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Board Policy #662.0 Student Health Supports

1. Policy Statement

The York Region District School Board (YRDSB) believes the provision of student health, medical and/or disability supports allows students to fully access school in a safe, accepting, healthy and inclusive learning environment that improves student success and well-being. Providing health, medical, and/or disability supports empowers students as confident and capable learners, to reach their full potential for-management of their health, medical condition(s) and/or disabilities. The safety and well-being of all students is a shared responsibility of the Board, staff, schools, families, students, health care providers and third-party health care providers. 

2. Application

“Supporting students with health/medical conditions in schools is complex. A whole-school approach is needed where education and community partners, including health care professionals, have important roles to play in promoting student health and safety and in fostering and maintaining healthy and safe environments in which students can learn.” (Policy/Program Memorandum 161 (PPM 161) Supporting children and students with prevalent medical conditions (anaphylaxis, asthma, diabetes, and/or epilepsy) in schools)

Providing health, medical and/or disability supports to students is a shared responsibility. Parent(s)/Guardian(s) and students shall inform the school about any serious or life-threatening medical conditions, disability or other health-related matters and take all reasonable measures to minimize the requirement for health/medical supports during school hours. Parent(s)/Guardian(s) and students work in partnership with schools to support student health, medical and/or disability needs.

The YRDSB engages the services of external partners, such as, but not limited to York Region Public Health and Third-Party Health Care Providers to support recommendations and the provision of health, medical and/or disability supports to students, as required.

The Board will collaborate with parent(s)/guardian(s) to support a safe environment for their children while at school and during school related activities, and endeavor to provide equitable opportunities to access the education system.

Health Care Plan(s) and/or Essential Routine Health Care Plan(s) will be created for students who are at known risk for specific medical emergencies and daily routine management that may occur at school and outline the management of these known conditions. Health Care Plans and/or Essential Routine Health Care Plans will be referenced in the Individual Education Plan (IEP), where applicable, and in accordance with the Ministry of Education Policy and Resource Guide: Special Education in Ontario – Kindergarten to Grade 12.

Staff members and those entrusted with student supervision have a duty of care to assist students with daily health routines, medical incidents and emergencies, to the extent of their capacity within the means available to them. Staff members cannot perform controlled acts as defined by the Regulated Health Professions Act as part of their assigned responsibilities unless otherwise authorized under any applicable legislation.

The Board is responsible for communicating annually, policies on supporting students with medical conditions to parent(s)/guardian(s), staff and others in the school community who are in direct contact with students, including but not limited to, food service providers, transportation providers and volunteers.

This policy and its related procedures are in compliance with Policy/Program Memorandum 161 (PPM 161) ): Supporting Children and Students with Prevalent Medical Conditions (Anaphylaxis, Asthma, Diabetes, and/or Epilepsy) in Schools, Ministry of Education and PPM 163 School Board Policy on Service Animals. Requests to have a guide dog, service dog or service animal accompany the student while attending school or a school-related event shall consider a student’s dignity, integration, independence and disability-related learning needs and the accommodations available to enable meaningful access to education. This policy also supports students with other health/medical and disability needs.

Training

Training related to health/medical conditions will be provided on an annual basis for all school staff who have direct contact with students with health/medical condition(s).

To ensure student safety and well-being, training will;

1. take place within the student’s first thirty (30) days of school, where possible; and
2. be reviewed as required.

Training opportunities will include:

1. strategies for preventing risk of student exposure to triggers and causative agents in the school;
2. expectations with regard to the ability of students to carry their medication and supplies while at school to support the management of their medical condition as outlined in the Health Care Plan;
3. identify expectations with regard to the safe storage and disposal of medication and medical supplies;
4. outline communication strategies with regard to expectations;
5. strategies for supporting inclusion and participation in school;
6. recognition of symptoms of a medical incident and a medical emergency;
7. information on school staff supports, in accordance with board policy;
8. medical incident response(s) and medical emergency response(s); and
9. documentation procedures.

Reporting/Documentation

The Board complies with applicable privacy legislation and obtains parent(s)/guardian(s) consent prior to sharing student health information in accordance with the legislation.

Subject to relevant privacy legislation, the Board will develop a process to regularly collect data, including but not limited to:

1. the number of students with prevalent medical conditions in schools;
2. the number of and circumstances associated with medical incidents and medical emergencies; and
3. requests for guide dogs, service dogs and service animals.

This data will be used as part of the Board’s cyclical policy reviews process and provided to the Ministry of Education, as required.

3. Responsibilities

3.1 The Board of Trustees is responsible for:

1. reviewing the Student Health Supports policy in accordance with the priorities in the Multi-Year Strategic Plan and the approved policy review cycle; and
2. understanding and communicating with members of the community about the Student Health Supports policy, as required.

3.2 The Director of Education is responsible for:

1. implementing and operationalizing the Student Health Supports policy and related procedures.

3.3 Principals are responsible for:

1. communicating to parent(s)/guardian(s) and appropriate staff the process for parent(s)/guardian(s) to notify the school of their child’s health/medical and disability condition(s);
2. communicating the expectation for parent(s)/guardian(s) to co-create, review and update a Health Care Plan(s) and/or Essential Routine Health Care Plan(s) with the principal or the principal’s designate at minimum:
   • during the time of registration;
   • each year during the first week of school when a child is diagnosed and/or returns to school following a diagnosis; and
   • when a child is diagnosed and/or returns to school following a diagnosis.
3. encouraging parent(s)/guardian(s) and students to supply information about any serious or life-threatening medical conditions or other health related matters;
4. ensuring that appropriate staff members are aware of and receive appropriate training to support students diagnosed with a serious or life-threatening medical condition or other health-related matter requiring school support;
5. identifying staff who can support the daily or routine management of health/medical needs of students in the school while honouring the provisions within their collective agreements;
6. ensuring medical occurrences, incidents and emergencies are recorded in the Medical Incident Record Form attached to the appropriate Health Care Plan(s);
7. maintaining a file with the supporting documentation for each student with a medical and/or health condition;
8. facilitating communication with parent(s)/guardian(s) in medical emergencies, as outlined in the Health Care Plan(s);
9. engaging with the appropriate community services, staff and parents/guardians on a regular basis to provide necessary supports;
10. encouraging parent(s)/guardian(s) to provide suitable medical identification for their child; and 
11. adhering to staff responsibilities as outlined below.

3.4 School Staff are responsible for:

1. implementing the contents of Health Care Plan(s) and/or the Essential Routine Health Care Plan(s) and/or protocols for any students with whom they have direct contact;
2. participating in training on health/medical conditions, at a minimum annually and as required;
3. sharing information on a student’s signs and symptoms with other students, if the parent(s)/guardian(s) give consent to do so and as outlined in the Health Care Plan and authorized by the principal in writing;
4. following school board strategies that reduce the risk of student exposure to triggers or causative agents in classrooms, common school areas, and extracurricular activities;
5. supporting a student’s daily or routine management, and respond to health/medical incidents and medical emergencies that occur during school as outlined in Board policies and procedures;
6. supporting inclusion by allowing students with health/medical conditions to perform daily or routine management activities in a school location (e.g., classroom) while being aware of confidentiality and the dignity of the student; and
7. enabling students with health/medical conditions to participate in school to their full potential.

3.5 Administrative Services is responsible for:

1. taking steps to ensure that facilities, permit holders, cafeteria service providers and Student Transportation Services adhere to the Student Health Supports policy and procedures, where applicable.

3.6 Parent(s)/Guardian(s) are responsible for:

1. partnering with the school as the primary caregivers of their child, in supporting the management of their child at school;
2. educating their child about their health/medical condition(s) with support from their child’s health care professional(s) as appropriate;
3. guiding and encouraging their child to reach their full potential for management and self-advocacy;
4. informing the school of their child’s health/medical condition(s) and complete documentation as required;
5. where possible, minimize the requirement for health supports during school hours, where applicable, such as, but not limited to the administration of medication;
6. working with the principal and appropriate school staff to co-create Health Care Plan(s) and/or Essential Routine Health Care Plan(s) based on the status of their child’s health/medical condition(s) or changes to their child’s ability to manage their health/medical condition(s);
7. annually confirming with the principal the status of their child’s health/medical situation;
8. participating in annual meetings to review their child’s Health Care Plan(s) and/or Essential Routine Health Care Plan(s) and/or protocol, as appropriate;
9. provide consent to share information on signs and symptoms of their child’s medical/health condition(s) with other students, when appropriate;
10. seeking medical advice from a licensed physician, nurse practitioner, or pharmacist where appropriate; and
11. covering any out of pocket costs incurred by the school associated with health/medical treatment, including the cost of transportation by ambulance should this be required.

3.7 Students who are cognitively, emotionally, socially and physically able to participate in the management of their health/medical condition, which may require use of their personal mobile device(s) are responsible for:

1. advocating for their personal safety and well-being;
2. participating in the development and review of the Health Care Plan(s) and Essential Routine Health Care Plan(s);
3. carrying out daily or routine management of their health/medical condition to their full potential, which may require use of their personal mobile device(s);
4. setting goals on an ongoing basis for management of their health/medical condition with their parent(s)/guardian(s) and health care professional(s);
5. communicating with their parent(s)/guardian(s) and school staff if they are facing challenges related to their health/medical condition(s) at school;
6. wearing medical alert identification that they and/or their parent(s)/guardian(s) deem appropriate; and
7. informing school staff if a health/medical incident or emergency occurs.

4. Definitions

4.1 Disability

As per the Ontario Human Rights Code and consistent with Board Policy and Procedure #240, Human Rights: Code-Related Harassment and Discrimination, a disability is defined as any of the following:

1. any degree of physical disability, infirmity, malformation or disfigurement that is caused by bodily injury, birth defect or illness, including, but not limited to, diabetes, mellitus, epilepsy, a brain injury, any degree of paralysis, amputation, lack of physical co-ordination, blindness or visual impediment, deafness or hearing impediment, muteness or speech impediment, or physical reliance on a guide dog or other animal or on a wheelchair or other remedial appliance or device;
2. a condition of mental impairment or a developmental disability;
3. a learning disability or a dysfunction in one or more of the processes involved in understanding or using symbols or spoken language;
4. a mental disorder; or
5. an injury or disability for which benefits were claimed or received under the Workplace Safety and Insurance Act, 1997.

4.2 Essential Routine Health Services

Services provided on a regular basis as part of a daily routine such as, but not limited to, feeding, clean intermittent catheterization, physical management, and/or administration of medication as outlined in the Essential Routine Health Care Plan(s).

4.3 Health Care Plan

A plan that contains individualized information on a student with a health/medical condition as outlined in the Health Care Plan that includes:

1. preventative strategies to be undertaken by the school to reduce the risk ofmedical incidents and exposure to triggers or causative agents in classrooms and common school areas, and on school trips;
2. identification of school staff who will have access to the Health Care Plan;
3. identification of routine or daily management activities that will be performed by the student, and/or identified staff;
4. a copy of notes and instructions from the student’s health care professional, to support daily or routine management;
5. when feasible, a student should not be excluded from the classroom during daily or routine management activities, (e.g. G-tube feeding, suctioning, etc.) unless the student or the parent(s)/guardian(s) indicate they prefer privacy;
6. information on how to support or accommodate the student to enable participation to their full potential in all school and school board activities (e.g., field trips, overnight excursions, Board-sponsored sporting events);
7. identification of symptoms (emergency and other) and appropriate response should a medical incident occur;
8. emergency contact information for the student;
9. details related to storage and disposal of the student’s prescribed medication(s) and medical supplies, such as;
   • parental permission for the student to carry medication and/or medical supplies,
   • location of spare medication and supplies stored in the school, where applicable, and
   • information on the safe disposal of medication and medical supplies. 

4.4 Third Party Health Care Providers

Are responsible for providing controlled act procedures related to health needs that must be addressed on a scheduled basis to enable a student to attend school (e.g., sterile catheterization, deep suctioning, injection or tube feeding).

4.5 Medical Emergency

An acute injury or illness that poses an immediate risk to a person’s life or long-term health and requires immediate assistance and contact with emergency medical services (EMS).

4.6 Medical Incident

A circumstance that requires an immediate response and monitoring, as the incident may progress to an emergency requiring contact with Emergency Medical Services.

4.7 Self-Management

A continuum where a student’s cognitive, emotional social and physical capacity and stage of development are determinants of their ability to confidently and independently manage their medical conditions(s). The students’ journey to reach their full potential along the self-management continuum is not linear and can require varying levels of support over time. A student’s capacity for self-management may be compromised during certain medical incidents and additional support will be required.

5. Contact

Director’s Office 

Student Services

Curriculum and Instructional Services

Plant Services

6. History

Approved: 1996

Amended: 2001, 2002, 2007, 2009

Working Document: July 2018, November 2023

Revised: July 2019, January 2020, October 2024

Final Approval: October 2024

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Board Procedure #662.1,
Administration of Medication to Students

1. Procedure Statement

This procedure outlines the process for administering medication to students.

2. Application

The administration of medication is a joint responsibility between the school and parent(s)/guardian(s) and students. Students are encouraged to be as independent as possible with the administration of medication, recognizing that in some cases support is required. In requesting assistance of staff members, parent(s)/guardian(s) should understand that this request is made of non-medically trained persons. Staff members cannot perform controlled acts as defined by the Regulated Health Professions Act (1991) as part of their assigned responsibilities unless otherwise authorized under another piece of applicable legislation.

This procedure only applies where it is medically necessary for medication to be administered during school hours.

Medication must be supplied in the original, clearly labeled container from a registered dispensary. It must include:

1. the student’s name;
2. date of issue;
3. name of the medication;
4. the name of the registered dispensary;
5. the prescribed dosage and frequency;
6. period of use; and
7. the name of the prescribing licensed physician or nurse practitioner. 

The dignity and privacy of students should always be considered.

