Administrative Procedure 314: Supporting Students with Prevalent Medical Conditions

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• to support students with prevalent medical conditions and other medically at-risk health conditions to fully access school in a safe, accepting and healthy learning environment that supports well-being;
• to empower students, as confident and capable learners, to reach their full potential for self-management of their prevalent medical condition(s) according to their Individual Medical Management Plan of Care, hereafter referred to as IMMP;
• to support parent(s)/guardian(s) in feeling confident that the IMMP provides for accessing all educational environments, while recognizing that it is not possible to provide an absolute guarantee or elimination of all risk; and,
• to support staff to be trained and confident in prevention strategies to minimize risks, recognize the signs and symptoms, and know the steps to follow in dealing with a medical emergency as it pertains to the four prevalent medical conditions.

• • Upon receipt of medical information provided by the parent to school staff, the Principal/designate must be notified.
  • The Principal/designate is responsible for collaborating with the parent/guardian in developing an IMMP and Transportation Medical Plan (if applicable) in Clevr for all students with a prevalent medical condition.
  • The IMMP and Transportation Medical Plans are maintained in the OSR.
  • Transportation Medical Plans are shared with bus operators via the Huron Perth Student Transportation Services.
  • The Principal/designate is responsible for notifying and training staff and must maintain a binder in the school office containing all student IMMPs. A display board may also be used provided it is not visible to the public.
  • In the student information system, the school Secretary is responsible for assigning an “Alert” naming the prevalent medical condition or other life-threatening condition. An “Ambulance” icon will be displayed for students with an IMMP.
  • The school Secretary is responsible for placing a red IMMP sticker on the top right corner of the student's OSR. Stickers can be requested from the Executive Assistant of Learning Services and Mental Health and Well-Being.

• • The IMMP is developed through a collaborative process, involving the student where appropriate, parent(s)/guardian(s) of the pupil, the principal/designate, school staff, and community health care partners where appropriate and requested by parent(s)/guardian(s), during the first 30 days of school for new registrations with a prevalent medical condition, or during the school year when a student has been diagnosed with a prevalent medical condition.

• • IMMPs shall be reviewed annually within the first thirty (30) days of school, when the plan of care changes, during transition and/or at times deemed appropriate by the principal/designate and parent(s)/guardian(s).
  • In the event of a medical incident or emergency, an evaluation of the IMMP shall be undertaken, responsive changes made if required, and the staff, parent(s)/ guardian(s) and others, as necessary, must be notified of the changes. In the event that revisions are made to the IMMP, due diligence should be taken to update and revise and redistribute printed versions. Parent(s)/guardian(s) must sign a new consultation record.
  • When a student with an IMMP changes schools, notification and review of the plan will take place as part of the Transition Meeting prior to the student’s first day of attendance.
  • During the annual review, and if no changes are required to the IMMP, it is sufficient for the parent(s)/guardian(s) and school team to sign the Consultation Record only.

• • educate their child about their medical condition(s) with support from their child’s health care professional, as needed;
  • guide and encourage their child to reach their full potential for self-management and self-advocacy;
  • inform the school of their child’s medical condition(s) and co-create the IMMP for their child with the Principal/designate;
  • provide the Principal/designate with supporting medical documentation upon request;
  • communicate changes to the IMMP, such as changes to the status of their child’s medical condition(s) or changes to their child’s ability to manage their medical condition(s), to the Principal/designate;
  • confirm annually to the Principal/designate that their child’s medical status and plan of care is unchanged;
  • participate in annual consultations to review their child’s IMMP;
  • plan for the administration of medication, when required, either before or after school, to the greatest extent possible;
  • for medication requiring administration at school, complete form(s) as per Administrative Procedure 315 Medication: Administration, Storage and Disposal;
  • provide their child and/or the school with adequate amounts of medication (e.g., EpiPen, inhaler) and supplies in their original, clearly labeled containers, following the instructions of a health care professional and monitor expiration dates;
  • seek medical advice from a medical doctor, nurse practitioner, or pharmacist, where appropriate; and,
  • provide consent for the sharing of the IMMP with school staff (both direct and indirect contact) and others as deemed appropriate (e.g., students, volunteers, occasional staff, transportation staff, cafeteria service contractors, etc.) to support the safety of the student.

