PRINTER'S NO. 2071
No. 1332 Session of 2006
INTRODUCED BY CONTI, SEPTEMBER 22, 2006
REFERRED TO EDUCATION, SEPTEMBER 22, 2006
AN ACT 1 Amending the act of March 10, 1949 (P.L.30, No.14), entitled "An 2 act relating to the public school system, including certain 3 provisions applicable as well to private and parochial 4 schools; amending, revising, consolidating and changing the 5 laws relating thereto," further providing for school health 6 services definitions, for health services, for dental 7 examinations and dental hygiene services, for facilities, for 8 examinations and for recommendations of health professionals; 9 deleting provisions relating to examination by family 10 physician or dentist; and further providing for care and 11 treatment of school-age children, for precautions against 12 spread of certain diseases and for medical examination of 13 school personnel. 14 The General Assembly of the Commonwealth of Pennsylvania 15 hereby enacts as follows: 16 Section 1. Section 1401 of the act of March 10, 1949 17 (P.L.30, No.14), known as the Public School Code of 1949, 18 amended or added July 15, 1957 (P.L.937, No.404), August 9, 1963 19 (P.L.641, No.339), and November 30, 2004 (P.L.1471, No.187), is 20 amended to read: 21 Section 1401. Definitions.--As used in this article-- 22 (1) "Children of school age" or "child of school age" means 23 every child attending or who should attend an elementary grade
1 or high school, either public or private, within the 2 Commonwealth and children who are attending a kindergarten which 3 is an integral part of a local school district. 4 (2) "Teachers" means professional employes, temporary 5 professional employes and substitutes and instructors in public 6 or private schools within the Commonwealth. 7 (3) "Other employes" means janitors, bus drivers, cooks and 8 other cafeteria help and all others employed at schools. 9 (4) "School physician" means a physician [legally qualified] 10 licensed to practice medicine and surgery or osteopathy or 11 osteopathic surgery in the Commonwealth, who has [been appointed 12 or approved by the Secretary of Health] contracted with a school 13 district or joint school board to provide school physician 14 services. 15 (5) "School dentist" means a [doctor of dental surgery or 16 dental medicine legally qualified] dentist licensed to practice 17 dentistry in the Commonwealth, who has [been appointed or 18 approved by the Secretary of Health.] contracted with a school 19 district or joint school board to provide school dentist 20 services. 21 (6) ["Family physician" means either a doctor of medicine 22 legally qualified to practice medicine and surgery in the 23 Commonwealth, or an osteopath or osteopathic surgeon legally 24 qualified to practice osteopathy or osteopathic surgery in the 25 Commonwealth, who has been designated by the parent or guardian 26 as the personal physician of the child.] "Primary care provider" 27 means a physician licensed to practice medicine and surgery or 28 osteopathic medicine and surgery, or other individual licensed 29 or certified to practice in the Commonwealth who works in 30 collaboration with and under the direction of a physician, who 20060S1332B2071 - 2 -
1 has been designated by the parent or guardian as the primary 2 care provider of the child. 3 (7) "[Family] Private dentist" means a [doctor of dental 4 surgery or dental medicine legally qualified] dentist licensed 5 to practice dentistry in the Commonwealth, who has been 6 designated by the parent or guardian as the [personal] primary 7 dentist of the child. 8 (8) "School nurse" means a [licensed] registered nurse 9 [properly certificated by the Superintendent of Public 10 Instruction as a school nurse] licensed to practice professional 11 nursing in the Commonwealth and certified by the Department of 12 Education as a school nurse, who is employed by a school 13 district or joint school board as a school nurse, or is employed 14 in providing school nurse services to children of school age by 15 a county health unit or a department or board of health of any 16 municipality with which a school district or joint school board 17 has contracted for school health services pursuant to the 18 provisions of section 1411 of this act. The employment of any 19 nurse employed by a school district or joint school board as a 20 school nurse prior to the effective date of this act shall not 21 be affected by a contract for school health services that may be 22 entered into by any school district or joint school board under 23 the provisions of this act. 24 (9) "Dental hygienist" means a dental hygienist licensed [by 25 the State Dental Council and Examining Board,] to practice 26 dental hygiene in this Commonwealth who is assigned to a school 27 district or joint school board, or a dental hygienist licensed 28 [by the State Dental Council and Examining Board and 29 certificated as a school dental hygienist by the Superintendent 30 of Public Instruction,] to practice dental hygiene in this 20060S1332B2071 - 3 -
