Transcript Legislation of Interest to School Health Center

18%
of reactions were in the school setting
(McIntyre CL Pediatrics 2005)
Data
collection over a 2 year time showed
majority of reactions occurred in the
classroom (Sicherer S JACI 2003)
Cow’s milk
Soy
Egg white
Wheat
Peanut
Tree nuts
Fish
Shellfish
Effective date 8-13-09
 Requirements

› Established a committee to develop guidelines for
the management of students with life-threatening
food allergies
› Required school districts to implement a policy
based on the guidelines by January 1, 2011
› Required training for school personnel who work
with pupils on management of students with life
threatening food allergies,

Education and training for school personnel
› Required at least every 2 years
› Guidelines include handouts for various staff on
preventing and responding to life-threatening
allergic reactions
› All must be trained on use of Epinephrine Auto
injector
 Use manufacturer video
 Provide written materials

Development and implementation of
individualized food allergy action plans
› Sample Plans in Guidelines
› Based on healthcare provider order
› Include parent input
Then
› Educate staff

Protocols to prevent exposure to food
allergens
› Handouts to educate staff
› Sample letters to parents
› Lunch room protocols
› Classroom protocols
› Wash hands
› Resources:
 www.Childrensmemorial.org/FACE
 www.faiusa.org
 www.foodallergy.org
› Christine Szychlinski, APN, CPNP
 Manager, Food Allergy Program at Children’s
Memorial Hospital Chicago, IL
 [email protected]
› Online course
 https://www.childrensmemorial.org/ce/online/article.
aspx?articleID=255
Train clinic staff to recognize severe
respiratory distress and anaphylaxis
 Have all staff trained in CPR
 Have epinephrine readily available in Clinic
emergency kit
 Educate your staff on use of epinephrine auto
injector

› When can they administer?
Allows schools to maintain stock supply of
Epinephrine auto-injectors as prescribed by a
physician
 Allows designated lay staff to administer stock
supply to students with individual order on file
 Allows nurses to administer to any student who
they believe is having an anaphylactic reaction
 Contains language affording protection from
liability except for willful and wanton conduct






Recent survey 618 responding, only 22.3% have
epi on hand
Good Samaritan Act does not cover lay school
staff who provide care to students
School code states that no non-administrative
personnel other than a school nurse can be
required to give medication
Unions tell members not to volunteer to give
medication
Person should be given written assurance that
they will be provided legal counsel if needed.

Child Health Examination Code was changed
› 5) Beginning with school year 2011-12, any child
entering sixth grade shall show proof (see Section
665.250(b) of receiving one dose of Tdap (defined
as tetanus, diphtheria, acellular pertussis) vaccine
regardless of the interval since the last DTaP, DT
or Td does.
› 6) Students entering grades seven through 12 who
have not already received Tdap are required to
receive 1 Tdap dose regardless of the interval since
last DTaP, DT or Td dose.
Will only be enforced for students entering
sixth and ninth grades fall 2012
› Students in these grades without one of the
following will be subject to exclusion:
 Proof of Tdap vaccination
 An approved medical or religious exemption on file
with the school,
 An appointment to receive the Tdap shot during the
school year.
› See FAQ
Pediatric DTaP or DTP is only licensed for use
in persons less than 7 years of age, but may be
accepted if inadvertently administered to
students aged 7 and older.
 Receipt of Td (brand name DECAVAC or
TENIVAC) or DT does not meet the new
school Tdap requirement because they do not
protect against pertussis.

Although school staff and parents are not
required to receive the Tdap vaccine, the
IDPH recommends that all persons 10 years of
age and older get vaccinated with Tdap to
protect against the ongoing threat of whooping
cough.

