Students and families are facing obstacles to obtaining medical exemptions from Governor Gary Herbert’s face mask mandate in schools. Alpine School District, along with many other districts in Utah, requires a doctor’s note for an exemption, and many doctors are not willing to sign them. Those unable to pay for a doctor’s visit also face difficulty.

The Utah Department of Health issued the public health order on July 17, 2020 under Herbert’s direction. It mandates the use of face coverings by students and staff in all public and private K-12 schools, with an exemption for individuals with medical conditions that make wearing face coverings difficult or dangerous. 

The directive allows but doesn’t require a school or district to require a “medical directive,” or doctor’s note, in order to grant an exemption. Alpine School District (ASD), like most districts and schools in the state, requires a doctor’s note.

Last Friday, the governor’s mandate was revised to specify the type of doctor allowed to issue a medical directive. “A school may require an individual to provide a medical directive from a Doctor of Medicine (MD), Doctor of Osteopathic Medicine (DO), Physician Assistant (PA), Advanced Practice Registered Nurse (APRN), documenting a need for an exemption.”

The situation has created a major challenge for Alicia Pead and her 12-year-old daughter, who suffers PTSD, anxiety and depression from past severe abuse. Pead lost her health insurance when she recently switched jobs. She said she can’t afford the cost of a doctor’s visit to get an exemption for her daughter. 

Pead, a single mother, drives a truck for a construction company, so she can’t be home to oversee online school, and has found it impossible to get an exemption from the school district without a doctor’s note. She was told that if she sends her daughter to school without a mask, and she can’t pick her daughter up if the school calls, her daughter will be sent home with a school resource officer.

“They’re denying my daughter an education,” Pead said, feeling like she’s “between a rock and a hard place,” with the options given her. 

Even if she could afford the doctor’s visit, she might find out the doctor won’t give one. Parents across the state are reporting that their doctors won’t sign exemptions after the Utah Medical Association put out a press release August 4 discouraging doctors from doing so.

Utah Valley Pediatrics (UVP), which has offices in nine locations across the county, does not provide medical exemptions for its patients. A statement from Kevin Moffitt, UVP administrator, referred to a statement from the Utah Chapter of the American Academy of Pediatrics, Intermountain Primary Children’s Hospital, and the University of Utah Department of Pediatrics titled “Wearing Masks at School During the Coronavirus Pandemic.”


The document strongly recommends the use of masks by all children, including those with autism and asthma. It recommends using reward systems for encouraging autistic children to comply with wearing a mask. Referring to asthmatic children, it says, “There is no evidence that a surgical or cloth mask impairs O2 intake or leads to CO2 retention.”

“UVP recommends that children should wear a mask while in school,” Moffitt said. “If a child cannot wear a mask, they should make arrangements for learning at home. If they attend school but need to remove the mask because of an acute situation such as a severe asthma attack, the child should finish the day at home and be allowed to do this without penalty. Other arrangements with the school for learning should be made for special needs children who may not be capable of wearing a mask.”

Alpine Pediatrics (AP), which has five locations in northern Utah County, allows a little more leeway. “Medical exemptions are sometimes given to children with special healthcare needs, such as those with autism or other severe developmental, thinking, or breathing problems,” said Jason Jaussi, administrator for AP.

But AP guidelines are the same for children with asthma or other pulmonary conditions. It is considered safer for them to wear a mask than not.

While Alpine School District requires a doctor’s note to grant an exemption, students who have an IEP or 504 plan that refers to their ability to wear a mask will be able to get an exemption even if they can’t get one from a doctor.

For students without those plans, masks will be strictly required. “How do we run and have school operational five days a week with 90% of our kids?” Kimberly Bird, Assistant to the Superintendent at Alpine School District, said. “We’re going to have to be very strict with what we’re expecting students to adhere to.”

Some school districts in Utah are returning to class with only half-day or every other day plans. 

Bird said that if a student is in a class with a teacher considered high-risk for COVID-19, arrangements will be made on a case-by-case basis with consideration to the needs of the students and the teacher. It is possible that students with exemptions in those classes may be separated from the other students, perhaps with the use of plexiglass barriers, or that transfer to another class may be arranged. 

The revision to the governor’s mandate issued last Friday also eliminated the option of using a clear face shield, replacing it with a mandate to use a cloth face mask. Many schools and teachers had purchased hundreds of face shields, especially for early grades where students learn the phonetic sounds essential for reading. This change has left some schools and parents scrambling to adjust their plans and acquire approved face masks.

Bird said they had purchased face shields for many of their teachers. Under the new directive, teachers in younger grades will instead wear cloth face masks with face shields. They will pull those face masks down during “phonemic instruction” so the children can see how to make the right sounds.

Schools will be lenient toward those with face shields during the first week of school as they give families time to acquire face coverings that are compliant with the new order.

Teachers and administrators are finding the frequent changes to state mandates challenging as they have had to revise plans multiple times.

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