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Chronic Conditions Management

Section 704.12 | Board Report 20-0624-PO4 | Date Adopted June 24, 2020

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THE CHIEF EXECUTIVE OFFICER RECOMMENDS:

The Chicago Board of Education (“Board”) rescind Board Reports 12-0125-PO4 (Diabetes Management Policy), 12-0125-PO3 (Asthma Management Policy), and 11-0126-PO2 (Food Allergy Management Policy), and adopt a new, comprehensive Chronic Conditions Management Policy.

PURPOSE:

The purpose of this new policy is to comply and incorporate extensive changes required by medical and scientific developments, updates to the Illinois School Code and the Illinois Nurse Practice Act. The policy additionally promotes the health and well-being of students with chronic conditions (asthma, diabetes, allergies and/or seizures) through guidelines, protocols, and procedures required during school and school-related activities. This policy also outlines training requirements for all school personnel.

This policy seeks to mitigate the impact of various health inequities on CPS students, staff, and families by ensuring safe and supportive environments for anyone experiencing chronic conditions. However, the Board recognizes that this policy does not address the root causes of said inequities (i.e. social determinants of health), which may disproportionately impact our greatest needs groups.

POLICY TEXT:

I. Definitions

Allergy: An inappropriate immune response that is reproduced upon exposure to a substance. References to food allergies herein shall also include food intolerances that may affect a student’s ability to participate in school or school activities.

Anaphylaxis (Life-threatening Allergic Reaction): An acute allergic reaction to an antigen (including but not limited to a bee sting, food, environmental substances) to which the body has become hypersensitive that results in respiratory/cardiac distress or arrest unless emergency intervention is immediate.

Asthma: A chronic health condition of the lungs that causes cough, wheezing, shortness of breath or other breathing difficulties by obstructing airflow.

Authorization: When the District transfers its authority (power or right to give orders, make decisions and enforce compliance) to perform a specific task or intervention in a specific situation to an individual. Examples of authorization include but are not limited to a principal authorizing a school clerk to enter immunization data or the role of a Delegated Care Aide.

Chronic Health Condition: Physical or mental conditions that require greater than six months of monitoring and/or management to control symptoms and to shape the course of the disease. Students with chronic conditions may qualify for an IEP or 504 Plan.

Delegation: When a Registered Nurse transfers to a specific individual the authority to perform a specific nursing task or intervention in a specific situation according to details outlined by the Illinois Nurse Practice Act.

Diabetes (DM): Includes diabetes mellitus, (type 1, type 2 and gestational): a group of diseases that affect how the body makes, releases, or uses sugar (glucose).

Diabetes Delegated Care Aide (DmDCA): A volunteer, full time, non-nurse CPS staff member who completes annual specialized training to assist students with diabetes management.

Epilepsy: Chronic neurological disorder characterized by recurrent (2 or more) unprovoked seizures. Often called seizure disorder.

Emergency Action Plan (EAP): Is a written document that facilitates and organizes the actions schools take during emergencies. This can be student-specific or provide general guidance during emergencies.

Individualized Educational Plan (IEP): A unique, formal, written document that specifies the program of support, services, and instruction for a student who has an identified disability covered by the Individuals with Disabilities Education Act (IDEA).

Medical Provider: A Medical Doctor (MD), Doctor of Osteopathic Medicine (DO), Advanced Practice Registered Nurse (APRN), or Physician Assistant (PA).

Medication: Any active ingredient intended to provide pharmacological activity or other direct effects on the prevention, treatment, mitigation, or cure of disease or to affect the structure or any function of the human body. In this policy, medication includes all manufactured, compounded, natural, herbal or synthetic drugs and remedies, prescribed or over the counter (OTC) substances; vitamins, minerals, nutritional/dietary supplements, energy boosters; and any other medical treatments-- allopathic, homeopathic, alternative; or any treatments or substances pharmacological, immunological or metabolic. This also includes all formats (aerosols, pills, liquids, creams, oils or ointments) and routes of delivery: oral, rectal, topical, inhaled, intranasal, injected or via pump-- external or implanted.

Emergency Medication: Substance used to avert an urgent or life-threatening health event. The use of an emergency medication must trigger an immediate 911 call.
Regulated Medications: Drugs and other substances that are considered controlled substances under the Controlled Substances Act.

Nurse: A staff member or contractor who holds a nursing license with the Illinois Department of Finance and Professional Regulation and is held to the guidelines of the Illinois Nursing Practice Act.

School Nurse (CSN-PEL): A Registered Nurse who has completed course work for a certified school nurse (CSN) and holds the corresponding Illinois Professional Educator License (PEL) under the Illinois State Board of Education.
Health Service Nurse (HSN): A Registered Nurse.
Licensed Practical Nurse (LPN): A licensed practical nurse who works under the delegation of a registered nurse.

Parent/Guardian: A person with legal authority to care for and protect the personal needs and interests of a minor. For the purposes of this policy, the rights of the parent/guardian are transferred to an emancipated minor or students 18 and older.

School Hours: The official, published times during which a school is in operation.

School Personnel: All staff including teachers, dining staff, safety and security, engineers, school dining staff, coaches, transportation staff, related service providers, paraprofessionals, and, substitutes, other school staff who serve, supervise, manage, monitor, administer, or work with students during CPS-sponsored activities (e.g. classes, recess, extra-curricular activities, field trips, sports, before and after school programs).

