STUDENTS 5141.3
HEALTH EXAMINATIONS/ASSESSMENTS AND IMMUNIZATIONS

The Board of Education recognizes the importance of periodic health examinations according to state health regulations.
Boards of Education shall require each pupil enrolled in the public schools to have a health examination, either by a legally qualified practitioner of medicine, the school medical advisor, or his/her designee.

Health examinations/assessments are required as follows:

A. Physical examinations: prior to initial enrollment in Connecticut public schools, prior to entrance into grade 7 and prior to entrance into grade 12.
B. Vision screening: Kindergarten through grade 6 and grade 9 and during physical examinations;
C. Hearing screening: Kindergarten through grade 3, grades 5 and 8;
D. Scoliosis screening: grades 5 through 9 and during physical examinations for grade 6.

The Board of Education adheres to those state laws that pertain to school immunizations.
Parent(s)/guardian(s) wishing their children exempt or excused from vision, hearing and scoliosis screenings may file annually with the district a statement in writing, signed by the parent(s)/guardian(s), requesting that the pupil be excused from these screenings.
I. HEALTH ASSESSMENTS

A. Health Assessments:

Health assessments shall be required:
1. Prior to initial enrollment in a Connecticut Public School;
2. in grade 6; and
3. in grade 10 or 11
4. Students entering the Manchester Schools for the first time

A physical assessment will be required of all students who enter the school system from outside the continental United States by a qualified practitioner within the past year. If the student resided in a country with a high incidence of tuberculosis, the student must provide proof of a tuberculin test or a negative chest x-ray prior to school entrance. If the student is unable to provide this test, the Manchester Board of Education will provide this test prior to the entrance to school. If the test is positive, the student will be referred to the Manchester Health Department for further assessment.
If the student is entering the Manchester School System from another Connecticut school district, he/she must show proof of having had the mandated physical. If the student is coming from another state, the student must show proof of having a physical assessment by a qualified practitioner within the past two years.

If the student does not have a primary care provider, or is unable to meet the requirement for the physical assessment, the Parent Information Center or Registrar will refer the student to the East Hartford or Vernon Community Clinics or to Doctor Source at Manchester Memorial Hospital.
Students presenting with unstable health conditions shall be referred to the Coordinator of School Health and/or School Medical Advisor for health assessments prior to entrance into school.

B. Scope:

Health assessments must include:
1. A physical examination, including hematocrit or hemoglobin tests, height, postural, weight, blood pressure, vision and auditory screening, and at discretion of medical provider, tuberculosis test.
2. Immunizations as required by Sec. 10-204a of the General Statutes;
3. Vision and hearing screenings; as required by 10-214 of the General Statutes;
4. Postural screening (only required at assessments in grades 6 and 11); as per Sec. 10-214 of the General Statutes;
5. Chronic Disease Assessment including asthma; as required by Public Act 01-4.
6. The results of the health assessments must be recorded on the State of Connecticut Health Assessment Record (blue HAR) distributed by the State Department of Education.
7. Health assessments shall be conducted by a legally qualified practitioner of medicine, an advanced practice registered nurse, a physician assistant, or a school medical advisor.

C. Responsibility:

Parents or guardians are responsible for providing the required health assessments. The Manchester Board of Education may provide health assessments for all pupils in grades 6 and 11 whose parents or guardians meet the eligibility requirements for free and reduced price meals under the National School Lunch Program or for free milk under the Special Milk Program.

D. Schedule:

Health assessments must be completed within 18 months of the final day of school of the grade in which the assessment is due. For example: A grade 6 health assessment period falls within the months of January for grade 5 and continues through grade 6.

II. HEALTH SCREENINGS
Screenings are required as part of the health assessment described above and as separate, regularly scheduled examinations.
A. Frequency: (other than during health assessments)
1. Vision screening is required annually for each pupil in grades K-6, inclusive, and in grade 9.
2. Audiometric screening is required annually for each pupil in grades K-3, inclusive, in grade 5 and in grade 8.
3. Postural screening is required for each pupil in grades 5 through 9, inclusive

III. IMMUNIZATIONS
A. The Manchester Board of Education requires that all students be protected by adequate immunization against the following diseases before being permitted to attend any public elementary or secondary school as determined by Sec. 10-204a of the CT General Statutes:

1. Diphtheria 6. Rubella 2. Pertussis 7. Mumps
3. Tetanus 8. Hemophilus Influenza type B
4. Poliomyelitis 9. Hepatitis B
5. Measles 10. Varicella - for students born after
1/1/97
Any other vaccine required by the schedule for active immunization as established by regulations (10-204a-1 through 10-204a-3).

B. Any student who has failed to provide evidence of immunization required by Sec. 10-214a shall not be enrolled in a public or non-public school. Enrollment means that a student is eligible to attend school; the statute provides that students shall be immunized before being permitted to attend school.

