S 606 Session 111 (1995-1996)
S 0606 General Bill, By Short
Similar(H 3771)
A Bill to amend Title 59, Chapter 65, Code of Laws of South Carolina, 1976,
relating to attendance of pupils, by adding Article 7 so as to enact the
School Health Act of 1995 so as to require pre-school health assessments as a
prerequisite to attending kindergarten or first grade and to provide
exceptions; and to amend Title 20, Chapter 7, relating to the Children's Code,
by adding Article 28 so as to direct each school district in conjunction with
the Department of Health and Environmental Control to convene a school health
planning committee to assess the health status of children and to develop and
implement a school-based health services program to complement existing health
services to be provided for students at the option of the parents and to
provide for the services to be provided, confidentiality of records, and
billing and program review procedures.
03/07/95 Senate Introduced and read first time SJ-6
03/07/95 Senate Referred to Committee on Education SJ-6
05/08/95 Senate Committee report: Favorable with amendment
Education SJ-10
02/01/96 Senate Read second time SJ-9
02/01/96 Senate Ordered to third reading with notice of amendments SJ-9
02/06/96 Senate Amended SJ-183
02/06/96 Senate Special order SJ-183
02/08/96 Senate Amended SJ-21
02/08/96 Senate Read third time and sent to House SJ-29
02/13/96 House Introduced and read first time HJ-23
02/13/96 House Referred to Committee on Education and Public
Works HJ-24
AS PASSED BY THE SENATE
February 8, 1996
S. 606
Introduced by SENATOR Short
S. Printed 2/8/96--S.
Read the first time March 7, 1995.
A BILL
TO AMEND TITLE 59, CHAPTER 65, CODE OF LAWS OF
SOUTH CAROLINA, 1976, RELATING TO ATTENDANCE OF
PUPILS, BY ADDING ARTICLE 7 SO AS TO ENACT THE
SCHOOL HEALTH ACT OF 1996 SO AS TO REQUIRE
PRE-SCHOOL HEALTH ASSESSMENTS AS A PREREQUISITE
TO ATTENDING KINDERGARTEN OR FIRST GRADE AND
TO PROVIDE EXCEPTIONS; AND TO AMEND TITLE 20,
CHAPTER 7, RELATING TO THE CHILDREN'S CODE, BY
ADDING ARTICLE 28 SO AS TO DIRECT EACH SCHOOL
DISTRICT IN CONJUNCTION WITH THE DEPARTMENT OF
HEALTH AND ENVIRONMENTAL CONTROL TO CONVENE
A SCHOOL HEALTH PLANNING COMMITTEE TO ASSESS
THE HEALTH STATUS OF CHILDREN AND TO DEVELOP
AND IMPLEMENT A SCHOOL-BASED HEALTH SERVICES
PROGRAM TO COMPLEMENT EXISTING HEALTH CARE
SERVICES TO BE PROVIDED FOR STUDENTS AT THE
OPTION OF THE PARENTS AND TO PROVIDE FOR THE
SERVICES TO BE PROVIDED, CONFIDENTIALITY OF
RECORDS, AND BILLING AND PROGRAM REVIEW
PROCEDURES.
Amend Title To Conform
Whereas, South Carolina and the Nation are dependent upon the
physical, educational, emotional, and social well-being of their
children; and
Whereas, in order to attain the highest level of school attendance, to
promote excellence of academic performance and achievement, and
to significantly reduce school dropout rates, the State must act to
inform parents about their responsibility in basic health care as well
as inform them of options which are available to them in helping
them to meet their child's physical, mental, and social needs; and
Whereas, children's poor health status, high-risk behaviors, family
discord, inadequate health insurance coverage, inappropriate use of
hospital emergency rooms, and poor use of existing health care
services have prompted public policymakers to consider a broader
role for school health services; and
Whereas, the school's ability to reach children, youth, and their
families who are disenfranchised from the health care system and at
highest risk for poor health and potentially health-threatening
behaviors is unmatched; and
Whereas, the challenge of addressing the health care needs of
children can be met by school-based health service programs
provided through the relocation and co-location of public and
private service providers on the school site; and
Whereas, it is an obligation of all state and local governmental
entities, along with private sector providers, to cooperate and
collaborate in order to ensure that all of this state's children's health
care needs are met; and
Whereas, school health programs are designed to supplement rather
than supplant the responsibility of the family for meeting the health
needs of children and to only be delivered with informed consent
by the child's parent or guardian; and
Whereas, the General Assembly finds that health services delivered
as a part of the total school health program should be carried out to
comprehensively appraise, protect, and promote the health of
students and are designed to encourage parents to devote attention
to their child's health, identify health problems, and encourage the
use of their physicians, dentists, and other community health
providers and agencies. Now, therefore,
Be it enacted by the General Assembly of the State of South
Carolina:
SECTION 1. This act may be cited as the School Health Act of
1996.
