Students with Chronic Health Conditions Regulation

Section J - Students

Regulation Title: Students with Chronic Health Conditions
Regulation Code: JHD-R

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Identification/Referral Process

  • At the beginning of school, the school nurse will review health data and note any students who were previously diagnosed as students with chronic health conditions.
  • The school nurse will refer all students with a current Medical Certification of Student with Chronic Health Condition form (JHD-E1) to the school's 504 Coordinator. The 504 coordinator will review the certification and determine whether a 504 team should be convened to consider whether further accommodations are necessary or review of a current 504 plan is necessary.
  • Attendance clerks will review attendance data. When a student's absences indicate an illness, disease, pregnancy complications, or an accident or severe health problems of an infant child of a student, attendance staff will inform the school nurse who will assess for possible intervention in securing a chronic health certification.
  • Additionally, the parent, guidance counselor, health staff, or teacher may initiate the process for chronic medical certification by informing the school nurse.
  • Upon referral, the school nurse will provide the parent with a letter of explanation and the Medical Certification of Student with a Chronic Health Condition form (JHD-E1) which needs to be completed by a licensed medical doctor, podiatrist, osteopathic physician, chiropractor, naturopathic physician, physician's assistant or nurse practitioner.
  • When the completed chronic medical certification form is returned to the school nurse, the nurse shall review the form for completeness and then complete the instructional plan (JHD-E2). (See below) The medical certification form may be retroactive up to fourteen (14) days.
  • Unless the original chronic medical certification is designated as permanent per the healthcare provider, an updated medical certification shall be obtained for each school year to verify the need for continuing instructional modifications and ADM adjustment, if applicable. However, the student may be recertified at any time to reevaluate appropriate services needed.
  • The Guidance Counselor, attendance clerk/office manager, principal or principal designee, and the 504 Coordinator will be notified of the chronic medical certification status of the student.


  • All students with a certified chronic medical certification form will be recorded in the electronic student file. Original records will be kept in the student's health folder. A copy of the Medical Certification of the Student with Chronic Health Condition (JHD-E1) will be placed in the student's cum file.
  • Each student absence must be coded appropriately when a chronic health condition exists. Parents will be instructed by the school nurse as to how to call in an absence due to a chronic health condition.

Provision of Instructional Services and Instruction Plan

  • If a student has a Section 504 plan for the same condition as the chronic medical certification, an instructional plan will not be needed.
  • If no 504 plan is in place, appropriate instructional services will be documented by the school nurse on an instructional plan (JHD-E2) specifying (1) the delivery and return of homework assignments, (2) the anticipated contact time with the teacher, (3) the physical activity restrictions and other limitations affecting school activities as set forth by the healthcare provider and any specific restrictions requiring flexibility in physical education classes. The nurse may also include suggestions to assist teachers in working with students who have identified chronic health conditions. The school nurse will send the plan electronically to teacher and provide a copy to the parent.
  • On a yearly basis, the District shall review instructional needs of every student with a chronic health condition.

Homebound Services Eligibility
If the student absences exceed three (3) school months (or sixty [60] school days), a review of services will be convened and a process of continuous learning will be decided. If Homebound Services are appropriate, the policies for referral shall be followed which may entail:

  • Obtaining parental consent to evaluate student placement for Homebound Services.
  • Obtaining Medical Certification for Homebound Services.

Additional Provisions

  • Homework assignments will be provided during absences of students with medical certification of chronic health conditions, and credit will be given for course work completed within established time lines. Course credit will be given for completed course requirements.
  • The counselors who schedule students with chronic health conditions will take into consideration the anticipated days of absence (noted on the medical certification form) and feasibility of completing courses requiring laboratory work or vocational workshops.
  • Physical education course-work requirements shall include flexibility and adaptation for students with chronic health conditions to participate in regular program activities as much as their health permits.

File Maintenance

Reviewed: 8-17-07 (Friday Report)
Revision: 01/22/2015

Legal Ref: A.R.S. 15-346, Policies and Procedures Concerning Pupils with Chronic Health Problems

Cross Ref: IHBF - Homebound Instruction
IHAE - Physical Education
JE -Student Attendance
IHBA - Special InstructionalPrograms and Accommodations for Disabled Students

Replaces TUSD Regulation # 5501 Students with Chronic Health Conditions