MANAGEMENT OF CASUAL-CONTACT DISEASES | Administrative Guideline Manual

8450 - MANAGEMENT OF CASUAL-CONTACT DISEASES

Diseases spread by airborne and/or direct contact with germs from sneezing, coughing, and speaking shall be managed according to the current guidelines set forth by the Wisconsin Department of Health Services (DHS), the Jefferson County Health Department, the District's Medical Advisor, and a student or staff member's health care provider. District staff shall use the Wisconsin Childhood Communicable Diseases Chart (https://www.dhs.wisconsin.gov/publications/p4/p44397.pdf) provided by DHS as a general guide for school-based management of various communicable diseases.

School staff are not qualified to diagnose a communicable disease. However, any school staff member who knows or suspects that a certain communicable disease is present must immediately notify the school nurse and/or Principal.

Students identified to have symptoms of a communicable disease will follow the exclusion and return to school guidelines set forth by DHS, the Jefferson County Health Department, and their individual health plan (IHP). The parent(s) will be immediately notified for the reason of the exclusion.

The school nurse or designee will notify the school custodian or Buildings and Grounds Director as needed for any services related to the disinfection of contaminated areas/surfaces.

If an outbreak of a communicable disease is suspected, the school nurse and principal will work directly with the Jefferson County Health Department and the District's Medical Advisor, as needed, to properly manage the outbreak, which may include closure of a classroom/grade/school as warranted. Such a closure is a joint effort and decision by a Response Team that will include the:

District Administrator.
Principal.
School Nurse.
Buildings and Grounds Director.
Jefferson County Health Department.

Timely communications to staff, students, parents, and the community shall be issued as deemed by the District Administrator to be necessary and appropriate. Any communications related to the disease must preserve confidentiality according to State law.

HAND HYGIENE PRACTICE

Employees and students should wash their hands with soap and water for at least 20 seconds as frequently as possible. When soap and water is not available employees and students should use hand sanitizer. Employees and students are encouraged to wash their hands:

Before:

Having contact with another person
Putting on gloves
Using equipment shared by others
Handling food that others may consume or share
Administering medications
At the start of each work day or shift
Between classes
When starting new tasks
Using the restroom
Before a break

After:

Having contact with another person
Having contact with bodily fluids
Having contact with equipment shared by others
Taking off gloves
Using the restroom
Coughing or sneezing
Administering medications
After a break
After eating
The end of the work day or shift

If:

Hands are soiled or visibly dirty

Hand Washing Procedure:

Wet hands with water
Apply soap
Rub hands together for at least twenty (20) seconds, covering all surfaces, focussing on fingertips and fingernails
Rinse under running water and dry with a disposable towel
Use the towel to turn off the faucet

Hand Rub (Hand Gel) Procedure:

Apply to palm the amount gel specific to the product
Rub hands together, covering all parts of the hand, especially fingertips and fingernails
Use enough rub to require at least fifteen (15) seconds to air dry

Employees are responsible for replenishing or letting the person in charge know when hand washing supplies or hand sanitizer are low.

Cough and Sneeze Etiquette

The District will provide tissues for District employees and students, if feasible. To help stop the spread of germs, employees and students should:

cover mouth and nose with a tissue when coughing or sneezing;
throw used tissues in the trash;
cough or sneeze into elbow, not hand, if a tissue is not available for use; and
wash hands after coughing or sneezing.