• • take responsibility for advocating for their personal safety and well-being that is consistent with their cognitive, emotional, social and physical stage of development and their capacity for self-management;
  • participate in the development of their IMMP, and participate in meetings and/or consultations to review their IMMP;
  • carry out daily or routine self-management of their medical condition to their full potential, as described in their IMMP;
  • carry their own medication, equipment and/or materials for their prevalent medical condition (e.g., EpiPen, inhaler) where deemed appropriate and with parent(s)/guardian(s) permission, given the student’s development and their capacity for self-management;
  • set goals on an on-going basis, for self-management of their medical condition, in conjunction with their parent(s)/guardian(s) and health care professional(s);
  • communicate with their parent(s)/guardian(s) and school staff if they are facing challenges related to their medical condition at school;
  • if applicable to their condition, be vigilant in their awareness when purchasing food from on-site providers, and vending machines, etc. for possible ingredient triggers;
  • wear medical alert identification that they and/or parent(s)/guardian(s) deem appropriate;
  • if possible, inform school staff and/or their peers if a medical incident or a medical emergency occurs; and,
  • follow risk reduction strategies (e.g., nut, latex, and scent sensitive) and adhere to safety measures to avoid contributing to prevalent medical conditions.

• • review and follow the contents of the IMMP for any student with whom they have direct contact;
  • complete required training, at a minimum annually;
  • participate in the co-creation and/or review of the IMMP and the Transportation Medical Plan when directed;
  • participate in a debrief/review following a medical incident or emergency;
  • support a student’s daily or routine management, and respond to medical incidents and medical emergencies that occur during school, as outlined in this board procedure and other applicable procedures;
  • support inclusion by allowing students with prevalent medical conditions to perform daily or routine management activities in a school location (e.g., classroom), as outlined in their IMMP, while maintaining confidentiality and dignity of the student;
  • enable students with prevalent medical conditions to participate in school and related activities to their full potential, as outlined in their IMMP;
  • follow Administrative Procedure 315 Medication: Administration, Storage and Disposal when an IMMP includes the use of medication and complete the log of administration of medication as required;
  • notify the Principal/designate when they become aware that the expiry date on medication(s) has been reached;
  • follow the established IMMP to support students in the event of a school emergency (e.g., bomb threats, lockdown, hold/secure, evacuation, fire, severe weather, medical), or for activities off school property;
  • on authorized, out-of-school excursions, carry the IMMP and forms associated with Administrative Procedure 315 Medication: Administration, Storage and Disposal;
  • report medical incidents and emergencies as per the directions in Administrative Procedure 175 Reporting Hazards, Incidents and Occupational Illness;
  • follow the additional responsibilities listed in the associated appendices, and consider carefully the information therein, for prevalent medical conditions when co-creating, developing and/or reviewing the IMMP;
  • follow risk reduction strategies (e.g., nut, latex, and scent sensitive) and adhere to safety measures to avoid contributing to prevalent medical conditions.
    In accordance with the requirement of the Child, Youth and Family Services Act 2017, SO 2017, c. 14, Schedule 1, where board employees have reason to believe that a child may be in need of protection, board employees must call the Children’s Aid Society and file a formal report. See Administrative Procedure 346 Children in Need of Protection.

