School health services are intended to minimize health barriers to learning for public school students in pre-kindergarten through 12th grade. To help ensure the provision of safe and appropriate county-level school health services, the Florida Department of Health’s School Health Program provides funding, technical assistance, and oversight of health services provided in Florida’s public schools.
In partnership with the Florida Department of Education, the School Health Services Program provides the services according to sections 381.0056, 381.0057, and 402.3026, Florida Statutes.
State funding for the school health services program is supplemented by funding from local school districts and community partners, consisting of three components:
- Basic School Health Services
- Comprehensive School Health Services
- Full Service Schools
Core Services include
- Health assessments
- Training and education
- Preventative dental screenings
- Vision, hearing, scoliosis, and growth and development screenings
- Health counseling
- Referrals and follow-up of suspected or confirmed health issues
- First aid and emergency health services
- Medication administration
- Assistance for students with chronic or acute health conditions
School Health Resources
Whole School, Whole Community, Whole Child
The ten components of this strategy, when looked at in a coordinated manner, have been shown to be highly effective in facilitating the creation of policies and environments that provide students and staff the opportunity to reach their personal potential by removing health related barriers to academic success.
Healthy Schools: E-Learning Series Training Tools
The Training Tools for Healthy Schools: Promoting Health and Academic Success e-learning series consists of four core training tools. Each module is 1-1.5 hours.
SHAPE America – Society of Health and Physical Educators
The organization’s extensive community includes a diverse membership of health and physical educators, as well as advocates, supporters, and 50+ state affiliate organizations.
OPEN – Physical Education Curriculum
Serves as a centralized educational ecosystem serving educators, coaches, parents and students.
School Health Services
Basic School Health Services
Basic school health services is managed by a registered nurse (RN) that addresses day-to-day student health needs, emergency health needs, and in-school management of chronic and acute health conditions like diabetes, asthma, allergies, and epilepsy.
In-school care management helps to ensure that student health conditions do not prevent students from attending school. Under the guidance of RNs, the county-level school health programs are implemented by county health departments, school districts, and public-private partners with services provided by RNs, licensed practical nurses, health aides, and trained school staff.
Comprehensive School Health Services
In addition to provision of all Basic school health services, comprehensive school health services include increased services in accordance with section 381.0057, Florida Statutes, for student health management, interventions, and classes. These services promote student health, address high-risk behaviors and prevention (substance use, injury, and disease prevention).
A total of 46 counties receive funding to implement comprehensive school health services programs in locally selected schools based on health outcomes and other factors.
Full Service Schools
In addition to provision of all basic school health services, full service schools provide additional school-based health and social services in accordance with section 402.3026, Florida Statutes. This can include nutritional services, economic and job placement services, parenting classes, counseling for mental health and substance use, and adult education for parents.
A total of 66 counties receive funding to provide full service school programs in locations that have high rates of medically underserved, high-risk students.
Guidelines and Reports
Guidelines
- School Health Administrative Resource Manual (2021)
- School Health Coding Training (2021-22)
- School Health Coding Manual (2021-22)
- Emergency Guidelines for Schools – 2019 Florida Edition
- Role of the Registered Nurse in the Delegation of Care in Florida Schools (2022)
- DPSL 2017-96 Updated Guidelines for Students with Life-Threatening Allergies
Reports
Planning, Reporting, and Program Monitoring
Privacy of Student Health Record
Section 1002.22, Florida Statutes, Student records and reports; rights of parents and students; notification; penalty
This purpose of this section is to protect the rights of students and their parents with respect to student records and reports as created, maintained, and used by public educational institutions in the state.
Family Education Rights and Privacy Act (FERPA) – 20 U.S.C. § 1232g and regulations 34 C.F.R. § 99
FERPA defines and provides privacy protections for educational records when such records are held by educational institutions that receive federal funds. FERPA defines education records as those records, files, documents and other materials that contain information directly related to a student and that are maintained by an educational agency or institution.
U.S. Department of Education
- Joint Guidance on the Application of the Family Educational Rights and Privacy Act and Health Insurance Portability and Accountability Act of 1966 (HIPAA) to Student Health Records
- FERPA
- FERPA Guidance for Students
Florida Department of Education
Health Insurance Portability and Accountability Act (HIPAA) – Public Law 104-191
HIPAA is intended to promote the confidentiality of individually identifiable health information and mandates that covered entities and providers engaged in certain types of transactions comply with the privacy requirements of the rule.
