Current through Register Vol. 63, No. 9, September 1, 2024
(1) School
districts, education service districts, and public charter schools shall
develop, implement, and annually update a written prevention-oriented health
services plan for all students. The plan must describe a health services
program for all students at each facility that is owned or leased where
students are present for regular programming. The health services plan will be
created and maintained by the administration of each district and charter
school serving students. Health services plans must include:
(a) Health care space that is appropriately
supervised and adequately equipped for providing health care and administering
medication or first aid.
(b)
Communicable disease prevention and management plan that includes school-level
protocols for:
(A) Notifying the local public
health authority (LPHA) if absence due to illness threshold, as established by
the Oregon Health Authority (OHA) or LPHA, of students and staff is
attained.
(B) Exclusion of
individuals consistent with OAR 333-019-0010, with a description of an
isolation space that is appropriately supervised and adequately equipped and
that can be used exclusively for the supervision and care of a sick child when
a sick child is present in the school.
(C) Implementing mitigation measures if cases
warrant or if recommended by the Oregon Health Authority or LPHA.
(D) Identifying, understanding and responding
to the needs of students who are more likely to have severe disease outcomes or
loss of access to education due to a communicable disease, and responding to
those needs.
(E) Responding to the
mental health impacts of a communicable disease outbreak in the
school.
(F) Ensuring continuity of
education for students who may miss school due to illness.
(c) A district-to-school communication plan
that includes a:
(A) Point of contact to
facilitate communication, maintain healthy operations, and respond to
communicable disease questions from schools, state or local public health
authorities, state or local regulatory agencies, students, families and
staff;
(B) Protocol to provide all
staff and families with contact information for the point of contact;
and
(C) Process to notify as soon
as possible all families and other individuals if there has been a case of a
restrictable disease as defined by OAR 333-019-0010 on the premises if advised
by an LPHA or the OHA.
(d) Health screening information, including
required immunizations and TB certificates, when required by ORS
433.260 and
431.110 and OAR
333-019-0010.
(e) Services for all
students, including those who are medically complex, medically fragile or
nursing dependent, and those who have approved 504 plans, individual education
program plans, and individualized health care plans or special health care
needs as required by ORS
336.201,
339.869, OAR 581-021-0037,
581-015-2040, 581-015-2045, and 851-045-0040 to 0060;. and 851-047-0010 to
0030.
(f) Integration of school
health services with school health education programs and coordination with
health and social service agencies, public and private.
(g) Hearing screening; and vision and dental
screening as required by ORS
336.211 and
336.213.
(h) Process to assess and determine a
student's health services needs, including availability of a nurse to assess
student nursing needs upon, during, and following enrollment with one or more
new medical diagnose(s) impacting a student's access to education, and
implement the student's individual health plan prior to attending as per
336.201.
(i) Compliance with
OR-OSHA Bloodborne Pathogens Standards for all persons who are assigned to job
tasks which may put them at risk for exposure to body fluids per OAR
437-002-0360.
(j) Policy and
procedures for medications, as per ORS
339.866 to
339.874 and OAR
581-021-0037.
(k) Guidelines for
the management of students who are medically complex, medically fragile, or
nursing dependent as defined by ORS
336.201, including students with
life-threatening food allergies and adrenal insufficiency while the student is
in school, at a school-sponsored activity, under the supervision of school
personnel, in before-school or after-school care programs on school-owned
property, and in transit to or from school or school-sponsored activities. The
guidelines must include:
(A) Standards for the
education and training of school personnel to manage students with life
threatening allergies or adrenal insufficiency;
(B) Procedures for responding to
life-threatening medical conditions including allergic reactions or adrenal
crisis;
(C) A process for the
development of an individualized health care plan for every medically complex,
medically fragile, nursing dependent student, including students with a known
life-threatening allergy and an individualized health care plan for every
student for whom the school district has been given proper notice of a
diagnosis of adrenal insufficiency per OAR 581-021-0037;
(D) Protocols for preventing exposures to
allergens; and
(E) A process for
determining if or when a student may self-carry prescription medication when
the student has not been approved to self-administer medication as allowed by
581-021-0037.
(2) School districts, education service
districts, and charter schools shall ensure that nurses who provide health
services to students are licensed to practice nursing by the Oregon State Board
of Nursing (OSBN):
(a) School districts,
education service districts, and charter schools may employ Licensed Practical
Nurses (LPN) in alignment with LPN supervision requirements of OAR 851-045-0050
to 0060.
(b) Job descriptions and
nursing delegation considerations shall reflect assignments complying with the
Oregon State Board of Nursing Scope of Practice Administrative Rules for all
levels of licensed providers, including standards for the evaluation and
assessment of students, provision of services, medication administration,
supervision of unlicensed staff and documentation of services provided per
Division 47.
(c) School districts,
education service districts, and charter schools that employ Registered Nurses
who are not certified by the Teacher Standards and Practices Commission as
school nurses, shall not designate such personnel as "school nurse" by job
title.
(3) Each school
shall have, at a minimum, at least one staff member with a current first
aid/CPR/AED card for every 60 students enrolled, as set by ORS
339.345, and
342.664 and who are trained
annually on the district and building emergency plans. Emergency planning will
include the presence of at least one staff member with a current first
aid/CPR/AED card for every 60 students for school-sponsored activities where
students are present.
(4) Schools
that contract or pay for health services must ensure services are
comprehensive, medically accurate, and inclusive as defined by OAR
581-022-2050.
(5) Each school
building must have a written plan for response to medical emergencies; such
plan should be articulated with general emergency plans for buildings and
districts as required by OAR 581-022-2225.
