Asthma Action Plan

Bacterial Meningitis

Senate Bill 31 of the Texas Legislature requires that school districts provide information relating to bacterial meningitis to all students and their parents each school year. The following documents on bacterial meningitis are for your information only and do not indicate an outbreak in our area. We encourage you to check out our Department of State Health Services- DSHS information about Meningitis vaccinations by clicking on the Immunization link at the left, on our Health Services home page. 

DSHS Bacterial Meningitis information

Organism, Causative Agent, or Etiologic Agent

Bacterial meningitis is caused by different types of bacteria. Streptococcus pneumoniae, Streptococcus agalactiae, Neisseria meningitidis, Haemophilus influenzae, Escherichia coli, and Listeria monocytogenes are examples of bacteria that can cause bacterial meningitis.

Transmission

Some forms of bacterial meningitis are contagious. The bacteria can mainly be spread from person to person through the exchange of respiratory and throat secretions. This can occur through coughing, kissing, and sneezing. Fortunately, none of the bacteria that cause meningitis are as contagious as things like the common cold or the flu. The bacteria are not spread by casual contact or by simply breathing the air where a person with meningitis has been.

Symptoms

Common symptoms of bacterial meningitis are high fever, headache, and stiff neck in anyone over the age of 2 years. These symptoms can develop over several hours, or they may take 1 to 2 days. Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness. In newborns and small infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to detect. Infants with meningitis may appear slow or inactive, have vomiting, be irritable, or be feeding poorly. As the disease progresses, patients of any age may have seizures.

Bacterial meningitis can be quite severe and may result in brain damage, hearing loss, limb amputation or learning disabilities.

The following groups of people are at high risk for bacterial meningitis:

• children between the ages of one month and two years old,
• people who abuse alcohol,
• people with chronic nose and ear infections,
• people who have sustained a head injury,
• people who get pneumococcal pneumonia or widespread blood infection
• people who have a weakened immune system,
• people who have had their spleen removed, or have had brain or spinal surgery,
• people who are on corticosteroids because of kidney failure
• people with sickle cell disease,
• people who live in close quarters with others including military recruits and college students

Neisseria meningitidis and Haemophilus influenzaeType b can spread to other people who have had close or prolonged contact with a patient with meningitis caused by Neisseria meningitidis (also called meningococcal meningitis) or Haemophilus influenzae Type b. People in the same household or daycare center or anyone with direct contact with a patient's oral secretions (such as a boyfriend or girlfriend) would be considered at increased risk of getting the infection.

Prevention

There are vaccines available that offer protection against some of the bacteria that can cause bacterial meningitis. The pneumococcal conjugate vaccine, pneumococcal polysaccharide vaccine, meningococcal conjugate vaccine, meningococcal polysaccharide vaccine, and Haemophilus influenzae Type b vaccine can assist in preventing infection from certain bacteria that can cause bacterial meningitis.

Maintaining healthy habits, like getting plenty of rest and not coming into close contact with people who are sick can also help prevent infection. Using good health practices such as covering your mouth and nose when coughing or sneezing and washing your hands frequently with soap and water can also help stop the spread of the bacteria. If you are pregnant, you can reduce your risk of meningitis caused by Listeria bacteria (listeriosis) by cooking meat thoroughly and avoiding cheeses made from unpasteurized milk.

School Exclusion Criteria

Children with bacterial meningitis should be kept out of school or childcare until they are fever free for 24 hours without the use of fever suppressing medications.   Rules for exclusion of sick children from school and childcare are outlined in the Texas Administrative Code, specifically Rule 97.7 for schools and Rule 746.3603 for childcare.

• Texas DSHS- Information about Bacterial Meningitis

Bed Bug Policy

Anaphylaxis Risk

• Anaphylaxis Conditions and Treatment – American Academy of Allergy, Asthma & Immunology
• Anaphylaxis – National Library of Medicine

Asthma

• Asthma Symptoms - Asthma and Allergy Foundation of America
• Asthma – National Library of Medicine

Seizure Disorder

• About Epilepsy – Centers for Disease Control and Prevention
• What Is Epilepsy? – Epilepsy Foundation 

Communicable Diseases

Communicable disease means an illness caused by an infectious agent or its toxins that occurs through the direct or indirect transmission of the infectious agent or its products from an infected individual or via an animal, vector or the inanimate environment to a susceptible animal or human host (CDC definition of Communicable Diseases.