Florida Laws
| Law/Rule | Title | Summary of Health-Related Requirements |
| 39.201 | Mandatory reports of child abuse, abandonment, or neglect; mandatory reports of death | Any person who knows, or has reasonable cause to suspect, that a child is abused, abandoned, or neglected shall report such knowledge or suspicion to Department of Children and Families. Physician, osteopathic physician, chiropractic physician, nurse, or hospital personnel engaged in the admission, examination, care, or treatment of persons; school teacher or other school official or personnel; and reporters in other defined occupation categories are required to provide their names to the hotline staff. |
| 154.01 | County health department delivery system | County health department services shall be established to include three levels of service and funded as follows: (a) “Environmental health services”, (b) “Communicable disease control services”, (c) “Primary care services”. Primary care services are acute care and preventive services supported by available federal, state, and local funds and shall include services mandated on a state or federal level. Examples of primary health care services include, but are not limited to school health and other listed services. |
| 381.001 | Legislative intent; public health system | The department, in carrying out the public health mission, shall provide preventive and primary health care, including but not limited to, school health. |
| 381.0022 | Sharing confidential or exempt information | The Department of Health and the Department of Children and Families may share confidential information or information exempt from disclosure under Chapter 119 on any individual who is or has been the subject of a program within the jurisdiction of each agency. |
| 381.003 | Communicable disease and acquired immunodeficiency virus prevention and control | The department’s communicable disease prevention and control program must include programs to immunize school children as required by s. 1003.22(4)(a) |
| 381.0031 | Report of diseases of public health significance to department | Any practitioner licensed in Florida shall report a disease of public health significance to the department. |
| 381.005 | Primary and preventive health services | The Department of Health shall conduct a primary and preventive health care program that includes, but is not limited to school health services in accordance with Chapters 1003 and 1006, Florida Statutes. |
| 381.0056 | School health services program; “School Health Services Act” | Shall have the responsibility, in cooperation with the Department of Education, to supervise the administration of the school health services program and perform periodic program reviews. However, the principal of each school shall have immediate supervisory authority over the health personnel working in the school. |
| 381.0056 (4)(a)(19) | Reasonable attempt to notify | A reasonable attempt to notify a student’s parent, guardian, or caregiver before the student is removed from school, school transportation, or a school-sponsored activity to be taken to a receiving facility for an involuntary examination pursuant to s. 394.463, including and subject to the requirements and exceptions established under ss. 1002.20(3)(l)(1) and 1002.33(9), as applicable. |
| 381.0057 | Funding for school health services | Provides funding, in addition to that allocated under the School Health Services Act, for promoting the health of students, reducing risk-taking behavior, and reducing teenage pregnancy. |
| 381.0059 | Background screening requirements for school health services personnel | Any person who provides services under a school health services plan pursuant to 381.0056 must meet level 2 screening requirements per 435.04. |
| 381.00593 | Public school volunteer health care practitioner program | Encourages health care practitioners to provide voluntary services in public schools and provides for incentives. |
| 381.006 | Environmental Health | The department shall conduct an environmental health program as part of fulfilling the state’s public health mission. Rules related to public (6A-2) State Requirements for Education Facilities 2014 and private schools (6A-2.0040) shall be developed by the Department of |
| 381.088 | Emergency allergy treatment | This section and s. 381.885 may be cited as the “Emergency Allergy Treatment Act,” and covers the training and certification requirements for authorized entities to acquire and individuals to administer stock epinephrine auto-injectors to an individual experiencing a severe allergic reaction. |
| 381.986 | Medical use of marijuana | This section and s. 1006.062 provided guidance regarding use or administration of medical marijuana to students who are qualified patients by a caregiver with a caregiver identification card. |
| 394.463 | Involuntary examination | A person may be taken to a receiving facility for involuntary examination if there is reason to believe that the person has a mental illness and because of his or her mental illness. |
| 402.3025 | Public and nonpublic schools | Describes public school and childcare programs and associated age requirements. |
| 402.3026 | Full-service schools | Jointly establish full-service schools to serve high-risk students needing medical and social services. |
| 464 | Nurse Practice Act | Definitions, requirements, and practice standards for advance practice registered nurses, registered nurses,licensed practicalnurses and certified nursing assistants. |
| 466 | Dentistry, Dental Hygiene, and Dental Laboratories | Provides definitions, specifically “School-based prevention program” and “health access settings”. |
| 624.91 | The Florida Healthy Kids Corporation Act | Increases access to health care for children in under insured or uninsured families. School district and school health staff may refer families requiring assistance to this program. |
