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MICHIGAN SCHOOL HEALTH SERVICE
Laws and Model Policies
that Guide School Health Service Programs
in Michigan
A resource for School Nurses
Date of initial Issue: 2013 Michigan Association of School Nurses
Revised: July 2021
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MICHIGAN SCHOOL HEALTH SERVICE
Laws and Model Policies That Guide School Health Services Programs in Michigan
1
As schools plan for the health needs of children, instruction, and safe learning environments, there must be a foundation
upon which they are based. Legal standards and model policies are key to the foundation for administering school health
services. Legal standards include federal laws, federal regulations and Supreme Court decisions; state laws and state
regulations; local ordinances, policies and procedures; and professional standards of practice (Laubin, Schwab and Doyle,
2012). It is imperative that school policies are developed and adopted in accordance with laws and standards of practice
to ensure ethical and legal school health practices along with protecting student health and safety.
HOW TO USE THIS DOCUMENT
There are a full range of laws and regulations relevant to school health service programs. This document does not cover
the entire current legal and policy landscape for school health services and new laws are continually enacted. This
guide provides an overview of federal and state laws that can establish parameters for policy options concerning
Michigan school health services. Resources are listed in alphabetical order. Links to the specific federal laws are included.
State laws that guide school health services include the Michigan Revised School Code (designated with 380 prefix) and
the Michigan Public Health Code (designated with 333 prefix ). These state laws are hyperlinked in this document to the
specific area in each of the legislative documents that best demonstrate the content being highlighted. In some current
cases, the Public Act is also included to better leverage familiarity with the law.
This document is offered as a resource to guide policy and procedure development, but it is not intended as a
substitute for legal counsel. As part of any policy development, legal review should be required.
1
Adapted from Legal Issues Affecting School Nurse Practice, Michigan Association of School Nurses, July 10, 2003, (Updated 2009;
2014; 2016).
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MICHIGAN SCHOOL HEALTH SERVICE
Table of Contents
FEDERAL STATUTES ............................................................................................... 5
MICHIGAN GENERAL STATUTES – School Health .............................................. 9
Absenteeism ............................................................................................................. 9
Abuse ........................................................................................................................ 9
Anaphylaxis – Non-Specific Epinephrine .............................................................. 9
Asthma .................................................................................................................... 10
Autism...................................................................................................................... 10
Bullying .................................................................................................................... 11
Bloodborne Pathogens .......................................................................................... 11
Cardiac Emergency Response Plan .................................................................... 11
Child Protection ...................................................................................................... 12
Communicable Disease ........................................................................................ 12
Concussions ........................................................................................................... 12
Confidentiality ......................................................................................................... 13
Controlled Substances .......................................................................................... 13
Coordinated School Health ................................................................................... 13
Curriculum ............................................................................................................... 14
Delegation and Scope of Practice ........................................................................ 15
Dental ...................................................................................................................... 15
Diabetes .................................................................................................................. 16
Do Not attempt rescusitation ................................................................................ 16
Environment ............................................................................................................ 16
Emergency Preparedness .................................................................................... 16
Family Engagement ............................................................................................... 16
First Aid and CPR .................................................................................................. 17
Hearing and Vision ................................................................................................. 17
Health Disparities ................................................................................................... 17
Health Services ...................................................................................................... 17
HIV ........................................................................................................................... 18
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MICHIGAN SCHOOL HEALTH SERVICE
Immunizations ........................................................................................................ 18
Marijuana ................................................................................................................ 20
Medication Administration ..................................................................................... 20
Meningitis ................................................................................................................ 21
Mental Health ......................................................................................................... 21
Opioid Antagonist ................................................................................................... 21
Pregnancy ............................................................................................................... 22
Record Retention ................................................................................................... 22
Reproductive Health .............................................................................................. 22
Restraint and Seclusion ........................................................................................ 23
Rights of Minors ..................................................................................................... 23
School Nursing ....................................................................................................... 24
School Safety ......................................................................................................... 24
School Wellness ..................................................................................................... 25
Social Worker Role ................................................................................................ 25
Suicide ..................................................................................................................... 25
Sun Safety .............................................................................................................. 25
Telehealth ............................................................................................................... 25
Tobacco .................................................................................................................. 25
Key Federal Legislation ............................................................................................ 26
RESOURCES ............................................................................................................ 29
A Brief Review of Federal Laws Protecting the Privacy of Education Records . 30
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MICHIGAN SCHOOL HEALTH SERVICE
FEDERAL STATUTES
Title
Description
Training Required
May include name of
legislation, Public Act,
Common Title or
Policy Title
Provides a general description of what the law or policy
entails.
Identifies the training
required by the law or policy
Americans with
Disabilities Act of 1990
ADA Amendments Act of
2008
Prohibits disability discrimination.
Restores the intent and protections of the Americans with
Disabilities Act of 1990.
Public Law No: 116-292
H.R. 2468 School-Based
Allergies and Asthma
Management Program
Act
Encourages states to improve allergy and asthma care in
schools by giving preference for federal grants to states that
adopt certain management programs and policies. States can
earn financial rewards for putting the following in place:
• Methods to identify all students who have
allergies/asthma
• Create individual student action plans
• Require school nurses or on-site trained staff during
operating hours to administer medicines for both
asthma and allergies
• Asthma/allergy training education for school staff
• Efforts to reduce indoor asthma/allergy triggers
• Coordinate management of care with families and
health care providers
Autism Collaboration,
Accountability,
Research, Education,
and Support (Autism
CARES) Act of 2014
Increases awareness of Autism Spectrum Disorder (ASD),
reducing barriers to screening and diagnostic services,
improving evidence-based research, and increasing training of
professionals to provide screening and intervention for
persons with ASD.
Child Abuse Prevention
and Treatment (CAPTA)
Reauthorization Act of
2010 Public Law 111-320
Amends and reauthorizes the Child Abuse Prevention and
Treatment Act, the Family Violence Prevention and Services
Act, the Child Abuse Prevention and Treatment and Adoption
Reform Act of 1978, and the Abandoned Infants Assistance
Act of 1988, and for other purposes.
Civil Rights Act of 1991
Applies to employee discrimination. Prohibits discrimination
on basis of disability.
Every Student Succeeds
Act (ESSA)
Reauthorizes the 50-year-old Elementary and Secondary
Education Act (ESEA), the nation’s national education law and
longstanding commitment to equal opportunity for all
students. ESSA replaces No Child Left Behind.