2.1 Pro Re Nata “PRN” / “As needed” Medication:

For students with PRN medication relating to behavioural issues, medication will only be administered in accordance with an Administration of Medication Form; and/or student’s Health Care Plan or Essential Routine Health Care Plan. 

PRN is used to support specific behaviours. The use of prescribed medication should only be administered on a pro re nata (PRN) (as needed) as per the directions of the prescribing clinician and as documented in the student’s Safety plan. 

For students with PRN medication relating to behavioural issues, or other conditions involving observation of a student’s conduct or symptoms:

1. staff will observe and document escalating behaviour and report to the principal or designate;
2. the principal (or designate) will contact the parent(s)/guardian(s) to report observations and seek their consent to administer the medication, otherwise 911 may be contacted; and
3. staff will document all administration of medication on YRDSB Administration of Medication Form.

3. Responsibilities

3.1 The Director of Education shall:

1. allocate staff and resources to support the Administration of Medication to Students procedure.

3.2 Associate Directors and Superintendents of Education shall:

1. support the implementation of the Administration of Medication to Students procedure at each school; and
2. develop, communicate and implement expectations for schools to support the safe storage and disposal of medication and medical supplies, including the safe disposal of sharps (NOTE - the family is responsible for the supply and safe disposal of the medication, medical supplies and/or biohazardous waste containers).

3.3 Principals shall:

1. ensure that all staff members, including occasional staff, are aware of and receive appropriate training to support students diagnosed with a serious or life-threatening medical condition or other health-related matter requiring school support;
2. identify staff who can support the daily or routine management needs of students in the school while honouring the provisions within their collective agreements;
3. facilitate the provision of relevant information from the student’s Health Care Plan(s) to school staff and others identified in the Health Care Plan(s) including, but not limited to food service providers, transportation providers, volunteers, and occasional staff members, including any revisions that are madeto the plan;
4. ensure Staff Administration of Medication or Self-Administration of Medication forms are completed by parent(s)/guardian(s) as applicable;
5. determine a secure place for storing medication;
6. designate staff member(s) and alternates, who are willing to administer the medication and ensure that any training required for safe administration is provided;
7. ensure designated staff members have all necessary information to support the administration of medication;
8. facilitate proper records being maintained and retained in a central file in the school, including but not limited to the appropriate administration of medication form and the Medication Administration Chart;
9. ensure the management and safe removal of the biohazard waste containers;
10. ensure that the administration of routine medication is included in the Essential Routine Health Care Plan and/or appropriate Health Care Plan where applicable; and
11. initiate a referral to the Third-Party Health Care Provider for the administration of medications other than those that can be taken orally, by inhalant, topically or self-injection.

3.4 Designated staff members shall:

1. administer medication in accordance with Staff Administration of Medication or Self-Administration of Medication forms and the student’s Essential Routine Health Care Plan(s) and/or a Health Care Plan(s), as applicable.

3.5 Parent(s)/guardian(s) shall:

1. take all reasonable measures to minimize the need to administer medication at school;
2. educate their child about their health/medical condition(s) with support from their child’s health care professional, as needed;
3. guide and encourage their child to reach their full potential for management and self-advocacy;
4. complete the Staff Administration of Medication Form or Self-Administration of Medication Form in accordance with licensed physician recommendations annually or as required;
5. submit all relevant medical documentation including, but not limited to, a medical note, order or report;
6. supply their child and/or school with sufficient quantities of medication and supplies in their original, clearly labelled containers, as prescribed by a licensed physician or nurse practitioner to be administered during the school day;
7. track the expiration dates; and
8. provide materials required to meet the health needs of their child, including, but not limited to medications, medical identification, specialized equipment, etc.

3.6 Students shall:

1. alert staff members if they believe they are experiencing any symptoms associated with their medical condition and require medication;
2. take responsibility for advocating for their personal safety and well-being that is consistent with their cognitive, emotional, social and physical stage of development and their capacity for management;
3. carry out daily or routine management of their medication to their full potential; and
4. wear medical alert identification that they and/or their parent(s)/guardian(s) deem appropriate.

4. Definitions

4.1 Administration of Medication

Administration of medication is the administration of medication prescribed by a licensed physician, nurse practitioner, pharmacist, or other health professional regulated under the Regulated Health Professions Act, 1991 (“Health Care Professional”).

4.2 Biohazardous Waste Container

Biohazardous containers are used for the disposal of waste that may be contaminated with pathogens that present a danger to people and the environment (sharps/needles).

4.3 Pro Re Nata “PRN” Medication

Pro Re Nata “PRN” is a prescribed medication that is outlined in an Administration of Medication Form; and/or student’s Health Care Plan or Essential Routine Health Care Plan and is used as prescribed by a physician to support a variety of clinical symptoms or behavioural presentation.

4.4 Registered Dispensary

A registered dispensary prepares and provides medication prescribed by a licensed physician or nurse practitioner, such as, but not limited to a pharmacy.

5. Contact

Curriculum and Instructional Services

Student Services

6. History

Approved: 1996

Amended: 2001, 2002, 2009

Working Document: July 2018

Revised: July 2019, November 2023

Final Approval: October 2024

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Board Procedure #662.2, Anaphylactic Reactions

1. Procedure Statement

This procedure outlines the process for managing anaphylactic reactions of students.

2. Application

The Board recognizes that there can be major challenges for students who are at risk of anaphylaxis. This procedure applies to anyone at risk who has been diagnosed by an allergist or a licensed physician or nurse practitioner responsible for prescribing treatment, and outlines strategies to reduce risk of a potential reaction.

If a student is known to be at risk of anaphylaxis and is experiencing a perceived anaphylactic reaction, the following steps should be taken:

1. follow the Anaphylactic Health Care Plan, including calling 9-1-1 and following Emergency Medical Services (EMS) direction;
2. assist in the administration of epinephrine even without a preauthorized consent and under Sabrina’s Law, no action for damages may be instituted against the staff acting in good faith or for neglect or default in good faith (except where there is gross negligence); and
3. where possible, and time permitting, take steps to provide the used epinephrine auto-injector and Anaphylactic Health Care Plan with the student to the hospital.

2.1 Strategies to Reduce Risk of Exposure to Anaphylactic Causative Agents

The four categories to consider when providing a safe environment for staff members, students and members of the community at risk of anaphylaxis are:

1. information and awareness for the entire school community or workplace;
2. reduction of the risk of exposure to the allergen that causes anaphylactic reactions wherever possible and acknowledging that it is impossible to eliminate all allergens in schools and workplaces;
3. emergency response procedures in case of accidental exposure; and
4. foster a safe, caring and supportive environment for those at risk of anaphylaxis. 

Strategies to reduce risk of exposure include, but are not limited to:

1. making all reasonable efforts to limit the student’s exposure to the life-threatening allergens;
2. avoiding the cross-contamination of food allergens;
3. establishing lunchroom/classroom eating area practices that limit allergen contact for the at-risk student;
4. taking special precautions in planning field trips, extra-curricular events, special celebrations and fundraising events; and
5. inviting the student at risk to identify a “buddy” who is able to recognize symptoms of an anaphylactic reaction and to alert an adult, when appropriate.

More information is available in the Best Practices for Avoiding Anaphylactic Reactions document.

3. Responsibilities

3.1 The Director of Education shall:

1. allocate staff and resources to support the Anaphylactic Reactions procedure.

3.2 Associate Directors and Superintendents of Education shall:

1. support the implementation of the Anaphylactic Reactions procedure at each school;
2. develop strategies that reduce the risk of student exposure to triggers or causative agents in classrooms and common school areas;
3. develop expectations for schools to support the safe storage and disposal of medication, medical supplies, and communicate these expectations to schools and support schools in the implementation of these expectations, including the safe disposal of sharps (NOTE - the family is responsible for the supply and safe disposal of medication, medical supplies, and biohazardous  waste containers); and
4. consider PPM 161 and related Board policies when entering into contracts and transportation, food services and other providers.

3.3 Principals shall:

1. annually ensure that all staff members, including occasional staff, are aware of and receive appropriate training to support students diagnosed with a serious or life-threatening medical condition or other health-related matter requiring school support;
2. identify staff who can support the daily or routine management needs of students in the school while honouring the provisions within their collective agreements;
3. co-create, review or update the Anaphylaxis Health Care Plan for a student with a medical condition with the parent(s)/guardian(s), in consultation with the school staff (as appropriate) and with the student (as appropriate);
4. provide relevant information from the student’s Anaphylaxis Health Care Plan to school staff and others who are identified in the Anaphylaxis Health Care Plan (e.g., food service providers, transportation providers, volunteers, occasional staff who will be in direct contact with the student), including any revisions that are made to the plan;
5. communicate the Anaphylactic Reactions procedure as outlined in the Anaphylactic Reactions Communication Protocol for Principals;
6. clearly communicate to parent/guardian and appropriate staff the process for parent/guardian to notify the school of their child’s medical condition(s);
7. maintain a file with the Anaphylaxis Health Care Plan and supporting documentation for each student with a medical condition;
8. ensure that the Anaphylaxis Health Care Plan is posted in a secure location accessible to staff location and provided to the student’s teachers and updated as required;
9. ensure medical occurrences, incidents and emergencies are recorded in the Medical Incident Record Form attached to the Anaphylaxis Health Care Plan;
10. encourage the entire school community to assist in managing exposure to identified allergens, by:
    • periodically communicating identified allergies and avoidance strategies, as outlined in Best Practices for Avoiding Anaphylactic Reactions; and
    • sending home a letter to parent(s)/guardian(s) informing them of known severe allergens and avoidance strategies, if applicable.
11. provide annual in-service training at the beginning of the school year for all school staff who are in direct contact with pupils on a regular basis in:
    • anaphylaxis prevention;
    • recognition of allergic reactions and appropriate responses;
    • proactive communication of a caring and safe environment;
    • Board policy and procedure related to students at risk of anaphylaxis, and
    • use and location of epinephrine auto-injectors.
12. invite before and after school program staff and volunteers to an annual in-service training;
13. ensure all staff members are made aware of students with anaphylaxis and the location of their epinephrine auto-injector at the time of registration and again at the beginning of each school year;
14. if no epinephrine auto-injectors have been provided, facilitate the purchase of back-up stock epinephrine auto-injector(s) using school funds through the Board’s Purchasing Services department;
15. if an anaphylactic reaction occurs and no epinephrine auto-injector is available for the student, ensure that either a school-purchased auto-injector or another student’s back-up epinephrine auto-injector is used, and replace the auto-injector using school funds through the Board’s Purchasing Services department as soon as possible;
16. consult the appropriate directives, legislation, regulations and guidelines for elementary lunch programs and permitting selected private suppliers to enter school premises in order to provide such services;
17. Secondary principals shall ensure only Board-contracted food service providers operate food services in all secondary schools except where the student instructional program provides food services;
18. support inclusion by allowing students with medical conditions to perform daily or routine management activities in a school location, as outlined in their Anaphylaxis Health Care Plan, while being aware of confidentiality and the dignity of the student; and
19. enable students with medical conditions to participate in school to their full potential.

In circumstances, when parents(s)/guardians(s) have advised the school that they will not provide the school with epinephrine auto-injectors and/or refuse to allow their child to carry an epinephrine auto-injector:

1. meet with the parent(s)/guardian(s) to discuss:
   • the student’s level of responsibility;
   • potential barriers to parent(s)/guardian(s) ability to supply or support their child in carrying an epinephrine auto-injector;
   • the consequences of not having the epinephrine auto-injector close to the child; and
   • an alternate plan that will allow efficient response, if it is determined that it is in the best interest of the child not to carry the epinephrine auto-injector.
2. if parent(s)/guardian(s) refuse to provide the school with epinephrine auto-injectors and/or refuse to allow the student to carry an epinephrine auto-injector:
   • immediately contact parent(s)/ guardians to discuss the risk to their child;
   • suggest the parent(s)/guardian(s) contact Food Allergy Canada to discuss the refusal;
   • seek permission of parent(s)/guardian(s) to discuss the refusal with their physician or nurse practitioner; and
   • consult with the superintendent of education regarding next steps.
3. if attempts to resolve compliance persist:
   • send a letter to the student’s parent(s)/guardian(s) outlining the risk to their child and have the letter signed and returned to the school;
   • inform teachers and others who have contact with this student that they will not be carrying an epinephrine auto-injector;
   • in consultation with the superintendent of education, the principal will create a local plan to ensure that epinephrine auto-injectors are available for students when parent(s)/guardian(s) have refused to provide and/or have their child carry an epinephrine auto-injector;
   • ensure that a notation is made on the student’s Anaphylaxis Health Care Plan; and
   • suggest notation on the Anaphylaxis Health Care Plan would read “As a result of parent(s)/guardian(s) refusal to provide their child with epinephrine auto-injectors and/or ensure that their child carry an epinephrine auto-injector as per Board policy, this plan has been created to support the student’s safety”.

3.4 School Staff shall:

1. annually participate in training for anaphylactic reactions, and review the Anaphylactic Reactions procedure and Best Practices for Avoiding Anaphylactic Reactions;
2. practice allergen avoidance measures within the school, at school or work-related events and out-of-school or workplace activities following the Best Practices for Avoiding Anaphylactic Reactions;
3. communicate health or safety concerns to an administrator or supervisor;
4. review the contents of the Anaphylactic Health Care Plan for any student with whom they have direct contact;
5. support a student’s daily or routine management and respond to medical incidents and health/medical emergencies that occur during school, as outlined in Board policies and procedures; and
6. enable students with medical conditions to participate in school to their full potential as outlined in the Anaphylactic Health Care Plan.

3.5 Teachers shall:

1. if asked, meet with the parent(s)/guardian(s) of a student with anaphylaxis to discuss and record:
   • the student’s needs; and
   • the school procedure in case of emergency and the Anaphylactic Reactions Procedure.
2. ensure that epinephrine auto-injectors and the student’s Anaphylactic Health Care Plan are taken on excursions and/or activities;
3. communicate to students and staff members about how to help avoid allergens and reduce risks; and
4. ensure that occasional staff in the classroom are aware of students at risk of anaphylaxis by including the Anaphylactic Health Care Plan and emergency procedures in daily plans.

