E.C. 46010.1 - Parents must be notified that a pupil may be excused from school for the purpose of  obtaining confidential medical services without the consent of the parent or guardian. The California  State Attorney General has opined that school districts must excuse pupils to obtain such confidential  medical services without notifying or requiring permission from the parent or guardian. 

AB 354 – All students entering 7th grade effective July 1, 2010, are required to have Tdap (1 dose) and  Varicella (2 doses) immunizations. 

E.C. 48211 – The governing body of any school district may exclude children of filthy or vicious habits,  or children suffering from contagious or infectious diseases. 

E.C. 48213 – Prior to excluding a child from attendance pursuant to Section 48211 or Section 48212,  the governing board shall send a notice to the parent or guardian of the child. The notice shall contain  each of the following: 

1. A statement of the facts leading to a decision to propose exclusion of the child.
2. A statement that the parent or guardian of the child has a right to meet with the  governing board to discuss the proposed exclusion.
3. A statement that at any meeting with the governing board held to discuss such proposed  exclusion, the parent or guardian shall have an opportunity to inspect all documents which the  governing board relied on in its decision to propose exclusion of the child; to challenge any  evidence on the child’s behalf, including witnesses. The statement shall also include notice that  the parent or guardian may designate one or more representatives to be present with the parent  or guardian at the meeting. 

HSC 124085, 124100, 124105, State law requires that the parent or legal guardian of each pupil  provide the school documentary proof that the pupil has received a health screening examination by a  doctor within 90 days after entrance to first grade. Pupils may be excluded for up to 5 days from school  for failing to comply or not provide a waiver. Free health screening is available through the local health  department.

E.C. 49451, B.P. 5141.3(a) - A child may be exempt from physical examination whenever the parents  file a written statement with the school principal stating that they will not consent to routine physical  examination of their child. Whenever there is good reason to believe the child is suffering from a  recognized contagious or infectious disease, the child will be excluded from school attendance. 

E.C. 49452.8—Requires a pupil, while enrolled in first grade in a public school if the pupil was not  previously enrolled in kindergarten in a public school, to no later than May 31st of the school year  present proof of having received an oral health assessment that was performed no earlier than 12  months prior to the date of the initial enrollment of the pupil. 

E.C. 49452 and 49455 – During the school year pupils in grades TK, K, 2, 5, and 8, will have screening  tests for vision and hearing. 10th grade will have screening for hearing. In addition, any pupil new to  the district or referred by a teacher in another grade level will be screened. If the parent or guardian  prefers that this evaluation be waived, they may present to their school principal a certificate from a  physician or surgeon or optometrist setting forth the results of the testing of the ears and eyes; they  may write a statement to be filed with the school principal that they adhere to a healing-by-prayer  religion or denomination. 

E.C. 49452.5 – During the second semester of school, middle school students may receive education  and awareness about Scoliosis. 

E.C. 49456 – For those pupils for whom neither of the two above waiver procedures are on file,  required grade levels for state-mandated screening of vision and hearing and education about scoliosis  will be completed with follow-up information given to the parents of students with any reportable vision,  hearing concerns, and or concerns noted. 

E.C. 49452.6-Type 1 diabetes in children is an autoimmune disease that can be fatal if untreated, and  the guidance provided in this information sheet is intended to raise awareness about this disease. 

Description 

Type 1 diabetes usually develops in children and young adults but can occur at any age. 

• According to the U.S. Centers for Disease Control and Prevention (CDC), cases of  type 1 diabetes in youth increased nationally from 187,000 in 2018 to 244,000 in  2019, representing an increase of 25 per 10,000 youths to 35 per 10,000 youths,  respectively. 
• The peak age of diagnosis of type 1 diabetes is 13-14 years, but diagnosis can also  occur much earlier or later in life. 

Type 1 diabetes affects insulin production: 

• As a normal function, the body turns the carbohydrates in food into glucose (blood  sugar), the basic fuel for the body’s cells. 
• The pancreas makes insulin, a hormone that moves glucose from the blood into the  cells. 
• In type 1 diabetes, the body’s pancreas stops making insulin, and blood glucose  levels rise.
• Over time, glucose can reach dangerously high levels in the blood, which is called  hyperglycemia. 
• Untreated hyperglycemia can result in diabetic ketoacidosis (DKA), which is a life threatening complication of diabetes. 

Risk Factors Associated with Type 1 Diabetes 

It is recommended that students displaying warning signs associated with type 1 diabetes, which are  described below, should be screened (tested) for the disease by their healthcare provider. 