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MICHIGAN SCHOOL HEALTH SERVICE
FEDERAL STATUTES (Continued)
Title
Description
Training Required
Family Educational
Rights and Privacy Act
(FERPA) 34 CFR 99
Joint Guidance on the
Application of FERPA
and HIPAA to Student
Health Records 2019
Provides privacy restrictions on student records. School
health records are covered under this act. At the elementary
or secondary school level, students’ immunization and other
health records that are maintained by a school district or
individual school, including a school-operated health clinic,
that receives funds under any program administered by the
U.S. Department of Education are “education records” subject
to FERPA, including health and medical records maintained by
a school nurse who is employed by or under contract with a
school or school district.
Clarifies for school administrators, health care professionals,
families and others how FERPA and HIPAA apply to education
and health records maintained about students. This updated
guidance includes additional frequently asked questions and
answers addressing when a student’s health information can
be shared without the written consent of the parent or
eligible student under FERPA, or without written authorization
under the HIPAA Privacy Rule.
Female Genital
Mutilation 18 U.S. Code
116
Addresses Female Genital Mutilation (FGM) in the U.S.
Makes it illegal to perform FGM in the U.S. or knowingly
transport a girl out of the U.S. for purpose of inflicting FGM
(Equity Now, 2016).
Presidential Policy
Directive /PPD-8
FEMA Guide for
Developing High-Quality
School Emergency
Operations Plans
Strengthens the security and resilience of the United States
through systematic preparation for the threats that pose the
greatest risk to the security of the Nation, including acts of
terrorism, cyber-attacks, pandemics, and catastrophic natural
disasters.
Requires emergency plans to comply with legal requirements
for language access.
Food Safety
Modernization Act
Enables FDA to better protect public health by strengthening
the food safety system.
Health Insurance
Portability and
Accountability Act of
1996 HIPAA Public Law
104-191
Provides privacy restrictions on student records.
When a school provides health care to students in the normal
course of business, such as through its health clinic, it is also a
“health care provider” as defined by HIPAA. If a school also
conducts any covered transactions electronically in connection
with that health care, it is then a covered entity under HIPAA.
As a covered entity, the school must comply with the HIPAA
Administrative Simplification Rules for Transactions and Code
Sets and Identifiers with respect to its transactions (United
States Department of Education, Office of Elementary and
Secondary Education (2008).
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MICHIGAN SCHOOL HEALTH SERVICE
FEDERAL STATUTES (Continued)
Title
Description
Improving Head Start for
School Readiness Act of
2007
Updates Head Start Program requirements including a
physical exam based on EPSDT guidelines; dental exam;
immunizations; vision; hearing and developmental screening
and a nutritional snack and lunch. 10% of the enrolled HS
children must have a disability.
Individuals with
Disabilities Act of 1997
(IDEA) 34 CFR Part 300
Guarantees access to education and related services to assist
children with disabilities who benefit from special education.
Reauthorization of 2004, Sec. 62 (26) lists school nurse
services as a related service.
The Individuals with Disabilities Education Act includes the
Child Find mandate. Child Find requires all school districts TO
identify, locate and evaluate all children with disabilities,
regardless of the severity of their disabilities. This obligation
to identify all children who may need special education
services exists even if the school is not providing special
education services to the child.
Justice for Victims of
Trafficking Act of 2015
Public Law 114-22
Provides justice for the victims of trafficking through grants to
States for child abuse investigation and prosecution programs,
services for victims of child pornography, and domestic child
human trafficking deterrence programs. The act also
authorizes specialized training programs for law enforcement
officers, first responders, health-care and child welfare
officials, juvenile justice personnel, prosecutors, and judicial
personnel to identify victims and acts of child human
trafficking and to facilitate the rescue of child victims of
human trafficking.
McKinney-Vento
Homeless Education
Assistance Act
Ensures equal access to education for homeless youth by
providing federal funding to states for the purpose of
supporting district programs that serve homeless students.
Occupational Safety and
Health Administration
(OSHA) 29 CFR Part
1910.1030
Revised in 2001
Prescribes safeguards to protect workers against health
hazards related to bloodborne pathogens.
Revised Bloodborne Pathogens Standard; expands bloodborne
pathogens to include any pathogenic microorganism,
including hepatitis C virus (HCV) present in blood or other
potentially infectious materials (OPIM).
Protection of Pupil
Rights Amendment
(PPRA) 34 CFR Part 98
Provides mandates to school districts for the protection of
student’s privacy in any program funded by the U.S.
Department of Education.
USDOE Protecting Student Privacy
Section 504,
Rehabilitation Act of
1973
Protects the rights of children with special health-care needs
(CSHCN) by providing related services, including health
services, to those not eligible for special education.
Title IX Discrimination
Based Upon Sex or
Blindness
Prohibits discrimination and exceptions on the basis of sex
under any education program or activity receiving Federal
financial assistance.
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MICHIGAN SCHOOL HEALTH SERVICE
FEDERAL STATUTES (Continued)
Title
Description
Title IV of the Civil Rights
Act of 1964
Title VI of the Civil Rights
Act of 1964
Authorizes the Attorney General, when certain statutory
conditions are met, to institute a lawsuit against public school
boards, public colleges and universities, and others upon
receiving a complaint of discrimination or segregation.
Prohibits discrimination on the basis of race, color, and
national origin in programs and activities receiving federal
financial assistance.
USDA Food and
Nutrition Service Local
School Wellness Policy
Requires local education agencies to establish a local school
wellness policy. The policy must include goals for nutrition
education, physical activity, nutrition guidelines for all foods
sold on campus, assure that school meals meet United States
Department of Agriculture (USDA) regulation, establish plan
for measuring implementation of wellness policy, involve
students, parents, representatives of school food authority
and others.
USDA Healthy Hunger-
Free Kids Act of 2010
USDA Healthy,
Hunger-Free Kids Act
Updates
Authorizes funding and sets policy for USDA's core child
nutrition programs improving the critical nutrition and hunger
safety net for millions of children.
National School Lunch Program
School Breakfast Program
The USDA recently announced guidance for schools in
ensuring access to healthy food, nutrition standards for foods
sold at school, and greater integrity for school wellness
policies. Includes final rules on "Smart Snacks in School",
"Local School Wellness Policy", "Community Eligibility
Provision" & "Administrative Review".