1 Commonwealth and certificated by the Department of Education as 2 a school dental hygienist who is employed by a school district 3 or joint school board as a dental hygienist. The employment of 4 any dental hygienist employed by a school district or joint 5 school board as a dental hygienist prior to the effective date 6 of this act shall not be affected by a contract for school 7 health services that may be entered into by any school district 8 or joint school board under the provisions of this act. 9 (10) ["Medical technician" means a person skilled in the 10 operation of X-ray or other diagnostic equipment having such 11 training and experience as required by the Secretary of Health.] 12 "Health care assistant" means a licensed or unlicensed 13 individual who assists the school nurse, school physician, 14 school dentist or other qualified health professional by 15 performing assigned duties and who has no pupil assignments. 16 (11) ["Sanitarian" means a person having such training and 17 experience as required by the Secretary of Health and qualified 18 to conduct sanitary inspections of school buildings and grounds 19 in connection with water supply, sewage and refuse disposal, 20 food service, heating, lighting, ventilation and safety.] 21 "Qualified health professional" means an individual who holds a 22 license or certification issued by the Commonwealth which allows 23 for the performance of a physical or dental examination or 24 evaluation. 25 (12) "Asthma inhaler" means a prescribed device used for 26 self-administration of short-acting, metered doses of prescribed 27 medication to treat an acute asthma attack. 28 Section 2. Section 1402 of the act, amended or added July 29 15, 1957 (P.L.937, No.404), December 7, 1965 (P.L.1041, No.390) 30 and July 11, 2006 (P.L.1092, No.114), is amended to read: 20060S1332B2071 - 4 -
1 Section 1402. Health Services.--(a) [Each] A school 2 district or joint school board shall provide the following to 3 each child of school age [shall be given by methods established 4 by the Advisory Health Board], in accordance with guidelines 5 issued by the Department of Health: 6 (1) a vision [test by a school nurse, medical technician or 7 teacher,] screening; 8 (2) a hearing [test by a school nurse or medical technician,] 9 screening; 10 (3) a [measurement of height and weight by a school nurse or 11 teacher, who shall use the measurement to compute a child's 12 weight-for-height ratio,] growth screening, which shall include 13 computation of a child's weight-for-height ratio; 14 (4) [tests for tuberculosis under medical supervision,] a 15 scoliosis screening; and 16 (5) such other tests as the [Advisory Health Board] 17 Department of Health may deem advisable to protect the health of 18 the child. [Vision tests shall be given at least annually and 19 other tests at intervals established by the Advisory Health 20 Board.] 21 A school district or joint school board shall make information 22 available to the parent or guardian of each child informing the 23 parent or guardian of the health screenings to be performed 24 during the school year. School nurses and other qualified school 25 personnel as determined by the rules and regulations of the 26 Department of Health shall be authorized to perform screenings 27 under this section. 28 (a.1) Every child of school age shall be provided with 29 school nurse services: Provided, however, That the number of 30 pupils under the care of each school nurse shall not exceed one 20060S1332B2071 - 5 -
1 thousand five hundred (1,500). 2 (b) [For each child of school age, a comprehensive health 3 record shall be maintained by the school district or joint 4 school board, which shall include the results of the tests, 5 measurements and regularly scheduled examinations and special 6 examinations herein specified.] A school district or joint 7 school board shall maintain for each child of school age a 8 health record which shall include the following: 9 (1) a record of immunization as required by Article XIII; 10 (2) results of all screenings and measurements; 11 (3) results of regularly scheduled and special examinations; 12 (4) documentation of special health care needs and plans of 13 care; and 14 (5) other information as specified by the Department of 15 Health. 16 (b.1) Health records shall be maintained on forms prescribed 17 by or approved by the Department of Health. 18 (c) Medical questionnaires, suitable for diagnostic 19 purposes, furnished by the Secretary of Health and completed by 20 the child or by the child's parent or guardian, at such times as 21 the Secretary of Health may direct, shall become a part of the 22 child's health record. 23 (d) All teachers and other employes shall report to the 24 school nurse [or], school physician or school dentist any 25 unusual behavior, changes in physical appearance, changes in 26 attendance habits and changes in scholastic achievement, which 27 may indicate impairment of a child's health. The school nurse or 28 school physician or school dentist may, upon referral by the 29 teacher or other employe or on his own initiative, advise a 30 child's parent or guardian of the apparent need for a special 20060S1332B2071 - 6 -
