Student Accidents Employment Poster Requirements Field

School & Department Secretarial Presentation:
June 12 and June 23, 2014
Risk Management – Mark Langdorf
Student Accidents
Board Policy 5340 – Student Accidents
The Board believes that school personnel have certain responsibilities in case of
accidents which occur in school. Said responsibilities extend to the administration of first
aid by persons trained to do so, summoning of medical assistance, notification of
administrative personnel, notification of parents, and the filing of accident reports.
Employees should administer first aid within the limits of their knowledge of
recommended practices. All employees should make an effort to increase their
understanding of the proper steps to be taken in the event of an accident.
The Superintendent shall develop administrative procedures to include the reporting of
accidents, when appropriate.
F.S. 381.0056, 1001.43
Student Accident Forms
Student accident form filled out by student in their own writing or verbatim based on injury or
Statements of witness attached to form on separate paperwork.
A copy of the student accident report may be given to the student/parent ONLY if form is filled
out by student or verbatim of student. This is to protect the District in the event of lawsuit.
If the form has any attached statements they will not be provided to student or parent. If the
parent has any questions, please direct them to Risk Management, (321) 633-1000, ext. 620.
Field Trip & Transportation
Board Policy 2340 & Board Policy 8660
Please see our website:
Select the Procedures and Criteria for Field Trips Tab (on the left side) to access these forms:
Board Policy 8660 - Transportation by Private Vehicle
2010-11 Procedures and Criteria for Field Trip Manual
Sponsors Application for Off-Campus Activity
Student Medical Release Form for Out-of-County or Overnight Travel (Band and
Choral students only)
Parent Permission and Responsibility Statement for Off-Campus Activity
Parent Permission and Responsibility Statement for Off-Campus Extra-Curricular
Statement of Insurance on Privately Owned Vehicles
Employment Posters
Employment posters are required at each worksite location
Posters should be placed in a common area such as a break room or mail room accessible to all
employees or employee groups. If not accessible to all groups additional sets of posters can be
obtained and displayed in a common area for those employees. (i.e. cafeteria workers,
2014 poster requirements on Risk Management website link:
Please contact Risk Management for additional posters or email
[email protected]
Workers’ Compensation
When to report a claim
When an employee suffers an injury in the workplace
Reporting an injury when an employee is already treating for
an injury or reporting the injury late
All injuries that occur in the workplace must be reported to Sedgwick CMS once reported
to the Employer (i.e. Supervisor notified)
When employees, volunteers, substitute teachers are injured
in the workplace, the injuries are reported to Sedgwick, CMS
When reporting a work-related injury, all the above descriptions are considered
employees for the School Board of Brevard County.
All employees injured in workplace are REQUIRED to drug
test whether seeking medical attention or not.
Workers’ Compensation
 When injured employees are placed on restrictive duties by the authorized treating
physician, it is imperative we find a way to accommodate the restrictions and return the
employee back to work.
 Please do not refer employees injured at work to the emergency room unless it is a lifethreatening condition:
Loss of consciousness or head injury/wound.
Breathing terminated or an individual who reports or shows signs of breathing difficulty.
Wounds with profuse bleeding (difficult to stop or control) to the head, abdomen, extremities.
Severed extremity or eye gouge.
Compound bone fracture (bone protruding from the skin). Other bone fractures may also be life
threatening. If you are not sure if the fracture is life threatening it is best to treat it as life threatening.
 Cardiac arrest, tight chest, or signs of a heart attack. In most cases
 These will not be workers' compensation, but they are life threatening and the decision as to whether it
is workers' compensation or not can be made after the condition is stabilized.
Worker’s Compensation website available to all employees, administrators, and secretaries:
Use of District Facilities
The main function of our school facilities, property & equipment is intended for public
educational purposes
Our facilities, property & equipment may be made available for community or other public use
as long as that use does not disrupt our main function of education (Board Policy 7510 – Use of
District Facilities)
Facility Use Agreement forms were revised as of September 2013 and may be ordered through
Printing Services. These are NCR forms that are not available on the website. Please do not copy
the facility use agreement as it has language on the back of the form that the applicant agrees to
when signing the facility use agreement
All requested information must be completed on the Facility Use Agreement form such as
Organization making application, name of President/individual completing application including
telephone number and e-mail contact information (extremely important), etc.