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MICHIGAN SCHOOL HEALTH SERVICE
MICHIGAN GENERAL STATUTES – School Health
ABSENTEEISM
Description
Training Required
Requires districts to address truancy or chronic
absenteeism through use of early warning,
parent conferencing, and parental sanctions.
ABUSE
Description
Training Required
Requires certain professions to report their
suspicions of child abuse or neglect”. State list
of mandated reporters for abuse or neglect
and online site for reporting available on the
Online Reporting System.
722.629 Multidisciplinary
services; biennial report;
continuing education
programs; dissemination of
information. The program shall
include responsibilities,
obligations, and powers under
this act and the diagnosis and
treatment of child abuse and
neglect when committed by
persons responsible for the
child's health or welfare.
ANAPHYLAXIS – NON-SPECIFIC EPINEPHRINE
Description
Training Required
Section 333.17744a - Addresses stock
epinephrine in schools. A prescriber may issue
a prescription for and a dispensing prescriber
or pharmacist may dispense an auto-injector
epinephrine to school boards and authorized
entities under certain circumstances and limit
liability. This would include non-public schools.
PA 221 of 2015 Sec. 1774d(3)
Person(s) or entity
administering an epinephrine
auto injector must complete an
initial anaphylaxis training
program and a subsequent
anaphylaxis training program
at least every 2 years.
The training program for non-nursing staff
designated to use an epinephrine autoinjector
shall be conducted under the supervision of,
and shall include evaluation by a licensed,
registered professional nurse.
MASN Safe and Legal
Support of Students with
Health and Medication
Needs at School: Module 3
Section 380.1178 - If an epinephrine auto-
injector is administered to an individual
consistent with the policies under section
1179a, they are not liable in a criminal action
or for civil damages as a result of an act or
omission in the administration of the
medication or epinephrine auto-injector,
except for an act or omission amounting to
gross negligence or willful and wanton
misconduct.
Michigan Department of Environment, Great
Lakes and Energy, EGLE, Regulations for
disposal of unused auto-injector.
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MICHIGAN SCHOOL HEALTH SERVICE
Michigan General Statutes – School Health
ASTHMA
Description
Training Required
Allows pupil to carry and self-administer
prescribed inhalers and/or epinephrine auto-
injector for emergency use with the written
order and approval of the child’s physician and
written permission of the parent/legal
guardian.
Model policy from the Michigan Department
of Education (2004). Note: Not a law.
Levels of Training
Recommended*
Tier 1: General Staff Education
regarding condition
Tier 2: Emergency care
Tier 3: Daily Support
AUTISM
Description
Training Required
Mandates for-profit, commercial, Health
Maintenance Organizations (HMO), and non-
profit health insurance companies regulated
by the state of Michigan to provide an autism
benefit to its insured members covering
services related to the diagnosis and treatment
of autism spectrum disorders (ASD) through 18
years of age.
Creates an autism coverage reimbursement
program to encourage insurance and health
coverage providers to provide autism
coverage; to impose certain duties on certain
state departments, agencies, and officials; to
create certain funds; to authorize certain
expenditures; and to provide for
appropriation.
An informational bulletin published in July
2014 clarifying Medicaid coverage of services
for children with ASD under the federal
Medicaid Early and Periodic Screening,
Diagnostic and Treatment (EPSDT) benefit.
Michigan’s Medicaid treatment coverage of
ASD in children, covering Behavioral Health
Treatment, including Applied Behavior
Analysis, and services to individuals with ASD.
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MICHIGAN SCHOOL HEALTH SERVICE
MICHIGAN GENERAL STATUTES – SCHOOL HEALTH
BULLYING
Description
Training Required
Prohibits bullying; adoption/implementation;
public hearing; submission of policy to
department; contents of policy; annual report
of incidents of bullying; form and procedure;
school employee, school volunteer, pupil, or
parent or guardian reporting act of bullying to
school official; modified policy; definitions.
Amends Revised School Code to include cyber
bullying as form of bullying.
PA 241 of 2011 Sec. 131 (6b)
Strongly encourages annual
training for administrators,
school employees, and
volunteers who have
significant contact with pupils
on preventing, identifying,
responding to, and reporting
incidents of bullying.
Provides a tool to assist Michigan school
districts in developing, updating, or revising
their local codes.
The Revised School Code requires the board of
a school district or intermediate school district,
or board of directors of a public-school
academy, to adopt and implement a policy
prohibiting bullying at school.
BLOODBORNE PATHOGENS
Description
Training Required
Outlines employer responsibilities to employee
regarding training and response to exposure to
blood borne pathogens.
R 325.70016 Information and
training. Rule 16. (1) An
employer shall ensure that all
category A employees
participate in a training
program provided at no cost to
the employees and during
working hours.
CARDIAC EMERGENCY RESPONSE PLAN
Description
Training Required
Requires K12 schools to adopt and implement a
cardiac emergency response plan for the
school. The cardiac emergency response plan
shall address and provide for at least all of the
following:
(a) Use/regular maintenance of automated
external defibrillators, if available.
(b) Activation of a cardiac emergency response
team during an identified cardiac emergency.
(c) A plan for effective/efficient communication
throughout school campus.
(d) If the school includes grades 9 to 12, a
training plan for the use of an automated
external defibrillator and in CPR techniques.
(e) Incorporation/integration of the local
emergency response system and emergency
response agencies with the school's plan.
(f) An annual review and evaluation of the
cardiac emergency response plan.
If the school includes grades 9
to 12, a training plan for the use
of an automated external
defibrillator and in CPR
techniques.
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MICHIGAN SCHOOL HEALTH SERVICE
Michigan General Statutes – School Health
Cardiac Emergency Response Plan (Continued)
Description
Training Required
Requires one-time CPR and AED instruction for
pupils enrolled in grades 7 through 12.
CHILD PROTECTION
Description
Training Required
State records and reports related to HIV/AIDS
are not confidential if information is required
under the Child Protection Law.
A child protective services worker may
interview a child in the school setting without
parental consent/school personnel
involvement.
Delineates persons required to report child
abuse or neglect; written report; transmitting
report and results of investigation to
prosecuting attorney or county family
independence agency; pregnancy of or
venereal disease in child less than 12 years of
age. Section 8(8) of the Child Protection Law
requires the school to cooperate with the
investigation and to permit access “if access is
necessary to complete the investigation or to
prevent abuse/neglect child.”
