Use of Undesignated Epinephrine by Non-Nurse Personnel
Schools who adopt a policy for the use of undesignated epinephrine by non-nurse personnel may utilize one of these resources to satisfy some of the training requirements of the law. Additional training requirements include a review of the high risk areas within the school and its related facilities, and documented practice on a training device of the same type ordered for the undesignated epinephrine. It is recommended that the school RN or another medical provider be the person who provides and documents the practice session and basic understanding of the prevention, indications and use of an epinephrine auto injector.
CDC Toolkit for Managing Food Allergies in Schools
Free Epi-Pen® to schools who have physician orders for stock epinephrine
The Illinois Emergency Epinephrine Act,
PA97-0361, allows schools to stock a supply of epinephrine auto-injectors, authorizes schools to enter into an agreement with a physician to provide the school with a prescription to obtain the auto-injectors, and gives school nurses (RN) the power to administer the epinephrine to any student whom the registered nurse believes is having an anaphylactic reaction.
Mylan© Pharmaceuticals has agreed to provide free epinephrine auto-injectors (Epi-Pen®) again this school year to all schools that have a standing order for this emergency drug. The program requirements are: 1) school must have a doctor’s order for the use of this drug and 2) a representative of the school or district must sign the order form. The instructions and order forms can be accessed at
The Illinois Attorney General's office and other agencies and associations last year produced the “Physician’s Toolkit”, which among other objectives, can assist a physician in writing the school prescription. The “toolkit” also answers physician questions on liability.
The Centers for Disease Control and Prevention have identified some communicable diseases that health care providers, including nurses, must report to the state or local health department. These mandated reporters, such as health care providers, hospitals and laboratories, must report suspected or confirmed
cases of these diseases to the local health department within the number of days or hours indicated in parentheses. Due to the immediate threat posted by some diseases, the diseases listed that are immediately to be reported (within three hours) and those to be reported within 24 hours should be reported by school nurses within those time frames as soon as notified by a parent or the student's health care provider that the disease is present or suspected. Diseases that are to be reported within seven days must be accompanied by a written parental release. Refer to the
Reporting Poster for details.
For additional information, refer to the
IDPH chart on communicable diseases.
In accordance with Public Act 99-0320, the Illinois State Board of Education is part of a statewide PANDAS and PANS Advisory Council. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) or Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is a complicated condition with academic, behavioral, and social/emotional issues. The disease is often, but not always associated with the infection with the streptococcus bacteria, or "strep throat." It is misunderstood and often goes undiagnosed. Students exhibit confusing symptoms associated with signs of mental illness or other behavioral issues. Preliminary data suggest that appropriate treatment early in the course of illness and effective use of antibiotics prophylaxis may be able to prevent up to 25-30 percent of childhood mental illnesses. To learn more about this disorder, go to the
IDPH PANDAS/PANS webpage and download the recent presentation of the PANDAS/PANS Standard of Care Summit held in Springfield on Oct. 4, 2018.
Training Resources for School Nurses
The Illinois Youth Sports Concussion Safety Act (P.A. 99-0245 and its companion legislation, P.A. 99-0486) requires that if a school employs a nurse, that nurse must be a member of the school concussion oversight team. The nurse (and others on the concussion oversight team) must obtain training in concussion from an authorized training provider at least once every two years, beginning September 2016. The training course for the nurse must be one that meets the continuing nursing education requirements set by the Illinois Department of Financial and Professional Regulation (IDFPR).
- HEADS UP for Clinicians - Ongoing Online Training - 1.0 CEU
This one-hour course is provided by the Centers for Disease Control and the American College of Sports Medicine, in collaboration with medical and nursing professional association partners, including the National Association of School Nurses.
This course provides Continuing Medical Education (CME) and therefore may be used to fulfill the nurse training requirement according to IDFPR rules on continuing education.
The 1.0 Continuing Education Credit certificate
must be printed or saved at the conclusion of the course. Once you close the program you will not be able to access your certificate without repeating the course. The website also has numerous resources, including assessment checklists.
http://www.cdc.gov/concussion/HeadsUp/clinicians/index.html to register and take the course.
