The School Health Program provides registered nurses who coordinate health services to manage students’ health needs during the school day. The school nurses serve as the link between the schools, parents and healthcare providers. Parents should notify school administration and/or the school nurse of any chronic health conditions, acute hospitalizations, or any change in medical condition that may affect the student’s academic success. If a health-related emergency occurs during the school day, it may be deemed necessary to call 911 to active emergency medical services (EMS) for continuation of prompt medical care. The policies and procedures of Pitt County Schools’ must be adhered to when determining whether or not a student should be excluded from school due to a health-related condition or illness.
Student Physical Exams (Student Health Assessment) (Policy 4110)
Pursuant to NCGS 130A-440, all kindergarten children and all students entering the public schools in North Carolina for the first time, regardless of grade level, shall receive a health assessment made no more than 12 months prior to the date of school entry:
- A completed health assessment form must be presented by the parent/guardian to the principal on or before the child's first day of attendance. This form is the blue Health Assessment Report form (PPS-2K) and is the only acceptable form.
- A 30-calendar day grace period after school entry is allowed. A student who fails to meet this requirement will not be permitted to attend school until the required health assessment form has been presented. Such absences will not be considered as a suspension, and the student will be given an opportunity to make up work missed during the absence as required by law and stated in policy 4110
- Within 60 calendar days after the commencement of the school year, principals are required to file health assessment status reports with the Department of Environment, Health and Natural Resources on forms provided by the Department.
- Religious exemptions from North Carolina Health Assessment requirements must be documented according to NCGS 130A-442.
Immunizations (Policy 4110)
No child shall attend a school (pre-K-12) unless a certificate of immunization indicating that the child has received the required immunizations has been provided to the school.
North Carolina State Law requires the following minimum doses:
- 5 DTaP, DTP, or DT doses (If 4th dose is after 4th birthday, 5th dose is not required);
DT requires medical exemption.
- 4 Polio Vaccine doses. The booster (4th) dose is required on or after the 4th birthday
and before entering school for the first time.
- 1-4 Hib doses (Children beyond their 5thbirthday are not required to have any Hib
- 3 Hep B doses (Children born on or after July 1, 1994 are required to have 3 doses;
3rd dose on/after 6 months).
- 2 Measles doses (At least 28 days apart; 1st dose on/after 12 months of age).
- 2 Mumps dose (1st dose on/after 12 months of age).
- 1 Rubella dose (On/after 12 months of age).
- 2 Varicella doses administered at least 28 days apart or documentation of disease
from a physician, nurse practitioner or physician’s assistant verifying history of
varicella disease. (Documentation must include student’s name, approximate date
or age of infection and healthcare provider signature.)
Students entering 7th grade or who have reached 12
- 1 Booster dose of tetanus/diphtheria/pertussis (Tdap)
- 1 Meningococcal conjugate vaccine (MCV) doses.
Students entering 12th grade or who have reached 17, whichever comes first.
1 Meningococcal conjugate vaccine (MCV) doses.
*Individuals who entered seventh grade before July 1, 2015 are not required to
receive the first dose. The booster dose does not apply to individuals who entered
the 12th grade before August 1, 2020.
If documentation of the required immunizations is not presented on or before the first day of attendance, it is the duty of the school principal/designee to notify the parent/guardian of the deficiency. The parent/guardian shall have 30 calendar days from the first day of attendance to obtain the required immunization(s).
If the administration of the vaccine in a series of doses given at medically approved intervals requires a period in excess of 30 calendar days, additional days may be allowed to obtain the required immunizations upon certification by a physician.
The student will not be allowed to continue beyond the 30 calendar days or the extended period unless the required immunization(s) has/have been obtained.
Medical or religious exemptions from North Carolina immunization requirements must be documented according to NCGS § 130A-156 or NCGS § 130A-157. Documentation of any exemption must be on file at the school in the student’s permanent record. Parents/guardian seeking an exemption should contact the Pitt County Health Department at (252) 902-2305.
Epinephrine Auto-Injector Devices (Epi-Pens) (Policy 6125)
In accordance with N.C.G.S. §§ 115C-375.1 and 375.2A, each school has designated trained school personnel authorized to use emergency epinephrine auto-injector devices to deliver emergency medical aid to any person suffering from an anaphylactic reaction during the school day or at a school-sponsored event on school property. At least two emergency epinephrine auto-injector devices are located at each school for this purpose.
Epinephrine auto-injector devices provided by the school are not intended, and cannot be used, as the sole supply for students known to have medical conditions requiring the availability of an epinephrine auto-injector device. Parents of students with known life threatening allergies and/or anaphylaxis should provide the school with written instructions from the student’s health care provider for handling anaphylaxis and all necessary medications for implementing the student specific order in accordance with Policy 6125, Administration of Medication. If an epinephrine auto-injector is administered to a student while on school campus, 911 will be called to activate emergency medical services (EMS).
Communicable Diseases (Policy 4230)
In accordance with NCGS § 130A-136, school principals who have reason to suspect that a student or adult in the school has a communicable disease or condition shall report the information required to the local health director in the county in which the school is located. Confidentiality of such reports is protected by law and school principals making such reports in good faith shall be immune from liability.
A safe and secure environment shall be provided for all students and employees. Under certain circumstances, students with communicable diseases or conditions may pose a threat to the health and safety of others. Decisions regarding the educational status of students with communicable diseases will be made on a case-by-case basis in accordance with Policy 4230.