| 743.064 | Emergency medical care or treatment to minors without parental consent | Emergency medical care may be rendered by a physician due to accident, acute illness, disease or condition if a delay in emergency care or treatment would endanger the health or physical well-being. Also applies to paramedics, emergencymedical technicians or emergency personnel under Chapter 401, Florida Administrative Code. Other requirements are provided. |
| 743.0645 | Other persons who may consent to medical treatment of a minor | Provides requirements and a listing of persons who may provide consent: stepparent, grandparent, adult brother or sister, adult aunt or uncle. |
| 743.065 | Unwed pregnant minor or minor mother; consent to medical services for minor or minor’s child valid | An unwed pregnant minor may consent to the performance of medical or surgical care or services relating to her pregnancy by a hospital or clinic or by a physician licensed under chapter 458 or chapter 459, and such consent is valid and binding as if she had achieved her majority. An unwed minor mother may consent to the performance of medical or surgical care or services for her child by a hospital or clinic or by a physician licensed under chapter 458 or chapter 459, and such consent is valid and binding as if she had achieved her majority. Nothing in this act shall affect the provisions of s. 390.0111. |
| 1001.43 | Supplemental powers and duties of district school board | The school board may adopt programs and policies for the provision of first aid and emergency medical care, and the provision of school health care facilities and services. |
| 1002.20 | K-12 student and parent rights | Section (3) Health Issues includes exemptions upon written parental request for school-entry examinations, immunizations, reproductive health and disease education. Contraceptive services may not be provided without parental consent. Addresses metered dose inhaler use, epinephrine auto- injector use, diabetes management, and use of prescribed pancreatic enzyme supplements. |
| 1002.22 | Student records and reports; rights of parents and students; notification Education records and reports of K-12 students; rights of parents | The rights of students and their parents with respect to education records created, maintained, or used by public educational institutions and agencies shall be protected in accordance with the Family Educational Rights and Privacy Act (FERPA), 20 U.S.C. s. 1232g, implementing regulations, and this section. |
| 1002.221 | K-12 education records | Related to confidentiality and release of student education records, as defined in the Family Educational Rights and Privacy Act (FERPA), 20 U.S.C. s. 1232g |
| 1002.23 | Family and School Partnership for Student Achievement Act | Provides a parent guide that includes information on the importance of student health and available immunizations, and detailed information on meningococcal disease. |
| 1002.33 | Charter schools | Section (16) provides that a “charter school shall operate in accordance with its charter and shall be exempt from all statutes in chapters 1000-1013″. And chapters 1000-1013″. An exception requires that a charter school shall be in compliance with those statutes in Chapters 1000-1013 pertaining to student health, safety, and welfare. |
| 1002.42 | Private schools | School-entry health examinations and a certificate of immunization are required for school entry. |
| 1003.22 | School-entry health examinations; immunization against communicable diseases | Public and private schools shall: require each child to present a school- entry examination performed within 1 year; provide for temporary exemptions; require a certificate of immunization on file; provide scoliosis screening. |
| 1003.25 | Procedures for maintenance and transfer of student records | A permanent cumulative record is maintained for each student; DOE prescribes rules for transferring and maintaining student records. Student records are defined according to FERPA. See 1002.22 |
| 1003.42 | Required instruction | Public school instructional staff shall teach comprehensive health education that addresses, among others: benefits of sexual abstinence, consequences of teenage pregnancy, personal health, prevention and control of disease. |
| 1003.453 | School wellness and physical education policies; nutritional guidelines | DOE provides links to each district wellness and physical education policies and links that include information on the eight components of the coordinated school health program. |
| 1003.455 | Physical education | Each school district shall adopt a written physical education (PE) policy and provide 150 minutes of PE each week for grades K-5. |
| 1003.46 | Health education; instruction in acquired immune deficiency syndrome | School districts may provide instruction in acquired immune deficiency syndrome as a specific area of health education. |
| 1003.54 | Teenage parent programs | Shall provide pregnant students or students who are parents and the children of these students with a comprehensive teenage parent program; includes provisions for child care, health care, social services, parent education and transportation. See 6A-6.0525 |
| 1003.57 | Exceptional student instruction | Provides special instruction, classes, and services. A student may not be given special instruction or services as an exceptional student until after he or she has been properly evaluated, classified, and placed. See 6A-6.0331 and 64F- 6.006 |
| 1006.061 | Child abuse, abandonment, and neglect policy | Pursuant to Chapter 39, all employees and agents of the district school board have an affirmative duty to report all actual or suspected cases of child abuse, abandonment, or neglect. See 39.201 and 39.01 |
| 1006.062 | Administration of medication and provision of medical services by district school board personnel | Shall adopt policies governing the administration of prescription medication by district school board personnel and include in its approved school health services plan a procedure to provide training by a licensed health professional to the school personnel. Addresses delegation of health- related tasks by UAPs. See 64B9-14.002 |