Researchers do not completely understand why some people develop type 1 diabetes and others do  not; however, having a family history of type 1 diabetes can increase the likelihood of developing type  1 diabetes. Other factors may play a role in developing type 1 diabetes, including environmental  triggers such as viruses. Type 1 diabetes is not caused by diet or lifestyle choices. 

Warning Signs and Symptoms Associated with Type 1 Diabetes and Diabetic Ketoacidosis Warning signs and symptoms of type 1 diabetes in children develop quickly, in a few weeks or months,  and can be severe. If your child displays the warning signs below, contact your child’s primary health  care provider or pediatrician for a consultation to determine if screening your child for type 1 diabetes is appropriate: 

• Increased thirst 
• Increased urination, including bed-wetting after toilet training 
• Increased hunger, even after eating 
• Unexplained weight loss 
• Feeling very tired 
• Blurred vision 
• Very dry skin 
• Slow healing of sores or cuts 
• Moodiness, restlessness, irritability, or behavior changes 

DKA is a complication of untreated type 1 diabetes. DKA is a medical emergency. Symptoms include:

• Fruity breath 
• Dry/flushed skin 
• Nausea 
• Vomiting 
• Stomach pains 
• Trouble breathing 
• Confusion 

Types of Diabetes Screening Tests That are Available: 

• Glycated hemoglobin (A1C) test. A blood test measures the average blood sugar  level over two to three months. An A1C level of 6.5 percent or higher on two separate  tests indicates diabetes. 
• Random (non-fasting) blood sugar test. A blood sample is taken any time without  fasting. A random blood sugar level of 200 milligrams per deciliter (mg/dL) or higher  suggests diabetes. 
• Fasting blood sugar test. A blood sample is taken after an overnight fast. A level of  126 mg/dL or higher on two separate tests indicates diabetes. 
• Oral glucose tolerance test. A test measuring the fasting blood sugar level after an  overnight fast with periodic testing for the next several hours after drinking a sugary  liquid. A reading of more than 200 mg/dL after two hours indicates diabetes. 
• Type 1 Diabetes Treatments

There are no known ways to prevent type 1 diabetes. Once type 1 diabetes develops, medication is the  only treatment. If your child is diagnosed with type 1 diabetes, their health care provider will be able to  help develop a treatment plan. Your child’s health care provider may refer your child to an  endocrinologist, a doctor specializing in the endocrine system and its disorders, such as diabetes. 

Contact your student's school nurse, school administrator, or health care provider if you have  questions. 

E.C. 49452.7 (a) On and after July 1, 2010, the school district shall provide an information sheet  regarding type 2 diabetes to the parent or guardian of incoming 7th grade pupils. 

Description: 

Type 2 diabetes is the most common form of diabetes in adults. Until a few years ago, type 2 diabetes  was rare in children, but is becoming more common, especially for overweight teens. 

Type 2 diabetes affects the way the body is able to use sugar (glucose) for energy. 

The body turns the carbohydrates in food into glucose, the basic fuel for the body’s cells. The pancreas  makes insulin, a hormone that moves glucose from the blood to the cells. 

In type 2 diabetes, the body’s cells resist the effect of insulin, and blood glucose levels rise. Over time, glucose reaches dangerously high levels in the blood, which is called hyperglycemia. Hyperglycemia  can lead to health problems like heart disease, blindness, and kidney failure. 

Risk Factors Associated with Type 2 Diabetes: 

It is recommended that students displaying or possibly experiencing the risk factors and warning signs associated with type 2 diabetes be screened (tested) for the disease by their physician. 

Researchers do not completely understand why some people develop type 2 diabetes and others do not; however, the following risk factors are associated with an increased risk of type 2 diabetes in children: 

• Being overweight. The single greatest risk factor for type 2 diabetes in children is excess weight.  In the U.S., almost one out of every five children are overweight. The chances are more than double that an overweight child will develop diabetes. 
• Family history of disease. Many affected children and youth have at least one parent with diabetes or have a significant family history of the disease. 
• Inactivity. Being inactive further reduces the body’s ability to respond to insulin.
• Specific racial/ethnic groups. Native Americans, African Americans, Hispanics/Latinos, or Asian/ Pacific Islanders are more prone than other ethnic groups to develop type 2  diabetes. 
• Puberty. Young people in puberty are more likely to develop type 2 diabetes than younger children, probably because of normal rises in hormone levels that can cause insulin resistance  during this stage of rapid growth and physical development.

Warning Signs and Symptoms Associated with Type 2 Diabetes: 

Warning signs and symptoms of type 2 diabetes in children develop slowly, and initially there may  be no symptoms. However, not everyone with insulin resistance or type 2 diabetes develops these  warning signs, and not everyone who has these symptoms necessarily has type 2 diabetes.