Reportable Diseases and Conditions
The diseases and conditions that are declared to be dangerous to the public health are reportable to the local health department within specific time periods after the disease or condition is reasonably suspected to exist. The local health director will advise the school of precautionary action(s) needed to prevent the spread of disease. The list of reportable diseases can be found at http://epi.publichealth.nc.gov/cd/lhds/manuals/cd/reportable_diseases.html
Non-Reportable Contagious Conditions
The following procedures are recommended for these non – reportable contagious conditions:
- Varicella (Chickenpox): Student is excluded from school until all blisters have formed scabs.
- Pediculosis (Head Lice): Student should be referred for treatment at the end of the school day. Until the end of the school day, avoid any activity that involves the student in head-to-head contact with other children or sharing of any headgear. Student can return to school when treatment is completed and proof of treatment (prescription or box top from over-the-counter treatment) is provided to the school.
- Scabies: Student is excluded from school until one (1) treatment with prescription medication is completed (usually overnight).
- Conjunctivitis (Pink Eye): Student does not need to be isolated from other students, and treatment is not required in order for the student to return to school. If a student is unable to participate in classroom activities or drainage cannot be contained, parents should be notified and consider sending the student home.
- Impetigo: Student is considered contagious until treated with antibiotics for at least 24 hours or the crusting lesions are no longer present. If the student is at school when the lesions are discovered, direct contact with other students should be minimized to the extent possible for the rest of the day. The student should remain out of direct contact with other children if he or she has more than three to four sores until seen by a physician for evaluation and treatment. The student may return to school when topical, oral or other systemic antibiotics are started or if the sores can be covered and kept dry.
- Streptococcal and Staphylococcal Infections: Student is excluded from school until treated with a prescription antibiotic for 24 hours.
- Ringworm: For ringworm of the skin, parent/guardian must send the box top of the antifungal medicine with the child when he/she returns to school. For ringworm of the nails or scalp, parent/guardian must send a doctor’s note to school verifying treatment. Students may return to school once treatment begins.
- MRSA (Methicillin-Resistant Staph Aureus): Student should be referred to his/her healthcare provider and is excluded from school until antibiotic treatment is started or a doctor’s note is provided stating that antibiotic treatment is not necessary. Lesion(s) must be covered with a bandage/dressing that is sealed (taped) on all four sides while at school.
- Vomiting: Student should be excluded from school when vomiting occurs more than 2 times in a 24 hour period, or when there is vomiting with a fever and the child looks or acts ill.
- Diarrhea: If a student is unable to participate in classroom activities or has accompanying signs of illness such as fever then the parent school be notified. A student with frequent loose stools, especially if the child is unable to control those bowel movements, should be evaluated by a physician as the condition may lead to dehydration.
- Fever: Student is excluded from school when the student is unable to participate in classroom activities and when oral temperature is above 101 degrees F. Student may return to school when fever-free for 24 hours without the use of fever reducing medications.
- Bed Bugs: See Pitt County Schools Bed Bug Protocol for the prevention of bed bug infestations in the school setting.
Administration of Medication (Policy 6125)
It is the policy of Pitt County Schools that medications should not be administered to a student during school hours or by school personnel unless the health of the student will be adversely affected. If a student is required to take medication during school hours and the parent cannot be at school to administer the medication, school personnel may administer medication with proper documentation from physician and parent.
Pitt County Schools defines medication to mean “any prescription or over-the-counter medication or supplement which a medical care source deems essential to be administered during school hours.”
The intent of this policy is to encourage students to take required medications prior to school hours and to discourage students from bringing prescription and nonprescription medicines to school or administering such drugs to themselves without assistance of school officials. Neither the Pitt County Schools nor any of its employees are responsible for the improper self-administration of prescription or nonprescription drugs at school.
- “Authorization for Medication” form will be completed by the physician and parent.
- “Authorization for Medication” form may be obtained at the health care provider’s office or the school’s administrative office.
- All medication administered (prescription and non-prescription) by school personnel must be presented in the original container.
- If a student needs a non-prescription (over-the-counter) medication, an “Authorization for Medication” form needs to be signed by the physician and the parent specifying the dosage, time and frequency of medication. If the need is short term (less than a week), only a parents note is required that states the medication, dosage, time and frequency of medication. The parent always has the option to come to school and administer the medication.
- School personnel responsible for dispensing medication (prescription and non-prescription) shall document on the “Medication Log” or electronic health record.
- Parents are responsible for informing the school principal of any serious changes in the child’s health or any change in the medication to be administered. Changes in medication, including altered dosage and changes in time and frequency of administration, requires authorization from the prescribing physician on a new “Authorization for Medication” form.
- All medications shall be transported to and from school by parent/guardian for elementary and middle school students. The only exception is that with prior documentation on the “Authorization for Medication” form, students who have permission to self-medicate may carry rescue medications; (Examples: asthma inhalers, insulin)
- It is a privilege for students to be allowed to self-medicate during school hours. Abuse of this privilege will result in its revocation.
- Under no circumstances will unauthorized over-the-counter medication be given to any student by any member of the school staff.
- At the end of the year, authorization for medication forms and daily medication logs shall be filed in student’s health folders.
- At the end of each school year, schools will notify parents/guardians that medications should be picked up from school or they will be disposed of if they remain on school property after a designated date.