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HCPSS / POLICIES

Policy 5120 Implementation Procedures - Communicable Diseases – Prevention and Control

Policy Document

Implementation Procedures

I. Definitions

Within the context of these implementation procedures, the following definitions apply:

  1. Contagious Period – The time during which an illness is capable of being transmitted from one person to another by contact or close proximity.

  2. Homeless Student – A student who lacks a fixed, regular, and adequate nighttime residence, whether or not the temporary housing is located in Howard County, including:

    1. Students who are sharing the housing of other persons due to loss of housing or to economic hardship, or due to a similar reason; living in motels, hotels, transitional housing, or campgrounds due to the lack of alternative accommodations; living in emergency or transitional shelters; abandoned in hospitals; are runaways, living in shelters or other inadequate accommodations; or awaiting foster care placement.

    2. Students who have a primary nighttime residence that is a public or private place not designed for or ordinarily used as, a regular sleeping accommodation for human beings.

    3. Students who are living in cars, parks, public spaces, abandoned buildings, substandard housing, bus or train stations, or similar settings.

    4. Migratory students as defined under federal law who qualify as homeless because they are living in the circumstances above.

  3. Infectious Agents – Microorganisms capable of producing infections in susceptible hosts.

  4. Other Potentially Infectious Materials (OPIM) – An Occupational Safety and Health Administration (OSHA) term that refers to:

    1. The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids where it is difficult/impossible to differentiate between body fluids.

    2. Any unfixed tissue or organ (other than intact skin) from a human (living or dead).

    3. Human Immunodeficiency Virus (HIV)-containing cell or tissue cultures, organ cultures, HIV or Hepatitis B Virus (HBV)-containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV.

  5. Parent – Any one of the following, recognized as the adult(s) legally responsible for the student:

    1. Biological parent – A natural parent whose parental rights have not been terminated.

    2. Adoptive parent – A person who has legally adopted the student and whose parental rights have not been terminated.

    3. Custodian – A person or agency appointed by the court as the legal custodian of the student and granted parental rights and responsibilities.

    4. Guardian – A person who has been placed by the court in charge of the affairs of the student and granted parental rights and responsibilities.

    5. Caregiver – An adult resident of Howard County who exercises care, custody, or control over the student but who is neither the biological parent nor legal guardian, as long as the person satisfies the requirements of the Education Article, §7-101 (c) (Informal Kinship Care) or has been issued a U.S. Department of Health and Human Service’s Office of Refugee Resettlement (ORR) Verification of Release form entering into a custodial arrangement with the federal government.

    6. Foster parent – An adult approved to care for a child who has been placed in their home by a state agency or a licensed child placement agency as provided by the Family Law Article, §5-507.

  6. Personal Protective Equipment (PPE) – Specialized clothing or equipment worn by an employee for protection against a hazard (e.g., gloves, masks, protective eyewear, gowns). General work clothes (e.g., uniforms, pants, shirts or blouses) not intended to function as protection against a hazard are not considered PPE.

  7. Regulated Medical Waste – Liquid or semi-liquid blood or other potentially infectious materials; contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed; items that are caked with dried blood or OPIM and are capable of releasing these materials during handling; contaminated sharps; and pathological and microbiological wastes containing blood or other potentially infectious materials.

  8. Sharps – Medical articles that may cause punctures or cuts to those handling them, including all broken glassware, syringes, needles, scalpel blades, suture needles and disposable razors.

  9. Standard Precautions – Guidelines recommended by the Centers for Disease Control (CDC) to reduce the risk of infection. These precautions (e.g. hand washing and wearing PPE such as gloves, mask, eye protection, and gown) apply to all blood, all body fluids, secretions, excretions (except sweat), nonintact skin, and mucous membranes of all students and employees and are the primary strategy for successful infection control.

II. Routine Measures

Diseases have varying periods of communicability that precede the onset of identifiable symptoms and, in some cases, are without symptoms throughout the entire contagious period. Methods used to control the spread of communicable disease in the school setting have limitations; therefore, general efforts to control communicable diseases must be carried out on an ongoing basis. General efforts include the following:

  1. Hand Washing

    Hand washing is the single most effective technique for preventing the spread of disease and will be encouraged throughout the school day. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol.

    1. Hand washing will be included in the Health Education Disease Prevention and Control Unit wherever it is included in the curriculum.

    2. School health employees will provide up-to-date information on proper hand washing techniques to school administrators/designees.

    3. School administrators will be responsible for implementing hand washing procedures and encouraging students, employees, service providers and volunteers to follow proper hand washing techniques.

  2. Personal Protective Equipment (PPE)

    The purpose of PPE is to keep blood and OPIM from contacting the employee’s, service provider’s or volunteer’s skin, eyes, and mucous membranes.

    1. Appropriate PPE will be determined by the Office of Safety and Security and the Office of Health Services.

    2. PPE will be provided by the respective office/department.

    3. General work clothes, e.g., uniforms, pants, shirts and blouses are not considered to be personal protective equipment. The level of protection required is determined by the nature of the tasks being performed.

