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School-Level Communicable Disease Management Plan Overview

2023-2024 School Year

Student Success & Health Department

Office of Student Support Services

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What’s Included

Overview of the CDMP

School Team Roles & Responsibilities

Communicable Disease Prevention & Mitigation

Responding to Illness & Communicable Disease

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Overview

PPS must submit assurances to ODE that every public school and programs has a School-Level Communicable Disease Management Plan (CDMP) completed by August 25th.

Changes to the CDMP include a broader response to communicable disease in school, inclusive but not limited to COVID-19.

Schools should review and personalize their own school level CDMP and return it to the Health Services Team so that it can be publicly posted on the PPS School Health Services site by August 21st.

Previous COVID-19 SOPs have been archived. The CDMP template will provide guidance to schools about about how to prevent, detect, respond to, and recover from communicable disease.

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Regulation

Oregon has several laws that confer certain

responsibilities on school administrators:

OAR 581-022-2220: Health Services
OAR 581-022-2225: Emergency Plans and Safety Programs
OAR 333-019-0010: Disease Related School, Child Care, and Worksite Restrictions: Imposition of Restrictions

With appropriate planning and prevention strategies in place, schools can reduce the need for school exclusions and ensure that all students have access to a full school year.

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Equity

Through the use of PPS RESJ Lens, PPS works to strengthen our strategies and approaches toward more equitable outcomes for every student, especially in our individual school community responses to communicable diseases.

Schools will:

Ensure continuity of instruction for students who may miss schools due to illness.
Utilize Attendance Support and Engagement Response Team (ASERT), Student Intervention Team (SIT) and Partners Meetings to identify students and families disproportionately impacted by communicable disease.
Make reasonable accommodations and modifications to health and safety protocol requirements for students with IEP and 504 plans.

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School Health Team Roles and Responsibilities

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The School Health Team Should:

Include the following staff:

Building Administrator(s)
Front office Staff/Attendance Support Staff
School nurse/SHA
Other school staff

Assign the following roles and responsibilities as outlined in the School-Level CDMP:

Educate/train school staff and families re: communicable disease (CD) response.
Report CDs and unusual absence due to illness.
Communicate with and notify school community members as directed by the MESD CD Team.
Collaborate with the MESD CD Team and Multnomah County Health Department.

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Communicable Disease

Prevention & Mitigation

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If you feel sick, please stay home. Individuals who test positive for COVID-19 will no longer be excluded from school if they are fever free for 24 hours and symptoms are improving.

Staff and students will follow the Symptom-Based Exclusion Chart and the Communicable Disease Guidance to know when to keep students home due to excludable symptoms or a school-restrictable disease.

Stay Home When You’re Sick

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If You Test Positive for COVID-19

It is not required for you to report your positive test result to the school.

If you have COVID-19, you should stay home from school based on any excludable symptoms you are exhibiting. You do not need to isolate for a set number of days, but should stay home until symptoms resolve (see below).

Be aware that you can get others sick. If you have COVID-19:

Stay home until you have not had a fever for 24 hours without using fever reducing medication and other COVID-19 symptoms are improving.
If you experience vomiting and diarrhea, you should be symptom-free for 48 hours before returning to school.
Avoid contact with individuals at high risk for severe disease for 10 days.
Mask when you are around other people in the 10 days after you become sick or test positive.

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Effective June 17, 2023, the COVID-19 vaccination requirement for public and private school teachers, staff and school volunteers and contractors (OAR 333-019-1030) is lifted.

Schools will:

Communicate with families school required vaccines
Collect student immunization status information and enter it to Synergy and Docuware
Exclude individuals not fully immunized by exclusion day 3rd Wednesday in February.
Identify resources for students to obtain immunizations such as MCHD Student Health Centers and the OHSU Benson Wellness Center.

Vaccination

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The use of masks will remain optional for students, staff, volunteers, and visitors.

Schools will:

Ensure masks continue to be accessible in the Health Room, Isolation Space, and to students and visitors who request them.
Offer a mask when individuals have respiratory symptoms.
Individuals who test positive for COVID-19 should wear a mask for 10 days after they develop symptoms or test positive.
Order and restock masks via PeopleSoft.

*Please note that students should not wear a mask if they are sleeping.

Masking

In schools, mask use remains optional. Individuals should decide for themselves if and when it is appropriate to wear a mask based on their current health status & risk factors. Individuals may choose to wear a mask if they live with someone at high-risk of severe disease, if they have a weakened immune system or other chronic health conditions or if they are acutely ill. Please ensure that each person’s choice regarding mask use is respected.

Masks will continue to be available at schools. Please offer a mask to individuals who have respiratory symptoms, which include, but are not limited to, cough, sore throat, runny nose, fever, generalized malaise and fatigue. If you are caring for someone with respiratory symptoms, then consider putting a mask on yourself; being careful to cover both your mouth & your nose. Public health recommends that individuals who test positive for COVID-19 wear a well-fitting, multilayered mask for 10 days after symptoms appear or following the test date if they do not have symptoms.