Requires certain professions to report their
suspicions of child abuse or neglect”.
State list of mandated reporters for abuse or
neglect and online site for reporting available
Online Reporting System.
COMMUNICABLE DISEASE
Description
Training Required
Establishes requirements for reporting and
other surveillance methods for measuring the
occurrence of diseases, infections, and
disabilities and the potential for epidemics.
CONCUSSIONS
Description
Training Required
Lists components of concussion awareness
training program, the Michigan Department of
Health and Human Services (MDHHS)
requirement to review programs and
materials, provides definitions.
Michigan Law requires all
coaches/employees/volunteers
/other adults involved with
youth athletic activities to
complete concussion
awareness training every 3
years.
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MICHIGAN SCHOOL HEALTH SERVICE
Michigan General Statutes – School Health (continued)
CONCUSSIONS (Continued)
Description
Training Required
Outlines criteria for completion of training
program every three years, training material
requirements, removal of youth if concussion
suspected, requirement for clearance from
health professional
HEADS UP to Youth Sports:
Online Training | HEADS UP |
CDC Injury Center
High School Sports Training
(Concussion in Sports)
CONFIDENTIALITY
Description
Training Required
Communication between teacher, guidance
officer, school executive, or “other professional
person” are confidential.
A local school district, public school academy, or
intermediate school district shall not disclose
any personally identifiable information
contained in a student record to a law
enforcement agency, except in compliance with
20 USC 1232g, commonly referred to as the
family educational rights and privacy act.
CONTROLLED SUBSTANCES
Description
Training Required
(1) A controlled substance that is listed in
schedule 1 of R 338.3111 to R 338.3114a shall
be stored in a securely locked, substantially
constructed cabinet that is anchored to a wall or
the floor.
(2) A controlled substance that is listed in
schedules 2, 3, 4, and 5 of R 338.3116 to R
338.3126 shall be stored in a securely locked,
substantially constructed cabinet, room, or cart.
COORDINATED SCHOOL HEALTH
Description
Training Required
Requires critical health problems education
program to include Coordinated school health
education.
Rule 3. The department shall develop policies
to be approved by the state board of
education, with research-based statements,
guidance, and resources on coordinated school
health for school districts that includes, but are
not limited to, all of the following:
Assist school districts in the planning,
organization, administration and evaluation of
their coordinated school health initiatives.
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MICHIGAN SCHOOL HEALTH SERVICE
Michigan General Statutes – School Health (continued)
CURRICULUM
Sex Education, HIV Education, Health Education and Physical Education
Description
Training Required
Requires that health and physical education
for pupils of both sexes be established and
provided in all public schools.
Students attending public school who are
physically fit and capable of doing so must take
the course in physical education.
Requires that the principal modes by which
communicable diseases including HIV/AIDS are
spread and the best methods for preventing
these diseases be taught in every Michigan
school.
Requires that each person who
teaches K-12 about HIV and
AIDS to be trained in HIV &
AIDS through the coordinators
that are attached to the ISD
unless the instruction is coming
from a health care provider
Requires Health Instruction to be given in
physiology and hygiene, with special reference
to substance abuse, including the abusive use
of tobacco, alcohol, and drugs, and their effect
upon the human system.
Requires community input and advanced
parent notification with op-out option of
instruction in sex education; instructors,
facilities, and equipment; stressing abstinence
from sex; elective class; notice to parent or
guardian; request to excuse pupil from
attendance; qualifications of teacher; sex
education advisory board; public hearing;
distribution of family planning drug or device
prohibited; “family planning, class,” and
“course” defined.
A pupil shall not be enrolled in a class in which
the subjects of family planning or reproductive
health are discussed unless the pupil's parent
or guardian is notified in advance of the course
and the content of the course, is given a prior
opportunity to review the materials to be used
in the course and is notified in advance of his
or her right to have the pupil excused from the
class. The state board shall determine the form
and content of the notice required in this
subsection.
Parents may review HIV/AIDS curriculum,
observe its instruction, and, if desired, excuse
their child from these instructional units.
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MICHIGAN SCHOOL HEALTH SERVICE
Michigan General Statutes – School Health (Continued)
DELEGATION AND SCOPE OF PRACTICE
Description
Training Required
Defines nursing scope of practice. The RN’s
scope of practice includes the teaching,
direction, and supervision of less skilled
personnel in the performance of delegated
nursing activities. Public Health Code, 1978 PA
368, as amended, recognizes registered nurses
as fully licensed health professionals.
Defines delegation as the “authorization
granted by a licensee to a licensed or
unlicensed individual to perform selected acts,
tasks, or functions which fall within the scope
of practice of the delegator and which are not
within the scope of practice of the delegatee
and which, in the absence of the authorization,
would constitute illegal practice of a licensed
profession”.
The Michigan Board of Nursing has
promulgated specific administrative rules
about delegation. Only a registered nurse may
delegate nursing acts, functions, or tasks.
Defines Supervision: Supervision requires
continuous availability of direct
communication in person or by radio,
telephone, or telecommunication between the
supervised individual and a licensed health
professional, the availability of the licensed
health professional to review the practice of
the supervised individual, to provide
consultation to the supervised individual, to
review records, and to further educate the
supervised individual in the performance of
the individual’s functions.
DENTAL
Description
Training Required
By the 2021-2022 school year, the department
shall establish and maintain a dental oral
assessment program to provide dental oral
assessments to children residing in this state
whose parents, guardians, or persons in loco
parentis do not have dental oral assessments
conducted as described in subsection (5)(a)
but otherwise decide to have dental oral
assessments conducted on their children
under this section.
The law does not have an appropriation
allocated to implement it and the program
does not have to be implemented in any year
in which there is no appropriation. The law
sunsets in three years.
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MICHIGAN SCHOOL HEALTH SERVICE
MICHIGAN GENERAL STATUTES – SCHOOL HEALTH (CONTINUED)
DIABETES
Description
Training Required
Model policy approved by Michigan
department of Education 2011. Note: Not a
law.
3 Tiers of Training *
DO NOT ATTEMPT RESCUSITATION
Description
Training Required
Allows a parent or guardian to execute do-not-
resuscitate orders on behalf of a minor child;
and creates filing, storage and notice rules
regarding do-not-resuscitate orders and
comfort or care plans and limitation of liability
for providing these measures.