- Online Concussion Management Resources
The Illinois High School Association has a variety of resources on concussions on its website at
www.ihsa.org/Resources/SportsMedicine.aspx. Check under “Recent Announcements” for the latest, including guidelines for management of concussion in sports and a video on the National Federation of State High School Associations’
Concussion Risk Program.
CPR/AED Training for Students
A student who has been shown a video on cardiopulmonary resuscitation (CPR) may be in a better position to save a life in school, at home or in the community.
Public Act 097-0714, effective June 28, 2012, recommends such training for students in grades 6 through 8 as part of the school’s safety education curriculum. Schools may choose to but are not required to provide this training. The training in “hands only” CPR and in the use of automated external defibrillator (AED) may be met through a free video provided to schools courtesy of the Northwestern University Department of Emergency Medicine. The video has the endorsement of Illinois State Board of Education, the American Heart Association and other community health agencies.
Additional Diabetes Resources
Synthetic Drug Information:
Vision screening is required annually on all children in special education, children new to the district, and teacher/parent referrals. Vision screening is also required beginning at age 3 in all licensed daycare/preschool programs. Once a child begins school, vision screening is required in grades K, 2 and 8.
Health Examination and Immunization Forms
Child Health Examination Forms
Students entering kindergarten (or first grade if not previously enrolled in kindergarten), sixth grade and ninth grade at any Illinois public or private school (including charter schools) must provide proof of physical examination on a form approved by both the Illinois Department of Public Health and the Illinois State Board of Education. Students entering an Illinois school from out of state or out of country for the first time at any grade level must also provide the physical exam form. The exam must be completed no earlier than a year (365 days) prior to the start of attendance at an Illinois school.
The Child Health Examination Form labeled 11/15 must be used by students who need to provide proof of the physical exam.
Hearing screening is required annually on all children in special education, children new to the district, and teacher/parent referrals. Hearing screening is also required beginning at age 3 in all licensed daycare/preschool programs. Once a child begins school, hearing screening is required at grades K, 1, 2 and 3.
Wind Chill and Heat Index Charts
Students should be encouraged to engage in physical activity year-round, including winter, when they are adequately protected from exposure to extreme weather. Attached is a chart, created by Iowa Department of Public Health and distributed nationally, which may help school districts decide when to limit outdoor play and other activities. The chart explains both wind chill and heat index and is based on information provided to Iowa DPH by the US National Weather Service. To be most useful, the chart, if printed, should be printed in color.
Irregular Days Policy
Some students are in need of instruction provided at home or in the hospital, or another location that temporarily provides for a safe and healthy learning environment. In those situations, a certificate of need is provided by the student’s physician, advanced practice registered nurse, or physician assistant. The school district, in consultation with the parents and the health care provider, determine how much time each day the student can tolerate instructional services. These forms and documents may be but are not mandated to be used. They are provided for the convenience of the school district and could serve evidence of having met the student’s need for services related to a medical disability.
Illinois Dept. of Public Health (IDPH) Immunization Documents
- Guidelines on Administration of Medications -
Use of Undesignated Epinephrine
Use of Undesignated Opioid Antagonist
Public Act 99-0480 (also known as HB 1 and Lali’s Law) created a pilot program and process by which schools may stock an antidote to overdoses of opioid drugs in the schools.
The requirements in the legislation are many, with a number of state agencies carrying out various parts of the law. School officials and parents have taken note of recent news reports about the use of this drug (commonly referred to by the brand name Narcan® or the generic name naloxone hydrochloride) in schools. Adapt Pharma announced recently that it would provide a carton of Narcan free to all U.S. high schools. The company is also partnering with the National Association of School Nurses to provide educational materials. See
- School nurses and administrators who are interested in considering a policy on the use of this drug may want to review the
- Prescriptions for the drug are required in Illinois, whether purchased or provided free to the school.
- Training is very specific and must meet the requirements of the Act.
- In addition, a
report to ISBE is required within three days of use of the drug.
ISBE, Illinois Department of Public Health (IDPH) and the Illinois Department of Human Services (IDHS) are working collaboratively to carry out the law.