  3. Personal Hygiene Measures

    Employees, service providers, volunteers, and students will use good personal hygiene measures, including hand washing measures and the use of PPE, to protect both themselves and others from potential exposure to infectious agents.

  4. Environmental Control

    Environmental factors contribute to the spread of infectious agents so it is imperative that:

    1. All buildings be maintained and cleaned on a regular basis.

    2. All departments are responsible for implementing procedures for maintaining and cleaning related to the activities conducted.

    3. All departments will implement appropriate cleaning schedules for the maintenance of their locations.

  5. Standard Precautions

    Standard precautions will be observed in order to prevent contact with blood or OPIM. When working with blood or OPIM, gloves and in some cases other protective clothing or PPE will be worn.

    1. The Office of Health Services, in collaboration with the Office of Safety and Security will be responsible for annual training to review standard precautions.

    2. School administrators and department supervisors are responsible for ensuring that professional development occurs annually for their employees.

  6. Handling of Regulated Medical Waste

    Potential health hazards are associated with the disposal of certain refuse and regulated medical waste and this disposal is subject to state regulations. Regulated medical waste will be disposed of in accordance with regulations set forth by OSHA and MOSH.

    The Office of Health Services and the Office of Safety and Security, in collaboration with the Howard County Health Department (HCHD) and other agencies, will comply with all applicable regulations and implementation procedures.

  7. Immunization Procedures

    Immunizations significantly reduce occurrences of communicable disease. State law requires that all students show proof of compliance with state immunization requirements. Current immunization requirements, distributed by the Maryland Department of Health (MDH), will be reviewed annually.

    1. The Office of Health Services will develop and distribute to all school administrators an annual immunization memo which describes the current immunization requirements from the MDH.

    2. School administrators will follow current immunization requirements and procedures as outlined in the Requirements and Procedures for School Health Services Manual and in the current memo regarding immunization requirements.

    3. School administrators will not knowingly admit a student, or retain a student who does not meet the immunization requirements as defined in COMAR 10.06.04. Principals may temporarily admit students who present an appointment date (not to exceed 20 calendar days) to obtain missing immunization records or receive needed immunizations.

    4. Students of active military families, entering a Howard County Public School System (HCPSS) school from certain recognized states, who do not have the required immunization records may be eligible to have 30 calendar days to comply with the requirements instead of 20 calendar days.

    5. Homeless students cannot be denied entry into school. Pupil Personnel Workers, in collaboration with Health Services employees, will provide assistance to obtain required documentation for immunization and compliance.

  8. Reporting of Absentee Rates

    High absentee rates in schools may be an indication of an outbreak of communicable disease.

    1. The school administrator/designee will monitor student absenteeism and will report a ten percent absentee rate or suspected outbreaks to the Office of Health Services as soon as it occurs and subsequently on a daily basis.

    2. The Health Services Specialists will monitor these absentee rates and will consult with the HCHD where there is an increase in the number of schools reporting high absentee rates and/or suspected outbreaks.

III. Management of Students with Suspected or Confirmed Communicable Disease

The Office of Health Services will work in collaboration with the Office of Safety and Security and the HCHD for evaluation and management of students with suspected or confirmed communicable diseases.

Students with a suspected or confirmed communicable disease will be referred to the Health Services employees for evaluation and management.

  1. Health Services employees will follow procedures for the management of students as indicated in the Requirements and Procedures for School Health Services Manual.

  2. Health Services employees will notify the school’s administrators and the student’s parents of suspected communicable disease.

  3. Health services employees have the authority to dismiss/exclude student(s) as appropriate and may require medical clearance to return to school.

  4. Health Services employees will report confirmed or suspected reportable diseases to the HCHD and the Office of Health Services and/or the Office of Safety and Security.

  5. All employees will maintain the student’s right to privacy under Policy 9050 Student Records.

  6. Health Services employees will assist administrators/designees in informing individuals/groups regarding potential exposures.

IV. Management of Employees, Service Providers, and Volunteers with Suspected or Confirmed Communicable Disease

The Office of Safety and Security will work in collaboration with the Office of Health Services and the HCHD for evaluation and management of employees, service providers, and volunteers with suspected or confirmed communicable diseases.

When an employee, service provider, or volunteer is suspected of having a communicable disease, the following steps will be taken:

  1. The administrator, school health professional, or department supervisor will contact the Office of Safety and Security and/or the Office of Health Services for evaluation and management of the employee, service provider, or volunteer.

  2. The administrator or department supervisor, with guidance from the Office of Health Services, will have the authority to dismiss/exclude employees, service providers, or volunteers as appropriate and may require medical clearance to return to the school/office.

  3. The Office of Safety and Security and/or the Office of Health Services will report suspected and confirmed reportable diseases to the HCHD and the Superintendent/designee.

  4. All employees will maintain the right to privacy of employees, service providers, and volunteers.

  5. Health Services employees, in collaboration with the Office of Safety and Security will assist administrators or department supervisors in informing individuals/groups regarding potential exposures.

V. History

ADOPTED: March 23, 2004

REVIEWED:

MODIFIED: November 7, 2019

REVISED: February 13, 2013

EFFECTIVE: November 7, 2019