ENVIRONMENT
Description
Training Required
Encourages districts to utilize environmentally
safe chemicals/to reduce chemical exposure in
schools.
2004 update includes Integrated Pest
Management.
EMERGENCY PREPAREDNESS
Description
Training Required
Requires School districts to develop School
Safety Information Policy (SSIP) and
Emergency Operations Plans (EOPs) that
include procedures for plan review and
update.
Requires districts to implement multi-hazard
practice drills (e.g., fire, lockdown, active
shooter, or evacuation drills) and encourages
or requires inter-agency coordination.
FAMILY ENGAGEMENT
Description
Training Required
Encourages parent or family member
representation on school governance councils
or in school improvement planning efforts.
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MICHIGAN SCHOOL HEALTH SERVICE
MICHIGAN GENERAL STATUTES – SCHOOL HEALTH (CONTINUED)
FIRST AID AND CPR
Description
Training Required
Requires employer to have an adequately
trained first aid certified person on site.
[BSR/CET-5951 (11/01)] “in the absence of an
infirmary, clinic, or hospital in near proximity
to the workplace which is used for the
treatment of all injured employees.” An
employer shall ensure that suitable facilities
for quick drenching or flushing of the eyes and
body are provided within the work area for
immediate emergency use when the eyes or
body of any person may be exposed to
injurious or corrosive materials.
Requires newly hired teachers to be certified
in CPR/AED/First Aid. There are no
requirements for recertification.
HEARING AND VISION
Description
Training Required
Requires local health departments to conduct
free periodic hearing and vision testing for
children.
Requires a child registered for the first time in
a kindergarten or first grade in a school in this
state to present to school officials, at the time
of registration or not later than the first day of
school, a certificate of hearing and vision
testing or screening or statement of
exemption.
HEALTH DISPARITIES
Description
Training Required
Recommends strategies to ensure students
have access to breakfast and lunch programs
at school.
HEALTH SERVICES
Description
Training Required
Requires the department (MDHHS) to establish
a plan for health services for pupils in
elementary and secondary schools of this
state. Plan shall include a definition of school
health services and standards for
implementation.
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MICHIGAN SCHOOL HEALTH SERVICE
Michigan General Statutes – School Health (Continued)
HIV
Description
Training Required
Allows information pertaining to an individual
infected with HIV, or diagnosed with AIDS, to
be released if the information is part of a
report required under the child protection law.
HIV-related information is confidential and
cannot be released unless the patient
authorizes disclosure, or a statutory exception
applies.
Allows Exceptions for the Michigan
Department of Health and Human Services or
local health officer to release information
pertaining to an individual who has HIV/AIDS
to a school employee if the information is
necessary to prevent a reasonable foreseeable
risk of transmission of HIV to pupils in the
school district. The school employee is bound
by the confidentiality requirements of the
statute.
IMMUNIZATIONS
Description
Training Required
Requires that a parent/guardian of a child
provide for the child's immunization by an
authorized health professional, physician, local
health department, clinic, or other agency
offering immunizations for diseases and within
an age period prescribed by the department.
Requires a parent, guardian, or person in loco
parentis applying to have a child registered for
the first time in a school, to present to school
officials, at the time of registration or not later
than the first day of school, a certificate of
immunization or statement of exemption.
Immunization exemption/waiver
requirements.
Requires the parent/guardian of a child
enrolling in school for the first time to submit a
certificate showing required immunizations
have been given; or a physician-signed waiver
that required immunizations could not be
given because of medical contradictions or a
parent/guardian signed waiver that for
religious or other reasons the immunization
has not been given.
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MICHIGAN SCHOOL HEALTH SERVICE
Michigan General Statutes – School Health (Continued)
Immunizations (Continued)
Description
Training Required
Requires schools to report their students'
immunization status to their Local Health
Departments before November 1 of each year
and before the following February 1, to update
the list to show the additional immunizations
received by each child since entering the
school.
Requires a parent, guardian, or person in loco
parentis applying to have a child registered for
the first time in a school in this state and,
beginning January 1, 2014, a parent, guardian,
or person in loco parentis of a child entering
the seventh grade, to present to school
officials, at the time of registration or not later
than the first day of school, a certificate of
immunization or statement of exemption.
A teacher or principal shall not permit a child
to enter or attend school unless a certificate
indicating that a minimum of 1 dose of an
immunizing agent against each of the diseases
specified by the department has been received
and certified to by a health professional.
Requires a child enrolling in a public or
nonpublic school for the first time or,
beginning in the 2014-2015 school year,
enrolling in grade 7 for the first time to submit
1 of the following: 1) signed physician
statement of immunization compliance, signed
parent statement for religious objection or
signed physician statement child in the process
of compliance.
Requires any parent/guardian who claims a
nonmedical waiver to receive education
regarding the benefits of vaccination and the
risks of disease from a county health
department before obtaining the certified
nonmedical waiver form through the Local
Health Department. The new rule requires the
use of the State of Michigan nonmedical
waiver form dated January 1, 2015.
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MICHIGAN SCHOOL HEALTH SERVICE
MICHIGAN GENERAL STATUTES – SCHOOL HEALTH (CONTINUED)
MARIJUANA
Description
Training Required
Prohibits :
(b) transfer of marihuana/marihuana
accessories to person under 21;
(c) any person under the age of 21 to possess,
consume, purchase or otherwise obtain,
cultivate, process, transport, or sell marihuana.
(h) possessing marihuana accessories or
possessing or consuming marihuana on the
grounds of a public or private school where
children attend classes in preschool programs,
kindergarten programs, or grades 1 through
12, in a school bus, or on the grounds of any
correctional facility.
MEDICATION ADMINISTRATION
Description
Training Required
Sets forth legal provisions for the immunity of
school employees, designated by the school
administrator, against an allegation of
“simple” negligence if the employee
administers the medication under certain
requirements including being in the presence
of another adult.
A student may self-carry and an asthma
inhaler of an epinephrine auto injector
providing provisions have been met.
PA 187 Section 11.78 (1), A school board shall
insure in each school that operates with an
instructional and administrative staff of at
least 10, there is at least 2 employees at the
school who have been trained in the
appropriate use and administration of an
epinephrine auto-injector and that, in each
school it operates with an instructional and
administrative staff of fewer than 10, there is
at least 1 employee at the school who has
been trained in the appropriate use and
administration of an epinephrine auto-
injector.
