N.J. Admin. Code § 6A:16-2.3

Current through Register Vol. 56, No. 9, May 6, 2024

Section 6A:16-2.3 - Health services personnel

(a) The district board of education shall appoint a school physician pursuant to N.J.S.A. 18A:40-1.

1. The school district shall conduct a criminal history background check on any physician before entering into an agreement for delivery of services.

2. The school physician shall be currently licensed by the New Jersey Board of Medical Examiners in medicine or osteopathy and shall have a training and scope of practice that includes child and adolescent health and development.

3. A contract between a school district and a school physician appointed pursuant to N.J.S.A. 18A:40-1 shall include a statement of assurance that the school physician has completed the Student-Athlete Cardiac Screening professional development module developed pursuant to N.J.S.A. 18A:40-41d and has read the sudden cardiac arrest pamphlet developed pursuant to N.J.S.A. 18A:40-41.

4. The school physician shall provide, at a minimum, the following services:

i. Consultation in the development and implementation of school district policies, procedures and mechanisms related to health, safety and medical emergencies pursuant to N.J.A.C. 6A:16-2.1(a);

ii. Consultation to school district medical staff regarding the delivery of school health services, which includes special health care needs of technology-supported and medically fragile children, including students covered by 20 U.S.C. §§ 1400. et seq., Individuals with Disabilities Education Act;

iii. Physical examinations conducted in the school physician's office or other comparably equipped facility for students who do not have a medical home;

iv. Provision of written notification to the parent stating approval or disapproval of the student's participation in athletics based upon the medical report;

v. Direction for professional duties of other medical staff;

vi. Written standing orders that shall be reviewed and reissued before the beginning of each school year;

vii. Establishment of standards of care for emergency situations and medically related care involving students and school staff;

viii. Assistance to the certified school nurse or noncertified nurse in conducting health screenings of students and staff and assistance with the delivery of school health services;

ix. Review, as needed, of reports and orders from a student's medical home regarding student health concerns;

x. Authorization of tuberculin testing for conditions outlined in N.J.A.C. 6A:16-2.2(c);

xi. Review, approval, or denial with reasons of a medical home determination of a student's anticipated confinement and resulting need for home instruction; and

xii. Consultation with the school district certified school nurse(s) to obtain input for the development of the school nursing services plan, pursuant to N.J.A.C. 6A:16-2.1(b).

(b) The district board of education shall employ a certified school nurse to provide nursing services while school is in session pursuant to N.J.S.A. 18A:40-1 and 3.3.

1. The certified school nurse shall work under the direction of the school physician and chief school administrator.

2. The certified school nurse shall receive training in airway management and in the use of nebulizers and inhalers consistent with nationally recognized standards including, but not limited to, those of the National Institutes of Health and the American Academy of Allergy, Asthma and Immunology.

3. The role of the certified school nurse shall include, but not be limited to:

i. Carrying out written orders of the medical home and standing orders of the school physician;

ii. Conducting health screenings, which include height, weight, blood pressure, hearing, vision, and scoliosis pursuant to N.J.A.C. 6A:16-2.2; and monitoring vital signs and general health status for emergent issues for students suspected of being under the influence of alcohol and controlled dangerous substances pursuant to N.J.S.A. 18A:40-4 and 18A:40A-12;

iii. Maintaining student health records, pursuant to N.J.S.A. 18A:40-4 and N.J.A.C. 6A:16-2.4;

iv. Recommending to the school principal students who shall not be admitted to or retained in the school building based on a parent's failure to provide evidence of the child's immunization according to the schedules specified in N.J.A.C. 8:57-4;

v. Annually reviewing student immunization records to confirm with the medical home that the medical condition for the exemption from immunization continues to be applicable, pursuant to N.J.A.C. 8:57-4.3;

vi. Recommending to the school principal exclusion of students who show evidence of communicable disease, pursuant to N.J.S.A. 18A:40-7, 8, and 10;

vii. Directing and supervising the emergency administration of epinephrine and glucagon, and training school staff designated to serve as delegates, pursuant to N.J.S.A. 18A:40-12.6 and 12.14;

viii. Administering asthma medication through use of a nebulizer;

ix. Directing and supervising the health services activities of any school staff to whom the certified school nurse has delegated a nursing task;

x. Classroom instruction in areas related to health education pursuant to N.J.A.C. 6A:9B-14.3;

xi. Reviewing and summarizing available health and medical information regarding the student and transmitting a summary of relevant health and medical information to the child study team pursuant to N.J.A.C. 6A:14-3.4(h);

xii. Writing and updating, at least annually, the individualized health care plans and the individualized emergency healthcare plans for students' medical needs, and instructing staff as appropriate;

xiii. Writing and updating, at least annually, any written healthcare provisions required under Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794.(a), for any student who requires them;

xiv. Assisting in the development of and implementing healthcare procedures for students in the event of an emergency;

xv. Instructing teachers on communicable disease and other health concerns, pursuant to N.J.S.A. 18A:40-3; and

xvi. Reviewing completed health history update questionnaires and sharing with the school athletic trainer for review, if applicable, pursuant to N.J.S.A. 18A:40-41.7; and

xvii. Providing other nursing services consistent with the nurse's educational services certification endorsement as a school nurse issued by the State Board of Examiners and current license approved by the State Board of Nursing.

(c) School districts may appoint a noncertified nurse under the supervision of a certified school nurse to supplement the services of a certified school nurse provided that:

1. The noncertified nurse shall be assigned to the same school building or complex as the certified school nurse pursuant to N.J.S.A. 18A:40-3.3.a.

2. A noncertified nurse is limited to providing services only as permitted under the noncertified nurse's license issued by the State Board of Nursing.

N.J. Admin. Code § 6A:16-2.3

Amended by R.2002 d.134, effective 5/6/2002.
See: 34 N.J.R. 355(a), 34 N.J.R. 1667(a).
In (e), amended N.J.A.C. reference; added (g) and (h).
Repeal and New Rule, R.2006 d.366, effective 10/16/2006.
See: 38 N.J.R. 2294(a), 38 N.J.R. 4411(c).
Section was "Required school health services".
Amended by R.2007 d.184, effective 6/4/2007.
See: 39 N.J.R. 294(a), 39 N.J.R. 2243(a).
In (d)3viii, deleted "educational services certification endorsement as a school nurse issued by the State Board of Examiners and" following "nurse's".
Amended by R.2014 d.047, effective 3/17/2014.
See: 45 N.J.R. 987(a), 46 N.J.R. 505(a).
Rewrote the section.
Administrative change.
See: 46 N.J.R. 1743(a).
Amended by R.2015 d.158, effective 10/5/2015.
See: 47 N.J.R. 569(a), 47 N.J.R. 2492(b).
Added new (a)3; recodified former (a)3 as (a)4; in (a)4iii, deleted "or whose parent has identified the school as the medical home for the purpose of the sports physical examination" following "home"; in (b)3ii, substituted "18A:40A-12" for "12"; added new (b)3xvi; and recodified former (b)3xvi as (b)3xvii.
Amended by R.2021 d.073, effective 7/19/2021.
See: 53 N.J.R. 197(a), 53 N.J.R. 1216(a).
In (b)3x, updated the N.J.A.C. reference; and in (b)3xi, deleted "for the meeting" following "team".