• Increased hunger, even after eating. 
• Unexplained weight loss. 
• Increased thirst, dry mouth, and frequent urination. 
• Feeling very tired. 
• Blurred vision. 
• Slow healing or sores or cuts. 
• Irregular periods, no periods, and/or excess facial and body hair growth in girls. 
• High blood pressure or abnormal blood fats levels. 
• Dark velvety or ridged patches of skin, especially on the back of the neck or under the arms. 

Type 2 Diabetes Prevention Methods and Treatments 

Healthy lifestyle choices can help prevent and treat type 2 diabetes. Even with a family history of  diabetes, eating healthy foods in the correct amounts and exercising regularly can help children  achieve or maintain a healthy weight and normal blood glucose levels. 

• Eat healthy foods.  
• Make wise choices.  
• Eat foods low in fat and calories. 
• Get more physical activity.  
• Increase physical activity to at least 60 minutes every day. 
• Take medication. 

If diet and exercise are not enough to control the disease, it may be necessary to treat type 2 diabetes with medication. 

The first step in treating type 2 diabetes is to visit a doctor. A doctor can determine if a child is overweight based on the child’s age, weight, and height. A doctor can also request testing of a child's  blood glucose to see if the child has diabetes or pre-diabetes (a condition which may lead to type 2 diabetes). There are four tests that a physician may order: 

• Glycated hemoglobin (A1C) test 
• Random (non-fasting) blood sugar test 
• Fasting blood sugar test 
• Oral glucose tolerance test 

Type 2 diabetes in children is a preventable/treatable disease and the guidance provided in this information sheet is intended to raise awareness about this disease. Contact your student’s school nurse or health care provider for more information or if you have questions.

HSC 120325, 120335, 120338, 120365, 120370, and 120375 
Students must be immunized against certain communicable diseases. Students are prohibited from  attending school unless immunization requirements are met for age and grade. The school district shall  cooperate with local health officials in measures necessary for the prevention and control of  communicable diseases in school age children. The district may use any funds, property, or personnel  and may permit any person licensed as a physician or registered nurse to administer an immunizing agent to any student whose parents have consented in writing.

Beginning January 1, 2016, parents of students in any school will no longer be allowed to submit a  personal beliefs exemption to a currently required vaccine. A personal beliefs exemption on file at school prior to January 1, 2016, will continue to be valid until the student enters the next grade span at  kindergarten (including transitional kindergarten) or 7th grade.

Beginning January 1, 2021, medical exemption forms will be collected electronically by the state. Under  SB 276 and SB 714, medical exemptions will be reviewed when 1) The schools immunization rate falls  below 95% or 2) A doctor writes more than 5 medical exemptions per year beginning January 1, 2020,  or 3) A school fails to provide reports of vaccination rates to CDPH. In addition, a medical exemption  that does not meet the above criteria, may be reviewed if CDPH determines it is necessary to protect  public health. Until January 1, 2021, parents will continue to submit a medical exemption to a school  using a form or letter prepared by their medical provider. Beginning January 1, 2021, all medical  exemptions will be submitted electronically directly to the California Immunization Registry (CAIR)  utilizing a standard form. Parents of students with existing medical exemptions will need to submit a  new exemption when the student begins a new grade span. Grade spans are defined as birth to  preschool, kindergarten (including transitional kindergarten), and grades 1-6, and grades 7-12. 

Students are not required to have immunizations if they attend a home-based private school or an  independent study program and do not receive classroom-based instruction. However, parents must  continue to provide immunizations records for these students to their schools. 

The immunization requirements do not prohibit students from accessing special education and related  services required by their individualized education programs. 

A student not fully immunized may be temporarily excluded from a school or other institution when that  child has been exposed to a specified disease and whose documentary proof of immunization status  does not show proof of immunization against one of the communicable diseases described above. 

Students who are 26 years of age or younger are advised to adhere to current immunization  guidelines, as recommended, regarding full HPV immunization before first-time enrollment at an  institution of the California State University, the University of California, or the California Community  Colleges. Requires, upon a pupil's admission or advancement to the 6th grade level, the governing  authority to submit to the pupil and their parent or guardian a notification containing a statement about  the state's public policy on HPV and advising that the pupil adhere to current HPV guidelines. Specifies  that the notification provisions do not apply to a pupil in a home-based private school. 