3.6 Outdoor Education Centre staff members and teachers planning remote field trips shall:

1. include a process and appropriate resources to support the student during activities off school property, including:
   • when students have potentially life-threatening allergies, ensure awareness of the estimated time to reach the nearest hospital or medical facility; and
   • provide school staff members with the availability of two-way communication.

3.7 Student Transportation Services (STS) shall:

1. ensure that the current Anaphylactic Health Care Plan is available on file in the STS office, in the appropriate service provider’s dispatch office, and in the appropriate school vehicle(s);
2. ensure all regular and substitute drivers who transport students with anaphylaxis have received training, including, but not limited to, recognition of symptoms of anaphylactic reactions, proper administration of epinephrine auto-injector, and how to contact emergency services;
3. ensure that service providers have developed an emergency plan to respond to anaphylactic reactions;
4. work with the principal and the service provider to assign a specific seat to a student with anaphylaxis, if required; and
5. advise bus drivers to enforce the no food or beverage consumption rule on school buses.

3.8 Food Service Provider (Secondary Schools) shall:

1. ensure that the current Anaphylactic Health Care Plan is available on file in their office;
2. ensure that all personnel are trained to reduce the risk of cross-contamination through purchasing, handling, preparation and serving of food;
3. ensure that the contents of all foods served in school cafeterias and brought in for special events are clearly identified;
4. participate in the school’s anaphylaxis training on how to recognize the symptoms of an anaphylactic reaction and how to respond;
5. ensure notices are posted stating that products may contain allergens such as, but not limited to nuts, to which individuals may be allergic; and
6. adhere to all applicable directives, legislations, contractual obligations, regulations, guidelines and Board policy and procedures.

3.9 Parent(s)/guardian(s) shall:

1. inform the school of any known allergies and if their child is at risk of anaphylaxis by completing the Anaphylactic Health Care Plan upon registration, new diagnosis and/or each September;
2. co-create Anaphylactic Health Care Plan for their child with the principal or the principal’s designate, as appropriate;
3. initiate and participate in meetings to review their child’s Anaphylaxis Health Care Plan;
4. provide the school with at least one in-date epinephrine auto-injector, and preferably two, to be used in the event of an anaphylactic reaction;
5. ensure that their child, where age and/or developmentally appropriate, carries the epinephrine auto-injector with him/her at all times;
6. replace the epinephrine auto-injectors before the listed expiry date;
7. consider providing their child with medical identification, e.g. Medic Alert® bracelet or necklace;
8. encourage the child to practice allergen avoidance measures at all times educate their child about their medical condition(s) with support from their child’s health care professional, as needed;
9. guide and encourage their child to reach their full potential for management and self-advocacy, as appropriate;
10. communicate changes to the Anaphylaxis Health Care Plan, such as changes to the status of their child’s medical condition(s) or changes to their child’s ability to manage their medical condition(s), to the principal or the principal’s designate; and
11. provide the school with copies of any medical reports or instructions from the student’s licensed physician or nurse practitioner.

3.10 Students shall:

1. carry their epinephrine auto-injectors at all times, where age and/or developmentally appropriate;
2. practice allergen avoidance measures;
3. refrain from sharing food or items that could include an allergen;
4. alert staff if they believe they have been accidentally exposed to an allergen or have any concerns related to potential allergens;
5. take responsibility for advocating for their personal safety and well-being that is consistent with their cognitive, emotional, social and physical stage of development and their capacity for self-management;
6. participate in the development and participate in meetings to review their Anaphylaxis Health Care Plan as appropriate; and
7. communicate with their parent(s)/guardian(s) and school staff if they are facing challenges related to their medical condition(s) at school as appropriate.

4. Definitions

4.1 Age and/or Developmentally Appropriate

Students in Junior Kindergarten to Grade 12 are required to carry their epinephrine auto-injector with them at all times. However, it is recognized that age and/or developmental concerns for individual students will need to be considered by the superintendent of education and principal in consultation with the parent(s)/guardian(s).

4.2 Allergens

For the purpose of this policy, allergens are any substance or condition that can bring on an allergic reaction leading to a life-threatening allergic reaction known as anaphylaxis.

4.3 Anaphylaxis

Anaphylaxis is a sudden and severe allergic reaction, which can be fatal, requiring medical emergency measures to be taken (PPM 161).

4.4 Anaphylactic Reaction

Signs and symptoms of anaphylaxis can occur within minutes of exposure to an allergen. In rarer cases, the time frame can vary up to several hours after exposure. The ways symptoms appear can vary from person to person and from episode to episode in the same person.

Symptoms of anaphylaxis generally include two or more of the following body systems: skin, respiratory, gastrointestinal and/or cardiovascular. However, low blood pressure alone, in the absence of other symptoms, can also represent anaphylaxis.

1. Skin - hives, swelling (face, lips, tongue), itching, warmth, redness;
2. Respiratory (breathing) - coughing, wheezing, shortness of breath, chest pain or tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms (runny, itchy nose and watery eyes, sneezing), trouble swallowing;
3. Gastrointestinal (stomach) - nausea, pain or cramps, vomiting, diarrhea;
4. Cardiovascular (heart) - paler than normal skin colour/blue colour, weak pulse, passing out, dizziness or lightheadedness, shock; and
5. Other: anxiety, sense of doom (the feeling that something bad is about to happen), headache, uterine cramps, metallic taste.

4.5 Biohazardous Waste Container

Biohazardous containers are used for the disposal of waste that may be contaminated with pathogens that present a danger to people and the environment.

4.6 Epinephrine Auto-injector

A medical device that is used to deliver a pre-measured dose (or doses) of epinephrine.

4.7 Epinephrine

Epinephrine is a synthetic version of the hormone adrenaline that is used in the treatment of anaphylaxis and life-threatening asthma attacks. A second dose of epinephrine may be administered as early as 5 minutes after the first dose if there is no improvement in symptoms.

5. Contact

Administrative Services

Curriculum and Instructional Services

Student Services

6. History

Approved: January 2006

(formerly part of Procedure 662, Provision of Health Support Services in School Settings)

Policy Memo Recommendation to Delete 2017 (Subsumed into Policy and Procedure #662.0, Health Supports)

Working Document: May 2012, February 2013, December 2015, July 2018

Revised: May 2008, March 2013, July 2019, November 2023

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Board Procedure #662.3 Asthma Management

1. Procedure Statement

This procedure outlines the process for supporting the needs of students with asthma.

2. Application

People with asthma have sensitive airways that react to triggers. There are many different types of triggers for example poor air quality, mold, dust, pollen, viral infections, animals, smoke and cold air.

If a student is known to have asthma and is experiencing asthma symptoms, any staff member may assist in the administration of the prescribed asthma medication as outlined in the Asthma Health Care Plan. There are legal protections for staff acting in good faith in such circumstances set out in Ryan’s Law (Ensuring Asthma Friendly Schools, 2015).

Under Ryan’s Law, the student can consent if the student is:

1. capable of understanding the information relevant to making a decision about the assistance; and 
2. is able to appreciate the reasonably foreseeable consequences of a decision or lack of a decision. It may be presumed that the student has the capacity to consent unless there are reasonable grounds to believe the person is incapable of consenting” (Ryan’s Law).

3. Responsibilities

3.1 The Director of Education shall:

1. allocate staff and resources to support the Asthma Management procedure.

3.2 Associate Directors and Superintendents of Education shall:

1. support the implementation of the Asthma Management procedure at each school;
2. develop strategies that reduce the risk of student exposure to triggers or causative agents in classrooms and common school areas; and
3. consider PPM 161 and related Board policies when entering into contracts with transportation, food services and other providers.

3.3 Principals shall:

1. support the implementation of the Asthma Management procedure at each school;
2. co-create, review or update the Asthma Health Care Plan with the parent(s)/guardian(s), in consultation with the school staff (as appropriate) and with the student (as appropriate) as required;
3. ensure parent(s)/guardian(s) are aware that any staff member may administer the prescribed reliever asthma medication if an employee has a reason to believe that the student is experiencing an asthma exacerbation, even where there is no signed authorization;
4. ensure that the Asthma Health Care Plan is posted in a secure location accessible to staff location and provided to the student’s teachers and updated as required;
5. if a second reliever inhaler is provided, keep in main office or other easily accessible location and ensure staff are aware of its location;
6. invite before and after school program staff and volunteers to the annual in-service training;
7. supply the Asthma Health Care Plan to Student Transportation Services;
8. establish a communication plan for the dissemination of information on asthma to parent(s)/guardian(s) pupils and employees;
9. facilitate regular training on recognizing asthma symptoms and managing asthma exacerbations for all employees, as well as others in direct contact with pupils on a regular basis;
10. clearly communicate to parent(s)/guardian(s) and appropriate staff the process for to notify the school of their child’s health/medical condition(s);
11. ensure medical occurrences, incidents and emergencies are recorded in the Medical Incident Record  Form attached to the Asthma Health Care Plan;
12. maintain a file with the Asthma Health Care Plan and supporting documentation for each student with an Asthma condition;
13. provide relevant information from the student’s Asthma Health Care Plan to school staff and others who are identified in the Asthma Health Care Plan (e.g., food service providers, volunteers, occasional staff who will be in direct contact with the student), including any revisions that are made to the plan;
14. support inclusion by allowing students with medical conditions to perform daily or routine management activities in a school location, as outlined in their Asthma Health Care Plan, while being aware of confidentiality and the dignity of the student; and
15. enable students with medical conditions to participate in school to their full potential.

3.4 School Staff shall:

1. participate in training, on health/medical conditions, at a minimum annually, as required by YRDSB;
2. take appropriate action in the event of an emergency, as outlined;
3. follow Board strategies that reduce the risk of student exposure to triggers or causative agents in classrooms, common school areas, and extracurricular activities, in accordance with the student’s Asthma Health Care Plan;
4. follow the contents of the Asthma Health Care Plan for any student with whom they have direct contact; and
5. enable students with medical conditions to participate in school to their full potential.

3.5 Outdoor Education Centre Staff members and teachers planning remote field trips shall:

1. include a process and appropriate resources to support the student during activities off school property; and
2. provide school staff members with the availability of two-way communication.

3.6 Student Transportation Services:

1. ensure that the current Asthma Health Care Plan is available on file in the STS office, in the appropriate service provider’s dispatch office, and in the appropriate school vehicle(s);
2. require the service provider to ensure all regular and substitute drivers who transport students with asthma have received training, and how to contact emergency services; and
3. work with the principal and the service provider to assign a specific seat to a student with asthma if required.

3.7 Parent(s)/guardian(s) shall:

1. ensure that their child, where age and/or developmentally appropriate, carries their in-date asthma medication;
2. educate their child about their medical condition(s) with support from their child’s health care professional, as needed;
3. guide and encourage their child to reach their full potential for self-management and self-advocacy;
4. inform the school of their child’s medical condition(s) and co-create the Asthma Health Care Plan for their child with the principal or the principal’s designate;
5. communicate changes to the Asthma Health Care Plan, such as changes to the status of their child’s medical condition(s) or changes to their child’s ability to manage their medical condition(s), to the principal or the principal’s designate;
6. participate in meetings to review their child’s Asthma Health Care Plan; and
7. supply their child and/or school with sufficient quantities of medication and supplies in their original, clearly labelled containers, as directed and prescribed by a licensed physician or nurse practitioner and as outlined in the Asthma Health Care Plan, and track the expiration dates if they are supplied.

3.8 Students shall:

1. carry asthma medication with them if appropriate to age and capacity;
2. take responsibility for advocating for their personal safety and well-being that is consistent with their cognitive, emotional, social and physical stage of development and their capacity for self-management;
3. participate in the development of, and attend meetings for, their Asthma Health Care Plan as appropriate;
4. communicate with their parent(s)/guardian(s) and school staff if they are facing challenges related to their medical conditions(s) at school as appropriate; and
5. alert staff if they are experiencing asthma symptoms and require assistance.

4. Definitions

4.1 Asthma

A chronic inflammatory disease of the airways in the lungs. Symptoms of asthma can include coughing, wheezing, difficulty breathing, shortness of breath and chest tightness.

4.2 Asthma medication – controller medication

Controller medications are prescribed and usually taken regularly every day to control asthma. Usually, they are taken at morning and at night and not generally taken at school.

4.3 Asthma medication – reliever medication

Reliever medication is prescribed, fast-acting medication (usually blue in colour) that is issued when someone is having asthma symptoms.

5. Contact

Administrative Services

Curriculum and Instructional Services, Student Services

6. History

Drafted: May 31, 2017

Working Document: July 2018

Revised: July 2019, November 2023

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Board Procedure #662.4 Diabetes Management

1. Procedure Statement

This procedure outlines the process for meeting the needs of students diagnosed with diabetes.

2. Application

People with diabetes require support to both produce and manage their insulin and glucose levels. There are two types of diabetes - Type 1 and Type 2 Diabetes. Students with Type 1 Diabetes, a life-threatening medical condition, will be supported long-term by a medical team who will be important partners in the completion of the Diabetes Health Care Plan and ongoing management.

If a student is known to have diabetes, different factors throughout the school day may impact their glucose levels. Factors such as sleep, time of day, vigorous exercise, stress among other factors, can contribute to changes in glucose levels. As Type 1 Diabetes can be a life-threatening condition it is essential to ensure that the Diabetes Health Care plan is completed in partnership with student, parent/guardian(s), Diabetes Medical Team and school staff and is carefully followed.

3. Responsibilities

3.1 The Director of Education shall:

1. allocate staff and resources to support the Diabetes Management procedure.

