Although the district is implementing safety protocols and disinfecting efforts, families are encouraged to drop students off, carpool or walk with their students to school to reduce possible exposure on buses.  Students using school bus transportation services will follow revised protocols. Bus windows will be opened and/or partially opened to promote air circulation.

The District recommends that all students and drivers wear face masks while on the bus. 

SYMPTOMATIC STUDENT/STAFF ON CAMPUS PROTOCOL - CAMPUS

• When a student displays symptoms of COVID-19, the school nurse will assess the students and determine if and when a student needs to be sent home. In the event the student requires isolation, the school nurse will activate the COVID response team to begin case review and determine if close contact has occurred. 

• (Exception: If an individual develops a fever during the 24-72 hours after receiving dose 2 of the covid vaccine they may not have to be considered to have a covid-like illness. All students and staff must remain home while they have a fever (temperature of 100.0 F or more). The presence or absence of other symptoms will be considered in determining when the person may return to work/school.)

• Students who are determined to be ill should be picked up within 30 minutes and no later than 1 hour from the time the campus contacted the student’s parent/guardian. The parent/guardian or staff member should be encouraged to contact their primary care provider for guidance on testing or followup. 
• Staff/teacher displaying COVID-19 symptoms which are not related to an underlying condition will immediately notify an administrator and Human Resources.  The following form should be completed as soon as possible: . HR Notification of Staff COVID like/COVID positive/Close Contact Form. The administrator will verify with the employee that they have completed the form. In the event the employee has an off-campus supervisor, that supervisor shall instruct the employee to report the issue to the affected Campus Covid Response Team immediately and verify that the campus has been notified. 
• In the event a student or staff member displays highly symptomatic (two or more symptoms with at least one being COVID-like respiratory symptoms (coughing and sneezing etc)) and is sent home during the school day, the CAMPUS COVID-19 RESPONSE TEAM WILL BE ACTIVATED and the space(s) HEAVILY used by the affected individual will be disinfected as soon as possible.

CONFIRMED POSITIVE COVID-19 TEST RESULT PROTOCOL - CAMPUS

If a HCISD student/employee/volunteer has tested positive for COVID-19:

• The covid-positive person must remain off of school property and out of school functions for 
• 10 days

AND

• Fever free for at least 24 hours

AND

• Significant improvement in symptoms

• The Campus COVID Response Team will be activated to determine if the individual had close contact with any other individuals on campus. (Close contact is defined as being within 6 feet for a cumulative duration of 15 minutes or more within the 48 hours prior to the person becoming symptomatic or testing positive. It also includes being directly exposed to infectious secretions (e.g. being coughed on while not wearing a mask and face shield or without being fully vaccinated).

• Positive cases must be reported to the health department immediately 
• In the event the district is notified of a positive COVID-19 student/staff/volunteer/visitor who is actively on campus during the day, THE CAMPUS COVID-19 RESPONSE TEAM WILL BE ACTIVATED to identify and communicate with any potential close contacts.
• If the student/staff has a positive COVID-19 result and the person is NOT actively on campus, the Campus COVID response team will be activated and follow the steps below. 

INDIVIDUALS WHO HAVE BEEN IN CLOSE CONTACT WITH A COVID-POSITIVE PERSON

If a person has been identified as having been in close contact (less than 6 feet for greater than 15 cumulative minutes in the 48 hours before a person tested positive for covid-19 or began experiencing symptoms):

• Individual who had close contact MUST self-monitor for covid-like symptoms
• Quarantine is recommended, but individuals may decide based on their circumstances
• Quarantine is 10 days if the person remains asymptomatic and does not take a covid PCR test
• Quarantine is 7 days if the person remains asymptomatic and they receive a negative covid PCR test that was collected on or after day 5 of quarantine
• If a person develops any symptoms of Covid-19 within 14 days after being in close contact with a covid-positive person they MUST quarantine
• May return after negative PCR test result is provided
• If a person has close contact with a person in their home who has Covid-19 they MUST quarantine unless
• They can completely isolate themselves from the person with covid-19 for the duration of the infectious period
• They are fully vaccinated against covid-19 (at least 14 days from final vaccine injection) AND they remain asymptomatic

CAMPUS COVID RESPONSE TEAM ACTIVATION PROTOCOL 

The following steps may be completed simultaneously by different team members. 