[EC 48980.4, 1367.66, HSC 120390, 120336, 120390.6, IC 10123.8] 

EC 49423 and 49423.1 

Any pupil who is required to take, during the regular school day, medication prescribed by a physician  or surgeon, may be assisted by the school nurse or other designated school personnel or may carry  and self-administer auto-injectable epinephrine or inhaled asthma medication if the school district  receives both a written statement of instructions from the physician detailing the method, amount and  time schedules by which such mediation is to be taken and a written statement from the parent or  guardian requesting the school district assist the pupil with prescribed medication as set forth in the  physician statement. 

This law requires school districts, county offices of education, and charter schools to store emergency  epinephrine auto-injectors in an accessible location for emergency use and the specified location must  be included in their annual notifications. An Activity Supervisor Clearance Certificate is needed to  administer epinephrine auto-injectors. [EC 48985.5] 

EC 49414.7 
If a pupil with epilepsy has been prescribed an emergency anti-seizure medication by his or her health  care provider, the pupil’s parent or guardian may request the pupil’s school to have one or more of its  employees receive training in the administration of an emergency anti-seizure medication in the event  that the pupil suffers a seizure when a nurse is not available. 

E.C. 32221.5, 49470, 49473 – Under state law, school districts are required to ensure that all  members of school athletic teams have accidental injury insurance that covers medical and hospital  expenses. This insurance requirement can be met by the school district offering insurance or other  health benefits that cover medical and hospital expenses. Some pupils may qualify to enroll in no - cost or low-cost local, state, or federally sponsored health insurance programs. Information about  these programs may be obtained by calling 888-747-1222, Healthy Families Program or 760-770- 2300, Medi-Cal. 
E.C. 49471, 49472 – The governing board does NOT provide medical or hospital services for pupil  injuries. Parents interested in such coverage may obtain information on a voluntary insurance pro gram from the building principal. 

EC 49452.9 – Your child and family may be eligible for free or low-cost health coverage. For  information about health care coverage and enrollment assistance, visit the California Health  Benefit Exchange at https://www.ca.gov/service/?item=Apply-for-Medical-Insurance or go to  www.CoveredCA.com. 

Heat-induced illness is preventable. During times of high heat, the following precautions shall be  taken for all outdoor physical activity including but not limited to recess, physical education, classes,  field trips, and outdoor fine art and athletic practices and competitions. Drinking water will be easily  accessible during periods of outdoor activity. When the Heat Index reaches Category II or higher,  activity limitations will be communicated by the District Office to the Principal or designee. Each  school site shall determine a Heat Advisory Protocol for the site. Students participating in athletics  are managed using California Interscholastic Federation (CIF) guidelines in relation to Heat Illness  Prevention. 

The law requires the written emergency action plan now must include the location and procedures to  be followed in the event of heat illness related to the athletic program’s activities or events. In addition,  the California Interscholastic Federation, in consultation with the California Department of Education, to  develop guidelines, procedures, and safety standards for the prevention and management of exertional  heat illness by July 1, 2024. [EC 35179.4 and 35179.8] 

Requires school safety plans, including charter schools, serving students in grades seven (7) to twelve  (12) to include a protocol for responding in the event a pupil is suffering, or is reasonably believed to be suffering, from an opioid overdose. The CDE is required to curate and post informational materials and resources on its website on opioid overdose prevention.  

[EC 32282, 47605, 47605.6, 49414.4 and 49428.16]  

Requires LEAs to annually inform parents or guardians of the dangers associated with using synthetic  drugs and post this information on their respective internet websites. [EC 48985.5] 

(EC 49476) 

EC 49476 Prescription opioids may be used to help relieve moderate-to-severe pain and are often  prescribed following surgery or injury, or for certain health conditions. These medications can be an  important part of treatment but also come with serious risks. It is important to work with your healthcare  provider to make sure you are getting the safest, most effective care.  

WHAT ARE THE RISKS AND SIDE EFFECTS OF OPIOID USE?  

Prescription opioids carry serious risks of addiction and overdose, especially with prolonged use. An  opioid overdose, often marked by slowed breathing, can cause sudden death.  