1 medical or dental examination. If a parent or guardian fails to 2 obtain the examination or fails to report the results to the 3 [nurse or school physician] school nurse, school physician or 4 school dentist, the [nurse or school physician] school nurse, 5 school physician or school dentist shall arrange, in 6 collaboration with the parent or guardian, a special [medical] 7 physical or dental examination for the child. 8 (e) [The school physicians of each district or joint board 9 shall make a medical examination and a comprehensive appraisal 10 of the health of every child of school age, (1) upon original 11 entry into school in the Commonwealth, (2) while in sixth grade, 12 (3) while in eleventh grade, and (4) prior to the issuance of a 13 farm or domestic service permit unless the child has been given 14 a scheduled or special medical examination within the preceding 15 four months. The health record of the child shall be made 16 available to the school physician at the time of the regularly 17 scheduled health appraisals.] A school district or joint school 18 board shall ensure evidence of a physical examination of every 19 child of school age: 20 (1) within one year prior to original entry into school; 21 (2) one year before or during the fourth grade; 22 (3) one year before or during the eighth grade; 23 (4) one year before or during the eleventh grade; and 24 (5) prior to the issuance of an employment certificate, or 25 farm or domestic service permit. 26 (e.1) A physical examination under subsection (e) shall be 27 performed by the child's own primary care provider and the 28 parent or guardian shall provide the results of the physical 29 examination to the school district or joint school board. If the 30 parent or guardian does not provide the results of the physical 20060S1332B2071 - 7 -
1 examination prior to the deadline established by the school 2 district or joint school board for the conduct of the 3 examination, the school district or joint school board shall 4 schedule the child to be examined by a qualified health 5 professional designated by the school district or joint school 6 board. 7 (f) The Secretary of Health, upon petition of the school 8 board or joint school board or on his own initiative with the 9 concurrence of the school board or joint school board, may 10 [modify for individual school districts] approve a modification 11 to the school health services program specified in this 12 [section] this article. [The program as modified shall conform 13 to approved medical or dental practices and shall permit valid 14 statistical appraisals of the various components of the 15 program.] Modifications must conform to generally accepted 16 standards of medical, dental and nursing practices. 17 Section 3. Section 1403 of the act, amended August 27, 1963 18 (P.L.1380, No.535), is amended to read: 19 Section 1403. Dental Examinations and Dental Hygiene 20 Services.--(a) [All children of school age in the Commonwealth, 21 (i) upon original entry into the school, (ii) while in the third 22 grade, and (iii) while in the seventh grade, shall be given a 23 dental examination by a school dentist: Provided, however, That 24 this requirement shall not apply to those school districts or 25 joint school boards which have instituted a program of dental 26 hygiene services as provided in subsection (b) of this section.] 27 A school district or joint school board shall ensure evidence of 28 a dental examination of every child of school age: 29 (1) within one year prior to original entry into school; 30 (2) one year before or during the third grade; and 20060S1332B2071 - 8 -
1 (3) one year before or during the seventh grade. 2 (a.1) A dental examination under subsection (a) shall be 3 performed by the child's own private dentist and the parent or 4 guardian shall provide the results of the dental examination to 5 the school district or joint school board. If the parent or 6 guardian does not provide the results of the dental examination 7 prior to the deadline established by the school district or 8 joint school board for the conduct of the examination, the 9 school district or joint school board shall schedule the child 10 to be examined by a school dentist. 11 (b) Any school district or joint school board may institute 12 a program of dental hygiene services for children of school age, 13 which program shall be approved by the [Secretary] Department of 14 Health, and for that purpose may employ dental hygienists. 15 Section 4. Sections 1404 and 1405 of the act, added July 15, 16 1957 (P.L.937, No.404), are amended to read: 17 Section 1404. [Place of Examination; Use of Hospital 18 Facilities.--The school physician and school dentist shall 19 conduct medical, dental and other examinations in rooms set 20 aside for this special purpose and equipped with adequate 21 facilities and with such other accessories as may be required by 22 the Secretary of Health for the thorough examination of 23 children. The school physicians shall require the removal of 24 sufficient clothing to insure complete examination. If 25 facilities in schools are inadequate for conducting medical, 26 dental and other examinations, the school districts or joint 27 school boards and private schools may, subject to the approval 28 of the Secretary of Health, make arrangements for the use of 29 laboratories and facilities of hospitals or clinics for 30 examinations herein provided for.] Facilities for Delivery of 20060S1332B2071 - 9 -
