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702 KAR 1:160. School health services


Published: 2015

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      702 KAR 1:160. School health services.

 

      RELATES TO: KRS 156.160(1)(h), (i), (j),

156.501, 156.502, 158.035, 158.160, 158.838, 161.145, 214.034, 214.036, 29

C.F.R. 1910.1030

      STATUTORY AUTHORITY: KRS 156.070,

156.160(1)

      NECESSITY, FUNCTION, AND CONFORMITY: KRS

156.070(1) requires the Kentucky Board of Education to manage and control all

the common schools and all programs operated in these schools. KRS

156.160(1)(h) requires the board to promulgate administrative regulations

governing medical inspection, physical and health education and recreation, and

other administrative regulations necessary or advisable for the protection of

the physical welfare and safety of the public school children. KRS

156.160(1)(i) and (j) require the board to promulgate administrative

regulations governing a required vision examination and a dental screening or examination.

This administrative regulation establishes criteria for preventive student health

care examinations at the local school district level.

 

      Section 1. School Employee Medical

Examinations. (1) Except as provided in subsection (2) of this section, a local

board of education shall require a medical examination of each certified or

classified employee, including each substitute teacher. The medical examination

shall:

      (a) Be conducted prior to initial

employment; and

      (b) Include a tuberculosis (TB) risk

assessment.

      1. If the individual is identified by

that assessment as being at high risk for TB, the individual shall be required

to undergo the administration of a tuberculin skin test (TST) or a blood test

for Mycobacterium tuberculosis (BAMT).

      2. The TB risk assessment shall be

performed and reported by a physician, an advanced practice registered nurse, a

physician’s assistant, or a registered nurse.

      (2) The medical examination requirement

shall not apply to school bus drivers who are covered by 702 KAR 5:080.

      (3) A local board of education may

require by policy that a school employee physical examination be conducted no

earlier than a ninety (90) day period prior to initial employment.

      (4) A medical examination shall be

reported on the form Medical Examination of School Employees, KDESHS001, or an

electronic medical record that includes all of the data equivalent to that on

the Medical Examination of School Employees form.

      (5) A person who tests positive for TB

shall be required to comply with the directives of the local board of health

and the Kentucky Department for Public Health for further evaluation and

treatment of the TB infection.

      (6)(a) Following the required medical

examination for initial employment and any subsequent examinations as may be

required for positive tuberculin reactors, a school district employee other

than a bus driver shall submit to the local school superintendent the completed

Medical Examination of School Employees form or an electronic medical record

that includes all of the data equivalent to that on the Medical Examination of

School Employees form required by subsection (4) of this section.

      (b) The medical examination shall be performed

and signed for by a physician, physician's assistant, or an advanced practice

registered nurse. Transmission of an electronic medical record to the school

district via email from the health care provider’s office may be accepted as

the official signature.

      (7) Documentation of a TST, BAMT, and

chest x-ray, if performed, shall include:

      (a) The date given;

      (b) Type of test;

      (c) Millimeters of induration;

      (d) Date read and by whom; and

      (e) Date x-ray taken and results as

related to TB status.

      (8)(a)1. A local board of education shall

require all school personnel exhibiting symptoms of chronic respiratory disease

to undergo a TB risk assessment and examinations as indicated.

      2. The evaluation and any recommended

treatment for TB infection shall be based upon the directives of the local

board of health and the Kentucky Department for Public Health.

      (b) An employee exposed to infectious TB

shall be tested and, if necessary, treated for TB infection according to the

directives of the local board of health.

      (c) The school district shall require

school district employees to undergo more extensive testing for TB if:

      1. The number of active TB cases in the

county is equal to or greater than the national average, as established by the

Department for Public Health, Division of Epidemiology and Health Planning,

Tuberculosis Prevention and Control Program; and

      2. The local board of health, with the

approval of the Kentucky Department for Public Health, requires more extensive

testing for TB of school district employees.

 

      Section 2. Preventive Student Health Care

Examinations. (1)(a) A local board of education shall require a preventive

health care examination for students within one (1) year prior to initial entry

to school.

      (b) A second examination shall be

required within one (1) year prior to entry into the sixth grade.

      (c) A third examination may be required

by policy of the local board of education within one (1) year prior to entry

into the ninth grade.

      (2) An out-of-state transfer student

shall be required to submit documentation of a preventive health care examination.

      (3) A local board of education may extend

the deadline by which to obtain a preventive student health care examination,

not to exceed two (2) months.

      (4) A preventive student health care

examination shall be performed and signed for by a physician, an advanced

practice registered nurse, a physician's assistant, or by a health care

provider in the early periodic screening diagnosis and treatment programs.

Transmission of an electronic medical record to the school district via email

from the health care provider’s office may be accepted as the official

signature.

      (5) A preventive student health care

examination shall be reported on the Preventive Student Health Care Examination

Form, KDESHS002, or an electronic medical record that includes all of the data

equivalent to that on the Preventive Student Health Care Examination Form, and

shall include:

      (a) A medical history;

      (b) An assessment of growth and

development and general appearance;

      (c) A physical assessment including

hearing and vision screening; and

      (d) Recommendations to the school

regarding health problems that may require special attention in classroom or

physical education activities.

      (6)(a) A vision examination shall be

reported on the form, Kentucky Eye Examination Form for School Entry,

KDESHS004, or other electronic medical record that includes all of the data

equivalent to that on the Kentucky Eye Examination Form for School Entry.