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Symptom/ Isolation Space at School

Every PPS school building must have:

A dedicated Health Room to provide first aid and address minor illnesses and injuries
A distinct Symptom/Isolation Space or plan to separate individuals who present with communicable diseases and/or excludable symptoms from the healthy school population.

If a school is not able to provide a designated symptom space, an office or other multi-purpose space may be designated as the symptom space with additional precautions.*

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COVID-19 Testing Resources

Diagnostic (Symptom-based) Testing

To be use onsite at school for students and staff with symptoms compatible with or who have been exposed to COVID-19.

Schools will:

Remain registered if previously registered.
Identify a Testing Administrator and staff back up.
Complete required training on pg. 6
Collect consent forms for the new school year.
To re-order tests use the BinaxNOW Order Form.

iHealth/ BinaxNOW Self Test for At-Home Use

Schools may offer COVID-19 rapid self test for at home use when students have symptoms compatible with COVID-19 or have exposed during a COVID-19 outbreak (limited availability).

Self test do not require consent to provide to families.
Schools can order iHealth self-tests by submitting an iHealth Test Order Form.

Family Resources: Beginning September 25th, U.S households can order up to 4 COVID-19 test directly to their homes from COVID.gov

OHA will continue to make available Abbott BinaxNOW diagnostic testing resources for students and staff with symptoms or exposure to COVID-19 to use onsite at school through July 31, 2024. Schools will remain registered to participate in OHA’s diagnostic testing program. Registered schools can order tests for onsite, diagnostic use by completing this Abbott BinaxNOW Order Form.

Students who develop symptoms consistent with COVID-19 outside of school can be tested for COVID-19 & receive medical care at no charge at one of the school-based health clinics. Please advise the parent/guardian to call the clinic to schedule an appointment. Additionally, these clinics can provide a range of health services including sports physicals, treatment for illness and injury, vision, dental and blood pressure screenings, school immunizations, mental health services, age-appropriate reproductive health care, health education, & referrals to services they don’t offer.

To look up if student has consent on file, check in Synergy and look for the Box entitled *Consent for COVID-19 Onsite Testing* on the Student screen > Additional Tab > Under Permission.

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Handwashing and ‘covering your cough’ continue to be important components of basic hygiene and disease prevention.

Schools will:

Model and teach students when and how to wash their hands to prevent the spread of germs.

Remind staff and students to fully cover their mouth and nose when sneezing or coughing.

Consider posting hand-washing posters in bathrooms, cafeteria, and other high traffic areas.

Wash Your Hands

Cover Your Cough

All students and staff should be educated to practice good hygiene to reduce the spread of disease. The school can promote health by modeling & encouraging staff and students to effectively wash their hands throughout the day and cover coughs and sneezes. Staff are encouraged to provide the students with structured time to wash their hands or use sanitizer when entering the class, prior to meals/snacks, after using the bathroom and after recess. After using the bathroom, before eating & when hands are visibly soiled, the best practice is hand washing with soap & water for at least 20 seconds. Hand soap and sanitizer will be readily available at school. Additionally, remind students and staff to fully cover their mouth and nose with the inside of their elbow or a tissue whenever they cough or sneeze & wash their hands afterwards.

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Airflow and Circulation

Identify locations of and maintenance schedules for facility ventilation sources that improve air quality.

Identify locations in which to place one or more portable high-efficiency particulate air (HEPA) ventilators, e.g. Symptom spaces, classrooms/instruction spaces.

Educate staff about where and when to utilize non-mechanical methods such as opening doors and windows where reasonable to increase air circulation, while avoiding propping open doors that can pose a safety or security risk to students and staff (e.g., exterior doors and fire doors that must remain closed).

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Cleaning and Disinfection

Custodians are an integral part of maintaining a clean and sanitary school environment by helping prevent exposure to pathogens present in body fluids. Bodily fluids generally consist of the following: vomit, feces, blood, urine, etc.

Schools will:

Maintain regular cleaning and disinfection of high touch surfaces.
Alert custodian when there are body fluid spills for clean up.
Alert custodian for enhanced cleaning and disinfection as directed by the MESD CD Team due to a possible outbreak or increased illness in school.

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Responding to Illness and Communicable Disease

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PPS aligns our communicable disease response with Oregon’s Communicable Disease Guidance for Schools.

Our Why and Theory of Action: Racial Equity (standard 3)

Instructional Leadership: Curriculum & Instruction

(standard 4,6,7)

Data-Driven Improvement

(standard 4, 10)

Culturally-

Specific Community Building & Engagement

(standard 5, 8)

Leading Adaptive Change

(standard 10)

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When Someone Appears Sick at School

Send individuals with symptoms of illness to the MESD Nurse, SHA, or trained school staff to check symptoms and assign them to either the:

Health Room
Symptom/Isolation Space

Offer a mask to the individual while they wait.
Provide line-of-sight supervision of students at all times.
Rapid COVID-19 tests may be available for individuals with COVID-like illness.