C. Public Act (P.A.) 91-327 requires:
1. All students entering Connecticut public or non-public schools before the age of five must show proof of adequate immunization against Hemophilus Influenza Type B (HIB) after age 15 months.
2. Students entering school before their sixth birthday shall have had at least four doses of DPT vaccine - the last dose received after their fourth (4th) birthday.
3. Students entering grade seven must show proof of a second immunization against measles.

IV. EXEMPTIONS (Sec. 10-204a and 10-208)
A. Immunization requirements are satisfied if a child:
1. Presents a certificate from a physician or a local health agency stating that initial immunizations have been given to the child and additional immunizations are in process;
OR
2. Presents a certificate from a physician stating that, in the opinion of the physician, immunization is medically contra-indicated because of the physical condition of the child;
OR
3. Presents a statement from the parent(s)/guardian(s) of the child that such immunization would be contrary to the religious beliefs of the child;
OR
4. Has had a natural infection confirmed in writing by a physician or laboratory;
OR
5. In the case of Pertussis, has passed his/her sixth birthday;
OR
6. Has had varicella confirmed in writing by a physician or laboratory report;
OR
7. In the case of Hemophilus Type B, has passed his/her 5th birthday.

IV. Exemptions (continued)
B. Health assessment and health screening requirements are waived if the parent or legal guardian of the pupil, or the pupil (if he/she is an emancipated minor or is eighteen years of age or older) notifies the school nurse in writing that the parent(s)/guardian(s) or pupil objects on religious grounds.

V. RECORDS, REVIEW, NOTIFICATION AND REPORTING
A. Records:
1. The results of all:
a. health assessments;
b. screenings;
c. immunizations;
d. test or treatment provided as a part of the screening or assessment; and
e. health data pertinent to the modifications of the educational program (i.e. physical education excuses, medications, waivers) shall be recorded on the student's health record.

2. Each physician or his/her designee performing health assessments or screenings shall sign such form and provide any recommendations concerning the pupil in writing.
3. If a pupil permanently leaves the Manchester School System, the pupil's original cumulative health record shall be sent to the Connecticut school district to which the student transfers, and a true copy will be kept on file in this district.
4. When a student leaves the State, a copy will be forwarded to the new school district and the original kept on file in this district.

B. Review and Notification:

1. School nurses will review the results of each health assessment and screening.

2. Where the results of a pupil's health assessment or screening indicate a health problem that may affect educational progress of such pupil, the school nurse will inform the pupil's teacher(s), parent(s)/guardian(s) and other appropriate school personnel as may be necessary.

3. Where the results of a pupil's health assessment or screening indicate that a pupil for whom free assessment must be provided is in need of further testing or treatment, the Superintendent of Schools must give written notice of such need to the parent(s)/guardian(s) of such pupils and shall make reasonable efforts to assure that such further testing or screening be provided.

4. In the case of pupils who are eligible for free health assessments, parent(s) and/or guardian(s) shall be notified in writing of such assessments and have the opportunity to be present.

5. Parent(s)/guardian(s) are notified in the spring of their child's 5th grade year and 9th grade year of the requirements of physical assessments due in the next school year.

Parent(s)/guardian(s) who have not submitted the physical assessments are again notified by mail in the spring of their child's 6th grade year and 11th grade year.

By June 1, a list of students who are not in compliance with the physical assessment requirement will be submitted to the Coordinator of School Health. These names will be submitted to school administrators for exclusion from school at the start of the next school year. Parent(s)/guardian(s) so effected will be given written notification of this exclusion status. In August, the schedules of all students who are not in compliance will not be mailed to the home until the required physical assessment is submitted.

C. Reporting

Prior to the start of the school year, the Coordinator of School Health will submit to the Superintendent of Schools a list of students entering grade 7 and 12 who are not in compliance with Sec. 10-206 of the General Statutes.

Effective February 1, 2004, certain information concerning students who have asthma shall be reported to the State Department of Public Health and the Manchester Advisory Board of Health.

Legal Reference
Connecticut General Statutes:
10-191 Physical Examinations
10-204a Immunization against diphtheria, pertussis, tetanus, poliomyelitis, measles and rubella when required
Exceptions - mumps (P.A. 80-139)
10-206 Health Examinations
10-208 Exemption from examination or treatment
10-209 Records not to be public
10-210 Notice of disease to be given parent or guardian
10-214 Vision, audiometric and postural screenings

Section 41 of Public Act 01-4 of the June 2001 Special Session Inclusion of Chronic Disease Assessment.
Annual report to Connecticut Health Department concerning students with asthma.

Adopted: March 8, 1982
Revised: March 24, 2003