Step 1 - Health Information Review - Nurse 

• STUDENT CASE - Ask the following questions of the positive person or their family member
• When did symptoms start? (Infectious period begins 48 hours prior to the time of symptom onset through last date on campus)
• If asymptomatic, what date was the date of the positive test (not the date of result but date of test).
• Date last on campus and locations (determine dates on campus during infectious period)
• Did the student ride the bus?
• Does the student participate in extracurriculars?
• Do they know they were within 6 feet of anyone for more than 15 minutes (if so with whom)
• Verify attendance dates for the sick student.
• STAFF CASE - Ask the following questions and ensure the campus administrator notifies HR same day with the following information:
• When did their symptoms start? (Infectious period begins 48 hours prior to the time of symptom onset)
• If asymptomatic, what was the date of the positive test (not the date of result but date of test).
• Date last on campus and locations (determine dates on campus during infectious period)
• Do they know they were within 6 feet of anyone for more than 15 minutes (if so with whom)
• Instruct the staff member to complete the HR notification form immediately , https://forms.gle/CyFvoehNY5TtpHEo9
• Please complete the form and contact HR.
• Document the case on the appropriate location in the Campus tracking sheet

Step 2 - Close Contact Identification - Administrator or COVID Team Member

• Gather assigned seating charts/rosters for classes, cafe, and bus as applicable.
• Make sure to include extra-curricular activities.
• Identify those who have been within six feet of the individual for a cumulative 15 minutes or more within a 24 hour window at any time within 48 hours before the individual’s onset of symptoms (or positive test result if asymptomatic) until the individual has left school property.
• For example, a student began experiencing symptoms on Monday and was sent home from school. The close contact review would include the 48 hours prior to symptom onset (Sat and Sun) and the date the child was last on campus before going home. The case review would be for Monday only. 
• For example, a student began experiencing symptoms on Wednesday and did not report to the nurse until Thursday at which time the student was isolated and sent home. The close contact and case review would begin 48 hours prior to symptom onset (Mon and Tues) through the date the child was last on campus before isolation (Wed and Thurs). Any close contacts on Mon-Thurs for students and staff must be identified and added to the tracking spreadsheet. 
• Quarantine : Hays CISD recommends that students and staff who are not fully vaccinated against covid-19 quarantine according to the following guidelines:
• If an individual tests on day 5 or later of the quarantine and the test result is negative, the individual may return after 7 days of the last close contact with the positive person if they do not develop any covid-like symptoms. 
• If an individual does not test, the individual may return after 10 days of the last close contact  with the positive person if they do not develop any covid-like symptoms. 
• Day of exposure is considered “Day 0”
• Day following exposure is considered “Day 1”
• PCR (not antigen or rapid) COVID test is taken on “Day 5”
• Negative test is received – can return on “Day 8” 
• No COVID test is taken – can return on “Day 11”
• Anyone who is in close contact with a covid-positive person who lives in their home MUST quarantine if they are unable to effectively isolate within the home. 
• Anyone who has been in close contact with a person who has covid-19 and becomes symptomatic MUST quarantine, regardless of vaccination status, until cleared by a physician or until they receive a negative covid PCR test.

Step 3 - Notification - Covid Team Member

NOTIFICATION WILL NOT BE SENT UNLESS A CONFIRMED POSITIVE TEST RESULT IS RECEIVED. Note - two notifications may be required. Close contact notifications should be sent first then the general campus notification. See below for the notification wording. PRIOR to any notification being sent, the administrator should notify the District COVID Response team (Director of Student Health, Director of Safety and Security, District Communications Officer, Human Resources , Chief Operations Officer, and Director of Custodial Services) must be notified. 

