WELLNESS REGULATION IMPLEMENTATION AND MONITORING NUTRITION EDUCATION The District Coordinated School Health Committee and the School Health Advisory Council (SHAC) composed of the District Instructional Services in conjunction with Health Services, Food and Child Nutrition Services, Physical/Health Education, Parental Involvement and Communications Departments will provide guidance and act in an advisory capacity for oversight of the Student Wellness Regulation. The Superintendent of Schools or designee will ensure compliance with established Districtwide wellness policies. The Coordinated School Health Committee will advise the administration with recommendations for the development of administrative procedures for periodic measurement of progress on implementation and goal achievement as stated in the wellness policy [see (LOCAL)]. The Superintendent of Schools or designee will provide an Annual Report to the Board on the Wellness Policy Initiatives to include: 1. Integration of a standardized health curriculum program that incorporates nutrition education; 2. Teacher training to ensure classroom implementation of the required health education standards; 3. Promotion of physical activity initiatives; 4. School menus information; 5. Wellness Policy Scorecard for each campus [see (EXHIBIT)]; 6. Youth Risk Behavior Surveys (YRBS) conducted biannually; and 7. Annual health fitness screening outcomes for grade levels as appropriate. The District wellness policy and regulation will be reviewed and updated by the District Coordinated School Health Committee and the SHAC as needed but no less than biannually. The District will implement a state-approved healthy curriculum as part of the Coordinated School Health Program that emphasizes the importance of proper nutrition. Additionally, the District will establish the following goals for nutrition education: 1. Maintenance of healthy eating behaviors; 2. Nutrition education integrated at all levels across the curriculum; DATE ISSUED: 9/29/2016 1 of 12
3. Professional development activities to prepare teachers to effectively deliver scientific-based nutrition information; 4. Coordinated nutrition messages in the cafeteria and school community; 5. Family and school community material to positively influence the health of students and community members; and 6. Adherence to state and federal guidelines and USDA Biosecurity Guidelines for School Food Service. NUTRITION GUIDELINES AND ENVIRONMENT The Coordinated School Health Committee (CSHC) will recommend age-appropriate guidelines for healthy food and beverage choices during the regular and extended school day that follow Healthier U.S. School Challenge criteria and dietary guidelines for Americans, as well as meet federal, state, and local nutrition and health requirements [see COB]. The goal is to create a healthy school environment that encourages and reinforces healthy eating and will not be dependent on revenue from high fat, low-nutrient dense foods to support school programs. The following goals were established to create a healthful eating and physical activity environment: 1. Meal time schedules will be based on enrollment, cafeteria serving, and seating capacity to minimize wait time and allow sufficient time to eat. 2. The minimum recommended eating times after being served are: a. Ten minutes for breakfast; and b. Twenty minutes for lunch. 3. Lunch will be scheduled as close to midday as possible with special consideration of time between meals for the elementary students. 4. Dining room facilities are maintained for safety, cleanliness, and comfort and provide for adequate seating. 5. Students are always provided an opportunity to eat, even if meetings or activities are scheduled during meal time. 6. Handwashing is facilitated. 7. Water is available during meals and encouraged throughout the day. DATE ISSUED: 9/29/2016 2 of 12
FOOD SAFETY AND SECURITY COMPETITIVE FOODS FUNDRAISING ACTIVITIES VENDING MACHINES USDA Biosecurity Guidelines for School Foodservice will be followed to ensure food and facility safety and security. Hazard Analysis and Critical Control Points (HACCP) plans and guidelines will be implemented by the Food and Child Nutrition Services to maintain food safety. Access to food service facilities will be limited to authorized personnel [see GKD]. Ice machines must be secured and handled by authorized personnel, to prevent cross contamination and risk of tampering [see (EXHIBIT)]. All foods made available on school campus must comply with state and local food, safety, and sanitation regulations. Individually packaged items from approved vendors are recommended for safety and sanitation purposes. Competitive foods are defined as foods and beverages sold or made available to students that compete with the school s operation of the National School Lunch Program, which includes the Seamless Summer Option, After-School Care Program, and/or School Breakfast Program. This definition includes, but is not limited to, food and beverages sold or provided in vending machines, in school stores, or as part of school fundraisers [see COB]. Competitive foods are not allowed in elementary schools during the regular or extended school day if state or federally funded. Competitive foods are allowed 30 minutes after the end of the last lunch period in middle school. High school competitive foods are not allowed before school or during meal periods with the exception of the Career and Technology Education Marketing Stores. All competitive foods sold in permitted Career and Technology Marketing Stores and vending machines or given away must comply with state and federal nutrition standards and portion size limits [see COB]. School fundraisers include food sold by school staff, students, student groups/clubs, parents or parent groups, or any other person, company or organization, and/or affiliated organizations, and must comply with state and federal competitive food rules in time, place, portion size, and nutrient content as well as Healthier U.S. Schools criteria during the regular and extended school day if state or federally funded. These groups/organizations are encouraged to engage in fundraisers that reinforce healthy behaviors. Companies providing vending machines to District schools are required to comply with wellness policy and regulations on competitive foods including nutrition standards, hours of operation, and placement of machines. Campuses are encouraged to follow the wellness policy and regulation at all times and in all locations that are not regulated by the wellness policy or regulation. [See DATE ISSUED: 9/29/2016 3 of 12