School Clubs, PTO/PTA/Booster Clubs
Complete a Facilities Use Agreement Form
Submit Certificate f Insurance or evidence they self-insure exposures (PTO/PTA/Booster Clubs)
No facility use costs/utilities with the exception when a school employee is required to work overtime to accommodate
another school’s use or any of the District’s performing arts theatres support a school function.
 AAU, USSSA, Girl Scouts, Boy Scouts, YMCA, Parent-Initiated Student Clubs, etc., not-for-profit school age organizations
 Charter Schools, Private Schools, churches, for-profit school age organizations, etc. where use of school property is not
the main source of income (less than 25%) annually for the business.
 Any organization that does not meet criteria listed in Category III or that utilize school property for a large
percentage (twenty-five percent (25%) or more) of its annual revenue
 Must complete a facility use agreement form
 Submit a Certificate Of Insurance evidencing General Commercial Liability policy of $1,000,000.
 All facility use fees, utilities, and school personnel and/or any additional clean-up costs outside normal personnel
schedule, weekends, holidays.
Facility Use Agreement Form-NCR Form
Amusement Type Equipment Brought onto Campus
Amusement Type Equipment
Bounce Houses
Air Filled Slides or Equipment
Dunk Tanks
Rock Climbing Walls
Facility Use Agreement/Insurance
 PTO/PTA Paying for Equipment – PTO/PTA completes Facility Use Agreement, submits
Certificate of Insurance along with amusement company’s Certificate of Insurance and a
signed Hold Harmless Agreement
 School Paying for Equipment – Amusement company completes Facility Use Agreement,
submits Certificate of Insurance along with signed Hold Harmless Agreement.
All Participating Students on Amusement Type Equipment, Parents Sign Parent’s Approval & Student
Waiver Prior To Use.
For additional information, please visit the Risk Management website link:
Amusement Type Equipment Brought onto Campus Forms
Changes to Ethics Administrative Procedures
Board Policy 3210 - Ethics
The Board wanted more clarity for this policy
Cyndi Van Meter, Associate Superintendent of Curriculum & Instruction, Dr. Beth Thedy, Assistant
Superintendent of Student Services, Dr. Mark Mullins, South Area Superintendent, Jane Cline, Central Area
Superintendent, Laura Rhinehart, North Area Superintendent, and Mark Langdorf, Director of Risk
Management worked in collaboration to develop changes.
Changes and examples have been identified for
 Conflict of Interest
 Dual Employment
 Gifts
 Personal Advertisements
Mark Langdorf will be holding training sessions with school/department administration as well as athletic
directors regarding changes.
Changes will go into effect August 11, 2014. A copy has been provided underlining changes.
Unemployment Claims
The Florida Department of Economic Opportunity makes the determination whether an individual
is qualified for benefits. The School Board of Brevard County does not make this
The Office of Risk Management responds to the Florida Department of Economic Opportunity
when a request for unemployment benefits has been filed by an employee based on the
separation process by the Human Resources and the school principal.
Documentation needed for voluntary resignation: resignation form completed by employee
Documentation needed for termination/forced resignation:
 All oral warnings reduced to writing
 Written reprimands
 Summary conferences
 Letters of suspension
 Letters of being placed on administrative leave/suspension pending investigation
 Disciplinary actions within a 14 month period
Documentation needed for employees on a leave of absence:
 Leave of absence completed by employee
 If medical leave of absence accompanying physician notes.
Locating and Viewing Board Policies and Administrative Procedures
School/Workplace Safety
The Office of Risk Management began a school/workplace safety initiative to increase safety
awareness and reduce work-related injuries at all sites.
The District's insurance broker, Arthur J. Gallagher and Company is coordinating the safety
initiatives with their Managing Director, Jim Smith, M.S., CSP.
Mr. Smith has begun to work with selected schools by initially meeting with principals and
further site safety plans will be developed in cooperation with school/department needs and
Mr. Smith's vast knowledge in workplace safety initiatives and programs.
Please visit the Risk Management link: for monthly news
letters and school/workplace safety information from Mr. Smith. Please share this information
with employees even if your site is not one of the initially selected sites Mr. Smith will visit.

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