To view the full text of current language in
Section 665.240 of the IDPH rules, go to
http://www.ilga.gov/commission/jcar/adminco
de/077/077006650B02400R.html.
FOR USE IN DCFS LICENSED CHILD CARE FACILITIES
CFS 600
Rev 12/2011
State of Illinois
Certificate of Child Health Examination
Student’s Name
Birth Date
Last
First
Address
Middle
Street
City
Sex
Race/Ethnicity
School /Grade Level/ID#
Month/Day/Year
Parent/Guardian
Zip Code
Telephone # Home
Work
IMMUNIZATIONS: To be completed by health care provider. Note the mo/da/yr for every dose administered. The day and month is required if you cannot
determine if the vaccine was given after the minimum interval or age. If a specific vaccine is medically contraindicated, a separate written statement must be
attached explaining the medical reason for the contraindication.
1
MO DA YR
2
MO DA YR
3
MO DA YR
4
MO DA YR
5
MO DA YR
TdapTdDT
TdapTdDT
TdapTdDT
TdapTdDT
TdapTdDT
TdapTdDT
 IPV  OPV
 IPV  OPV
 IPV  OPV
 IPV  OPV
 IPV  OPV
 IPV  OPV
Vaccine / Dose
6
MO DA YR
DTP or DTaP
Tdap; Td or Pediatric
DT (Check specific type)
Polio (Check specific
type)
Hib Haemophilus
influenza type b
Hepatitis B (HB)
COMMENTS:
Varicella
(Chickenpox)
MMR Combined
Measles Mumps. Rubella
Measles
Single Antigen
Vaccines
Rubella
Mumps
Pneumococcal
Conjugate
Other/Specify
Meningococcal,
Hepatitis A, HPV,
Influenza
Health care provider (MD, DO, APN, PA, school health professional, health official) verifying above immunization history must sign below. If adding dates to
the above immunization history section, put your initials by date(s) and sign here.)
Signature
Title
Date
Signature
ALTERNATIVE PROOF OF IMMUNITY
Title
Date
1. Clinical diagnosis is acceptable if verified by physician.
*(All measles cases diagnosed on or after July 1, 2002, must be confirmed by laboratory evidence.)
*MEASLES (Rubeola) MO DA YR MUMPS MO DA YR VARICELLA MO DA YR
Physician’s Signature
2. History of varicella (chickenpox) disease is acceptable if verified by health care provider, school health professional or health official.
Person signing below is verifying that the parent/guardian’s description of varicella disease history is indicative of past infection and is accepting such history as documentation of disease.
Date of Disease
Signature
3. Laboratory confirmation (check one) Measles
Lab Results
Date
Title
Mumps
MO
DA
Rubella
Date
Hepatitis B
Varicella
(Attach copy of lab result)
YR
VISION AND HEARING SCREENING BY IDPH CERTIFIED SCREENING TECHNICIAN
Date
Code:
Age/
Grade
R
Vision
Hearing
L
R
L
R
L
R
L
R
L
R
L
R
L
R
L
R
L
P = Pass
F = Fail
U = Unable to test
R = Referred
G/C =
Glasses/Contacts
Student’s Name
First
HEALTH HISTORY
ALLERGIES
Sex
Birth Date
Last
Middle
School
Grade Level/ ID #
Month/Day/ Year
TO BE COMPLETED AND SIGNED BY PARENT/GUARDIAN AND VERIFIED BY HEALTH CARE PROVIDER
MEDICATION (List all prescribed or taken on a regular basis.)
(Food, drug, insect, other)
Diagnosis of asthma?
Child wakes during night coughing?
Yes
Yes
No
No
Loss of function of one of paired
organs? (eye/ear/kidney/testicle)
Yes
No
Birth defects?
Yes
No
No
Yes
No
Hospitalizations?
When? What for?
Yes
Developmental delay?
Blood disorders? Hemophilia,
Sickle Cell, Other? Explain.
Diabetes?
Yes
No
No
No
Surgery? (List all.)
When? What for?
Serious injury or illness?
Yes
Yes
Yes
No
Head injury/Concussion/Passed out?
Yes
No
TB skin test positive (past/present)?
Yes*
Seizures? What are they like?
Yes
No
TB disease (past or present)?
Yes*
No *If yes, refer to local health
department.
No
Heart problem/Shortness of breath?
Yes
No
Tobacco use (type, frequency)?
Yes
No
Heart murmur/High blood pressure?
Yes
No
Alcohol/Drug use?
Yes
No
Family history of sudden death
before age 50? (Cause?)
Yes
No
Yes
No
Dizziness or chest pain with
exercise?
Eye/Vision problems? _____ Glasses  Contacts  Last exam by eye doctor ______
Other concerns? (crossed eye, drooping lids, squinting, difficulty reading)
Ear/Hearing problems?
Yes
No
Bone/Joint problem/injury/scoliosis?
Yes
Dental
 Braces