The training required under
this subsection shall be
conducted under the
supervision of, and shall
include evaluation by, a
licensed registered
professional nurse.
See “Anaphylaxis” for
additional information.
Michigan Association of
School Nurses
States that a physician delegates and,
therefore must supervise the act of medication
administration if the school district does not
employ a school nurse.
The Michigan Department of Education memo
to school superintendents outlining a model
medication policy (2002). Note: Not a law.
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MICHIGAN SCHOOL HEALTH SERVICE
MICHIGAN GENERAL STATUTES – SCHOOL HEALTH (CONTINUED)
MENINGITIS
Description
Training Required
Requires schools to provide information on
meningococcal disease, vaccine & availability
of vaccine to parents of 6th, 9th & 12th
graders.
MENTAL HEALTH
Description
Training Required
Allows a minor of 14 years of age or older up
to 12 visits or four months whichever comes
first to request and receive mental health
services on an outpatient basis without the
consent or knowledge of a parent or guardian.
Consent to inform the parent or guardian must
be obtained from the minor unless there is a
compelling need for disclosure and the minor
is informed of the health professional’s intent
to notify the party.
OPIOID ANTAGONIST
Description
Training Required
Repeals Revised School Code language relating
to the authority of school districts and school
employees to administer opioid
antagonists.
PA 385 – Optional legislation allows a school
board to require, in each school it operates,
that there are at least two employees who have
been trained in the appropriate use and
administration of an opioid antagonist.
An agency that purchases, possesses, or
distributes an opioid antagonist under section
103, and an employee or agent that possesses
or in good faith administers an opioid
antagonist under section 105, is immune from
civil liability for injuries or damages arising out
of the administration of that opioid antagonist
to an individual under this act if the conduct
does not amount to gross negligence that is
the proximate cause of the injury or damage.
Immunity is assured in this case
if the employee or agent has
been trained in the proper
administration of that opioid
antagonist.
If a district chooses to stock
opioid antagonist, at least two
employees in each school are
recommended to be trained in
the appropriate use and
administration of an opioid
antagonist.
Training materials available:
MASN Safe and Legal Support
of Students with Health and
Medication Needs at School:
Module 4
NASN Naloxone Toolkit
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MICHIGAN SCHOOL HEALTH SERVICE
MICHIGAN GENERAL STATUTES – SCHOOL HEALTH (CONTINUED)
PREGNANCY
Description
Training Required
Allows a minor to consent to the provision of
prenatal and pregnancy related health care by
a health facility or agency or health
professional.
For medical reasons the treating physician or
another health professional (on the advice of
the treating physician) may withhold or
provide information regarding the minor to
the parent, guardian, or person in loco
parentis even if the minor refused to have the
information released.
Requires all school districts to provide
homebound or hospitalized instructional
services to students who are absent for five or
more consecutive school days because of a
medical condition, including pregnancy,
childbirth, and recovery.
Allows parents to safely surrender their
newborn child no more than 72 hours old to
an employee who is inside and on duty at any
hospital, fire department, police station, or by
calling 911. This program is a safe, legal and
anonymous alternative to abandonment or
infanticide and releases the newborn for
placement with an adoptive family.
RECORD RETENTION
Description
Training Required
Requires that all public records be listed on an
approved Records Retention and Disposal
Schedule that identifies the minimum amount
of time that records must be kept to satisfy
administrative, legal, fiscal and historical
needs.
Identifies acceptable formats for retaining
public records. Different types of school health
records vary in the amount of time they need
to be retained.
REPRODUCTIVE HEALTH
Description
Training Required
Requires School Boards to adopt and
implement a disciplinary policy for dispensing
or distributing family planning or drug or
device, dispensing prescriptions for family
planning drug, or making referrals for abortion
or assisting pupil in obtaining abortion.
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MICHIGAN SCHOOL HEALTH SERVICE
MICHIGAN GENERAL STATUTES – SCHOOL HEALTH (CONTINUED)
REPRODUCTIVE HEALTH (C0NTINUED)
Description
Training Required
Prohibits a person from dispensing or
otherwise distributing a family planning drug
or device in a public school or on public school
property.
"Family planning" means the use of a range of
methods of fertility regulation to help
individuals or couples avoid unplanned
pregnancies; bring about wanted births;
regulate the intervals between pregnancies;
and plan the time at which births occur in
relation to the age of parents. It may include
the study of fetology. It may include marital
and genetic information. Clinical abortion shall
not be considered a method of family
planning, nor shall abortion be taught as a
method of reproductive health.
Prohibits an abortion to be performed on
minor without her consent and that of one
parent or guardian except in medical
emergency; court may waive parental consent
if minor is mature and well-informed so as to
be able to make the decision, or waiver is in
minor's best interest.
RESTRAINT AND SECLUSION
Description
Training Required
Requires districts to adopt policies limiting use
of restraint and seclusion that include
comprehensive student protections, including
the provision of mandatory training for school
personnel.
A comprehensive training
framework including
awareness training for all
school personnel who have
regular contact with pupils, and
CPR/First Aid for key identified
personnel.
RIGHTS OF MINORS
Description
Training Required
Allows a minor to request and receive mental
health services on an outpatient basis without
the consent or knowledge of a parent or
guardian. Consent to inform the parent or
guardian must be obtained from the minor
unless there is a compelling need for
disclosure and the minor is informed of the
health professional’s intent to notify the party.
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MICHIGAN SCHOOL HEALTH SERVICE
Michigan General Statutes – School Health (Continued)
RIGHTS OF MINORS (Continued)
Description
Training Required
Allows a minor professing to be a substance
abuser to consent for the provision of
treatment for the substance abuse may be
provided by the minor.
Allows a minor who professes to be infected
with an sexually transmitted infection (STI) to
seek medical or surgical treatment or services
by a hospital, clinic, or physician without the
consent of a parent, guardian, or person in
loco parentis. For medical reasons, the treating
physician or another health professional (on
the advice of the treating physician) may
withhold or provide information regarding the
minor to the parent, guardian, or person in
loco parentis even if the minor refused to have
the information released.
Summarizes the rights of minors to consent to
various types of health care without the
consent or knowledge of their parents. It also
covers whether the law permits information
concerning the minor’s health care to be
shared with the parent.
SCHOOL NURSING
Description
Training Required
Allows a board of a school district to employ
registered nurses necessary to provide
professional nursing services.