COMMUNICABLE DISEASE CONTROL GUIDELINES

Educational and Preventive Measures
1. The District will ensure that all immunizations (or related waiver) and health examinations/tests (e.g., tuberculin skin test or chest x-ray) required of students and staff by law and Board policy have been obtained. Staff shall refer to and follow the District’s immunization plan and related District policies when carrying out this task.
2. The School Nurse shall be responsible for the maintenance of a health station/area in each school building.
3. First aid kits and other supplies and equipment appropriate to reducing the risk of transmission of communicable diseases in the school environment, as determined in consultation with public health officials, will be provided in each school building.
4. The School Nurse shall ensure that the District provides parents and guardians of students in the 6th grade with information about meningococcal disease as mandated by state law.
5. The School Nurse shall provide general information regarding suppression and control of communicable diseases to all new employees (i.e., substitutes, coaches, professional and support staff). This information will be provided periodically in training programs for all existing staff. In addition to this training, those employees who are occupationally exposed to blood or other potentially infectious materials in the performance of their duties shall receive special training upon initial employment and annually thereafter. Such training shall be provided in accordance with provisions of the District's Exposure Control/Bloodborne Pathogens Plan. 'Occupationally exposed' means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties.
6. District employees shall comply with provisions of the Exposure Control/Bloodborne Pathogens Plan when they are exposed to blood or other potentially infectious agents or materials in the school setting or during school related activities.
Communicable Disease Reporting
1. The building principal shall function as the District's liaison with students and staff, parents and guardians and physicians, public health officials and the community at large concerning communicable disease issues in the school.
2. Any person who knows or suspects that a student or District employee has a communicable disease has a duty to report such facts to the principal or his/her designee. The principal or designee will confer with the nurse serving the school and, to the extent circumstances warrant and permit, with the subject of the report and, for student subjects, the student's parent or guardian.
3. The principal or designee, in conjunction with the School Nurse, will report any known or suspected communicable disease that is present in the school to the local public health officer or to the local health officer’s designee in accordance with state law requirements. Reportable disease categories are as follows:
  1. Category I - diseases are of urgent public health importance and must be reported immediately by telephone to the local public health officer or to the local health officer’s designee upon identification of a case or a suspected case. In addition to the immediate report, a written report must be made on the required reporting form within twenty-four (24) hours. Examples of such reportable diseases include, but are not limited to measles, rabies (human, animal), tuberculosis, foodborne or waterborne outbreaks, occupationally-related diseases, COVID-19, and hepatitis
  2. Category II - diseases must be reported by fax, mail, or electronic reporting to the local public health officer or to the local health officer’s designee on the required reporting form or by other means within seventy-two (72) hours of identification of a case or suspected case. Examples of such reportable diseases include, but are not limited to lyme disease, meningitis (bacterial), mumps, salmonellosis, sexually transmitted diseases (e.g., gonorrhea, chlamydia), varicella (chicken pox), and suspected outbreaks of other acute or occupationally-related diseases.
  3. Category III - diseases include acquired immune deficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection and must be reported to the state epidemiologist on the required reporting form or by other means within seventy-two (72) hours after identification of a case or suspected case. While nuisance diseases like head lice are not required to be reported to the local public health officer, the principal or designee may contact public health officials for information about the prevention, control and treatment of such diseases and request their involvement in recurrent infestations.
4. When an occupationally exposed employee, as defined above, has had an incident of occupational exposure to blood or other infectious agents or materials, he/she should report the incident in accordance with provisions outlined in the District's Exposure Control/Bloodborne Pathogens Plan.
Exclusion from School
1. Students
  1. Students who are suspected of having a communicable disease that could be detrimental to the health of self or others in the school environment may be sent home from school by any teacher, nurse serving the school or principal for diagnosis and treatment. Students who are diagnosed as having a communicable disease that renders them unable to pursue their studies or poses a significant risk of transmission to others in the school environment shall be excused from school attendance until their presence no longer poses a threat to the health of themselves or others, as determined by a health care provider.
  2. The determination as to whether and under what circumstances a student may be sent home for diagnosis and treatment or excused from school attendance shall be made in consultation with appropriate health care professionals (e.g., the nurse serving the school, local public health officials). If such consultation cannot be completed prior to an initial decision to send a student home, it shall be completed at the earliest reasonable opportunity, and the school’s initial decision may be revised as appropriate.
    1. The principal or designee may refer this determination to a health care team if the disease in question appears to require a lengthy period of exclusion from school or to pose a serious health threat to the student or others. If a health care team is convened to make this determination, it will consist of the principal, the nurse serving the school, the local public health officer, and—to the extent the cooperation of the individuals can be obtained—the student and/or the student’s parent or guardian and the student’s physician. The team will confer, as necessary, with the District’s medical consultant and legal counsel and with state public health officials.
    2. For a student with a disability or a student whose communicable disease may give rise to a disability, the principal or designee, in consultation with the Director of Special Education and Pupil Services, may refer this determination to an individualized educational program (IEP) team or to the District’s Section 504 coordinator. The normal membership of any IEP team making any such determinations should be supplemented to the extent possible by the student’s physician, the local public health officer, the principal, and the nurse serving the school.
  3. Before sending a student home for diagnosis and treatment or making a determination to excuse a student from school attendance due to a concern surrounding a communicable disease, the student shall be informed of the reasons for the contemplated action to the extent appropriate for the student’s age, and the school shall attempt to contact and provide relevant information to the student’s parent or guardian.
  4. A teacher who sends a student home from school under Board policy and these procedures must also notify the principal of the action and the reasons for the action. The nurse serving the school should also be notified when a student is sent home from school with a known or suspected communicable disease.
  5. Alternative educational opportunities will be arranged for students who must be excused from school attendance for a significant period of time.
  6. The principal or designee, in consultation with the nurse serving the school and, where appropriate, with local public health officials, shall determine when a student who has been excused from school attendance for a communicable disease may be readmitted. The administration may require a medical statement from the local health department or private physician about a student’s suitability to return to school, if the disease warrants such a statement.
  7. Appeals: Students who dispute the determinations or actions of the District concerning exclusion from school under these procedures may appeal such determinations or actions to the Superintendent or his/her designee within five school days of the District’s initial decision or any subsequent decision that materially changes the extent or conditions of the student’s exclusion. The appeal shall be in writing and shall include the following:
    1. statement of facts;
    2. statement of the relief requested; and (3) any necessary medical information required. The Superintendent or his/her designee shall render a decision in writing within five (5) school days.