1 Health Services.--Health services delivered to children of 2 school age by school health program staff shall be provided in 3 rooms or facilities set aside for this purpose and equipped to 4 meet minimum standards as required by the Department of Health. 5 A school district or joint school board may, subject to the 6 approval of the Department of Health, make arrangements for the 7 use of alternate facilities for the provision of health 8 services. 9 Section 1405. [Assistance; Presence of Parents.--Every 10 school physician shall be assisted by a school nurse and every 11 school dentist by a dental hygienist, if available, or trained 12 assistant, who shall be present during each examination. Parents 13 or guardians of children of school age shall be advised in 14 advance of the date of examination and urged to be present. 15 Medical examinations shall be made in the presence of the parent 16 or guardian of the child when so requested by the parent or 17 guardian.] Physical Examinations and Dental Examinations or 18 Dental Screenings by Qualified Health Professionals.--(a) A 19 qualified health professional designated by a school district or 20 joint school board shall perform an examination only when the 21 parent or guardian of a child of school age fails to obtain a 22 private examination within the time frames specified by the 23 school district or joint school board. A school nurse, dental 24 hygienist or health care assistant shall assist the qualified 25 health professional during the examination. A school with a 26 dental hygiene services program may use a dental hygienist to 27 perform a dental screening and permit a school nurse or health 28 care assistant to assist during a dental screening. 29 (b) A school district or joint school board shall advise the 30 parent or guardian of a child in advance of the date, time and 20060S1332B2071 - 10 -
1 place of a physical or dental examination or dental screening 2 and invite the parent or guardian to be present. A physical or 3 dental examination or dental screening shall be made in the 4 presence of the parent or guardian of a child when the parent or 5 guardian requests to be present. A school district or joint 6 school board shall obtain the prior written consent of the 7 parent or guardian before a qualified health professional 8 conducts a physical or dental examination or dental screening. 9 (c) A qualified health professional performing a physical or 10 dental examination or dental screening shall have access to a 11 child's health record maintained by the school. The results of 12 the physical or dental examination or dental screening shall be 13 recorded on forms prescribed or approved by the Department of 14 Health and included in a child's health record. 15 Section 5. Section 1406 of the act, amended December 9, 2002 16 (P.L.1317, No.153), is amended to read: 17 Section 1406. [Recommendations.--(a) Recommendations as to 18 medical, surgical or dental care shall be sent to each parent or 19 guardian and to the family physician or family dentist on forms 20 prepared or approved by the Secretary of Health with 21 instructions to the parent or guardian to consult the family 22 physician or family dentist and to notify the school authorities 23 of the action taken with respect to the recommendations. 24 (b) School physicians or school nurses shall inform teachers 25 of the health conditions of pupils which may affect behavior, 26 appearance or scholastic performance.] Referral for Evaluation 27 and Treatment.--(a) In the event the school district or joint 28 school board provides the physical or dental examination, the 29 school district or joint school board shall send the 30 recommendation of a qualified health professional for further 20060S1332B2071 - 11 -
1 evaluation or treatment of a child to the child's parent or 2 guardian with instructions to the parent or guardian to consult 3 the child's primary care provider, private dentist or other 4 appropriate health care provider and to notify the school nurse 5 of the action taken with respect to the recommendation. 6 (c) Notice of the existence of and eligibility for the 7 program under Article XXIII of the act of May 17, 1921 (P.L.682, 8 No.284), known as "The Insurance Company Law of 1921," shall be 9 prepared by, paid for and provided to each school district in 10 Pennsylvania by the Insurance Department annually, not later 11 than the fifteenth day of August, in sufficient quantities to 12 provide the parent or legal guardian of every school student 13 enrolled in the district with such notice. The school district 14 shall provide such notice to the parent or guardian of each 15 student enrolled in the district during the school year. The 16 Insurance Department shall provide sufficient copies of the 17 notice to nonpublic schools upon request. 18 Section 6. Section 1407 of the act is repealed. 19 Section 7. Sections 1414 and 1416 of the act, added July 15, 20 1957 (P.L.937, No.404), are amended to read: 21 Section 1414. [Care and Treatment of Pupils] Ancillary 22 Health Services.--Any school district or joint school board may 23 provide for the health care and treatment of [defective eyes, 24 ears and teeth of] all children of school age within the 25 district if the school district or joint school board has 26 obtained prior written consent of the child's parent or 27 guardian. 28 Section 1416. [Precautions Against Spread of Tuberculosis.-- 29 No person having any form of tuberculosis in a transmissible 30 stage shall be a pupil, teacher, janitor or any other employe in 20060S1332B2071 - 12 -
