DISCUSSION/ACTION
5.0
MONTGOMERY COUNTY BOARD OF EDUCATION
Rockville, Maryland
October 22, 2012
MEMORANDUM
To:
Members of the Board of Education
From:
Patricia O’Neill, Chair, Board of Education Policy Committee
Subject:
Final Action, Policy JPD, Emergency Care for Students Experiencing Anaphylaxis
On September 24, 2012, the Montgomery County Board of Education tentatively adopted Policy
JPD, Emergency Care for Students Experiencing Anaphylaxis. The tentatively adopted policy was
distributed for public comment. Eighteen comments were received. While some comments offered
suggestions of a regulatory nature, the comments largely supported the intent of the policy.
On October 18, 2012, the members of the Board of Education Policy Committee further discussed
Policy JPD, Emergency Care for Students Experiencing Anaphylaxis, and reviewed the public
comments. No further recommendations were suggested at that time.
The committee recommended draft is included as Attachment A. The public comments are
summarized in Attachment B. The original public comments are included in Attachment C.
The following resolution is provided for your consideration:
WHEREAS, Policy JPD, Emergency Care for Students Experiencing Anaphylaxis, promotes and
protects children’s health, well-being and ability to learn; and
WHEREAS, The draft of Policy JPD, Emergency Care for Students Experiencing Anaphylaxis, was
tentatively adopted by the Montgomery County Board of Education on September 24, 2012, and was
sent out for public comment; and
WHEREAS, The Montgomery County Board of Education has received comments and the Board of
Education Policy Committee’s recommendations; now therefore be it
Resolved, That the Montgomery County Board of Education adopt Policy JPD, Emergency Care for
Students Experiencing Anaphylaxis, as reflected in the attached committee recommended draft.
Present at the table for the discussion are Dr. Ursula A. Hermann, director, Department of Student
Services, Office of Special Education and Student Services, and Mrs. Stephanie P. Williams,
director, Department of Policy, Records, and Reporting, Office of Shared Accountability.
PO:hp
Attachments
ATTACHMENT A
COMMITTEE RECOMMENDED DRAFT
JPD
1
Related Entries:
JPD-RB
2
Responsible Office: Special Education and Student Services
3
Related Sources:
Annotated Code of Maryland Education
Article, §7-426.2
4
5
Emergency Care for Students
6
Experiencing Anaphylaxis
7
8
9
A.
PURPOSE
10
The Board of Education (Board) is committed to a school
11
environment that promotes and protects children’s health,
12
well-being, and ability to learn. Preparation for medical
13
emergencies that children may encounter during the school
14
day is an important part of that environment.
15
16
B.
ISSUE
17
18
Some students have severe, life-threatening reactions to
19
nuts or other foods, insect venom, and or other substances
20
in the environment and rapidly develop a condition called
21
anaphylaxis.
22
injection of epinephrine while awaiting transport to the
23
hospital.
These
students
may
need
an
immediate
24
25
1 of 4
Draft 3
9/18/12
JPD
26
C.
POSITION
27
28
Schools
29
medical care to any student who is determined or perceived
30
to be in anaphylaxis.
31
1.
The
shall
establish
school
nurse,
the
and
to
other
provide
school
33
designee, are authorized to administer auto–injectable
34
epinephrine,
35
determined to be or perceived to be in anaphylaxis,
36
regardless of whether the student—
37
(a)
been
available,
identified
a
schools
student
having
an
(b)
39
who
is
anaphylactic
has a prescription for epinephrine as prescribed
40
by
41
practitioner.
2.
an
authorized
licensed
health
care
School personnel shall be trained on—
43
(a)
how to recognize the symptoms of anaphylaxis;
44
(b)
procedures
for
the
emergency
administration
of
auto–injectable epinephrine; and,
45
46
or
allergy; or,
38
42
as
to
of
personnel
identified
if
superintendent
emergency
32
has
by
procedures
(c)
the proper follow–up emergency procedures.
2 of 4
Draft 3
9/18/12
JPD
3.
47
A school nurse may obtain and store auto–injectable
epinephrine to be used in an emergency situation.
48
49
50
D.
DESIRED OUTCOMES
51
An
educational
environment
that
52
children’s
health,
53
preparing
for
54
encounter during the school day.
well-being,
medical
promotes
and
and
ability
emergencies
that
protects
to
learn
children
by
may
55
56
E.
IMPLEMENTATION
57
58
The
59
procedures
for
60
epinephrine
to
61
recognizing
symptoms
62
identified
in
63
administering
64
proper follow-up emergency procedures.
65
F.
superintendent
of
schools
obtaining
be
this
used
of
and
in
or
designee
storing
an
auto-injectable
for
situation,
providing
school
epinephrine,
develop
auto–injectable
emergency
anaphylaxis,
policy
will
and
training
personnel,
completing
REVIEW AND REPORTING
66
This policy will be reviewed in accordance with the Board
67
policy review process.
68
69
3 of 4
Draft 3
9/18/12
JPD
70
71
Policy History:
Adopted by Resolution No.
4 of 4
Attachment B
Summary of Responses to
Policy JPD, Emergency Care for Students Experiencing Anaphylaxis
Public
Response
Number
Commentator
Issue/Concern
Line #’s refer to the Draft
for Public Comment
1
Sheila Holmes
2
Angela Magliozzi,
parent
3
Carol Volk
Supports the policy.