School Principal: The primary authority over the teachers, staff, curriculum and professional development with a focus on student learning, safety, and health.

Seizure: A brief, excessive discharge of electrical activity in the brain that can alter movement, sensation, behavior, and/or awareness.

Seizure Delegated Care Aide (SzDCA): A full time, non-nurse CPS staff member who completes annual specialized training to assist students with a seizure disorder.

504 Plan (504): A formal written document developed by a school to provide students with disabilities the accommodations they need to access their learning environment. Implementation of this document is intended to prevent discrimination and to protect the rights of students with disabilities in school as defined by Section 504 of the Rehabilitation Act.

II. Scope

This policy applies to all students in all schools regardless of whether the school has any current students identified with asthma, diabetes, allergies or seizure disorder.

III. 504 Plan/IEP

Nursing Role: Nurses are assigned to schools by the district to provide assessment and planning of health care for students so they may access learning. A registered nurse works in collaboration with the Principal to address the health needs of students with acute or chronic conditions for school attendance. Nursing service provision is determined by Assessment (interview, observation, and record review), Planning, Implementation, and Evaluation which is encompassed in the 504/IEP for each student where care is deemed necessary to attend and participate in learning.

Plan Updates: 504/IEPs are updated annually. In the event the parent/guardian furnishes new written medical orders by a medical provider that include changes to the medical management of the student’s asthma, allergy, or diabetes the 504/IEP will be updated to address the new information.

Plan Dissemination: Those portions of the student’s 504/IEP relevant to asthma, allergy, diabetes management and/or seizures, including but not limited to the Healthcare Plan, Emergency Action Plan and emergency medications, must be disseminated (by Principal or Principal Designee) to all school personnel who supervise the student during the school day and at school-sponsored activities, or are responsible for the provision of food to the student or supervision of the student during provision of school meals and snacks. This plan must be distributed at the beginning of each school year, upon school entry, or for newly diagnosed students, and whenever the 504/IEP is revised.

Non-Cooperation: Non-cooperation is defined as when the parent/guardian of a student with a known or suspected condition is not in agreement with and/or does not assist the school with an evaluation or implementation of an appropriate 504/IEP, does not provide the documentation required to offer a 504/IEP, or refuses to supply the school with medications and supplies required to manage the student’s condition in school. Families can contact the Office of Student Health and Wellness (OSHW) Hotline (773-553-KIDS) for assistance with public benefits or to connect with a medical provider.

If the parent/guardian of a student with a known or suspected asthma, allergy, diabetes or seizures is not in agreement with and/or does not assist the school with an evaluation or implementation of an appropriate 504 Plan or provide the documentation required to offer a 504 Plan, the school must implement a simple Emergency Action Plan (EAP) stating to call 911 immediately upon recognition of symptoms. The school must send a written notification to the parent/guardian of the student’s EAP and contact the parent/guardian if the EAP is activated.

IV. Asthma Management

V. Diabetes Management

VI. Allergy Management

VII. Seizure Management

VIII. Emergency Response

In the event emergency response measures outlined in a student’s Emergency Action Plan are undertaken but not effective, 911 must be called. School personnel shall remain with the student at all times during a medical emergency or perceived medical emergency. If a student is transported to a hospital, a full-time non-nurse school staff member shall accompany the student until the parent/guardian or emergency contact arrives. The school shall complete an incident report in all instances when emergency response measures are activated or another emergency health issue occurs.

VIII. Training

Annually, all school personnel must complete an in-service training program on the prevention, management, and emergency response for asthma, allergies, diabetes and seizures in the school setting and emergency response. The Office of Student Health and Wellness will establish an in-service training program that complies with the Illinois School Code, sections 2-3.148 and 10-22.39(e).

IX. Guidelines

The Chief Health Officer or designee is authorized to develop and implement asthma, allergy, diabetes management, and seizure guidelines, standards and procedures for the effective communication and implementation of this policy pursuant to the Illinois School Code and state guidelines. Additional information and resources can be found on the Office of Student Health and Wellness website at cps.edu/oshw.

Policy References

Amends/Rescinds Rescinds 12-0125-PO4 Diabetes Management Policy; 12-0125-PO3 Asthma Management Policy; 11-0126-PO2 Food Allergy Management Policy
Cross References 12-0125-PO4; 12-0125-PO3; 11-0126-PO2
Legal References Disability History and Awareness Campaign, 105 ILCS 5/2-3.148; In-service Training Programs (Anaphylactic Reactions and Management), 105 ILCS 5/10-22.39(e); Individuals with Disabilities Education Act, 20 U.S.C. § 1400 et seq.; Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. §706 et seq. and 34 C.F.R. 100 et seq.; Americans with Disabilities Act (42 §§ U.S.C. 12101 et seq.); Care of Students with Diabetes Act 105 ILCS 145; Food Allergy Guidelines,105 ILCS 5/2-3.148; Self-administration and Self-Carry of Asthma Medication and Epinephrine Injectors, 105 ILCS 5/22-30; Nurse Practice Act, 225 ILCS 65; Seizure Smart School Act, 105 ILCS 150; and Controlled Substances Act, 21 U.S. Code § 812.
Public Comment Pursuant to Board Rule 2-6 this Policy was subject to Public Comment from 4/20/20 – 5/19/20 and adopted at the June 24, 2020 Board Meeting [Board Report 20-0624-PO4]

Policy and Procedures

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