.

Self- administration means the control of the medication by the student at all times and is self-managed by the student according to the individual medication plan. The school nurse’s review of a student’s competency to self-administer inhalers for asthma and cartridge injectors for medically-diagnosed allergies will not prevent a student from retaining and self-administering inhalers for asthma and cartridge injectors for medically-diagnosed allergies.

A school nurse, or in the absence of the nurse, a “qualified school employee” (who has completed the required training) may administer epinephrine in a cartridge injector for the purpose of emergency first aid to students who experience allergic reactions but were not previously known to have serious allergies and therefore do not have prior written authorization of a parent/guardian or qualified medical professional for the administration of epinephrine. It is to be administered only on school grounds during regular school hours in the absence of the school nurse.

Parents/guardians may submit in writing to the school nurse and school medical advisor that epinephrine shall not be administered to his/her child.

A school nurse, or in the absence of the nurse, a “qualified/school employee” (who has completed the required training) may administer anti-epileptic medication to a specific student with a medically diagnosed epileptic condition that requires prompt treatment in accordance with the student’s individual seizure action plan. A medication authorization form must be completed and signed by the health care provider and the parent/guardian.

A student with diabetes may test his/her own blood glucose levels if the student has written permission from his/her parents/guardian and a written order from the health care provider.  A medication authorization form must be completed and signed by the health care provider and the parent/guardian. The time or place of such testing shall not be restricted.

A school nurse or the principal will select a qualified school employee to, under certain provisions, to administer glucagon injection to a student with diabetes who may require prompt treatment to protect him/her from serious harm or death. This would be limited to situations when the school nurse is absent or unavailable. A medication authorization form must be completed and signed by the health care provider and the parent/guardian.

The Health District does not allow the ingestion of marijuana for palliative (medical) use in any school, on school grounds or at school-sponsored activities, on or off school grounds.

At end of the school year, medications must be picked up by parent/legal guardian or they will be destroyed. Medications will not be released to students.

 

COMMUNICABLE /INFCTIOUS DISEASES:

Students with any medical condition which within the school setting may expose others to disease or contagious and infectious conditions may be excluded from school and referred for medical diagnosis and treatment. Before a child may return to school after an absence due to such condition, parents will be required to submit a statement from the health care provider that their child has recovered sufficiently to prevent exposing others. Additional information concerning this may be obtained from the school nurse.

 

STUDENT ILLNESS:

It is important that parents call the school when student is sick. If a student is to be excused or limited for an extended period from participation in school activities, he/she is required to bring a statement signed by a health care provider. The school nurse is available to parents and students for conferences regarding health issues.

If a child is dismissed from school by the school nurse and is not allowed to return the next day, the school nurse will complete an excused absence form for that day. If a student presents with a fever of 100 degrees or higher, the student is unable to return to school until FEVER-FREE FOR 24 HOURS.

 

Health Reasons for Dismissal:

The following are some common health reasons for dismissal. A student may also be dismissed for other health related issues:

Chickenpox/Breakthrough Chickenpox: A student may not return to school until all   lesions are dry (usually 4-6 days after onset of rash).

Fever: A student will be sent home for a fever of 100 degrees or higher. A student must be fever free for 24 hours without fever medication in order to return to school.

Fifth’s Disease: A student must be fever free for 24 hours without fever medication in order to return to school.

Hand, Foot and Mouth Disease: A student will not be allowed in school with draining hand lesions, blisters in mouth with drool or a fever of 100 degrees F or higher. A student may return to school when hand lesions are dry, drool free and fever free for 24 hours without fever medication.

Impetigo: A student must be treated with a prescribed antibiotic for 24 hours in order to return to school.

 MRSA (skin infection): A student will be dismissed from school for open draining sores/boils that cannot be covered. The student may return to school if affected area is covered and is fever free and has been on a prescribed antibiotic for at least 24 hours.

Pediculosis (head lice): A student will be dismissed if live lice have been found. The student will be able to return to school after appropriate treatment. The student and parent/legal guardian must report to the school health room upon return. The student will then be checked daily for the next 10 days.  The student will not be allowed back to school if live lice are found.

Rashes: A student will be dismissed from school for a rash with fever and/or behavioral changes. A note from the health care provider is required in order to return to school.

Ringworm: A student may return to school once a prescribed treatment from a health care provider has been started.