COC for further managerial requirements for vending machines.] CONCESSIONS CLASSROOM CELEBRATIONS REWARDS AND INCENTIVES AFTER-SCHOOL PROGRAM SNACKS ADDITIONAL HEALTHY SNACK INFORMATION DISTRICT EXEMPTION DAYS Concessions at school-related events outside the school day are encouraged to include healthy options, to offer plain water, and limit portion sizes to those recommended in state and federal nutrition standards and Healthier U.S. Schools criteria. Food may be used for instructional purposes as long as they are not foods of minimal nutritional value (FMNV). (FMNV provided to students as part of a cultural heritage event for instructional or enrichment purposes are allowed.) FMNV may not be given during meal times in areas where school meals are being served or consumed, and regular meal service must continue to be available to all students in accordance with federal regulations. While allowed, this should be on an occasional basis. Foods restricted by FMNV are permitted for classroom student birthday parties. These parties must be scheduled after the end of the lunch period for the designated class so that they do not replace a nutritious meal. Campus procedures on these events may be more restrictive than the regulation. Food and beverages will not be used as a reward or withholding as a punishment, with the exception of such specification in a student s individualized education plan (IEP) or 504 Accommodation Plan. Sale of competitive food is not allowed during any meal period, including when after-school snacks are served if state or federally funded. When allowed, all competitive foods for sale outside of the school meals program during the regular and extended school day must meet the state and federal nutrition standard and Healthier U.S. Schools criteria. Elementary school students may be provided one healthy snack per day outside of designated meal time, to include standardized achievement test days. The snack must comply with state and federal nutrition standards and may not be a FMNV. Packaged snacks must be in single-size servings. Parents may provide their own child with snacks during the school day with no restrictions. FMNV and other restricted foods are allowed on three Districtidentified days per year. The identified days are the last day of October or the preceding Friday, the last day before Winter Break, and Valentine s Day or the preceding Friday. These snacks may not be allowed during meal times in areas where school meals are being served or consumed. Regular meal service must continue and be available to all students on the three designated days. DATE ISSUED: 9/29/2016 4 of 12
SCHOOL MEALS NUTRITION PROMOTION HEALTH EDUCATION PHYSICAL EDUCATION The District Food and Child Nutrition Services will provide school meals to students each day that school is in session as well as a la carte items consistent with the state and federal regulations to meet the Healthier U.S. Schools criteria and adhere to or exceed USDA Food Security Guidelines. Healthy eating promotion activities may include visual cues, marketing materials, food service line placement, and incentives to encourage healthy food selection. In addition, wellness information will also be promoted at school activities. The District Health and Physical Education Department will implement, in accordance with the law, a Coordinated School Health Program to include health education consistent with nutrition, exercise, and prevention. Campuses will utilize Health Education Curriculum Planning Guides to deliver sequential and developmentally appropriate curriculum that includes state requirements [see EHAA(LEGAL), EHAA(LOCAL), and EIF(LOCAL)]. The Health and Physical Education and Health Services Departments will coordinate sharing of data results between teachers and nurses. The District will encourage parents to support their children s participation in physical fitness activities, to be active role models, and to include physical activity in family events. The District will recommend time management strategies and age-appropriate sleep requirements. The District will promote assistance/resources in stress reduction and/or management. Health education will provide and encourage peer education that encourages positive life style changes that help students with energy balance between calorie intake and energy expenditure. The District Curriculum and Instruction and Health and Physical Education Departments will implement a Coordinated School Health Program that meets the requirements of the law [see EHAB, EHAC, and EIF(LOCAL)]. Physical education and physical activity components will offer at least the required amount of physical activity for all grades. In addition, the District establishes the following goals for physical activity that fosters safer and enjoyable fitness activities for all students, including noncompetitive activities and special needs students. Physical education curriculum will address lifelong health and wellness in the form of activities that promote such learning and behavior and will not disproportionately emphasize team sports. Campuses will utilize Physical Education Curriculum Planning Guides (CPG) to teach sequential and developmentally appropriate curriculum. Physical education classes will emphasize daily moderate to vigorous activity at least 50 percent of class time. DATE ISSUED: 9/29/2016 5 of 12