3.2 Associate Directors and Superintendents of Education shall:

1. support the implementation of the Diabetes Management procedure at each school;
2. develop, communicate and implement expectations for schools to support the safe storage and disposal of medication and medical supplies, including the safe disposal of sharps (NOTE - the family is responsible for the supply and safe disposal of medication. medical supplies and biohazardous waste containers); and
3. consider PPM 161 and related Board policies when entering into contracts with transportation, food services and other providers.

3.3 Principals shall:

1. ensure that all staff members, including occasional staff, are aware of and receive appropriate training to support students diagnosed with a serious or life-threatening medical condition or other health-related matter requiring school support;
2. identify staff who can support the daily or routine management needs of students in the school while honouring the provisions within their collective agreements;
3. co-create, review, or update the Diabetes Health Care Plan with the parent(s)/guardian(s), in consultation with the school staff and with the student, as appropriate;
4. ensure all supplies are kept in a secure location and information is available to staff members;
5. ensure students are provided with an appropriate location to administer insulin;
6. ensure a planning meeting for school entry occurs to support effective transition;
7. clearly communicate to parent/guardian and appropriate staff the process for parent/guardian to notify the school of their child’s medical condition(s);
8. arrange and facilitate a case conference with parent/guardian, third party service provider, appropriate staff members and student (as appropriate) to determine the level of intervention required;
9. ask parents/guardians to provide the school with all supplies required for the ongoing management of their child’s diabetes at school;
10. ensure medical occurrences, incidents and emergencies are recorded in the Medical Incident Record Form attached to the Diabetes Health Care Plan;
11. maintain a file with the Diabetes Health Care Plan and supporting documentation for each student with Diabetes;
12. provide relevant information from the student’s Diabetes Health Care Plan to school staff and others who are identified in the Diabetes Health Care Plan (e.g., food service providers, transportation providers, volunteers, occasional staff who will be in direct contact with the student), including any revisions that are made to the plan;
13. ensure that the Diabetes Health Care Plan is posted in a secure location accessible to staff location and provided to the student’s teachers and updated as required;
14. ensure annual in-service training is provided for school staff members at the beginning of each school year (and as needed during the school year) by a regulated health professional in the management of diabetes to ensure awareness of diabetes management, signs, symptoms and emergency treatment of hypoglycemia and hyperglycemia and location of emergency kits where applicable;
15. ensure teachers are aware of signs and symptoms of hypoglycemia and the emergency treatment plans for each student;
16. assign a staff member and designate, as outlined in the Diabetes Health Care Plan, to support the student in monitoring their glucose levels and respond accordingly as per the instructions outlined on the Diabetes Health Care Plan;
17. where the student requires adult management, to manage the daily or routine management needs as outlined in the Diabetes Health Care Plan a referral should be made to a third-party health care provider; 
18. assign the identification of staff who can support the daily or routine management needs of students in the school with medical conditions, while honouring the provisions within their collective agreements;
19. ensure parent(s)/guardian(s) are informed that, even if they have provided consent to let their child monitor their diabetes, the severity of their child’s reaction may require action under the Diabetes Health Care Plan;
20. ensure the Request for Special Transportation form has been completed through SSNET for any students with known health conditions that may require special consideration affecting transportation, and supply a copy of the Diabetes Health Care Plan to Student Transportation Services;
21. work with the bus company to facilitate appropriate seating for a student with diabetes if required;
22. support inclusion by allowing students with medical conditions to perform daily or routine management activities in a school location, as outlined in their Diabetes Health Care Plan, while being aware of confidentiality and the dignity of the student;
23. enable students with medical conditions to participate in school to their full potential; and
24. ensure the management and safe removal of the biohazardous waste containers.

3.4 Teachers shall:

1. annually participate in training as required;
2. ensure an emergency kit provided by parent(s)/guardian(s) is available in the classroom and taken on excursions and/or activities;
3. ensure parent(s)/guardian(s) are aware of the need to replace items in the emergency kit, as required;
4. review the contents of the Diabetes Health Care Plan for any student with whom they have direct contact; and
5. support a student’s daily or routine management and respond to medical incidents and health/medical emergencies that occur during school, as outlined in Board policies and procedures.

3.5 Educational Assistants and Designates shall:

1. annually participate in training as required;
2. support the student in self-monitoring their glucose levels and respond accordingly as per the instructions outlined on the Diabetes Health Care Plan; 
3. review the contents of the Diabetes Health Care Plan for any student with whom they have direct contact; and
4. support a student’s daily or routine management and respond to medical incidents and health/medical emergencies that occur during school, as outlined in Board policies and procedures.

3.6 Outdoor Education Centre staff members and teachers planning remote field trips shall:

1. include a process and appropriate resources to support the student during activities off school property; and
2. provide school staff members with the availability of two-way communication.

3.7 Student Transportation Services (STS) shall:

1. ensure that the current Diabetes Health Care Plan is available on file in the STS office, in the appropriate service provider’s dispatch office, and in the appropriate school vehicle(s);
2. ensure an emergency kit provided by parent(s)/guardian(s) is available for use during transportation;
3. ensure parent(s)/guardian(s) are aware of the need to replace items in the emergency kit, as required;
4. ensure all regular and substitute drivers who transport students with diabetes have received training, and how to contact emergency services; and
5. work with the principal and the service provider to assign a specific seat to a student with diabetes if required.

3.8 Parent(s)/guardian(s) shall:

1. provide the school with all supplies required for the ongoing management of their child’s diabetes at school;
2. educate the child about their health/medical conditions(s) with support from their child’s health care professional as needed;
3. consider providing their child with medical identification (e.g. MedicAlert® bracelet or necklace);
4. guide and encourage their child to reach their full potential for management and self-advocacy;
5. inform the school of their child’s health/medical condition(s) and complete documentation as required;
6. co-create Diabetes Health Care Plan for their child with the principal or the principal’s designate, as appropriate;
7. communicate changes to the Diabetes Health Care Plan such as changes to the status of their child’s medical condition(s) or changes to their child’s ability to manage the medical condition(s), to the principal or the principal’s designate;
8. initiate and participate in annual meetings to review their child’s Diabetes Health Care Plan as appropriate;
9. seek medical advice from a licensed physician, nurse practitioner, or pharmacist where appropriate; and
10. cover any out of pocket costs incurred by the school associated with health/medical treatment, including the cost of transportation by ambulance should this be required.

3.9 Students shall:

1. take responsibility for advocating for their personal safety and well-being that is consistent with their cognitive, emotional, social and physical stage of development and their capacity for self-management;
2. participate in the development and in meetings to review their Diabetes Health Care Plan as appropriate;
3. carry out daily or routine management of their medical condition to their full potential, as described in their Diabetes Health Care Plan (e.g. carry their medication and medical supplies; follow school board policies on disposal of medication and medical supplies) as appropriate (NOTE – the family is responsible for the supply and safe disposal of medication, medical supplies and biohazardous waste containers);
4. set goals on an on-going basis, for management of their medical condition, in conjunction with their parent(s)/guardian(s) and health care professional(s) as appropriate; and
5. communicate with their parent(s)/guardian(s) and school staff if they are facing challenges related to their medical conditions(s) at school as appropriate.

4. Definitions

4.1 Biohazardous Waste Container

Biohazardous containers are used for the disposal of waste that may be contaminated with pathogens that present a danger to people and the environment.

4.2 Blood glucose control

Blood glucose control is the proper balance of food and insulin in the body. The balance may be affected by missing a meal or snack, or eating less than planned and could be a serious problem as it can easily result in very low blood glucose or hypoglycemia and requires immediate response.

4.3 Continuous Glucose Monitor (CGM)

A continuous Glucose Monitor (CGM) is a wearable device that tracks blood glucose levels (sugar) every few minutes throughout the day and night. Students with a CGM will have a small, implanted disc to continuously monitor their glucose levels.

4.4 Diabetes

Diabetes is a chronic disease, in which the body either cannot produce insulin or cannot properly use the insulin it produces.

Type 1 Diabetes is a life-threatening autoimmune disorder in which the pancreas no longer produces insulin-the hormone that turns glucose (sugar) into energy. Treatment for Type 1 Diabetes involves daily doses of insulin, along with regular blood glucose monitoring checks and careful attention to food intake and physical activity.

Type 2 Diabetes affects how the body uses sugar (glucose) for energy. It stops the body from producing or using insulin properly which can lead to high levels of blood sugar if left untreated.  

4.5 Diabetes Medical Team

A group of health professionals, generally comprised of hospital and community health care practitioners with expertise in diabetes and may include diabetic educators, social workers, dietitian and licensed physicians who support the student and his/her family.

4.6 Glucometer

A small device called a glucose meter or glucometer measures how much sugar is in the blood sample.

4.7 Hyperglycemia

Hyperglycemia or high blood glucose is when the blood glucose (sugar) is higher than an individual’s target range.

4.8 Hypoglycemia

Hypoglycemia is an abnormal, low level of glucose in the blood. It can happen within minutes of a person appearing healthy and normal and may quickly become an emergency situation.

4.9 Insulin

Insulin is a hormone produced by the pancreas. Students with diabetes use insulin syringes, pens or pumps to give insulin.

4.10 Insulin pump

Insulin pumps are small, computerized devices that deliver insulin in two ways:

1. a steady measured and continuous dose (the basal insulin); or 
2. a surge (bolus) dose around mealtimes, as directed in the Diabetes Health Care Plan. 

4.11 Target Range

Target range is acceptable blood glucose levels based on the Canadian Diabetes Association’s Clinical Practice Guidelines and is personalized for the student by the parent(s)/guardian(s) and Diabetes Medical Team.

5. Contact

Administrative Services

Curriculum and Instructional Services

Student Services

6. History

Approved: 1996

Amended: 2001, 2002, 2009

Working Document: July 2018

Revised: July 2019, November 2023

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Board Procedure #662.5 Epilepsy (Seizure Disorder) Management

1. Procedure Statement 

This procedure outlines the process for meeting the specific needs of students with seizures.

2. Application

Students with seizure disorder or epilepsy require support to manage their health condition. Epilepsy can be a serious neurological disorder characterized by repeated seizures of various types and severity.

There are many different types of seizures which can be categorized into two broad categories. 

Generalized seizures are disruptions in the brain that involve both sides of the brain, and can result in loss of consciousness, falls, or massive muscle contractions:

1. absence (previously called petit-mal);
2. atonic;
3. tonic;
4. clonic;
5. myoclonic; and
6. tonic-clonic (previously called grand-mal).

Focal seizures are a specific focal area on one side of the brain. Focal seizures can also become generalized seizures. The types of focal seizures are:

1. motor focal; 
2. sensory focal;
3. autonomic focal; and
4. psychological focal seizures.  

Epilepsy and seizures can be a life-threatening condition. It is essential to ensure that the Epilepsy (Seizure Disorder) Health Care Plan is completed in partnership with student, parent/guardian(s), Medical Team and school staff. The Epilepsy (Seizure Disorder) Health Care Plan should be accessible to supporting staff and accompany the student at all times. 

3. Responsibilities

3.1 The Director of Education shall:

1. allocate staff and resources to support the Seizure Management procedure.

    

3.2 Associate Directors, Coordinating Superintendents and Superintendents of Education shall:

1. support the implementation of the Epilepsy (Seizures Disorder) Management procedure at each school;
2. develop strategies that reduce the risk of student exposure to triggers or causative agents in classrooms and common school areas;
3. develop, communicate and implement expectations for schools to support the safe storage and disposal of medication and medical supplies, including the safe disposal of sharps (NOTE - the family is responsible for the supply and safe disposal of medication and medical supplies); and

4. consider PPM 161 and related board policies when entering into contracts and transportation, food services and other providers.

    

3.3 Principals shall:

1. ensure that all staff members, including occasional staff, are aware of and receive appropriate training to support students diagnosed with a serious or life-threatening medical condition or other health-related matter requiring school support;
2. identify staff who can support the daily or routine management needs of students in the school while honouring the provisions within their collective agreements;
3. co-create, review or update the Epilepsy (Seizure Disorder) Health Care Plan for a student with a medical condition with the parent(s), in consultation with the school staff (as appropriate) and with the student (as appropriate);
4. provide relevant information from the student’s Epilepsy (Seizure Disorder) Health Care Plan to school staff and others who are identified in the Health Care Plan (e.g., food service providers, transportation providers, volunteers, occasional staff who will be in direct contact with the student), including any revisions that are made to the plan;
5. ensure the administration medication for seizure management as outlined in the Administration of  Medication to Students procedure;
6. inform parent(s)/guardian(s) (or emergency contact if unable to reach the parent(s)/guardian(s) if a student has experienced a seizure as per the Epilepsy (Seizure Disorder) Health Care Plan;
7. ensure the Request for Special Transportation form has been completed through SSNET for any students with known health conditions that may require special consideration affecting transportation;
8. clearly communicate to parent/guardian and appropriate staff the process for parent/guardian to notify the school of their child’s medical condition(s);
9. ensure that the Epilepsy (Seizure Disorder) Health Care Plan is posted in a secure location accessible to staff location and provided to the student’s teachers and updated as required;
10. ensure medical occurrences, incidents and emergencies are recorded in the Medical Incident Record Form attached to the Epilepsy (Seizure Disorder) Health Care Plan;
11. maintain a file with the Epilepsy (Seizure Disorder) Health Care Plan and supporting documentation for each student;
12. support inclusion by allowing students with medical conditions to perform daily or routine management activities in a school location (e.g., classroom), as outlined in their Epilepsy (Seizure Disorder) Health Care Plan, while being aware of confidentiality and the dignity of the student; and
13. enable students with medical conditions to participate in school to their full potential.

3.4 School Staff shall:

1. participate in training, on health/medical conditions, at a minimum annually, as required by YRDSB;
2. review and follow the contents of the Epilepsy (Seizure Disorder) Health Care Plan for any student with whom they have direct contact;
3. support a student’s daily or routine management, and respond to health/medical incidents and supporting inclusion by allowing students with health/medical conditions to perform daily or routine management activities in a school location; and
4. enable students with medical conditions to participate in school to their full potential.