DSHS Communicable Diseases chart with rules of school exclusion. CLICK HERE for Chart and Notes (PDF)

Our CHISD Policy:

Your CHISD Nursing Team follows the guidelines specifically outlined by the DSHS rules for exclusion, treatment and follow-up for all possible and confirmed communicable diseases. For all additional clarification and guidance for specific health concerns, your Nursing Team has direct contact with our Regional Epidemiologist.  

Please see the most current DSHS chart link above. 

DSHS Communicable Disease footnotes:

1. Fever is defined as 100 degrees Fahrenheit or higher.
2. The student or faculty must be fever free for 24 hours, without the use of fever reducing medications prior to returning to our CHISD campus.
3. Diarrhea is defined as 3 or more loose stools in a 24 hour period.
4. The student or faculty must be free of diarrhea for 24 hours without the use of diarrhea suppressing medications prior to returning to our CHISD campus.

DSHS information about Tuberculosis

Tuberculosis (TB) - Texas Department of State Health Services

CHISD Policy for Pediculosis - Live Head Lice 

DSHS information about Head Lice  CLICK HERE Managing Head Lice (Pediculosis) in School/Home Settings

Our CHISD Policy:

According to the DSHS exclusion policy for Communicable Diseases, the day pediculosis is found on a student, the student does not have to be sent home that day after the parent/guardian is updated. The student is to be made aware of the diagnosis. Educating the student on the importance of ​not ​sharing headphones, hair bows, hats, headbands, brush/combs, running fingers through hair, shaking head, and hugging or close contact with other students/teachers is conducted by the school nurse. 

Teachers are privately updated on the active pediculosis case by the school nurse. Teachers are offered OFF with deet as a possible personal preventative measure. Lounging or close contact group activities in the classroom are discouraged for Day 1.

A general lice information sheet is to be sent home in the folder of every child in the same class as the student with known pediculosis on the day of diagnosis. No names are given on any information shared with other students.

DAY 2:

1. Proof of actual FDA approved lice shampoo bottle is required to be brought to the school to be visualized by the school nurse on the morning of return to CHISD.
2. Hair is to be rechecked for any live lice.
3. If no live lice, the student may stay at school on Day 2, with a note of clearance to the teacher.
4. If live lice are found, the student is to be sent home. 

• Physician awareness by the parent/guardian is
  recommended. 
• Day 2 policy for Day 3, Day 4, etc..., with possible prescription strength lice shampoo treatment bottle visualized and/or physician order received.

FOLLOW UP:

1. Students are encouraged to come to the nursing office for head checks for recurrent itching scalp.
2. Teachers are encouraged to send students to the nursing office for all itching scalp concerns.
3. The school nurse may recheck students at any time during the school year to help ensure the student maintains lice free hair.

COVID-19 Information
COVID Guidelines

TEA Public Health Guidance Update

Student or Faculty Positive Test:
Call a school nurse; a 5 day off campus return date will be set by your school nurse; return to campus if symptoms are better and 24 hours without fever.

DSHS Communicable Disease footnotes:

    1. Day 0 is the first day of symptoms.

    2. Day 1 is the first full day after symptoms develop.

    3. Isolation can end after 5 full days, if 24 hours without fever and symptoms improving. 

or

    1. Day 0 is the day of the positive viral test. 

    2. Day 1 is the first full day after the test was performed. 

    3. Isolation can end after 5 full days.

The American Rescue Plan Act was signed into law, dedicating funds for K-12 schools through Elementary and Secondary School Education Relief (ESSER) III funds. CHISD has applied for the one-time, ARP (American Rescue Plan) ESSER III funding. The purpose of this funding is to help safely reopen and sustain the safe operation of schools and address the impact of the coronavirus pandemic on students.  The details of CHISD’s plan for these funds can be viewed below.  

CHISD ISD 2020-2023 ESSER III Uses of Funds Plan

Other helpful links are listed below:

Return to In-Person Instruction and Continuity of Services Plan (RIPICS)

TEA Integration of Digital Devices in Public Schools

Drug Testing Policy

Texas Health & Human Resources Website for more info on Allergies & Anaphylaxis

Food Allergy & Anaphylaxis Emergency Care Plan

Immunizations

Texas Minimum State Vaccine Requirement Chart for Students Grades K-12
Go to Texas Health & Human Services Website

Texas Minimum State Vaccine Requirements for Child-Care Facilities through PreKindergarten
Go to Texas Health & Human Services Website

To access Vaccine Exemption information and requirements
Go to Texas Immunization Exemptions Website

If a student should not be immunized for medical reasons, the student or parent must present a certificate signed by a U.S. licensed physician that states that, in the doctor’s opinion, the immunization required would be harmful to the health and well-being of the student or any member of the student’s family or household. This certificate must be renewed yearly unless the physician specifies a life-long contradiction.