Qualified physical education staff provides developmentally appropriate physical education instruction. Staff development will be available for teachers, coaches, and other identified school staff members to promote and encourage life-long physical activity for themselves and students so they will be able to administer CPR/AED and ensure their capability of handling emergencies. Physical fitness assessments will be conducted annually. [See A] PHYSICAL ACTIVITY OPPORTUNITIES PUNISHMENT HEALTH SERVICES All students in elementary schools should have an opportunity to engage in unstructured recess daily, weather/space permitting, in addition to 135 minutes per week of state-required structured physical activity that is provided in the District via three 45-minute physical education classes per week. It is recommended that either recess or physical education, but not both, should be scheduled prior to lunch each day, unless medically precluded. Recess may not reduce the required 20 minutes for eating lunch. Recess should be supervised by individuals who have received training on best practices of free play and other relevant issues. The District will encourage all classroom teachers to integrate physical activity into the academic curriculum (e.g., brain breaks, energizers, and the like) where appropriate. The District will encourage students, parents, staff, and community members to use the District s recreational facilities that are available outside the school day. Before- and after-school physical activity programs will be offered, and students will be encouraged to participate in a safe monitored area. School and/or community personnel working in the school will not use physical activity/physical education as punishment nor will physical activity/education be withheld except for physical health reasons, IEP, or 504 Accommodation Plan implementation [see FO(LOCAL)]. School health services will be considered as part of the educational program of the students of Texas. These services will be provided to all students through local education agencies, in accordance with State Board rules, standards established by the Texas State Department of Health, and applicable laws. The District will ensure appropriate coordination of school health services, other student services, and related instructional programs. The program of school health services will be maintained in accordance with the following requirements: DATE ISSUED: 9/29/2016 6 of 12
1. The school health services program will be devised and described in accordance with State Board rules and policies approved by the Board. 2. School health services will be addressed by policies of the Board, and these policies will address: a. Exclusion and reporting of students or employees who have communicable diseases. [See D] b. Emergency care of the sick. [See C and item 3e, below] c. Immunization. [See B] d. Reporting child abuse. [See FFG] e. Authority to make health appraisals of students. [See A] f. Administration of medication by school personnel. [See C] 3. School health services will include the following special functions designed to enhance and improve the learning process of students: a. Planning, developing, and evaluating: In order to make the District school health program more effective, the nurse in each school will work with the principal and appropriate classroom teachers in planning the local building program for students. The nurse and homeroom teachers will make a schedule whereby health evaluations may be accomplished with minimum interruption to the classroom programs. It may be necessary at times for students to be called from basic subjects, in which case the nurse will notify the teacher in advance and will limit the student s absence from class to a minimum. Appraisal of the school health program is necessary to measure the completeness and effectiveness of the program. The evaluation should point up its strengths and weaknesses in terms of the degree to which it has met departmental and District-wide goals. The minimum data base will be the annual statistical report of health services compiled from District-wide health professional activities, including the student health assessment activities form. b. Health counseling, which will be a helping relationship designed to assist students and parents in meeting DATE ISSUED: 9/29/2016 7 of 12
health-care needs, consisting of the following components: (1) Crisis intervention for situations involving drug abuse, suicide threats or attempts, or other indications of acute stress. Health maintenance, providing information and support in coping with illness and disability and consumer options for making health-care choices. Health counseling will be provided to students identified through the health appraisal process, a referral by the principal, teacher, parent, self, or special education department. MENTAL HEALTH RELATED ACTIVITIES (2) The District Counseling Services, Psychological and Social Services, Special Education, Youth and Family Centers, and departments will implement coordinated instruction and service delivery of mental health-related activities to include: (a) (b) (c) (d) (e) (f) (g) Required topical guidance lessons at the appropriate grade levels; Response to referrals for social, emotional, and behavioral needs for all students as appropriate and with prior written consent of the parent/legal guardian; Classroom instruction and counseling service as specified in a student s IEP or 504 Accommodation Plan; Family counseling and psychiatric services to any students with prior written consent of the parent/legal guardian; Staff training on Developmental Assets, HIV, Human Growth and Sexuality, and Positive Behavior and Intervention support-related topics upon request and as deemed appropriate; Participation in informational events for students, staff, or parents as deemed appropriate; Consultation to teachers, students, and parents regarding mental health issues as deemed appropriate; DATE ISSUED: 9/29/2016 8 of 12