• Once a confirmation of a positive test result is provided for any individual on campus (student/staff/volunteer), a Campus COVID Team member will compile a list of any close contacts (to include email addresses) based on the close contacts identified in Step Two. 
• IF CLOSE CONTACTS ARE IDENTIFIED A Notification will be sent AT THE DIRECTION OF THE CAMPUS ADMINISTRATOR to ONLY those who have been determined to have close contact (within 6 feet for more than 15 minutes cumulatively) using the following message. 

Close Contact Notification Letter

Step 4 - Case Follow Up and Guidelines for Return - Nurse / HR

Human Resources is responsible for follow up with any staff members related to COVID. Nurses are responsible for any follow up with students related to COVID.

• RETURN AFTER COVID-LIKE SYMPTOMS*

Students and staff sent home with COVID-like symptoms shall not return to campus until all of the following criteria are met:

• Remain out of school for at least 10 days

AND

• At least 24 hours fever-free and significant improvement of symptoms

OR

• They are cleared of COVID-19 by a physician and provide a record of an alternate diagnosis

OR

• The student/staff has a negative Covid-19 PCR test. A rapid antigen test will not be accepted. 

• RETURN AFTER COVID POSITIVE TEST CONFIRMATION 

Students and staff self-isolating after COVID positive test result shall not return to campus until all of the following criteria are met:

• 10 days have passed since symptoms onset (or if asymptomatic 10 days since positive test date), AND
• 24 hours fever-free (without fever reducing medication, AND
• Improvement in symptoms 

• Close Contact

If, at any point in the 2 weeks after close contact occurs, a person becomes symptomatic, that person is presumed to have covid-19 until and unless they satisfy the return criteria for covid-like symptoms.

All parents and other campus visitors must check in with the front office upon arrival to the campus.  All visitors will pre-screen themselves for COVID-19 symptoms prior to visiting a district building. Visitors should not enter campuses or district buildings if any of the symptoms are present.

The safety and health of our employees and students is our top priority. Sanitation of classroom and workspaces will take place throughout the school day and each evening after dismissal of students. The cleaning steps will be instituted to disinfect workplace surfaces, chairs, tables, etc. to protect employees and reduce the risk of spread of infection. To mitigate the spread of the virus, everyone must manage their immediate area and employ good habits including wiping of surfaces, frequent hand washing and disinfecting an area whenever possible.  Reminder signage should be  prominently displayed regarding cleaning, sanitizing and disinfecting measures. 

General cleaning measures should be followed regularly. The custodial staff will clean all instructional, restroom and common areas frequently.  The cafeteria will be cleaned between lunch periods. Custodial staff will disinfect every night, starting right after the building becomes unoccupied.  However, keep in mind that they will not be able to get to all areas without help from the team.  Your willingness to aid in the mission will mitigate the spread of germs in your campus community.  

Employees will disinfect their own personal workspaces (handles, switches, counter/desk, phone, etc.) throughout the day, giving special attention to commonly touched surfaces. 

CLEANING STANDARDS 

All bottles MUST be labeled with the chemical contained within.  If you have a bottle with no label, immediately seek assistance from custodial services for a replacement. Only clean with district-approved materials.

STAFF/TEACHER Guidelines 

Category	Area	Frequency
Workspaces & Instructional Spaces	Classrooms, offices, restrooms located in classrooms	As needed AND Mid-morning and mid-afternoon; At the end of each day (At least 4 times per day) and with any student changes between classrooms.
Restricted area items	Refrigerators, microwaves, coffee machines, storage areas	Daily and as needed
Electronic Equipment*	Copy machines, shared computer stations, TV’s, telephones, keyboards, shared kiosks *Do NOT spray directly onto electronics.  Use a district approved cleaning wipe with an alcohol-based solution.	Daily and as needed
General Use Objects	Counters, handles, light switches, sinks, etc.	As needed (At least 4 times a day)

CUSTODIAL GUIDELINES

Common areas will be the primary focus of custodial staff during the school operating day including door knobs, restrooms, light switches, cafeteria, library, etc.

