Clinical Procedure Guidelines for Connecticut School Nurses

Clinical Procedure Guidelines for Connecticut School Nurses

6. Entry/Re-entry Process

It is the responsibility of local school districts to promote and ensure the earliest possible entry into school of any eligible child. Unnecessary barriers to immediate school entry have uniformly been deemed illegal by the courts. There are, however, a few “necessary” restrictions to entry, 

A current health assessment and up-to-date immunizations are essential for student enrollment in Connecticut schools.

which exist in Connecticut law to protect the health of an individual student, others in the school building or the community in general. Connecticut General Statutes Sections 10-204 and 10-206 require that prior to entry into school students must show proof of:

  • a completed program of immunizations or initiation of an ongoing schedule of immunizations to meet the requirements; and
  • a health assessment.

The intent of these mandated restrictions on school entry is fourfold:

  1. To prevent students from entering school with communicable diseases that may put others are risk (such as active tuberculosis).
  2. To ensure that adequate levels of immunization are maintained in the community to prevent outbreaks of those diseases controlled through immunization.
  3. To identify children with previously unknown health conditions that may be cured or ameliorated with proper treatment, or of students with inadequate immunization protection.
  4. To ensure that students with chronic or significant health conditions are assessed for special needs in school and that health care providers communicate those needs to school health personnel who can then plan for appropriate school adaptations, services or monitoring.
Exception: Subtitle VII-B of the McKinney-Vento Homeless Assistance Act

Homeless students have the right to enroll in school immediately, even if lacking documentation normally required for enrollment, such as:

  • previous school records;
  • medical or immunization records;
  • proof of residency;
  • birth certificate;
  • proof of guardianship; or
  • other documents.

If a student does not have immunizations, or immunization or medical records, the local homeless education liaison must assist in obtaining them immediately; the student must be enrolled in school in the interim. Federal law supersedes state and local laws where there is a conflict (U.S. Constitution, Article VI).

In the large majority of cases, these health requirements are sufficient to protect the safety of the student and others, and school entry can proceed rapidly as long as these basic requirements are met. Assessment and planning for special services, program adaptations and/or the development of a health care plan, if indicated, can proceed at the time of or after the student’s entry into school.

For some students, entry or re-entry into school requires a more complex process. These students have known health conditions, which may require:

  • advanced planning to ensure appropriate management of a potential physiological or psychological emergency in school;
  • advanced preparation of personnel, the environment, and other protections necessary to prevent deterioration in the student’s health condition while in school; or
  • specialized health services requiring planning and preparation in advance of the student’s attendance.

In order to accommodate these students safely, it is critical that school districts, regional educational service centers, and other educational settings develop a process to ensure assessment of the student’s individual health and safety needs in school and allow for sufficient preparation of both personnel and the environment before entry. This assessment and planning process, which may require some delay in school entry, should serve to minimize risks to the student once in school, and to maximize his or her potential to benefit from the educational program. When possible, advanced notification to schools by the parent or guardian and primary health care provider may allow the school adequate preparation time and eliminate the need for a delay at the desired time of entry. When advanced notification is not feasible or has not occurred, delay in entry must be restricted to the absolute minimum time necessary to prepare for safe entry into school. If, for any reason, this delay may be longer than three weeks, an alternative education program, such as interim homebound, should be immediately developed and implemented until entry can proceed.

The development of appropriate entry procedures for new students and re-entry procedures for students who have been absent due to illness, injury, hospitalization, or outside placement in an educational program, should promote:

  • family and professional collaboration;
  • a safe environment; and
  • the provision of appropriate health and other related services.

While procedures should be both straightforward and consistent, they should also be flexible and based on the collaborative judgments of families and professionals. Additionally, the process may vary depending on the point of entry/re-entry, the child’s age and presenting health needs, established family-professional relationships, and other factors. Regardless of these variations, the health assessment component of the entry/re-entry process is essential for all students with known or potential health impairments, whether physiological or psychological in nature. For example, when a student’s presenting health need is behavioral or psychiatric in nature, the school psychologist or school social worker often takes the leadership role in the process of educational assessment and planning. The process is further enhanced when the mental health professional closely collaborates with the school nurse in the health assessment and development of the individualized health care plan.


Connecticut Department of Public Health: Immunization Program.

Connecticut General Statutes. Chapter 169 School Health and Sanitation: Section 10-204a, Required immunizations. Section 10-204b, Rubella immunization. Section 10-204c, Immunity from liability. Section 10-206, Health assessments.

Immunization Requirements for Newly Enrolled Students at Connecticut Schools.

McKinney-Vento Homeless Assistance Act. Reauthorized in January 2002 as Title X, Part C, of the No Child Left Behind Act. Retrieved on November 30, 2011.