If a student’s religious or conscience beliefs conflict with the requirement that the student be immunized, the student must present an official Department of State Health Services affidavit that is completed in entirety with valid notarization. The original exemption affidavit will be kept in the student’s file and must be renewed every two years from notarized date. 

Meningococcal (Menactra, Menomune, Menveo)

Protection from Meningococcal Meningitis

Meningococcal meningitis, a form of meningococcal disease, is a serious bacterial infection. Unlike viral meningitis, it can potentially kill or disable an otherwise healthy young person within 1 day after the first symptoms appear. Even people who are usually healthy can get meningitis. However, data from the Centers for Disease Control and Prevention (CDC) have shown that the risk of getting meningitis increases in teens and young adults. For more information about meningococcal meningitis.
Go to Vaccines Informational Page.

Students in grades 7-12 are required to receive vaccination against this form of bacterial meningitis in order to attend school. The American Academy of Pediatrics recommends a booster dose of the vaccine for 16 – 18 year olds who received the vaccine between 11 and 15 years of age, since studies have shown that protective immunity to the disease declines after a 5-year period.

In response to outbreaks of meningitis at Texas universities, which resulted in the death or near-death of students, the Texas Legislature passed SB 62 which requires college students to provide proof of vaccination against bacterial meningitis within the past 5 years. This law expands on a previous law which required only those students living on-campus to receive the vaccine. For more information about meningococcal vaccine college requirements.
Go to Meningococcal Vaccines for College Website

Vaccine Information Sheets

Required for school:

Quadrivalent Meningococcal Vaccine (English)

Quadrivalent Meningococcal Vaccine (Spanish)

Also Recommended:

Serogroup B Meningococcal Vaccine (English)

Serogroup B Meningococcal Vaccine (Spanish)

Influenza Prevention & Treatment

The flu, caused by the influenza virus, infects the lungs, nose, and throat. Typical flu symptoms include fever, cough and sore throat that come on suddenly. Appropriate fluid intake, fever-reducing medication, rest and careful monitoring are recommended. 

People who think they have the flu should contact their health care provider immediately.  COVID 19 spread is still a great concern.  Your doctor and/or health clinic will need to determine if your diagnosis is Flu, COVID 19, or possibly both. 

Students who come to school with flu-like symptoms will be sent home. If your child misses school due to flu-like symptoms, it is important to call the school and speak with your campus nurse directly. This allows your CHISD Nurse Team to investigate and to track illness data as directed by our county health department. 

Please consider getting you and your family vaccinated for influenza this year. 

Below is helpful information on influenza prevention and treatment.

Websites for Influenza Information:

• Texas Department of State Health Services: Flu Information
• CDC Seasonal Flu Info - Spanish

Central Heights ISD Medication Guidelines

Medication Administration

To comply with State Laws, a very strict procedure for administering medication is followed here at CHISD. Please refer to the Texas DSHS Guide to Medication Administration in the School Setting, 4th main box in link below; for full guidance on Public School medication administration.

School Health Services - School Nurse Practice - Texas

CHISD Medication Policy:

CLICK HERE for CHISD Medication Form for Prescription Medication

CLICK HERE for CHISD Medication Form for Over the Counter Medication

 CHISD Medication Administration Form
● Medications to be given to a student on a routine or as needed basis must be provided to the school in its
original labeled container by the parent/guardian.
● Prescription medication must be labeled with the student's name, date, dosage, expiration date,
directions for use and prescribing Physician and accompanied by a doctor's note.
● Over the counter (OTC) medication must be provided by the parent, in the original container with
expiration date, correct dosages appropriate for age and size of student indicated and accompanied by a
doctor’s note.
● The only medication administration exception: Central Heights ISD staff can provide first aid
treatments and as needed medications listed on our student Emergency Health Care Permission form
for needs indicated per W E Furniss III, MD with annual parent/guardian signature of consent.