1 any school except in a special school carried on under the 2 regulations made for such schools by the Secretary of Health. 3 The board of directors of any school district or joint school 4 board may appropriate the necessary funds to pay for X-ray or 5 other medical examinations to determine the presence or absence 6 of tuberculosis in any teacher, janitor or other employe of the 7 district.] Precautions Against the Spread of Communicable 8 Disease.--A student or any person having direct contact with 9 students having or suspected of having a communicable disease, 10 infection or condition listed in 28 Pa. Code § 27.71 (relating 11 to exclusion of children, and staff having contact with children 12 for specified diseases and infectious conditions), 27.72 13 (relating to exclusions of children, and staff having contact 14 with children, for showing symptoms) and 27.75 (relating to 15 exclusion of children, and staff having contact with children, 16 during a measles outbreak) shall be excluded from school in 17 accordance with the applicable regulation. Readmission to school 18 shall be governed by 28 Pa. Code § 27.71, 27.73 (relating to 19 readmission of excluded children, and staff having contact with 20 children) or 27.74 (relating to readmission of exposed or 21 isolated children, and staff having contact with children), as 22 applicable. A school district or joint school board may 23 appropriate the necessary funds to pay for examinations and 24 testing to determine the presence or absence of a communicable 25 disease. 26 Section 8. Section 1418 of the act, amended July 14, 1971 27 (P.L.229, No.47), is amended to read: 28 Section 1418. [Medical Examinations of Teachers and Other 29 Persons.--(a) All teachers, janitors, cooks and other cafeteria 30 help and all others employed at schools shall be required to 20060S1332B2071 - 13 -
1 take a pre-employment medical examination, the results of which 2 shall be recorded on forms prescribed by the Secretary of Health 3 and shall be made available to the employing authorities. 4 (b) Each teacher, any other school employe and any person 5 providing services for school children under contract shall be 6 given tests for tuberculosis in accordance with rules and 7 regulations adopted by the Advisory Health Board. Each student 8 teacher and volunteer participating in student activities shall 9 be given the same tests for tuberculosis, but no person shall be 10 required to submit to a particular test if he shall furnish a 11 statement setting forth adequate reasons for being excused from 12 taking the test. In such case, an alternative method of testing 13 shall be administered. 14 (c) School boards may require a special medical examination 15 for any school employe at any time. 16 (d) Medical examinations shall be made by the school 17 physician of the district if provision therefor is made by the 18 district or joint school board or by a physician of the 19 employe's own choice legally qualified to practice medicine and 20 surgery or osteopathy or osteopathic surgery in the 21 Commonwealth.] Health Evaluations of School Personnel.--(a) A 22 school district or joint school board shall insure that each 23 teacher and other employe, prior to beginning work, provides 24 documentation on a form prescribed or approved by the Department 25 of Health evidencing a physical examination performed by a 26 qualified health professional within one (1) year prior to the 27 person's start date. The results of the physical examination 28 shall include information showing that the individual was 29 evaluated for tuberculosis risk factors and for other 30 communicable diseases listed in 28 Pa. Code § 27.71 (relating to 20060S1332B2071 - 14 -
1 exclusion of children, and staff having contact with children, 2 for specified diseases and infectious conditions), § 27.72 3 (relating to exclusion of children, and staff having contact 4 with children, for showing symptoms) and § 27.75 (relating to 5 exclusion of children, and staff having contact with children, 6 during a measles outbreak) and tested as necessary. 7 (b) A school district or joint school board shall insure 8 that each individual, including a volunteer, who will have 9 direct contact with students for ten (10) or more hours weekly, 10 be evaluated prior to contact with students for tuberculosis 11 risk factors and other communicable diseases as listed in 28 Pa. 12 Code §§ 27.71, 27.72 and 27.75 and tested as necessary. 13 Documentation shall be provided on a form prescribed or approved 14 by the Department of Health. 15 (c) School boards may require a special medical examination 16 for any school employe at any time. 17 (d) The physical examination and evaluation for tuberculosis 18 risk factors, other communicable diseases and special medical 19 examinations shall be made by the school physician, or other 20 qualified health professional of the district, or by a qualified 21 health professional of the employe's own choice. 22 Section 9. The Department of Education shall establish a 23 three-year implementation schedule for phasing in the physical 24 examination requirements for school-age children under section 25 1402(e) of the act. 26 Section 10. This act shall take effect in 180 days. I15L24BIL/20060S1332B2071 - 15 -