Scabies: A student may return to school after a prescribed treatment from a health care provider has been started.

Strep Throat: A student may return to school when fever free and has been on antibiotics for at least 24 hours.

Vomiting or Diarrhea: A student will be dismissed from school. The student may return to school when symptom free (no vomiting, diarrhea) for at least 24 hours.

HEALTH SCREENINGS:

Screenings performed in school are hearing, scoliosis and vision. These screenings are mandated by Connecticut State law. The purpose of the screenings is to identify students with possible difficulties that need further evaluation and possible treatment/intervention in order to reduce impact on the learning process.

The screenings are provided annually as follows:

Hearing: Kindergarten, grade 1, and grades 3 through 5.

Scoliosis: female in grades 5 & 7. Males in grade 8.

Vision: Kindergarten, grade 1, and grades 3 through 5.

In addition, the following screenings are provided annually:

Pediculosis (head lice): Pre – Kindergarten through grade 5.

Height and Weight: Pre-Kindergarten to grade 5.

 

STUDENT HEALTH RECORDS:

The school nurse maintains individual student health records using the State of Connecticut“Cumulative Health Record”. Information in these records are accessible are on a need to know basis with permission granted by the school nurse or Health Director.  Parents may request to inspect the health records of their child. Copies may be provided if requested.

When a student transfers to another school within the state, the original record is sent. A copy of the health record is maintained at the Bristol-Burlington Health District.

In the case of student moving out-of-state, a copy of the health record, when requested, is sent to the school the student will be attending. The original health record is maintained at the Bristol- Burlington Health District.

Health records are maintained for at least six years after the student graduates.

The Health District does comply with the requirements of the Health Insurance Portability and Accountability Act (HIPPA) and Family Educational Rights and Privacy Act (FERPA) to maintain the privacy of protected health information.

 

Additional Resources:

  • Bristol Public Schools
  • Connecticut State Department of Education
  • Family Educational Rights and Privacy Act (FERPA)
  • Connecticut State Department of Public Health –Immunization Program
  • Center for Diseases Control

 

Frequently Asked Questions

When should I keep my child home from school?

                • When child complains of being sick.
                • Symptoms such as sore throat, head cold, diarrhea, vomiting, fever greater than 100 degrees F within last 24 hours.
                • If child had dose of Tylenol or Ibuprofen in morning. Medication will wear off and fever will return.
                • More difficult situation when child complains of being sick in morning, but does not appear to have symptoms. Use your best judgment in those situations.

When are students sent home from school?

                • Fever of 100 degrees or higher.
                • A complaint of severe nausea, vomiting, stomach aches, headache, or sore throat, and appears to be sick.
                • Presence of head lice, head lice nits, or conjunctivitis (pink eye).
                • Infectious diseases such as chickenpox and impetigo.

When will students not be sent home?

                • A compliant of nausea, stomach aches, headache or sore throat, but who do not act sick when lying down in Health Room (playful, talkative and active).

When my child has been home sick, when can they return to school?

                • Once symptoms have stopped and they are fever free (temperature less than 100 degree F) for 24 hours.
                • If child has a fever in evening/night before, please do not send child to school in morning even if fever is down first thing in morning. Often early morning temperatures are a degree or two lower than afternoon temperatures.

When will I be called by the school health room staff?

                • If child is sick (vomiting, diarrhea, temperature over 100 degree F), has head lice, or a problem such as a rash not previously identified that was brought to the attention of Health Room staff.
                • For injuries of significance (small scrapes will be treated without calling), any changes in known health conditions, and any health conditions not responding as expected to medications/treatments provided in Health Room.
                • If Health Room staff is worried about a behavior or behavior change.

When reporting my child is sick, what should I report to school?

                • Let school staff know what is wrong with child.
                • Try to be as specific as possible. Example: let school health staff know if he/she has fever, diarrhea, or head cold.
                • When a physician diagnoses a  contagious illness such as strep throat, mononucleosis, meningitis, Shigella, ringworm, scabies, influenza, or any childhood disease such as chickenpox or Fifth’s disease.
                • When the child is admitted to a hospital.

When my child has had head lice, when can they return to school?

            • When your child has been treated with an anti-lice product such as RID or NIX and all lice and nits (eggs) have been removed from their head.
            • Rechecks will be done by Health Room staff before child allowed to return to school.
            • For more information about elimination of head lice, contact Health Room staff.