The daily tasks for each campus building will include measures to clean, disinfect, refill and restock cleaning materials to prepare for the next day.  Many areas will have received attention during the day to allow custodial staff to concentrate on the tasks and areas listed below:

HEATING, VENTILATION AND AIR CONDITIONING (HVAC) FILTRATION/VENTILATION GUIDELINES

The District uses a filter service to maintain filters in the HVAC equipment districtwide.Filter changes occur 10 times per year.  Prior to COVID-19, changes were made six times per year.  This change was made to address air quality in response to COVID-19 issues.

Current filters are rated at MERV 8. Existing filter frames are rated for up to MERV 11.  However, upgrading to a higher MERV filter can cause reduced air flow, freeze-up and more restriction which will ultimately lead to comfort issues.

Additionally, in response to building occupation times, the HVAC schedule has adapted to start two hours before any building is occupied per recommendations.

In response to ensuring proper ventilation by introducing outside air to increase air exchange and indoor air quality guidelines; the district has installed bi-polar ionization units in select areas.

Category	Area
Workspaces	Classrooms and offices
Nurses area & Isolation room	Areas utilized for ill or suspected ill students; this area should be deep cleaned (fogged) daily
Restricted area items	Refrigerators, microwaves, coffee machines, storage areas, teacher works rooms, break rooms, etc.
Restrooms	Counters, faucet handles and sinks, paper towel and toilet paper dispensers, toilet flush mechanism, seat and door latch, light switches, door handles, and soap refills
Common Areas	Cafeteria, water fountain bottle areas, barrier/shields, gyms, library, conference rooms, areas utilized by campus population
Trash	Staff will leave trash outside the door for removal at the end of the day.  Custodial staff will leave new bags for the room based on size and needs of left trash.

PREVENTIVE MATERIAL INVENTORY

• District leaders have provided supplies in preparation of anticipated needs.
• Each Head Custodian will establish a protocol to ensure their campus (faculty, students and staff) has an adequate supply of soap, disinfectant, hand sanitizer and paper towels in the necessary areas. 
• The campus protocol must include a process for campus restocks from existing stock AND making orders to the central warehouse in anticipation of inventory needs. 

District COVID Response Team

• Team Members - team members should consist of the following departments or positions

• Human Resources 
• Chief Operations Officer or Designee - Max Cleaver
• Chief Communications Officer - Tim Savoy
• Director of Student Health Services or Designee - Justin Mccorkle  - will serve as the District COVID-19 point of contact
• Director of Safety & Security - Jeri Skrocki
• Director of Custodial Services - Brandon Porter

• Responsibilities

• Establish district protocols for response to possible COVID affected persons according to TEA, CDC, and local health department guidelines.
• Serve as liaison between the district and the local health authority.
• Provide support and resources for campuses.
• Conduct training of district protocols for faculty, staff and students.

Campus COVID Response Teams

• Team Members - team members should consist of the following positions:

• School Nurse - will serve as the campus COVID-19 point of contact
• Head Custodian
• Principal or Assistant Principal
• Administrative Staff member who will assist with notifications

• Responsibilities

• Determine need for physical relocation of any student/classes which require deep cleaning due to use by the affected person.
• Determine necessity of required cleaning and disinfection protocols and implementation of said protocols.
• Identify individuals who were in close contact with the individual who was positive within the time the person was infectious (within 48 hours of symptom onset or positive test date). 
• Notify the District COVID Response Team and local health department as required. 
• Contact Human Resources for required employee notifications for exposure.
• Coordinate and complete required personal contacts of those with close contact.
• Coordinate and complete required district communication as needed.

Alcohol-based hand sanitizer will be available at campus entrances, in classrooms, in the cafeteria and in other district facilities. 

Staff and students will be expected to wash or sanitize their hands regularly.

Requirement for hand washing and/or use of provided hand sanitizer:

• Provide hand sanitizer upon entry to classroom and periodic teacher reminders during instructional day.
• Habitual and thorough hand washing after recess, before eating and following restroom breaks.