SECTION 2. Title 59, Chapter 65 of the 1976 Code is amended
by adding:
"Article 7
Pre-school Health Assessment
Section 59-65-710. (A) Beginning with the 1998-1999 school
year, except as provided for in subsection (B) or (C), before
entering public school a student must have a health assessment
conducted if the student has not previously been enrolled in a
public school in this State and the student is:
(1) entering four-year-old kindergarten, kindergarten, or the
first grade; or
(2) entering the second or a higher grade and is under nine
years old.
(B) If a student has not had a health assessment, the student may
obtain an extension and enter public school if the student's parent
or guardian signs a statement on a form provided by the school
district stating that a health assessment has been scheduled and the
results of the assessment will be submitted to the district within
ninety days of the student entering school.
(C) A health assessment is not required for a student who is an
adherent of a religious denomination whose religious teachings are
opposed to such assessments, and the student's parent or guardian,
submits a statement to that effect.
(D) The health assessment must be conducted by a physician,
physician assistant, nurse practitioner, or a registered nurse licensed
in the State of South Carolina, and must include, but is not limited
to, a health history, physical examination, and screening tests as are
medically indicated to determine hearing ability, vision ability,
nutrition adequacy, and appropriate growth and development. A
standard form developed by the Department of Health and
Environmental Control indicating that the assessment has been
completed and indicating adequate health for public school
attendance must be submitted to the school the student will be
attending and must have been conducted within twelve months of
being submitted. A similar form from another state, territory, or
military branch of the United States satisfies this requirement.
Section 59-65-720. The school district shall exclude from
attendance any student who has not submitted the results of a health
assessment unless a statement is submitted as provided for in
Section 59-65-710(B) or the student is exempt from having an
assessment conducted pursuant to Section 59-65-710(C). If a
student is excluded from attendance, the school district shall notify
in writing the student's parent or guardian stating:
(1) the reason for the exclusion;
(2) that the student will continue to be excluded until the
student has complied with the requirements of this article; and
(3) that upon written request the parent or guardian has the
right to a hearing before the school board.
Section 59-65-730. Information contained in the health
assessment and the results of the health assessment are confidential
and must not be disclosed or made public except:
(1) to appropriate school district personnel to the extent
necessary to administer this article and to protect the health of the
student;
(2) if a medical emergency exists, to medical personnel to the
extent necessary to protect the health of the student and the health
care provider;
(3) if the parent or guardian of a student under eighteen years
of age consents or if the student is eighteen years of age or older, if
the student consents;
(4) if no person can be identified in the information to be
disclosed and the disclosure is for statistical or research purposes.
Section 59-65-740. To assist parents and schools, the
Department of Health and Environmental Control and the State
Department of Education jointly shall promulgate regulations
necessary to carry out this article. The regulations shall include,
but are not limited to, tests to be included in the health assessment
and procedures for taking corrective action and conducting
follow-up on problems identified in the assessment."
SECTION 3. Title 20, Chapter 7 of the 1976 Code is amended
by adding:
"Article 28
Health Services for Children and Youth
Section 20-7-6305. (A) Each school district in conjunction with
the Department of Health and Environmental Control shall convene
a district health planning committee which at a minimum, when
possible, should be composed of representatives from the local
departments of education, health, social services, mental health,
alcohol and other drug abuse services, and juvenile justice and from
the local school board, public and private health care providers,
private nonprofit community-based child advocacy organizations
and parents, teachers, and, where appropriate, students. Each
committee shall conduct an assessment of the status of the health of
the children and youth in the district, of the health needs of the
district children and youth, and of the community resources
available and needed to address these health needs.