The use of prescription opioids can have a number of side effects as well, even when taken as  directed: 

• Tolerance – meaning you might need to take more medication for the same pain relief.  • Physical dependence – meaning you have symptoms of withdrawal when a medication is stopped. • Increased sensitivity to pain  

• Constipation  

• Nausea, vomiting, and dry mouth  

• Sleepiness and dizziness 

• Confusion  

• Depression  

• Low levels of testosterone that can result in lower sex drive, energy, and strength • Itching and sweating  

RISKS ARE GREATER WITH:  

• History of drug misuse, substance use disorder, or overdose  

• Mental health conditions (such as depression or anxiety)  

• Sleep apnea  

• Pregnancy  

Avoid alcohol while taking prescription opioids. In addition, unless specifically advised by your  healthcare provider, medications to avoid include: 

• Benzodiazepines (such as Xanax or Valium)  

• Muscle relaxants (such as Soma or Flexeril)  

• Hypnotics (such as Ambien or Lunesta)  

• Other prescription opioids  

KNOW YOUR OPTIONS 

Talk to your health care provider about ways to manage your pain that do not involve prescription  opioids. Some of these options may actually work better and have fewer risks and side effects. Options  may include:  

• Pain relievers such as acetaminophen, ibuprofen, and naproxen 

47 

• Some medications that are also used for depression or seizures. 

• Physical therapy and exercise. 

• Cognitive behavioral therapy, a psychological, goal-directed approach, in which patients learn how to   modify physical, behavioral, and emotional triggers of pain and stress.  

IF YOU ARE PRESCRIBED OPIOIDS FOR PAIN  

• Never take opioids in greater amounts or more often than prescribed.  

• Follow up with your primary health care provider. 

• Work together to create a plan on how to manage your pain. 

• Talk about ways to help manage your pain that don’t involve prescription opioids.  

• Talk about all concerns and side effects.  

• Help prevent misuse and abuse. 

• Never sell or share prescription opioids. 

• Never use another person’s prescription opioids. 

• Store prescription opioids in a secure place and out of reach of others including visitors, children,  friends, and family.  

• Safely dispose of unused prescription opioids: Find your community drug take-back program or your  pharmacy mail-back program, follow guidance from the Food and Drug Administration  www.fda.gov/Drugs/ResourcesForYou 

Visit www.cdc.gov/drugoverdose to learn about the risks of opioid abuse and overdose.  If you believe you may be struggling with addiction, tell your healthcare provider and ask for guidance  or call SAMHSA’s National Helpline at 1-800-662-HELP.  

BE INFORMED 

Make sure you know the name of your medication, how much and how often to take it, and its potential  risks and side effects. For more information, visit:  

www.cdc.gov/drugoverdose/prescribing/guideline.html 

 Parents and student athletes must sign acknowledgement of receipt of the document annually. 

(EC 33479) 

Sudden Cardiac Arrest (SCA) is when the heart stops beating, suddenly and unexpectedly. When this  happens, blood stops flowing to the brain and other vital organs. SCA is not a heart attack; it is a  malfunction in the heart’s electrical system, causing the victim to collapse. The malfunction is caused  by a congenital or genetic defect in the heart’s structure. SCA is more likely to occur during exercise or  sports activity, so athletes are at greater risk. These symptoms can be unclear and confusing in  athletes. Often, people confuse these warning signs with physical exhaustion. If not properly treated  within minutes, SCA is fatal in 92 percent of cases. In a school district, charter school, or private school  that elects to conduct athletic activities, the athletic director, coach, athletic trainer, or authorized  person must remove from participation a pupil who passes out or faints, or who is known to have  passed out or fainted, while participating in or immediately following an athletic activity. A pupil who  exhibits any of the other symptoms of SCA during an athletic activity may be removed from  participating if the athletic trainer or authorized person reasonably believes that the symptoms are  cardiac related. A pupil who is removed from play may not return to that activity until he or she is  evaluated by, and receives written clearance from, a physician or surgeon. On a yearly basis, an  acknowledgement of receipt and review of information regarding SCA must be signed and returned by  the pupil and the pupil’s parent or guardian before a pupil participates in specific types of athletic  activities, which generally does not apply to those conducted during the regular school day or as part of  a physical education course.

(EC 49432) 

This policy supports the mission of the Palm Springs Unified School District by providing the  environment that cultivates maximum student potential. Nutrition and physical activity influence a  child’s development, health, well-being, and potential for learning. To afford students the opportunity to  fully participate in the education process, students must attend school ready to take advantage of their  learning environment. This wellness policy encourages all members of the school community to create  an environment that supports lifelong healthy habits. Decisions made in all school programming reflect  and encourage positive nutrition messages and healthy food choices. It shall be the mission of the  district to give all students the knowledge and skills necessary to make nutritious food choices and  healthy activity choices for a lifetime. Using a coordinated health system, the district will support health  literacy through health education, physical education and activity, health services, nutrition services,  psychological and counseling services, safe and healthy school environment, and parent/guardian and  community involvement.  

Expands the requirement that schools serving students in grades 6 through 12 stock specified  restrooms with menstrual products to include schools serving students in grades 3 to 5. [EC 35292.6]