3.5 Outdoor Education Centre staff members and teachers planning remote field trips shall: 

1. include a process and appropriate resources to support the student during activities off school property; and 
2. provide school staff members with the availability of two-way communication. 

3.6 Student Transportation Services (STS) shall:

1. ensure that the student’s Epilepsy (Seizure Disorder) Health Care Plan is available on file in the STS office, in the appropriate service provider’s dispatch office, and in the appropriate school vehicle(s); and
2. the Student Transportation Services Form Request for Special Transportation is received and is accessible in the event of an emergency.

3.7 Parent(s)/guardian(s) shall:

1. educate their child about their medical condition(s) with support from their child’s health care professional, as needed;
2. guide and encourage their child to reach their full potential for management and self-advocacy, as appropriate;
3. inform the school of their child’s medical condition(s) and co-create the Epilepsy (Seizure Disorder) Health Care Plan for their child with the principal or the principal’s designate;
4. communicate changes to the Epilepsy (Seizure Disorder) Health Care Plan, such as changes to the status of their child’s medical condition(s) or changes to their child’s ability to manage their medical condition(s), to the principal or the principal’s designate;
5. initiate and participate in meetings to review their child’s Epilepsy (Seizure Disorder) Health Care Plan;
6. complete all required documentation for the Administration of Medication to Students procedure, if applicable; 
7. supply their child and/or the school with sufficient quantities of medication and track the expiration dates if they are supplied; and
8. provide the school with copies of any medical reports or instructions from the student’s licensed physician or nurse practitioner.

3.8 Students shall:

1. take responsibility for advocating for their personal safety and well-being that is consistent with their cognitive, emotional, social and physical stage of development and their capacity for management;
2. participate in the development and meetings to review their Epilepsy (Seizure Disorder) Health Care Plan, as appropriate;
3. carry out daily or routine management of their medical condition to their full potential, as described in their Epilepsy (Seizure Disorder) Health Care Plan, as appropriate;
4. set goals on an on-going basis, for management of their medical condition, in conjunction with their parent(s)/guardian(s), and health care professional(s), as appropriate;
5. communicate with their parent(s)/guardian(s) and school staff if they are facing challenges related to their medical conditions(s) at school as appropriate; and

6.  complete all required documentation for the Administration of Medication to Students procedure, if applicable

    

4. Definitions

4.1 Biohazardous Waste Container

Biohazardous containers are used for the disposal of waste that may be contaminated with pathogens that present a danger to people and the environment.

4.2 Epilepsy

Is a neurological condition that affects the nervous system. Epilepsy is also known as a seizure disorder or by many as convulsions (PPM 161).

4.3 Seizure disorder

Is a neurological disorder which causes uncontrolled electrical activity in the brain. This activity produces seizures which vary from one person to another in frequency and form. A seizure may appear as a brief stare, change of awareness or convulsion. It may last seconds or minutes.

5. Contact

Administrative Services

Curriculum and Instructional Services

Student Services

6. History

Approved: 1996

Amended: 2001, 2002, 2009

Working Document: July 2018

Revised: July 2019, November 2023

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Board Procedure #662.6 Concussion Management

1. Procedure Statement

This procedure outlines the steps to follow if a student has a suspected or diagnosed concussion and effective management procedures to guide a student’s return to learning and physical activity after a diagnosed concussion.

2. Application

Recognizing the serious effects concussions can have on student learning, achievement and well-being, the Board is committed to working with parent(s)/guardian(s) and community partners to provide appropriate supports to prevent and minimize the risk of sustained concussions.

This procedure applies to all students, including those suspected of having a concussion or who have been diagnosed with a concussion by a licensed physician or nurse practitioner. It does not apply to staff members who may have a concussion. The Health and Safety – Employees policy and procedure outlines the commitment of the Board to providing and maintaining a safe and healthy working environment that supports the safety and well-being of employees.

If a concussion is suspected, the following steps must be taken:

1. stop the activity and do not allow the student to participate in physical activity that day even if the student states that they are feeling better;
2. monitor the student;
3. call 911 if student loses consciousness or if symptoms are serious or worsen;
4. if the student can be safely moved, remove them from the activity unless the student has lost consciousness; and
5. contact parent(s)/guardian(s) or emergency contact (if the parent(s)/guardian(s) is not available) and inform them that:
   • they need to pick up their child;
   • their child should be examined by a licensed physician or nurse practitioner as soon as possible; and
   • their child should be monitored for 24-48 hours as concussion signs and symptoms may take hours or days to emerge.
6. stay with the student or ensure the student is supervised by an adult;  
7. continue to monitor and document any changes until parent(s)/guardian(s) or emergency contact arrives;
8. ensure the principal is aware of the incident and completes a student Accident Injury Report Form;
9. provide  parent(s)/guardian(s) with Student Tracking for Concussion Management  Protocol and Recognizing and Monitoring Symptoms during Recovery from a Concussion;
10. inform parent(s)/guardian(s) that they must return the Student Tracking for Concussion Management Protocol with a signature from a licensed physician or nurse practitioner; and
11. do not administer medication unless required for other conditions.

If a concussion is suspected, the following steps must be taken:

1. follow the Student Tracking for Concussion Management Protocol;
2. ensure all appropriate staff members are aware of and implement any modifications/accommodations as outlined in the Student Tracking for Concussion Management Protocol;
3. ensure the student does not participate in physical activity before the concussion management team meeting takes place and determines proper protocol;
4. hold a concussion management team meeting to determine appropriate levels of support for the student;
5. ensure all appropriate staff members are aware of and provide accommodations and appropriate strategies as outlined in the Summary of Accommodation for Students Returning to School after a Concussion;
6. share information with before and after school providers, occasional staff members and volunteers, as required;
7. continue to monitor student’s physical, cognitive, social and emotional well-being;
8. communicate with parent(s)/guardian(s) as needed and share progress or address concerns;
9. maintain communication with the concussion management team as needed;
10. once a licensed physician or nurse practitioner has provided clearance for return to learn:
    • follow return to physical activity stages as outlined in the Student Tracking for Concussion Management Protocol; and
    • if any signs or symptoms of a concussion reappear, follow the steps for a suspected concussion.

3. Responsibilities

3.1 The Director of Education shall:

1. allocate staff and resources to support the Concussion Management procedure; and
2. follow policies and guidelines with respect to concussions in students established by the Minister of Education in accordance with PPM 158 and Rowan’s Law (Concussion Safety), 2018.

3.2 Associate Directors and Superintendents of Education shall:

1. support the implementation of the Concussion Management procedure; and
2. follow policies and guidelines with respect to concussions in students established by the Minister of Education in accordance with PPM 158 and Rowan’s Law (Concussion Safety), 2018.

3.3 Principals shall:

1. ensure that information about the Concussion Management procedure and supporting documents are shared with all school staff, parent(s)/guardian(s), students, and before and after school program providers at the beginning of the school year;
2. ensure all staff complete the annual training in concussion identification and management;
3. ensure all coaches, including staff and volunteers:
   • follow the appropriate Ontario Physical Activity Safety Standards in Education;
   • review the relevant Concussion Awareness Resources; and
   • review the appropriate Concussion Codes of Conduct.
4. within 24 hours of a suspected concussion while on Board property or at a Board-related activity or event, submit a student Accident/Injury Report Form to the Comptroller, Corporate and Legal Affairs as outlined in Procedure #NP138.0, Insurance: Personal Liability, Property Damage and Student/Visitor Injuries;
5. when there is a suspected concussion provide the parent(s)/guardian(s) with the Student Tracking for Concussion Management Protocol; and
6. schedule and participate in a concussion management team meeting to identify accommodations required for the student, ensuring students and parent(s)/guardian(s) have the opportunity to participate.

3.4 Concussion Management Teams shall:

1. assess needs of the student and determine the supports or accommodations required as per the Student Tracking for Concussion Management Protocol, taking into account input from the student, parent(s)/guardian(s); licensed physician, nurse practitioner or regulated health care provider recommendations; inform parents and students of the importance of disclosing the concussion diagnosis to any relevant recreation and sport organizations with which the student is involved or registered;
2. complete the Summary of Accommodation for Students Returning to School after a Concussion; and
3. hold follow-up meeting(s) if needed to consider all relevant and new information and determine appropriate supports.

3.5 School Staff shall:

1. participate in annual training on concussion management and awareness;
2. implement appropriate strategies to minimize the risk of concussion, as outlined in the Ontario Physical Activity Safety Standards in Education;
3. provide students, who are taking part in  interschool activity, and their parent(s)/guardian(s) with the Informed Consent Agreement-Sport as a condition of participating in the sport;
4. in the case of a suspected or confirmed concussion, adhere to the Student Tracking for Concussion Management Protocol; and
5. when a concussion has been confirmed, adhere to the Summary of Accommodations for Student’s Returning to School Protocol.

3.6 York Region Athletic Association (YRAA) and York Region Elementary School Athletic Association (YRESAA) shall:

1. annually inform all coaches, team trainers, officiants and volunteers for Interschool Sports where to access the relevant Concussion Awareness Resources and Concussion Codes of Conduct, and

2. review the Ontario Physical Activity Safety Standards in Education for the relevant sport or activity prior to commencement of the sport.

    

3.7 Volunteer Coaches and Team Trainers shall:

1. review the relevant Concussion Awareness Resource and Concussion Code of Conduct, and indicate completion on the Volunteer Safety Orientation Checklist;
2. implement appropriate strategies to minimize the risk of concussion, as outlined in the Ontario Physical Activity Safety Standards in Education; and
3. adhere to the Student Tracking for Concussion Management Protocol.

3.8 Parent(s)/guardian(s) shall:

1. sign and follow the Informed Consent Agreement-Sport as a condition of their child participating in an interschool activity;
2. review the relevant Concussion Awareness Resource and the Concussion Code of Conduct;
3. inform the school if their child has a suspected or confirmed concussion;
4. if their child has a suspected concussion at school or a school-related event:
   • understand that their child will be removed from physical activity even if the student states that he/she is feeling better
   • arrange to pick up their child;
   • understand that their child should be monitored for 24-48 hours, as signs and symptoms may take hours or days to emerge;
5. complete and adhere to the Student Tracking for Concussion Management Protocol with a licensed physician or nurse practitioner;
6. participate in the concussion management team meeting; and
7. educate their child about their concussion with support from their child’s health care professional, as needed.

3.9 Students shall:

1. provide a signed copy and follow the Informed Consent Agreement – Sport as a condition to participate in an interschool activity;
2. review the relevant Concussion Awareness Resource and Concussion Codes of Conduct;
3. participate in concussion awareness learning for students as determined by YRDSB and the school;
4. take responsibility for advocating for their personal safety and well-being that is consistent with their cognitive, emotional, social and physical stage of development and their capacity for self-management; and
5. adhere to the Student Tracking for Concussion Management Protocol and follow the Summary of Accommodations for Student’s Returning to School Protocol.

5. Contact

Administrative Services

Curriculum and Instructional Services

Student Services

6. History

Working Document: Policy and Procedure February 2015 Policy subsumed by Policy #662.0, Health Supports Working Document: July 2018

Revision drafted January 28, 2020

Revised: July 2019, January 2020, November 2023

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Board Procedure #662.7 Students with Significant Medical Complexity

1. Procedure Statement

This procedure outlines the process for students who are deemed medically fragile.

2. Application

Students who are deemed significantly medically complex will require a variety of health supports. A student with significant medical complexity will require 24-hour supervision and provision of care from a skilled nurse or caregiver. The processes for providing these additional health supports may be outlined in the following additional procedures:

1. Management of Physical Challenges;
2. Management of Catheterization;
3. Management of Suctioning; and
4. Management of Communication Disorders.

Epilepsy (Seizure Disorder) Management. Also see Administration of Medication to Students Procedure.

3. Responsibilities

3.1 The Director of Education shall:

1. allocate staff and resources to support the Medically Fragile Student procedure.

    

3.2 Associate Directors, Coordinating Superintendents and Superintendents of Education shall:

1. support the implementation of the Medically Fragile Student procedure at each school.

    

3.3 Principals shall:

1. co-create, review or update the required Health Care Plan(s) and/or Essential Routine Health Care Plan(s) with the parent(s)/guardian(s), in consultation with school staff and the student, as appropriate at the time of registration and the beginning of each school year;
2. ensure that the Health Care Plan(s) and Essential Routine Health Care Plan is posted in a discrete location and provided to the student’s teachers and updated as required;
3. take steps to ensure health supports for students with medical complexity are provided in accordance with specific procedures (e.g. suctioning and catheterization etc.);
4. coordinate the completion and collection of appropriate documentation, including, but not limited to Essential Routine Health Care Plan, and appropriate Health Care Plan(s) as required;
5. ensure completion of the third party health care provider referral for nursing needs at school;
6. work with third party health care provider Care Coordinator, as outlined, to support student and staff member needs, where required;
7. allocate appropriate staff members to support student needs;
8. ensure appropriate staff members are made aware of student needs;
9. ensue the Request for Special Transportation form has been completed through SSNET for students requiring special consideration affecting transportation, and supply the Health Care Plan(s) or Essential Routine Health Care Plan(s);
10. clearly communicate to parent(s)/guardian(s) and appropriate staff the process for parent(s)/guardian(s) to notify the school of their child’s medical condition(s);
11. ensure medical occurrences, incidents and emergencies are recorded in the Medical Incident Record Form attached to the appropriate Health Care Plan(s);
12. maintain a file with the Health Care Plan(s) and supporting documentation for each student with a medical condition;
13. provide relevant information from the student’s Health Care Plan(s) and/or Essential Routine Health Care Plan(s) to school staff and others who are identified in the Health Care Plan(s) (e.g., food service providers, transportation providers, volunteers, occasional staff who will be in direct contact with the student), including any revisions that are made to the plan;
14. support inclusion by allowing students to perform daily or routine management activities in a school location (e.g., classroom), as outlined in the Essential Routine Health Care Plan(s) and the Health Care Plan(s), while being aware of confidentiality and the dignity of the student; and
15. enable students with medical conditions to participate in school to their full potential.