(B) Based on the assessment, the committee shall develop by
July 1, 1997, a school health services program which must:
(1) be an interagency multidisciplinary service delivery plan
to meet the comprehensive health needs of the district's children
and youth and which may be a multidistrict or multicounty plan;
(2) assign the responsibility for the provision of services and,
to the extent possible, provide services by and through a
coordinated referral system to existing resources available in schools
and communities including, but not limited to, public and private
health providers, health agencies, and social services agencies;
(3) identify the physical sites for the delivery of services and,
whenever practical, deliver services on the school site;
(4) identify and maximize the use of all existing available
federal, state, local, and private funding sources.
(C) A school health services program must include:
(1) Health and nursing services including, but not limited to,
preventive services directed at eliminating destructive lifestyle
behaviors; formulating individual student health care plans when
needed, in consultation with students and their families about the
student's plan and other health needs; coordinating student health
care; assessing, evaluating, and treating minor illnesses and injuries;
providing temporary emergency care pending other disposition;
administering medications; referring for intervention and
remediation of specific health problems; follow-up for illnesses and
injuries; assisting families in obtaining medical, dental, and other
health care; counseling and must include, but is not limited to, these
health and nursing screening and assessment services:
(a) health assessments, as provided for in Section
59-65-710;
(b) oral health screenings;
(c) vision screenings;
(d) hearing screenings;
(e) scoliosis screenings;
(f) growth and development screenings.
Health and nursing services must be provided by or under the
direction of a physician, physician assistant, nurse practitioner or a
registered nurse licensed in the State of South Carolina.
For purposes of this item `screening' means presumptive
identification of unknown or unrecognized diseases or defects by
application of tests that can be given with ease and rapidity to
apparently healthy persons.
(2) Nutrition services including, but not limited to, nutrition
assessment, intervention, and counseling for students with diseases
or medical conditions that place the student at risk for nutritional
problems or who require nutrition therapy; and programs that offer
opportunities for students to experience learning through classroom
nutrition and health education.
(3) Counseling and social work services including, but not
limited to, services that are broad-based, comprehensive individual,
family and group assessments, interventions and referrals which
promote the mental, emotional, and social health of students.
(a) Social services including, but not limited to, services
that are designed to enhance the economic and social well-being of
students and their families;
(b) Mental health services including, but not limited to,
mental health assessment and counseling of students and their
families. Mental health services include those provided in, or
accessible to, schools by community mental health centers
administered by the Department of Mental Health.
(c) Alcohol and other drug abuse services including, but
not limited to, services that educate students and their families
about the health and social problems resulting from the use and
abuse of alcohol, tobacco, and other drugs and services that prevent
or treat use and abuse of alcohol, tobacco, and other drugs.
(4) Health education in a school setting that is planned and
carried out with the purpose of maintaining, reinforcing, or
enhancing the health, health-related skills, and health attitudes and
practices that are conducive to their good health and that promote
wellness, health maintenance, and disease prevention.
Section 20-7-6310. No school health services program may:
(1) provide abortion counseling or advocate abortion in any way
or refer a student to an organization for abortion counseling or to
an organization which performs abortion counseling;
(2) distribute at a public school a contraceptive or abortifacient
drug or device or similar device or refer an individual to an
organization for distribution of these drugs or devices.
Section 20-7-6315. In addition to the requirements for a school
health services program as provided for in Section 20-7-6305, the
program also may include, but is not limited to:
(1) healthy school environment component which addresses the
physical and aesthetic surroundings and the psycho-social climate
and culture of the school. Factors that influence the physical
environment include, but are not limited to, the school building and
the area surrounding it, biological or chemical agents that may be
detrimental to health, and physical conditions including, but are not
limited to, temperature, noise, and lighting;
(2) health promotion programs for school staff that provide
health assessments, health education, and health related fitness
activities.
Section 20-7-6320. The district health planning committee shall
formulate charges and a sliding fee schedule for appropriate
services under the program and also shall develop and implement
procedures for billing third party providers.