Ensure optimal healthy hygiene practices, including handwashing or the use of alcohol-based hand sanitizers, to prevent infections and reduce the number of viable pathogens that contaminate the hands. Handwashing is the single most effective infection control intervention (CDC). Hand sanitizing dispensers will be located throughout the campus Students, staff, and volunteers will be encouraged to wash hands/use hand sanitizer often:

SIGNAGE - Encouraging Preventative Measures 

Preventative measures signs will be posted in high-traffic areas that will educate students and staff and serve as reminders of ways to prevent the spread of COVID-19.  

In May 2021, Texas Governor Greg Abbott issued an executive order prohibiting schools in Texas from requiring masks on campus. Therefore, Hays CISD will not require masks. However, the district still strongly encourages masks for those who are not vaccinated.

Read the governor’s GA - 36 order online.

The district does not require any employee, student or volunteer to be vaccinated but strongly encourages those who are unvaccinated to wear a mask for protection of themselves and others. 

In May 2021, Texas Governor Greg Abbott issued an executive order prohibiting schools in Texas from requiring masks on campus.

Hand dryers will be disabled where possible and paper towels will be provided.

Campus staff should develop plans based on their individual campus needs to limit the number of students that enter the bathroom at one time. 

Elementary campuses could consider the scheduling of whole class restroom breaks to eliminate co-mingling of students across various classes and to ensure teacher monitoring of social distancing guidelines.

Increased disinfecting by custodial staff will occur throughout the school day. 

Staff and students must wash hands with soap and water prior to exiting the restroom.

• When possible, restroom doors will be propped open and paper towel dispensers and trash cans will be placed outside the door to ensure sanitary protection for all parties. 

Visuals indicating proper handwashing techniques and social distancing will be displayed to consistently reinforce this practice.

Staff will be required to self-screen for COVID-19 symptoms prior to reporting to work each day (including temp check) and the district may require further screening of employees at any time based on current state and federal guidelines.  

Parents/guardians are expected to screen their students for COVID-19 symptoms each day prior to sending their student to school (including temp check). 

• Parents must ensure they do not send a child to school on campus if the child has COVID-19 symptoms (as listed in this document) or is lab-confirmed with COVID-19. If a student has covid-like symptoms or has tested positive or been diagnosed with covid-19, parents must communicate this information to the campus nurse.

Staff and students should not enter campuses or district buildings if any of the following apply. 

• The individual experiences any of the following symptoms in a way that is not normal for them:
• Temperature of 100 degrees Fahrenheit or higher when taken by mouth; 
• Loss of taste or smell 
• Cough
• Difficulty breathing 
• Shortness of breath 
• Fatigue 
• Sore throat 
• Diarrhea 
• Vomiting
• Has a confirmed case of COVID-19 or is awaiting test results.

Spatial distancing, defined as keeping a safe distance of six feet when contact is longer than 15 minutes, is an effective way to prevent potential infection. Efforts should be made to avoid close contact when possible.

Close contact, defined as: 

1. direct exposure to infectious secretions (e.g., being coughed on while not wearing a facial covering) or 
2. being within six feet of the individual for a cumulative duration (meaning the total amount of time in a day that individuals are within 6 feet) of 15 minutes, within 48 hours before the individual’s onset of symptoms to the time of isolation. Close contact is regardless of mask usage. 

It is recommended that those individuals who have been in close contact self-quarantine for:

At least 7 days if the individual remains symptom-free and has a negative covid-19 test that was collected on or after day 5 of quarantine.

OR

At least 10 days if the individual remains symptom-free, but does not take a covid-19 test. 

Anyone who is in close contact with a covid-positive person who lives in their home MUST quarantine if they are unable to effectively isolate within the home. 

Anyone who has been in close contact with a person who has covid-19 and becomes symptomatic MUST quarantine, regardless of vaccination status, until cleared by a physician or until they receive a negative covid PCR test.

• Day of exposure is considered “Day 0”
• Day following exposure is considered “Day 1”
• PCR (not antigen or rapid) COVID test is taken on “Day 5”
• Negative test is received – return on “Day 8” 
• No COVID test is taken – return on “Day 11”

Teachers will be provided disinfectant supplies and will ensure high-touch areas in the classroom are disinfected throughout the day as per the cleaning protocols.