| 1006.0625 | Administration of psychotropic medication | A public school may not deny any student access to programs or services because the parent of the student has refused to place the student on psychotropic medication. |
| 1006.165 | Automated external defibrillator; user training | Each public school that is a member of the Florida High School Athletic Association must have an operational automated external defibrillator on the school grounds; must ensure that all employees or volunteers who are reasonably expected to use the device obtain training, including completion of cardiopulmonary resuscitation or a basic first aid. |
| 1006.20 | Athletics in public K-12 schools | The Florida High School Athletic Association is designated as the governing nonprofit organization of athletics in Florida public schools. All participating students must satisfactorily pass a preparticipation physical evaluation each year. |
| 1012.465 | Background screening requirements for certain noninstructional school district employees and contractors | Noninstructional school district employees or contractual personnel who are permitted access on school grounds when students are present, who have direct contact with students must meet level 2 screening requirements as described in s. 1012.32. Contractual personnel include any vendor, individual, or entity under contract with a school or the school board. See 1012.467 and 1012.468 |
| 1012.55 | Positions for which certificates required | Each person employed as a school nurse shall hold a license to practice nursing in the state, and each person employed as a school physician shall hold a license to practice medicine in the state. |
| 1014.06 | Parental consent for health care services | Except as otherwise provided by law, a health care practitioner, as defined in s. 456.001, or an individual employed by such health care practitioner may not provide or solicit or arrange to provide health care services or prescribe medicinal drugs to a minor child without first obtaining written parental consent. |
| 6A-1.0955 | Education Records of Pupils and Adult Students | Education records shall mean those records, files, documents and other materials as defined in Section 1002.22(2), Florida Statutes (see 1002.22) which: contain information directly related to a student, maintained by an educational institution, and are accessible to other professional staff. Required health information is classified as a Category B – temporary information record. See 64F-6.005 |
| 6A-3.0121 | Responsibility of School District and Parents or Guardians for Students Who Are Transported at Public Expense | The operator and attendant shall be provided training related to students; however, the operator and attendant shall not give medicine and shall limit his or her assistance to that which may normally be expected of a reasonable, prudent person or as specified in the student’s Individual Educational Plan. |
| 6A-6.024 | School Entry Health Examination | This rule implements the school entry health examination requirements. See 1003.22 |
| 6A-6.0251 | Use of Epinephrine Auto Injectors | This rule implements requirements for the self-administration of epinephrine auto-injectors by students. See 1002.20(3)(i) |
| 6A-6.0252 | Use of Prescribed Pancreatic Enzyme Supplements | This rule implements requirements for the self-administration of pancreatic enzymes by students. See 1002.20(3)(k) |
| 6A-6.0253 | Diabetes Management | This rule implements requirements for diabetes self-management management. See 1002.20(3)(j) |
| 6A-6.0331 | Identification and Determination of Eligibility of Exceptional Students for Specially Designed Instruction | Screening for hearing and vision for the purpose of ruling out sensory deficits shall be required prior to conducting an evaluation to determine the student’s eligibility as a student with a disability. See 64F-6.006 |
| 6A-6.0525 | Teenage Parent Programs | School district Teenage Parent programs are designed to provide comprehensive educational and ancillary services to facilitate completion of high school. Districts shall develop and implement ancillary services for child care, social services, health services and transportation for pregnant and parenting students. Health services include health and nutrition education and routine prenatal/postnatal health checkups. See 1003.54 |
| 64B9-14 | Delegation to Unlicensed Assistive Personnel | Provides definitions, delegation of tasks or activities, and prohibited tasks. Applies to county health department and school district registered nurses and licensed practical nurses providing health services in schools. |
| 64D-3.046 | Immunization Requirements: Public and Nonpublic Schools, Grades Preschool, K-12, and Adult Education Classes | Provides immunization documentation requirements, specific immunization requirements by grade, and documentation requirements for schools. See 1003.22 |
| 64E-16.004 | Biomedical Waste: Storage and Containment | Provides storage and containment requirements for biomedical waste that may be generated in school health rooms and stored in bags or sharps containers. See 381.0098 and 64E-16 for the full requirements. |
| 64F-6 | School Health Services Program | Provides definitions, requirements for the school health services plan, screening requirements, emergency health needs, records maintenance, and exceptional student education. See 381.0056 |
| 65C-22.006 | Child Care Standards | Provides children’s health requirements, including Student Health Examination (valid for two years from date performed), Certificate of Immunization. |
| GS7 | General Records Schedule GS7 for Public Schools Pre-K-12 | Provides records retention and disposal instructions for school records. See GS7GeneralRecordsSchedule for all educational records, including health related records. |
| SREF 14 | State Requirements for EducationalFacilities: 2014. | Provides design and inspection standards for new and existing educational facilities – including clinics. See https://www.fldoe.org/core/fileparse.php/7738/urlt/srefrule14.pdf for the complete document. |