Section 20-7-6325. Annually before the commencement of the
school year, the school district shall notify parents of the services
available to students and families under the district's school health
services program. In order for a student to have access to or
receive services under the program, the student's parent or guardian
annually must sign a consent form provided by the district.
Section 20-7-6330. Services provided under the program must
complement services provided by existing health care providers;
however, if the student does not have a primary care provider,
primary care services may be provided to the student under the
program. When a student has a primary care provider and services
are rendered at a school site or school-linked facility, to the extent
it is necessary for continuity of care, as provided for in regulation,
the student's primary care provider must be notified that the
services were provided.
Section 20-7-6335. A student's health record and information
obtained on a student, including records and information on or
pertaining to the student's family, in connection with the school
health services program or services rendered under the program are
confidential and must not be disclosed or made public unless:
(1) to appropriate school district personnel to the extent
necessary to administer the school health services program and to
protect the health of the student;
(2) a medical emergency exists, to medical personnel to the
extent necessary to protect the health of the student and the health
of the medical personnel;
(3) the parent or guardian of a student under eighteen years of
age consents or if the student is eighteen years of age or older, if
the student consents; and
(4) no person can be identified in the information to be
disclosed and the disclosure is for statistical or research purposes
only.
Section 20-7-6340. For administrative purposes, the principal of
each school has immediate supervisory authority over the health
personnel working on the school site.
Section 20-7-6345. (A) The Department of Health and
Environmental Control and the Department of Education shall
convene an expanded school health services statewide committee of
public and private sector representatives of the health and business
communities. The committee shall develop a competitive grant
process, solicit proposals, and award grants for expanded services
under the school health services program to schools and school
districts where there is a high incidence of medically underserved
and high-risk children. Criteria for evaluating the incidence of
medically underserved and high-risk children include, but are not
limited to, rates of communicable diseases, inappropriate use of
hospital emergency rooms, low birthweight babies, infant mortality,
teenage pregnancy, teenage suicide, juvenile delinquency and crime,
school dropout, child abuse and neglect, family violence, substance
abuse, and enrollment in special education programs for
handicapped children. Grant awards are dependent upon the
availability of funding. Grants must be awarded to schools and
school districts whose proposals are based on innovative, creative,
and collaborative services and programs which have the greatest
potential for promoting the health and well-being of medically
underserved high-risk students; however, the awarding of grants is
dependent upon the availability of funding.
(B) Expanded school health services funded under this section
must not include the distribution of any contraceptive or
abortifacient drug or device or similar device and must not include
abortion counseling, abortion services, or referral to an organization
for abortion counseling or abortion services and may not advocate
abortion in any way.
Section 20-7-6350. (A) The Department of Health and
Environmental Control and the Department of Education shall:
(1) oversee the delivery and coordination of school health
services programs and periodically review and evaluate the
effectiveness and adequacy of these programs;
(2) collect and compile budget and financial information on
each school health services program;
(3) report on the development of the school health services
programs and on the results of the periodic program reviews and
submit district program budget and financial reports to the
Governor, the Human Services Coordinating Council, and the Joint
Legislative Committee on Children and Families.
(B) Upon review of the reports submitted by the Department of
Health and Environmental Control and the Department of
Education, the Human Services Coordinating Council shall develop
in conjunction with these departments a joint budget request for
expanded school health services programs. The council shall
provide advisory assistance to the district health advisory
committees as needed including, but are not limited to,
recommendations for promoting coordination and collaboration in
the planning process and in the delivery of services and for
maximizing the use of federal funds. The council also shall
develop a single form to capture basic referral information to be
used by the member agencies and their respective local entities.
Section 20-7-6355. In the administration of services under a
school health services program pursuant to this article, an employee
is immune from liability for negligence as provided for in the Tort
Claims Act.
Section 20-7-6360. The Department of Health and
Environmental Control and the Department of Education jointly
shall promulgate regulations to carry out this article."
SECTION 4. The school health services programs, as provided
for in Section 20-7-6305 of the 1976 Code as added by Section 3 of
this act, may be implemented in school year 1997-1998, following
the completion of the program planning process but must be
implemented no later than the first day of the 1998-1999 school
year.
SECTION 5. This act takes effect upon approval by the
Governor.
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