All classrooms will be outfitted with:

• Refillable alcohol-based hand sanitizer.

Whenever possible, students should maintain 3 feet from one another (6 feet when masks are not in use). 

The instructional staff should maintain a minimum of 6 feet during classroom instruction whenever possible. Staff should avoid contact within 6 feet for longer than 15 minutes.

Whenever possible, students and staff will maintain consistent groupings of people to minimize the spread of the virus. 

Staff should determine procedures for classroom movement. Dismissals should be orderly, using one way movement whenever possible. 

Small group learning in the classroom should allow for at least 3 feet of spatial distancing whenever possible.

Staff should plan for more frequent hand washing and/or hand sanitizing throughout the day. 

The use of outdoor space for learning will be considered when possible. Classroom groups working outside will maintain social distancing from other classroom groups.

The following protocols are intended to provide guidance for care of the health needs of students during the school day. In this COVID-19 pandemic, clinic processes and flow will need to be amended to protect students and staff and decrease unnecessary exposure. These guidelines are specific to the current needs of the COVID-19 pandemic and may be amended as the recommendations or situation changes. 

IDENTIFYING INDIVIDUALS AT HIGHER RISK OF COVID-19

The CDC lists  medical conditions which may cause people to be at increased risk for severe illness from COVID-19. These include:

• moderate to severe asthma
• hypertension or high blood pressure
• , pregnancy
• smoking
• diabetes mellitus

The CDC also states, “children who have medical complexity, who have neurologic, genetic, metabolic conditions, or who have congenital heart disease might be at increased risk for severe illness from COVID-19 compared to other children. Similar to adults, children with obesity, diabetes, asthma and chronic lung disease, or immunosuppression might be at increased risk for severe illness from COVID-19.” (CDC, People with Certain Medical Conditions, Updated July 17, 2020) 

CDC also notes that children with intellectual and developmental disabilities are more likely to have comorbid medical diseases of the circulatory system that may put them at increased risk for severe illness from COVID-19.

VISITS TO THE CAMPUS CLINIC

In order to prevent potential exposure to infectious diseases for vulnerable students receiving other medical treatments, all student visits to the Campus Clinic will follow campus procedure. When possible, care should be provided in the classroom. 

If a staff member believes a student needs to be seen in the clinic:

• Staff will be asked to call or radio the Campus Nurse with a request for an ill student visit.
• Students will independently walk to the campus clinic unless it is unsafe to do so or considered an emergency. 
• If it is an emergency, 911 should NEVER be delayed. Activate EMS and delegate as appropriate.

CLASSROOM-BASED CARE AND FIRST AID

First aid to the degree possible, should be handled by the student and in the classroom to prevent office congregation and possible cross exposure.  

The following recommendations are:

1. All classrooms will be stocked with limited first aid supplies (bandaids, gloves, gauze, and menstrual pads). 
2. To the extent possible, students provide self-care with staff direction and physical distancing.
3. Teachers will be able to consult over the phone with the campus nurse if guidance is needed. If it's determined that care cannot be done in the classroom the student will be sent to the designated clinic area for care. 

Teachers generally shouldn’t contact parents regarding health issues without the nurse. In the event a teacher believes a parent notification is warranted for care provided in the classroom, the teacher should touch base with the nurse regarding that communication. If a parent notification is warranted, the nurse may need to see the student. 

Teachers must contact the campus nurse prior to sending the student to the clinic if they are uncertain or need guidance about student care. Ideally teachers will consult with the campus nurse over the phone prior to sending students to the clinic. If a student arrives at the clinic prior to a phone consultation, they will be expected to wait in the designated clinic waiting location on campus until the campus nurse or principal delegated trained staff member can get to them. 

Examples of Classroom-Based Care - Teacher one pager 

• Minor Toothache / Primary Tooth comes out
• Small paper cuts, abrasions, picked scabs.
• Localized bug bites. (no HX of allergy)
• Minor headache or fatigue with no other symptoms.  
• Mild stomach ache or nausea.  
• Readily controlled nosebleeds, where the student can deliver self-care.
• Anxiety/stress/psychological issue- try calming techniques and/or contact the school counselor.