      (b) A dental screening or examination

shall be reported on the form, Kentucky Dental Screening/Examination Form for

School Entry, KDESHS005, or other electronic medical record that includes all

of the data equivalent to that on the Kentucky Dental Screening/Examination

Form for School Entry.

      (7) A local school district shall

establish a plan for implementation and compliance required for the sixth grade

preventive student health care examination.

      (8) A current Immunization Certificate,

EPID-230, incorporated by reference into 902 KAR 2:060, or an immunization

certificate meeting the requirements of 902 KAR 2:060, Section 4, shall be on

file within two (2) weeks of the child's enrollment in school.

      (9) (a) A board of education shall adopt

a program of continuous health supervision for all currently enrolled students.

      (b) Supervision shall include scheduled

screening tests for vision and hearing.

      (10) A school shall have emergency care

procedures, which shall include:

      (a) First aid facilities meeting the

requirements of 702 KAR 4:170, including provisions for designated areas for

the child to recline;

      (b) A requirement that whenever children

are present during school hours, there shall be at least one (1) adult present

in the school who is certified in a standard first aid course which includes

CPR for infants and children;

      (c) A requirement that, at all times when

enrolled students, for whom documentation under KRS 158.838(2) or (7) has been

provided to the school, are present during school hours or participating in

school-related activities, there is a school employee who is trained to

administer and can administer or assist with the self-administration of

glucagon, insulin, or seizure rescue medications. A student shall be permitted

to conduct the actions and possess the supplies and equipment described in KRS

158.838(7) at school-related activities regardless of whether the student is a

participant or mere observer of the school-related activity;

      (d) A number at which parents can be

reached; and

      (e) The name of a family physician.

 

      Section 3. Cumulative Health Records. (1)

A school shall initiate a cumulative health record for each student entering

its school.

      (a) The record shall be maintained

throughout the student’s attendance.

      (b) The record shall be uniform and shall

be on the form Student’s Cumulative Health Record, KDESHS006, or the record

shall be maintained electronically in the student information system.

      (c) The record shall include screening

tests related to growth and development, vision, hearing, and any dental

screenings other than the initial dental screening recorded on the Kentucky Dental

Screening/Examination Form for School Entry, KDESHS005, and findings and

recommendations of a health care provider and a dentist.

      (d) A follow-up by the proper health or

school authorities shall be made on each abnormality noted, and the result

shall be recorded.

      (2) A local school district shall report

all known or suspected cases of communicable disease immediately to the local

health department.

 

      Section 4. School District Health

Personnel. (1) A superintendent shall designate a person to serve as school

health coordinator for the district. The person designated shall meet the following

minimum qualifications:

      (a) A valid license to practice as a

registered nurse, issued under KRS 314.041 by the Kentucky Board of Nursing,

and three (3) years of registered nursing practice, as defined in KRS 314.011(6);

      (b) A school psychologist certificate,

issued by the Education Professional Standards Board (EPSB) pursuant to 16 KAR

2:090, and a minimum of three (3) years of related work experience in a school

setting; or

      (c) A school social worker certificate,

issued by the EPSB pursuant to 16 KAR 2:070, and a minimum of three (3) years

of work experience practicing social work in a school setting.

      (2) The school health coordinator shall

work in cooperation with all school personnel, the local board of education,

the department, the local health department, and family resource and youth

services centers, in promoting and implementing a school health services

program.

 

      Section 5. Delegation to Perform

Medication Administration. A local board of education shall require proof that

all unlicensed school personnel who have accepted delegation to perform medication

administration in school have completed a training course provided by the

department or allowed under KRS 158.838(1)(c). The department’s course shall be

developed in consultation with the Kentucky Board of Nursing to ensure

compliance with 201 KAR 20:400 and KRS 156.502.

 

      Section 6. Incorporation by Reference.

(1) The following material is incorporated by reference:

      (a) "Medical Examination of School

Employees", KDESHS001, January 1, 2015;

      (b) "Preventive Student Health Care

Examination Form", KDESHS002, January 1, 2015;

      (c) "Student’s Cumulative Health

Record", KDESHS006, January 2, 2015;

      (d) "Kentucky Eye Examination Form

for School Entry", KDESHS004, January 1, 2015; and

      (e) "Kentucky Dental

Screening/Examination Form For School Entry", KDESHS005, January 2, 2015.

      (2) This material may be inspected,

copied, or obtained, subject to applicable copyright law, at the Division of

District Support, Department of Education, 500 Mero Street, Frankfort, Kentucky

40601, Monday through Friday, 8 a.m. to 4:30 p.m. (SBE

48.011; 1 Ky.R. 81; eff. 11-13-1974; Am. 5 Ky.R. 1086; eff. 8-1-1979; 7 Ky.R.

28; eff. 9-3-1980; 8 Ky.R. 1162; 9 Ky.R. 114; eff. 6-22-1982; 1315; eff.

7-6-1983; 17 Ky.R. 2245; eff. 3-13-1991; 18 Ky.R. 1202; 2256; eff. 1-10-1992;

19 Ky.R. 2494; 20 Ky.R. 75; 509; eff. 8-5-1993; 26 Ky.R. 1449; eff. 3-10-2000;

27 Ky.R. 1332; eff. 1-15-2001; 34 Ky.R. 628; 1421; eff. 1-4-2008; 36 Ky.R. 653;

1218; eff. 1-4-2010; Recodified from 704 KAR 4:020, 1-13-2012; 38 Ky.R. 1799;

39 Ky.R. 28; eff. 7-13-2012; 41 Ky.R. 597; 1101; 1337; eff. 1-5-2015.)