School Nurse Certification rules through the
Michigan Department of Education.
SCHOOL SAFETY
Description
Training Required
Amends the Fire Prevention Code to require a
school that has any grades between K-12 to
conduct a minimum of two (2) drills in which
occupants are restricted to the interior of the
building (Lock Down Drills) and the building is
secured. Requires a K-12 school to conduct a
minimum of six (6) rather than eight (8) fire
drills.
Also amends the Fire Prevention Code to
require a school that operated any grades
between K-12 to conduct some of the drills
required under the Code during lunch or
recess or at other times when a significant
number of students were gathered, but not in
the classroom. (Terrorism Drills)
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MICHIGAN SCHOOL HEALTH SERVICE
Michigan General Statutes – School Health (Continued)
SCHOOL WELLNESS
Description
Training Required
Michigan State Board of Education Model
Local Wellness Policy.
SOCIAL WORKER ROLE
Description
Training Required
State law encourages or requires districts to
implement identification and referral
processes to link students and families with
needed resources.
SUICIDE
Description
Training Required
Ensures that each school that offers any of
grades 6 to 12 and that provides identification
cards to pupils enrolled at the school includes
on each identification card provided to a pupil
a local, state, or national suicide prevention
hotline telephone number printed on it
SUN SAFETY
Description
Training Required
Requires a tanning customer under 18 years of
age, a written statement signed by the
customer's parent or legal guardian while the
parent or legal guardian is physically present at
the tanning facility and signed in the presence
of the owner or operator. The customer
agrees to use protective eyewear.
TELEHEALTH
Description
Training Required
Provides for medical reimbursement for in
home or in school telemedicine services.
TOBACCO
Description
Training Required
Prohibits sale of electronic cigarette or any oral device that provides
vapor nicotine to minors.
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MICHIGAN SCHOOL HEALTH SERVICE
Key Federal Legislation
Anti-Discrimination Laws Regarding HIV Infection
There are a number of federal and state statutes that prohibit discrimination against someone who is HIV-infected or
believed to be HIV-infected. These include Section 504 of the Federal Rehabilitation Act of 1973, the Fair Housing
Amendments Act of 1988, the Americans with Disabilities Act (ADA) of 1990, and the Michigan Persons with Disabilities
Civil Rights Act of 1976. These statutes provide that a person who is HIV-infected, or is believed to be HIV infected, must
be treated in a non-discriminatory manner as any non-HIV-infected person.
Americans with Disabilities Act
The ADA prohibits discrimination on the basis of disability in employment, state and local government, public accommodations,
commercial facilities, transportation, and telecommunications. To be protected by the ADA, one must have a disability or have a
relationship or association with an individual with a disability. An individual with a disability is defined by the ADA as a person
who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or
record of such impairment, or a person who is perceived by others as having such impairment. The ADA does not specifically
name all of the impairments that are covered.
A major life activity includes education. Therefore, if a student attends school and has a disability (of which HIV is one), the ADA
affects the school’s responsibility to that student. School teams are responsible for determining what barriers exist for a student
with a disability and how to resolve those issues.
The Americans with Disabilities Act (ADA) provides comprehensive civil rights protections for individuals with disabilities.
Title II of the ADA covers programs, activities and services of public entities. Title II requires that “No qualified individual
with a disability shall, by reason of such disability be excluded from participation in or be denied the benefits of the
services, programs, or activities of a public entity, or be subjected to discrimination by such entity”.
The Family Educational Rights and Privacy Act (FERPA)
The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR Part 99) is a Federal law that protects
the privacy of student education records. The law applies to all schools that receive funds under an applicable program of
the U.S. Department of Education.
FERPA gives parents certain rights with respect to their children's education records. These rights transfer to the student
when he or she reaches the age of 18 or attends a school beyond the high school level. Parents or eligible students have
the right to inspect and review the student's education records maintained by the school. In general, parental consent is
required for others to access information in students’ health records. FERPA allows schools to disclose those records,
without consent, to the following parties or under the following conditions (34 CFR § 99.31):
• School officials, including teachers who have a “legitimate educational interest”
• Mandatory reporting of certain communicable diseases
• Instances of child abuse or neglect
• Appropriate officials in cases of health and safety emergencies
• To comply with certain legal situations including subpoenas or investigations of criminal offenses
Health Information Portability and Accountability Act of 1996 (HIPAA)
Public Law 104-191, Health Information Portability and Accountability Act of 1996 (HIPAA) was implemented by the
federal government to ensure uniform privacy protections of individuals’ health information, including those with HIV.
HIPAA provides privacy regulations to protect patients by limiting the ways that health plans, pharmacies, hospitals, and
other covered entities can use patients’ personal medical information. A school is subject to HIPAA if it provides medical
care and electronically transmits health information as part of a “covered transaction” (i.e., billing). The Privacy Rule of
the law, however, provides a broad exemption for personal health information maintained in education records, which is
protected under FERPA.
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MICHIGAN SCHOOL HEALTH SERVICE
Joint Guidance on the Application of FERPA and HIPAA to Student Health Records
The U.S. Department of Education and the Office for Civil Rights at the U.S. Department of Health and Human Services
released updated joint guidance in December 2019 addressing the application of the Family Educational Rights and
Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule to records
maintained on students.
The guidance, which was first issued in November 2008, clarifies for school administrators, health care professionals,
families, and others how FERPA and HIPAA apply to education and health records maintained about students. The
revised guidance includes additional frequently asked questions and answers addressing when a student’s health
information can be shared without the written consent of the parent or eligible student under FERPA, or without written
authorization under the HIPAA Privacy Rule
Individuals with Disabilities Education Act
The Individuals with Disabilities Education Act (IDEA) (formerly called P.L. 94-142 or the Education for all Handicapped
Children Act of 1975) requires public schools to make available to all eligible children with disabilities, a free appropriate
public education in the least restrictive environment appropriate to their individual needs. IDEA requires public school
systems to develop appropriate Individualized Education Programs (IEP's) for each child. The specific special education
and related services outlined in each IEP reflect the individualized needs of each student.
2
The IEP outlines the specific services and supports the child's needs within the least restrictive environment (LRE). The IEP
and LRE provisions have been protected as basic rights of children with disabilities. Parent involvement is also a
fundamental principle of IDEA. Parents must be fully informed of their children's rights, and they can participate in all
decisions affecting their child. IDEA also outlines due process provisions, which allow parents to challenge school district
decisions.
