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8315 R1 - Accommodating Students with Life Threatening Conditions - Administrative Procedures



A District Certificated School Nurse is appointed to:

  • Consult and coordinate with the parents and health care providers of students with Life Threatening Conditions; and
  • Train and supervise the appropriate staff in the care of students with Life Threatening Conditions.

The district shall develop and follow an individual health plan for each student with a Life Threatening Condition. Each individual health care plan shall include an individual emergency plan element. The health plans shall be updated annually, and more frequently as needed.

In addition to adhering to the requirements of each individual health care plan, for the general care of students with Life Threatening Conditions, the district shall:

  • Acquire necessary parent requests and instructions for treatment.
  • Acquire monitoring and treatment orders from licensed health care providers prescribing within the scope of their licensed authority.
  • Provide sufficient and secure storage for medical equipment and medication provided by the parent.
  • Permit students with diabetes to perform blood glucose tests, administer insulin, and treat hypoglycemia and hyperglycemia, with easy access to the needed supplies, equipment and medication necessary under their individual health care plan. This includes the option for students to carry the needed supplies, equipment and medication on their person and to perform monitoring and treatment functions consistent with the individual health care plan wherever they are on school grounds or at school sponsored events.
  • Permit students with diabetes unrestricted access to necessary food and water on schedule and as needed, and unrestricted access to bathroom facilities. When food is served at school events, provision shall be made for appropriate food to be available to students with diabetes.
  • School meals shall not be withheld from any student for disciplinary reasons. Students with diabetes shall not miss meals because they are not able to pay for them. The charge for the meal will be billed to the parent or adult student and collected consistent with district policies.
  • Parents and health care providers of students with diabetes will be provided with a description of their student's schedule to facilitate the timing of monitoring, treatment and food consumption.
  • Each student with a Life Threatening Condition shall have an individual health care plan which is distributed to appropriate staff based on the student's needs and the staff member's contact with the student.

Procedures for Parent-Designated Adult Care Provider:
Parents of students with Life Threatening Conditions may designate an adult to provide care for their student consistent with the student's individual heath care plan. At parent request, school district employees may volunteer to be a parent-designated adult under this policy, but they shall not be required to participate. 
If parents choose to designate an unrelated adult to provide blood sugar testing, insulin administration, or administer other injectable medication, the parent/guardians should secure legal documents which they sign that transfers power of attorney for health care procedures for their child to a designated adult.

Parent-designated adults:
1. Are to meet school district requirements for volunteers.
2. Shall receive additional training from a parent-selected heath care professional or expert in diabetic care to provide the care requested by the parent.
3. File an annual voluntary, written, current and unexpired letter of intent stating their willingness to be a parent-designated adult. There should be additional legal documentation that holds the district harmless and not responsible for costs associated with the procedures done by the designated adult. 
4. All parent-designated adults who are serving students with Diabetes are required to show evidence of professional Diabetes training.

The District Certificated School Nurse is not responsible for the supervision and/or training of procedures authorized by the parents and carried out by the parent-designated adult.

The district, its employees, agents or parent-designated adults who act in good faith and in substantial compliance with a student's individual health care plan and the instructions of the student's health care provider shall not be criminally or civilly liable for services provided under chapter 350, Laws of 2002.

Procedures for When No Medication or Treatment Order Provided:

Students who have a life-threatening health condition and who fail to present a medication or treatment order shall be excluded from school, to the extent that the district can do so consistent with federal requirements for students with disabilities under the Individuals with Disabilities Act and Section 504 of the Rehabilitation Act of 1973, and pursuant to the following due process requirements:

1. Written notice to the parents, guardians or persons in loco parentis delivered to the parents in person or by certified mail.
2. Notice of the applicable laws, including a copy of the laws and rules.
3. The order that the student shall be excluded from school immediately and until a medication or treatment order is presented.
4. Describe the rights of the parents and student to a hearing, the hearing process and explain that the exclusion continues until the medication or treatment plan is presented or the hearing officer determines that the student should no longer be excluded from school.
5. If the parents request a hearing, the district shall schedule one within three school days of receiving the request, unless more time is requested by the parents.
6. The hearing process shall be consistent with the procedures established for disciplinary cases pursuant to Chapter 180-40 WAC.

Procedures for Overnight field trips:

Edmonds School District desires to provide a safe learning environment for all students. When a student has a life threatening condition and an overnight field trip is planned, the following needs to be considered:

1. The student's developmental level. The older the student, the more 
independent it is assumed they can be in managing their medical condition.
2. The student's level of understanding and demonstration of competent management of the condition.
3. The length of time the student has competently managed their medical condition.
4. If a student cannot fully manage their medical condition, procedures r/t providing support will be followed according to the Health Services Medication Policy. In this case, a parent/guardian is the first choice to provide these support services. 
5. The parent's desires for the student's participation in the learning experience.
6. The Educational Health Specialist's professional judgment of the student's ability to manage their condition.
7. The location and activities planned for the field trip.
8. The proximity to emergency services.

If there is disagreement about the student's ability to safely participate in an activity, the student's family may choose one of the following:

1. Provide:
a) A Parent Designated Adult (PDA) volunteer who meets the guidelines for the same.
b) A hold harmless agreement for the student's participation.


2. Provide:
a) A statement from the student's doctor (Licensed Health Care Provider) as to the student's ability to competently manage their medical condition.
b) A hold harmless agreement for the student's participation.

Procedures for when a Parent/Guardian submits a Do Not Resuscitate (DNR)/Do Not Intubate (DNI) Order to the District:

1. School district staff will not accept or retain copies of DNR/DNI orders. The school district will not convey such orders to emergency medical personnel.

2. School district staff will provide reasonable emergency care and assistance when a student is undergoing a medical emergency during school or school activities.

3. School district staff will activate emergency medical services (911) as soon as possible when a student is undergoing a medical emergency during school or school activities.

4. The parent/guardian will be notified of the emergency as soon as possible.

5. Any student with a life threatening condition is required to have a medical alert (emergency care plan).

6. Parents/guardians who request that emergency care be withheld for their child or who present DNR/DNI orders shall be advised of and shall be given a copy of this policy.

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