DNR Note: if a parent(s)/guardian(s) provides a DNR Confirmation (DNR-C) Form Do Not Resuscitate (DNR) request to the School, the principal (in consultation with the superintendent) will connect with their Student Services Coordinator to engage in a consultation regarding the response and develop a detailed health care plan and prepare a response. Together, these parties will prepare a response to the family explaining that the Board is not in a position to legally comply with the Non-Resuscitation Order and will follow established emergency protocol; however, the School will take steps to provide the emergency care information, including a DNR Confirmation (DNR-C) Form request to the emergency response personnel upon arrival.

3.4 Teachers and Educational Assistants and Designates shall:

1. provide health supports as required for students with medical complexity in accordance with all procedures, and as outlined in documentation such as, but not limited to, Essential Routine Health Care Plan(s) and the required Health Care Plan(s);
2. meet with parent(s)/guardian(s), to discuss their child’s needs;
3. ensure that occasional staff in the classroom are aware of students with medical by including a communication on daily plans about emergency procedures;
4. review and follow the contents of the Essential Routine Health Care Plan(s) and the Health Care Plan(s) for any student with whom they have direct contact;
5. support a student’s daily or routine management; and
6. respond to medical incidents and medical emergencies that occur during school, as outlined in Board policies and procedures.

3.5 Educational Assistants and Designates shall:

1. provide health supports as required for students with medical complexity in accordance with all procedures, and as outlined in documentation such as, but not limited to, Essential Routine Health Care Plan(s) and the required Health Care Plan(s); 
2. review and follow the contents of the Essential Routine Health Care Plan(s) and the Health Care Plan(s) for any student with whom they have direct contact;  
3. support a student’s daily or routine management; and 
4. respond to medical incidents and medical emergencies that occur during school, as outlined in Board policies and procedures.

3.6 Outdoor Education Centre staff members and teachers planning remote field trips shall:

1. include a process and appropriate resources to support the student during activities off school property, including:
   • ensure awareness of the estimated time to reach the nearest hospital or medical facility;
   • provide school staff members with the availability of two-way communication; and
   • collaborate with Student Services, as required, to examine barriers to access and develop appropriate accommodations.

3.7 Student Transportation Services (STS) shall:

1. take steps to meet the health and safety needs of students with medical complexity, who travel unattended, on STS provided transportation;
2. retain the student’s Essential Routine Health Care Plan(s) and Health Care Plan(s) form(s) on file in the STS office, in the appropriate service provider’s dispatch office, and in the appropriate school vehicle(s); and
3. ensure the Board’s Student Transportation Services form Request for Special Transportation are received by the principal and are accessible in the event of an emergency.

3.7 Parent(s)/guardian(s) shall:

1. provide the school with all appropriate supplies to meet the student’s health support needs;
2. consider providing their child with medical identification (e.g. Medic Alert bracelet or necklace);
3. co-create Essential Routine Health Care Plan(s) and appropriate Health Care Plan(s) for their child with the principal or the principal’s designate, as appropriate;
4. communicate changes to the Essential Routine Health Care Plan(s) and appropriate Health Care Plan(s) based on the status of their child’s medical condition(s) or changes to their child’s ability to manage the medical condition(s), to the principal or the principal’s designate;
5. initiate and participate in annual meetings to review their child’s Essential Routine Health Care Plan(s) and Health Care Plan(s), as appropriate;
6. seek medical advice from a licensed physician or nurse practitioner where appropriate; and
7. provide the school with copies of any medical reports or instructions from their child’s licensed physician or nurse practitioner.

3.8 Students shall:

1. take responsibility for advocating for their personal safety and well-being that is consistent with their cognitive, emotional, social and physical stage of development and their capacity for management;
2. participate in the development of and meetings to review the Essential Routine HealthCare Plan(s) and  Health Care Plan(s), as appropriate;
3. set goals on an on-going basis, for management of their medical condition, in conjunction with their parent(s)/guardian(s) and health care professional(s) as appropriate; and
4. communicate with their parent(s)/guardian(s) and school staff if they are facing challenges related to their medical conditions(s) at school as appropriate.

4. Definitions

4.1 Students with Medical Complexity

A student’s condition is deemed medically complex (previously referred to as ‘medically fragile’) when medical and/or physiological condition(s) require ongoing, frequent intervention and monitoring on a 24-hour basis.

There must be a demonstrable risk of significant exacerbation of the student’s health status associated with not meeting those care requirements. A student with medical complexity student is determined through an assessment completed by a licensed physician or nurse practitioner of the student’s needs which may involve the following procedures/health risks:

1. deep suctioning (suction beyond the mouth/oral cavity);
2. tracheotomy tube care with or without oxygen;
3. continuous (all day) gastrostomy (G tube), gastrostomy-jejunostomy tube (g-j tube) or jejunostomy (j tube) feeds;
4. extreme risk of respiratory or cardiac arrest (life threatening not due to anaphylaxis);
5. ventilators or breathing supports (e.g. CPAP etc.); and/or
6. administration of intravenous medication.

5. Contact

Administrative Services

Curriculum and Instructional Services

Student Services

6. History

Working Document: July 2018

Revised: July 2019, November 2023

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Board Procedure #662.8 Students with Physical Management

1. Procedure Statement

This procedure outlines the process for supporting students with physical management needs.

2. Application

Students with physical management need to experience impairments or health conditions that require support at school. Physical management supports may be required to support: 

1. self-care routines (e.g., toileting, lifts/ transfers, feeding or dressing);
2. ability to access and participate in their school day; and
3. the use of specialized equipment (e.g., stander to access specific classroom activities, donning and doffing Ankle Foot Orthosis (AFO) when going out for outdoor activities), as required.

All daily or regular physical management needs should be outlined on an Essential Routine Health Care Plan with detailed instructions for support staff within the classroom to follow. The Essential Routine Health Care plan should be completed in partnership with the student, parent/guardian(s), Medical or Community Based Rehabilitation Services (CBRS) Team and school staff including PTOT service. The Essential Routine Health Care Plan should be accessible to supporting staff and always accompany the student.

3. Responsibilities

3.1 The Director of Education shall:

1. allocate staff and resources to support the Management of Physical Challenges procedure.

    

3.2 The Associate Directors and Superintendents of Education shall:

1. support the implementation of the Management of Physical Challenges procedure at each school.

    

3.3 Principals shall:

1. co-create, review or update Essential Routine Health Care Plan(s) with the parent(s)/guardian(s) in consultation with school staff including PTOT service:
   • during the time of registration;
   • each year during the first week of school; and
   • when a child is diagnosed and/or returns to school following a new diagnosis or change in status.
2. clearly communicate to parent(s)/guardian(s) and appropriate staff the process to notify the school of their child’s medical condition(s);
3. support the initiation of a referral to the Board’s physiotherapist or occupational therapist as required;
4. maintain a file with the supporting documentation for each student with a medical condition;
5. provide relevant information from the student’s Essential Routine Health Care Plan to school staff and others as required (e.g. transportation providers, volunteers, occasional staff who will be in direct contact with the student), including any revisions that are made to the plan;
6. arrange for annual safe lifting training provided by regulated health professional (PTOT Service) in the Board, or as needed;
7. ensure the completion of annual inspections for all person lifting devices;
8. designate a staff member to perform a daily visual inspection of all person lifting devices;
9. consult with the Board’s physiotherapists and/or occupational therapists to determine the appropriateness for referral to third party health care provider for intervention (e.g. chest physiotherapy intervention) not provided by Board physiotherapy and occupational therapy services;
10. ensure that school staff members are not involved with providing general physical management routines to students in schools without first consulting with Board physiotherapy or occupational therapy services, prior to providing general physical management routines and that any such routine would be in accordance with the Student’s Essential Routine Health Care Plan(s);
11. identify staff who can support the daily or routine management needs of students in the school with health/medical conditions, while honouring the provisions within their collective agreements;
12. ensure the Request for Special Transportation form has been completed through SSNET for any students that may require special consideration affecting transportation;
13. support inclusion by allowing students with medical conditions to perform daily or routine management activities in a school location (e.g., classroom), as outlined in their Essential Routine Health Care Plan, while being aware of confidentiality and the dignity of the student; and
14. enable students with medical conditions to participate in school to their full potential.

3.4 Board Physiotherapists and/or Occupational Therapists shall:

1. with parent(s)/guardian(s) consent, provide assessment, intervention and training to appropriate school staff members to address physical management need of students, as required;
2. provide training to designated school staff on safe lifting procedures as requested by principal;
3. initiate appropriate referrals for students who are eligible for physiotherapy and/or occupational therapy from the Children’s Treatment Network; and
4. assist principals with referrals from the appropriate third party health care provider, if required.

3.5 Teachers shall:

1. initiate referrals for physiotherapy and/or occupational therapy service using the Request/Consent for Professional Services referral process;
2. incorporate, as appropriate, physical management routines in a student’s Individual Education Plan, where the student is engaged in increasing independence; and
3. follow the Essential Routine Health Care Plan(s).

3.6 Educational Assistants and Designates shall:

1. as designated by the principal:
   • provide services to support physical management routines as per the Essential Routine Health Care Plan(s), (e.g., lifts or transfer equipment use, shallow suctioning, administration of continuous pre-set passive oxygen, care for ostomy bag and appliance, application of condom for urinary drainage, monitoring clean intermittent catheterization, etc.) as required;
   • engage in annual training on safe lifting procedures where required, or as needed;
   • perform a daily visual inspection of all person lifting devices;
   • participate in training, on health/medical conditions, at a minimum annually;
   • review the contents of the Essential Routine Health Care Plan(s) for any student with whom they have direct contact; and
   • support a student’s daily or routine management and respond to medical incidents and health/medical emergencies that occur during school, as outlined in Board policies and procedures.

3.7 Parent(s)/guardian(s) shall:

1. educate their child about their medical condition(s) with support from their child’s health care professional, as needed;
2. guide and encourage their child to reach their full potential for management and self-advocacy;
3. inform the school of their child’s medical condition(s) and co-create the Essential Routine Health Care Plan(s) for their child with the principal or the principal’s designate;
4. communicate changes to the Essential Routine Health Care Plan(s), such as changes to the status of their child’s medical condition(s) or changes to their child’s ability to manage their medical condition(s), to the principal or the principal’s designate;
5. confirm annually to the principal or the principal’s designate that their child’s medical status is unchanged;
6. initiate and participate in meetings to review their child’s Essential Routine Health Care Plan(s);
7. provide the school with copies of any medical reports or instructions from the student’s health care provider; and
8. provide materials required to meet the health needs of their child, including, but not limited to, medical identification and specialized equipment.

3.8 Students shall:

1. take responsibility for advocating for their personal safety and well-being that is consistent with their cognitive, emotional, social and physical stage of development and their capacity for management;
2. participate in the development and in meetings to review of their Essential Routine Health Care Plan(s) as appropriate;
3. carry out daily or routine self-management of their medical condition to their full potential, as described in their Essential Routine Health Care Plan as appropriate;
4. set goals on an on-going basis, for self-management of their medical condition, in conjunction with their parent(s)/guardian(s) and health care professional(s) as appropriate; and
5. communicate with their parent(s)/guardian(s) and school staff if they are facing challenges related to their medical conditions(s) at school as appropriate.

4. Definitions

4.1 Physical Management Routines

Physical management routines include daily activities during which some students require the assistance of another person. This may include, but is not limited to, supports for lifting, positioning, mobility, oral feeding, toileting, range of motion activities and programming to meet the student’s physical needs. Physical management routines may be part of a student’s Individual Education Plan (IEP) and Essential Routine Health Care Plan(s) and are developed with consideration of the health and safety needs of students and staff members.

5. Contact

Curriculum and Instructional Services;

Student Services

6. History

Approved: 1996

Amended: 2001, 2002, 2009

Working Document: July 2018

Revised: July 2019, November 2023

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Board Procedure #662.9 Management of Catheterization

1. Procedure Statement

This procedure outlines the process for meeting the needs of students who require catheterization.

2. Application

Students with bladder, some neurological or medical conditions may require catheterization support and management of their bladder function at school. Catheterization can be either clean intermittent or sterile catheterization. Clean intermittent catheterization can be taught to school support staff and completed with a detailed Essential Routine Health Care Plan. Third party health care providers may be available to provide school staff with training specific to catheterization. The Essential Routine Health Care plan was created for students who require support with clean intermittent catheterization. This should be completed in partnership with the student, parent/guardian(s), Medical or third-party health care provider team members and school staff. The Essential Routine Health Care Plan should be accessible to supporting staff and accessible within the washroom or classroom space designated for catheterization. For students who require sterilized catheterization at school, a referral to a third-party health care provider is required. Sterile catheterization is a controlled act that is performed in schools by a regulated health care professional.

3. Responsibilities

3.1 The Director of Education shall:

1. allocate staff and resources to support the Management of Catheterization procedure.

3.2 Associate Directors and Superintendents of Education Shall:

1. support the implementation of the Management of Catheterization procedure at each school;

2. develop, communicate and implement expectations for schools to support the safe storage and disposal of medication and medical supplies, including the safe disposal of catheterization supplies (NOTE - the family is responsible for the supply and safe disposal of medical supplies); and provide schools with appropriate supplies to support safe disposal of medication and medical supplies.