ISBE Administrative Rule 1.540 Undesignated Epinephrine Auto-injectors went into effect as of March 2, 2016.
Use of Medicinal Marijuana
Special Education and Mental Health
PANDAS and PANS Standards of Care Summit - October 4, 2018
For nearly thirty years, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) has been studied extensively at the National Institute of Mental Health (NIMH) and elsewhere across the U.S. and internationally. More recently, a consortium of clinicians, researchers, and scientists has dedicated considerable time and effort to clinical care and study of children with PANDAS and the larger cohort of patients with Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). A medically treatable cause can be found for most cases of PANDAS and PANS. Preliminary data suggest that with appropriate treatment early in the course of illness, and effective use of antibiotics prophylaxis, we may be able to prevent up to 25-30% of childhood mental illnesses.
In accordance with P.A. 99-0320, the Illinois State Board of Education is part of a statewide Advisory Council on PANDAS and PANS. The Council is charged with a number of activities including education and outreach to educators, parents, and health care providers. The Council is sponsoring a Standards of Care Summit on PANDAS/PANS on Oct. 4, 2018. Registration is fee and available at https://ipac-summit-2018.bpt.me
Residential Treatment for Youth With Mental Health Needs: A Guide for Parents and Guardians
Comprehensive System of Learning Supports
School Health Services and Health Education – What's New? Applications for Special Education Presentation
Section 504 on the Rehabilitation Act of 1973
Special Education Directors Needing Nurses to Complete Health Evaluations
Health assessments and recommendations for health-related goals for students with Individuals Education Programs (IEPs) must be provided by a Registered Nurse (RN) with an ISBE-issued Professional Educator License (PEL) endorsed in school nursing (as written in School Code). The PEL (formerly known as CSN) is the legally defined and required School Code credential for school nurses performing any job duties that include student academic evaluations.
Many RNs have completed coursework and internships leading to the PEL, but some districts have tried and been unable to hire a qualified school nurse. Such districts may apply to ISBE to hire and train a non-PEL RN and remain in compliance with special education evaluation rules if they follow these steps:
- Encourage, require, and/or support an existing staff RN with at least a bachelor’s degree to enter into an approved school nurse certification program offered by an Illinois university. DePaul University, Lewis University and the University of Illinois-Chicago currently have approved programs. The programs offer extensive distance learning options, and most nurses would be able to complete the program within 12 months.
- If time is of the essence, you may apply to ISBE to have an RN obtain an IEP designation through two other options, but only after a district submits prerequisite documents to ISBE that verify a search for a fully qualified RN (PEL with school nurse endorsement) has been made:
- An ISBE-sponsored IEP course is available through Illinois Virtual Schools. Next school year, the course will be offered once, in as many sections as needed, in a six-week course that runs Jan. 16 through Feb. 26.
- An RN may opt out of the ISBE-sponsored IEP course and directly take the school nurse content test #236, which is available from the Illinois Licensure Testing System (ILTS) beginning Sept. 3, 2018. The test option remains available through the ILTS system year-round.
It may be helpful in some districts to restructure the job duties of personnel in the nursing services department. A nurse with a bachelor’s degree who does not hold either the PEL or IEP designation may still perform 80 percent, four of the five components, of IEP health evaluations as identified in 23 IAC 226.160 (a) - Medical Review.
Hiring an RN who already holds the IEP designation does not remove the requirement upon the district to first seek a PEL school nurse and apply to ISBE to utilize the new hire who holds only an IEP designation.
Since the rule creating the IEP designation credential was instituted in the fall of 2013, 802 RNs obtained the IEP designation through additional coursework and 45 by testing out. During this same time period, 208 RNs have obtained the PEL license with the school nurse endorsement. It is important to note that fully qualified RNs (PEL with school nurse endorsement) are entitled, according to the School Code, to the same benefits and compensation as teachers.
More information is available by contacting Rebecca Doran at RDORAN@isbe.net or by reviewing information regarding the required credentials. (pursuant to 226.160 Special Education, Medical Review)
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