3
IDEA release and disclosure requirements are substantially identical to those in FERPA.
Section 504 of the 1973 Rehabilitation Act
Section 504 of the Rehabilitation Act of 1973 prohibits discrimination against persons with disabilities in all programs and
activities conducted by recipients of federal financial assistance. This applies to employees of education agencies as well
as to students.
In matters pertaining to education, the lead agency is the U.S. Office for Civil Rights, U.S. Department of Education.
Section 504 has a substantial effect on education, since educational programs for students with disabilities must be equal
to those provided to others. Educational agencies that receive U.S. Department of Education funds, either directly or
indirectly, are considered recipients.
Like IDEA, Section 504 requires identification, evaluation, and provision of appropriate services, notification of parents,
an individualized accommodation plan, and procedural safeguards. Accommodation plans (including individual health
care plans) are developed to provide needed health services in the school for children requiring medication or other
health services. These activities must be performed in accordance with Section 504 regulations, which have some
requirements that differ from those of IDEA.
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MICHIGAN SCHOOL HEALTH SERVICE
Bloodborne Pathogen Standard
29 CFR Part 1910 (December 1991), Occupational safety; Bloodborne Pathogen Standard is a law requiring employers to
protect employees from occupational exposure to bloodborne pathogens. Under 1910.1030, public school employers
who have employees with occupational exposure (as defined by paragraph (b) of the standard) must establish an
Exposure Control Plan which describes how the following elements of the standard, at a minimum, will be
implemented: methods of compliance, including engineering and work practice controls, personal protective equipment,
and housekeeping; Hepatitis B Vaccination and Post-Exposure Evaluation and Follow-up; Communication of Hazards to
Employees; and Recordkeeping, including medical records, training records, and Sharps Injury Logs.
The Exposure Control Plan also must include an exposure determination, which lists all job classifications in which all
employees in those job classifications have occupational exposure, all job classifications in which some employees have
occupational exposure, and those tasks and procedures in which occupational exposure occurs and are performed by
those employees determined to be occupationally exposed. Any employee, determined to be occupationally exposed, as
defined by the standard, must be offered the Hepatitis B vaccination within 10 working days of initial assignment but
after the employee has received the initial training required by this standard.
The Exposure Control Plan must be reviewed at least annually and updated whenever necessary to reflect new or
modified tasks and procedures which affect occupational exposure and also to reflect new or revised employee positions
with occupational exposure. Although documentation of the review is not required, it is recommended that the
employer do so to ensure that the review is being conducted at least on an annual basis and that each affected employee
has access to the most current plan.
In addition to the annual review of the Exposure Control Plan, the employer must provide information and training as
outlined in paragraph (g) (2) (vii) to employees with occupational exposure at the time of initial assignment to tasks
where occupational exposure may take place, at least annually thereafter (which means within one year of their previous
training), and whenever changes (i.e. to tasks or procedures) take place that affect the employee’s occupational
exposure. Training must be documented in accordance with paragraph (h) (2) (i) of the standard.
*Tiers of Training
Refers to the multi-tiered system of support recommended to train staff to support a student with a health need in
school.
29
MICHIGAN SCHOOL HEALTH SERVICE
RESOURCES
Jones, S.E. (2008). Executive Summary. A CDC review of school laws and policies concerning child and adolescent health.
Journal of School Health, 78(2), 69 -128. doi: 10.1111/j.1746-1561.2007.00272_4.x
Laubin, M.C., Schwab, N., & Doyle, J. (2012). Understanding the legal landscape. In C. Constante (Ed.), School Nurse
Administrators (pp. 459 – 519). Silver Spring, MD: National Association of School Nurses.
HIV/STD and Sex Education in Michigan Public Schools, A Summary of Legal Obligations and Best Practices. Available at
http://www.michigan.gov/documents/mde/3_Four_Page_Summary_of_Legal_Obligations_249414_7.pdf
Michigan Board of Nursing Administrative Rules
http://www.state.mi.us/orr/emi/admincode.asp?AdminCode=Single&Admin_Num=33810101&Dpt=CH&RngHigh=
Michigan Revised School Code http://www.legislature.mi.gov/documents/mcl/pdf/mcl-act-451-of-1976.pdf
http://www.legislature.mi.gov/documents/mcl/pdf/mcl-act-451-of-1976.pdf
Michigan Current Revised School Code (PA 451 of 1976) and State School Aid Act (PA 94 of 1979)
Provisions Regarding the Teaching of HIV/AIDS, Sex Education, Health Education, and Physical Education in Michigan
Schools
http://www.michigan.gov/documents/Current_Revised_School_Code_115941_7.pdf
Michigan Public Health Code
http://www.legislature.mi.gov/(S(mcs4ho55goeot1royfu1ne45))/mileg.aspx?page=getobject&objectname=mcl-act-368-
of-1978
Protecting and Disclosing Student Health Information. How to Develop School District Policies and Procedures, 2005. The
Guidelines, reviewed by representatives from the U.S. Depts. of Education and Health and Human Services, were
developed in conjunction with representatives from 20 national organizations. Available from the American School Health
Association at http://www.ashaweb.org/i4a/ams/amsstore/category.cfm?category_id=1
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MICHIGAN SCHOOL HEALTH SERVICE
A Brief Review of Federal Laws Protecting the Privacy of Education Records
Federal Law
Federal Agency
Right Afforded to
Contents of
Education Records
Notification
Requirement
Prior Consent
Requirement of
Recording Release
Family Educational
Rights and Privacy
Act (FERPA)
Family Policy
Compliance Office
Parents and
eligible students
All education records
as defined in the law
Local education
agency to notify
annually
Required with
exceptions
Recordation
requirements
Every Child
Succeeds Act
(ESSA)
U.S. Department of
Education
Parents and
eligible students
Individuals with
Disabilities
Education Act
(IDEA)
Office of Special
Education Programs
Parents and
students who have
reached the age of
majority under
state law
All education records
as defined in FERPA
Local education
agencies to notify
annually
Required with
exception
Health Insurance
Portability and
Accountability Act
Office for Civil Rights
of U.S. Department
of Health and Human
Services
Patients
Privacy Rule does
not apply to records
protected by FERPA
and IDEA
Health care providers
must provide Notice
of Privacy Practices
By patient