All medications must be accompanied by our CHISD Medication Administration Form, next tab on our Health Services homepage. Your nurses require this completed and signed form prior to any medication administration at CHISD.

All forms must be completed and signed by the parent/guardian.

All medications must be given to the nurse immediately upon arrival to campus.

All medications will be stored and dispensed ONLY in the school nurse office, *UNLESS, after review of medical necessity, the nurse grants individual permission to carry self-dosing medications (example: Epipens, Asthma inhalers, permission granted by MD first, then school nurse- see Individual/Emergency Health Plans for specific medical concern paperwork).

In accordance with the Nurse Practice Act, Texas Code, Section 217.11, the campus nurse has the responsibility and authority to refuse to administer any medication/s that, in the nurse’s judgment, is not in the best interest of the student.

Parents are now responsible to collect all medication at the end of each school year. Medications will no longer be sent home with students at the end of the school year. 

*** The only exception to the above stated is as follows: Central Heights ISD staff can provide first aid treatments and medications listed on our student Emergency Health Care Permission form for health needs indicated per W E Furniss III, MD (these forms are sent out with week-one student packets annually, signed by Parents/Guardians and kept in the Nurse Clinic each school year). 

We WILL NOT provide any other medications UNLESS provided by the parent/guardian.

A copy of our current campus wide Emergency Health Care Permission Form is in your Student Handbook. If there are any concerns related to this medication/treatment list, contact the school nurse immediately.

Nutrition & Wellness Plan

State law requires school districts to annually assess the physical fitness of students enrolled in grade three or higher and to provide the results of individual student performance on the administered physical fitness assessments to the Texas Education Agency (TEA). The Physical Fitness Assessment Initiative (PFAI) is a program designed to collect and analyze the required student physical fitness data. To learn more, you can visit the TEA website for PFAI. 

Mental Health Support (All Grade Levels)
The district has implemented programs to address the following mental health, behavioral health, and
substance abuse concerns:
● Mental health promotion and early intervention;
● Building skills to manage emotions, establish and maintain positive relationships, and engage in responsible decision-making;
● Substance abuse prevention and intervention;
● Suicide prevention, intervention, and postvention (interventions after a suicide in a community);
● Grief, trauma, and trauma-informed care;
● Positive behavior interventions and supports;
● Positive youth development; and
● Safe, supportive, and positive school climates.

If a student has been hospitalized or placed in residential treatment for a mental health condition or
substance abuse, the district has procedures to support the student’s return to school. Please contact
the district’s mental health liaison for further information.

Physical and Mental Health Resources (All Grade Levels)
Parents and students in need of assistance with physical and mental health concerns may contact the
following campus and community resources:

District nurse team:
High School: Jodi Mullins 936-554-0273
Middle School: Stefanie Shoemaker 936-552-3448
Elementary: Emily Penney 936-552-3423

Local Public Health Authority – Nacogdoches DSHS Clinic
2614 NW Stallings Drive
Nacogdoches TX 75964
936-569-4961

Local Mental Health Authority – Burke Center
3824 N University Drive
Nacogdoches, TX 75965
936-558-6200

Life-Threatening Allergic Reactions During the School Day

Anaphylactic reactions are severe and life-threatening allergic reactions that require immediate treatment.  In accordance with Chapter 38.212 of the Education Code Subchapter E, and local policy, Central Heights ISD will have auto-injectable epinephrine (unassigned/stock epinephrine) at each school campus. Epinephrine is to be administered by a school nurse or a designated employee authorized and trained in the administration of epinephrine to anyone believed to be having an anaphylactic reaction while on school premises during the academic day. The school’s emergency stock of unassigned epinephrine does not replace student-specific orders and does not extend to activities off school grounds (including transportation to and from school, field trips, etc.) or outside of the academic school day (sporting events, extracurricular activity, etc.). For children diagnosed with an allergy/health condition that requires the use of injected epinephrine, it is the parent’s responsibility to provide the child’s epinephrine auto-injector and medical orders to the school nurse on or before the first day of class. For more information, contact the District’s coordinator of school health services.

School Health Advisory Council - SHAC

Seizure Management and Treatment Plan Form

Food Allergy Questionnaire

Lactose Form

Self Carry Form

Student Asthma Medical Plan

Student Head Lice Policy

Student Non-Food Allergy Medical Plan

Student Seizure Medical Plan