    

3.3 Principals shall:

1. nitiate a referral to the third party health care provider, as appropriate;
2. work with the Student Services Coordinator to allocate appropriate staff members to support clean intermittent catheterization;
3. ensure parent(s)/guardian(s) provide catheterization materials;
4. ensure the management and safe removal of biohazard waste containers;
5. request the third party health care provider provide consultation and training for educational assistants and designate, with parent(s)/guardian(s) permission;
6. clearly communicate to parent(s)/guardian(s) the process for parent(s)/guardian(s) to notify the school of their child’s medical condition(s);
7. co-create, review or update the Essential Routine Health Care Plan(s) with the parent(s)/guardian(s), in consultation with school staff, third party service provider and the student, as appropriate;
8. maintain a file with the supporting documentation for each student with a medical condition;
9. provide relevant information from the student’s Essential Routine Health Care Plan(s) to school staff and occasional staff who will be in direct contact with the student, including any revisions that are made to the plan; and
10. assign the identification of staff who can support the daily or routine management needs of students in the school with health/medical conditions, while honouring the provisions within their collective agreements.

3.4 Teachers shall:

1. follow the Essential Routine Health Care Plan; and
2. enable students with health/medical conditions to participate in school to their full potential.

3.5 Health Assistants, Developmental Service Workers and Intervention Support Workers shall:

1. administer or monitor clean intermittent catheterization and/or supervise student self-catheterization, as required;
2. dispose of biohazardous materials in accordance with Board procedures;
3. participate in training to provide clean intermittent catheterization;
4. follow the Essential Routine Health Care Plan(s) for any student with whom they have direct contact; and
5. support a student’s daily or routine management procedures.

3.6 Outdoor Education Centre staff members and teachers planning remote field trips shall:

1. include a process and appropriate resources to support the student during activities off school property; and
2. provide school staff members with the availability of two-way communication.

3.7 Parent(s)/guardian(s) shall:

1. co-create Essential Routine Health Care Plan(s) for their child with the principal or the principal’s designate, as appropriate;
2. communicate changes to the Essential Routine Health Care Plan(s) based on the status of their child’s medical condition(s) or changes to their child’s ability to manage the medical condition(s), to the principal or the principal’s designate;
3. confirm annually to the principal or the principal’s designate that their child’s health/medical status is unchanged;
4. participate in annual meetings to review their child’s Essential Routine Health Care Plan(s) and/or protocol, as appropriate;
5. seek medical advice from a licensed physician or nurse practitioner where appropriate;
6. provide the school with copies of any medical reports or instructions from the student’s licensed physician or nurse practitioner; and
7. provide materials required to meet the health needs of their child.

3.8 Students Shall:

1. take responsibility for advocating for their personal safety and well-being that is consistent with their cognitive, emotional, social and physical stage of development and their capacity for management as appropriate;
2. participate in the development and meetings to review their Essential Routine Health Care Plan(s) as appropriate;
3. carry out daily or routine self-management of their medical condition to their full potential, as appropriate;
4. set goals on an on-going basis, for self-management of their medical condition, in conjunction with their parent(s)/guardian(s) and health care professional(s) as appropriate; and
5. communicate with their parent(s)/guardian(s) school staff if they are facing challenges related to their medical conditions(s) at school as appropriate.

4. Definitions

4.1 Biohazardous Waste Container

Biohazardous containers are used for the disposal of waste that may be contaminated with pathogens that present a danger to people and the environment.

5. Contact

Curriculum and Instructional Services

Student Services

6. History

Approved: 1996

Amended: 2001, 2002, 2009

Working Document: July 2018

Revised: July 2019, November 2023

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Board Procedure #662.10 Management of Suctioning

1. Procedure Statement

This procedure outlines the process for meeting the needs of students who require suctioning.

2. Application

Students with excess secretions, complex chest, airway congestion, or with an alternative airway (e.g. tracheostomy) may need to be suctioned using a suction machine at school. Students may need suctioning if they are not able to clear secretions (mucus) from their airways by blowing their nose. The main types of suctioning are nasal (in the nose), oral (mouth), nasopharyngeal and oropharyngeal (throat), tracheostomy (tube in larynx) and deep suctioning. For students who require shallow suctioning, the Essential Routine Health Care plan is completed in partnership with student, parent/guardian(s), Medical Team, third party health provider and should be accessible to supporting staff and accompany the student at all times.   For students who require deep or tracheostomy suctioning, a referral for a third-party health care provider is required, as deep suctioning is a controlled act that is performed in school by a regulated health care professional.

3. Responsibilities

3.1 The Director of Education shall:

1. allocate staff and resources to support the Management of Suctioning procedure.

    

3.2 Associate Directors and Superintendents of Education:

1. support the implementation of the Management of Suctioning procedure at each school; and
2. develop, communicate and implement expectations for schools to support the safe storage and disposal of medical supplies. (NOTE - the family is responsible for the supply, safe disposal of medical supplies, and biohazardous waste containers).

3.3 Principals shall:

1. with parent(s)/guardian permission, refer to third party health care provider to provide consultation and training for educational assistants or initiate a referral for a third-party health care provider to complete the deep suctioning at school;
2. ensure parent(s)/guardian(s) provide suctioning materials;
3. ensure the management and safe removal of the biohazard waste containers;
4. clearly communicate to parent(s)/guardian(s) the process for parent(s)/guardian(s) to notify the school of their child’s medical condition(s);
5. co-create, review or update the Essential Routine Health Care Plan(s) with the parent(s)/guardian(s), in consultation with school staff, Third Party Health Care Provider and the student, as appropriate;
6. maintain a file with the supporting documentation for each student with a medical condition;
7. provide relevant information from the student’s Essential Routine Health Care Plan(s) to school staff and occasional staff who will be in direct contact with the student, including any revisions that are made to the plan;
8. assign the identification of staff who can support the daily or routine management needs of students in the school with health/medical conditions, while honouring the provisions within their collective agreements;
9. support inclusion by allowing students with medical conditions to perform daily or routine management activities in a school location while being aware of confidentiality and the dignity of the student; and
10. enable students with medical conditions to participate in school to their fullest potential.
11. follow the Essential Routine Health Care Plan; and
12. enable students with health/medical conditions to participate in school to their full potential.

3.4 Educational Assistants and Designates shall:

1. provide shallow suctioning as outlined in the Essential Routine Health Care Plan(s);
2. follow Board procedures regarding the safe storage and removal of biohazardous materials; and
3. engage in training to provide shallow suctioning.

3.5 Outdoor Education Centre staff members and teachers planning remote field trips shall:

1. include a process and appropriate resources to support the student during activities off school property; and
2. provide school staff members with the availability of two-way communication.

3.6 Parent(s)/guardian(s) shall:

1. provide equipment for shallow suctioning;
2. co-create Essential Routine Health Care Plan(s) for their child with the principal or the principal’s designate, as appropriate;
3. communicate changes to the Essential Routine Health Care Plan(s) based on the status of their child’s medical condition(s) or changes to their child’s ability to manage the medical condition(s), to the principal or the principal’s designate;
4. confirm annually to the principal or the principal’s designate that their child’s health/medical status is unchanged;
5. initiate and participating in annual meetings to review their child’s Essential Routine Health Care Plan and/or protocol, as appropriate;
6. seek medical advice from a licensed physician or nurse practitioner where appropriate;
7. provide the school with copies of any medical reports or instructions from the student’s licensed physician or nurse practitioner; and
8. provide materials required to meet the health needs of their child.

3.7 Students Shall:

1. take responsibility for advocating for their personal safety and well-being that is consistent with their cognitive, emotional, social and physical stage of development and their capacity for management;
2. participate in the development of and meetings to review the Essential Routine Health Care Plan(s) as appropriate;
3. set goals on an on-going basis, for self-management of their medical condition, in conjunction with their parent(s)/guardian(s) and health care professional(s) as appropriate; and
4. communicate with their parent(s)/guardian(s) and school staff if they are facing challenges related to their medical conditions(s) at school as appropriate.

4. Definitions

4.1 Biohazardous Waste Container

Biohazardous containers are used for the disposal of waste that may be contaminated with pathogens that present a danger to people and the environment.

4.2 Deep Suctioning

Also referred to as chest suctioning, deep suctioning is a regulated health act to be performed by a trained regulated health professional under licensed physician orders. The suctioning tube passes beyond the larynx or into a tracheostomy. This procedure is not to be performed by Board staff.

4.3 Shallow Suctioning

Shallow suctioning is not a regulated health act. The suction tube vacuums saliva from oral and/or nasal passages, and does not go beyond the teeth. Shallow suctioning may be performed by trained Board staff.

5. Contact

Curriculum and Instructional Services

Special Education Services

6. History

Approved: 1996

Amended: 2001, 2002, 2009

Working Document: July 2018

Revised: July 2019, November 2023

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Board Procedure #662.11 Management of Communication Disorders

1. Procedure Statement

This procedure outlines the process for supporting the needs of students with communication disorders as outlined in Policy and Program Memorandum (PPM) No. 81 Provision of Health Support Services in School Settings.

2. Application

Management of Communication Disorders procedure. Under PPM 81, the provision of supports for students with speech and language disorders is governed by A Model for the Provision of Speech and Language Services and Interministerial Guidelines for the Provision of Speech and Language Services.

3. Responsibilities

3.1 The Director of Education shall:

1. allocate staff and resources to support the Board’s responsibilities associated with the Management of Communication Disorders procedure.

2.2 Associate Directors and Superintendents of Education shall:

1. support the implementation of the Management of Communications Disorders procedure.

    

3.3 Principals shall:

1. familiarize themselves with the Management of Communication Disorders procedure;
2. initiate a referral to the Board’s Speech-Language Pathology (S-LP) Services to determine eligibility for referral to a third party health care provider for speech therapy services;
3. designate a staff member within the school that will work with the school assigned speech-language pathologist to support referrals; and
4. during the referral process ensure principal authorization.

3.4 Board Speech-Language Pathologists shall:

1. with parent(s)/guardian(s) consent, support staff members and parent(s)/guardian(s) to address all communication needs of students, as required, except the speech therapy services provided by the third party health care provider; 
2. with parent guardian consent, assess students’ speech and where determined eligible, initiate the referral process to the third party speech therapy services using the appropriate School Based Rehabilitation Services (SBRS) referral process for speech therapy services;
3. ensure completion of referral process and assume responsibility for sending in the referrals to the third party health care provider; and
4. support staff members and parent(s)/guardian(s) for all communication needs that fall outside of the speech therapy services provided by the third party health care provider.

3.5 Teachers, including Special Education Resource Teachers shall:

1. refer students with speech language or communication concerns to the Board’s Speech and Language Pathology (SL-P) Services using the appropriate referral process;
2. participate in meetings, as appropriate, to support student speech, language or communication needs;
3. participate in the referral process to the third party health care provider as required; and
4. file a copy of the referral form in the Ontario Student Record.

3.6 Parent(s)/guardian(s) shall:

1. complete all appropriate forms, as required; and
2. participate in meetings/student discussions as appropriate.

4. Definitions

4.1 Language Disorders

Language disorders are characterized by delayed or impaired development of comprehension and/or spoken/written language and/or other symbol system. They may involve the form of language, the content of language and/or the function of language in any combination.

4.2 Speech Disorders

Speech disorders include articulation/speech sound production problems, fluency disorders, voice disorders and resonance problems.

5. Contact

Curriculum and Instructional Services

Student Services

6. History

Approved: 1996

Amended: 2001, 2002, 2009

Working Document: July 2018

Revised: July 2019, November 2023

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Board Procedure #662.12

Communicable Diseases

1. Procedure Statement

This procedure outlines the process for addressing communicable diseases.

2. Application

The Board will prevent discrimination against persons with communicable diseases or infections, recognizing that students with communicable diseases or infections have a right to privacy and to accommodations, in keeping with current legislation. Medical information regarding communicable diseases for students will be kept confidential, and no person will be privy to such information unless required by law.

3. Responsibilities

31. The Director of Education shall:

1. allocate staff and resources to support the Communicable Diseases procedure

    

3.2 Associate Directors and Superintendents of Education shall:

1. support the implementation of the Communicable Diseases procedure at each school.

    

3.3 Principals, Managers and Supervisors shall:

1. report reportable diseases to the local Medical Officer of Health or designate;
2. if a principal believes a student or staff is exposed to communicable diseases requiring an order under s. 22 of the Health Protection and Promotion Act, refuse to admit the student or staff to their school or work location until receiving a certificate from the local Medical Officer of Health or a legally qualified medical practitioner approved by the Medical Officer of Health confirming that all danger from exposure to contact with the person in question has passed;
3. ensure all staff are familiar with routine practices to protect their health and well-being;
4. ensure staff members who are required to clean up blood and body fluid spills receive information and instruction about infection control to protect their health and well-being; and
5. work with their superintendent, Corporate Communications and the local Medical Officer of Health or designate, to inform staff members, students and the community about the presence of reportable diseases, where appropriate.

3.4 Corporate Communications shall:

1. liaise with York Region Community and Health Services and the superintendent or designate, to inform staff members, students and the community about the presence of reportable diseases, as appropriate.

3.5 School Staff shall:

1. follow established disposal of sharps protocol for the safe management and disposal of sharps, where applicable;
2. follow established cleaning protocols and infection control practices, where applicable; and
3. seek appropriate medical care and follow health care professional’s advice.

4. Definitions

4.1 Communicable Disease

A communicable disease is any condition which is transmitted directly or indirectly to a person from an infected person or animal.

4.2 Reportable Diseases

A reportable disease is a disease, which must be reported to the local Medical Officer of Health, in accordance with Ontario Regulation 559/91, Specification of Reportable Diseases and amendments under the Health Protection and Promotion Act. If a disease is reportable, contact ACCESS YORK at 1-877-464- 9675.

5. Contact

Corporate Communications

Human Resource Services

Student Services

6. History

Approved: 1989

Amended: 1995, 2001, 2008, 2013

Revision drafted: May 31, 2017 Working Document: July 2018

Revised: July 2019, November 2023

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Board Procedure #662.13 Pediculosis (Head Lice)

1. Procedure Statement

The procedure outlines how issues related to pediculosis (head lice) in schools will be addressed.