Anytime staff notice that an individual appears ill while at school, then they send them to the health room or symptom space to be check out by the health assistant, nurse or other designated employee. If the individual has excludable symptoms, then send them to the designated Symptom Space until they are picked up. The Symptom Space is an area to separate individuals with symptoms of illness from the healthy population. The Symptom Space is separate from the Health Room, which is where students with minor injuries and chronic conditions receive care.

Do not put individuals in the Symptom Space if they have vague or somatic complaints, like a headache (without fever) or a stomach ache (without vomiting or diarrhea). Individuals with illness symptoms who have compromised immune systems or underlying health conditions, such as diabetes and sickle cell anemia, may need to be placed in a separate isolation space that is not shared with other symptomatic individuals.

Students must be continuously monitored in direct eyesight of staff at all times when in the symptom space.

Individuals with symptoms should wear a medical-grade mask if tolerated (unless they are sleeping). Staff working in the symptom space must wear, at a minimum, medical grade face mask and gloves. A face shield or gown should be worn if there is a risk of splash of bodily fluids. All PPE (except mask) should be removed when leaving the symptom space & between care of individuals. Clean and disinfect area after dismissal of an ill person while wearing full PPE.

A COVID-19 rapid test can also be provided in the symptom space for staff or students (with written consent on file) and who are onsite with symptoms.

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When Student/ Staff Reports a Restrictable Disease

The nurse/site administrator must complete a PPS Communicable Disease Information Form (SCIF) for the following reportable, restrictable diseases:

Varicella (chicken pox),
Pertussis (whooping cough)
Measles
hMPXV
Meningitis

Or if an absenteeism threshold is met.

After the SCIF is submitted, the MESD Communicable Disease (CD) Team is alerted, reviews the Form, and provides guidance to the building admin via email.

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Updates on the Communicable Disease Sheet (CDS)

Staff are no longer required to use the CDS tool to track reports of excludable illness, infectious disease or other health concerns.
The MESD CD Team will email guidance to the Building Administrator and school nurse following submission of a SCIF report.
For possible outbreaks, the MESD CD Team will provide the Building Administrator with a debrief outlining responsive steps and possibly a notification to the school community.

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Significant Student/Staff

Absence Due to Illness

Alert the building nurse and submit a SCIF.
K-12 schools and Early Learning Division (ELD) childcare providers are asked to report respiratory illnesses associated with unusually high levels of absenteeism (on any given day) to public health using the following thresholds:
At the school/facility level: ≥30% absenteeism, with at least 10 students/children or staff absent.
At the cohort level (e.g., classroom): ≥20% absenteeism, with at least 3 students/children or staff absent.

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Communication About Illness

Communication to a cohort or school community regarding communicable disease will vary depending on the disease.

The MESD Communicable Disease Team will determine if a notification to a cohort or school is needed and if a suspected outbreak is occuring at your site/program. Please do not send any communication to staff/ families without consulting the the MESD CD team.

The administrator will be responsible for notifying the affected cohort or school community.

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Scenario 1

A parent calls the school to report that their student has tested positive for COVID-19.

COVID-19 is no longer a reportable disease. No SCIF needs to be submitted.
Refer to the OHA Symptom-Based Exclusion Chart. Student may return to school after being fever-free for 24 hours without the use of fever-reducing medication AND other symptoms are improving for at least 24 hours.
Student should be encouraged to wear a mask for 10 days after they develop symptoms or test positive.
Notification to cohort or school community is not required or advised.

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Scenario 2

In a class of 25, including students and staff, 5 students are reported home sick with cough, fever, & congestion but have not been diagnosed.

Cough and fever are excludable symptoms.
Exclude each student until they are fever-free for 24 hours without the use of fever-reducing medication AND other symptoms are improving for at least 24 hours.
Nurse/Building Administrator submits a SCIF to report that a classroom absentee threshold has been met, e.g. 5 ill students in a class of 25 individuals = 20%.
MESD CD team works with Multnomah County Health Department to determine if an an outbreak of a communicable disease is present.
MESD CD Team provides Building Administrator with a debrief outlining responsive steps and possibly a notification to the school community.

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Scenario 3

School secretary receives a call that a student has been diagnosed with chickenpox (varicella).

Exclude the student.
Nurse/Building Administrator submits a SCIF to report the case of chickenpox.
The MESD Communicable Disease Support Team provides guidance to the Building Administrator or Nurse which may include notification to cohorts/classrooms in which the student was during their infectious period.
Building Administrator alerts the student’s teacher to provide the student with supplemental educational resources for the duration of the exclusion.

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Reporting Concerns

Report health concerns to the Building Administrator, MESD school health staff (Nurse or Nurse Supervisor) or the MESD CD Team at cdsupport@mesd.k12.or.us

Contact the Health Services Team in the Dept. of Student Success & Health for additional information:

Leti Ayala, layalaguillen@pps.net
Betse Thielman, ethielman@pps.net

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Thank you for helping students stay healthy and in school!