Complaints involving the identification, evaluation, educational placement, or provision of a free and appropriate public education of a student with a disability will be resolved through the procedures as identified by federal, state, and local rules.

Complaints alleging student discrimination on the basis of handicap or disability will be resolved through the District’s student discrimination complaint process. Except to the extent prohibited by law, a student may be excluded from school during the pendency of any appeal.

Aside from resolving formal appeals, the District shall be willing to consider the effect that any changed circumstances or newly available information may have on a District decision to exclude a student from school under these procedures.

Employees
1. Employees who are suspected of having or diagnosed as having a communicable disease that poses a significant health risk to any other person in the school environment or that renders them unable to safely or adequately perform their duties may be excluded from work consistent with District policies and procedures, provisions of the Employee Handbook, and legal requirements. Such decisions shall be made by the Superintendent in consultation with one or more appropriate health care professionals (e.g., the nurse serving the school, local public health officials).
2. Before making a determination that an employee should be excused from work, the following actions should occur:
  1. The employee should be informed of the reasons for the contemplated action.
  2. Any information the employee may choose to offer regarding his/her condition(s) shall be considered.
  3. Consideration should be given to whether a reasonable accommodation could eliminate the health risk to others and/or permit adequate performance. An accommodation is not considered reasonable if it results in undue hardship to the District or when the employee poses a 'direct threat' to the health or safety of others. In determining whether the risk to health or safety of others is significant enough to justify exclusion of the employee from school, the following factors will be considered (a) the duration of the risk; (b) the nature of severity of the potential harm; (c) the likelihood of potential harm; and (d) the imminence of potential harm.

In accordance with state law, school food service employees shall refrain from handling food while they have a disease in a form that is communicable by food handling.

The Superintendent or designee shall provide written notice to any District employee excused from work pursuant to these procedures. Employees so excused may utilize any applicable employment opportunities provided under applicable law, existing Board policies, and/or provisions of the Employee Handbook—which may include sick leave, family and medical leave, applying for unpaid leave of absence, or consideration for reassignment—but are not guaranteed continued or renewed employment except to the extent provided under such policies or provisions or legal requirements. The administration may require a medical statement from the local health department or private physician about an employee’s suitability to return to school after having had a communicable disease if the disease warrants such a statement.
Appeals: A District employee who disputes the determinations or actions of the District concerning exclusion from work under these procedures may appeal the determination or action to the Superintendent. The appeal shall be in writing and shall include the following:(1) statement of facts; (2) statement of the relief requested; and (3) any necessary medical information required. The Superintendent shall render a decision in writing within ten (10) school days. Complaints alleging employment discrimination on the basis of handicap or disability will be resolved through the District’s employment discrimination complaint process.

Maintenance and Confidentiality of Communicable Disease Records and Information
1. Except as outlined below or otherwise specifically provided by law, information concerning a student's or employee's communicable disease shall be kept confidential and may be released only upon the informed written consent of the employee or student, or if the student is a minor, his/her parent or guardian. Patient health care records, except HIV-related record information, may be released without informed consent to a District employee or agent if any of the following apply:
  1. The employee or agent has responsibility for preparation or storage of patient health care records.
  2. Access to the patient health care records is necessary to comply with a requirement of state or federal law.
2. As authorized by federal law, the following individuals may have access to information obtained from required employee medical examinations:
  1. Supervisors and managers may be informed regarding necessary restriction on the work or duties of the employee and necessary accommodations.
  2. First aid and safety personnel may be informed, when appropriate, if the employee's disability might require emergency treatment.
  3. Governmental officials investigating compliance with the Americans with Disabilities Act shall be provided relevant information on request.