Detailed guidance on the possible student situations that should be attempted to be handled in the classroom. Teachers generally shouldn’t contact parents regarding health issues. In the event a teacher believes a parent notification is warranted for care provided in the classroom, the teacher should touch base with the nurse regarding that communication. If a parent notification is warranted, the nurse may need to see the student. 

Minor Toothache / Primary tooth comes out

• Have child rinse mouth with water
• Place tooth in tooth container from first aid kit
• Wash hands

Minor cuts / scrapes, small abrasions, picked scabs

• Wash hands and scraped area with soap and water
• Assist the student to wash hands and apply band-aid if needed.
• Wash hands.

Minor headaches and/or fatigue & student is not acting ill in the classroom, especially immediately after lunch or recess

• Encourage snack or drink water.
• Apply cool water to the face and neck.
• Rest 20 minutes.
• If worsening, contact the nurse for a clinic visit.

Mild indigestion and/or upset stomach especially immediately after lunch or recess

• Allow to use the restroom.
• Drink water.
• Rest 30 minutes.
• If worsening, contact the nurse for a clinic visit.

Localized bug bite (no known Hx of allergy) 

• Apply a cool damp paper towel.

Glasses repair

• Email or call the campus clinic to determine what supplies are needed.

Clothing

• Soiled underwear or clothing
• Classroom teachers need to encourage parents to keep supplies and multiple changes of clothing in all student backpacks.
• Students may be directed to self-clean up and discard fecal contaminated clothing in a double bag by a first aid provider, paraprofessional, or instructional aid. If the student is unable to be self-directed and needs assistance, the person assisting must have another adult present. Whenever possible, accidents should be handled in the classroom to decrease the risk of exposure.
• If the student needs to be sent home for hygiene, the parent/guardian may be contacted by the teacher, staff, or campus nurse.

GUIDELINES FOR CAMPUS OR CLASSROOM COVID-19 EXPOSURE 

In the event the campus or district is notified of a student or staff member with a positive test result, the campus administrative team/designee will begin a case review and follow reporting guidelines.

STUDENT MENTAL HEALTH

As students return, the primary goal will be to support the whole child. The HCISD Health Services Department and Counselling Department will work closely together to identify ways to support students appropriately.  

MEDICATION ADMINISTRATION

To the degree possible, make every effort to identify ways that medications may be taken at home, instead of during school hours.The following steps should be taken to ensure the safety of all students and minimize office clustering.

1. Nurses should send a letter home to all parents explaining that students that must take medication during school will need to make an appointment prior to the start of school to bring the medication in so that delivery time may be staggered. 
2. NO Nebulizing treatments will be provided on campus unless the student is incapable of using an inhaler. Any nebulizer medication delivery must be converted to an inhaler with a spacer to avoid Aerosolized Transmissible Diseases (ATD) of COVID-19 (Taras, 2020). The school nurse will work with the primary care physician and parents. 
• Aerosol Generating Procedures (AGP) are those that are more likely to generate higher concentrations of infectious respiratory aerosols than coughing, sneezing, talking, or breathing.  These procedures potentially put healthcare personnel at an increased risk for pathogen exposure and infection. 
• **In the event a nebulizer is medically necessary on campus, the nebulizer must be provided in a room separate from the health clinic that may be isolated for at least 1 hour after the procedure is complete. In addition anyone present should wear full PPE: isolation gown, goggles, face shield, KN95 mask, and outer protective surgical mask. Upon completion of the procedure the gown and protective surgical mask must be thrown away. The face shield and goggles must be cleaned before further use. 

Water fountains will be open for water bottle filling only. Administrators will provide signage, education, and oversight to ensure safe use of water fountains.

Reusable water bottles are encouraged to be utilized by every student and have been added to the school supply list. 

Water fountains will be regularly cleaned and sanitized by custodial service staff.