2. Application

In responding to pediculosis in schools, the dignity of students and their families will be given the highest priority.

The Ministry of Health, York Region Health Services and the Canadian Pediatric Society consider pediculosis (head lice) to be a nuisance and not a communicable disease.

3. Responsibilities

3.1 The Director of Education shall:

1. allocate staff and resources to support the Pediculosis (Head Lice) procedure.

    

3.2 Associate Directors and Superintendents of Education shall:

1. support the implementation of the Pediculosis (Head Lice) procedure at each school.

    

3.3 Principals shall:

1. review the Pediculosis (Head Lice) procedure with staff members and distribute the Prevention of Pediculosis Guideline as required; 
2. share information with parents(s)/guardian(s) about pediculosis, as appropriate;
3. direct parents(s)/guardian(s) to contact ACCESS YORK at 1-877-464-9675 for additional information on pediculosis;
4. take all reasonable precautions as outlined in the Prevention of Pediculosis Guideline;
5. where a family has ongoing concerns regarding pediculosis:
   • refer the parents(s)/guardian(s) to York Public Health and/or the Canadian Pediatric Society for further information; and
   • ensure school staff members take additional preventative measures to avoid transfer of pediculosis, as outlined in the Prevention of Pediculosis Guideline.
6. if a student is identified as having live pediculosis, the following steps should be taken:
   • call the parents(s)/guardian(s) and recommend contacting Public Health for management of pediculosis as soon as possible;
   • send home A Message to Families about the Presence of Pediculosis (Head Lice) and the Canadian Pediatric Society Head Lice Facts; and
   • take all reasonable precautions as outlined in the Prevention of Pediculosis Guideline; and
7. when a student is identified as having nits and not live pediculosis, the following steps should be taken:
   • send home A Message to Families about Possible Exposure to Pediculosis (Head Lice) and the Canadian Pediatric Society Head Lice Facts.

3.4 School Staff shall:

1. communicate any suspected or confirmed cases of pediculosis to the principal; and 
2. take all reasonable precautions as outlined in the Prevention of Pediculosis Guideline. 

3.5 Parent(s)/guardian(s) shall:

1. connect with the school should they have any questions regarding management of pediculosis. 

4. Definitions

4.1 Nits (eggs)

Nits are half the size of the head of a pin and shaped like a teardrop. They are a creamy colour and found close to the scalp, on the shaft of the hair. They resemble dandruff but are attached to the hair by a cement-like material and are very difficult to remove. It is usually the eggs that are noticed first.

4.2 Pediculosis (Head Lice)

Head lice are tiny (3mm long) wingless insects with flattened bodies. They cling to the hair by means of six legs. They live mostly behind the ears and at the nape of the neck. The female lays tiny, cream coloured eggs called nits.

5. Contact

Curriculum and Instructional Services

Student Services

6. History

Revised: December 1996

Amended: 2004

Working Document: January 2015, July 2018

Revised: July 2019; November 2023

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Board Procedure #662.14 Student Use of Guide Dogs, Service Dogs or Service Animals

1. Procedure Statement

This procedure identifies the individualized process to be followed when a student and/or parent/guardian applies to have a guide dog, service dog or service animal support the disability related needs of the student while they are attending school or a school-related event.

2. Application

Meaningful access to education for students with disability-related learning needs is our priority. A variety of student placements, differentiated programming, and evidence-based interventions and strategies will be considered.

In Ontario, the Accessibility for Ontarians with Disabilities Act, 2005 (the “AODA”) sets out a framework related to the use of service animals by individuals with a disability. The Ontario Human Rights Code sets out the conditions for accommodations for persons’ with disabilities and the Blind Persons’ Rights Act sets out a framework specifically for the use of guide dogs for individuals who are blind. Any special consideration, including all supporting documentation (e.g., letter from a regulated health professional) of whether a guide dog, service dog or service animal is an appropriate accommodation for a student while receiving education services is a decision of the Board. A regulated health professional cannot unilaterally prescribe a guide dog, service dog or service animal as a specific accommodation for a student while at school.

When a student, and/or parent/guardian is requesting to attend school or school-related events with a guide dog, service dog or service animal, the following applies:

1. guide dogs, service dogs or service animals will not be provided by the Board; and
2. the guide dog, service dog and the student handler must be certified as having been successfully trained by an accredited training facility; a training of potential guide dogs or service dogs in the school setting or during school activities is not permitted due to safety risks as well as disruption and distraction in the learning environment.

Notable differences between a guide dog and service animal must also be considered in applying this procedure.

The Board will consider a species, other than dogs, as an accommodation for student if other accommodations in the school setting have been unsuccessful in providing meaningful access to education. A service animal must be trained to provide services. Household pets are not considered service animals.

The Customer Service Standards under the Accessibility for Ontarians with Disabilities Act (AODA) as they relate to service animals do not apply in the case of schools. As outlined in the Education Act, a school is a highly regulated space and is not generally accessible to the public.

2.1 Process

A school principal has authority to exclude any animal, including service dogs and service animals, from entry onto school premises and school building(s) as an accommodation for a student, provided that the student is offered appropriate alternative accommodation to meet the student’s meaningful access to education.

Parents/guardians are required to submit a completed Application for Guide Dog/ Service Dog or Application for Service Animal in order for a school principal to consider admitting a guide dog/service dog into the school.

The accommodation process shall include any special considerations that may arise if an animal is a species other than a dog, including the ability to be trained, necessary biological functions, the capacity for the animal to respond to commands, whether the animal can be kept on a leash/harness, and how such restrictions might impact accommodations.

On receipt of an application for guide dog/service dog or service animal, the school principal shall review the application for completeness and may request any additional information or clarification necessary to assess the request for accommodation. 

2.2 Assessment of the Accommodation Request

Once the application and all necessary documentation is received by the school principal, a review will take place by the student’s educational team supporting the student and a meeting shall be scheduled to review the accommodation request with stakeholders. Every effort will be made to review the documentation and schedule a meeting in a reasonable timeframe.

Each request for a guide dog/service dog or service animal will be addressed on an individual basis giving consideration to:

1. the individual learning strengths and needs of the student,
2. the student’s Individual Education Plan (IEP) goals, safety plan, behaviour plan and/or student’s medical plan of care, if any;
3. supporting documents such as psychological assessments, occupational or physical therapy assessments, functional behaviour assessments etc.;‌
4. evidence of how the guide dog/service dog or service animal’s attendance at school might provide accommodation for a demonstrated disability-related learning need and/or activities of daily living necessary while at school;
5. assessment information provided by a regulated health professional with expertise regarding the student’s disability-related needs supporting the request for a guide dog/service dog or service animal;
6. the training and certification of the guide dog/service dog and student handler;
7. the impact of the accommodation on the student’s dignity, integration and independence;
8. whether one or more alternative accommodations can meet the needs of the student;‌
9. the impact of the accommodation on the learning environment for the student, other students, including, health, safety, disruption and distraction; and
10. any competing human rights of students, staff, and community members, and recommendations for accommodation plans to reconcile competing rights.

The process of accommodation, including inquiries regarding competing rights and notice to the school community, shall respect the student’s right to privacy regarding their disability and specific learning needs and/or needs of daily living.

The determination with respect to the application for a guide dog/service dog/service animal shall be communicated to the parent/guardian in writing.

2.3 Implementation of the Accommodation

Where approval is granted, the following will be done:

1. make changes to the student’s IEP goals and/or student’s health care plan, as required; 
2. develop a plan for how the care guide dog, service dog and service animal will be provided; 
3. consider if an assessment is required by the Board’s health and safety officer regarding health and safety issues applicable to different areas/activities in the school; 
4. develop emergency procedures, to include a fire exit plan, lockdown plan, evacuation plan; 
5. provide notice to the community via a letter to parents/guardians; signage on the school’s front door, gymnasium, and library doors; communication to potential occasional staff accepting a position where the guide dog/service dog or service animal may be providing service to the student; 
6. create a plan for introducing the guide dog/service dog to and from school, if necessary, and complete the following: 
   • ​​​make inquiries regarding competing rights if the guide dog/service dog will be accompanying the student on a school vehicle;
   • ensure the transportation plan specifies where the guide dog/service dog and student will be located; and ensure the school vehicle shall have a sticker/sign identifying the presence of a guide dog/service dog is on board;
   • provide documentation about the guide dog/service dog to be included with the route information so that new or substitute bus drivers are aware of the guide dog/service dog or service animal’s presence.

Specialized transportation shall not be provided solely for the purpose of enabling the guide dog/service dog or service to travel to and from school with the student. 

2.4 Continuous Assessment

A review of the effectiveness of the guide dog/service dog or service animal in supporting the student’s learning goals shall be undertaken as part of each review of the student’s IEP and as deemed necessary by the Principal.

Approval may be revoked at any time by the principal if:

1. there are any concerns for the health and safety of students, staff or the guide dog/service dog or service animal and other animals in the school;
2. the guide dog/service dog or service animal demonstrates distracting, disruptive or aggressive behaviour, including but not limited to, making noise, failing to follow commands, growling or nipping;
3. there has been a change to the student’s circumstances or disability-related needs, which had supported the original approval or a change to the needs of students/staff such that there is a new competing right; and
4. the Board in its discretion determines that the accommodation is not effective for the student’s demonstrated disability-related learning needs or activities of daily living.

In the event the guide dog/service dog or service animal demonstrates distracting, disruptive or aggressive behaviour, the student handler will be required to remove the guide dog/service dog or service animal from the classroom immediately and the student’s parent/guardian will be called to pick up the guide dog/service dog or service animal from the school. Any such behaviour is grounds to prohibit the guide dog/service dog or service animal’s attendance on school property and in the school building. Alternative options for accommodation will be discussed.

2.5 Records

A copy of the application and confirmation of approval, as well as any other relevant documents supporting the accommodation shall be retained in the student’s Ontario Student Record.

The Board shall collect, use and disclose the personal information of the student in order to fulfill the accommodation process. Notice of the collection, use and disclosure must be provided to the parent/guardian. Efforts should be made to limit the personal information to only that which is necessary.

The Board will collect the number of requests for students to be accompanied by guide dog/service dog/service animal to inform the cyclical review of the procedure.

2.6 Food Areas

Ontario Agency for Health Protection and Promotion Act, allows guide dogs and service dogs in areas where food is served, sold, and offered for sale. Steps should be taken to ensure that guide dogs and service dogs in school cafeterias, or areas where students are consuming food, are not disruptive and do not eat student food.

Access may be limited to certain activities, areas of the school, or certain times of the day.

No animals are allowed in areas where food is prepared, processed, or handled such as the kitchen of the school cafeteria or the hospitality classroom.

3. Responsibilities

3.1 The Director of Education shall:

1. allocate staff and resources to support the Communicable Diseases procedure.

3.2 Associate Directors and Superintendents of Education shall:

1. follow process in determining whether a guide dog, service dog and/or service animal would be an approved accommodation for a student to access education in a meaningful way as outlined in the Checklist for Guide Dog, Service Dog or Service Animal;
2. be responsible for communication with the parent/guardian with respect to the accommodation process, and where approved the implementation and management of the accommodation;
3. inform Student Services Coordinator of requests for guide dogs, service dogs, and service animals; and
4. ensure the accommodation plan addresses the competing rights of others.

3.3 Student Services Coordinator shall:

1. collect and retain data on requests for guide dogs, service dogs, and service animals.

3.4 Parents/guardians shall:

1. provide all necessary documentation;
2. engage in the consultation to support the application for a guide dog/service dog, service animal to accompany their child at school and/or on school-related activities;
3. submitting the Application for Guide Dog/Service Dog or Application for Service Animal;
4. assume responsibility for all costs related to the guide dog, service dog or service animal (e.g., food, guide dog, service dog or service animal identification, grooming, harness and/or mat and veterinary care);
5. comply with an accommodation plan that competing rights of others;
6. understand that applications for guide dogs, service dogs, and service animals are reviewed by the Board on a case-by-case basis; and
7. schedule a meeting with the school principal or superintendent to discuss the process of having a guide dog, service dog or service animal to support the disability-relate learning needs of their child.

3.5 Student shall:

1. be expected to act as the guide dog/service dog or service animal’s handler;
2. demonstrate the ability to control the guide dog/service dog or service animal in accordance with the training received;
3. ensure that the guide dog/service dog or service animal at all times while on school property is responsive to commands and demonstrates that it can perform the necessary tasks or accommodations;
4. ensure the guide dog/service dog or service animal is always wearing an identification vest and leash or harness;
5. ensure the guide dog/service dog or service animal does not disrupt the learning of others with unnecessary movement, vocalization, or other behaviour, including aggressive or threatening behavior; and
6. ensure the guide dog/service dog or service animal’s biological needs are addressed.

4. Definitions

4.1 Accredited Training Organization

Is a guide dog or service dog trainer that is accredited by: International Guide Dog Federation or Assistance Dogs International.

This may also include confirmation from a guide dog or service dog trainer that attests to compliance with the Meghan Search and Rescue Standard in Support of Accessibility: Persons with a Disability Teamed with Service Dogs standard for training (MSAR).

4.2 Handler

Refers to the individual trained by an Accredited Training Organization who is managing the guide dog/service dog.

4.3 Guide Dog

A dog trained as a guide for a blind person and having the qualifications prescribed by the regulations pursuant to the Blind Persons’ Right Act.

4.4 Service Dog

A highly trained dog that assists individuals with various tasks of daily living including, but not limited to, a guide dog, hearing and signal dogs, mobility assistance dogs and/or seizure response dogs.

4.5 Service Animals

An animal that provides support relating to a student’s disability to assist that student in meaningfully accessing education.

5. Contact

Student Services

Curriculum and Instructional Services

6. History

Approved: January 2020

Revised: November 2023