13A.05.05.07

.07 School Health Services Standards — For All Students.

A. Physical Examination.

(1) A physical examination is required of each child entering the Maryland public school system for the first time. The examination shall be completed within the period of 9 months before entrance or 6 months after entrance. The physical examination form designated by the Department of Education and the Department of Health and Mental Hygiene shall be used to meet this requirement.

(2) The physical examination shall be completed by a physician or certified nurse practitioner.

(3) For each school year each public school shall report to the local board of education or local health department the number of children entering the public school system for the first time who have not had a physical examination because of the lack of access to health care, insufficient financial resources, or any other reason, including a religious reason, as the public school deems appropriate.

(4) An effort should be made to facilitate students and their families in obtaining a physical examination. However, if a student is unable to obtain a physical examination, the student may not be excluded from school.

(5) For each school year the local board of education or local health department shall report the number of children who have not had a physical examination and the reason or reasons for not obtaining the physical examination to the Department of Health and Mental Hygiene.

B. Review of Students' Health Records. The initial review of students' health records may be conducted by the designated school health professional or a school health services aide. The review of records shall include a review of the student's health history, health screening reports, physical examination form as designated by the Department of Education and the Department of Health and Mental Hygiene, dental examination records, and other health reports. During the record review, the designated school health services professional or school health services aide shall document whether the student has a primary care provider. Students with health problems or concerns identified during the initial review of records by the school health services aide shall be referred to the designated school health services professional for a health appraisal.

C. Health Appraisal. A health appraisal for students identified through the review of records as having health problems or concerns shall be conducted by the designated school health services professional. The health appraisal may include health observations, interviews, and conferences with parents/guardians, students, educators, and other health professionals. Health appraisals shall be conducted as follows:

(1) The health appraisal shall take place not later than 6 months after the date of entry to a school system and after that as indicated in §C(2), of this regulation.

(2) The health appraisal of students with identified health problems shall be repeated as frequently as deemed necessary by the designated school health services professional.

(3) Screening of students shall be carried out according to mandated or recommended screening programs established by the Department of Education and the Department of Health and Mental Hygiene. These shall include:

(a) Hearing and Vision Screening Tests. The local board of education or local health department shall provide and fund hearing and vision screenings for all students in the public schools. The local health department shall provide and fund hearing and vision screenings for all students in any private school that has received a certificate of approval under Education Article, §2-206, Annotated Code of Maryland, and students in any nonpublic educational facility in this State approved as a special education facility by the Department.

(b) Unless evidence is presented that a student has been tested within the past year, these hearing and vision screenings shall be given in the years that a student enters a school system, enters the first grade, and enters the eighth, or ninth grade. Additional screenings may be required under the policies adopted by the local board of education or local health department.

(c) The results of the hearing and vision screenings shall be made a part of the permanent record file of each student and given to the parents of any student who fails the screenings and reported to the local board of education or the local health department. If a student fails the screenings, the parent/guardian shall report on the recommended services received by the student to the local board of education or local health department on an approved form.

(d) The local board of education or local health department shall report to the Department of Health and Mental Hygiene the results of the hearing and vision screenings and, to the extent practicable, the number of students receiving the recommended services.

(e) Students may be exempt from these hearing and vision screenings if the parent/guardian objects in writing on the ground that it conflicts with the tenets and practice of a recognized church or religious denomination of which the parent/guardian is a member.

(4) When a health problem has been identified through the health appraisal process, the designated school health services professional or designee shall notify and assist students, or parents/guardians, or both, in selecting recommended services.

(5) For students without a usual source of care, the designated school health services professional or designee shall assist the student/family to identify a primary care provider.

(6) The designated school health services professional shall be responsible for follow-up.

(7) The designated school health services professional or the school health services aide shall inform appropriate school personnel of students who have health problems which may impede learning or require special care, or both.

D. Health Counseling.

(1) The designated school health services professional shall offer health counseling after the identification of a health need.

(2) If any additional counseling services are required, the designated school health services professional shall assist students and families in selecting the additional counseling services.

E. Communicable Diseases.

(1) A school shall comply with the Department of Health and Mental Hygiene's immunization requirements in accordance with COMAR 10.06.04.

(2) The principal or the principal's designee shall notify the local health department of all suspected or diagnosed cases of reportable communicable diseases in compliance with Health-General Article, Title 18, Annotated Code of Maryland. The local health department shall assist the local board of education in implementing a plan for preventing the spread of the reported disease.

(3) The local health department and the local board of education, following State guidelines, shall jointly develop written policies and procedures for dealing locally with outbreaks of nonreportable communicable diseases such as scabies, pediculosis, and athlete's foot.

F. Physical Education Program.

(1) The designated school health services professional shall be available for consultation in planning, implementing, and evaluating those aspects of the physical education program which specifically relate to the health and safety of the participants.

(2) Before participating in interscholastic sports, students shall have a physical examination in compliance with COMAR 13A.06.03.02I. A copy of the results of the physical examination shall be kept in the school health record.

(3) In compliance with COMAR 13A.06.03.04B(3), all coaches shall be required to enroll and complete a one-credit course in the prevention and care of athletic injuries.