Information may be shared with appropriate personnel for health and educational purposes.
Parent/Guardian
Signature
No
PHYSICAL EXAMINATION REQUIREMENTS
Date
Entire section below to be completed by MD/DO/APN/PA
HEAD CIRCUMFERENCE if <2-3 years old
HEIGHT
WEIGHT
BMI
B/P
DIABETES SCREENING (NOT REQUIRED FOR DAY CARE) BMI85% age/sex Yes No And any two of the following: Family History Yes  No 
Ethnic Minority Yes No  Signs of Insulin Resistance (hypertension, dyslipidemia, polycystic ovarian syndrome, acanthosis nigricans) Yes No  At Risk Yes  No 
LEAD RISK QUESTIONNAIRE Required for children age 6 months through 6 years enrolled in licensed or public school operated day care, preschool, nursery school and/or kindergarten.
Questionnaire Administered ? Yes  No 
Blood Test Indicated? Yes  No 
Blood Test Date
(Blood test required if resides in Chicago.)
TB SKIN OR BLOOD TEST Recommended only for children in high-risk groups including children immunosuppressed due to HIV infection or other conditions, frequent travel to or born in
high prevalence countries or those exposed to adults in high-risk categories. See CDC guidelines.
No test needed 
Test performed 
Skin Test: Date Read
/ /
Result: Positive  Negative 
mm ______________
Blood Test: Date Reported
/ /
Result: Positive  Negative 
Value ______________
Date
LAB TESTS (Recommended)
Results
Date
Hemoglobin or Hematocrit
Urinalysis
SYSTEM REVIEW
Results
Sickle Cell (when indicated)
Developmental Screening Tool
Normal Comments/Follow-up/Needs
Normal Comments/Follow-up/Needs
Skin
Endocrine
Ears
Gastrointestinal
Eyes
Amblyopia Yes
No
Neurological
Throat
Musculoskeletal
Mouth/Dental
Spinal Exam
Cardiovascular/HTN
LMP
Genito-Urinary
Nose
Nutritional status
 Diagnosis of Asthma
Respiratory
Currently Prescribed Asthma Medication:
 Quick-relief medication (e.g. Short Acting Beta Antagonist)
 Controller medication (e.g. inhaled corticosteroid)
NEEDS/MODIFICATIONS required in the school setting
Mental Health
Other
DIETARY Needs/Restrictions
SPECIAL INSTRUCTIONS/DEVICES e.g. safety glasses, glass eye, chest protector for arrhythmia, pacemaker, prosthetic device, dental bridge, false teeth, athletic support/cup
MENTAL HEALTH/OTHER
Is there anything else the school should know about this student?
If you would like to discuss this student’s health with school or school health personnel, check title:
 Nurse
 Teacher  Counselor  Principal
EMERGENCY ACTION needed while at school due to child’s health condition (e.g. ,seizures, asthma, insect sting, food, peanut allergy, bleeding problem, diabetes, heart problem)?
Yes  No 
If yes, please describe.
On the basis of the examination on this day, I approve this child’s participation in
PHYSICAL EDUCATION
Print Name
Address
Yes 
No 
(If No or Modified,please attach explanation.)
Modified 
INTERSCHOLASTIC SPORTS (for one year)
(MD,DO, APN, PA)
Signature
Phone
(Complete both sides)
Yes 
No 
Limited 
Date