• • ensure that an IMMP is developed and training is provided to school staff within the first thirty (30) days of school or of being made aware of a student’s prevalent medical condition;
  • complete an annual review of this procedure;
  • promote a supportive inclusive learning environment recognizing the need for an accepting social climate for students with prevalent medical conditions;
  • clearly communicate to parent(s)/guardian(s) and staff the process for parent(s)/guardian(s) to notify the school of their child’s medical condition(s), as well as the expectation for parent(s)/guardian(s) to co-create, review, and update IMMPs with the principal/designate. This process should be communicated to parent(s)/guardian(s) at a minimum:
    • during the time of registration;
    • each year during the first week of school (e.g., via school website, newsletter, planners, email); and,
    • when a child is diagnosed and/or returns to school following a diagnosis;
  • use the IMMP Parent Form to gather relevant medical information from the parent(s)/guardian(s) for use in developing the plan;
  • co-create, review or update the IMMP with the parent(s)/guardian(s), in consultation with school staff (with direct contact) and with the student (as appropriate);
  • if the student is bussed, co-create, review or update a Transportation Medical Plan with the parent(s)/guardian(s), in consultation with school staff, transportation staff, and student, as appropriate;
  • clearly communicate the roles and responsibilities listed within this procedure to students, parent(s)/guardian(s), and to staff;
  • inform parent(s)/guardian(s) about relevant board and school procedures and encourage them to review them;
  • inform parent(s)/guardian(s) and school staff of the measures to protect the confidentiality of students’ medical records and information (e.g., OSR guidelines, IMMP distribution, access to student information systems);
  • consult with the health care provider/partners, with consent from the parent(s)/guardian(s), in order to create or review the IMMP, if appropriate;
  • require the parent(s)/guardian(s) to provide supporting medical documentation in the event that additional medical direction/information if necessary;
  • obtain parent/guardian consent for prevalent medical information to be shared with staff, students, and others, as appropriate, to support the safety of the student;
  • provide access to the IMMP to school staff with direct student contact, with consent;
  • provide relevant information from the student’s IMMP to those with indirect contact, as appropriate, and for whom consent has been provided;
  • ensure occasional teachers have access to a list of students with prevalent medical conditions and those who are medically-at-risk, as per collective agreements;
  • identify staff who can support the daily or routine management needs of students in the school with prevalent medical conditions, while honouring the provisions within their collective agreements;
  • maintain a file including the IMMP and all relevant supporting documentation in the documentation folder in the Ontario Student Record (OSR);
  • ensure staff complete the required training and are provided time to complete the training requirements;
  • should a medical incident or emergency occur, facilitate a debriefing and notify school and transportation staff, as deemed appropriate, and parent(s)/guardian(s) of the results of the debrief;
  • follow the procedure related to reporting and documenting a medical incident or medical emergency, as per Administrative Procedure 175 Reporting Hazards, Incidents and Occupational Illness;
  • communicate with parent(s)/guardian(s) and other contacts, as needed, in medical incidents or emergencies, as outlined in the IMMP;
  • follow Administrative Procedure 170 School Emergency Procedures: make arrangements to support students with prevalent medical conditions in the event of a school emergency (e.g., bomb threats, lockdown, hold/secure, evacuation, fire, severe weather, etc.); include all student IMMPs in the Emergency Response Bag;
  • follow Administrative Procedure 266 Field Trips and Excursions, making arrangements to support students with IMMPs on school trips and excursions;
  • maintain a binder in the school office containing all student IMMPs; a display board may also be used provided it is not visible to the public;
  • follow Administrative Procedures 170 School Emergency Procedures, and 180 First Aid and Medical Emergencies: maintain a list of school personnel who have received First Aid training and have volunteered to be an Emergency Response Team member and review with staff the names of the team members at the beginning of each school year;
  • follow Administrative Procedure 315 Medication: Administration, Storage and Disposal when an IMMP includes the use of medication and complete the log of administration of medication as required;
  • designate staff to assist with the hands-on practice in the use of the EpiPen auto-injector when requested by Occasional Staff, and ensure the Occasional Staff sign the Confirmation of Staff EpiPen Training;
  • ensure, when hired, that long-term occasional staff receive the required in-school portion of the training;
  • consult with the School Council to determine and implement risk management procedures (e.g., nut, latex, and scent sensitive); and
  • support all staff and students in following risk reduction strategies (e.g., nut, latex, and scent sensitive) and adhere to safety measures to avoid contributing to prevalent medical conditions.
    Note: Diabetes Canada recommends that “schools should permit a student living with diabetes to carry their cell phone as a tool to help manage their blood glucose levels and prevent emergency events. For many students with type 1 diabetes, a cell phone works with insulin pumps and continuous glucose monitoring systems to provide essential information to inform diabetes treatment decisions.” This recommendation is in alignment with Policy/Program Memorandum 128, the Provincial Code of Conduct and School Board Codes of Conduct which allows for the use of mobile devices for health and medical purposes.

• • provide training materials and resources on prevalent medical conditions annually;
  • provide each school site with two EpiPens annually, via the Learning Services and Mental Health and Well-Being Department;
  • provide red IMMP stickers to be affixed to the student OSR, via the Learning Services and Mental Health and Well-Being Department;
  • implement expectations for schools to support the safe storage and disposal of medication and medical supplies, as per Administrative Procedure 315;
  • communicate expectations that AMDSB students are encouraged and allowed to carry their medication and supplies to support the management of their medical condition, as outlined in their IMMP;
  • consider PPM 161 and related board procedures when entering into contracts with transportation, cafeteria service contractors, and other providers;
  • require that parent(s)/guardian(s) provide information about prevalent medical conditions at the time of registration;
  • provide templates and sample communication statements for administrator use, maintained in Clevr;
  • support all staff and students in following risk reduction strategies (e.g., nut, latex, and scent sensitive) and adhere to safety measures to avoid contributing to prevalent medical conditions.

• • understand the 4 most common prevalent medical conditions;
  • become knowledgeable about the contents of the IMMP;
  • become knowledgeable of and apply strategies to eliminate and/or minimize the risk of student exposure to triggers and causative agents;
  • recognize the signs and symptoms of a medical incident or emergency;
  • know how to respond to a medical incident or emergency;
  • hands-on practice using an EpiPen;
  • understand how to use BaqsimiTM Nasal Powder;
  • implement strategies to support inclusion and participation in school;
  • become familiar with available school staff supports (i.e., emergency kits, additional resources);
  • understand and be able to report and document a medical incident or emergency;
  • understand confidentiality requirements of student information;
  • understand the requirements under the related Board Administrative Procedures; and
  • be knowledgeable of the location of: First Aid Kits, Medical Information Board/Binders, Medications and the log for recording administration.

• • Appendix A: Definitions
  • Appendix B: Asthma
  • Appendix C: Anaphylaxis
  • Appendix D: Diabetes
  • Appendix E: Epilepsy