4
Elisabeth Bendo, parent
Supports the policy.
5
Roxanne Deciutiis
6
7
Laurie Schniebolk,
parent
Alison Friedman, parent
The author shares her
personal experience with
anaphylaxis at school.
Supports the policy.
8
Ed Fowlkes, Jr., parent
Supports the policy.
9
Jason Shelton, parent
Supports the policy and
advocates for guidelines for
teaching students about
allergies.
Summary of Responses Policy JPD
10/16/12
The author’s first
impression was that the
policy seemed dangerous
but reflects that it might be
helpful. She asks for
background on why policy
is being proposed.
Supports the policy.
Expresses concern about
possible side effects of
giving epinephrine.
Supports the policy.
Staff Response
Line #’s refer to the
Committee
Recommended Draft
This policy is being
implemented to comply
with recently enacted
Maryland law.
MCPS is implementing this
policy in cooperation with
the Montgomery County
Department of Health and
Human Services, School
Health Services (health
department). Impacted
staff members are being
trained by the health
department.
The Board appreciates
support and feedback.
The Board appreciates
support and feedback.
The Board appreciates
support and feedback.
The Board appreciates
support and feedback.
The Board appreciates
support and feedback.
The Board appreciates
support and feedback.
The Board appreciates
support and feedback.
Page 1
Attachment B
Public
Response
Number
Commentator
10
Alison Kobey, parent
11
Jim Boyce, Ph.D. parent
12
Darci Botti, parent
Summary of Responses Policy JPD
10/16/12
Issue/Concern
Line #’s refer to the Draft
for Public Comment
Supports the policy, and
appreciates that the policy
does not require nut-free
schools. Additional
questions are expressed
regarding implementing
details.
Supports the policy.
Suggestions for
implementation are as
follows: “1) The parties
responsible for keeping
children’s dose epinephrine
on site maintain multiple
twin pack injectors of
epinephrine with that
number being based on
student enrollment and that
they will also be responsible
for monitoring and replacing
these by expiration date. 2)
The parties responsible for
being trained as well as
peripheral staff at the
schools engage in regular
emergency response drills at
the schools. There should
be consideration of a
student’s individualized
physician-signed emergency
treatment plan on file for
each student with a known
allergen, in whatever
response training is
conducted.”
Supports the policy.
Staff Response
Line #’s refer to the
Committee
Recommended Draft
Implementing details will
be found in the
accompanying regulations
and health department
procedures.
1) The procedures for
determining the number of
EpiPens at each school and
replacing used EpiPens
were established in
cooperation with the health
department. Procedures
are in place for monitoring
and replacing auto injectors
at school sites, as well as
informing appropriate
school staff of students’
Individual Health Care
Plans. 2) School staff
members have been trained
to recognize symptoms,
and identified staff
members have been trained
by the health department
on how to administer auto
injectors and implement
follow-up procedures.
Additional implementing
details will be found in the
accompanying regulations
and health department
procedures.
The Board appreciates
support and feedback.
Page 2
Attachment B
Public
Response
Number
Commentator
Issue/Concern
Line #’s refer to the Draft
for Public Comment
Staff Response
Line #’s refer to the
Committee
Recommended Draft
School staff members have
been trained to recognize
symptoms, and identified
staff members have been
trained by the health
department on how to
administer auto injectors
and implement follow-up
procedures.
An existing regulation sets
forth guidance for care of
students known to have
anaphylactic allergies.
13
Cheryl Lohman, MD
Supports the policy.
Believes that any school
employee should be allowed
to administer epinephrine in
an emergency situation
without prior parental
consent.
14
Stephen and Alicia
Wilson
15
Brenda Bonazelli,
parent
16
Judy Kettl, RN, BSN
17
Jackie Zak, parent
The policy should describe
how students with known
anaphylactic allergies
should be supervised on
field trips. Such students
should be under the
supervision of a teacher or
staff member trained to
administer auto injector.
Supports the policy. Agrees The Board appreciates
with the authorization of the support and feedback.
school nurse and other
trained personnel
administering epinephrine to
a student after recognizing
symptoms of a reaction.
Supports consideration of
preventing exposure to
students.
Supports the policy.
The Board appreciates
support and feedback.
Supports the policy.
Guidance from both the
Questions whether there will state and local health
be a policy in place to
departments says that there
identify students who have a is no contraindication for
preexisting medical
administration of the
condition that would be a
epinephrine auto-injector
contraindication for
for anaphylaxis.
administration of the
EpiPen.
Summary of Responses Policy JPD
10/16/12
Page 3
Attachment B
Public
Response
Number
18
Commentator
Erika Vassell, parent
Summary of Responses Policy JPD
10/16/12
Issue/Concern
Line #’s refer to the Draft
for Public Comment
Supports the policy. Asks
that 1) staff members other
than those trained to
administer the EpiPen be
trained to recognize
symptoms; 2) that MCPS
consults with medical
professionals. Attaches a
flyer to raise awareness.
Staff Response
Line #’s refer to the
Committee
Recommended Draft
School staff members have
been trained to recognize
symptoms. The policy,
implementation
procedures, and trainings
have been developed in
partnership with the
medical professionals at
the health department at the
local and state levels.
Page 4
Attachment C
ORIGINAL PUBLIC COMMENTS
POLICY JPD, Emergency Care for Students Experiencing Anaphylaxis