(h) (i) (j) Training and implementation of the Suicide Risk Assessment/Risk of Violence Assessment and planning for students who are at risk for suicide or acts of violence; Crisis team response to any campus experiencing a death and/or crisis involving students, staff, or parents; and Bullying prevention activities and response to request for interventions in accordance with Board policy [see FFI(LOCAL)]. c. Screening that will be done at prescribed grade levels and with designated student groups. [See A(LOCAL)] d. Prevention and control of communicable diseases: The school nurse staff will be responsible for maintaining immunization records of protection levels to reduce incidence of preventable diseases and will follow Texas Department of State Health guidelines for control of diseases not amenable to immunization. Pediculosis and scalp ringworm screening will be conducted for early identification and control. e. Provision for emergency cases: Temporary and immediate care of the seriously ill or critically injured student will be administered in the following manner: (1) The nurse or other responsible person will remain with the sick or injured student at all times. (2) The student s parents will be contacted by the principal s office. (3) When parents cannot be contacted within a reasonable period of time, Youth Action Center staff will be contacted to assist in locating a responsible family member. (4) When parents cannot be located, District staff may refer to the emergency form for information about family choice of physician, hospital, and persons who may be called in an emergency. (5) In extreme emergency, the city or county emergency medical service will be called, and the student will be taken to a hospital emergency room in accordance with C. The family DATE ISSUED: 9/29/2016 9 of 12
will be billed by the city and emergency ambulance service. (6) A copy of the Student Emergency Form will be taken to the hospital room by a school staff member in the absence of the parents. (7) When parents cannot be located, a school staff member will go to the hospital and remain at the hospital with the student until the parent or other responsible family member arrives. (8) In case of emergency, the nurse will telephone a report of incident to the central school health services as soon as possible. f. Consultation and coordination with other student services and related instructional programs will focus on the health-related needs of students and their families. The school health service staff will enhance the educational setting of students by working cooperatively with educators, families, and community agencies. g. Liaison with community health resources: The school health staff will be familiar with all health and medical resources and will cultivate a two-way communication and productive work relationship with community personnel. h. Referral with follow-up, which is vital to care for acute and chronic health conditions: The nurse will notify appropriate building staff of students with significant medical defects and health program adjustment. i. Health appraisal of students: The nurse s inspection of the student will evaluate: head, eyes, ears, nose, mouth/throat, chest/breast, abdomen, musculoskeletal system, skin, nutrition, height, weight, speech, general behavior, and blood pressure. j. Maintenance of student electronic health records: A cumulative, kindergarten grade 12 student health record that serves as a supplement to the student s scholastic cumulative record will be maintained. Health record entries will be made only by the nurse or nurse aide staff, and attention will be given to the quality and authority of all health data entries. [See FL] Electronic health record screens relating to immunizations, vision, and hearing, as well as spinal screening, will be completed by Health Service personnel. DATE ISSUED: 9/29/2016 10 of 12
k. Remote health-care technology: The provision of student health-care through remote health-care technology may be used by trained school nurses to assist students with common acute health conditions that include, but are not limited to: (1) Respiratory complaints, including asthma; (2) Nasal congestion; (3) Fever; (4) Ear pain; (5) Sore throat; (6) Rash and skin irritations; and (7) Eye irritations and drainage. Remote health-care technology does not replace the need for a primary health-care provider. l. A trained school nurse staff may implement the delivery of remote health-care technology to assist students with common acute health conditions in the following manner: (1) A student presents to school nurse. (2) The school nurse determines whether remote health-care technology is appropriate to meet health-care needs of the student. (3) The school nurse verifies parent consent for remote health-care technology. (4) The school nurse contacts the remote health-care technology appointment line. (5) The school nurse conducts a remote health-care technology consult with the health-care provider. (6) The school nurse records the remote health-care technology consult in the student s electronic health record. (7) The school nurse sends a summary of the consultation home with the student that explains the student s condition, as well as treatment recommendations and next steps. HEALTH ROOM The clinics and all their compartments will be carefully designed to make them functional in delivering the diverse health services re- DATE ISSUED: 9/29/2016 11 of 12
quired for students. The objectives of the health program can be most effectively accomplished when use of the clinics is limited to the purpose for which they are intended, namely: 1. Emergency care for acutely ill and seriously injured students; 2. Screening procedures necessary to determine health status of the students; and 3. Privacy for students being screened and for parents, teachers, and students in conference. Clinics will not be used for the following: 1. Storage of nonmedical supplies and equipment such as photocopy machines, PTA supplies, and the like; 2. Dressing room for school programs or lost and found storage; 3. Office space for data controllers, computer record controllers, office clerks, teacher aides, or other nonhealth personnel; 4. Retreat for discipline cases when physical illness or injury is not involved; 5. Vending machines, coffee pots, or hot plates; 6. Staff lounge or lunch room; or 7. Passageway to other facilities. Building managers will consult with school health services personnel when clinic sites are being built or remodeled. ADOPTION OR LAST AMENDED DATE This regulation was last adopted or amended on September 9, 2016. DATE ISSUED: 9/29/2016 REVIEWED: 12 of 12